Tag Archives: Thai herbs
A Thai Approach to Constipation
©2006 Laura Hoge
Laura Hoge, RYT, CMT is the owner of Peaceful Edge Yoga, LLC offering private yoga instruction, western and Thai massage to the Central/Northern NJ area since 2003. She currently teaches Thai massage within the Tao Mountain Network. Prior to her current profession, Laura worked as a New Jersey State Licensed Funeral Director and spent years helping clients process grief and grief related complications. Her current practice is based on a similar heart centered approach to well being. Aside from her study and practice of Asian energy work, Laura has recently completed her second album and devotes her time to musical composition, creative writing, spiritual research and philosophical study. For information regarding Thai massage instruction or upcoming concerts, please visit her websites: www.peacefuledgeyoga.com or www.laurahiggins.com.
Definition, Symptoms and Causes
Constipation, or a lack of proper frequency in bowel movements, can be frustrating on many levels. Though it is more commonly associated with the aging community, most people have been constipated at one point or another due to situational stress or an unhealthy diet. It has also become one of the more frequent side effects of both anti- depressant and chemotherapeutic therapies here in the west.
Some of the symptoms of constipation include, but are not limited to, difficulty starting and/or finishing bowel movements, infrequent passage of stool, passing hard stool after prolonged straining, cramping, abdominal pain, excessive gas or the inability to pass gas, and in the cases of obstruction, nausea and vomiting, distended abdomen, headaches and loss of appetite.
Aside from the physical discomfort it creates, identifying causative factors can vary from person to person. Many times, constipation is a result of improper nutrition. For example, eating foods that are highly refined or high in animal fat content can be to blame. Insufficient intake of fiber is another known trigger. Other causes include, but are not limited to, medications such as antidepressants, chemotherapeutics, antispasmodics, iron supplementation tablets, overuse of antacids, and painkillers. Many people find that traveling causes lackluster bowel functioning as well. Unfortunately, some of the more insidious, and thankfully rarer causes for constipation include blockages resulting from hernias, intestinal tumors, damage to nerves within the intestine, gallstones, and/or thyroid or metabolic disorders.
Though it is always necessary to identify the cause of constipation, especially to root out some of the more serious conditions or blockages, Traditional Thai Massage can be an effective means of alleviating some of its discomfort and help the client to stimulate his/her own healthy flow of digestive energy and proper intestinal peristalsis.
Treating Constipation – Western Style
Just as causes for constipation vary in severity, so do treatments. In most cases simple lifestyle and dietary changes will suffice. When conditions are more severe, additional regimens of medications, enemas, colonic irrigation and/or surgery may be necessary.
In cases where improper nutrition is the cause, apposite intake of nutrients is often the remedy. By increasing one’s intake of water and natural liquids, fiber, fresh fruits and whole grains and at the same time decreasing the intake of highly processed foods, dairy and animal fat, a person’s digestive tract can return to an effective homeostasis. In Thailand, some of the more commonly ingested foods and herbs that treat constipation include galangal, ginger, lemongrass, basil, hot herbs such as black pepper, cayenne, cloves, red and green curries, etc. Papaya, banana and tamarind are also added to the diet to stimulate digestion and an increase in exercise can also prove helpful. Included in this article you will find a recipe for what has essentially become the “chicken soup” of Thailand. It can be a helpful remedy for constipation because of its inclusion of galangal (or ginger) and other hot tasting herbs. Also included are directions to make Som Tam, another therapeutic dish that features both papaya and green chili, two effective supplements for treating constipation.
When dietary treatment proves ineffective, allopathic doctors often recommend an over- the-counter laxative or regimen of enemas to stimulate peristalsis. Unfortunately, this type of treatment can carry contraindications for those taking certain medicines since it impedes the body’s natural absorption of supplements, minerals and nutrients. These therapies also carry addictive concerns when used to often, sometimes leaving the body reliant upon them to maintain what should be a natural bodily function.
For those who are constipated because of an obstructive mass, hernia, nerve damage, etc., surgery to remove the tumor and/or correct the condition may be required. In these cases, Traditional Thai Massage is not the best course of treatment.
How Thai Massage Can Help
When a person is experiencing discomfort as a result of mild to moderate constipation (where obstructions, hernias, etc. are not the cause), Traditional Thai Massage can be a highly effective means of treatment. According to Thai belief, all of the energetic meridians in the body, or sen, originate at the navel. Because of this, a significant amount of emphasis is placed upon manipulating and removing energetic imbalances in the abdomen. A common byproduct of this is a regular gastrointestinal response.
