Thai massage – past and present

In common with Dr. Varma’s ‘Pranatherapy’, Thai massage is said to derive from Indian Ayur-vedic medicine; Jivaka Kumar Bhaccha, a North Indian physician, is generally regarded as the father of Thai medicine. The Foundation of Dr. Shivaga Komarpaj in Chiang Mai preserves his name in its Thai version. The foundation runs the Old Medical Hospital where it has offered short courses in Thai massage since 1962.

Jivaka Kumar Bhaccha was a member of the community (sangha) that gathered around the Buddha 2500 years ago. According to an account in the Vinaya Pitaka, a Theravadin document that records the life of that original sangha, Jivaka’s father was King Bimbisara, a contemporary of the Buddha, and the ruler of the Magadha Empire in North India. Jivaka’s mother was the wife of a merchant who fell for the charms of the king while her unfortunate husband was away on business. Soon after his birth Jivaka was taken by his mother to the king and was raised in the royal household.

As a young man Jivaka realized that medicine was to be his vocation. With his father’s permission he went to study under Atreya, the renowned Rishi physician. Atreya was the personal physician to King Bimbisara’s father, Padma dPal. The years of study bore fruit and Jivaka stood out as the most brilliant student in his class. He quickly developed a reputation as a great physician and his pride grew to match his fame. He is said to have boasted that nobody could cure a somatic disorder, as could he; just as nobody could cure a psychological disorder, as could the Buddha. In time, like many of his contemporaries, Jivaka went to the Buddha to learn the path by which he could free himself from his suffering (Rapgay 1981).

It is generally believed that Jivaka’s name and the medical system he practised came to Thailand with the teachings of the Buddha, although it is not known exactly when that was. Some accounts suggest that Asoka, India’s first Emperor, sent missionaries in the second century BC. Asoka embraced Buddhism in response to the terrible cruelty he saw during the conquest of Kalinga and came to be known as ‘The Prince of Peace’ (Kinder & Hilgemann 1978).

A stone inscription from 1292 AD records the declaration of Rama Khamheng, King of Siam, that Buddhism be recognized as the country’s official religion (Gold 2007, p. 65). Beyond that little more is known. When the Burmese invaded Thailand in 1767 they destroyed the old royal capital of Ayutthia and with it most historical and medical texts.

In 1832 King Rama III gathered what fragments of the medical texts survived and had them carved on stone and set into the walls of Wat Pho, the main Buddhist monastery in Bangkok. These carvings comprise 60 figures and are said to indicate treatment lines and points on the human body along with explanatory notes (Brust 1990, p. 5).

Until the late 1980s Thai massage was little known outside of Thailand. Even within the country the traditional medical system to which the massage belonged was losing favour. In common with many of its Asian neighbours, Thailand was embracing a Western model of industrial and economic development and the modern medical system it brought with it.

Thai massage is now enjoying a new lease of life in Thailand as well as finding its way into massage centres and hotel spas around the world. This revival owes much to the interest shown by Western travellers, some of whom found their way to the traditional massage schools or studied directly with village massage practitioners. Lacking the necessary language skills they learned Thai massage as a practical study with little theory to explain the techniques. Despite, and possibly because of this lack of theory some of these early Western students discovered an affinity with the practice and went on to become teachers themselves.

Between the late 1980s and the present day much has changed in the world of Thai massage. There are now many more schools offering courses in Thailand as well as around the world. There is now an abundance of books on the subject. ‘Thai Reflexology’ and ‘Thai Head Massage’ have emerged as standalone therapies. Even aspects of Thai herbal medicine have entered the mainstream and it is now quite common to see the use of ‘Thai herbal compresses’ in hotel spas. Despite the global reach of Thai massage there has been little development in understanding the medical system to which the massage belongs.

We do know that Thai massage is one of the three branches of traditional Thai medicine; the others being naturopathic medicine and spiritual practices. Traditional Thai medicine is intimately entwined with Theravada Buddhism, the esoteric and monastic branch of Buddhism practised in Southeast Asia and Sri Lanka. In Thailand this traditional medicine is still typically offered under the auspices of the Buddhist monastic community.

Given that Thai massage is but a small part of a Buddhist approach to medicine it is, perhaps, not so surprising that our knowledge is so limited. Buddha taught Jivaka Kumar that the cause of all suffering, whether physical or mental, is the greed, anger and ignorance generated by the unenlightened mind. Although traditional Buddhist medicine includes naturopathic remedies and physical therapy, of far greater importance is the spiritual teaching and practical guidance offered by the lama physicians of the monastic community. Buddhist medicine is taught within the broader context of Buddhist philosophy and medical intervention is similarly prescribed.

