Ayurveda, Indigenous Traditional Thai Medicine and Yoga Therapy is strongly based on Classical Indian Ayurveda. The Indigenous medicine systems of India (Ayurveda, Yoga) have been practiced in one form or another in the land we call Thailand longer than the land has been called Thailand. Ayurveda of Thailand and Thai Yoga originated in the pre-Thai dawn of the great Indian vassel kingdoms of the Khymer and Mon civilizations and in the Theraveda Buddhist medicne practices found within the orders of monks and nuns (the Sangha). The term “Ayurveda” combines the Sanskrit words ayur (life) and veda (science or knowledge). Ayurvedic medicine, originating in India, is one of the oldest systems of indegenous, traditional medicine in the world. Many Ayurvedic practices predate written records and were handed down by word of mouth. The ancient Thai people adopted these ancient traditions and over time adapted them to their way of life. Ayurveda of India, Khymer and Mon cultures became “ Ayurveda of Thailand”! The ancient Sage and Vidya (Ayurvedic Physician) Jivaka or Shivago Komalaboat, the patron saint of ITTM is credited with introducing Ayurveda first to the Buddha himself, successfully treating his illnesses over time and then under the Buddha’s authority to the developing Sangha. This became one of the foundations of Buddhist medicine and led to the idea that medicine and wellness of mind, body and spirit together were equally important in pursuing a compassionate life and spiritual enlightenment. These teachings spread across Asias and S.E. Asia and became the dominant medicine of the indigenous cultures found there. Both rural, monastic and royal communities needed medicine and healing. The teachings of Shivago came to be known as Indigenous Traditional Thai Medicine, Thai Massage and/ or Yoga Therapy, called ‘Ryksaa thang nuat phaen boran thai’, literally meaning ‘the ancient Thai way of healing with the hands ’. Ayurveda of Thailand, ITTM is an Indigenous, traditional Chirothesia or spiritually based, sacred medicine and healing art. ITTM offers solutions for ailments and diseases which might concern every part of life from the purely physical and structural to the mental, psychological and emotional; from the correction of elemental imbalances to the development of a more balanced and healthy life based on Love, Compassion, Joy and Equinimity (Promiiwihan sii). The four principle methods used in traditional healing are Wai Khruu (Puja: prayers and spiritual practice for mental, emotional and or psychological health ), Plants and Herbs, Food and Diet, Midwifery and Laying On of Hands. ITTM (Thai Yoga) facilitates and promotes a harmonious state of being. Life cycles out of harmony with nature keep people from experiencing life in a full and productive way. These healing practices are seen as opportunities to learn a balanced way of living with nature.These remarkable teachings regarding restoration and maintenance of life have now been passed on to this generation. Thai Ayurveda/ITTM/ Yoga Therapy incorporates elements of counseling, energy balancing, sacred nutrition and plant based diet, mindfulness, gentle rocking, deep stretching and rhythmic compression to create a singular healing experience. This work, as it brings fundamental elements and energy into harmony; creates wholeness of mind, body and spirit, in the client and the practitioner as well. Anthony B. James, an Aachan and Master Instructor, has taught Indigenous, Thai Ayurveda/ ITTM/ Yoga Therapy to thousands of students around the world since 1983. He is an Ordained Priest and Minister of the Sacred Medical Order of the Church of Hope (SMOKH) a Dioces of the Eastern Orthodox Catholic Church. He holds docorates and formal degrees in Western Medicine, Ayurveda, Oriental Medicine, Naturopathy and a PhD in Indigenous Medicine. A specialist in Sacred Complimentary and Alternative medicine with a spirtual basis and Native American Medicine. Current Director of Education of the SomaVeda College of Natural Medicine and The Thai Yoga Center. Ayurveda of Thailand: Indigenous Traditional Thai Medicine and Yoga Therapy • Anthony B. James What Is the Ayurveda of Thailand? Ayurveda of Thailand Indigenous Traditional Thai Medicine and Yoga Therapy P. 1 P. 2 Ayurveda of Thailand Indigenous Traditional Thai Medicine and Yoga Therapy By Anthony B. James Meta Journal Press P. 3 P. 4 Ayurveda of Thailand Indigenous Traditional Thai Medicine and Yoga Therapy By Anthony B, James New Edition Copyright© 2016 by Anthony B. James All rights reserved under International and Pan American copyright conventions. World rights reserved. No part of this book may be reproduced or utilized in any form or by any means - electronic, digital or mechanical, including photocopying and recording or by any information storage and retrieval system without permission in writing from the author/publisher, except in the case of brief quotations embodied in critical articles and or reviews. ISBN 13: 978-1-886338-05-0 (Perfect Bound) Published in USA Inquiries should be addressed to: Anthony B. James Meta Journal Press 5401 Saving Grace Ln. Brooksville, FL 34602 (706) 358-8646 www.ThaiMassage.Com www.ThaiYogaCenter.Com Printed in the U.S.A. Cover Illustration by Anthony B. James Original art and photography by Anthony B. James. Typography by Anthony B. James. Design art and original design by Anthony B. James. Additional Photo’s and Graphic Images under License, Courtesy Adobe Stock Photo’s New Edition. Body of original text first published as an instructional workbook, “Nuad Thai, Traditional Thai Medical Massage” Meta Journal Press, Atlanta GA 1983. Anthony B. James ISBN 9781886338029. Please note: It is important to state clearly that this body of work refers to and is a representation of a cultural heritage of the Thai nation and people. I recognize the unique and valuable body of science and information contained in the heritage of the Indigenous Traditional Thai Medicine, Massage Cultural Heritage to be the Indigenous cultural heritage of Thailand and the Thai people. In every way I seek to show my respect and admiration sincerely. All information, methods, traditional practices and references in this book are presented for the purpose of bringing public interest and or awareness as well as educating the public as to the value and benefit of these traditions. The Indigenous Thai Traditional Medicine practices should be recognized as one of the world’s great medical heritages, bridging the gap between Classical Ayurveda, Traditional Chinese Medicine and modern western medicine. P. 5 Dedication This book is dedicated to my teachers Phaa Khruu Samaii Mesamarn of the Buddhai Sawan Institute of Nongkam Thailand, Phrakhru Uppakarn Phatanakit, Phaa Khruu Men, Moh Boonsorn Kitnyam and Khruu Moh Velawong Sidtisopong of the Traditional Medical Massage Association of Wat Chetuphon (Wat Po). My Vipassana teachers Aachan Cha and Prakru Pipitpattanapirat (Wat Prakeodontao Suchadaram) Without their perseverance, dedication and honorable spirit we would not have this art to share with the west. I would also like to thank and give credit to all of my students and all those who support Indigenous Thai healing arts in America. Thank you to my wife Dr. Julie James for her tireless support of this project and Khruu Daniel Kram for being the sounding board and reviewer for the overall project. Thank you for the efforts and dedicated assistance in the editing of this book to Dr. Arianna Coe and Heather Rae Khruu James receiving his Diploma directly from Grand Master, Phaa Khruu Samaii Mesamarn of Buddhai Sawan Institute, Nongkam, Thailand, 1984. Khruu James and Moh Khruu Velawong Sidtisopong, Wat Po, Bangkok, Thailand, 1984. P. 6 “Healing Hands” Seated Buddha, Wat Mahatat, Sukhotai “Man must himself by his resolute efforts rise and make his way to the portals that give upon Liberty, and it is always at every moment in his power so to do. Neither are those portals locked and the key in possession of someone else from whom it must be obtained by prayer and entreaty. That door is free of all bolts and bars save those that man himself has made.” The Buddha A Living Message: Piyadassi Thera P. 7 Forward Ayurveda of Thailand: Indigenous Traditional Thai Medicine and Thai Yoga are part of what makes Thailand, Thailand. The Royal ( Court or “Southern” Style) is the most classical form. After 35 years of practicing and teaching this method full time, ITTM has proven its effectiveness and contribution to a good life. It has become the nucleus of a new lifestyle and right livelihood for the thousands of US and Thai students, practitioners and teachers who have graduated from our programs In 1983 I wrote and published the first version of this text [1] in the form of a workbook that I put together for my Aachan, Moh Boonsorn Kitnyam, students. The workbook was then further Wat Po Traditional School of Medicine developed and formally published as a textbook in 1984. During my initial time at Buddhai Sawan, I was not allowed to take photographs or notes during class as that was considered disrespectful. When I first started teaching in Atlanta in the 80’s, my western students were not content to just “take class”, they wanted documentation. At that time there were no other English Thai Massage texts available for students of the Southern style in English, so I made a commitment to make one. My notes became a memory project to keep it all sorted out over time. The original workbook I made was a recreation of my recollections and practice. The last full revision was in 1995. My goal from the beginning was to present an accurate representation on the living traditional healing work I was taught in Thailand. My first introduction to that, which is called “Ryksaa Thang Nuad Phaen Boran Thai,” Southern style (Royal Traditional Medicine of Wat Po) Indigenous Traditional Thai Medicine and Thai Massage was at the Buddhai Sawan Institute in Nongkam, Thailand. At that time Nongkam was in the “boonies” two hours outside Bangkok and surrounded with rice fields and water buffalo. After graduating as a “Khruu” or teacher in 1984, I was referred to Phrakhru Uppakarn Phatanakit, Phaa Khruu Men, Aachan, Moh Boonsorn Kitnyam and Moh Vilapong Sidtisoporn of the Traditional College of Medicine and Ayurved Vidyali schools, part of the Wat Pho Traditional Medicine school at that time. Under Phaa Khruu Phatanakit, Moh Kitnyam and Moh Sidtisoporn I studied intensively the Southern or Royal Traditional Medicine of Wat Po style. This Southern style became the foundation for my teaching and practice to the current day. One of my Thai Professors Aachan Sintorn Chaichagun of Chiang Mai, Thailand once said something which stuck with me. I had been one of his students for over ten years at that time and I had taken a group of my students with me to meet and pay respect to him. During the visit he asked me to do a session for him, which I did. Afterwards we were having a moment and he asked me all together how long have you been practicing? I replied “20 years Aachan, 10 years with you.” He looked thoughtful for a moment and then took my hand and said seriously, “Keep going. You’re almost there.” He then explained, in the old days there was no end to learning. Ancient Thai Reishi and Moh Nuad practiced for 30 to 40 years to gain mastery. You were not “there” until the 30 to 40 year mark. P. 8 In no sense do I want to claim that I know everything about ITTM and specifically the Royal or Southern style. However, after thirty five years of formal education and clinical practice in the ITTM; the Royal or Southern style , I have to say I know it pretty well! In this text I have worked hard to honor the Thai lineage of teachers and schools who have passed these collective traditions on to the present generation and specifically to myself and my students. The actual flesh and blood, living persons who so generously passed on this knowledge to me and whom I continue to honor and pay respect. I give homage by never forgetting, and by giving credit to my teachers and the schools or traditions they represented. I do so by following their expressed directives to bring it to the world in the best way possible. ITTM without question will continue to grow in popularity and be one of the most efficient therapeutic systems of reducing suffering and the ravages of disease in the world. Very Important! When I wrote and published my first class workbook and eventual textbook “Nuat Thai, Traditional Thai Medical Massage”[1] in 1983, in the USA, Thailand, Canada and most of the world, there was no such thing as “Massage Law” or “Massage Therapy Boards” or any variation thereof. These kinds of legislative, governmental attempts to control natural medicine from a secular, governmental point of view are becoming quite common. Due to the expansion of regulation, which primarily seeks to control the use of terms for marketing and taxation under the guise of public safety, terms such as “Massage”, “Massage Therapy”, “bodywork” etc. have become legally defined as basically “rubbing on the public for money” i.e. Gliding, Stroking, Kneading, Thumb press and Percussion in infinite variation for hire. The practice is allegedly derived from practices taught and refined by a Swedish gentleman Per Henrick Ling in Stockholm around the turn of the century and brought as a livelihood to America with Swedish and European immigrants. This mechanical art, “Swedish Massage” defined as an art of physical manipulation, primarily because of it’s market and financial potential, has become the mainstream’s idea of what basic manipulative therapy is. It appears that most regulatory agencies i.e. “Massage” Boards have no education or knowledges of the origins and history of what they are atempting to regulate! They attempt to argue that all touching, all healing should be regulated by beurocrasy of government. This should be shocking as it ignores both the fact that touching to express healing, community, love and nurturing are innate inclinasions and natural expressions of all primates including humans. ITTM is not based on manipulation and never was histo rically as you will see explained further in this text. ITTM is NOT “Massage and or Massage Therapy”! ITTM is NOT Massage Therapy nor Massage as defined by most secular state laws in the US. It is not related to nor a derivative of Swedish Massage. It is an ancient, indigenous, traditional cultural heritage of the Thai people. It is an art which is based on Ayurveda and Buddhist principles as well as the spiritualist beliefs and practices of indigenous, tribal people and those of traditional institutional practice such as within the Thai Royal Family. ITTM is not the same as “Massage”, “Massage Therapy,” or “bodywork,” as commonly defined in so-called “Massage Laws.” The term “Thai Massage” is western slang, mostly promoted by tourists in Thailand. Although the use of the term is now common, it still is misunderstood and misused by the misinformed. It is easy to be confused when similar words are used, such as “Massage,” but legally there are distinctions and differences in definitions. Please note: In common English when we as ITTM practitioners use the word “massage” we do not mean it in the same context as the typical western usage. In the west “Massage” means something like a “rub down” for money and is primarily referring to systems derived from Swedish Massage and Massage Therapy. “ITTM/ Thai Yoga and or Traditional Thai Massage” (Phaen Boran Ráksãa Thaang Nûat) is completely unrelated! P. 9 Legally words can have different meanings than words used in common, non-legal language. For example, “Massage and Massage Therapy” definitions are based on the commercial practice of “Swedish massage.” “Swedish Massage” is new (less than one hundred years) in European and American culture and it is defined legally as “the application of a system of structured touch, pressure, movement and holding to the soft tissues of the human body with the purpose of positively affecting the health and well being of the client. The practice includes the external application of water, heat, cold, lubricants, salt scrubs and other topical preparations and devices that mimic or enhance the actions of the hands.” ITTM is a comprehensive, sophisticated healing art derivative of Theraveda Buddhism, Buddhist medicine, Buddhist Psychology, Theraveda Vipassana Bhavana, Classical Indian Ayurveda and Tibetan Ayurveda and Yoga Vedanta. ITTM (Thai Massage/ Thai Yoga) sounds similar to Western-style massage at first glance, but what is not mentioned in the preceding statements is that ITTM is a spiritually based system of healing and movement education (Indigenous, traditional Ayurveda/ Yoga). It is based entirely on principles of energy balancing (Sen, Tri-Dosha, Lom, Chakra etc.) and the actual touching, contact or soft tissue manipulation is incidental to, and not the central aim of the practice! I want to emphasize this statement again “It is possible to have a ITTM session with little or no actual touching”. However, touching is good! This work brings fundamental elements and energies into harmony and creates wholeness of mind, body and spirit (Somatic Homeostasis). ITTM is a spiritually based Somatic technique and profession, a modality with standards established in the Buddhist holistic centers and temples thousands of years ago. It has an established code of ethics known as the Buddha Dharma, The Eight Fold Path, Ahimsa (non-violence) and the “Ten Rules of the Healer.” There is an established criterion for education and professional practice for services that were never intended to be “Massage” or “Massage therapy.” ITTM is founded on spiritual, energetic, natural principles, philosophies which require practitioners and recipients to profess belief in and to work from a belief in the unseen: Spirit, Puja, Prana (breath of life), Energy, Lom, Kwan (consciousness, entity or spirit), Elements Lom: Air, Fai: Fire, Din: Earth and Naam: Water), Humors, and various intelligent agencies such as the inherited healing essence and conscious guidance from deceased ancestors and teachers (lineage, Wai Khruu). Traditional emphasis includes addressing Kwan with rituals including prayers, mantra, smudging or burning of therapeutic and or blessed Joss (incense) and the invocation of deity. Religious and or spiritual ritual was more common when a malicious agency or Pii (Evil Spirit) was considered or diagnosed to be causative. This is a very similar concept to that shared in both Ayurveda, Chinese medicine and Native American Medicine that illness and infirmity can be caused by malicious, pernicious and or evil agency which needs to be appeased and or dispelled by magical practices and incantation (Mantra recitation). For example compare traditional Chinese medicine concepts of pathogenesis citing Pernicious or “Six Evil Influences” as the origin of a disease condition (Classic Chinese Medical Text: Nan Jing). This traditional ritualistic emphasis on faith and belief in the unseen as being a common and necessary part of the traditional Thai medicine practice was documented by Brun and Schumacher in their seminal work “Traditional Herbal Medicine in Northern Thailand”: 1994 edition, White Lotus, Bangkok, Thailand[2] as well as Chamchoy. P. 10 Taking into consideration the acient history, the traditional and modern understandings and clinical usage, the 1000 plus years of aactual documentation including Buddhist literature, Vedic text and Codex as well as practical understanding conveyed via both oral and in written form over the last hundred years, here is my definition: ITTM is an ancient, indigenous, traditional, spiritually based system of healing, Chirothesia and Somatic therapy in which the healer, practitioner, therapist, doctor or family member (provider), literally becomes the extension of sacred, divine intention, manifestation and expression. The provider becomes the embodiment of the sacred spirit of healing. It is a direct and literal, practical expression of compassion and loving kindness; reducing suffering, enhancing life, bringing health, wellness and happiness to all who are touched by it. ITTM is as beneficial in all aspects for the provider as for the receiver. The fact of its apparent sophistication, elegance, efficiency, power and vitality does not make it merely or simply a system of mechanical manipulation! In reference to the traditional Thai/Pali and or traditional Sanskrit names for the ITTM asana or therapeutic postures: The roots of the postures found in both the Traditional Thai Self Yoga or Reishi Yoga (Reusi Dottan) and in the traditional Vinyasa and techniques of the Southern or Royal style are greatly influenced or patterned after the Samana (Sramana: Sanskrit) practices of Buddhist monks. Who in addition to Vipassana and Shamatha meditation also had practices such as: Hatha Yoga (Reishi Yoga: Reusi Dotton, Rigveda, Yoga-Yajnavalkya, Harada Pradapika,) and Yoga Therapy (Sushruta Samhita, Charaka Samhita, Ashtanga Hridya etc.). There have always been Vedic terms from the original or classical Sanskrit and anachronistic Sanskrit (Pali) spoken by Thai Buddhist monks. However, it is also likely that most of the therapeutic Asana (postures) in one form or another predate the codification of Buddhism as a religion. As such and in the absence of clear delineations of the individual postures in the Thai or Pali language, I have included the traditional Sanskrit titles or names for helpful reference. My opinion as to why many of the traditional postures contained within the therapeutic Vinyasa (flows) themselves are not individually labeled, referred to and or precisely named, is that in the past the applications or techniques were more dance like with greater emphasis on the transitions than the techniques themselves. Additionally, different schools within the Royal tradition also used different names and terms for individual postures. Hopefully more research into the etymology of the names will be forthcoming. Wherever possible I have included the Thai names as taught originally to me, as well as English transliterations and Sanskrit as appropriate. Also note, I often add the prescript “Facilitated” to the Sanskrit term to clearly indicate that this is a traditional Yoga posture, incorporated into ITTM and the only substantial difference between it and the classic Hatha Yoga equivalent is that the posture is done passively and facilitated or co-facilitated by the practitioner. Important Note! We consider this ITTM (SomaVeda® Indigenous Traditional Thai Yoga & Thai Ayurveda and/ or Traditional Thai Massage) content to be a sophisticated beginner level. Basic practitioners and or self taught, should under no circumstances consider themselves to be professionals or present their practice to the public as professionals. This matieral is provided for educational purposes only and does not purport to make any specific medical recommendations. Medical recommendations and diagnosis for any disease condition is regulated by both Federal and State law and may only be practiced by a licensed physician or other licensed health care provider. However, this material when practiced under the guidance of an expert teacher may provide a very firm and substantial foundation from which to become a competent healer. P. 11 Table Of Contents Forward P. 8 About The Author P. 13 Unique Characteristics of ITTM P.18 Chapter 1: History of Ayurveda in Thailand: Origins of Indigenous, Traditional Thai Medicine and Massage P. 19 Chapter 2: Introduction to Indigenous, Traditional Thai Medicine and Massage P. 31 Chapter 3: Preparation for the Healing Session P. 35 Chapter 4: Basic Techniques P. 40 Chapter 5: The Royal Tradition Vinyasa: The Southern Style Supine Attitude Position Side Lying Attitude Position Prone Attitude Position Second Supine: Abdominal Attitude Seated Attitude Position P. 44 P. 45 P. 64 P. 74 P. 82 P. 92 Chapter 6: Thai and Chinese Medical Theory Sen Lines Traditional Chinese Meridians P. 98 P. 104 P. 117 Chapter 7: Western Validation P. 124 Chapter 8: Philosophy: ITTM is a Spiritual Practice P. 127 Appendices Appendix I, General Benefits Appendix II, Contraindication Appendix III, English/Thai Vocabulary Appendix IV, Illustrations, Photo’s, Graphics Bibliography Index P. 131 P. 139 P. 140 P. 144 P. 145 P. 147 P. 12 About The Author Aachan, Anthony B. James DNM, ND (T), MSc, MD(AM), DOM, PhD, DPHC (h.c.), DMM, RAC, SMOKH is a dedicated professor and teacher who has devoted his life and career to healing arts and sciences. The Martial Arts path that he began around age eleven eventually led him to a remote area of Thailand where he was accepted as an apprentice student of the famed Buddhai Sawan Institute. Dr. James became a recognized “Khruu” or teacher authorized to represent the Buddhai Sawan lineage of teachers and has been teaching Traditional Thai Healing arts and sciences since that time (1984). Note From The Author Over the years I have faced and overcome many serious health issues. In the 1960’s I was diagnosed with a bone cancer in my jaw which I survived after three surgeries at Emory Medical Center in Atlanta, GA. In the middle 80’s I was in a near fatal car crash which crushed several vertebrae and left me incapacitated for over a year… altogether from mayhem, mishap, competition injuries etc. I have accumulated over 41 broken bones and even had re-constructive surgery to my face. All things being equal, I attribute my health and ability to remain functional to my Thai Yoga (ITTM) practice! My injuries and my concern over health issues of my immediate family members gave me a deep personal interest in healing. When conventional medicine failed to give the answers and relief needed I increasingly came to rely on what worked best for me… Indigenous, traditional, natural medicine was the answer. Indigenous, Traditional Thai Medicine and massage kept me going when nothing else could or would. My training and education in Thailand began in the traditional schools of the Southern region and eventually over the next thirty five years came to encompass many of the unique and traditional schools and master teachers. The three primary Southern traditions I trained in and eventually became recognized by, first as a Khruu or teacher and then eventually as an Aachan or professor, were the Buddhai Sawan (Phaa Khruu Samaii Mesamarn), Wat Pho (Moh Boonsorn Kitnyam, Moh Vilapong Sidtisoporn) and Anantasuk (Aachan Phaa Khruu Anantasuk, Moh Nanthipa Anantasuk) schools. All three of these schools allege their origins in the Royal Traditional Medicine of Wat Po. However, over several hundred years they developed their own culture and systematic practices specific and appropriate to their respective communities. Each of them have a distinctive emphasis and have incorporated various colloquial traditions and specific treatment strategies which might be very different from what we see in the official, standardized Wat Po system taught today. On September 27th, 2002, at the Queen Sirkit Convention Center, Bangkok, Thailand I received the prestigious “Friend of Thailand” award. The award, a beautiful Ginari (Thai Angel) carved in Lucite was given in recognition of my work and contributions in the field of Traditional Thai Medicine and Thai Yoga Therapy. Accomplishments cited at the time included: publishing the first book on the Royal style of Thai Medical Massage by a US author “Nuat Thai, Traditional Thai Medical Massage” Metta Journal Press, Atlanta, GA: 1984. Becoming the first licensed Traditional Thai Massage practitioner in the United States (Dekalb County, GA 1984), the first professionally recognized Indigenous, Traditional Thai Massage Instructor in the US, American Oriental Body Work Therapy Association (AOBTA 1990 Member #37), where I also served on the AOBTA Board. Founder and President of ITTA, the International Thai Therapists Association (1992-2012, now defunct), Organizer and leader of “The Thailand Externship Training Program for non-thai practitioners” 1986 to present. Contribution and consultation to Prime Minister Thaksins “Task Force For Traditional Medicine in Thailand” (1998-2001), Traditional Thai Massage consultant Thai Consulate USA (1998 to present). And in 2002 I was Founder, Director and Chief Instructor of a 3000 hr. professional, full time, training and certification program based on Traditional Thai Yoga medicine at that time located in Chicago. P. 13 The award was presented on behalf of Prime Minister Thaksins given jointly by the Royal Thai Tourism Authority of Thailand (TAT, now TOT), Royal Thai Ministry of Commerce: Department of Export Promotion and the Royal Thai Ministry of Health: Department of Thai Traditional Medicine, for promotion of Thai Culture and Tourism in Thailand. Over 2000 dignitaries and representatives of Thai Govt and industry were in attendance at the award. The award itself was presented by Mrs. Juthamas Siriwan, Governor General, Tourism Authority of Thailand. This award notes the first such formal international recognition by the Royal Thai Govt for Traditional Thai medicine and Thai Massage for a Non-Thai Instructor and practitioner. It also was the first award of it’s kind for a professional organization (ITTA) representing Traditional Thai Massage in the west. Eventually, I became affiliated with and adjunct faculty of the Anantasuk School of Traditional Thai Medicine at the Wiangklaikangwan Industrial College in Hua Hin. These programs in Hua Hin operate in conjunction with and under patronage of the Royal Thai family and King Phumipon’s (H.M. King Bhumibol Adulyadej) Rajaprajanugrow foundation. After studying and teaching for over 24 years, I received my “Aachan” or Professor recognition in Thai Traditional Medicine via the Wat Po Association of Schools (2006). This was about the same time I was assisting to develop a standardized, bilingual, Thai Yoga and Traditional Thai Massage program under direction and patronage of Mr. Khwankeo Vajradaya, Chairman Rajaprajanugroh Foundation, Chairman Distance Learning Foundation Thailand and Grand Chamberlain to H.M. King Bhumibol. We co-developed a program of instruction that was broadcast to over 163 vocational schools across P. 14 Thailand as part of the Thai Traditional Medicine Multi-media curriculum. In 2009 I was privileged to receive professor recognition in the Royal/ Southern style of Traditional Thai Medicine and Traditional Thai Massage (ITTM/ TTM). I was issued a lifetime registry as a Doctor and teacher of Thai Traditional Medicine from the Union of Thai Traditional Medicine Society (UTTS Lifetime recognition and Teachers credentials #520121896), additionally I was Awarded the Golden Hanneman Medallion by Doctor Aram Amradit, President and founder of the UTTS. I was among the very first western students to be allowed to live and train in this way. I am also especially proud of my time training with Masters in the Northern provinces such as Buntautuk Northern Provincial Hospital and Foundation of Shivago Komarpai, Old Medicine Hospital (under Aachan, Sintorn Chaichagun, Aachan “John” Chongkol Settakorn, Khruu Pichest Bootum), Mama Lek Chaya (Jap Sen Nerve Touch), Aachan Tawee (Sawankhalok School for Blind Massage). Additionally, I was blessed to be welcomed to train with traditional medicine people in several different Hill tribes, primarily Shan, Karen, Akha and Lisu. Throughout Asia, Southeast Asia, South America and Caribbean I traveled and lived extensively completing advanced training programs in several different countries i.e. Thailand, Philippines, Indonesia, India and China, Mexico, Ecuador, West Indies etc. My primary focus, however, is and always has been on the indigenous, traditional healing arts of Thailand. I am proud to have received several significant formal recognitions for my teaching and practice of Indigenous Traditional Thai Medicine and Traditional Thai Massage (ITTM/ Thai Yoga). In 1998, I was invited to participate and present to Prime Minister Thaksin Shinawatra’s “Task Force For Traditional Medicine in Thailand” in conjunction with Royal Thai Department of Commerce: Export Promotion. In 2002 I received the “Friend Of Thailand 2002” Award, TAT, Trade Center , Royal Thai Dept. of Commerce. In 2006, Aachan/ professor Thai Traditional Medicine: Thai Yoga/ Thai Massage Teacher status through the Anantasuk system (Hua Hin Thailand), recognized by the Wat Po Association. In addition to my many years of dedicated practice of Thai healing arts and sciences, I have managed along the way to graduate with advanced medical and philosophical degrees. Two Doctoral degrees in Natural Medicine ND(T), MD (AM), Doctor of Oriental Medicine DOM, PhD (Indigenous Medicine), Doctorate in Pastoral Humanities DPHC (h.c.), RAC (Registered Ayurveda Clinician), Doctorate Classical Indian Naturopathy ND, Masters of Science Clinical Herbology MSc. and over 25 other professional certifications in various health, medical and allied medical specialties. P. 15 Currently, Dean and Director of Education for the SomaVeda College of Natural Medicine (SCNM) and Thai Yoga Center in Brooksville, Florida. The college offers 20 to 5000 hour professional development and educational programs consisting of six levels and supplemental courses. It is complimentary and designed to have parity with other similar certification training programs in indigenous, traditional, spiritually based healing arts and sciences. My family heritage is mixed Native American/Scottish and I am proud to represent my Native American and religious heritage of practicing sacred natural medicine based on indigenous, traditional, natural principles and ceremonies. I regularly lead sacred medicine ceremonies, such as: Sacred Sweat Lodge, Sacred Pipe, Breath, and others for my community. Although not as active in Martial Arts practice as I was in my younger days I remain an avid martial artist and hold Black Belts in several different styles and systems: Tang Soo Do Mu Duk Kwan (Master Hong Shik Chung, Lloyd Garrard), American Karate (Lloyd Garrard, Joe Corley, Bill Wallace, Joe Lewis), and Go Budo Jujitsu (Grand Master Daeshik Kim). I have enjoyed advanced teaching/ instructor credentials in several types of traditional oriental arts which do not use conventional ranking such as: Jeet Kune Do (Sifu Danny Inosanto, Larry Hartsell, Alfonso Tamez), Wing Chun Kung Fu (Sifu Francis Fong, Sifu Jason Lau), Kabri Kabrong (Grand Master Samaii Mesamarn), Zhang Yuan Ming Chi-Gung (Master Zhang Yuan Ming) and the Filipino arts of Kali (Sifu Danny Inosanto), Pekiti Tirsia (Tuhon Leo T. Gaje Jr.), Arnis de Mano (Jorge Lastra), Armas de Mano (Dionisio Canete, Nick Serrada) and Indonesian Pencak Silat (Pendekar Suyadi Jaffri: Jakarta). In my downtime I’m a sometime artist preferring to work with photography and graphic arts. I enjoy SCUBA, trekking and the great outdoors. Our five acre sanctuary provides lots of opportunities to get outside and work on the land. I hold the office of Knight Chevalier/Grand Council Member and volunteer as a Diplomat with the UN DESA NGO Sacred Medical Order of the Knights and Church of Hope (SMOKH/ SMOCH), a Diocese of the Eastern Orthodox Catholic Church and Grand Priory of the Hospitaller Knights of St. Lazarus of Jerusalem (HOSLJ) doing volunteer work on medical missions in Ecuador, West Indies and other countries. SMOKH gives me the opportunity to practice natural medicine in and with indigenous communities and the Thai work is always well received and respected. I am also an ordained priest in both the SMOKH Diocese under protection of the Eastern Orthodox Catholic Church and am a Director of the Priory of Saving Grace Church: SMOCH Priory #110 located in Brooksville, Florida. My family, friends and spiritual community mean a lot to me. They have made it possible for me to stay motivated and healthy! They encourage me to practice what I preach in my everyday life. The deep perspectives and disciplines brought by this experience is evident in my teaching. The learning curve has been a long and slow one. Many of my understandings have changed over time as I have continued the learning process. However, the core understandings and teachings given directly to me by my Thai teachers have stood the test of time and remain valid. One must not believe anything without verification and one must not do anything until one understands why… P.D. Ouspensky: The Fourth Way P. 16 THAILAND is situated in the southeast part of Asia between 5 degrees north parallel, and 21 degrees north parallel, 97 degrees east latitude and 106 degrees longitude. It is bordered by the countries of Myanmar (Burma), Kampuchea (Cambodia), Laos and Malaysia. The terrain is quite diverse with sub-tropical lowlands bordered by the gulf of Siam in the south, the spacious great central plains of Menam Chao Phraya, and the craggy mountains of the Northern Highlands. Note how centrally located in South and S.E. Asia the country of Thailand is. Not far geographically from India, China and the Philippines by land, river or ocean. Notice in this French map circa 1700 the varied and diverse cultural world Siam co-existed with at that time. P. 17 Unique Characteristics of ITTM 1. No restriction of age: ITTM can be practiced with anyone of any age; the very young or the aged with great benefit. It will tonify and strengthen the young and will stimulate and add vitality to the older clients, combating the degenerative effects of aging. 