Aside from abdominal manipulation, many of the yoga stretches performed during Traditional Thai massage can have a great impact on the constipated client. The use of herbal compresses can stimulate the body’s digestive responsibility as well, especially when using hot herbs such as ginger, galangal and/or turmeric.
Below is the traditional series for abdominal manipulation as is taught at the Shivagakomarpaj Traditional Medicine Hospital in Chiang Mai.
1. The practitioner applies moving pressure to the abdomen in the direction of the colon (clockwise).
Within any traditional Thai massage sequence, a practitioner will circle the abdomen once or twice, applying pressure at the points shown below. However, when treating issues of digestive stagnation it is therapeutic to increase the number of repetitions. It is also important to note that the abdomen may be a sensitive area for the client both emotionally and physically and careful consideration must be taken into account in order to ensure comfort during treatment. Each person will respond differently to levels of pressure.
2. Thumb pressure (jap sen) is applied on the eight points surrounding the navel. This pressure is often applied to two points at the same time, beginning with those directly lateral to the navel. Then the top left and bottom right points are addressed, followed by those above and below the navel. The circle is then completed with jap sen to the upper right and bottom left points. By completing the treatment in this sequence, the practitioner is always working in a clockwise fashion, complementing the body’s natural digestive flow.
The above step will not only treat constipation, but since all of the traditional Thai sen originate at the navel, it is not unusual for a client to experience a subsidence in symptoms associated with unrelated energetic imbalances.
3. Palm pressure on abdomen
The Shivagakomarpaj Traditional Medicine Hospital in Chiang Mai offers a variety of different techniques that can be employed when administering step 3 on a client. For those that are experiencing minor symptoms of constipation, a combination of gentle palm pressure (on eight points illustrated above in step 1) and cued exhalations of breath is quite effective.
For clients presenting with more advanced constipation, alternate and/or adjuvant therapies might be suggested. For example, a deeper application of pressure on the aforementioned eight points followed by alternating pressure on either side of the navel can be deeply therapeutic. This latter technique is administered by placing both palms lateral to the navel and then applying pressure alternately in combination with cued exhalations of breath.
Thai Yoga Stretches
In addition to abdominal manipulation, the following stretches may be useful in treating constipation.
- Pulling the client’s knees into his/her chest while in the supine position performs the first yoga stretch that is often employed during traditional Thai massage. The practitioner will then add additional pressure by leaning his/her own body weight into the stretch.The benefits of this stretch are in its ability to relieve gaseous accumulations in the intestines. This is largely due to the fact that pressure is applied directly to the ascending, transverse and descending colon. The digestive system responds in a similar fashion to that of a person “squeezing a tube of toothpaste.” The pressure alone inspires the bowels to loosen and move more efficiently.
- When mobilizing the joints during traditional Thai massage, practitioners often stretch the hip flexors by alternately bringing a client’s knee to his/her chest. This can also be an effective treatment for constipation as the stretch applies pressure to the ascending and descending colon, eliminates gas and inspires movement within the intestines.*Though traditional massage asks that a woman’s left side be treated first, a more western approach, and one that I find most therapeutic, would suggest that in cases with constipation, the right side be treated first regardless of gender. This is because of the natural clockwise movement of energy and substance through the intestines.
- Part of the traditional seated posture sequence, as taught by the Old Medicine Hospital, places the client into a forward bend with legs fully extended. From this posture, the practitioner then applies pressure from behind; the result increases flexibility in the entire back body (i.e. hamstrings, erector spinae, etc.). The byproduct of this stretch, however, can be seen in its additional pressure to the internal organs of the lower abdomen. The result is similar to that of both aforementioned steps.
For clients who have difficulty sitting upright with legs outstretched, the same stretch can be approached in the passive manner seen pictured above. In this instance, the practitioner places the client’s extended legs against his own and using a double grip technique and proper body mechanics, passively lifts the client into the stretch.
Dietary Supplementation
In Thailand, Thai massage is used to address energetic manifestations of illness. Herbs and dietary supplementations and/or restrictions are also important treatments. When addressing issues of constipation, the following recipes are tried and trusted methods for relief.
Ginger Tea
Ginger is a widely used ingredient when treating issues of gastrointestinal distress, constipation, nausea, flatulence, etc. Below is a traditional recipe for tea that is quite soothing to both belly and spirit.
Ingredients
3 cups water
3-5 inches fresh ginger root (washed) sugar (to taste)
1. Remove barky parts of 3-5 inches of fresh ginger root. Crush with mortar and pestle. (Keep in mind that the potency of the taste and the intensity of treatment depends upon the amount of ginger used in this recipe. It is always advisable to seek the help of a doctor or naturopathic practitioner prior to any self-medicating.)