Although some Westerners have made the effort to learn the Thai language and explore more deeply Thailand’s culture and religion I am not one of them. For this reason, in this discussion of Thai massage, I will disengage it from its spiritual context and look at it exclusively as a form of bodywork. We will see that in the West, although Thai massage carries with it no more than a fragment of the medical system to which it belongs, in this may lie its strength. Freed from the weight of a substantial theoretical foundation and from the rigour to be expected of a medical system it nevertheless stands its ground as an excellent massage technique. We will seek here to understand why.

Sen, nadi, meridian, myofascial pathway?

There are three main activities involved in the practice of Thai massage:

The balance of these three activities is quite individual and the massage will vary considerably depending on the massage practitioner’s preferences. Some massage practitioners are more attracted to the yoga aspects of the work and offer quite dynamic massage sessions. Some are drawn more to the stretches, and practise Thai massage with a ‘no pain, no gain’ style similar to that found in sports massage. My own approach to Thai massage focuses mainly on the manipulation of the sen and inducing relaxation. This is the style encouraged by my teachers, both of whom studied at the Old Medical Hospital in Chiang Mai.

The ‘sen’ are the lines documented in the stone carvings of Wat Pho. It is said that these carvings refer to a network of 72 000 lines or channels permeating the body. Ten of these are used for massage. These are known as the ‘ten sen’. In addition to the sen, the stone carvings of Wat Pho also record descriptions of treatment points.

When I first studied Thai massage in 1992, as well as diagrams of the sen, we were given others indicating treatment points on the hands, feet and face. These looked to me like Chinese acupressure and Western reflexology charts. There was little information to explain their use so I disregarded them and concentrated my efforts on the manipulation of the sen.

Asokananda (AKA Harald Brust), with whom I studied advanced Thai massage in 1995, says of treatment points: ‘Thai massage never developed a standardised set of points but therapy always was and is centred around intensive and complete line work’ (Brust 1996, p. 18). If we accept, therefore, to leave aside the idea of treatment points we are left with a simple massage based around the manipulation of treatment lines.

Even though it is said that there are ten main sen used in Thai massage this is actually open to debate. The ten sen are known as: sen sumana, sen ittha, sen pingkhala, sen kalathari, sen sahatsarangsi, sen thawari, sen lawusang, sen ulangka, sen nanthakrawat and sen khitchanna. However, sen lawusang and sen ulangka follow the same path but on the left side and right side of the body. The same goes for sen thawari and sen sahatsarangsi and for sen ittha and sen pingkhala. In all we really only find seven unique pathways.

The story is further confused by the fact that Thai massage only uses aspects of the sen mentioned above and there are many differences of opinion as to where these aspects run. This lack of clarity leads many Western Thai massage practitioners to other systems for the theory to support their practice. These include traditional Chinese medicine, Ayur-vedic medicine and Hatha Yoga, each of which incorporates a system of lines or channels with some similarities to the sen.

Sen and Chinese meridians

Of these traditional systems the best known in the West is traditional Chinese medicine (TCM). TCM is based on a Western anatomical model but with the addition of acupuncture channels and acupuncture points. The channels are used to describe the interconnection of the various functional systems of the body. In TCM however, there are not 7, nor 10 but 14 main channels. There are, in addition, numerous secondary channels. These include connecting channels, muscle channels and cutaneous regions. The connecting channels branch further into minute connecting channels, blood connecting channels and superficial connecting channels (Maciocia 1991). These form an intricate web involved in the distribution of fluids and energies throughout the body. Although there is no specific reference to 72 000 channels in TCM it is quite likely that this web of channels does have something in common with the system of sen referred to in traditional Thai medicine especially when we consider that both systems are thought to originate from around 2500 years ago.

Often, Western writers who liken the sen to acupuncture channels also generalize Thai massage as a form of ‘energy work’ similar to Japanese shiatsu or Chinese acupressure (Mercati 1998, Brust 1990, p. 6, Gold 2007, p. 12). From my own studies in traditional Chinese acupuncture with JR Worsley in the early 1980s I could recognize some similarities between the sen used in Thai massage and the channels used in acupuncture. However this is a perilous comparison. What it reveals are major shortcomings in our knowledge of the sen. In Thai massage there is no sense of a complete system of sen comparable with acupuncture channels and there is no system of diagnosis with which to justify the term ‘energy work’.