2. ITTM treats the total person: The practitioner is trained to look at the person being cared for in a holistic fashion, taking into account the ramifications of illness or injury on many aspects of the person’s body, mind, emotions and spirit. 3. Evaluation and therapy are combined: Every session gives the practitioner pertinent and valuable information and insight on facilitating a return to a harmonious condition. As the practitioner skillfully detects abnormality, imbalance in the client, they are led at once to the proper method and or program to facilitate wellness and healing. 4. ITTM uses the whole person to treat the whole person. Indigenous, Traditional Thai massage/Thai Yoga practitioners use their Spirit, Mind and Body to treat the Spirit, Mind and Body of the client. Treatment may include energy balancing, mental/emotional counseling, nutrition, use of sacred medicant such as herbs, oils, waters, light, sound and nurturing touch. 5. No side effects: As the specific treatment modalities used are traditional, natural, non-invasive, holistic and spiritually based then selected on the basis of their appropriateness for the individual client, there are no unpleasant after effects, such as excessive muscular soreness. 6. ITTM facilitates health maintenance: Regular sessions complement other health practices by improving psychological/mental and emotional states, balancing energy and maintaining strength and flexibility, helping to eliminate waste toxins from joints and soft tissue. This aids in reducing the effects of stress and fatigue by relaxing the body. 7. ITTM is a balanced blending of Indigenous Traditional Thai medicine, Ayurvedic medicine, Traditional Chinese medicine and Western Natural medicine: This allows the practitioner greater variety, flexibility and diversity in facilitating health for the client. 8. ITTM emphasizes that the spiritual development of the practitioner is as important as the therapy itself. 9. ITTM primary outcome is Promwihan Sii, or the cultivation of the “Four Divine, Unlimited States of Mind: loving kindness, compassion, vicarious joy and equanimity.” P. 18 Chapter 1 History of Ayurveda in Thailand: Origins of Indigenous Traditional Thai Medicine and Massage Indigenous, Traditional Thai Massage (Indigenous Thai Yoga Therapy), also called “Ryksaa Thang Nuad Phaen Boran Thai” or the “ancient Chirothesia (Yoga Therapy) or hands-on healing” of Thailand, is born of a long tradition. This unique system of indigenous, traditional, natural medicine and Yoga therapy finds it’s ancient roots first in the traditions of classical Ayurveda as far back as the 5th century BCE. Subsequently the Vedic health and medical practices eventually became common practice in SE Asia, and Burma (Myanmar) and Thailand were heavily influenced by succeeding generations of Buddhist influence, philosophy and practice. Some form of this traditional medicine has been taught and practiced in various locations for about 2500 years. When Theravada Buddhism arrives in the region (400-600 C.E.) it is firmly established as a colloquial and unique variation still founded primarily on its Vedic roots but progressively influenced by the diversity which is found in early Thailand beginning in the Sukhothai period, followed by the Ayutthaya and Bangkok eras. Beginning in the Ayutthaya period (1351) we see influences from the Burmese, Japanes, Chinese, Malay, Philipines and Portugal [3] consistent with the immigration and trade of the Kingdom during that time. This is also when we note the first documented arrival of western doctors. Traditional Burmese medicine especially came to the forefront before and after the sacking of Ayutthaya between 1765 and 1767 [4]. The classics of Indian literature and Ayurveda were known and being distributed and or used by the Royal Court in Ayutthaya such as the Ramayana, Rig Veda, Athara Veda, Pradapika and Sushruta Samhita. Additionally, the Thai Royal court from earliest days was likely knowledgeable, by way of local culture and the literature of the Vedas and the Puranas, of the Hindu deities and in particular the deity and iconic symbols associated with Dhanvantari (Thai Pra Narai, Narayana, Jagannath). It may be interesting to note that one of the oldest bronze statues in Thailand, now located in the National Museum in Sukhothai is that of Vishnu. Dhanvantari is an avatar of Vishnu in Hinduism. He is the physician to the Gods and generally the deity/spiritual icon of Ayurveda. Vishnu or Pra Narayana statue in Huytungtao, Chiangmai Thailand During the periods of war with neighboring Burma, many tens of thousands of Thai people were taken as prisoner and held for over 40 years before being able to establish their freedom and return to their homes, including the famous Thai Prince and later King Naresuan [5] [6]. When they returned they brought with them knowledge and practices obtained during their captivity including medicine, martial arts, music, food and more. These were incorporated into the dominant Thai culture over time and remain influential today by way of the many generations of Burmese people immigrating and now living in Thailand. P. 19 OM NAMO SHIVAGO Historically, the initial credit for the origination of what becomes Indigenous, Traditional Thai Medicine and Massage is given to one individual, a famous Indian doctor called Jivaka Komalaboat [12] (Shivago) other spellings include Jivaka Kumar Bhaccha and Jivaka Amravana. Jivaka, of Indian origin, is alleged to have been born in what is today the city of Rajgir, the ancient capital of the Magadha Kingdom (Later Majapahit/ Bihar). There are several different accountings of his birth, life, education and teachings. In looking for references that were more detailed and or which offered historically verifiable references to the life of Jivaka. I found several. One specific account crossed reference several other however, without specific references it is hard to verify all details. However, I am including it under fair use to present the details for further research and or verification: According to one author (Salina- Nalanda University) “According to the Anguttara commentary he was the son of Salavati, a courtesan of Rajagaha with Abhayarajakumara (Son of Raja Bimbisara) but some accounts maintain Jivaka was Ambapali’s son with Raja Bimbisara. As per the Vinaya sources the child was placed in a basket right after birth and thrown on a dust-heap, from where he was rescued by Abhayarajakumara. When questioned by Abhaya, people said “he was alive” (jīvati), and therefore the child was called Jivaka; because he was brought up by the prince, he was called Komārabhacca (child of a Prince). It has been suggested, however, that Komārabhacca meant master of the Kaumarabhrtya science (the treatment of infants); VT.ii.174; in Dvy. (506-18) [12] he is called Kumarabhuta because of his medical profession. When he grew up, he learns of his antecedents, and went to Takkasila without Abhaya’s knowledge and studied medicine for seven years. When he returned to Rajgir, Abhaya established him in his own residence. There he cured Bimbisara of a troublesome fistula and received as reward all the ornaments worn by Bimbisara’s five hundred wives. DalhaSa, the 12th century commentator of the Susruta Samhita, says that Jivaka’s compendium was regarded as one of the authoritative texts on the subject. Another text that quotes Jivaka’s formulas is the Navan_taka (meaning ‘butter’), a part of the Bower MSS discovered in 1880 from Kuchar in Chinese Turkistan. Based on earlier standard sources, this medical compilation of the 4th century AD, attributes two formulas dealing with children’s disease to Jivaka, saying ‘Iti hovaca Jivakah, i.e. thus it spoke Jivaka. One formula is: i.e., Bhargi, long pepper, Paha, payasya, together with honey, may be used as linctuses against emeses due to deranged phlegm.” A “Linctus” is a form of cough medicine [13]. In researching Jivaka, Rajgir and the ancient Nalanda University, there are references to Jivaka and also in connection with the Buddha from the Chinese authors Xuanzang (Hiuen Tsang) and Yijing, especially those of Xuanzang (Sixth Century between 630 and 643 CE). In one of his accounts he writes “North-east from Srigupta’s Fire-pit, and in a bend of mountain wall, was a tope (stupa) at the spot where Jivaka, P. 20 the great physician, had built a hall for the Buddha. Remains of the walls and of the plants and trees within them still existed. Tathagata often stayed here. Beside the tope the ruins of Jivaka’s private residence still survives.” Referred to in some ancient references as the Thrice Crowned King of Medicine, he was a classically trained Ayurvedic physician probably in the tradition of Atreya (Atreya Punarvasu/ Takkasila). Jivaka was known to be influenced by Buddhism and was possibly the personal physician to Raja Bimbisara, the Magadha king of that period and to the Buddha and local monks community on appointment of the king.[12] It is possible today to travel to see Jivaka’s home and the ancient Nalanda University in Rajgir still today. His name is mentioned in the traditional Pali canon or writings of Theravada (Hinayana) Buddhism (Zysk, Kenneth, G. 1982). Pali is anachronistic/ancient Sanskrit language still in use today by Theravada Buddhist monks. “Studies in Traditional Indian Medicine in the Pāḷi Canon: Jīvaka and Āyurveda”, (Kenneth G. Zysk, Journal of the International Association of Buddhist Studies 5, pp. 309–13) [15]. There are numerous additional references to him, his life and healing practices in the Pali Cannon. In fact there is some support for the idea that the “Giving of Robes” (Vin.i.268-81; AA.i.216) [16] where he made a gift to the Buddha of “a celestial shawl he received from king named “Chanda Pradyotha” prompting the Buddha to give a famous sermon leading to the practice still followed today. Another example found in the Pali Canon has Jivaka directly treating the Buddha for specific ailments using Ayurveda. “Once when the Buddha was ill, Jīvaka found it necessary to administer a purge, and he had fat rubbed into the Buddha’s body and gave him a handful of lotuses to smell. Jīvaka was away when the purgative acted, and suddenly remembered that he had omitted to ask the Buddha to bathe in warm water to complete the cure. The Buddha read his thoughts and bathed as required. (Vin.i.279f; DhA. (ii.164f)” [17] The above is an example of the therapeutic adjuncts we use in ITTM today: Chirothesia, Anointing, Oliation, Herbology, Aromatherapy, Pancha Karma, Marma Cichitsa etc. During his time in association with the Buddha he became a Buddhist monk (Sotāpanna) and continued to practice medicine and develop the strategies that would be the foundation for medical and healing practice in Buddhist temples until the present day. Jīvaka was eventually declared by the Buddha chief among his lay followers loved by the people (aggam puggalappasannānam) (A.i.26)[18]. He is included in a list of good men who have been assured of the realization of deathlessness (A.iii.451; DhA.i.244, 247; J.i.116f) [19]. He seemed to follow, teach and or exemplify the doctor’s moral obligations (Doctors Code of Conduct) as found in the Pali scripture, the Vejjavatapada. Attributed to actual practices and teaching directly from the Buddha. In the seven articles, excerpts from four passages in the Pali canon, the Buddha lays down the attitudes and skills which would make “one who would wait on the sick qualified to nurse the sick.” (Anguttara Nikaya III, p.144) [20]. The Vejjavatapada likely predates the Greek Hippocratic Oath. It does not just exhort doctors to practice ethically, it clearly specifies a true holistic practice of medicine addressing the spirit, mind and body in an integrated fashion. P. 21 The Lord said: “Health is the greatest gain.” He also said: “He who would minister to me should minister to the sick.” I too think that health is the greatest gain and I would minister to the Buddha. Therefore: (A) I will use my skill to restore the health of all beings with sympathy, compassion and heedfulness. (B) I will be able to prepare medicines well. (C) I know what medicine is suitable and what is not. I will not give the unsuitable, only the suitable. (D) I minister to the sick with a mind of love, not out of desire for gain. (E) I remain unmoved when I have to deal with stool, urine, vomit or spittle. (F) From time to time I will be able to instruct, inspire, enthuse, and cheer the sick with the Teaching. (G) Even if I cannot heal a patient with the proper diet, proper medicine and proper nursing I will still minister to him, out of compassion. Translated from Pali into English by Bhante Shravasti Dhammika The Brahmajala Sūtra says: “If a disciple of the Buddha sees anyone who is sick, he should provide for that person’s needs as if he were making an offering to the Buddha.” [12] Brahma Net Sutra, STCUSC, New York, 1998, VI,9[21]’ Jivaka is revered to this day. Many modern practitioners and schools begin every healing session with recitation of a Pali Mantra called OM NAMO SHIVAGO. Royal practitioners generally do this quietly while in the North of Thailand the Mantra may be recited out loud, sometimes with the receiver participating as well. The Wai Khruu or paying of respect to Jivaka (Shivago) is still done partly in remembrance of his contribution to the present day art. It is impossible to say to what extent other styles of medicine and massage have contributed to Indigenous, Traditional, Thai Medicine (TTM/ ITTM) development. The current capital of Thailand, Bangkok, was established in 1782 with the coronation of Chakri King Rama I in 1782. According to Thai historians the first meaningful building to be erected in the new capital was the rebuilding of the new Wat Pho (1789-1801). The original in the former capital (Ayutthaya) having been burned by invading Burmese armies. Primarily ITTM has been passed from one generation to the next in the form of an oral tradition, whereby one would serve an apprenticeship under a teacher, often for several years before practicing as a practitioner. In general, the teachings were preserved and cherished by the monks and nuns of the Buddhist Temples. In addition to the oral tradition there have been several treatises, hand written papers, Codices and or books written mostly for or by the Royal Court and not easily obtained by the general public. The most accessible documents detailing the practices of the Royal Court Traditional Medicine, were the stone carvings, built into the walls and pavilions of Wat Po in Bangkok. More on these later. Important to note also is that there have always been, from earliest days to the present, two different corollary systems of practice: Two types of traditional curing methodologies and or points of view in the way healing and traditional medicine was practiced in Thailand. The urban or variant descendant practice from the Royal schools of traditional medicine and the country/ rural and or common practices found in the village, jungle and countryside. The urban represents efforts at standardization and training, the rural or country incorporates the more indigenous ideas and practices restricted by tribe or geographic location. Most researchers agree that there has always been and still is cross sharing of ideas, influences and practices of both systems. Similar variations of this indigenous traditional medicine are practiced in Sri Lanka, Burma, Laos, P. 22 Cambodia and, of course, Thailand. There is also a dramatic similarity to Traditional Tibetan Medicine, Amma/Tui Na of China, the Anma/Shiatsu of Japan, and Filipino Hilot. History is unclear as to when specific developments were incorporated into the traditional medicine catalog of practices. Additionally there is a lack of documentation of the family, tribal and village specific practices that were passed on through oral tradition and not documented in the “official” and or sanctioned records and historical text. Further example is the significant differences, both historically and in contemporary, between “Official” Traditional Medicine practices and the “Rural” traditional medicine practices found in remote villages and among tribal communities. We don’t see the first official documentation until King Rama commissions the medical tablets (epigraphies) made and enshrined at the new Wat Pho in the 1830’s. According to the custodians of Wat Pho, after the capital (Ayutthaya) was destroyed in 1767 by Burmese invaders, rescued fragments of the original documents were used by King Rama to make the new ones. These tablets are a text of the theory behind ITTM and show the Sen or lines of energy running throughout the body. These charts of stone depict sixty figures, thirty of the front and thirty of the back. There are channels and points clearly displayed. One interesting observation is apparent: many channels directly correspond to Chinese meridians and special or Extraordinary vessels. Others correspond to the concepts of Prana Nadis from classic Indian Ayurvedic medical science. The charts detail many major and minor Marma/Chakras or centers of energy. In Traditional Thai Medicine these centralized point locations of energy/wind/breath/air are called “Lom” or Wind Gates. “Chart depicting female balancing points: Wat Po Massage Pavilion” The depiction of the knowledge of traditional medicine at Wat Po (Bangkok) and also at Wat Raja Orasaram Ratchaworawiharn (Thonburi) were considered incomplete. This was perhaps intentional as the “Secrets” of healing practiced by the Royal Court Doctors (Maw Nuad) at that time were closely guarded. The Royal practice of medicine was more likely passed on from one generation to the next within the family… father to son or nephew in formal apprenticeship. P. 23 Wat Raja Orasaram Ratchaworawiharn ITTM detail: Engraved stone plaque: Wat Raja-Orasarem, Korat In addition to the famous “Epigraphies of King Rama” ( Carved stone medical text) located at Wat Po and Wat Raja-Orasarem (King Rama III: in the Thai/ Chinese style called “The Royal Favorable Art” style) , there are also gunite statues of Thai Reishi Yogis practicing the various Asana or traditional Yoga postures - The Thai variation of Hatha Yoga or self treatment. In the past there were more than 100 of these interesting figures scattered about the courtyards of Wat Po. However, over the years many were damaged or deteriorated due to weathering and have been retired for preservation. The Yoga of the Thai Reishi is referred to as Reusi Dottan. In Thailand’s past, the people came to the temples for just about everything from medical help to education. Anyone could come to the temple for food, shelter, medical or spiritual healing. ITTM (Traditional Thai Medicine/Traditional Thai Massage) contributed to the emotional, physical and spiritual well being of the ancient Thais, and it continues to do so today. Thai culture as a whole is a blending of many cultures from east to west (India to China and from Tibet to Indonesia) and ITTM reflects this. In the present day, there are two primary schools of indigenous traditional Thai medicine and indigenous traditional Thai massage (Thai Yoga) and several minor. As well there are many private teachers and monks or nuns passing on multi-generational teachings in the oral tradition. Many of these, having grown up in families practicing for several generations, are very knowledgeable. P. 24 It is relatively recent in Thailand’s history (1990’s), that the Royal Thai Government under various ministries has shown interest and made dedicated efforts to catalog the various traditional schools and teachers from the entire country. Initially the emphasis was on the “official” or Bangkok styles and schools and over the years wider research has involved many more variations. There is now standardized practice and curriculum for the traditional practices under the Union of Thai Traditional Medicine Society (UTTS) which has been recognized by the United Nations formally as the Indigenous Traditional Medicine of Thailand (1978: WHO UN DESA, recognition Indigenous and Traditional Medicine). There are famous and well known traditional schools such as the Traditional College of Medicine, Wat Pho, Bangkok; Wat Raja Orasanam, Thonburi; Anantasuk School of Thai Traditional Medicine: Wiangklaikangwan Industrial College: Hua Hin and Lak Sii (Aachan, Phaa Khruu Anantasuk); Ayurved Vidyalai: Bangkok and the Foundation of Shivago Komarpaj, Buntautuk Old Medical Hospital in Chiang Mai (Founded by Aachan Sintorn Chaichagun in 1973). There are also satellite or derivative medical schools in the Wat Po tradition in various areas of the country outside of Bangkok located in Lamphun and Chiang Mai. Indigenous, Traditional Thai Medicine and Massage is also taught in other local temples, temple auxiliaries and by various competent individuals from Chiang Mai to Sri Lanka. I refer to the Wat Sawankhalok Medicine School for the Blind (Aachan Tawee), The School of Traditional Medicine at Wat Suandok in Chiang Mai, and Wat Amperwa, as well as in traditional sword fighting schools such as the Buddhai Swan Institute formerly located in Nongkham and now in Ayutthaya. The practices of ITTM are found in the Muay Boran and Muay Thai Boxing Traditions. Lastly, you see the practices and Ayurvedic influences in the Reusi Dottan or “Reishi/Yogi” still practiced and currently experiencing a renewed interest. PLEASE NOTE: Today the official designation of the Indigenous, Traditional Thai Medicine abbreviation in common use is TTM. For the purposes of this book, as we wish to emphasize the indigenous and traditional origins of both what is formally recognized and the oral traditional practices passed on and in common use by family, tribal and temple institutions, we will use ITTM. Much progress has been made towards formal recognition of ITTM in Thailand. It is now officially recognized with parity of its primary competitors the institutional and or corporate based western Allopathic medicine and that of Traditional Chinese Medicine. The Thai government defines the highest standard on ITTM practitioners i.e. Traditional Doctors (Moh Boran and or Moh Phaen Boran) as those “practicing the healing arts by means of knowledge gained from traditional text or study which is not based on science.” [22][23][24][26][27]. P. 25 This is not to say that the essentially traditional practices are unscientific! Many aspects and uses of ITTM for the reduction of suffering and the curing of disease have been clinically verified in published scientific articles and clinical trials. Today’s path for formal recognition in Traditional Thai Medicine (TTM) [24} Traditional Doctor follows a rigorous and defined course of study and National examinations followed by licensing.[27] Training duration, depending on area of specialization can be anywhere from two to four or more years. This is due to the long catalog of traditional areas of specialization from the Hands-on/Chirothesia to practices of Midwifery, Bone Setting, Herbal Medicine and more. The historical records appear to concur that from the earliest time the practice of medicine and traditional healing was a sacred act, performed by individuals obligated under oath to perform healing as a spiritual practice and sacred duty. Origins of the Thai people There is some controversy and differing opinions as to the historical origins of the Thai people who came to found the country of Thailand. Formerly the country was called Siam, a designation which likely originated with the Portuguese, who were among the first westerners to visit the region. Some historians estimate that the origin of the Thai people is in the north of what we today call Siberia. In a latter period, these people immigrated in a southerly direction and eventually settled in China in an area from the Huang Ho River downward. About 2,500 years before the Buddhist Era (about 4,500 years ago) displaced Chinese people crossed the Thien Cham Mountain and began to infiltrate the basin of the Huang Ho River. They met the “Ai Lao” or “Thai” people there. The Chinese called these people “Tai” meaning powerful and prosperous. The Thai themselves have always preferred to refer to themselves as “Meung Thai.” Recently, however, this migratory theory has been challenged by the discovery of prehistoric artifacts in the village of Ban Chiang in the Nong Han District of Udon Thani province in the Northeast [28]. There is evidence of bronze metallurgy going back 3,500 years, as well as other indications of a far more sophisticated culture than any previously suspected by archaeologists. Based on these discoveries a new origin theory has been proposed: the Thais may have originated here in Thailand and later scattered to various parts of Asia, including China! It is significant to note when talking about the history of Thailand that the Thais were not the first inhabitants of Thailand. Although over time the Thais became dominant through military conquest the majority of their subjects were not Thai. They were the remnants of the Mon/Khmer dynasties that ruled from India to Vietnam. The Mon/Khmer cultures had originally been part of a great Hindu empire that stretched from Tibet to the Philippines by way of South and Southeast Asia. Historically this Hindu empire dating back to the lifetime of the Buddha (500 BCE) was known as the Majapahit (Maharlika) empire (Virgil Apostal: Way of the Ancient Healers). Thai rulers in their expansion and southward migration gradually adopted many of the ways and cultures of the people they came to rule. According to researchers (Braun and Schumacher: Traditional Herbal Medicine in Northern Thailand: White Lotus 1994) [2] “The Thai Court followed a pattern of adopting (and adapting) the indianized culture of the people they conquered. During the Ayutthaya period Indian influence thus became firmly established in many domains: the concept of divine kingship replaced the original Thai version of feudalism; Indian Law - The Code of Manu - became the model for Thai law; The astrologers surrounding the king were Hindus; the alphabet was modeled after Indian (and Khmer alphabets); Indian literary genres and metrics were introduced and of course Buddhism became the national religion. P. 26 Please note: The Thai did not entirely abandon their original Chinese influenced heritage, according to Braun and Schumacher and other sources (Andaya, Reid, Wyatt, Wood). The Thai Kings up to relatively recently, this last century, looked to the emperors of China for official recognition. They maintained relationships formally through tributes made to the Chinese court and through trade. Large numbers of Chinese have always been part of the great migrations into Thailand bringing with them their cultural identities. We can see the Chinese influence in Wat Raja-Orasarem (Korat) and in Wat Po (Ayudthaya/ Bangkok) temple design. Wat Raja-Orasarem is literally a Chinese style temple built according to Feng Shui principles with eight sides, large circular doors, Chinese style mosaic decoration throughout and a grand multi-tiered pagoda right in the middle. Wat Po has adjacent to the Reclining Buddha statue an actual Taoist shrine and large guardian statues in the Chinese style posted at all entrances and exits. The Thais apparently split up into two main groups as they traveled along the southern part of China. One group eventually settled in the area of what is now Northern Thailand establishing the Lanna kingdom. The second group settled further south and after being conquered by the Khmer (Angkor: Kampuchea) founded the kingdom of Sukhothai. The Thai united and set up a large territory which they called “Narn Chao.” They controlled this area from approximately 648/B.E. 1192 to 1253/B.E. 1797, for a total of about 600 years. The Chinese continued to press the Thai people until finally a famous Chinese emperor, Ng Quan Lee Cho or Kublai Khan, lead a large army against the Narn Chao and conquered the territory. Most of the Thai’s fled further South, although there are still ethnic Thai people in the area of Yunnan China today. The remaining Thai people settled in the area which they now predominate and set up independent kingdoms (Ngoenyang, Sukhothai, Chiang Mai, Lanna) much like those of India of the same period. These kingdoms were assimilated into the kingdom of Ayudhya around 1369/B.E. 1913. Krungthep Dvaravati Sri Ayutthaya (also spelled Ayudhya, Ayudthaya or Ayuthia) was capital of Thailand for 417 years under 33 kings of the Ayudhya Dynasty. At its peak, this capital was larger and cleaner than contemporary European capitals. Ayudhya was founded on an island bordered by the Lopburi River on the North, the Pasak River on the East, and the Chao Phyra River to the West and South. In the 11th century A.D., before the Thai settled, there existed a small outpost settlement formed and named Ayudhya by the Khmer who dominated this region of the Menam Chao Phraya. Ayudhya was of some importance because it formed a boundary with the U-Thong (a vassal State under the Sukhothai - the first integrated Thai kingdom called the “Cradle of Thai Civilization”). The first King of Ayudhya was Somdej Phra Ramathibodi. The kingdom was ruled in succession by 33 kings for 417 years, from A.D. 1350 to A.D. 1767. Royal Chedi at Ayudthaya (World Heritage Site) When the original buildings of the new capital were completed in A.D. 1353, King Ramathibodi built the temple Wat Buddhai Swan on the site of his first residence at Wienglak. It is this wat or temple which became the home and training ground for the P. 27 Kabri-Kabrong Fighting Arts. These Arts were practiced by the monks as a form of meditation andphysical exercise, and the monks themselves were responsible for training the royal family and the military. Essentially, this tradition continues to the present day. Similarly, Wat Chetuphon (Wat Polater rebuilt in Bangkok) was also established as a teaching center for traditional healing and medicinal arts. In addition to the Chinese influence which the Thais brought with them and the integration of the Indian culture via the Mon/Khmer cultures they conquered, there was significant and continuous migration, trade and exchange directly between all of the neighboring states and cultures such as India, Burma, Malaysia, Indonesia, Cambodia, Laos and as far away as Persia and Japan. It is said there was one king of the Ayutthaya period whose entire personal retinue of bodyguards were Japanese Samurai! [7] This is part of the Buddhai Sawan history of the development of the Thai Martial Art Kabri-Kabrong which includes the use and techniques appropriate for the Katana and the Thai equivalent the Maha Deo or Great Sword. Phaa Khruu Samaii Mesamarn once gave a lecture on the Japanese influence in Thai Sword fighting and in Thai healing arts saying the Budo arts and Japanese (Chinese) Amma was influential beginning during the Ayutthaya kingdom period. Some of the Samurai allegedly returned to Japan where we suspect they shared Thai teachings of medicine and martial arts as well. I have two possible examples: 1) The “Extraordinary meridians” of Shiatsu Anma (Massanauga/ Ohashi Schools), which are virtually identical to the depictions and stated functions of Thai Sen Lines. This was corroborated by me in discussions with Dr. Do An Kaneko, PhD researcher, University of Tokyo in 1989 and 1991. 