- Place ginger with water in pot and boil.
- Allow mixture to simmer for 8-9 minutes.
- Strain mixture into mug.
- Stir and serve with sugar (or substitute honey, stevia, etc.) to taste.
Tom Yum (Koong)
Tom Yum can be made with chicken (kai), shrimp (koong) or for a vegetarian option, substituting vegetable stock and tofu for the base and protein portion of the dish will maintain its efficacy and taste.
1/3 lb shelled shrimp (for more authentic Thai preparation, leave tails on) Approx. 20 straw mushrooms (halved)
2 cups stock (chicken or vegetable)
1/2 lemongrass stalk (cut into 1 inch pieces)
4 kaffir lime leaves
4 slices galangal or ginger (remove barky portions) 10 small green chilies (halved lengthwise)
2 Tbsp. fish sauce
5 sliced shallots
2 Tbsp. lime juice
1/2 tsp. sugar
1/2 tsp. chili paste
1/2 tsp. soy bean oil
cilantro (as desired)
- De-vein the shrimp. Rinse, drain and set aside.
- In a large pot, combine chicken or vegetable stock, lemongrass, kaffir lime leaves,galangal or ginger, chilies and shallots. Bring to a boil.
- Reduce the heat to medium and add mushrooms, fish sauce, lime juice, sugar,chili paste, and soy bean oil and cook for 3-4 minutes.
- Add shrimp and continue to cook until shrimp changes color (approximately 2-3minutes)
- Remove from heat and serve with sprinkle of cilantro.
Som Tam – Green Papaya Salad
3 cloves of garlic
2-4 green chilies
1/2 Tbsp. sugar
4-5 green beans
2 small tomatoes (quartered) 2 cups grated green papaya 2 Tbsp. lime juice
1 Tbsp. fish sauce (or salt) 2 Tbsp. peanuts (optional)
- Shred papaya and set aside.
- Combine garlic and chilies in a pestle. Pound until thoroughly mixed.
- Add sugar and green beans. Pound again.
- Gently mash tomatoes into mixture.
- Add papaya. Pound again.
- Add lime juice, fish sauce and peanuts. Pound all ingredients together for 1-2minutes.
- Serve with a ginger based tea for extra digestive support.
Spiritual Practice
According to Thai tradition, any imbalance that presents in body and/or energy is bound to express itself within the spirit (citta) as well. It is because of this that both client and practitioner must cultivate positive intentions during all treatments whether they be physical, energetic or spiritual. By doing so, the natural healing response becomes inspired in all levels of life; body, energy and spirit.
Sources
“Constipation in Adults: Constipation Symptoms.” http://www.emedicinehealth.com
©2003-2005 eMedicine.com, Inc.
Salguero, Pierce. Encyclopedia of Thai Massage. Scotland: Findhorn Press, 2004, pp.87-93.
The author would like to thank Prathuang (Tim) Impraphai and all of her many guest house teachers for their classes in Thai cookery. The above recipes could not have been created without my initial studies at Thai Chocolate Cookery Center in Chiang Mai.
Thai Medicine for the New Mama: Part 3
Postpartum Recovery in a Tea Cup
When my son’s Papa was a young monk in his rural Thai village, he learned
to gather wild and cultivated herbs for his Abbot’s daily tea. Luang
Pau (roughly “Great Father”) taught him the medicinal uses of the local herbs. Each day the Abbot drank one cup of tea which the young monks made from lemongrass, kaffir lime skin and phrai (a Thai ginger). It was his daily health tonic.
After my son was born in Chiang Mai, my Thai family made this same tea for me. For the first ten days at home with our newborn, they kept our little pot replenished with fresh herbs and brought me a cup of tea three times a day. It was astringent, bitter and lemony in a pleasant sort of way. Because it had the sanction of Luang Pau and my husband’s grandmother Khun Yai, a midwife and massage therapist about whom I have written before, I happily submitted.
On the second day, I was sitting in our front room chatting with a Thai massage student about options for study in our little school (newborn in arms), when I realized I was sweating. Now, in hot season in
Thailand, even in the more moderate northern climate of Chiang Mai, you sweat every day. After a few years, you get used to it – even come to like it (miss it, actually).
You are always a little damp, but your skin glows and is beautifully clear. And, you conscientiously hydrate with water and a squirt of fresh lime. (In modestly posh cafes that tourists frequent, a fresh orchid is likely to rest on the rim of your glass. Heaven.)
On that particular day, day two home from the hospital, I noticed tiny beads of sweat on the backs of my fingers. I asked our student if she were unusually hot. Not particularly. It was hot, mind you, but I was a tad more than damp. I have never sweated like that before or since.