Sen and Ayur-vedic nadis

Another common source of information used to explain Thai massage is to be found in India. Here in the homeland of Jivaka Kumar, patron of traditional Thai medicine, a vast historical record exists in the form of the Upanishads and the Vedas. These document the development of the medical and spiritual system that forms the basis of the Hindu and Buddhist religions. The oldest Upanishads, the Brhadaranyaka and the Chandogya, have been dated to the eighth century BC while the Vedas date from 1000 BC (Milne 1995).

Ayur-veda, a naturopathic approach to medicine still practised in India today, dates from the Vedic Period (1800–1000 BC) and is thought to be the source of traditional Thai medicine. The oldest existing encyclopaedic medical work is the Sushruta-Samhita. Although much of this work was completed in the early Christian era, parts of this collection are pre-Buddhist (Feuerstein 1990, p. 88).

Hatha Yoga, the style of yoga practice most familiar in the West, is documented in a series of Upanishads written between the sixth and fourteenth centuries AD. This period saw the birth and development in India of the philosophy of Tantrism, the aim of which was ‘to overcome the dualism between the ultimate Reality (Self) and the conditional reality (ego) by insisting on the continuity between the process of the world and the process of liberation or enlightenment’ (Feuerstein 1990, p. 251).

Although for many Westerners Hatha Yoga represents little more than a system of exercise, for its founders it was the distillation of centuries of research. The result is a psycho spiritual system designed to integrate the spiritual life with the physical reality of the body. Hatha Yoga means ‘yoga of the force’ and its aim is nothing less than ‘the blissful state of ecstatic merging with the Divine’ (Feuerstein 1990, p. 246).

In the Yoga-Upanishads we find reference to ‘nadis’, the Ayur-vedic equivalent of the sen. The renowned, contemporary Hatha Yoga teacher, BKS Iyengar, refers to the nadis as channels ‘through which nervous energy passes’ (Iyengar 1984, p. 117). In common with the Thai system, some of the Yoga-Upanishads refer to 72 000 nadis. Others, however, refer to 350 000. Similarly, some refer to ten important nadis but others refer to fourteen or fifteen (Motoyama 2003, p. 135).

There are other similarities between the Thai sen and the Ayur-vedic nadis. In both systems three channels are considered to be particularly important. In Thai massage they are sen sumana, sen ittha and sen pingkhala. In Ayur-veda they are sushumna-nadi, ida-nadi and pingala-nadi. As well as the similarity of name, sen ittha and ida-nadi are in both systems symbolized by the moon and associated with the feminine quality while sen pingkhala and pingala-nadi are symbolized by the sun and associated with the masculine quality.

Hereafter we discover more differences than similarities. For instance, in the Thai description, sen sumana starts at the navel and ascends inside the throat, terminating at the base of the tongue. Sen ittha and sen pingkhala are described as lines that run either side of sen sumana and then continue down into the legs. In the Yogic tradition these lines are usually depicted as a caduceus; sushumna-nadi forms a central core while ida-nadi and pingala-nadi weave a double helix, intersecting sushumna-nadi at a series of seven centres along the vertical axis of the body. In Sanskrit these centres are called ‘chakras’, meaning wheel or vortex. They are thought to relate to nerve plexuses (Motoyama 2003, pp. 197–198).

According to the Yogic tradition, sushumna-nadi means ‘the current that is most gracious’ (Feuerstein 1990, p. 260). BKS Iyengar calls it the nadi of fire and locates it inside the spinal column. He says it is the main channel for the flow of nervous energy (Iyengar 1984, p. 439). Although there are some variations, most traditional Yogic sources agree that sushumna-nadi begins at the perineum and continues up to a point called ‘Brahman Gate’ at the top of the head (Motoyama 2003, p. 141).

The Yogic tradition goes still deeper, identifying within sushumna-nadi another channel called vajra-nadi and within that yet another called citrini-nadi (Feuerstein 1990, p. 260). According to the Shat-Chakra-Nirupana, written in 1577 by a Bengali guru known as Purananda there is within citrini-nadi yet another called the Brahma-nadi (Motoyama 2003, p. 164).

It soon becomes clear when reviewing Yogic literature that the nadis are part of a complete and complex system involved not only in medicine but also in the development of consciousness. What we know of this system in the West is generally limited to the practice of yoga asanas. According to the Yoga Sutras, compiled some time between the second century BC and the second century AD by Patanjali, the asanas are but one of the eight disciplines of Yogic practice. Hiroshi Motoyama, a Japanese Shinto priest, veteran yoga practitioner and scientist says of this practice:

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