2) Historical accounts of Japanese merchants and Samuri in Ayudthaya from the Twelth century through the fall of the old capital[8] [9] [10] [11]. “Thai-Japanese Relations in Historical Prospective (1988), edited by Chavit Khamchoo and E. Bruce Reynolds; and From Japan to Arabia: Ayudhya’s Maritime Relations with Asia (1999), edited by Kennon Breazeale. From Japan, besides historical material, come numerous tales narrating the adventures of Yamada Nagamasa (ca. 1585-1630), the most prominent Japanese figure in the history of Ayudhya” [7]. Yamada, a Samuri was first famous as a warrior and later in life as a merchant. There was a vibrant Japanses enclave in Ayudthaya for hundreds of years. There were also many accounts of commerce and communications, trade and exchange between the Thai Kings and Japanese Shoguns.” It is estimated that the Japanese district, in its heyday of the 1620, counted 1,000 to 1,500 inhabitants[29], making Ayudhya’s Nihonmachi the second in population size of the Japanese enclaves in southeast Asia. To the present day you will see ancient and famous Japanese weapons: Katana, Daisho, Yori etc. in the Royal Museum weapons Armory in Bangkok. Thai Kings in Royal Regalia wear and/or hold a Japanese sword decorated in the ornate Thai style. Burma was certainly one of the primary sources of cultural influence, however, with a periodically contentious and or warlike relationship. The period of settlement in the old Capital of Ayudhya is significant in that it was marked with numerous altercations and battles with the neighboring country of Burma. The Burmese captured the Capital of Siam (as it was called in 1568/B.E. 2112) and took most of the population as prisoners back to Burma (Myanmar). During this time period, Siam was a vassal State of the Burmese. Around 1582/B.E. 2126, the Thais, led by the self-declared Thai King Naresuan, revolted against the Burmese. King Naresuan had become famous for being a great boxer or fighter and founder of Buddhai Sawan. King Naresuan and the Burmese Crown Prince met in single combat mounted on elephants. They dueled fiercely and King Naresuan defeated the Prince and the Burmese army was routed. (A monument to both King Narasuan and the Kabri- Kabrong arts is located in Phitsanolaok not far from the night market.) In 1781/B.E. 2325, King Phra Buddha Yodfa Chulaloke ascended the P. 28 throne as the first King of the Chakri Dynasty. Thailand continued as an independent State from this time to the present day where it is currently under the patronage of H.M. King Bhumibol Adulyadej, ninth King of the Chakri Dynasty. The capital of Thailand presently is Krungthep or Bangkok, where the King resides in the Grand Palace next to Wat Phra Kaeo, the Temple of the Emerald Buddha, and Wat Pho, the Temple of the Reclining Buddha. Khmer/Mon/Sumatra/Majapahit Cultural Influence The influence of the Indianized Khmer/Mon culture in all aspects of traditional life in much of the central and western regions of Thailand should not be underestimated. Most aspects of life reflected this influence including the colloquial traditional medicine practices of the era. For a little over 300 years Mon/Khmer and Sumatra culture was the dominant culture of the region. Khmer culture was a Vedic culture, revering the Hindu art, culture, and text of classical India including the practice of traditional or classical Ayurveda. Khmer style architecture and decorative detail: Srisatchanali/ Sukhotai According to the World Health Organization (WHO) Legal Status of Traditional Medicine and Complementary/ Alternative Medicine: The use of traditional medicine is documented in the stone inscription of the King Chaivoraman (around 1182-1186) who ruled the Khmer Kingdom (Thai/ Cambodia) which is in the northeastern part of Thailand.Traditional medicine was used in one hundred and two hospitals which, at that time, was called ‘Arogaya sala’.[25] [31] “ P. 29 It can be inferred that Khmer doctors practiced Ayurveda and Vedic medical astrology (Jyotish). Remnants of this practice may be seen today in the Anantasuk TTM practice of medical astrology (Anantasuk Korosot) as taught at the Wiangklaikangwan Industrial College TTM curriculum in Hua Hin. From the 9th to the 11th century, the central and western area of Thailand was occupied by the Mon civilization called Dvaravati. The Mon share the same common lineage as the Khmer and settle in southern Burma later. The influence of Dvaravati includes Nakhon Pathom, Khu Bua, Phong Tuk, and Lawo (Lopburi). Dvaravati was Indianized culture, Theravada Buddhism remained the major religion in this area. After 1157 CE [25](Chockevivat, Chuthaputti, Chamchoy), Mon heavily influenced central Thailand. Khmer cultural influence was brought in the form of language, art and religion. The “Sanskrit” language entered in Mon-Thai vocabulary during the Khmer or Lopburi Period. The influence of this period has affected many provinces in the north-east such as Kanchanaburi and Lopburi. The Architecture in “Angkor” was also constructed according to the Khmer style. The Khmer built stone temples in the northeast, some of which have been restored to their former glory, those at Phimai and Phanom Rung and further cultures are stone sculptures and stone Buddha images. Politically, however, the Khmer cultural dominance did not control the whole area but exercised power and cultural influence through vassals and governors.” [32] Sumatra/Sumatran culture, a Buddhist culture until the 1300’s when it became officially Muslim, controlled or ruled southern Thailand and especially peninsular and coastal Thailand. Originally called the Melayu Kingdom (Malayu, Dharmasraya Kingdom or Jambi), it was absorbed by the Kingdom of Srivijaya. Sumatra was a vassal state in the Majapahit Empire which stretched from Sumatra to New Guinea. The Indianized Sumatran/Majapahit culture and trade were certainly factors in early Thai history from the Ayutthaya and Bangkok periods first simply because these were the culture and belief systems of the indigenous people who lived there before being assimilated into the Thai Kingdom and secondly due to trade and exchange. The common traditional medicine of the Majapahit was Ayurveda and their famous martial arts were based on Kalaripayattu. Thai Kings, traders and military would have encountered all of them! The vast Majapahit Empire controlled the seas and trade routes of the Asian, SE Asian, Malaysian, and Indonesian archipelago all the way to the Philippines. Keep in mind trade is a two way system and ancient trade always included medicine and medicine practices. The history and research I have given here is far from complete! My intention is to give the reader/ student a background and context for the birth and development of the Royal Thai Traditional Medicine and Healing system (Indigenous, Traditional Thai Medicine: Indigenous, Traditional Thai Massage: ITTM) which we simply call the Southern or Royal style. P. 30 Chapter 2 Introduction to ITTM According to Vichai Chokevivat, M.D., M.P.H, Department for the Development of Thai Traditional and Alternative Medicine, Ministry of Public Health, Thailand [27] “TTM is regarded as comprising the traditional philosophies, bodies of knowledge and modes of practice to care for the health of Thai people that are congruent with Thai culture and way of life, and based on the principles of Buddhism. TTM uses various forms of practices to complement each other, i.e., medicine, pharmacy, massage, midwifery and maternal and child health care, Buddhist rites and meditation, as well as other rituals based on the belief in supernatural power or power of the universe. TTM is a holistic and natural approach of health care that is derived from Buddhist beliefs, the observation of and respect for nature, and the wisdom of Thai ancestors. In addition, traditional knowledge of TTM was also built through the processes of “selection”, “adoption”, “adaptation” and “utilization” of traditional medicine of some countries with which Thailand had contact in the past, e.g., India and China, to suit the Thai way of life. Reshi Garden at Wat Po ITTM is a highly sophisticated and well-developed form of healing and manipulative therapy. Refined by diligent practitioners over a period of thousands of years, ITTM is not an anachronism, but a valid and scientifically based form of healthcare with a genuine historical basis, in common use and helping millions of people for hundreds if not thousands of years. The possibilities are only limited by the technical sophistication and imagination of the practitioner. The Thais believe all things should be considered with an open mind. This book should serve to give a very good idea as to the variety of benefits realistically attainable through the practice of ITTM. However, no book is an adequate substitute for a competent instructor or school. It is important to place a priority on finding a personal teacher if you really wish to master this or any sophisticated form of healthcare management. P. 31 How To Study Indigenous, Traditional Thai Massage There are nuances of technique and application which cannot adequately be conveyed, however detailed the text or photographs. If you choose to undertake the practice, work with a reliable consistent partner. GO SLOW! This system may also be used quite successfully in cooperation with many healing methods such as Native American Medicine, Traditional Natural Medicine (Naturopathy and Monastic Medicine), Neuromuscular therapy or Craniosacral therapy. It is especially well integrated with other oriental systems such as Shiatsu, Anma, Amma, Tui-NA or Jin Shin Do. The following principles, although not Thai in origin, taught to me by friend and former teacher, Kali and Jeet Kune Do Master Sifu Danny Inosanto (Bruce Lee protégé) will serve you the student as they have served me. 1) To “research your own experience” is to take stock of your capabilities physically, emotionally and spiritually before you ask for more. Find that which is relevant and useful from your own life and experience. Find that which is not useful. Correctly appraising one’s skill or knowledge often becomes the beginning of attaining wisdom. 2) To “absorb what is useful” is to consciously expose oneself to experience and information which is expected to increase one’s being. Knowledge may be useful, practical experience may be useful. But it is not enough just to gain access or proximity to these things which are useful, one must be prepared to receive them, to take them in. The Zen practitioners have a saying, “One may not add to a full cup.” Empty your cup! 3) To “reject what is useless” is to purposefully remove unproductive elements from your life or to extricate yourself from an unproductive area or situation. It also has the connotation of giving up or releasing attitudes and emotional baggage which may buffer or hinder you from reaching your true potential. There is an element of being selective of the many impressions chosen to be a part of one’s life. Also it refers to “doing,” to being an active participant, an “author of you own experience.” 4) To “add something specifically your own” is to draw upon your personal nature, experience and background. Your intuitions, insights, skills and information are as real and valid, as valuable as those from any other source. Your intuition may be correct. You may very well know what to do or where to go. This “adding to” is what makes the teaching personal and really practical. What you will end up with is a science and art that is practical, efficient, powerful and uniquely personal. However, there are additional guiding principles at work here such as “Give credit where credit is due” meaning to pay respect to the actual people who gave you what you value and to not pretend that you invented it! Additionally, the following tips will be of use. 1. When working with the body, everything is important, nothing is insignificant - seek to see the big picture by seeing the whole person, mind, body and spirit. 2. Don’t just go through the motions, try to understand why things are done as they are done. 3. Don’t do anything to anyone until or unless you know the reason, and know what to expect as a likely result of your actions and intent. 4. Intent is more valuable than technique. There may be many ways to accomplish the objective but first you must be clear as to what that objective is. Additionally, focused intent affects energy. 5. Seek to master the technical aspects of the work, the pathways and SEN, the physiology and P. 32 philosophy of the art as presented. Develop a clear understanding of the western anatomy and physiology; know the muscles, bones, nerves and circulatory systems affected by each movement. 6. You should be able to trace the SEN in the body and readily locate the chakras and major energy points. 7. The practitioner’s own strength and flexibility are important. Tai Chi, Qigong and Yoga training are all valuable and productive. Internal training and meditation are great assets: how can you direct and influence another’s energy with sensitivity if you have no valid conception of your own? 8. Phaa Khruu Samaii Mesamarn said “Go slow, slow. The slow, slow way is best.” Wait for the response to happen - everything in life changes at its own rate or in its own time. 9. Repeat and repeat every movement until the technique and method become second nature. Relax and train until you are able to function instinctively; at this point you will be able to bring your full attention to the client as opposed to thinking about what to do next. 10. Follow the Taoist maxim “At least do no harm.” Purposes Of Indigenous Traditional Thai Massage Indigenous, Traditional Thai Massage (Thai Yoga Therapy) is used to facilitate and promote an harmonious state of being. The ancient Thai people recorded various states of disease and imbalance within the body, the mind and the emotions. The Ayurveda theory of the elements and their relationships: Taad (Dhatu) stated that everything is made up of four principle elements Lom (Air), Fai (Fire), Din (Earth), Naam (Water) and a hidden fifth Lomnaichongwanng (Ether). One element will always be dominant: Tard-chao-ruan (Prakruti). When balanced in relation to each other and appropriate for the season and the diet or food being eaten the person is healthy and happy. When out of balance and or harmony with either each other or the season, food or lifestyle of the person disease would manifest. Over a period of time, practitioners carefully devised creative and practical methods of influencing the course of these imbalances. This was important as imbalances prevented people from fully experiencing life in a productive way. If someone suffered a trauma or injury then various therapies including the use of herbs and medication (singular and complex formulas) and spiritually based interventions including hands-on therapy were the primary method or vehicle of rehabilitation. If, for instance, a person suffered from disease related to poor circulation, it was noted that direct treatment not only could reduce the swelling, but that it could reduce or diminish the pain as well. ITTM could expand a person’s ability to move or relax someone overly excited. ITTM was never traditionally used as an exclusive therapy as the basic theory of disease indicated that any specific disease or trauma to any part of a person involved all of the whole person. Not only was ITTM one of the first traditional medical systems to recommend nutritional strategies as a first or primary response to all diseases, it was classically holistic with a multi-modality approach. Over the years the list of benefits of ITTM has expanded, but these can be categorized generally: Enhances Spiritual Practice supporting integrity within and without Enhanced body/mind connection Expression of loving kindness and nurturing Relaxation Reduction of pain Reduction of swelling/edema P. 33 Increased range of motion Management of stress See Appenix #1 Passive exercise Evaluation of soft tissue status Preparation for exercise Detoxification of soft tissue Directly alleviate and or cure specific illnesses and or disease conditions and syndromes Maintenance of general health without indications of disease This list of benefits is not complete or comprehensive. When we make a list of the modern benefits researched and clinically validated we see over 70 specific disease conditions in which the outcomes are improved, symptoms reduced and or have better outcomes with less side effects and or adverse results. If we then add the list of the traditional 100+ (unlimited) cures for diseases anecdotally and traditionally credited to ITTM the total list of ways ITTM is a boon to mankind as a healing art and Venerable Prakru Pipitpattanapirat, Abbot: Wat Prakeodontao Suchadaram, Lamphang, Thailand science is substantial. Equally substantial to any stand alone traditional medicine system such as Classic Ayurveda and or Traditional Chinese Medicine. Traditionally the Thai have always considered ITTM as a vital and integral part of their health maintenance practices. Until relatively recently (World War II), the use of massage and the use of herbal preparations constituted the bulk of their formal medical treatment for all diseases. Even with the advent of modern Western style hospitals and medical delivery models, the Thai people continue to rely on traditional therapeutic remedies. P. 34 Chapter 3 Preparation for the Session THE PRACTITIONER The practitioner should be mentally, emotionally and physically ready; that is, in a frame of mind to use the massage as a means of expressing care and compassion. The practitioner should be relaxed and healthy, not unduly under stress and certainly not under the influence of drugs or alcohol. Cleanliness and hygiene are paramount. Warm hands and short finger nails are also important. The practitioner should wear loose fitting, comfortable clothing, allowing for freedom of movement and the circulation of the practitioner’s own energy. It is inappropriate to wear rings, watches or bracelets which might distract from or interfere with the session. Before beginning, the practitioner should practice or recite the puja or prayer. It does not have to be a Buddhist prayer, as the practitioner may follow any creed. But the minute of quiet meditation and affirmation serves to ground one before actually touching the client. Additionally, the clothing and dress of the practitioner should be clean and neat, a reflection of the practitioner’s personal hygiene which should be exemplary. To prepare well for the intended work at hand is to be responsible for the intended result. To be ambiguous in preparation and action is to predicate ambiguous results. Everything is important. To quote the first century stoic philosopher Epictetus: “No part of life is exempt from needing our careful attention. Will you do anything the worse by taking pains and the better by neglect? Is any other, even the minutest operations best performed heedlessly?” THE CLIENT The client should be ready, able and willing to receive the session. Healing therapy is an intimate interaction involving often intense physical contact. Trust is imperative. The client should undress only to his or her level of comfort not for the convenience or comfort of the practitioner. ITTM may be performed perfectly with clothing on. If clients are clothed, the clothing should be light and non-restrictive to allow for unhindered movements. NOTE: Tight or restrictive undergarments and jewelry should be removed. The client should be on a thick blanket, futon or mat. The surface should not be too soft, as a soft surface tends to absorb the pressure the practitioner is trying to generate. The Corpse Pose (Savasana) The practitioner begins the therapy by placing the client in the supine, corpse pose or savasana. The client is instructed and assisted into a position lying flat on the back. The body is then adjusted to relieve or release any unnecessary tension. This is done by gently rocking the client’s body, beginning P. 35 at the hips and working down the legs. The legs are turned in and out several times, then allowed to fall gently to rest. It is useful to instruct the client to tuck the chin inward slightly, elongating the neck and helping to relax the spine. The practitioner may roll the client’s head back and forth before allowing it to sink and settle into its natural resting position. It is a good idea to concentrate or focus the client’s attention on the breath by having them breathe deeply and slowly from the abdomen. They will experience a relaxing state and a sense of sinking into the mat. Follow this same procedure when the client is positioned in the prone corpse position as well. Positioning the Client Specific positioning of the client is addressed for each technique, but as a general rule, the client should always be comfortable and well supported; the client should not have to exert any effort to hold himself in position. There are definitely times when it is appropriate to use pillows and bolsters to support or brace the client securely. A good example of this might be when the client is positioned in the Side Lying Position (S.L.P.) and support is appropriate for the head. THE SETTING A comfortable and pleasing environment is complementary to a peaceful state of mind. A peaceful mind complements a harmonious physical state, both for the practitioner and the client alike. The optimal area for massage should be distraction free, clean, quiet, well-ventilated. Outdoor places such as under a shaded tree or in a grassy field, a beach, beside a pond or lake or in a forest are all excellent choices. If the session is held in an office environment, it should be warm and comfortable, appealing and inviting. Songs or music without lyrics are preferable to enhance a relaxing mood. Many practitioners may work well sharing the same pleasant space. Pleasant aromas or natural fragrance are also complementary. In Thailand, it is common to find fresh flowers around the treatment or counseling area. Incense may be used but, care should be taken to avoid over stimulating the practitioner’s environment since some clients may be sensitive to the smoke. There should be no bright light shining directly on the client. Indirect, soft light is preferable. The exception to this is when doing very specific therapy; for example, when treating a knee or jaw injury for trigger points specific lights may be necessary. PRINCIPLES OF ITTM The practitioner and client should remain “centered” throughout the session. That means mentally and physically concentrated on the present moment and movement. Participate in the experience without straying into the past or future. If thoughts which are not relevant come up do not pursue them to excite them or give them more substance. Rather, let them simply pass on without owning or encouraging them; they will pass if you do not identify with or attach to them. P. 36 It should be understood that there will be a minimum of conversation which usually has a tendency to wander (i.e. “Who won the game Saturday,” or the like). The practitioner should take a quiet moment, but it is better if the practitioner and client can pray or meditate together to calm the mind. The client may be instructed to bring his attention specifically to the area of the body being treated. GO SLOW. Whenever there is a question and/or if you have to ask yourself: “Am I going too fast?” the answer is usually Yes. When in doubt, slow down. Phaa Kruu Samaii Mesamarn always said: “The slow, slow way is the best.” All pressure, regardless of how it is to be applied, is applied in a slow, firm and flowing manner. Technique should be applied by manipulating the body weight as opposed to using hand and arm strength. Lean and shift to push and to pull As a general rule, most pressure is applied for five (2 to 5) seconds and then released slowly. If a specific area is ischemic (low oxygen, poor circulation and or inflamed), or if it has taut bands of tissue, pressure may be held longer until the tissue releases ten to twelve (10 to 12) seconds. Once released, move smoothly to the next point. When applying pressure, use the breath to facilitate the flow of energy. Take a breath and exhale slowly as you apply pressure. Visualize energy rising from the lower belly or Second Chakra area upward and flowing out the arms and hands into the points of pressure. Sometimes it is useful to visualize this flow of energy as a colored light. Having a correct mental picture of the transfer of energy will intensify the results of your effort. It is often beneficial for the practitioner to close his or her eyes as this develops internal sight and proprioceptive facilitation; that is, it develops the practitioner’s ability to actually perceive or sense changes in tissue or energy states. Traditionally ITTM was an occupation of and performed by the blind. Although it’s not necessary to be blind, learning to look inward through versus at what you’re doing is helpful for training and practice. It is beneficial to instruct the client not to resist pressure. The client should “give before it,” release any counter strain and exhale, releasing tension. A common instruction we give clients, especially those new to the work is to not help or try to assist. As they do not yet know what to expect or “where we are going,” they invariably go the wrong way! The instruction to passively receive the work unless otherwise instructed by the therapist becomes one of the first and consistent core coaching strategies. This is the best advice to give in order to help clients receive fully the benefits of the work. Give the client a few moments to regroup and to recover at the end of the session; this time is especially important, as all the physical and energetic changes brought on by the massage do not manifest immediately. It is not uncommon for clients to report changes over a period of days after a good session. GENERAL NOTES ON DEVISING TREATMENTS A) Always work within the pain or sensitivity tolerance of the client. A good general rule is to use medium to firm pressure. This pressure may be described as a continuum from one to ten. One (1) represents pressure so light the client cannot tell they are being touched, and ten (10) represents pressure so excruciating they will run screaming from the room. To elicit the necessary response in the nervous system, soft tissue and fascia, the level of pressure should be about a six (6) to eight (8) on this scale depending on the client’s response. P. 37 B) Work or bring Energy, Attention, Consciousness, Breath and Pressure to the SEN or the channel closest to the specific area of pain or injury. Treat the whole line. C) Facilitate the range of motion in any joints near the area of greatest concern. D) Treat the Lom/Marma or pressure points in proximity to the area of concern. E) When there is more than one area of concern, prioritize them according to gravity or severity i.e. Acute versus Chronic. Approach with thoughtfulness and caution. Note: Oftentimes Severe injuries like broken bones do not hurt as much as bad bruises or sprains. F) Always look at the whole person before beginning any session or program and before finalizing the course of treatment. G) When a physician or doctor prescribes a particular course of treatment follow their guidelines explicitly; do not “wing it.” Do not contravene any proscription of a licensed physician. H) Clients who do not respond to the treatment, or those whose condition worsens progressively or acutely after the treatment, should immediately be referred to a competent physician. Build a referral network of medical persons you trust for this purpose. I) Begin with a general release, gradually become more specific or use more pressure, finish with the general once again. J) Pay attention to the space between one technique and another. The transition is no less important as it may reveal much and contribute much to the work as well. Think FLOW. It is important to have your own mind, your own appreciation for this work based on your own experience. Regardless of the lineage, the teacher or the origin of this work every person practicing should engage in their own practice of validation. As stated by P.D. Ouspensky in the book “The Fourth Way”: “One must not believe anything without verification and one must not believe anything until one understands why.” Make your own health and welfare a priority for your own sake, as well as an example to your client. Have regular healing sessions yourself, preferably several times a month. Build your healing integrity by submitting to the therapy you practice! All application of pressure is performed using the energy of the whole body. Don’t work with hand and arm strength, but rather work from your breath, lower Chakras and Dan Tien (energy center in lower abdomen). Practice all the principles of proper body mechanics and keep well balanced, evenly distributing your weight between the hands and the knees or the feet. Watch for unnecessary tension in your own body and relax these areas as the tension appears. This will reduce any chronic overuse strain and conserve your strength keeping your own energy from being restricted as you work. P. 38 Always keep both hands on the client. This is for security, balance, continuity and proper polarity. One hand represents a positive pole or the influence of the father and the other one a negative pole or the influence of the mother. When we ground or hold one hand or part in place while conducting a technique (Thumb Pressing, Palm Pressing etc.) on different parts with the other hand, we say this illustrates the “Mother/Son” principle. The mother is stable, central, overseeing while the son is free and darts or travels around but always within the envelope of the mother influence. As you work, maintain surveillance of the condition of the whole body as well as the specific areas you are currently working on. Have a “Soft Focus.” Be aware of and give consideration to areas of heat, cold, swellings, soft tissue variations, taut bands and tight or hard areas that should be soft, etc. It is soothing and comforting both for the client and the practitioner, to progress with a steady rhythm. Practice your transitions from one technique to the next so that they become smooth and fluid, like a dance. Dhanvantari statue. Angkor Wat Cambodia P. 39 Chapter 4 Basic Techniques And Yoga Postures Used In ITTM 1. Thumb pressure - Use the ball (tip and or pad) of the thumb to ischemically compress, to apply direct pressure. 2. Reinforced thumb pressure - One thumb is placed on top of the other to provide more potential pressure and greater control than feasible with one thumb only. The reinforced thumb also reduces fatigue for the practitioner. 3. Circular thumb pressure - Using either one thumb or reinforced thumb pressure, describe small half circles inward, then release out. 4. Rotating thumbs - Using both thumbs, rotate each one in circles either in opposition or in unison with light pressure. 5. Rolling thumbs - Press inward with both thumbs and then rotate from pressure being close to the thumbnail toward the pad of the thumb. Do this by beginning the technique with the wrist held low and then lift the wrist to change the angle of the thumb. Technically the rotation of contact on the end of the thumb is facilitated by the slight lifting of the wrist. The motion is over or away from the practitioner’s body. This may also be a rotation across the fascia, muscles, Sen or nerves. 6. Snake thumb pressure: Klai Sen - The thumbs undulate, sweeping from side to side as the hand moves along the line. P. 40 7. Palm pressure - Keep the arms locked out and use the shifting of the body’s weight to create and apply pressure through the palms. The hands may be together or separated. 8. Palm walking - Alternate palms in a walking fashion while adding pressure. 9. Rolling palms - Similar to the technique of the rolling thumbs. Press in with direct pressure and then rotate. Shifting the weight away or across the fascia, muscle, Sen or nerve. 10. Kneading - Cross the soft tissue firmly between the thumb and fingers and squeeze alternately. Starting with elbows up and dropping elbows down when you squeeze. 