I asked my family if it was the tea. Indeed, this concoction is a diaphoretic (it
makes you sweat!) and diuretic. In small doses, as with the Abbott’s one cup per day, it is a natural anti-inflammatory, blood purifier and can control high blood pressure.
At three cups a day, the tea eliminated the fluid of pregnancy, which my body no longer needed. Mind you, I hydrated carefully, ate good food, rested (really rested thanks to my beautiful family), and breast fed my son, all of which helped me recover and thrive as a new mama.
Ten days after my son was born, I and my little Thai family all trundled off to the hospital in a song tau (pick-up truck taxi) for our first check with the obstetrician. I and the little guy were doing great, and I had lost all of my baby weight. When I see photos of myself from that time, it is remarkable how clear and bright my skin and eyes are. Radiant new mama with a generous dose of Thai herbs!
Here’s Why It Worked
Lemongrass is a diuretic, an anti-inflammatory, and induces perspiration. The ethnic Hill-Tribes who live in the mountainous north of Thailand also use it as a tonic for sore muscles (had those, yup!).
Kaffir lime skin is bitter tasting and used as a blood tonic. After birth, it supports blood building. It is also given to women to promote regular
menstruation, and it is this uterine support that assists the natural process of clearing the uterus after delivery.
Phrai is used by some Hill-Tribes to help new mothers recover after childbirth because it supports uterine function, in the same way as kaffir lime skin. It is also used to treat injury to internal organs and can be used topically as an antiseptic.
Last fall, back here in the Hudson Valley of New York, I cooked up a pot of herbal tea with lemongrass from my garden and the skin of a kaffir lime which I found on a visit to the city (yay!). Sadly, phrai is impossible to come by here, so I did without.
I expected the same result as my postpartum experience, but no. My tea was very bitter without the gingery phrai, and no sweating to speak of. At first, I was puzzled. Without excess fluid in my body to begin with, however I had no need for a big sweat. Hmm… interesting compared to my first experience.
In the next post, a Thai herbal bath for the new mama.
Here are Parts One and Two of this series on Thai Medicine for the New Mama, if you missed them!
Thai Medicine for the New Mama: Part 2
When I was pregnant with my son in Thailand, the subject of heat, high heat, came up often. Hot season is a lucky time to have a baby, I was told. No worries keeping your little one warm. I found this perplexing. I am from central Maine. All of my baby pictures are taken in snow banks (the light is better there!). In Thai summer with days in the upper 90’s fahrenheit, I was worried about how to keep the little bean cool.
When I arrived in the hospital to give birth, heat (or a lack of cold) came up
again. When my mouth got dry during delivery, I asked for ice chips. I am sure I got that out of a movie, or something. Dr. Udom, my fabulous obstetrician, and the attending nurses (all dressed in Pepto-Bismol pink) looked at me quizzically. I repeated it in Thai language. Still not getting through, I dropped it, having other fish to fry at that moment.
Some time later a cup of room temperature water appeared. That will do just fine, I thought.
After he was born, we settled into our room to rest (and watch the World Cup on TV!). Not much of a soccer fan, I relaxed and waiting patiently for ice packs. Clearly, I had not fully converted to the theory of heat. I would never have guessed that I would want to ice …, but I really, really did. Ice packs didn’t come. I inquired after some. The very kindly nurse looked at me quizzically, and then advised warm water.
I made do with warm water.
Before we left the hospital the next morning, having had two beautiful Thai meals and plenty of visitors, Dr. Udom came to our room. His advice? Rest. No cold foods and no cold drinks for a month. No cold water in the shower (which in Thailand is worth specifying). And come back for a check in ten days.
At home with our newborn, my ex-husband and sister-in-law knew exactly how to care for me. We would use heat. My ex-husband recently explained it to me this way. In the past after giving birth, a Thai mother would sleep in a small tent with a fire in order to sweat. The heat and the sweat would clear the unneeded fluid of pregnancy from her body, release toxins and kill bacteria. He described it as purifying, like a Thai sauna.
The Thai family into which I married has a long tradition of practicing Thai medicine. My ex-husband’s grandmother, Khun Yai delivered scores of babies as the only mid-wife and massage therapist in their village, a
settlement which sprang up in the dust of a ruby strip mine, where even children worked sifting the dirt for gems. The rubies are long gone and with them the jobs. The village is now mostly old women, their children and grandchildren moved away to Bangkok.
This photo of Khun Yai was taken in her last year. She was 81. Though her health was declining, it was a year of great joy. Her second grandson ordained as a monk, and her first grandchild was born.