11. Hitting - Alternate open and closed hand techniques, striking areas of the body using light to moderate pressure. Slapping type movements may be included as well. There are fifteen or more basic striking techniques and variations are numerous. Thai striking techniques are virtually identical to Ayurveda Marma Massage, Chinese AMMA and Japanese Shiatsu/ANMA techniques. P. 41 12. Elbow pressure - Use direct pressure with the point of the elbow to give more penetration in large soft areas, or especially tough areas, than is possible with the thumbs alone. 13. Forearm pressure - Used to work a broader surface than possible with the elbow or to work areas that are more sensitive to more specific pressure. 14. Knee pressure - Kneel directly on the area to be treated; allow the hands to stabilize other areas or to work conjunctive pressure points, used to cover broad areas with great control. 15. Circular digital pressure - The fingers of the hand are held firmly together and straight out. The tips of the fingers are the primary contact surface and are applied in small circles. 16. Circular palm pressure - The palms are pressed in either small or large circles. This is generally a technique for superficial stimulation, calming and relaxing as well as promoting circulation.. 17. Reinforced finger pressure - The stiffened, outstretched fingers of both hands are used to press directly various pressure points and nerves. 18. Pinching and rolling - Tissue is squeezed between the thumb and fingers, especially good for toes and fingers. The tissue may also be pulled away from the body. 19. Foot pressure - The feet are used directly to work various Sen and points. The heel is used primarily for point application and the broad foot for the more general. This includes walking or standing on various parts of the body. ROCKING TECHNIQUE Just as we gently rock babies and children instinctively to calm them, we often do the same with adults. For when we are holding someone sick, injured or otherwise disturbed, there is a natural inclination to rock that person. Generally, this has the immediate effect of calming and soothing and it has a deep nurturing quality as well. The whole body may be gently rocked, or the practitioner may rock separate body parts, such as the extremities. Generally, rocking facilitates grounding of the client and relaxation as well. Gently rock a leg back and forth before working the energy lines, for instance. This simple technique, so beneficial on its own, is a good preparation for deeper work. Additionally, it is an excellent finishing technique after intense pressure or stretching. Rocking, by freeing joints and tissue to move, creates space in the body, also facilitating the flow of energy. YOGA THERAPY POSTURES Session protocols are facilitated sequences of Yoga Asana or therapeutic postures. Traditional, classical Hatha Yoga postures are co-facilitated by the therapist who also in turn is performing and using Yoga postures in their own movements. The Yoga Therapy Asana is represented by what both practitioner and recipient are doing together. The postures and transitions the practitioner is doing represent the Yang or masculine influence. The postures the client is being directed into represent the more feminine or Yin aspect. These different traditional postures both on the giving and on the receiving side are immediately recognizable to any Yoga practitioner and provide both benefits to clients as well as to the practitioner. P. 42 The client is taken through (literally facilitated) a catalog of classic Yoga Asana such as Corpse Pose (Savasana), Forward bends (Paschimotanasana, Uttanasana), Plow (Halasana), Backward bends ( Urdhva Dhanurasana, Dhanurasana, Setu Bandha Sarvangasana, Bhujangasana, Matsyasana, Chakrasana), Locust (Shalabasana, Dhanurasana), Half Locust (Ardis Shalabasana), Inversions such as Shoulder Stand (Sarvangasana), Warrior Poses (Virabhadrasana), Triangle and Side Postures (Trikonasana), Pigeon ( Eka Pada Rajakapotasana ), Downward Facing Dog (Adho Mukha Svanasana), Cobra (Bhujangasana), Twisting Poses (Ardha Matsyendrasana), Childs Pose (Balasana), Cow Face (Gomukhāsana). All of the facilitated postures eventually enhance the receivers access to the meditative or seated Yoga postures: Virasana, Sukhasana, Bhekasana, Padmasana as well as the unique facilitated postures derived from the Reishi Yoga (Reusi Dottan). This list is by no means comprehensive as there are hundreds if not thousands of traditional facilitated postures and there variations. Another reason it may take many years to fully comprehend and master this healing art. All the while the practitioner themselves are flowing from posture to posture in their application with the client. The sum of the two Yoga practice when done together in a dance like flow represent the Yoga Therapy aspect. Aside from the co-facilitation aspect, the practitioner applies Lom (Marma) Therapy to the Sen Lines (Prana Nadi) which are exposed and attenuated as the clients is moved from position to position. The point work on the line while engaging in the co-facilitated Yoga postures is uniquely Thai. BODY MECHANICS Principles of proper and correct posture and economy of movement should be adhered to at all times. There is always a more efficient way to perform a given technique. Avoid positions which strain the operator or which seem precarious. Always sit, stand or kneel close to the client to bring your center of gravity to bear. Keep the weight of your body evenly distributed in order to reduce fatigue. When using the hands, the knees or the elbows, share the load with the parts of your body not directly involved. For instance, when applying pressure with the palms, distribute your weight between the knees and the hands. Keep your back straight and the chin elevated. Most of all relax and breathe. When you notice that you are straining, release the tension in that area and adjust to a better position. With time and experience, your body will hunt for the path of least resistance. Proper and efficient body posture and body mechanics are one of the keys to maintaining and developing tactile sensitivity. The only way to learn the proper and refined traditional postures of ITTM is to study in person with an expert teacher. P. 43 Chapter 5 The Royal Tradition Vinyasa: The Southern Style Vinyasa is the Sanskrit term used in Yoga/ Yoga Therapy to denote a flowing sequence of Asana or therapeutic postures performed in a particular order or fashion. This sequencing is one of the key indicators of school, region, style or even specific teacher. Vinyasa provides a way not just to practice the art but represents a cataloging and or mnemonic device for memorizing and aiding in retention. The traditional flows are the oral tradition! Much information regarding the actual day to day practice of ITTM has been lost to antiquity. However, the process of implementing and applying the therapy protocols for disease and illness have not. These have been passed down from one generation to the next through the memorization and practice of specific moving mantra we call Vinyasa, and through both traditional Thai Medical codices, text and temple inscriptions, and sacred art. The ITTM Vinyasa portrayed and detailed in this book is the clearest example of the Southern or Royal traditional form as drilled and taught originally to me by Phaa Khruu Samaii Mesamarn (Buddhai Sawan, Nongkam/Ayutthaya), Phrakhru Uppakarn Phatanakit, Moh Boonsorn Kitnyam and Moh Velawong Sidtisoporn (Wat Po), Phaa Khruu Anantasuk & Aachan Nanthipa Anantasuk (Wiangklaikangwan Industrial College, Hua Hin/Anantasuk School of Traditional Thai Medicine, Lak Sii). I have been teaching this Vinyasa in every class since 1983. The Royal Vinyasa is Royal for good reason and not just because of association with the court or Thai Royal family, or for its acceptance as THE official standard by the government for all ITTM practitioners in the whole country (some say this is a biased strategy). No, for me it continues to reveal itself, it’s “Royal” nature, in its nuance, elegance, sophistication and practical applications. Practical therapeutic application originating in this form can solve a myriad of issues relating to health, wellbeing and the suffering associated with all diseases. The flows reveal different information based on the practice level of the practitioner, whether it is done fast or slow, how much the breath is emphasized, whether done meditatively or mechanically. It contains within it at least twelve different full protocols for therapy which can be used independently or as a comprehensive therapeutic protocol. For example doing a traditional assessment of Dosha imbalance and then changing the application and emphasis of the same Vinyasa creates immediately three different forms. By changing that emphasis you create a Vata balancing session, a Pitta balancing session and a Kapha balancing session! You can emphasize the lines and/or you can emphasize the Thai Lom or energy points (Jap Sen Nuad). This illustrates just one of the many ways that this system is holistic and adaptable to the client’s specific condition. PUJA/ WAI KHRUU At the beginning and end of every session we perform Puja and Wai Khruu. Puja is our traditional observance to clean house and pray for the wellbeing and happiness of our clients “May they be well and happy.” Wai Khruu means paying respect first to our founder Shivago (Jivaka) and then to Buddha, Dhamma and Sanga. The belief is that all healing comes from and is a manifestation of divine agency which in the moment we are representing. Sometimes these observances are in the form of a Mantra such as the OM NAMO SHIVAGO or similar, either prayed out loud or silently within. The idea is that the practice of Nuad provides opportunity for the healer/ therapist to make merit and for the client to receive vicarious healing via the exchange. P. 44 The Five Traditional Treatment Attitudes of the Body 1. Supine Position 2. Side Lying Position: SLP 3. Prone Position 4. Second Supine Position: Abdominal and Leg Stretching 5. Seated Position 1. SUPINE POSITION: SP (The First Treatment Attitude of the Body) SUPINE LATERAL UPPER LEG (Three Lines) Position: Seated in the wide knee sitting position, facing directly the area to be treated. Work effectively three lines, three times: first caudally, then cranially, then caudally again: i.e. Down, Up, Down. (Only work the line one time when flowing for practice and or for a shorter session.) Line 1. Visualize an imaginary line bisecting the entire leg from top to foot (toes pointing up). Starting at the first soft point below the front of the Anterior Superior Pelvis (ASIS) moving downward toward the knee (outside point #1 of the ), and lateral to the mid-line or imaginary center line, the width of the thumb. Press and hold points (Rolling Thumb) on the Sen line approximately the length of the clients thumb apart. Line 2. From a point just below the hip-bone (lesser-trochanter) One thumb length below and parallel to Line #1. The line follows the crease in the side of the thigh made by the Tensor fascia latae and Iliotibial band ending just above the outside of the knee. Line 3. Starting one length of the thumb below the starting point for Line #2, A point just below the hip bone to the crease in the upper back of the knee. As the direction of pressure is always towards the center of the body part being worked, you must get up under the leg slightly to work this line. Please note: Traditional technique is to use the Reinforced Rolling Thumb, however, if you can not bend your wrist back far enough to do it properly then invert your hands and use Reinforced Finger pressure. The back of the hand is on the mat and curling the reinforced fingers inward and upwards creates pressure on the line in the correct angle. P. 45 The basic treatment is the same as with all points in general in that they may be worked with any tool. The thumbs, palms, knees or elbows may be used to effectively massage the Sen (channel). It is recommended, however, that you begin superficially and then progress gradually to techniques which are more powerful. Also, it is important to vary the pressure according to the tolerance of the client. For instance, some people are toxic and sensitive, perhaps recovering from injury or disease. These persons would find even light finger pressure therapeutic. Always remember that it is the intent which affects the energy as much as the specific technique. Depending on the response and sensitivity of the client, it may also be possible to progress to even deeper pressure while working the same line. An example could be of using only one thumb on the first pass, reinforced thumbs on the second pass, and the elbow on the third. Other examples of changing the intensity or focus of the line work is to bring a breath or visualization focus in conjunction with pressure. The thighs in general are able to stand more pressure than some other areas of the body. However, in proximity to bony areas, joints or areas of attachments for ligaments and tendons, lighten up. These areas are almost always more sensitive. “Pressure is applied toward the center of the body part.” Indications: Line one primarily affects Rectus femoris muscle. Line two: Tensor fasciae latae, Iliotibial band, Vastus lateralis. Line three: Lower attachment of the Gluteus maximus and Biceps femoris. SUPINE ANTERIOR KNEE (Five Knee Lom/ Points) Position: Rotate and shift into a close knee sitting position, facing the client’s head. Back up until your knees are just below the bottom line of the client’s knee, sitting right next to the leg. Procedure: Work each Lom/ Marma point one time with a pressing, gliding pressure, then hold for 5 seconds and release. Almost always release slowly. Point 1 Superior lateral (Top outside) to patella, press down beginning one sun above and graduate toward the patella, displacing it caudally. Point 2 Superior medial (Top inside) to patella, same as Point 1. Point 3 Inferior medial (Bottom inside) to patella, press upward from one sun below and displace it cranially. Point 4 Inferior lateral (Bottom outside) to patella, same as in point 3. Point 5 This point is located exactly between points 3 and 4 (Centered on the patella tendon) and is treated in the same way. P. 46 Grasp the leg with both hands to pull and or push the Five Knee Points. SUPINE LATERAL LOWER LEG (Three Lines) “working line one on the lower leg” Position: center your body so as to be able to apply pressure without straining. Spreading the knees quite wide and resting them against the side of the leg being treated helps considerably. As you shift your weight forward, press directly toward the center of the leg. (Focusing pressure in visualization always towards the center or imaginary center of the part or line being worked is a constant rule of practice.) Line 1. Work one sun lateral of the tibia or shin bone, directly on the muscle (Tibialis anterior) directly to the space above and medial to the ankle bone (lateral malleolus). Press in thumb length increments along the line, with a medial shift or rolling motion at the end of the technique (Rolling Thumb technique). The direct pressure is toward the center of the leg. Work the line three times. At the end of the line on the third repetition hold the Lom on top of the ankle for five count. Note: keep the foot straight up; if it tends to roll out laterally as some do, sit closer and brace the foot inward with your lower knee or foot. Line 2. The mid-lateral lower leg line is a continuation of line 2, lateral upper leg. Begin just below the outside of the knee and proceed directly to the outside of the ankle (Lateral malleolus). The line ends four fingers above or superior to the ankle bone. Work the line in thumb length increments (Rolling Thumb technique). Line 3. The posterior lateral lower leg line is a continuation of line 3 on the lateral upper leg. You must turn the foot well inward and press up under the calf to massage this line. Massage this line three times (Rolling Thumb technique). At the end of the third repetition, hold the ankle Lom located in the cleft under the outside ankle bone (Lateral malleolus) for five count. Indications: Tibialis anterior, Peroneus longus, Extensor digitorum longus, Soleus and lateral head of Gastrocnemius. P. 47 SUPINE ANTERIOR FOOT (Lang Tao - Top of Foot) Step 1. While holding the foot firmly with both hands, begin with Reinforced Thumb Circles on the ankle Lom situated right on top of the front of the ankle itself. Step 2. Moving the hands together proximal to distal on the first line, using both thumbs gliding from side to side. One time only. Ankle crease to big toe. Use the Klai Sen or Snake thumb pressure technique. Step 3. Repeat the procedure of the first line. The second line runs slightly across the foot from the lateral malleolus to the second and third toe. Step 4. One time only on the extreme outside or lateral side of the foot from heel to the little toe. Use the Pinch and Drag (Thumb Sweep) technique, pinching with the outside hand and sweeping with the thumb across the top of the whole foot. Step 5. Circle, Pull and stretch each toe, also rolling it between the fingers. Use your center of gravity and lean back as you pull each toe. Note: Sometimes when pulled the toes make a popping and or cracking sound. This is because of a pressure change in the joint capsule of the toe itself. It is not required to make the toes pop! P. 48 Step 6. Twist the foot. Note: Applying pressure with the hand that is on the sole of the foot to ensure the leg is stable prior to twisting. While rotating the foot there should be no rotation of the leg or knee. Grasp the foot firmly, clasping the fingers together to lock it in place. Wing the elbows out to 90 degrees and then without turning the leg, twist the whole foot and ankle. First rotate inward then release and change the hand position and rotate the ankle outwards (Inversion/ Eversion). The reason we avoid rotating the whole leg while doing this technique is to protect the knee from twisting stress and to make the ankle twist more specific to the ankle. Step 7. Press the foot. Using both hands, grasp the foot firmly and press toward the ground. The hand position has both hands on top of the foot with the finger wrapping around to the bottom. This levers the lower foot over the heel, stretching and opening the ankle (Ankle extension/ Plantar Flexion). Note: Flexing and stretching the ankle, enhancing its range of motion, positively impacts a variety of disorders. Indications: sprains, strains, calf pulls, shin splints and Achilles tendon ruptures, foot stress, ankle and arch complaints are reduced. Tibialis anterior, (extensor) digitorem muscles. Sen Sahatsarangsi, Sen Thawari. Step 8. Press Toes Forward. Grasp the toes and bend them towards the shin firmly. Then as the heel or base of your palm makes contact, continue pushing strongly as if your intention was to flex the toes to touch the Shin bone. Of course this won’t happen! However the visualization gives you the correct projection and angle to properly extend (Ankle flexion/ Dorsiflexion). SUPINE POSTERIOR UPPER LEG (Ya Na Ka – Push the leg) P. 49 “Sit up straight while pushing” The client’s leg is bent and placed on top of your straightened outside leg. The client’s other leg is outstretched and held close to the practitioner’s hip with the inside hand. All of the work in “Ya Na Ka” is performed with the feet so that the practitioner’s two hands can be used to hold and support the feet of the client who is now held firmly in place. Begin massaging the second line on the medial upper thigh first (the midmost posterior line in this position). Push with the inside heel into the upper thigh at line #2, and as you release the pressure, roll the toes forward, thus moving the pressure toward line #1, or simply toward the top of the thigh. Work this line with the inside heel three times, beginning at the juncture of the knee and working to the groin area. Stay close to, but not touching the groin. In general, you will find that most clients can take a good bit of pressure with this method. However, as always, be considerate of the comfort and tolerance of the client, remembering one of the purposes of the healing sessions: the spirit of “Metta” or loving-kindness at all times. SUPINE MEDIAL UPPER LEG (Technique: Fa Meung - Palm Pressure) Position: First come out of Ya Na Ka and roll up into a good lunge. Have your outside foot just outside the knee of the client’s bent leg. Line 1. Move the leg farther inward, setting the foot of the working leg up against the inside of the still extended, non-working leg; kneeling close and bracing the client’s ankle with your inside knee, brace the client’s knee with your outside hand. There are two lines and one Lom to work on the upper thigh. On Line #1 use the Palm Press (PP) and move from inside upper thigh area downward to the knee. Palm Press the line three times (3X - Down, Up, Down). In the “Fa Meung” technique, it is important to keep the arms straight and shift the body weight forward over the hands to create pressure. Use a slow P. 50 rhythmic rocking motion, not a jerky movement. On the end of the individual movement, roll the pressure forward over the thigh and lighten up. As always exhale slightly as you rock forward projecting the breath. Remember, we don’t press on the person, we extend energy, attention, consciousness, breath and pressure, and pressure always receives the least emphasis. Line 2. Now come back to the hip area and bring energy and attention to the second line. Use the same Palm Press as on line #1. Push directly into the medial thigh. The initial pressure should always be focused internally or toward the center most of the body part being worked. In Fa Meung, use your body’s center mass to create the pressure. Do this by rocking forward into your lunge. As you move forward your pressure increases. As you rock back, away from the line your pressure lessons. Palm Press this line three times (3X - Down, Up, Down). Line two has the distinctive landmark of the Gracilis muscle. When the bent leg is adducted (moved away from the center) it flexes this muscle. When you’re Palm Pressing Line #2 you will be putting pressure on the Gracilis muscle. Using this rocking motion in the lunge demonstrates three of the salient features of ITTM. The Rocking Motion demonstrates efficiency, economy and finesse. All of these three happening at the same time indicate the antiquity and refinement of the Thai Therapeutic Postures (Asana) over a great deal of time. Efficiency means the application goes directly to the desired emphasis. Economy means there is no wasted or unnecessary exertion or motion other than exactly what’s needed. Finesse means we create maximum results with minimum effort. These characteristics are more common in traditional systems as they have been refined for generations. Indications: Affects the Adductor longus, Gracilis, Sartorius, Adductor magnus and Vastus medialis muscles. Sen Sumana, Sen Kalathari and Sen Sahatsarangsi, Sen Thawari. Open The Wind: At the top of the thigh between Line #1 and Line #2, in the Femoral Triangle there is a major Lom (Wind gate). Use Reinforced Palm Pressure, rocking forward into your lunge, then apply pressure, while sinking down and hold for a 10 count. Contraindication: Doing the “Open The Wind” technique is contraindicated for clients with severe and or an uncontrolled High Blood pressure/ Hypertension disorder. SUPINE MEDIAL LOWER LEG Line 1. The practitioner now moves their inside knee across the client’s non-working leg and sits down on their heel to face the client’s medial lower leg. Begin on the first line of the medial lower leg using the Reinforced Rolling Thumb. If this is too strong, then use only one thumb. Brace the foot with the lower hand and use the upper hand for applying technique to the line. Thumb press the line to the ankle three times (3X - Down, Up, Down). Line 2. Repeat the procedure as on line #1 down the medial lower leg/ calf all the way to the ankle. (Half way between Line #1 and Line #3 in this position.) P. 51 Line 3. Repeat the procedure as on Line#2 down the middle of the calf along the Achilles tendon to the calcaneus or heel. Supine Lower Leg Lines The three lines are easy to locate. Consider Line #1 is right on top of the calf in this position, adjacent to the Tibia (Shin bone). Line # 3 is in the most posterior aspect or in the center of the back of the Calf muscle and line # 2 is halfway between them. At the top of the lower leg the three lines are approximately the length of the thumb apart and at the ankle end they are immediately adjacent or right next to each other. Indications: Affects the Medial gastrocnemius, Soleus, Extensor hallucus and the medial side of the Achilles tendon. SUPINE INFERIOR FOOT (Fatao) Supine Inferior Foot Lines Line 1. The first line of the posterior foot begins high on the instep and progresses distally through the center of the big toe (First metatarsal). Thumb Press this line three times with Reinforced Rolling Thumbs. Pressure is toward the floor and into the foot. Line 2. The second line runs from the center of the heel (Calcaneus region) distally to the third toe. Use Reinforced Rolling Thumb technique, the same as on the first line. More attention may be given to points on the feet corresponding to problem areas elsewhere in the body (reflex areas). P. 52 Bi-Lateral Palm Press: Butterfly: Finish the foot by pressing on the whole foot with the “Butterfly Palm Press” technique. Rock all the way forward to give a broad, deep compression on the bottom of the foot. The Butterfly Palm - Palm press opens up and decompresses the arch of the foot. “Rock on and Rock off” Indications: Peripheral neuropathy, swelling and edema in the foot and ankle. SUPINE POSTERIOR LOWER LEG: Sao Nong Part 1 (Raised Bent Knee Position, Technique) “Sao Nong on the lower leg… Lean back and pull” Position: Raise up and bend the knee, sliding the heel toward the buttocks. Slide up close and capture the foot between your knees. Slide fingers under knee, lean back and pull (for stretch and decompression). From this position work the center-line of the lower leg or mid-calf area to the Achilles tendon using Sao Nong technique. Use the “Hooking Fingers” hand position (fingers bent and pointed towards the practitioner) and lean slightly backward to add pressure. As you pull back, pull the hand outward or toward the side and alternate hands, moving toward the ankle. There should be little muscular effort as you gently rock back and forth applying and releasing pressure. Work the line three times (3X - Down, Up, Down). If you have the sense of “hanging” from your hooked finger tips, your doing Sao Nong correctly. Sao Nong must be included if the client is experiencing knee pain! This position offers a unique and gentle traction and decompression of the knee joint. Sao Nong technique demonstrates the principle statement: “Any time you traction or decompress a joint there is movement of fluids. Interstitial, synovial etc. Whatever fluids return or re-inhabit the area will have more oxygen and nutrients than that which was expressed or moved out.” Indications: Affects the Soleus muscle, Achilles tendon and Gastrocnemius muscles P. 53 SUPINE ANTERIOR UPPER LEG: Sao Nong Part 2 (Raised Bent Knee Position) Hand position in Sao Nong, upper leg Without changing position, using the “Hooking Fingers” technique, work the first line of the lateral anterior thigh (Upper thigh). As the Knee is on the high side, begin at the hip and work upward (proximally) from the inguinal area. Work the line three times, (3X - Down, Up, Down). Indications: Anterior thigh muscles, Sartorius, Vastus intermedius, Vastus lateralis,Vastus medialis. Wat Mahatat: Sukhotai, Thailand: An original home for Vipassana and ITTM P. 54 SUPINE ANTERIOR LATERAL UPPER LEG (Dak Kha, Bent Inward Knee Position) “Pressing the knee to the mat in Dak Kha” Work the second line on lateral thigh with same Rolling Palm technique used in Fa Meung. Bend the knee inward and the foot to the outside in a “Hurdlers stretch” type of position. A flexible person’s knee may go to the mat; however, if unable to get the knee down, the practitioner kneels closely and supports the bent leg on the top of his thigh. Begin by bracing the inside hand on the client’s knee and press with the upper palm. Work from the hip to the knee in palm width increments, pressing in and rolling out as you release. After working the line on the lateral upper leg three times (3X - Down, Up, Down), proceed to the lateral lower leg without changing the position of the body. For the lower leg section, brace with the inside hand at the client’s knee and work the section from the knee to the ankle three times with palm press. P. 55 The Four Steps in Dak Kha 1. Test: Support the leg on your inside thigh as you back out from under the supported position, test the accessible range of motion, by pushing down with 2 finger pressure only. 2. Palm Press: Lock the end of the knee to your inside thigh with the inside palm and then Palm Press the Outside Line #1 with the outside palm three times. 3. Hit: Two Hand Hacking on the line. Really flex the elbows out and lean forward and back to move forward and back along the top of the thigh. 