The family remember Khun Yai packing a small sack and walking to the house of women in late pregnancy to prepare for birth. She lived with mother and child until they were ready to get on without her. She prepared food to support birth and lactation. She collected and blended Thai herbs in teas and herbal baths, and she prepared a fire in a small tent where the new mother could rest and sweat, purifying her body after giving birth.
Khun Yai began to learn massage when she was only ten years old. Her own mother and grandmother had been mau nuat pan boran, roughly translated as doctors of ancient massage. I suspect her family, in the female line, have been practicing massage since the beginning of time. As a teenager, she trained in a local hospital in massage and midwifery, which was an honor for her family. Her grandchildren like to say that her father agreed to let her study, even though the hospital uniform skirt was a bit too short. In my mind’s eye, I see her in a simple skirt of early 1940’s vintage, while the women of her village wore ankle length sarongs.
Khun Yai was too feeble to make the trip to us, but she guided us through the weeks following my son’s birth. Dr. Udom respectfully recommended that Khun Yai would know exactly what we needed. In that way, I had the best of traditional Thai medicine in the care of a Western trained doctor.
As you might imagine, I did not sleep in a small tent by a fire in front of our
little urban house in Chiang Mai. Because we were in the city, my family used Thai herbs, in a tea and an herbal bath, to increase my internal heat and promote a gloriously detoxifying sweat. That combined with the high heat of Thai summer were incredibly healing for me.
When I returned to see Dr. Udom ten days after giving birth, I had lost all of the 25 pounds I gained in pregnancy. My son was nursing well. I was resting and well fed with food supporting milk production. I was sleepy as all get out, but well on the way to recovering, deeply grateful for the care of my Thai family.
More on the Thai herbs we used in my next post on Thai medicine for the New Mama!
Thai Medicine for the New Mama: Part 1
My son was born in Chiang Mai on the very day he was expected, or a week early, depending on how you look at it.
His father’s best friend Phra Maha Soontorn, a Buddhist monk since the age of five, knew long before we did that our child would be a boy, that he would be born on a Sunday, and he chose his name accordingly. Arriya, which means “loyal follower of the Buddha” or “good person,” again depending on who you ask.
Thai people consider the day of the week on which you were born to be your “birth day.” When my Thai friends ask my birth day, I tell them I am a Monday, not some day in June.
Traditionally, monks are consulted to name a newborn. They select a name drawn from the letters of the child’s birth day. In Thailand, birth days are seen like signs of the zodiac. They determine your tendencies, your character. To be named in sync with your birth day, is therefore supportive of your true nature (and lucky!). I have even watched a monk remove a dog- eared “naming your baby” book from his satchel with a grin to demonstrate that picking a good baby name is part of the cycle of days for a monk.
Our son was born on wan athit, or Sunday, and Phra Maha Soontorn chose his name before he was born. Before.
Before we knew if our little bundle was a boy or a girl, Phra Maha Soontorn paid us an all too rare visit. As I knelt on the floor listening to him speak with my Thai family, I understood most but not all of what he was saying. Then, he turned to me and in English, a language he doesn’t speak, and he said, “boy.”
I nodded respectfully thinking, “Yeah. Yeah, all you monks want it to be a boy.” Neither I nor my ex-husband really understood that he was telling us it was a boy. Telling us. (I knew from the day before I boarded the plane to fly to Thailand and join my future husband that it would be a boy, because I had seen it in one of the clearest dreams of my life. Even though he would not be born for another 18 months.)
After an ultrasound at six months, we knew without doubt that our little bean was, indeed, a boy. We called family and friends. We called Phra Maha Soontorn. He told my ex-husband, “I know. I told you already.”
As my due date grew nearer, we heard again from Phra Maha Soontorn. This time with a name. A Sunday name. Okay. We’ll see, I think.
A week short of my due date, our son was born. On a Sunday with a beautiful full moon, the day on which Thai people go to the Temple to honor the teachings of the Buddha. We gave him the middle name Arriya.
Phra Maha Soontorn also made sure to tell me, through my ex-husband, that boys born on the Buddha day do not belong to us. They belong to the Temple. We are only keeping them for awhile.
We’ll see, I think. We’ll see.
This little story is the beginning of a series about Thai herbal medicine and the long tradition of caring for women after birth.
I am deeply grateful to have lived in Thailand while pregnant, giving birth, and caring for our son in the first year of his life. An entire community of family and friends supported me with their deep knowledge of Thai herbs and Thai food as medicine. Their generosity and loving kindness gave both son and mum an extraordinarily good start on a new life.