4. Stretch: Gently release the support and using both hands press the knee towards the floor as far as comfortably possible. Release the Asana by raising the knee straight up while pulling the foot directly up under the knee, this moves the leg back to the Sao Nong (Raised Bent Knee) position cleanly. By “cleanly” I mean without extending or twisting the knee as you recover and then move to the next position. Indications: Releases Lateral Front of Thigh and Knee: Rectus femoris, Vastus lateralis, Vastus medialis, Vastus intermedius - By releasing the lateral front quadriceps this technique also improves angle orientation of the pelvis reducing posterior compression of the low back reducing low back impingement and pain. P. 56 DAK WUKAO (Facilitated Ardis Eka Pada Rajakapotasana: Sleeping or Half Pigeon Pose: Four Positions) “Working the first position in Dak Wukao” Dak Wukao is a passive range-ofmotion type of therapeutic hip opening posture (asana) working the hip, lower back, ankle, and knee. This posture is 180 degrees rotation of the classic Yoga Therapy posture. Instead of the client facing down they are supine. Instead of the client’s body weight providing the pressure necessary for the release, the practitioner’s body weight emulates the floor! Position: Move up close to the hip, positioning your body with knees spread in such a way as to frame the hip. Raise the client’s knee upright and have their shin parallel to the floor. The first three positions are set up the same way, with only the active hand (Live Hand) moving or changing position. Additional emphasis is to direct the knee towards or slightly outside of the shoulder on the same side to avoid binding the lower abdomen. Position 1. Wrist: The practitioner takes the bent leg of the client with the lower hand and places the wrist of the top hand tight behind the knee. He then leans forward bracing the shoulder against the outer knee of the client. Pressure is applied by simply leaning farther forward, pushing the bent leg downward toward the client’s chest. Hold the bottom most position 5 seconds, then slowly release by backing up. Position 2. Forearm: The practitioner takes the bent leg of the client with the lower hand and places the middle forearm of the top arm behind the knee. He then leans forward bracing the shoulder against the outer knee of the client. Pressure is applied by simply leaning farther forward, pushing the bent leg downward toward the client’s chest. Hold the bottom most position 5 seconds, then slowly release by backing up. Position 3. Upper Forearm: The practitioner takes the bent leg of the client with the lower hand and places the upper forearm of the top arm behind the knee. He then leans forward bracing the shoulder against the outer knee of the client. Pressure is applied by simply leaning farther forward, pushing the bent leg downward toward the client’s chest. Hold the bottom most position 5 seconds, then slowly release by backing up. P. 57 Position Four. Straight Arm Press: The last and final position is to remove (roll out) the top arm entirely from behind the knee, and with one hand holding the foot and one on the knee, with straight arms, press the leg as far toward the body as possible, by leaning forward, then release slowly. Indications: Provides the external rotation and flexion that your hips need to remain agile; releases tension in your hips from sitting all day. Stretches the thighs, groin and Psoas muscles, abdomen, chest and shoulders, and neck, compresses and stimulates the abdomen, abdominal organs and the energetic structures of the Chakras, Sen Lines, Lom/ Marma from the feet to the core of the body. Contraindications: Sacroiliac injury, Ankle injury, Knee injury, Tight pelvis, hips or thighs. SUPPORTED STRAIGHT LEG (Facilitated Utthita Hasta Padangustasana: Hand to Big Toe Pose) “Working the #1 outside line” Position: Upright in a Lunge with the clients extended leg resting on the practitioners upper thigh. Rest the ankle of the extended straight leg on the top of the practitioners thigh. Take the ball of the foot in the lower hand, locking it to the side of your ribs. Once locked in place, lean forward until you feel tension locking the back of the leg and knee. Lean forward and Palm Press the lateral upper leg (Outside Line #1) from hip to knee with palm pressure (Fingers are pointing out or away from groin). Use a slight outward rotation as you apply pressure to the line. P. 58 STRAIGHT LEG STRETCH (Facilitated Ekapada Uttanapada Asana) “Use the body to move the leg” Hold (support without pulling) the knee and raise and push the ankle, stretching the straight leg toward the head. If more motion is possible, lean forward to extend. If the leg will go further than this lean, then release the tension on the leg shift your body position forward and then repeat. When you release, come out of the posture cleanly and bring the leg without stopping directly to the mat. Make nice! As soon as the leg is at rest drop the hands together onto the leg and roll the leg as if it were bread dough. Indications: Ham strings, hip and low back. OPEN THE WIND POSITION (Bput Bpa Tu Lom) •Proper hand position for open the wind technique. Kneeling to the outside of the client’s hip area, take the lower hand/palm and place it close to the inguinal area below the pelvic region - feeling for the femoral pulse. Once the pulse is located, place the upper hand on top (fingers of both hands are pointed away from the clients mid-line) and shift the body weight forward until the pulse diminishes. Hold the position for 20 counts slowly and then count to 10 as you shift backward, releasing the pressure slowly. Please Note: When performing Open The Wind, Lom or Marma point release near the groin. Please avoid placing direct pressure on the groin area itself. Plainly stated, do not poke the client in the groin with your fingers! By angling the direction of the fingers away from the center-line of the body we avoid inadvertent contact. Contraindications: In case of uncontrolled heart, hypertension, Varicose veins, Phlebitis or related issues. P. 59 SUPINE ANTERIOR ARM First Position: Medial Arm: Position: Extend the client’s arm 90° out to the side and sitting on the heels, frame the arm (work area) with your knees. There are four positions for the arm here. In the first three positions the client’s palm is facing up, turned up. On position four the palm is turned down. Step 1: First Open The Wind on the shoulder and wrist. Place the inside palm directly on the ball of the shoulder (Anterior deltoid) and the outside palm on the base of the outstretched hand. The hand position has the practitioners base palm and Carpal bones interlocking with the clients Carpal bones forming a cross or saddle joint. Rock up all the way to your knees to compress with both hands and hold for ten count. Without changing position continue Palm Pressing distally down the length of the arm along Line #1 (the most superior, medial aspect of the upper and lower arm to the wrist). Indications: There are two helpful aspects of this procedure. One is the compression on the shoulder actually decompresses the shoulder joint itself and secondly the compression on the base of the palm of the clients hand decompresses any restrictions between the base of the Carpal bones and the so called “Carpal Tunnel.” This allows for greater circulation to and from the hand while reducing inflammation surrounding the Radial and Ulnar nerves in the wrist and base of the hand. Indications: Very helpful for those suffering from Carpal Tunnel Syndrome or Repetitive Stress Syndrome (RSS) from overuse of the hand. Affects the Pectoralis major, Deltoid, biceps brachia, Brachioradialis and forearm muscles to the wrist as well as the Median and Radial nerves of the forearm. Second Position: Thumb Press: With the client’s arm still abducted to 90° (moved away from the side of the body), lateral to the body, begin in the Axilla (armpit) with Rolling Thumb pressure directly on the brachial plexus. Work down over the medial arm following the nerves to the elbow (Five major nerves extend from the brachial plexus into the arm: the axillary, musculocutaneous, median, radial, and ulnar nerves) and then follow the ulnar artery to the wrist, work this line three times (3X - Out, Back, Out). “Hands working second position“ P. 60 Thumb Press and hold the Axilla Lom for five count before moving down the arm. Third Position: Drag the arm downward to approximately 45°. Point the hand (still Palm up) towards your belly button. Knees slightly apart. Sit low and lean forward to create pressure. The inside hand reaches forward and using the Hooking Thumb technique, starting at the outside cap of the shoulder work the line from the shoulder to the center of the elbow. On the upper arm the hooking motion is inward toward the body. At the elbow, Change Hands! Continue with Rolling Thumb technique from the elbow to the wrist where you reverse direction, again changing hands at the elbow. Do this three times (3X - Out, Back, Out). Addressing these lines follows the maxim “When the line is on top, so are you, and when the line is on the side go low.” Fourth Position: With the arm still in the 45° angle, and the palm turned down in the pronated position, work downward from the cleft point between the juncture of the Posterior deltoid and Trapezius muscles to the top of the forearm (Attachment for the Pronator Teres/ Flexor carpi radialis) and the mid-line from the elbow to the wrist, three times. Indications: Affects the Pectoralis major, Anterior deltiod, Biceps, Brachioradialis and forearm muscles to the wrist as well as Brachial plexus. P. 61 SUPINE ANTERIOR HAND (Lang Myung) “Working the lines“ Step 1. Work Three Lines: Holding the client’s hand firmly in both hands (Palm still pointing downward), do reinforced thumb circles on the wrist Lom before starting each line. Working proximal to distal on line #1 using both thumbs gliding from side to side in Klai Sen technique. Repeat the same procedure for line #2. The hold the acupressure point “Large Intestine 4” (Ho Ku or Li-4) point at the proximal juncture of the first and second metacarpal, with pressure from thumb and index finger for 20 seconds, then releasing slowly. Step 2. Cross Thumbs: After working the top of the hand, flip the fingers upward without turning the wrist. Hold the hand firmly and rub and stretch the entire palm surface between your thumbs. Use the thumbs in opposition to create friction. It does not matter which side you begin from; however, be sure to thoroughly cover the whole palm area. This insures good coverage of many reflex points in the hand which may affect the whole body as well. Step 3. Stretch Fingers: Beginning with the little finger, press out and stretch each finger from base to tip. It is common practice to work two fingers at the same time, i.e. thumb & little finger, index & ring, then middle finger. Step 4. Circle and Pull: Now grasp, circle and pull each finger between your index and middle fingers in tum. The joints of the fingers may pop or crack, but it is not the sole intention. If the joint releases with an audible sound, that’s fine; if it does not, that’s fine also. Step 5. Break Bread: Grasp the hand firmly and as if you were breaking a piece of bread in half, squeeze and pull the hand apart. It won’t break! Step 6. Bicycle: Grasp the hand loosely with both hands and make a circular motion as if you were peddling a bicycle and rotate the hand: slow, fast, slow. P. 62 Indications: Affects the Trapezius, Supraspinatus, Infraspinatus and Teres Minor attachments (S.I.T.) of the shoulder, Medial deltoid, Corocobrachialis and forearm muscles. This completes the first section of the basic treatment session. Now return and repeat everything for the opposite side (Side B) of the Supine Position to balance. P. 63 2. SIDE LYING POSITION: SLP (The Second Treatment Attitude of the Body) “Massaging the inferior leg with reinforced thumb pressure” (S.L.P.) INFERIOR MEDIAL UPPER LEG Line 1: Support the ankle with the lower hand, upper hand placed at the top of the leg (as high up on the thigh as you can comfortably go) Open the Wind holding the top Lom for five count. Then work the first line with the Palm Press from the groin area to the ankle, three times, (3X Down, Up, Down). “Using the elbow to work pressure points” Return and press the line again using the elbow. However, only work three elbow points (Lom). The third or lowest elbow point is no lower than halfway to the knee itself. Starting from just below the medial knee, continue on the same line to the ankle using either Reinforced Rolling Thumb or Rolling Thumb depending on the client’s sensitivity to pressure. Practice sensitivity around the knee, above it and below it. The Adductor magnus and Gracilis muscles tend to adhere tightly to the hamstrings and the Vastus medialis above the knee. Indications: Affects the Iliopsoas, Iliopsoas major, Iliacus, Gracilis, Sartorius, Pectineus, Vastus medialis, Gactrocnemius and Soleus muscles. Sen Sumana. P. 64 “Working the second line with reinforced thumb pressure” Line 2: Line #2 in this position is found halfway between Line #1 and Line #3. Work the second line from the Gluteal sulcus (Gluteal fold) to below the ankle bone (Medial Malleolus), next to but not on the Achilles tendon with either Reinforced Rolling Thumb or Rolling Thumb pressure, three times (3X - Down, Up, Down). Optional: The second line may also be worked with the lower knee. Use the hands to support yourself and regulate the pressure. Line 3: The third line is found dead center down the back of the leg work the third line from the glutes to the ankle with either Reinforced Rolling Thumb or Rolling Thumb pressure, three times (3X - Down, Up, Down). (S.L.P.) INFERIOR FOOT Step 1. Support the foot on the bottom thigh while sitting in the Seiza (sitting on the feet) or cross-legged position and work the center line on the foot with the elbow one time. We call this an assembly line technique. You situate your body and position and then move the client’s foot to change which point is being treated. You lean forward, projecting the elbow to the same point on your thigh every time. Move the foot under your elbow in much the same fashion as moving fabric being sewn on a sewing machine is moved about under the footer and needle. Step 2. Finish with Ankle Rotations ten times in each direction. “Working line #2 on the posterior feet.” P. 65 (S.L.P.) BRING THE HEEL TO BOTTOM Bring the foot up to and alongside of your inside hip. You’ll have to adjust your inside leg to accommodate. Once the heel is in position, pivot on your knees to bring the lower leg inward until the heel reaches the clients bottom. Hold for five count. Indications: One of the best releases for the knee and Quadriceps muscles and leg lines on the anterior or front of the thigh. Does not cause constriction when releasing the Quads as some other heel to bottom poses. (S.L.P.) SUPERIOR LATERAL LEG “Working the superior leg with reinforced thumb pressure” Position: Step up into your lunge, blocking the foot on the superior leg to get into position. Line 1: Rock forward into your lunge to create pressure and Palm Press the first line from just below the hip to the ankle three times (3X - Down, Up, Down). This line ends about the width of the hand above the ankle (Lateral malleolus). P. 66 Three lines on the superior leg Line 2: Before starting on Line #2 in the SLP, drop down out of your lunge. Sit on your heel facing the bottom and the line. Use Reinforced Rolling Thumbs on the second line, midway between the first and third. This line ends just below or behind the ankle. Work this line three times (3X - Down, Up, Down). Indications: Affects the Tensor fasciae latae, Iliotibial band (IT Band), Vastus lateralis, lower attachment of Gluteus maximus, Anterior tibialis, Peroneus longus, Extensor digitorem longus, Extensor halicis longus, Gastrocnemius, Biceps femoris muscles. Line 3: Sitting in the same position as for line #2. Use Reinforced Rolling Thumbs on the third line which follows the most posterior aspect of the thigh and leg, from the glutes to the ankle, moving directly down the center of the posterior leg, onto the Achilles tendon. Work this line three times (3X - Down, Up, Down). Three Hip Points: Position: Raise up into a lunge straddling the Hip and Pelvis of the client with one foot blocking the client’s knee to keep them from rolling forward or into a supine position. The hips are cleanly stacked. The back knee on the ground in this lunge is at about the same level as the sacrum. Leaning forward with locked arms apply Reinforced Thumb pressure for five count. Release with a circular motion i.e. “Spiral Out.” P. 67 Lom/ Point Location: Point #1: Above the head of the Trochanter (first soft spot towards the head) on the center line. Point #2: In line with the knee, behind the head of the Trochanter (hip bone), (first soft spot towards the Sacrum). Point #3: Below the head of the Trochanter (first soft spot towards the head) on the center line. Point #’s 1 & 2 are on opposite sides, top and bottom of the hip bone. (S.L.P.) LOWER/MIDDLE BACK LINE/ POINTS “Working points on lower back” Position: Face the back. Sit up close behind the client with your knees wide, framing the spine. Beginning just above the sacrum, use Reinforced Rolling Thumb pressure to work the lamina groove to the top of the shoulders. Work about 8 points approximately the length of the thumb apart. Work the spinal line three times (3X - Up, Down, Up). P. 68 Indications: Affects the Sacrospinalis, Quadratus lumborem, Multifidi, Rotatores, Latissimus dorsi muscles. Sen Lines: Ittha, Pingkala, Kalathari and Chinese Acupuncture Meridian: Bladder. (S.L.P.) MEDIAL SCAPULA Position: Point both knees together at the client’s shoulder, while sitting at about a 45 degrees to the client’s back. Reach under the arm and cradle the arm and shoulder in the crook of your arm to support it. Beginning under the lower edge of the shoulder blade (medial scapula), Thumb Press the medial border and continue without stopping to the top or superior border (supra spinalis) as well. Work the shoulder blade line three times (3X - Up, Down, Up). As you work the medial points keep your elbow low. However, as soon as you “turn the corner” and are on the superior or top of the shoulder blade “Wing” or lift the elbow of the treating hand high. As you return back to the medial, drop the elbow once again. Pressure should be toward the center of the shoulder blade. The idea for techniques such as the Broken Bird’s Wing is to create an artificial or temporary center of gravity to support the Thumb or other pressure. Generally speaking in ITTM the rule is to P. 69 always work from the center, making maximum advantage of the body’s center-mass to create pressure. However, in some techniques we are working off center. By raising the elbow in this technique we support the wrist and hand reducing stress on the thumb. If the elbow is not involved then the only way the therapist can put pressure on the scapular points is by bending or hyper extending the wrist… almost always a weak position causing hand stress or injury. Indications: Affects the Rhomboids major and minor, Supraspinatus, Medial and lower Trapezius, Subscapularis and Levator scapula muscles. (S.L.P.) POSTERIOR CERVICAL: NECK Position: In a lunge, with the inside knee down and behind the back. Step over the head (But not on it!) to position your center over the neck. Support the shoulder down and slightly forward to reveal the side of the client’s neck and set the working arm against the inside of your raised thigh. To create the Rolling Thumb pressure on the posterior cervical points, simply lunge forward slightly dropping your body weight onto the hand. Be mindful and be careful not to apply pressure directly on the transverse processes of the spine. This position generates much leverage and the compression can be very strong. Start light and adjust pressure to the client’s tolerance and comfort. Begin at the base of the neck (C7 and T1 vertebrae), press in along the vertebral spine and rotate pressure outward or laterally. Apply pressure to each point between each vertebra to the occiput or base of the cranium. Repeat three times (3X - Up, Down, Up). Complete the neck area by holding the cranial base point (located between the upper attachments of the trapezius and the SCM) with Thumb Press. Drop back into a seated position on the heel to push forward on the point towards the center of the cranium. The cranial base Lom are synonymous with Acupuncture points: Gall Bladder 20 (GB 20). Indications: Affects the Sacrospinalis, Levator scapula, Upper Trapezius, Splenius capitus, Splenius cervicus, Sternoclidomastoidus and Sub-occipital muscles. P. 70 (S.L.P.) LATERAL CRANIUM Position: Still in lunge, with foot at the top of the clients head. Use digital circular pressure (thumb circles) across the temporal region of the head, just in front of the ear, and move medially around and behind the ear three times. Use a fair amount of pressure. This technique affects a section of the Small Intestine and Gallbladder meridians, with a balancing effect on emotional energy. Indications: Affects the Temporalis, Sternocleidomastoideus (SCM), Mastoideus muscles. (S.L.P.) LATERAL ARM PRESS Position: On both Knees, upright and tight to the clients body. Position yourself so you can lean forward with straight arms to create pressure. Lay the top arm straight alongside the body on top of the ribs and hip. (Ensure that hips are stacked one on top of the other.) Simultaneously press both hands, the bottom hand stays at the client’s wrist, as you work from the shoulder down to the wrist. Use palm pressure. Visualize as you press that you are gently compressing the whole body. Work downward in palm wide increments. Repeat this line three times, (3X - Down, Up, Down). P. 71 This gently tractions and decompresses the elbow and wrist while gently compressing the shoulder and torso. Not immediately visible is that this technique also compresses the axillary lymph node and vessels between the arm and the body. (Thoracic pump- facilitates lymphatic drainage in torso enhancing circulation of lymph and other vital fluids.) Indications: Affects the Medial deltoid, Bradioradialis and all forearm extensor muscles. fluids. The lateral compression of the Axilla, torso and upper abdomen indirectly acts as a thoracic pump- facilitates lymphatic drainage in torso enhancing circulation of lymph and other vital fluids. Stretches Thoracic fascia and connective tissue between the ribs. (S.L.P.) MEDIAL ARM PRESS Position: Sitting on the heels with the inside hip right up against the client’s back. Bring the client’s arm downward and back to position it over your slightly parted knees. The objective is to position the arm to rest (Palm Up) on your knees. Work the line: Hold the client’s hand against your outer thigh and Palm Press from shoulder to wrist. Then using the same inside hand Thumb Press the line from shoulder to wrist three times, (3X - Out, Back, Out). Caution! Be very gentle and slow while positioning the arm and bringing it around on to the knees. If the client’s accessible range of motion does not allow for the arm to be outstretched to 90 degrees, then slide your whole position backwards incrementally until the arm and hand can rest on your thighs. Indications: Anterior deltoid, Teres major, Teres minor, Anterior pectoralis and Coracobrachialis muscles. Brachial plexus and medial Brachial cutaneous nerve (Lesser internal cutaneous nerve; Medial cutaneous nerve of arm). Heart, Pericardium and Lung Chinese Meridians and Sen Kalathari. P. 72 (S.L.P.) SPINAL ROTATION AND STRETCH “Spinal Rotation” From the side lying position, brace the superior knee with the lower hand and move the client’s arm away from the body 90°. Now press the shoulder on the same side toward the mat as far as possible, within the tolerance of the client. It is very normal to hear one or a series of loud “pops” or “cracks” as this range of motion exercise is done. It is not the purpose of this movement to cause the back to crack. Rather, it is a stretch and rotation of the spine, as well as the muscles and nerves around the spine. This primarily facilitates the flow of chi (Prana/ sacred breath) through the bladder channel and related Sen lines. Any vertebral motion is incidental to the facilitated range of motion. The Spinal Rotation and Stretch especially when co-facilitated in cooperation with the client shows the five principles of the physical work: 1) Passive, 2) Assisted, 3) Non-specific, Co-facilitated, 4) Nonballistic, 5) Natural range of motion. This facilitated Yoga Therapy Asana, when properly facilitated, does not specifically bring pressure to any particular vertebrae, vertebral segment or Osseous structural relationship. It provides an optimum orientation of the hips, spine and shoulders to allow any corrections which can happen to happen. Note: Have client take a deep breath and have them exhale on the pressure of the rotation. Completing the stretch at the end of clients breath or the shoulder reaching the floor whichever comes first. Indications: Spine, Posterior, Lateral and Anterior Spinal muscles, Intercostal musculature between the Ribs, Fascia and Connective tissue, Sacrum, Mid Thoracic region including Shoulder on the operative side. Spinal Rotations assist in lymphatic drainage of the entire torso Abdomen and pelvis. Supports work on extremities and neck and useful in many treatment focuses including digestive issues, neurological issues and symptoms, and headaches. P. 73 3. PRONE POSITION: (Prone Savasana: The Third Treatment Attitude of the Body) PRONE TORSO LAMINA GROOVE ( Sen Ittha/ Pingkala, Bladder Meridian) In the sitting or kneeling position, use both hands to Rolling Thumb Press or compress the points bilaterally (Butterfly Thumb Technique), from the junction of L-5 and the sacrum, to T1 (base of neck). The thumbs should be just lateral to the spinous process. Work the line three times (3X - Up, Down, Up). As you treat each point, the pressure is inferior and lateral, down and out. The stride or distance between the points is the length of the thumb apart. Depending on the length of the torso work from 5 to 8 points. Indications: Affects the Erector spinae, Sacrospinalis, Rotatores, Multifidi, Latissimus dorsi, Rhomboids major and Trapezius muscles, Acupuncture Meridian: Bladder. PRONE LOW BACK LOM Position: Sit as close to the client as possible with your knees wide facing the low back. Rest the low or bottom hand on the client’s leg on the opposite side of the body from where you sit. Raise up on your knees to position the upper elbow on to the three low back Lom/ points. Keep your working hand soft and close to your shoulder. As you exhale drop your body mass to create weight in the Elbow Press. P. 74 Point #1: As close to the Sacroiliac joint between spine and hip without actually pressing on either! Point #2: The width of the elbow above the first point. Point #3: The width of the elbow above the second point. However, position this point below the twelfth or floating rib. Caution! Do not put Elbow Pressure directly on the lowest ribs in this position as the bottom two ribs are very slight and flexible. It is possible to cause an injury to these ribs with too fast or too heavy pressure with the elbow. PRONE POSTERIOR SIDE SHOULDER/ UPPER ARM Use Reinforced Rolling Thumb or Rolling Thumb pressure to work the lateral upper line from the inferior, lateral Shoulder Blade (Lateral Scapula) to the elbow (Olecranon process) three times (3X - Out, Back, Out). Change sides and repeat the Elbow Pressure on the three Prone Low Back Lom and then on the opposite Side Shoulder/ Upper Arm. Indications: Affects the Latissimus dorsi, Teres major, Teres minor, Posterior deltoid, Triceps brachia and Infraspinatus muscles. P. 75 PRONE POSTERIOR LEG Position: Kneeling between the parted legs of the client, facing the first leg (Left for women, Right for Men). Traditionally the therapist actually straddles the clients lower leg with their ankles. The toes are turned under and the feet together. The knees between the client’s legs are spread apart to give a base of support. Work the center line with Palm Pressure from the upper thigh (base of the gluteal area) to the ankle three times. Press on the foot with the lower hand while working points with the upper hand. Rock forward onto the knees and palms to create pressure. Rock back to change palm positions. Work points one hand width apart. Indications: Affects the Hamstrings: Adductor magnus, Semitendinosus, Semimembranosus, Biceps femoris, Gastrocnemius muscles and Achilles tendon. Repeat the same line with elbow pressure to no lower than halfway to the back of the knee, hold each elbow point for five count. Do not apply direct pressure to the knee with the elbow. Note: This is the same elbow technique used on the Prone Posterior Low Back Lom. Continue on the line below the knee using Reinforced Rolling or Thumb pressure, also three times, (3X - down, up, down). Repeat the process on the second leg. P. 76 PRONE TORSO AND GLUTEAL POINTS Stand between the separated knees, then kneel directly on the primary Lom/ Marma points located at the Gluteal sulcus (Gluteal fold). The knee position is such that you’re pressing halfway on the buttocks and halfway on the upper posterior thigh. Rock onto your palms and then use the palms to “walk” up the back to midway between the shoulders, three times (3X- Up, Down, Up), shifting the weight forward as you move up and backward as you move down. Indications: Affects the Gluteus maximus, six external rotators, Sacrospinalis, Quadratus lumborum muscles. THE COBRA ( Facilitated Bhujangasana) From the kneeling position on the buttocks, grasp both wrists individually with both hands and pull the arms backwards, raising the client’s body up and back. Ask the client to “hold my arms” as It is helpful if the client holds onto the practitioner’s wrists as well. Tell the client to take a breath and as they exhale do the pull up. Lean back and pull the client up into resistance being careful and considerate of the clients accessible range of motion. Hold the position for five seconds, then release slowly. Do one time only. Instruct the client not to strain or hold the breath, but to relax and exhale, releasing all tension as you pull him gently into an upright position. P. 77 Indications: Anterior Para-spinal and Abdominal muscles, Anterior Shoulder girdle and upper torso and chest, lungs when co-facilitated with the client’s breath (Prana Yama). Contra-indications: Common sense rules! Stop at resistance and work into any extensions of range of motion over time. Do not challenge rods, pins, plates and or any artificial medical devices which might restrict range of motion or access to natural motion, nor ruptured and or herniated disks, especially in the low back. Clients with medical issues severe enough to present reasonable risk of injury should do the modification: No Lift, arms and shoulders engaged only, pull the arms and shoulders down and away from the ears while monitoring the client for undue pain or discomfort. Always do Cobra slowly on new clients. Do not jerk or pull sharply at any time. THE PRONE LOWER LEG STRETCHING SEQUENCE This sequence is a perfect example of the dancing meditation and flowing motion characteristic of ITTM. Each step flows into the next with small but elegant transitions. As a whole it is restorative to tired and injured knees. It corrects and restores alignments of all structural relationships of the hip, knee and ankle. Additionally it provides gentle lengthening of the Quadriceps muscles which supports less compression of the lower back. Many times I have seen lower back pain reduce significantly after doing this sequence. PRONE POSTERIOR LATERAL LEG (Bent Knee Position) Position: Sit below the client’s knees with your knees against theirs. Generally start with the left leg for a woman and the right for a man. Fold the leg inward so the foot comes to a position over the posterior of the opposite knee (i.e. set the arch of the foot firmly against the back of the opposite knee). Press on the hip and hold for 5 count, then work the posterior lateral line with palm pressure, hip to ankle, three times. The fingers of the working palm are pointing out on the thigh and in (medial) on the lower leg. Indications: Lateral upper leg muscles, Gluteus maximus, Piriformis, Iliotibial tract (IT Band), Tensor fasciae latae muscle, internal rotation of Humerus/ Trochanter. P. 78 PRONE ANTERIOR LOWER LEG Fold the straight leg over the foot and support the ankle. Press inward on the newly folded leg close to the knee on three different Lom/ points (1, 2, 3, 2, 1) with Palm Press from just above the knee, moving upward toward the ankle and back down. If the foot is trapped and pressing into the back of the leg, the position is correct. You will notice that compression is made to the posterior thigh, calf, anterior lower leg and the ankle of the opposite foot, all at the same time. ITTM is efficient in this way of stressing several areas simultaneously. Repeat prone posterior lateral leg and prone anterior lower leg on the other side. Indications: Lateral lower leg muscles, Tibialis anterior, Semitendinosus, Biceps femoris and Peroneus longus muscles. CROSS ANKLES AND PRESS Just like the name says, then switch and repeat one time. Push to the buttocks. Indications: Releases and opens Knees and Ankles. Ankle Plantar-flexion. Affects Gluteus minimus, Pectineus. Additionally the six deep internal rotators of the hip are engaged. P. 79 PRONE FOOT PRESS Without changing position, hold the raised ankles together, feet parallel. Jerk sharply upwards and bump the knees together. Press downward on the ball of the feet. Bilateral Dorsiflexion of the ankle (Toes are pressed towards the floor, heels toward the buttocks). Indications: Gastrocnemius, Soleus, Triceps surae, Achilles tendon (Calcaneal tendon), Crural fascia, and fascia/ connective tissue of foot, ankles & toes. CROSS TOE PRESS (Facilitated Bhekasana: Frog Pose) Cross the raised feet at the balls and press to the buttocks (Bi-lateral Plantar flexion). Change and repeat. toes. P. 80 Indications: Affects the Tibialis anterior, Extensor digitorem as well as anterior fascia of feet and THE HALF LOCUST (Facilitated Ardis-Salabhasana) Position: In a lunge on the side of the client on same side as the first leg to be lifted. The knee on the ground is at about the same height towards the clients head as the first Lom/ point to be treated on the low back. Kneel beside the leg you are stretching and press with the upper hand (the hand closest towards the client’s head) on the Lom on the low back, just above the hip. Have the fingers of that hand turned away from the spine. Reach around the bent leg under the knee and lift the leg, hold 5 count, then release slowly. Repeat the second time, moving the hand to the second point at T-12. Repeat the third time, holding the first point again (1, 2, 1). Step between your clients legs so you can pick up the far knee and repeat the process on the other side. Indications: Affects the Para-spinals, Sacrospinalis, Gluteal Muscles, Semitendinosus, Biceps femoris as well as the Psoas- Diaphragmatic complex of muscles and fascia of the anterior. Step across between the legs to do the second side. P. 81 4. SECOND SUPINE POSITION: Abdomen & Leg Stretching (The Fourth Treatment Attitude of the Body) THE ABDOMEN AND TORSO ABDOMINAL TECHNIQUE (Thoung/ Sadung) Big Belly Circles Begin with some big belly circles. Do this as a warm up or as a prayer for this sacred part of the body. The Sadung (pronounced Saduu) is the origin of all of the body’s energy lines, Sen lines, Meridians, Chakra etc. And as such it represents the one single point on the entire body that has a history going back to the womb and continuing into the birth and physical manifestation of your life in this incarnation to the present moment. It is the one point on the body where one can treat or healthfully affect every Sen, energy line, Lom or point on the body at the same time. It represents the nexus where all emotional history of life is stored. The Thai call it “Gnathang Khong Rangkay” (H̄n̂āt̀āng k̄hxng r̀āngkāy) The window of the body. P. 82 The Wave The wave begins with both hands placed about evenly on either side of the abdomen. The fingers are pointed cranially. Taking the hand nearer the practitioner, begin the movement by exerting downward force with the heel of the palm. Gradually, the pressure is transferred from the heel to the mid-palm and onward to the fingertips. The finger tips then press in and shift the pressure to the opposite hands finger tips. At this point, the fingers of the opposite hand pick up the movement by pressing inward, as the first hand ceases to bear any pressure. The pressure is brought gradually from fingertips to the heel or bottom of the palm. The transfer of weight and pressure should be done in a smooth and gradual fashion. As each area is completed, it is released in favor of the next. The Thai believe that the stomach is the center of the body’s universe and, as such, is the “window to health.” As the heel of the second hand is reached, the first hand again picks up the movement. The second hand releases. The whole hand stays in contact the whole time. A gentle rhythm is developed as the pressure circulates in a continuous wave. For constipation, you might make as many as 100 revolutions clockwise; for diarrhea counterclockwise. I once watched Phaa Khruu Samaii Mesamarn during Puja do as many as 108 circles on a client’s abdomen reciting the mantra NAM PO PHUUT TA JAO TA PHUUT PO NAM (In Pali, the name of the Buddha forwards and backwards). Sadung technique generally releases tension in the abdomen, promoting freer movement of the various viscera by releasing fascial restrictions. It is beneficial in balancing the peristaltic action of the colon and Ileocecal valve. It is not unusual for there to be a general release of unnecessary tension throughout the body during and after the Sadung part of the session. Indications: Affects the Rectus abdominus, External obliques, Fascia and connective tissue of the whole abdomen and pelvis, Psoas, Ascending colon, Ileocecal valve, Transverse colon, Stomach, Descending colon, Small intestine, Uterus and Bladder. PUSH AND PULL Beginning on the near side holding the hands either on top of each other or close together (depending on girth of abdomen), push the palm heels slowly down and inward, moving pressure toward the navel. As you come to the navel, release the pressure and rock the hands over onto the fingertips at the opposite side of the abdomen. Press inward on the opposite side with the fingertips which are held rigid. P. 83 Drag or pull them back toward the navel. Upon reaching the navel area, gradually release and move to the next of 3 positions. Move slowly, watch your client and notice tense or sensitive areas; when encountered, hold that position and feel for the release of tension. The stomach in particular is sensitive for many people. There is invariably much emotion associated with tension in the abdomen. Be especially non-invasive here, never force your way in. With your hands and heart, ask permission to enter; be patient and prepared to wait until permission is given, to make your entry. Work each hand position up and down one time: i.e. 1, 2, 3, 2, 1. FIVE BASIC ABDOMINAL POINTS P. 84 Point 1. Located about 1.5 times the width of the thumb, lateral, off the center line. 1 length of the thumb above the navel. Use the Thumb Pressure of both hands to press directly downward toward the spine. As you feel resistance, the pressure is directed toward the navel. Hold for 5 seconds and then spiral out to release. Do points #1 & #2 simultaneously. Then do the same for points #3 & #4. It is also appropriate to work each point separately with greater focus. Point 2. Bilateral point to #1 on the opposite side of the body. Treat in the same fashion. Point 3. On the same line as #1, below the navel, 1 times the length of the thumb below the navel and 1.5 times the width of the thumb lateral. Treat in the same fashion. Point 4. Bilateral point to #3 on the opposite side of the body. Treat in the same fashion. Hold 5 seconds. Point 5. Located over navel and on center line directly between points #1 and #2, on Sen Sumana or Governing Vessel. Treat by pressing with Reinforced Spear Hand or Fingers, and then dragging the stiffened fingers to the umbilicus or navel itself. ABDOMINAL PRESS Position: Straddle the clients torso in a lunge, so that your center of gravity is balanced over their belly button. Using Reinforced cupped hands (one on top of the other) cover navel/ umbilicus adding gradual pressure with each exhale of the client. On the third exhale release quickly bringing your hands to your shoulder and dropping your head (with a snap). Variation 1: Abdominal push with the feet in 2 positions. Sitting in front of the seated client. Facing the client who has spread legs, stretch your legs and press the same Five Abdominal points described above with the toes of both feet; second, press in with the heels, turning the toes out, so as not to press on the rib cage. Hold each position 5 seconds. Exhale as you press inward. P. 85 ANTERIOR TORSO (Chest and torso) To move energy released by the abdominal work, use soft finger pressure to work points up and around each breast or the chest area. The pattern is Up, Down, UP on the sternum followed by figure eight circles with the soft finger pads completely around the chest and breast area. This technique also moves lymph fluid by addressing the lymph nodes of the upper torso and humeral region. This same pattern may also be used on the back with useful results. SUPINE MEDIAL UPPER LEG (Figure Four: Crossed Ankle Position) Position: Turn the knee outside and cross the ankle at the knee. Step 1. Palm Press the medial line on the upper thigh three times (3X - Down, Up, Down). Step 2. Simultaneously press and hold the ball of the foot and the knee to the mat for five seconds. You are leveraging the ankle over the thigh. If the ankle on the upper thigh is too sensitive then slide up under the ankle with your thigh and offer some support. Step3. Take both hands and press the bent knee to the floor (clients opposite hip may come off the floor and that’s perfectly fine). Release and raise the knee up towards the ceiling to set up the Spinal Rotation. Indications: Relieves pressure on lower back. Affects the Internal rotators of the hip, Iliopsoas, Adductor longus, Gracilis, Sartorius, Vastus medialis, Pectineus, Adductor Magnus, Adductor longus and Adductor brevis. P. 86 SUPINE SPINAL ROTATION (See S.L.P., Spinal Rotation) In the supine crossed leg position, with the nearest leg bent and crossed at the knee, brace the close shoulder to the floor and then push the knee up and across to the mat on the opposite side. It is helpful to coach the breath when pushing the knee…client should inhale, and then exhale as you press. Follow the breath. We always say the bottom of this motion is when the knee reaches the floor or the client runs out of breath whichever comes first. Release, return to neutral position and then repeat other side starting with Supine Medial Upper Leg and Supine Spinal Rotation. Note: This technique is a Passive, Assisted, Non-specific, Co-facilitated, Non-ballistic, Natural Range of Motion following the breath, performed slow and always within the comfortable, accessible range of motion of the receiver. Indications: Spinal rotations relieve or release tension in Thoracic, Lumbar and Abdominal fascia. Affects the spinal and para-spinals, as the rotations lengthens the muscles. Additionally, affects Erector spinae, Pectoralis Major, Pectoralis minor, Anterior deltoid, Rectus abdominus, External obliques, Latissimus dorsi. Stupa Courtyard at Wat Po, Bangkok P. 87 SUPINE POSTERIOR UPPER LEG AND CROSSED LEG COMBINED At the completion of the second Supine Spinal Rotation, release the pressure and return the knee to the upright position. Leave the leg crossed and raise the lower straight leg up and set it firmly on top of your inside shoulder. The practitioner’s inside hand reaches around the leg to secure the foot of the bent leg; once the leg is positioned, press the bent knee toward the chest area. Use your lunge and Palm Press the posterior line of the bent leg from the back of the hip to the knee with the outside hand. By beginning the Palm Press close to the hip, we start with less leverage and progress to more leverage and compression as the points closer to the knee are worked. Indications: This complex therapeutic Asana- Yoga Therapy posture engages and lengthens the muscles of the hip joint, Pelvic girdle and posterior leg and lower back. The effect of the hip flexions affect from the knees to the upper cervical areas. Also affects the hamstrings, Internal hip rotators. Change position and repeat on the opposite side. P. 88 SUPINE INFERIOR FOOT (Standing Position) Leaving the last leg crossed at the knee, stand beside the client (bent knee side) and while holding the foot securely, Lever the whole leg forward three times (3X) to release the low back and hamstrings preparing to step behind the upright leg. Brace the raised leg against the body, and once in position with the upright leg centered on your body, Elbow Press the center of the line of the sole of the foot (or use Hooking Fingers with a very tall person). The pressure is applied up the line moving toward the toes. Once you reach the ball of the foot close to the toes (Kidney 1 point), press the point specifically and lean slightly forward. Hold this position for five count before changing legs and repeating on the opposite leg. Note: For further emphasis, you may stand on the same side as the bent knee, catching and supporting it behind your forward knee. SUPPORTED SHOULDER STAND ( Inversion: Facilitated Sarvangasana) Position: While holding onto to both feet, walk up on the side of the client until standing with your navel lined up with the top of the clients shoulders. With both legs raised and held together by the practitioner, the client is instructed to lock the knees and to secure them in this position with both arms, which are also locked in place. Additionally it is very important to coach the client to breath and to NOT hold their breath. Hold the ankles firmly and with a three part motion: Pull, Turn and Push to press the feet forward into inversion over the client’s head until the weight of his body is on his shoulders. Hold in this position for five count, then slowly release. If the client is comfortable you may hold the inversion progressively longer each session. When client is in this posture have them move their neck from side to side to ensure mobility and comfort. Have them take a breath and release the posture. Note: Most of the hesitancy in receiving and or performing inversions is due to past emotional issues relating to falling. Express confidence and control and know where you are going before you start this Asana. Always check out your environment, surroundings and make sure that you will not run into any obstacles from initiation to completion of this technique. Lastly, you want to be the strongest and most stable at the point in this inversion where the client is most vulnerable. If you feel you can not completely and or competently perform this posture then by all means leave it out or modify to be received safely. P. 89 STRAIGHT LEG PULL UP (Facilitated Ubhaya Padangusthasana) The Straight Leg Pull Up is a Full Forward Bend in the Vertical axis. In the standing position, brace the client’s legs upright against your body. Grasp both of the client’s arms at the wrist and use a combination of a leaning and pulling motion. Use good lifting mechanics, the same as a weight lifter would use. Drive your hips forwards first and use your legs more than your back to facilitate or drive the lift. As you lift it is ok to drop your shoulders and on heavier clients rock your head backwards to add more weight on your side of the leverage. Pull the client upright into the forward, bending position. Hold position for five count. Do three times (3X). THE PLOW (Facilitated Halasana) Raise the client’s legs together to an upright position; their hands will be alongside their body for support. Continue pressing the feet over gradually as far as accessible range of motion and comfortable tolerance allows. A healthy person with no injuries or history of such will be able to go all the way over to the floor above the head. Return slowly, pressing forward and rolling one vertebra out at a time. Once the Hips/ Sacrum reach the floor you’re done. Contraindications: Not recommended for cases of uncontrolled hypertension, High blood pressure, heart disease or excess menstruation. P. 90 CROSS LEGGED PULL UP Another Full Forward Bend. This time with the legs crossed emphasizing pressure on the hip and alignment of the knees. In the standing position, cross the client’s ankles and tuck/ brace inward against them with your lower legs. Grasp both of the client’s arms at the wrist and use a combination of a leaning and pulling motion. Use good lifting mechanics, the same as a weight lifter would use. Drive your hips forwards first and use your legs more than your back to facilitate or drive the lift. As you lift it is ok to drop your shoulders and on heavier clients rock your head backwards to add more weight on your side of the leverage. Pull the client upright into the forward, bending position. Hold position for five count. Do three times (3X). Finish by stepping backward and pulling the client upright into the seated position. P. 91 5. SEATED POSITION: (The Fifth Treatment Attitude of the Body) POSTERIOR UPPER TORSO Position: Standing directly behind the client, with the knees together providing upright support for the seated client. 1. Work the area between the shoulder blades to the base of the neck, three times with bilateral rolling thumbs/ butterfly thumb technique. (Up, Down, Up) 2. Again, with the thumbs, work from the base of the neck out to the tip of the. shoulder, three times using the kneading/ natural thumbs technique. (Out, Back, Out) 3. Tilt the head forward and steady it with one hand while working up the lamina groove with the using the rolling thumb technique, three times. (Up, Down, Up) Change hands and work the opposite side equally. P. 92 4. Cranial lift: Raise the head upright and with the thumbs on the cranial base points, and the fingers on the temporal area, lift the cranium for five seconds and release slowly. 5. Make circles on the temples with circular digital pressure. 6. Governing vessel. Work the center line down the back of the head three times with Snake Thumb (Klai Sen) technique. P. 93 NECK ROTATION (Facilitated Namaskar Mudra) While in the kneeling position behind the client and your hands in the “Wai” position, hold the client’s head between your hands and slowly pull and tilt the head as far back as possible. Move smoothly and return smoothly so that the client is relaxed and confident. Once back to the center position, slowly rotate to the side and pull back, return to the center and repeat to the other side. SEVENTH CHAKRA RELEASE (Crown or Sahasara Chakra) Find the seventh chakra point by following a line from the folded ear to the top of the head, bisecting the conception vessel. This point is called the window to consciousness. Either standing or kneeling, use reinforced pressure to press and hold the point for one minute then release slowly. This point may be used as a direct aid to improve the quality of one’s meditation. It is also a useful point in the treatment of headaches. P. 94 REINFORCED UPPER TORSO ROTATION With the hands of the client clasped firmly behind the head, the practitioner, in a kneeling position, reaches up and under the arms to grasp the forearms in a firm grip. The practitioner will then brace the knee opposite the direction of rotation and once in the position twist and stretch as far as comfortably possible. Without altering the hand position, the practitioner changes sides and repeats the procedure. SPINAL PUSH While still holding the arms with the clients fingers interlaced or locked together behind the head, raise both your knees together to about T-12 and pull the client backwards on to the knees. Release and raise the knee and repeat. Do this three times, then finish the movement at the original position. P. 95 FULL FORWARD BEND (Facilitated PaschiMottanasana) Bend the client forward, with the legs straight out before them: 1. With the top hand pressing at the base of the neck, press three positions, one time each with palm pressure. a. Lower Back b. Middle Back c. Upper Middle Back The lower hand presses the client’s back opposite the side the practitioner is kneeling on. Change sides and repeat on opposite side. 2. Both hands are placed at the base of the client’s neck, and the standing practitioner presses the upper torso as far down as comfortably possible. Hold in position for five seconds, then release slowly. P. 96 FACE TREATMENT (Thai Facial) Move to a Standing Position behind the client or to a seated or kneeling position in front of the client. A) With the thumbs, Thumb Press and or finger circles press out each of twelve lines one time. Each of the lines terminates or ends on the Lom/ Marma point just in front of the opening of the ear. 1. Hairline (3X- Out, Back, Out) 2. Upper-forehead 3. Mid-forehead 4. Eyebrow (3X- Out, Out, Out) 5. Top bridge of nose/ Under eyes 6. Mid bridge of nose/ Across upper cheek bone 7. Bottom bridge of nose, across nostrils and cheek bone 8. Maxilla (Center, under nose), Across under cheekbone 9. Outside corners of mouth, Across Jaw and up to Lom 10.Below Mouth/ Mid-chin 11. Front of Chin/ Ramus 12. Under Chin, Jaw and Mandible to in front of ear B) Using the fingers gently squeeze and twist the ears moving from bottom earlobe to the top of the ear three times. ( 3X) C) Press the ears closed and hold for five seconds, release quickly. P. 97 Chapter VI. Thai and Chinese Medical Theory “The medical texts which His Majesty King Rama III had engraved at Phra Chetuphon (Wat Pho) in B.E. 2375 (AD 1832) now located in Bangkok.” ORIGINS OF INDIGENOUS TRADITIONAL THAI MEDICAL THEORY Classically, the theoretical basis of Ryksaa Thang Nuad Phaen Boran Thai (Indigenous Traditional Thai massage/ Thai Yoga/ ITTM) is found in the adopted practices, theories and practices of Ayurveda arriving by way of the Mon/ Khmer, Burmese and Majapahit cultures which pre-existed modern Thai culture as explained and detailed in the Chapter of Thai history. Additional cultural influences, although less pronounced were Traditional Chinese Medicine, Traditional Japanese Medicine (Amma, Shiatsu Anma) and Muslim influence primarily in the South of Malay/ Indonesian Yunani (Persian/ Greek) medicine. From the Indian classics of Ayurveda such as the Charaka Samhita and Sushruta Samhita and others known to the Royals of Thailand even in the ancient past the Vedic cosmology, (Satkhya/ Samkya) theories and principles were well known and incorporated in early treatises on medicine. For example, theories of Sheaths (Kosha), Tanmatra (Rajas, Satvas, Tamas), Elements (Dhatu), Dosha, Prana Nadi, Chakra (Chaka: Thai), Marma, Pancha Karma etc. In treatment there is a strong emphasis on the Prana Nadis, or energetic pathways of the life giving breath in the body. These invisible lines form the energetic body or “Pranamaya Kosha.” The pathways of energy interrelate and communicate with each other, circulating through and around specific major concentrations of energy called Chakras. Minor Chakras are referred to as energy points or pressure points. P. 98 Phaa Khruu Moh Shivago Komalabat (Jivaka), the original founder of Thai medical massage, in the Anantasuk tradition is credited as having selected and distilled 10 individual pathways, or lines of energy called Sen or Sip Sen (10 lines), and the corresponding Chakras and Lom (Marma/ points) associated with them (see History of ITTM). In classical Ayurveda theory there are 350,000 Prana Nadis! Imagine the time it would have taken to learn these. Now appreciate the simplicity of having only ten to contend with. By saying that there are Sip Sen or ten different pathways of energy, we are not saying that that is all there is. It’s easier to understand these ancient Ayurvedic principles if you consider the ten primary lines as centers of pranic force the same way an interstate highway is a consolidation of many surface roads. These ten lines and their associative points are sufficient to generate, maintain and correct a harmonious state in the body/mind/spirit. The lines should be considered “fields of influence” and not precisely situated with exact anatomical landmarks. Several of my Thai teachers referenced their belief that Sen were subject to move or to be more or less influential according to season and even time of day! The ‘Non-Specific” local and shifting nature of the location of the Sen may in part account for the seeming inconsistencies with the traditional descriptions of the primary indications associated with the lines and their presumed pathways. Lom or Marma points located on the Sen Lines (Prana Nadi) can be thought of as cosmic windows facilitating an exchange of energy between the human body and the energetic universe. When this energy does not flow in a harmonious and undisrupted fashion, imbalance or disharmony results. When the Thai energy points or Lom are considered, their placement and function distinctly mirror the Ayurveda concept of Marma points. In our practice we use the term Lom which is synonymous with the Ayurvedic term Marma. In Ayurveda the practice of treating Marma/ Marman is referred to Marmashastram or Marmachikitsa. Imbalance and disease are self evident. The ancient Reishi Vidya sought answers from both their personal experience and observations as well as the extant ancient texts. They came to believe that the energy flow can be restricted, disturbed or otherwise inhibited by tension and inflexibility anywhere in the body. Restrictions which disrupt the free and natural flow of life energy may be superficial or deep within the body. By specifically releasing tension and restriction in the body, the energetic harmony, or homeodynamic state, of the body is achieved, restored or maintained P. 99 It is also immediately obvious to the trained observer, the similarity of Sip Sen to the concept of Meridians or energy channels found in traditional Chinese medicine Acupuncture theory. One theory is that the Sip Sen represent special channels connecting and regulating energy from the various meridians. Many Thai medical practitioners take this view in practice by using the fourteen traditional Chinese meridians and their points, in addition to the traditional Sip Sen. When practiced in this way, ITTM is obviously a distant relative of the same family as other medical traditions evolving from the Chinese model such as the Japanese system, Shiatsu. There is and probably will continue to be, much debate on the distant origins of ITTM (Indigenous Traditional Thai Medicine). Some authorities even credit Ayurvedic medicine as the origin of Traditional Chinese Medicine (TCM), alleging that this practice was brought to China by Indian Saints. This is disputed by many Chinese. As discussed earlier in the “history and origins”/ Chapter One: It is also possible that Ayurvedic medicine entered the culture by way of the Vedic Khmer/ Mon Indianized cultures who ruled Central and Western Thailand for over 300 years and/ or the Sumatran-Majapahit who controlled the South of Thailand until the 1500’s. The terminology for the Sip Sen very closely correlate with specific names and descriptions of Nadis and Chakras. We see Lom correlating with the Marma points and theory of Ayurveda. However, many of the Lom/ pressure points used in ITTM do not correlate exactly to Marma points at all but fall more directly in the path of the traditional Chinese model’s meridians or channels. These contributory and historical ideas will continue to be discussed, researched and refined. Whatever the exact path of development, the bottom line is the system works. Theory behind the practice The purpose of ITTM as a therapy is to promote the free and unrestricted circulation of “life energy.” This concept of life energy is known by different names in different cultures. The Thais call it “Prana,” the Chinese “Chi,” the Japanese “Ki.” When the flow of Prana is restricted, inhibited or disrupted, a state of disharmony or dis-ease occurs. In theory it works like this: every substance, every matter in the body has it’s own energy field which is synonymous with the Ayurvedic term Marma. Every component of the body has it’s own characteristic movement which is peculiar to it and separate and apart from every other component of the body. The body itself is a symphony of individual energy transforming elements working synergistically and sympathetically with each other, providing a vehicle for the transformation and elevation of the soul in life or the world. The proper organization and functioning of the composite matters of the body, i.e. the cells, the soft tissues, the muscles, viscera, nerves, bones and hormone secreting glands, absolutely depend on their autonomous though collaborative, relationship. Each must be free and unrestricted to perform its function, so that the whole organism may operate optimally. There must be space in order for this freedom, or the pure flow of unrestricted energy, to exist within the body. When this space or freedom is not present or is blocked in any way, a diminishing in the flow of prana or chi occurs and is reflected throughout the entire being instantly. Wherever any two component elements of the body come into proximity with each other there is the capacity for the transfer of energy or the potential for restriction of that energy. P. 100 When two bones or Osseous structures come together in a joint and have adequate space and/or lubrication and support between them, allowing them to work independently but supportively, they are healthy and transfer energy between each other freely. If the same two bones do not have enough space between them as a result of compression from excessive muscular tension or damage to the supporting cartilage there will be a restriction in the flow of energy between them. There will be inflammation, edema and calcification which the body will announce by creating pain. When the tension is removed and the freedom returned, the energy will once again flow freely and pain will diminish or disappear altogether. This process holds true for both like matter and unlike matter in the body: muscle restricting muscle, muscle compressing nerve, bone compressing nerve, fascia restricting muscle or viscera, viscera displacing viscera or viscera compressing nerves. All signify a diminished capacity for the free flow of live energy. The energy or prana of the body flows in both superficial and deep pathways within, upon, above and below the physical body. The superficial flow of energy is affected by the use of superficial pressure to specific points along SEN or meridians; this also affects energy traveling within the epidermis, as well as in the superficial fascia and soft tissue. The deep flow travels through, along or around the Osseous structures of the body, the bones themselves and the connective tissue between them. This deep energy is primarily affected by manipulations designed to create space between the Osseous structures of the skeletal system and the soft tissue, nerves and fascia which surround, energize and support it. More specifically, these deep channels are treated by releasing pressure at the joints through traction, and various forms of stretching, or range-of-motion techniques both passively and actively assisted. So in other words the anklebone is connected to the head bone! “Statue holding point while meditating, Wat Pho “ P. 101 The practitioner can facilitate the flow of energy by maintaining contact with both hands; this creates a circuit of energy with the hands acting as positive and negative poles. Regarding the locations of the Sen Lines or energy pathways themselves there is some dispute among the various regional schools. Of course, the Wat Po Epigraphies are considered authoritative, however both they and other traditional texts lack or do not represent detailed and or precise anatomical landmarks for reference or precise location. There are two considerations here. One, the lack of exact anatomical references probably stems from the traditional Buddhist proscriptions against defiling deceased bodies and the landmarks indicated would be more generally based on non-invasive external palpation and observation. “Aachan John” The second, as related to me by one of my former teachers in Chiang Mai, Aachan John, a former monk at Wat Suan Dok, was that the charts were just the idea of the densest influence area of the line and it was up to the practitioner to literally discern the pathway in real time. The practitioner was to discern by feel, by intuition, and based on experience. There was also some discussion regarding the lines being fluid and actually moving around based on season, time of day, illness and the will of spirit. This sounds more like the Ayurvedic idea of Prana Nadis as being not literal lines but channels, vessels and general pathways in the sense of fields of influence. Juxtapose this with the TCM or Chinese Medicine/ Acupuncture idea of precise lines (meridians) flowing from precise point to point with exact anatomical references and measurements. Take into consideration and compare and contrast the various stone carvings, epigraphies (Wat Po, Wat Raja Orat etc.) and the codices collected and preserved by the King and the Ministry of traditional Medicine there are literally hundreds if not thousands of lines depicted one way or another! There are primary and more common pathways depicted and then in other illustrations the lines continues. One way or another the entire body is then covered or addressed by one line or combination of lines and extensions. “Wat Buddhai Sawan Stupas in Ayudthaya” I was first introduced to the idea of Sen lines by Aachan, Phaa Khruu Samaii Mesamarn of the Buddhai Sawan Institute while studying in Nongkham (1983). Buddhai Sawan followed the same idea for location of the lines as found on the tablet inscriptions first of Wat Raja Korat in Korat and secondly Wat Chetuphon in Bangkok. P. 102 The descriptions and lines in this book follow both systems which I have studied and visited in person many times. Regarding the “Indications.” The indications are traditional and anecdotal. Some of the ones listed here are taken directly from translated texts literally carved in stone at various temples in Thailand but most importantly those of Wat Korat and Wat Pho. All Thai schools of indigenous traditional medicine teach some variation of the listed indications. The specifics of what might be included on their list of indications vary according to their individual tradition and particular healing focus of their practices. This could also be an example of prejudice of style. These idiosyncratic beliefs and practices are part of what makes the traditional practices traditional in the first place! The “Indigenous” part refers to the regional and local, cultural beliefs that make any particular practice unique to the people living and practicing it. Depiction: Ayurveda Doctor and Reishi Yogi practicingKorost Medical Astrology: Wat Prakhaeo ITTM detail: Engraved stone plaque: Wat Raja-Orasarem, Korat P. 103 ITTM SEN LINES (Ten Energy Pathways) 1. Sen Sumana 2. Sen Ittha 3. Sen Pingkhala 4. Sen Kalathari 5. Sen Sahatsarangsi 6. Sen Thawari 7. Sen Lawusang 8. Sen Ulangka 9. Sen Nanthakrawat a. Sen Sikhini b. Sen Sukhumang 10. Sen Khitchanna a. Sen Itaken b. Sen Kitcha P. 104 ONE: SEN SUMANA (Sushumna Nadi) Central: Rajas Guna Location: Originates at the tip of the tongue, travels down the throat and chest to the solar plexus. The path is similar to that of the Sushumna Nadi of yoga. This is the external description; actually, the SEN is located inside of the body within the spine. It may be visualized from the outside and affected from there as well. Indications: Asthma, bronchitis, chest pain, heart disease, spasmolytic diaphragm, nausea, cold, cough, throat problems, digestive tract disorders, abdominal pain, gastralgia, hiccups, mental disorder, epilepsy, vomiting, infantile milk regurgitation, intercostal neuralgia, paralysis of larynx, facial paralysis, trigeminal neuralgia. Esoteric Aspects of Three Principal Nadis: Sumana, Ittha, & Pingkhala: Sen Sumana, the current that is most gracious also called “Brahma” Nadi because it is the pathway of the ascending kundalini shakti. Ittha Nadi, the left; Pingkhala right. These pathways, hot sun, cool moon, wind around the sumana column forming a vital stairway. They meet each chakra, rising in turn to the next, terminating behind and between the eyes. The monk’s discipline is to stabilize the flow of energy in the sumana pathway. As long as the energy flows or is concentrated in the external pathways of Ittha and Pingkhala the monk’s consciousness is dominated by externals, the sun and the moon. By focusing prana along Sumana, the dormant Kundalini is stimulated and rises upward through each Chakra successively, until the crown Chakra is flooded with light and life energy, creating the blissful state of Samadhi. This is also referred to as the union of the sun and moon. P. 105 Sen ITTHA Sen ITTHA TWO: SEN ITTHA (Ida Nadi) Left Side/ Female : Tamas Guna Sen ITTHA Location: Sen Ittha starts at the left nostril, travels up over the head and down the neck. It continues down the left of the spine, follows closely the left side of the sacrum, crosses the gluteal area and posterior thigh, crosses around and upward on the inside of the thigh, goes up the lower abdomen and stops in the navel area (Umbilicus). Indications: Headache, neck pain, shoulder pain, cold symptoms, cough, nasal obstruction, throat ache, eye pain, chill and fever, abdominal pain, back pain, urinary tract disorder, dizziness, optical disorders, glaucoma, epilepsy, sinus disorders, sore throat, angina, insomnia, chest pain, edema, chronic diarrhea, lumbago, sciatica, hernia, irregular menses, habitual constipation and hiccups. P. 106 General lttha Sen Functions A. Conserves body resources B. Generally represents body calmness C. Generally antagonistic to sympathetic system General Effects of Parasympathetic Activity Resulting from stimulation of Sen lttha: A. Decreases heart Rate B. Decreases Respiratory Rate C. Decreases Blood Pressure D. Increases Gastrointestinal Motility and overall digestive function E. Stimulates Pupillary Dilation (Reflex: relaxes Iris dilator muscle) F. Increases Bronchiolar Constriction The Ittha Sen (Left Nadi) is said to govern the Para-Sympathetic nervous system and the Pingkala Sen line (Right Nadi) governs the Sympathetic. If as some evolutionary theorists suggest that the sympathetic nervous system operated in early organisms to maintain survival then the sympathetic nervous system is responsible for priming the body for action and for preparing the body for stress i.e. fight or flight response. The Parasympathetic function is seen as one to counteract the short term (hopefully!) effects of Sympathetic dominance. The ancient Yogi’s didn’t know Sympathetic from parasympathetic. What they did know was the effects of both over stimulation of Yang/ Male i.e. fight or flight tension states and their effects on systems, organs and mental states. Conversely, coming from meditative communities the benefits were clear regarding decompressing and relaxing on the very same systems, organs and mental states. The ambition was to balance these two states in harmony with one another not just by emphasizing one or the other Sen line but specifically the way the line was worked. If the person was sluggish and deficient then they could be stimulated predictably to beneficial result. If they were hyper, stressed in excess they could be routinely relaxed and decompressed. With concentration of energy along the Ittha Sen line the monk can slow his heart rate and metabolism. He can allegedly reduce the metabolism to a great degree even to the point of not requiring oxygen or breathing for long periods of time. This application of concentration of prana to change the physical is not the ultimate objective; rather, the monk seeks to reduce and or eliminate all obstruction and to bring the Kundalini Shakti or vital life force to the crown chakra and become a god realized, conscious being. P. 107 THREE: SEN PINGKHALA (Pingala Nadi) Right Side/ Male: Satvas Guna Sen Pingkhala Sen Pingkhala Sen Pingkhala General Pingkhala Sen Functions: A. Speeds body resources B. Functions during arousal C. Prepares body for “fight or flight” Location: The bilateral half of Sen lttha, Pingkhala starts at the right side of the nose. It follows the same path as Sen Ittha but on the right side of the body. Indications: (Sympathetic Nervous System) Same as sen Ittha with the addition of Liver and Gallbladder functions. P. 108 General Effects of Sympathetic Activity Resulting from Stimulation of Pingkhala Sen: A. Speeds body resources B. Functions during arousal C. Prepares body for “fight or flight” D. Increases Blood Pressure E. Decreases Gastrointestinal Motility (slows or halts digestion) F. Stimulates Pupillary constriction (Reflex: contracts Iris dilator muscle) G. Causes Bronchiolar Dilation With concentration of energy along sen Pingkala, the monk can speed up his heart rate and metabolism and improve the functioning of the eyes and ears. This application of concentration of Prana to change the physical is not the ultimate objective; rather, the monk seeks to focus his attention like a laser beam and bring the Kundalini Shakti to the crown Chakra and become a God-realized, conscious being. Sen Line and Lom/ Marma Points: Wat Po: Bangkok P. 109 FOUR: SEN KALATHARI (Vishvodara Nadi) Location: Begins at the navel and divides into four pathways, two on the right and two on the left. From the umbilical area, the upper pathways move upward, crossing the nipples to the lateral clavicle and then down the medial arm to the tips of all the fingers. The lower pathways travel down the medial leg (following the kidney channel) to the foot, branching to all the toes. The five lines to the toes separate from the main line at or about Kidney 1. Sen Kalathari unites the functions of the kidney, spleen, pericardium and lung Chinese meridians. Think skeleton. Think Bone Marrow Chi. Indications: Kidney, spleen, pericardium, lung abdominal distension, sleep disturbance, convulsion, mental disorder (hysteria, schizophrenia), gastric pain, indigestion, nausea and vomiting, diarrhea, dysentery, constipation, jaundice, foot and ankle pain, toe drop, knee pain, irregular menstruation, edema, uterine bleeding, lymphadenitis of inguinal region, hemorrhoids, chest pain, chest cough, palpitations, gastroenteritis, malaria, hysteria, epilepsy, sore throat, intercostal neuralgia, carpal tunnel syndrome, coma, fever, heatstroke, psychic disorders. Distributes the flow of prana throughout the body, especially the prana that rises through Sen Sumana. May also be channel for Bone Marrow Chi. P. 110 FIVE: SEN SAHATSARANGSI (Ghandari Nadi) (Left Side of Body) Sen Sahatsarangsi Sen Sahatsarangsi Sen Sahatsarangsi Location: Begins in the left eye and travels down the face, throat, left side of chest crossing the nipple, left side of abdomen (Lateral over the outside of the hip); then crosses to the outside of the leg, becoming the third line of the lateral leg, continues from the knee becoming outside line #1 below the knee to the foot just forward of the ankle bone (Lateral Malleolus), wrapping under the foot. It then rises, becoming the first inside line of the leg, continues upward to abdomen and then terminates at a point about a hand width below the navel. The major wind gates (Lom) of the upper thigh are located on or near this line. Indications: Myopia, redness and swelling of the eye, night blindness, spasm of the eyelids, facial paralysis, trigeminal neuralgia, conjunctivitis, toothaches, asthma, sore throat, cough, tuberculosis of the cervical lymph nodes, hiccups, intercostal neuralgia, chest pain, shortness of milk in lactating women, abdominal pain, lack or loss of appetite, indigestion, gastric and duodenal ulcers, diarrhea, edema, neurosis and psychosis, dysentery, appendicitis, nocturnal emission, dysmenorrhea, irregular menses, chronic inflammatory disease of the pelvis, endometriosis, prolapse of uterus, impotence, genital disease for male and female, numbness of lower extremity, arthritis of knee and ankle. P. 111 SIX: SEN THAWARI (Hastajiva Nadi) (Right Side) Sen Thawari Sen Thawari Sen Thawari SEN THAWARI (Side View) Sen Thawari is the bilateral counterpart to Sahatsarangsi, running on the right side of the body. Location: Follows the same path as Sen Sahatsarangsi but on the right side of the body. Indications: Same as Sen Sahatsarangsi, with the addition of jaundice. P. 112 SEVEN: SEN LAWUSANG (Yashasvini Nadi) Sen Ulangka (Left Side) Location: Beginning in the left ear and traveling down the left side of the throat it descends toward the inside of the nipple. It then turns medial and descends toward the navel terminating at the solar plexus. Indications: Deafness, ear diseases, cough, facial paralysis, toothache, throat ache, chest pain, gastrointestinal disorders, spleen disorders. Sen Thawari EIGHT: SEN ULANGKA (Pusha Nadi) (Right Side: Also Called Sen Rucham) Location: Sen Ulangka is the bilateral counterpart of Sen Lawusang on the right side of the body. Indications: Same as Sen Lawusang with the addition of disorders of the Liver. P. 113 NINE: SEN NANTHAKRAWAT (Kuhu Nadi) General Nanthakrawat Sen Functions: (Detoxification) Sen Nanthakrawat is the principle sen associated with the elimination and detoxification function of the organism. The function of this line is closely tied to the proper balance and operation of the first chakra (Muladhara Chakra). Sen Nanthakrawat is in reality two separate lines closely associated with one another. Location: Sen Nanthakrawat divides into two pathways: A. Sen Sikhini (Urinary vessal- Water) Sen Sikhinis originates at the navel and then runs to the principle orifice, the Penis or Urethral orifice of the Vagina. Its path includes Kidney, Bladder and the Prostrate in men. B. Sen Sukhumang (Fecal vessel - Earth ) Sen Sukhumang originates at the navel as well and runs to its principle orifice the Anus or Fecal Passage. Its path includes the Lower colon and Rectum. Indications: Hernia, frequent urination, female infertility, precox ejaculation, irregular menstruation, uterine bleeding, retention of urine, diarrhea, abdominal pain. TEN: SEN KHITCHANNA (Shakini Nadi) General Khitchanna Sen Functions: (Sex/ Procreation) Location: Both aspects male and female of this Sen begin at the navel and run to their respective organs. Like Sen Nanthakrawat, Khitchanna is also really two separate however related lines. These lines are related to and govern the procreative function and sexual energy. Sen Nanthakrawat, is governed by the second chakra (Svadhisthana Chakra). A. Sen Itaken (Male, Penis vessel) The principle orifice or opening of the body is the Urethral opening of the penis in men passing through the Ductus Deferens. Includes testes and sperm production. Also erection and erectile/ penil dysfunction during arousal as well as ejaculatory response. B. Sen Kitcha (Female, Vaginal vessel) originates at the umbilicus and runs to the vagina. The principle orifice or opening of the body is the Vaginal opening of the vagina in women passing through the Uterus. Female arousal response, including turgidity of labia, lubricatory response and ejaculation. Indications: Similar as Sen Nanthakrawat with a strong emphasis on reproductive health and the releasing of Prana or Chi from the lower Chakras or Dantien. Sexual organs & procreative energy. P. 114 Anatomical Illustration of Sen Nanthakrawat & Sen Khitchanna Sen Khitchanna: Male Sen Nanthakrawat: Male Sen Khitchanna: Female Sen Nanthakrawat: Female P. 115 SEN LINES OF 3D MODEL WITH LINES EXTENSIONS P. 116 TRADITIONAL CHINESE ENERGY PATHWAYS USED IN ITTM These are the same pathways found in TCM (Traditional Chinese Medicine). The actual use or incorporation of TCM meridians / channels into ITTM practice varies widely. The variances are primarily regional and cultural in nature. For example, Thai practitioners who live closer to China, along the Border with Laos and in the Golden Triangle region are more likely to emphasize the meridians and acupuncture points located on them. Thai practitioners of Chinese and or mixed Chinese origin fit the same profile. It is very interesting to note that on the Wat Po epigraphies you see little apparent correlation to Chinese meridians. However, when you consider the more comprehensive charts and codices in the Royal Library collections there are “extensions” of the Sen lines which do seem to correlate with the meridians. P. 117 EXPLANATION OF THE SEVEN CHAKRAS The Primary Chakra is the person. Ayurveda sees the human being itself as a conduit of Pranic force between the celestial heavens (Sun) and the terrestrial ground (Earth). We are both transforming, changing state or stepping down the grand energy of the heavens and sky, including the solar influences of the Sun, and we are transmuting the gross and low frequencies of the Earth, bringing them up into the realm of manifestation. These two male and female polarities or energies come together in the person and through a series of definite stages become the basis for the expression of our life and humanity and all of the varied expressions of consciousness of which we are capable. The Chakra theory attempts to quantify this phenomenon and experience. The Primary Chakra collects and distributes these very grand energies and then distributes the modified fields produced to the secondary and tertiary chakra or Lom. From the Chakra/ Lom themselves is derived the energy or Prana flowing and manifested via the Sen (Nadi). The Chakras, wheels of light as some have referenced them, provide the pumping or circulatory engines that drive all of the Prana throughout the body in energetic or physical form. P. 118 The Chakras represent centers of energetic influence in the human body. They are traditionally described as having a certain definite number of petals attached to them. These petals correspond to the number of Sen, Nadis or channels originating from them. The Chakras also traditionally were described as vibrating with a certain sound as the prana or life force energy flowed through them. They additionally have been given the characteristics of a particular color of light. The particular color is also a reference to the rate of vibration of the Chakra. The nadis or pathways of energy in which the prana circulates become restricted due to tension, stress, disease and trauma. Manipulating the body to open the pathways allows greater circulation of life energy to each of the Chakras in turn. The Seven Yogic Chakras 1. Sahasrara Chakra: The thousand petaled Crown Chakra corresponds to the Absolute. When Kundalini reaches this point, the yogi or adept attains super-consciousness. It’s mantra is OM. Sahasrara - crown, gland - Pineal: governs cranium, cerebral cortex, right eye. 2. Ajna Chakra: This snow white Chakra has two petals. The seat of the mind, it’s mantra is AUM. Ajna - brow, gland - pituitary: governs forehead, ears, nose, left eye, base of skull, medulla and nervous system. 3. Vishuddha Chakra: This sea blue Chakra has sixteen petals. It’s element is ether and it’s Mantra, Ham. Vishuddha - throat, gland - thyroid: governs arms, hands, throat, mouth, voice, lungs, cervical vertebrae and respiratory system. 4. Anahata Chakra: This smoke colored Chakra has twelve petals. It’s element is air and it’s Mantra, Yam. Anahata - gland - thymus: governs heart, lower lungs, chest, breast, thoracic vertebrae, circulatory system. 5. Manipura Chakra: This red Chakra has ten petals. It’s element is fire and it’s Mantra, Ram. Manipura - solar plexus chakra, gland - pancreas: governs lumbar vertebrae, stomach, gall bladder, liver, diaphragm, nervous system. 6. Swadhisthana Chakra: This white Chakra has six petals. It’s element is water and it’s Mantra, Varn. Swadhishthana chakra - Hara chakra, gland - gonads: governs pelvis, genitals, reproductive system, belly, sacrum, lumbar vertebrae. 7. Muladhara Chakra: This yellow Chakra has four petals. Its elements is earth and its Mantra, Lam. Muladhara Chakra - root chakra, Gland - adrenal: governs legs, feet, genitals, anus, coccyx and kidneys. P. 119 Definition of Prana and the Nadi’s It is no wonder the Thai’s believe that the force or element of life exists in the air brought into the body by the breath. We can live without many things for days, weeks, months and even years, but deprive us of breath and death occurs within minutes. Everything in the universe, organic and inorganic, is composed of or defined by Prana or Chi. The literal definition of Prana is “Vital Life Force.” The concept of what is Prana encapsulates the ideas of vitality, either, breath and fundamental life forces which permeate everything and which create and connect everything. It ranges from ideas of Plasma, electromagnetic fields and electricity, Aether to wind and the breath we exhale. Prana has many characteristics from pure light and energy to gross physical manifestation. Prana is gas, however, every physical conduit and structure in the body also has a pranic attribute. So for example we have the Prana of the breath which we focus through Yogic practice of Prana Yama. However, every blood vessel and vein, every tendon and connective tissue, every bone and every hair is a conduit of Pranic force. Prana is not air or oxygen, but is an element (Dhatu) of air. In the Thai way we not only call the Marma points Lom we call the Air element, one of the four Thai Ayurvedic Dhatus, Lom (Thaat Thang Sii: Lom, Fai, Din, Naam). Prana animates or gives life to matter. Prana is not matter nor is it, strictly speaking, energy; it might be more accurate to say that Prana is matter transcending to energy and energy transforming into matter. Human beings are composed of two bodies-an astral body and a physical, or causal, body. Prana links the two together through the network of Sen or Nadis. As long as Prana flows in the Astral, there is animation and life in the physical. When the flow ceases, so does life. Disease is regarded as anything which interrupts or diminishes the flow of Prana. P. 120 Introduction to Thai Ayurveda Style Diagnostic Techniques Diagnostic Techniques and procedures will be approached from a general or nonspecific viewpoint, as ITTM practitioners we may however perform very sophisticated assessments/ evaluations from which to base the course of our sessions. A physician’s diagnosis supersedes the evaluations performed by a practitioner in almost every case. However, the practitioner may make substantial contributions to the whole process of coming to terms with the health concerns of the patient. When in the course of a client’s life their mind, body or spirit are affected by either internal or external pernicious or stressing influences a state of disease may result. In order to treat the apparent disorder one must take as many different factors into consideration as possible. In order to assess and understand the system of dis-harmony or dis-ease being experienced we should begin with close contact with the client. We should study the client without prejudice and with an open mind. Allow them to communicate in an unrestricted fashion. Through the intelligent use of case histories, interviews and hands on physical examinations we are able to acquire an enormous amount of significant information. This information is then used to assess the etiology, pathology, diagnosis, treatment and prognosis of their state of disharmony. Essentially the methods used to procure the necessary information are interviewing, observation, listening, and palpation. The evaluation is not a one time event, rather it is repeated periodically throughout the course of treatment. The treatment technique being used is always subject to change or adaptation. If the course of treatment is effective the results of this continuous evaluation should be changing. Interview The interview is a specific form of question and answer dialogue between the practitioner and the client. Basically the purpose is to gain the history and personal context of the injury or disease. It is one on one, except in the case of children or clients who may not be able to communicate effectively themselves. In which event the parents or other responsible persons would be consulted. An effective interview is focused and systematic in determining the important or the relevant points of information. Generally speaking the interview should at least address the following: A. Chief complaint: Why has this person come to you? B. History of onset: The client describes the course of the appearance of his symptoms, for example “developed over a specified time period, or car wreck last Friday afternoon.” Look for: 1. 2. 3. 4. 5. Chills and fever Perspiration Changes in stools and urine Changes in diet, tastes, food preference Changes in menstruation and pregnancy C. Past History: Long past, not necessarily past of current complaint. For instance, tendencies toward certain kinds of illnesses or complaints in childhood could be significant. P. 121 D. Observation (Sang-ket): Observation consists of actually looking at the client and the client’s body as well as its various excretions and secretions. Everything may be significant, changes in skin color, texture of the tongue. What kind of state or mood is the client in - do they look overly tense or relaxed. What is their general physical condition, coordination. Additionally, the observation of any obvious correlation of the illness to any orifice of the body is made. Located in the Wat Pho medical pavilion area is an engraved chart explaining the correlations of orifice to Sen lines and used as a traditional assessment. E. Listening (Fang): Listening is examination of the client by using your own senses of hearing and smelling. How does the breathing of your client sound? What are qualities of their speech, abdominal sounds, etc.? Is there any coughing? If so, what are its qualities? F. Palpation (Jap): Palpation is heavily emphasized. This is particularly notable when compared to many Western methods of examination. The taking of the pulse (Nadi Vignyam) alone has been elevated to a high and fine art, discriminating more than twenty variations of pulse type alone! The first quality the practitioner discerns is the presence of any imbalance in the three Dosha (Ayurvedic Body types) Vata, Pitta or Kapha. Dosha are composites of the influences of the Thaat Thang Sii or four principle elements of Lom, Fai, Din, Naam (Air, Fire, Earth and Water). The practitioner uses their hands to feel, touch, and manually examine the client for various abnormalities. Their skin, extremities, abdomen and soft tissue reveal the tonus or state of the body. Gentle or probing massage may be used to determine the temperature of various tissue. Organs of the abdomen may be palpated individually. Also traditional reflex test such as knee jerk, Plantar reflex (Babinski’s sign) and neck flexion (Brezinski’s sign) may be incorporated. Palpation is also used to measure and weigh the activity of the various SEN, meridians, points and surface channels. Whether these channels are hypoactive, or hyperactive is important in determining the overall pathology of a disorder. Lastly, palpation is the best way to determine the presence of both active and latent trigger points. These trigger points (T.P.’s) or areas of high neurological activity are commonly located in taut bands of tissue, muscle, fascia, tendons, and connective tissue. The hands may locate ischemic areas and areas characterized by blocked or poor circulation. After evaluation the practitioner may release spasms and T.P.’s as well. The feet of the Reclinning Buddha located at Wat Po, Bangkok reveal qualities of spirit and energy fundamentals from “the ground up”! P. 122 How Do We Feel Energy? In order for us to become aware of anything it must come within our dynamic sphere; that is, the immediate vicinity of our sensual receptivity. The scope or diameter of this sphere varies considerably from one individual to another. It includes not only what perceptions and stimulations come to the attention of our conscious awareness, but those which we perceive subconsciously as well. These fine and gross impressions come into our world or nervous system via our sensual receptors. Our hands, feet, eyes, ears, mouth and nose are only the beginning. Our nervous system has a vast array of antennae at its disposal in order to “sense” our internal and external world. Actually our entire body, from the skin to our internal organs, reacts to the environment we find ourselves in and relays all of this information all the time through the circuitry of the nervous system to the brain where it is sorted and interpreted. Once an impression has caused a stimulation of the nervous system and that information is passed onward, various physical and energetic systems within us begin to respond. It is possible to notice a change of state of metabolism in the whole body within a fraction of a second from the slightest input. Simply seeing something frightening, or experiencing the light touch from a loved one, is more than enough stimulation to cause a response. The pulse changes, hormones are produced, metabolic rate speeds up or slows down, respiration speeds up or slows down, energetic channels are influenced, all of these systems react and adapt. Energy affects us via the nervous system, and we may affect the internal quality of energy via the nervous system as well. Sound is energy, music is definitely known to affect physiology. Light is energy, and its effect on metabolism is now being recognized by the development of therapies based solely on the administration of light. We can see how our nervous system accepts and reacts to these obvious examples of energy; it does not require too much of a leap of faith to imagine how we can perceive more subtle energies and react to or act on them as well. When we massage the body or compress a pressure point, the receptors located in the surface of the skin relay an impulse to the nervous system directly which immediately triggers a reaction and response both in the physiology of the person’s body and in their chakras and energetic pathways as well. The combination of effects of these two complementary and interdependent forces within the body, physiology and pranic energy, begin the change to the body’s chemistry, tonicity and structural alignment. As the energy in the channels and pathways alter in response to the outer pressure, the nervous system begins to respond in turn, altering the surface of the body’s response to the pressure. This explains how pressure points will have a completely different characteristic after treatment than before. The medium for us to sense energy is then the central nervous system, the very same medium through which we perceive or sense anything in our world whether internally or externally. P. 123 Chapter VII. Western Validation Indigenous, Traditional/ Classical Thai Yoga/ Thai Massage contains the following areas of emphasis and therapeutic modalities: 1) Sophisticated and refined Manual/ Physio/ Body-centric Hands-on interventions: Thai Yoga Therapy incorporates elements of energetic (unseen energy: magnetic, electric, sonic etc.) and prana assessment, mindfulness, gentle rocking, asana (positional/ postural), structural release, deep stretching, focused deep breathing or Prana yama, chakra balancing (Psycho-emotional, Somatic and proprioceptive emphasis), Prana Nadi or Sen line balancing (Lines of stress, trans-subcutaneous muscle channels, fascia and connective tissue planes and or lymphatic pathways), and rhythmic compression with broad, deep, non specific tools such as palm, foot, elbow and knee to emphasize with either a specific point (area of high neurological potential) or a broad trans-subcutaneous muscular or fascial plane to create a singular healing experience. Osteo and or Skeletal emphasis including “Bending the bones” stimulates the production of osteoblasts as stress to the bones stimulates bone densification and production of marrow factors such as stem cells and lymphocyte production. Application acts as a sophisticated complex decongestive therapy, as manual lymph drainage reduces stagnant lymph and increases interstitial circulation. It is both stimulating to key beneficial biochemical processes and deeply relaxing and nurturing at the same time. Thai Yoga is a passive, assisted and or co-facilitated, slow or non-ballistic therapy it is non-invasive and appropriate for patients at all levels of care including physical therapy, palliative hospice and end of life strategy as well as non medical treatment for pain. Over 1000 distinctive therapeutic techniques have been refined in common use over centuries of practice. Thai Yoga also emphasizes the development of a personal mild Yoga posture routine (personal exercise) for wellbeing maintenance. This type of low impact, non-ballistic exercise meets all criteria for physical training. It is an especially safe practice for patients as it is self-paced and once learned can be practiced without supervision. 2) Nutritional and or Dietary Strategies: Food, eating and nutritional protocols are based on Classical Indo-Tibetan- Burmese Ayurveda (Thai Ayurveda) and local or indigenous nutrition emphasize whole, fresh foods, unadulterated (No Chemical, processed, GMO), varietal, seasonal and local. Nutritional emphasis includes hydration therapy, eating and meal planning, natural supplementation with herbs, minerals, salts, oils and fats. Foods, herbs and traditional medicines recommended or commonly used emphasize anti-inflammatory, antitumorigenic, and alkaline or acid reducing qualities. These not only include varietal and wholesome fresh vegetables but nuts, seeds, herbs and fresh fish high in all essential nutrients including trace minerals and EFA’s. 3) Psychological/ Mental and Emotional Support: Traditional healthcare delivered in the context of a nurturing, counseling model. Strategies include addressing old unresolved negative emotional issues (NEMO’s/ Karma) with practical positive initiatives and activities (Metta or making Merit). Counseling strategies are varied from the use of prayers and singing to recitation of positive and affirming statements with meditation (Neuro/ emotional and or neuro-physical integration strategies). Although in traditional terms these would be called by different names. P. 124 4) Spiritual Counseling: Origins date back to eleventh century and earlier in Hindu and especially Buddhist teachings stressing individual responsibility and capability of the individual to control their thoughts and inner life. Specific approaches vary according to specific individual beliefs and needs. However, the cultivation of self awareness, self realization, mindfulness and the Four Divine qualities (Four boundless/ unlimited states of mind) expressed as Promiiwihan Sii (Thai language) of Love, Compassion, Joy and Equanimity (Balanced Mind) are considered paramount to the healing process of any debilitating or chronic disease. Emphasis on cultivation of high functioning and functional relationship dynamics, inter-family and inter-community, leads to enhanced sense of self worth and reduction in Depressive symptoms. Benefits of ITTM: There are many! In the past few years there has been an outpouring of interest in the healing and health benefits of ITTM/ TTM. This has manifested in the form of research, scientific studies and clinical trials. The scope of these studies and the papers published in various scientific journals around the world varies considerably. For a more comprehensive list of benefits and to read various articles on the scientific and clinical validations for this work visit the website www.ThaiMassage.Com where articles are regularly updated. Additionally as ITTM is Ayurveda albeit “Thai Style”, we can claim both the traditional and scientifically verified benefits of Classical Ayurveda as well. 1. Increases and maintains complete range of motion of the joint. 2. Relieves muscle soreness. Light exercise promotes a better supply of blood and oxygen to the muscles than complete rest and should be pursued unless severity of injury to muscles or joints precludes further activity. 3. Helps improve our capacity for activity; stretched muscles require less energy for completion of movements. 4. Assists in decreasing unnecessary neuromuscular tension, promoting general body relaxation and reducing emotional stress. 5. Relieves muscle-joint stiffness associated with the process of aging. 6. Increases muscular tendinous extensibility. Muscle can be stretched 1.6 times it’s resting length before it tears. 7. Elongates and releases the fascia, which is the binding and the muscles’ support system. Elasticity varies between individuals and is a major reason some individuals experience slower progress in attaining flexibility. 8. Helps prevent joint sprains, muscle strains or tears, including preventing re-injury to previous joint and muscle trauma. 9. Increases tissue temperature by increasing the metabolic rate through positive and progressive stress, a major part of the pre-activity warm up. 10. Reduces soreness, relaxes muscles, eliminates toxic waste products from cells by increasing blood flow to the fatigued area as part of the warm-down process. P. 125 11. Helps provide greater potentials of physical and athletic skills. 12. Reduces tightness that may contribute to pain, spasm or cramping. 13. Provides an important adjunct toward recovery during the process of rehabilitation. 14. May reduce symptoms of Cachexia or “wasting away” in Cancer patients. 15. A virtual cure for many soft-tissue related disorders such as Carpal Tunnel Syndrome, Fibromyalgia and tension related headaches. 16. Improves outcomes for pregnancy, delivery, postpartum expulsion of placenta and post delivery care. 17. Improves immune system function. ITTM may be enjoyed everyday with few or minimal restrictions or contraindications. Regular and consistent sessions will guarantee results and a greater harmony of mind, body and spirit. Passive, Assisted, Non-specific, Co-facilitated, Non-ballistic, Natural Range of Motion Aside from the energetic and meditative considerations, ITTM is exceptionally valid as a complete system of passive/active assisted range of motion. When there is restriction and/or limitation in range of motion, there is a denigration of function. Limitation and inhibition may be the result of a variety of factors, such as neurological damage from injury or disease, trauma from accident, post fracture-dislocation or post-operative conditions. ITTM may affect the recuperative possibilities of all of these. It may also effectively prevent many kinds of athletic related soft tissue trauma; the effects of stretching for prevention of injury in athletes is well recognized. After injury or disability occurs, normal movement may be difficult or impossible to perform due to excessive pain, or inhibited, or overly weak, antagonist muscles. This is where the practitioner or body worker comes into the picture. The practitioner assists the client through a concentrated series of very specific movements extending the range of motion in the disabled or restricted part of the body. Duplicating a given range of motion stimulates neuromuscular facilitation in both the agonistic and antagonistic musculature involved. Generally, facilitation is enhanced even in musculature and nerves not directly involved through a process of synergy and sympathy. One obvious example is that by rotating and flexing the spine, nerves and tissue in many parts of the body are tonified and beneficially affected. When seen from this point of view, ITTM may be effectively used in a tremendous variety of medical and health situations from rehabilitation of orthopedic and soft tissue trauma to maintenance of bedridden patients in hospitals or nursing homes. Please Note: For a more comprehensive list of both scientifically validated and anecdotal health and healing benefits see APPENDIX: 1 P. 126 Chapter VIII. Philosophy ITTM IS A SPIRITUAL PRACTICE Indigenous, Traditional Thai Medical Massage (Indigenous, Traditional Thai Yoga) has always been considered a spiritual practice. The administration and practice of massage and healing is understood to be the physical or practical application of Metta, the Pali (Thai) word for loving kindness. Thai massage demonstrates the “Promiiwihan Sii” or the “Four Divine States” of mind: loving kindness, compassion, vicarious joy and equanimity. These qualities are especially significant in the face of modern trends toward commercialism and exploitation. P. 127 The Theravada (Hinayana) Buddhists place much emphasis on practical application of spiritual philosophy. The practitioner prepares himself in a variety of ways by diligent practice and study under competent masters, by personal cleansing and exercises (Wai Khruu) and by performing Puja (prayer) before beginning the actual session. The session itself is considered to be a form of meditation, with benefit to the practitioner as well as to the recipient. The practitioner endeavors to work in a state characterized by a fully centered intent, well grounded. The practitioner is to be fully aware, mindful, concentrated and present to the moment during the session. Every movement, every breath, every posture and position is achieved with intent. This is a high art and difficult to sustain, however, it is possible. The cultivation of the meditative state of mind leads one eventually to the intuition and heightened perception necessary to perceive the flow of energy through the various channels. The energetic state of every person is unique and should not be addressed mechanically. Each person should be evaluated in light of his unique character and needs. The specific treatment should be personal. General Thoughts on ITTM Touch the body, affect the heart Affect the heart, touch the spirit Touch the spirit, free the mind Free the mind, realize the soul Realize the soul, know no limitation Know no limitation and become one with the universe Whatever affects the body leaves a trace, however faint. This trace is evident throughout the person’s mind, body, emotions and spirit. Whatever affects the emotions leaves a trace, however faint. This trace is evident throughout the person’s mind, body, emotions and spirit. Whatever affects the mind leaves a trace, however faint. This trace is evident throughout the person’s mind, body, emotions and spirit. Whatever affects the spirit leaves a trace, however faint. This trace is evident throughout the person’s mind, body, emotions and spirit. We are all connected in some way. This connection should be explored with consideration, compassion and loving kindness. As we reveal and facilitate the release of obstruction in those we love, we reveal and release obstruction and restriction in ourselves. Working compassionately on others is the same as working on ourselves. As we work on ourselves, our work on others will change. To be of any real value, our theories on balance, harmony and management of energy must be verified and proven as facts. Proving our work on the complex and varied human being gives our work validation, and significantly increases our capacity to do more. P. 128 Begin with small objectives, session by session. It may have taken years for a person to get into the state in which you find them. With some, it will be sufficient to simply begin to create movement and focus mentally. By giving even the smallest picture, the nervous system begins to facilitate new neural pathways which may eventually allow the completion of a more significant movement, opening still other doors. Begin with small aims and small successes to build a foundation of trust and accomplishment from which to do serious work. The more we accomplish in real terms during each session, the greater the results we can look forward to. We do not absolutely know anyone’s limitations, much less our own. Expect to see the miraculous. Expect people to respond well and to be able to continue on their own. Courage to confront disease and illness can have limitations; healing often takes more perseverance than courage. If you can achieve and maintain a state of meditation during body work, you can meditate while looking, walking or participating in any function of life. When confronted with a situation beyond your control or ability to alleviate, apply common sense by proceeding practically. At the very least, do no harm. Rely on your own hands, heart and mind for the solutions you need; however, always maintain the ability to seek knowledge from higher or better sources upon necessity. The outward physical body is a manifestation of the greater energetic body within and without. The “real” body is the energetic; the state of the physical body may be profoundly altered or affected by slight changes there. Focus on energy, and physiology will follow. However, you may affect energy through physical manipulation. Listen to your client. Listen with your hands, eyes and heart. Every aspect of feedback coming from the client may be significant. Learn to accept the information the client gives and work with it supportively, not in opposition. There will be many clues as to how the therapy is being received (or not, as the case may be). For instance, the client resists by pushing back or tensing as you apply too much pressure. The client’s breathing and respiration rate or depth may change. They may be in so much pain they are unable to communicate this to you. Give them a way out and the confidence to use it, when necessary, by demonstrating a responsiveness to their more subtle communications. Do not adhere to any particular period or duration of treatment. Traditionally a Thai massage session could last from 1 - 3 hours. The time and length of the massage session should be adapted to the specific needs of each individual client. P. 129 TEN RULES FOR ITTM PRACTITIONER 1. Study diligently the techniques and the practice of the therapy. 2. Do not practice at public places but at a place suitable for healing work. 3. Do not hope for any gains, expect neither material profits nor glory or fame. 4. Do not take patients from another practitioner. 5. Do not boast about your knowledge. 6. Ask for advice and listen to people who are more knowledgeable than you. 7. Bring a good reputation to the seven schools. 8. Do not give out certificates in “ITTM” to persons who are not qualified. 9. Remember and honor daily the roots of the healing art and its origins. Give credit where credit is due. 10. Practice ITTM as meditation to elevate the spirit. P. 130 APPENDIX I. General Benefits of Integrative Indigenous and Traditional Therapies Treatment adjuncts: (Clinically researched i.e. validated in clinical trials and traditional anecdotal and benefits) A} References clinical trials: Reduces symptoms of anxiety, stress and depression (1, 2, 3, 4, 5, 12, 37, 45) Enhances the function of the parasympathetic nervous system and other stress-related variables (5) May reduce Chemotherapy induced vomiting (37) Helps normalize blood sugar levels (3) Boosts Lymphocyte count by 11% (4) Boosts immune system, helps increase resistance to infection (4, 8, 9) Lupus, autoimmune syndrome support improves immune function (4, 11) TTM Traditional Herbal remedies proven to kill Head and Neck Cancer (1, 2) Improves cellular immunity in Colorectal cancer patients receiving chemotherapy (4) Effective lymphatic drainage modality, reducing and or eliminating static lymph, lymphadenosis/ lymphedema. (Acts as a Complex Decongestive Therapy: CDT enhance the resolution of edema via the lymphatic system and are especially beneficial post surgery, Orthopedic injuries) (39, 40, 41) Addresses nutritional and food issues and increases nutrient motility (32) May alleviate oxidative stress and improve antioxidant system (32, 33) Reduces toxicity and lymphatic stagnation in breast tissue and surrounding areas. (39, 41) Significantly reduces chronic pain (1, 2, 4, 5, 13, 14, 15, 16, 17, 18, 46, 49) Increases Parasympathetic activity, decreases Sympathetic activity (5, 45) Increases delta, reduces theta, alpha and beta brainwave activity (1) Assist in managing type 2 diabetes (3, 10) Lowers blood pressure (reduces muscle tension)(2) Significantly reduces Peripheral Neuropathy in Diabetic Patients (1, 3) May improve activities of daily living, mood and sleep patterns, and pain intensity of stroke patients over time. (15, 49) P. 131 Effective in treating TMJ (temporal, Mandibular Cranial and Jaw Dysfunction) (16) Increase bone density, resorption, formation by stressing connective tissue and “bending the bones” (19, 20) Resolves many soft tissue/ connective tissue disorder (Fibromyalgia, Carpal Tunnel Syndrome)(16, 21, 23) Reduces, improves hand mobility for Scleroderma patients (21, 46) Effective in reducing chronic tension and migraine headache severity (24, 25) Promotes health related fitness, bone formation and quality of life in menopausal women (3, 26, 27) Reduces and or eliminates active/ latent Trigger Points and equalizes/ reduces areas of low oxygen, chronic inflammation and high neurological activity. (16, 44) Improves physical fitness and performance in athletes (7, 49) Increases relaxation and decreases anxiety and pain in Scapulocostal Syndrome patients (2) Helpful in rehabilitation of stroke patients. (29, 30) Decreases spasticity and aids in rehabilitation in elderly stroke patients (29, 30, 31) Effective treatment for Repetitive Stress Disorders (1, 16, 26) May improve mental and emotional/ psychological/ neuro-emotional issues (1, 10, 34) Facilitates Birth and Delivery, May reduce Postpartum hemorrhage after vaginal delivery (35) May reduce Post Partum Depression (1, 4, 34, 35) Can facilitate, assist release of afterbirth (35) Reduces pain, particularly soft tissue, joint, back, low back and neck pain (2, 16, 36, 38, 44, 46, 49) Reduces Spasticity in patients with Cerebral Palsy (42) More effective than OTC medications in symptomatic treatment of Osteoarthritis pain (1, 2) (43, 44, 49) Improves blood sugar levels of pregnant women with gestational diabetes mellitus (3) Beneficial effect on autistic children’s behavior (6) Reduces risk of heart attack (1, 2, 3, 4, 5, 12, 45, 46) P. 132 B} Anecdotal/ Historical/ Traditional Therapeutic Outcomes and Indications: Based on genuine Indigenous, Traditional, Native, Tribal, Familial and or Natural spiritual and vitality based medicine systems and philosophies, Traditional Thai Medicine, Classical Indian Ayurveda (22), Traditional Chinese Medicine, Indian Naturopathy/ Homeopathy. Increases happiness and a general sense of well being for receivers and therapist/ counselors alike. Indigenous food and Diet principles address chronic, long term malnutrition issues Virtual “Cure” for some Cancers The practice is an expression of compassion Practically expresses loving kindness (Promiiwihan Sii) Helps with weight management (stimulates metabolic processes) As good for the practitioner as it is for the receiver Is by definition a form of Chirothesia/ Laying on of Hands health care (d) Can be done in groups and or in less than private surroundings Increases lean muscle mass as passive exercise Reduces toxicity and lymphatic stagnation in breast tissue and surrounding areas. May reduce risk of some cancers (Static Lymph and or site toxic) Raises high-density lipoprotein (HDL) cholesterol (the “Good” cholesterol) Lowers low-density lipoprotein (LDL) cholesterol (”bad” cholesterol) Can be done “hands free” Virtual cure for many soft tissue/ connective tissue disorder (Fibromyalgia, Carpal Tunnel Syndrome) (a, b) Can be performed on a Portable Massage Chair (c) Anyone can do it with adequate training. Integrates and supports proper alignment of all structural parts of the body without ballistics or force. (Non ballistic, non-specific, facilitated, passive assisted, natural range of motion supporting nominal osseous structural alignment) Sharing facilitates nurturing and community values. Does not require special equipment P. 133 Can be done virtually anywhere in any clinical or home environment Is a great way for patients to be more active and engaged in active life style. Low impact exercise i.e. facilitated range of motion Reduces and or eliminates cystic and or fibrotic syndromes and corresponding nodules Increases range of motion and reduces resistance to motion (PNF) Increases tendon and connective tissue extensibility. (Strengthens extensor and support ligaments in breast tissue thus correcting sedentary/ non-ambulatory based atrophy and decrepitude.) Helpful in reducing dependence and or eliminating psychiatric medications for various disorders. Practice causes NO harm to world ecosystem Flow practice improves cardiovascular fitness Activates experience of Joy Integrates mind, body and spirit Reduces risk of heart attack Increases tendon and connective tissue density and elasticity Can address and support treatment for infertility New scientific research supports the knowledge, wisdom and practical solutions for suffering, injury, and disease. 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Disayavanish C1, Disayavanish P. Psychiatry Clin Neurosci. 1998 Dec;52 Suppl:S334-7. Source NCBI: PubMed: http://www.ncbi.nlm.nih.gov/pubmed/9895186 Appendix II. CONTRAINDICATIONS OF ITTM The primary contraindications for ITTM are based on the use of common sense! Before any treatment is undertaken, a thorough assessment evaluation should be performed to rule out organic disease. The practitioner does not challenge or interfere with anything artificial in the client’s body. This includes but is not limited to rods, pins, plates, meshes, artificial joints: hip, knee, shoulder etc. Additional considerations are for spinal issues such as fused or damaged vertebrae. Pressure should always be tolerable to the client no matter if they demand “Deep Pressure.” Many times we rewrite the client’s ideas as to what “Deep Pressure “ is once they begin to receive sessions and therapeutic programs. Avoid overstretching or over emphasizing range of motion! ITTM is NOT a system of stretching! Remember you can do a whole session from the point of view of Puja and either not touch the client at all or only very lightly. P. 139 Appendix III ENGLISH/THAI VOCABULARY (I recommend finding a Thai person to work with in perfecting pronunciation.) Parts ofthe Body Ankle Khaw thao Appendix P̣hākh p̄hnwk Back H̄lạng; Klạb Blood Lo hit; Leụ̄xd Bone Ka-dook; Kradūk Breast Ok; Xk/ Thaam-nong; Têā nm Cheek Kam; Kæ̂m Nose Cha-mouk; Cmūk Chin Karng; Khāng Mouth Park: Pāk Tongue Leen; Lîn Gum Nguck; H̄engụ̄xk Teeth Faan; Fạn Ear Houu; H̄ū Eye Thaa; Tā Eye brow Kue-Thaa; Khîw tā Eyelid Nang ta; H̄nạng tā Eyelashes Khune tha; K̄hntā Face Bi-nah; Bıh̄n̂ā (Si-nah; S̄īh̄n̂ā) Hair Porm; P̄hm Shoulder Hua-lai; H̄ạwh̄ịl̀ Arm Khaen; K̄hæn Elbow Aeo/ Khaw sok; K̄hæn Hand Mue; Mụ̄x Palm/ Palm of hand Paam; Pāl̒m/ Fa-meung-kong; F̄̀āmụ̄x k̄hxng Finger Niew; Nîw Forehead Nah-pak; H̄n̂āp̄hāk Head Hua; H̄ạw Neck Kor/ Kaw; Khx Chest Nah-ok; H̄n̂āxk Heart Hua-jai; H̄ạwcı Lung Bpord; Pxd Rib Si-krung; Sī̀khorng Intestines Lam-sai; Lảs̄ị̂ Hip Sa-poke; S̄aphok Thigh Thon-kha; T̂n k̄hā Knee Khao; K̄hèā/ Hua-khao; H̄ạw k̄hèā Patella Kraduk-sabaa; Kradūk s̄ab̂ā Leg Khaa; K̄hā Foot Thao; Thêā Toe Niew-thao; Nîw thêā Jaw Kha-kan-krai kangnung; K̄hā krrkịr k̄ĥāng h̄nụ̀ng/ Kram; Krām Lip Rim fee park: F̄īpāk Liver Thab; Tạb P. 140 Spleen Mam; M̂ām Muscle Klarm-nua; Kl̂ām neụ̄̂x Tendon Sen-en; S̄ên xĕn Nail Leb-niew; Lĕb nîw Nerve Sen-pra-sat; S̄ên pras̄āth Skin Pew; P̄hiw Epidermis Nang-kam-phra; H̄nạngkảphr̂ā Vien Sen lord-lo-hit-dam; H̄lxdleụ̄xd dả Artery Sen leud-daeng; S̄ênleụ̄xd dæng Capillary Sen leud-hit-foi; S̄ênleụ̄xd f̄xy Skull Kah-loke see-sah; Kah̄olk ṣ̄īrs̄a Temple Wat Wrist Kha-mue; K̄ĥx mụ̄x Waist Bagew; Xew Stomach Kra-poh ah-harn; Krapheāa xāh̄ār Armpit Rak-rae; Rạkræ̂ Belly Thoung; Tĥxng Bowels Lang-si; Lảs̄ị̂ Brain Sa-mong; S̄mxng Calf Nong; Ǹxng Collarbone Kradouk hai-plara; Kradūk h̄ịplār̂ā Cornea Kaew-ta/ krachkok-ta; Kracktā Esophagus Lawd a-harn; H̄lxdxāh̄ār Eye ball Louk-ta; Lūk tā Gall bladder Thoung narm-di; T̄hung nả̂ dī Glands Thawm; T̀xm Heel (calcaneus) Sonh; S̄̂n/ Calcaneous Joints Reum-gan; R̀wm kạn Kidney Dthai; Tị Lips Rim-fi-paak; Rimf̄īpāk Mustache Nuwad; H̄nwd Pancreas Tab-onn; Tạbx̀xn Pupil Louksi-kong-douk-tha; Lūkṣ̄is̄y̒ k̄hxng dwngtā Penis Kradjiew; Kraceī́yw Rectum Si-drung; S̄ị̂ trng Retina Yeua Louk-ta/ Jaw-tha; Cxtā Roots of hair Raak kam-phom; Rāk k̄hxng p̄hm Scrotum Thoung anthah, T̄hung xạṇṯha Shoulder Lai; H̄ịl̀ Spine Kraduksanhlang; Kradūks̄ạnh̄lạng Stomach Krapaw-ahann; Krapheāa xāh̄ār Sweat Glands Thawn-neua; T̀xm h̄engụ̄̀x Sole of the foot Fa-thao; F̄̀āthêā Temples Wad-chak-hua; Wạd cāk h̄ạw Testicles Luk-an-thah; Lūk xạṇṯha Throat Lang-khaw; Lảkhx Thumb Niew hua-mae-mue; Nîw h̄ạwmæ̀mụ̄x Thigh Thomb-kha; T̂n k̄hā Torso Nua-tua; Neụ̄̂xtạw Waist Banh-aeow, Xew Womb Mod Louk/ Khaan; Khrrp̣h̒ Wrist Khan mueh; K̄ĥx mụ̄x P. 141 Body Ramg-kie; R̀āngkāy Breath Lom hai-jai; Lm h̄āycı Flatulence Kwam mi-lom/ Tot; Khwām mī lm Feet Tou; Thêā Navel Su-duu; S̄adụ̄x Nipples Hua-nom; H̄ạwnm Nostrils Ruu-ja-mue; Rūc mūk Pore Ryu-Khum-Khon; Rū k̄hum k̄hn Saliva Narm-lie; N̂ảlāy Shin Nah-khaeng; H̄n̂āk̄hæ̂ng Feces Hu-jara; Xuccāra Urine Bpa-sawa/ Yee ou; Pạs̄s̄āwa Vagina Chang claud/ Yoe-nee; Ch̀xng khlxd Fore finger Niew-chi; Nîw chī̂ Middle finger Niew-klang, Nîw klāng Ring finger Niew-nang/ waan; Nîw klāng Little finger Niew-koi; Nîw k̂xy Marrow Khai khaw/ Hai-graduk; K̄hịkradūk Neck Khaw; Khx Action of the Body Box/hit Muay/ Chok/ Thee; Tī Break Hak/ Hyud; H̄yud Breathe Hie-jai; H̄āycı Carry (with the hand) Yip Carry (with the shoulder) Baek Chew Kee-ew; Kheī̂yw Cut Dtat; Tạd Digest Yoi-ahaan; Ỳxy xāh̄ār Drink Duem; Dụ̄̀m Eat Gin; Kin Embrace/Hug Kort; Kxd Feel for Kwam-reusuk-samrap; Khwām rū̂s̄ụk s̄ảh̄rạb Hear Nae-Yin; Dị̂yin Jump Kra-doet; Kradod Kick Tip, Te; Tea Kiss Joob; Cūb Listen Fang; Fạng Look at Forng doo, Doo Ti; Dū thī̀ Measure Hu-wad; Wạd Urinate Yee-au/ Bpa-sawa; Pạs̄s̄āwa Raise Yok; Yk Sit Nang; Nạ̀ng Smell Dom/ Kling; Klìn Spit Nam-li/ Thom; N̂ảlāy Swallow Kluen; Klụ̄n Taste Aahan-ro-chaat; Xāh̄ār rs̄chāti/ Leum-rot; Lîm rs̄ Think Kitd; Khid Walk Dern Lift Yok; Yok huen; Yk P. 142 Bleed Ta-bawd; Pxklxk Cough Aye; Xị Drink Duem; Dụ̄̀m Fall Dtok; Tk Itch Khan; Khạn Move Khleuan yaai; Ŷāy Open Bput; Peid Pain Kwan-jep-puad; Khwām cĕbpwd Pale Seed-siao; Sīd Press Good; Kd Pressure Khauam kod danh; Khwām dạn Pull Deung awk ma; Dụng Push Phlak; Danh khow pai; Dạn Rotate Wien; Moon-wien; H̄mun Rub Thou; T̄hū Sick/ Not well Puay/ Mai sabai; P̀wy Slow/ Slow down Cha; Cha cha/ Cha long noi; Cĥā lng h̄ǹxy Sore Cheb-saeb; Cĕb Sprained Yawk/ Thi-ni-tawk-bid; Thī̀ dị̂ t̄hūk bid General Vocabulary Woman/female Phu-ying; P̄hū̂h̄ỵing Man/male Phu chaai; Chāy Massage Nuad; Nwd Monk Phra/ Bhikkhu/ Awasi; Xāwās̄ik Student Nakrian; Nạkreīyn Study Rian sik-saaa; Ṣ̄ụks̄aā Teacher Khruu; Khrū Temple Wat; Wạd Walk Dern; Dein Okay/ Yes Chai; Chı̀/ Thuk; T̄hūk Thank you Khrap khun; K̄hx k̄hxbkhuṇ Excuse me Kaw tote; K̄hxthos̄a Yes Khrap; kha Advance Loke/ Kwan khao-na; Khwām k̂āwh̄n̂ā No Mai; Mị̀ School Rongrian; Rongreīyn Hello Sa-wat-dee; S̄wạs̄dī Master Phaa khruu; Achaan; Xācāry̒ Hard Khaeng/ Yaak; Yāk Soft Nim/ An-num; X̀xn nùm In Nai; Nı Out Nawk; Xxk Energy Line Sen; S̄ên Meridian Sen Meridian; S̄ên mexrideīyn Anterior Lang-tao/ Naa; H̄n̂ā Push the leg Ya-na-ka/ Plak-dang-ka; P̄hlạk dạn k̄hā Pull the leg Deung-ka; Dụng k̄hā Practical Loving kindness Kwan -rak-tham-metta/ Metta; Khwām rạk khwām mettā Snake Hand Meung-meu; Mụ̄x ngūā P. 143 Snake thumb Niu-meu; Nîw ngū Raised Bent Knee Sao-nong Bent Inward Knee Dak-kha Pigeon Pose Dak-wukao Open the wind Bput bpa-tu-lom Bangkok Krungthep Ancient Thai Massage Nuat phan bo-ran Ten lines Sip sen Pay respect to the teacher Wai khruu Prayer Puja Insight Meditation Vipassana Four Divine States Promwihan Sii Calm Abiding Meditation Samatha; Shamatha Hello Sa Wat Dii Khrap (Kha: Feminine) Goodbye/ See you later Pop-gan-mai APPENDIX IV Illustrations, Photo’s and Graphics P.1: Shivago Graphic: Original art: Courtesy Anthony B. James P. 6, 7, 8: Original Photo images: Courtesy Anthony B. James P. 14, 15: Original Photo images: Courtesy Anthony B. James P. 17: Images, Under License; Adobe Stock Photo Service, Used in compliance P. 19: Image, Under License; Adobe Stock Photo Service, Used in compliance P. 20: Original Photo images: Courtesy Anthony B. James P. 23, 24, 25: Original Photo images: Courtesy Anthony B. James P. 27: Original Photo images: Courtesy Anthony B. James P. 29: Original Photo images: Courtesy Anthony B. James P. 31: Original Photo images: Courtesy Anthony B. James P. 38: Original Photo images: Courtesy Anthony B. James P. 39- 44: Original Photo/ Graphic images: Courtesy Anthony B. James P. 45: Original Graphic image: Top of page: Courtesy Anthony B. James P. 45: Legs Image, Under License; Adobe Stock Photo Service, Used in compliance P. 47- 81: Original Photo images: Courtesy Anthony B. James P. 82: Abdomen Image, Top page: Under License; Adobe Stock Photo Service, Used in compliance P. 82: Original Photo images: Bottom Page: Courtesy Anthony B. James P. 83-84: Original Graphic image: Top of page: Courtesy Anthony B. James P. 83: Abdomen Image, Top page: Under License; Adobe Stock Photo Service, Used in compliance P. 84: Original Photo images: Bottom Page: Courtesy Anthony B. Jame P. 85- 114: Original Photo/ Graphic images: Courtesy Anthony B. James P. 116: Sen Lines: Three Views: Original Photo/ Graphic images: Courtesy Anthony B. James P. 117: The Body’s Meridians: Graphic, Under License; Adobe Stock Photo Service, Used in compliance P. 118: The Seven Chakras: Graphic, Under License; Adobe Stock Photo Service, Used in compliance P. 119- 120: Original Photo/ Graphic images: Courtesy Anthony B. James P. 122: Original Photo/ Graphic images: Courtesy Anthony B. James P. 123: Healing Hands: Graphic, Under License; Adobe Stock Photo Service, Used in compliance P. 127: The Monk: Original Photo/ Graphic images: Courtesy Anthony B. James P. 144 BIBLIOGRAPHY [1] Nuat Thai, Traditional Thai Medical Massage… [2] Brun and Schumacher: “Traditional Herbal Medicine in Northern Thailand”: 1994 edition, White Lotus, Bangkok, Thailand. [3] Barbara Andaya, “Political Development between the Sixteenth and Eighteenth Centuries” in The Cambridge History of Southeast Asia, Volume One, Part Two, from c.1500 to c.1800 (Singapore: Cambridge University Press, 1992), 66-67. [4] Anthony Reid, Southeast Asia in the Age of Commerce 1450-1680—Volume Two, Expansion and Crisis (New Haven and London: Yale University Press, 1993), 69. [5] David Wyatt, Thailand: A Short History (New haven and London: Yale University Press, 1982), 104. [6] William A. R. Wood, A History of Siam (Bangkok: Chalermnit Bookshop, 1959), 146. [7] http://www.samurai-archives.com/jia.html [8] Seiichi Iwao, editor and translator. Jeremias van Vliet Historiael verhael der Sieckte Ende (Tokyo: The Toyo Bunko, 1958) vii-viii. [9] Kennon Breazeale, “Thai Maritime Trade and the Ministry Responsible” in From Japan to Arabia: Ayutthaya’s Maritime Relations with Asia (Bangkok: Printing House of Thammasat University, 1999), 7. [10] Barbara Andaya, “Political Development between the Sixteenth and Eighteenth Centuries” in The Cambridge History of Southeast Asia, Volume One, Part Two, from c.1500 to c.1800 (Singapore: Cambridge University Press, 1992), 66-67. [11] Khien Theeravit, “Japanese-Siamese Relations 1606-1629: in Chavit Khamchoo and Reynolds Thai-Japanese Relations in Historical Perspective (Bangkok, Innomedia Co. Ltd., 1988), 19. [12] Jivaka-Komarabhacca in Pali Cannon: http://www.palikanon.com/english/pali_names/j/jiivaka. htm [13] Jivaka called ”Komarabhaca: “The treatment of infants”, VT.ii.174; in Dvy. (506-18) [14} Jivaka: http://nalanda-insatiableinoffering.blogspot.com/2010/06/jivaka-amravana.html [15] Jivaka name documented in Pali Cannon: Studies in Traditional Indian Medicine in the Pāḷi Canon: Jīvaka and Āyurveda”, (Kenneth G. Zysk, Journal of the International Association of Buddhist Studies 5, pp. 309–13, 1982) [16] Jivaka: “Giving of Robes” (Vin.i.268-81; AA.i.216) [17] Jivaka treats Buddha’s ailments: Buddha reads Jivaka’s thoughts and bathed as required: Vin.i.279f; DhA. (ii.164f) [18] Jivaka declared by the Buddha chief among his lay followers loved by the people (aggam puggalappasannānam) (A.i.26) [19] Jivaka included in a list of good men who have been assured of the realization of deathlessness (A.iii.451; DhA.i.244, 247; J.i.116f) [20] Jivaka and Vejjavatapada: In the seven articles, excerpts from four passages in the Pali canon, the Buddha lays down the attitudes and skills which would make “one who would wait on the sick qualified to nurse the sick.” “Doctors Code of Conduct”: Anguttara Nikaya III, p.144 (The Vejjavatapada likely predates the Greek Hippocratic Oath.) [21] Provide for the sick: Brahma Net Sutra, STCUSC, New York, 1998, VI,9. [22] Traditional Medicine in Kingdom of Thailand: http://www.searo.who.int/entity/medicines/topics/traditional_medicines_in_the_kingdom_of_thailand.pdf?ua=1 [23] Traditional knowledge and traditional medicine: https://www.wto.org/english/tratop_e/trips_e/ trilatweb_e/ch2d_trilat_web_13_e.htm [24] Ministry of Public Health also controls the curricula of the institutions which provides teaching and practicing of Thai traditional medicine.: http://www.thailawforum.com/articles/Thai-traditional-medicine-protection-part1-3.html#64 [25] The efficacies of trance possession ritual performances in contemporary Thai Theravada Buddhism, p. 120: https://ore.exeter.ac.uk/repository/bitstream/handle/10871/15758/ChamchoyP_TPC. pdf?sequence=3&isAllowed=y [26] The Use of Traditional Medicine in the Thai Health Care System: http://www.thai-institute.net/ P. 145 thai-massage-herbs-articles/Thai%20Healthcare.pdf [27] The Role of Thai Traditional Medicine in Health Promotion: Vichai Chokevivat, M.D., M.P.H. and Anchalee Chuthaputti, Ph.D. Department for the Development of Thai Traditional and Alternative Medicine, Ministry of Public Health, Thailand [28] Ban Chiang Archaeological Site: http://whc.unesco.org/en/list/575 [29] Kennon Breazeale, “Thai Maritime Trade and the Ministry Responsible” in From Japan to Arabia: Ayutthaya’s Maritime Relations with Asia (Bangkok: Printing House of Thammasat University, 1999), 7.[30] Legal Status of Traditional Medicine and Complimentary/ Alternative Medicine: A Worldwide Review: Thailand: Kennon Breazeale, “Thai Maritime Trade and the Ministry Responsible” in From Japan to Arabia: Ayutthaya’s Maritime Relations with Asia (Bangkok: Printing House of Thammasat University, 1999), 7. [31] Vichi Chockevivat and Anchalee Chuthaputti, ‘The Role of Thai Traditional Medicine in Health Promotion’ (Paper presented at the 6th Global Conference on Health Promotion, Bangkok, Thailand, 7-11 August 2005) 2. [32] Angkor influenced Architecture in Thailand: http://www.hellosiam.com/html/Thailand/thailand-history.htm Websites and Blogs: (http://nalanda-insatiableinoffering.blogspot.com/2010/06/jivaka-amravana.html) Politically, however, the Khmer cultural dominance did not control the whole area but exercised power and cultural influence through vassals and governors.” (http://www.hellosiam.com/html/Thailand/ thailand-history.htm) ITTM/ Thai Massage Reference: www.ThaiMassage.Com P. 146 Index A Abhayarajakumara 20 Achilles tendon 49, 53, 65, 80 Adductor longus 51 Adductor magnus 51, 64 Ahimsa 10 Ai Lao 26 Air 10, 33, 119, 121 Amma 23, 28, 31, 98 Angkor 27, 30, 39 Anguttara commentary 20 Annointing 21 Anthony B. James 3, 5, 13, 135, 136 Aromatherapy 21 asana 11, 57, 123 Ashtanga Hridya 11 ASIS 45 Athara Veda 19 Atreya 21 Ayurveda 1, 3, 5, 9, 10, 12, 15, 19, 21, 29, 30, 33, 34, 41, 98, 99, 100, 117, 120, 123, 124, 132, 135 Ayutthaya 19, 22, 23, 25, 26, 27, 28, 30, 44 B Bangkok 6, 8, 10, 13, 19, 22, 23, 25, 28, 30, 98, 102, 121, 143, 144 Bicycle 62 Bihar 20 Bi-Lateral Palm Press 53 BODY MECHANICS 43 Bone Setting 26 Bput Bpa Tu Lom 59 Brahmajala Sūtra 22 Break Bread 62 Brun 10, 144 Buddha 7, 10, 20, 21, 22, 26, 27, 28, 30, 43, 44, 83, 121, 144 Buddhist medicine 10 Buddhist medicine 10 Buddhist Psychology 10 Burma 17, 19, 22, 28, 29 Burmese 19, 22, 23, 28, 98, 123 Butterfly 53, 74 C Cambodia 17, 23, 28, 39 Carpal Tunnel 60, 125, 131, 132 Chakra 10, 37, 82, 94, 98, 105, 109, 114, 117, 118 Charaka Samhita 11, 98 China 15, 17, 23, 24, 26, 27, 100, 116 Chinese medicine 10, 18, 100 Chirothesia 11, 19, 21, 26, 132 Circle and Pull 62 Circular thumb pressure 40 P. 147 CLIENT 35 Cross Thumbs 62 D Dak Kha 55, 56 DAK WUKAO 57 DalhaSa 20 Danny Inosanto 16, 32 Dhanvantari 19, 39 Dharma 10 Din 10, 33, 119, 121 disease 9, 10, 11, 20, 26, 33, 34, 44, 46, 99, 105, 111, 118, 120, 124, 125, 128, 133, 138 Dosha 10, 44, 98, 121 Dvaravati 27, 29 E Earth 10, 33, 114, 117, 121 Eight Fold Path 10 Ekapada Uttanapada Asana 59 Elbow 42, 74, 75, 89, 139 epigraphies 23 Epigraphies of King Rama 24 Expect to see the miraculous 128 Extensor digitorum longus 47 Extraordinary meridians 28 F Fai 10, 33, 119, 121 Fa Meung 50, 51, 55 Fatao 52 Filipino Hilot 23 Fire 10, 20, 33, 121 Five Knee Lom 46 Five Knee points 45 Four Divine States 126, 143 Friend of Thailand 13 G Gastrocnemius 47, 53, 80 GENERAL NOTES ON DEVISING TREATMENTS 37 General Thoughts on ITTM 127 Giving of Robes 21, 144 Gracilis 51, 64 H Half Locust 42 Half Pigeon Pose 57 Hand to Big Toe Pose 58 Harada Pradapika 11 Hatha Yoga 11, 24, 42 Herbology 15, 21 Hill Tribes Akha 15 Karen 15 Lisu 15 P. 148 Shan 15 Hinayana 21, 127 Hindu 19, 26, 29, 124 Hiuen Tsang 20 holistic 10, 18, 21, 33, 44 Humors 10 I India 15, 17, 24, 26, 27, 28, 29 Indian Law 26 Indian Naturopathy 15, 132 Indigenous Traditional Thai Medicine 1, 3, 5, 8, 15, 19 ITTA 13, 14 J Jagannath 19 Japanese Samurai 28 Jap Sen Nerve Touch 15 Jivaka Amravana 20 Jivaka Komalaboat 20 Jivaka Kumar Bhaccha 20 Jyotish 29 K Kabri-Kabrong 27, 28 Kampuchea 17, 27 Kapha 44, 121 Khmer 26, 27, 28, 29, 30, 98, 100, 144 Khruu 6, 8, 10, 13, 15, 22, 25, 28, 33, 44, 83, 102, 127, 142 King Bhumibol Adulyadej 14 King Bhumibol Adulyadej 14 King Naresuan 19, 28 Klai Sen 40, 48, 62, 93 Korosot 29 Krungthep Dvaravati Sri Ayutthaya 27 Kubla Khan 27 Kwan 10, 16, 142 L Lang Myung 62 Lanna kingdom 27 Laos 17, 22, 28, 116 LATERAL UPPER LEG 45, 55 lineage 9, 10, 13, 29, 38 Locust 42 Lom 10, 23, 33, 38, 43, 44, 46, 47, 48, 50, 51, 58, 59, 61, 62, 64, 68, 70, 74, 75, 76, 77, 79, 81, 82, 97, 99, 100, 111, 117, 119, 121, 141 M Magadha Kingdom 20 Maharlika 26 Majapahit 20, 26, 29, 30, 98, 100 Malay 19, 98 Malaysia 17, 28 P. 149 Mantra 10, 22, 44, 118 Marma 21, 23, 38, 41, 43, 46, 58, 59, 77, 97, 98, 99, 100 Marma Cichitsa 21 Massage Law 9 Massage Therapy 9, 10 Massanauga 28 Metta 13, 50, 123, 126, 142 Midwifery 26 Moh Boran 25 Moh Phaen Boran 25 Mon 26, 28, 29, 98, 100 Mon/Khmer 26, 28, 29 Muay Boran 25 Muay Thai Boxing 25 Myanmar 17, 19, 28 N Naam 10, 33, 119, 121 Nalanda University 20, 21 Narayana 19 Narn Chao 27 Navan_taka 20 neuromuscular facilitation 125 Ng Quan Lee Cho 27 Nuat Thai, Traditional Thai Medical Massage 9, 13 O Ohashi 28 Oliation 21 OM NAMO SHIVAGO 20, 22, 44 OPEN THE WIND 59 P Pali 11, 21, 22, 83, 126, 144 Palm 39, 41, 50, 51, 53, 55, 56, 58, 60, 61, 62, 64, 66, 72, 76, 79, 86, 88, 139 Palm pressure 41 Pancha Karma 21, 98 Paschimotanasana 42 Per Henrick Ling 9 Peroneus longus 47, 79 Phaen Boran Ráksãa Thaang Nûat 9 Philipines 17 Pitta 44, 121 PRACTITIONER 35, 129 Pradapika 11, 19 Prakru Pipitpattanapirat 6, 34 Prana 10, 23, 43, 73, 78, 98, 99, 100, 102, 109, 114, 117, 119, 123 Pranamaya Kosha 98 Prana Nadis 23, 98, 99, 102 Pra Narai 19 Press the foot 49 Press Toes Forward 49 PRINCIPLES OF ITTM 36 Promiiwihan Sii 124, 126, 132 Prone Position ANTERIOR LOWER LEG 79 P. 150 CROSS ANKLES AND PRESS 79 CROSS TOE PRESS 80 LOW BACK LOM 74 POSTERIOR LATERAL LEG 78 POSTERIOR LEG 76 POSTERIOR SIDE SHOULDER/ UPPER ARM 75 PRONE FOOT PRESS 80 THE COBRA 77 THE HALF LOCUST 81 TORSO AND GLUTEAL POINTS 77 TORSO LAMINA GROOVE 74 Puja 10, 44, 83, 127, 138, 143 Puranas 19 R Raja Bimbisara 20, 21 Rajgir 20, 21 Ramayana 19 range of motion 33, 38, 49, 56, 72, 73, 77, 78, 87, 90, 124, 125, 132, 133, 138 Reclining Buddha 27, 28, 43 Reinforced thumb pressure 40 Reishi Yoga 11, 43 Reusi Dottan 11, 24, 25, 43 Rigveda 11 Rig Veda 19 ROCKING 42 Rolling 40, 41, 45, 47, 51, 52, 55, 60, 61, 64, 65, 67, 68, 70, 74, 75, 76 Royal Thai Tourism 14 S Salavati 20 Samana 11 Sanskrit 11, 21, 29, 44 Sao Nong 53, 54, 56 Sartorius 51 Savasana 35, 42, 74 Schumacher 10, 26, 27, 144 Seated Position Cranial lift 93 FACE TREATMENT 97 FULL FORWARD BEND 96 NECK ROTATION 94 POSTERIOR UPPER TORSO 92 REINFORCED UPPER TORSO ROTATION 95 SEVENTH CHAKRA RELEASE 94 SPINAL PUSH 95 Second Supine Position ABDOMINAL PRESS 85 ABDOMINAL TECHNIQUE 82 ANTERIOR TORSO 86 Big Belly Circles 82 CROSS LEGGED PULL UP 91 Figure Four 86 FIVE BASIC ABDOMINAL POINTS 84 INFERIOR FOOT 52, 65, 89 MEDIAL UPPER LEG 50, 86 POSTERIOR UPPER LEG AND CROSSED LEG COMBINED 88 P. 151 PUSH AND PULL 83 SPINAL ROTATION 87 STRAIGHT LEG PULL UP 90 SUPPORTED SHOULDER STAND 89 THE PLOW 90 The Wave 83 Sen 10, 15, 23, 28, 40, 41, 42, 43, 44, 45, 46, 48, 58, 62, 69, 72, 73, 74, 82, 85, 93, 99, 100, 102, 104, 105, 106, 107, 108, 109, 110, 111, 112, 113, 114, 115, 116, 117, 118, 119, 121, 123, 140, 142 Sen Kalathari 51, 72, 104, 110 Sen Sahatsarangsi 49, 51, 104, 112 Sen Sumana 51, 104, 105, 110 Sen Thawari 49, 51, 104, 112 Shiatsu 23, 28, 31, 41, 98, 100 Shivago 15, 20, 22, 25, 44, 99 Shoulder Stand 42 Side Lying Position BRING THE HEEL TO BOTTOM 66 INFERIOR FOOT 52, 65, 89 INFERIOR MEDIAL UPPER LEG 64 LATERAL ARM PRESS 71 LATERAL CRANIUM 71 LOWER/MIDDLE BACK LINE/ POINTS 68 MEDIAL ARM PRESS 72 MEDIAL SCAPULA 69 POSTERIOR CERVICAL: NECK 70 SPINAL ROTATION AND STRETCH 73 SUPERIOR LATERAL LEG 66 Three Hip Points 67 Six Evil Influences 10 Snake thumb 40, 48, 143 soft tissue 10, 18, 33, 37, 39, 41, 101, 121, 125, 131, 132 Soleus 47, 53, 80 Somatic Homeostasis 10 Somatic technique 10 Somatic therapy 11 Southern Style 12, 44 Sri Lanka 22, 25 Straight Arm Press 58 STRAIGHT LEG STRETCH 59 Stretch Fingers 62 Sukhothai 19, 27 Sumatra 29, 30 Supine Position DAK WUKAO 57 Five Knee Lom 46 OPEN THE WIND POSITION 59 Position Four. Straight Arm Press 58 STRAIGHT LEG STRETCH 59 SUPINE ANTERIOR ARM 60 SUPINE ANTERIOR FOOT 48 SUPINE ANTERIOR HAND 62 SUPINE ANTERIOR KNEE 46 SUPINE ANTERIOR LATERAL UPPER LEG 55 SUPINE ANTERIOR UPPER LEG 54 SUPINE INFERIOR FOOT 52, 89 SUPINE LATERAL LOWER LEG 47 SUPINE LATERAL UPPER LEG 45 P. 152 SUPINE MEDIAL LOWER LEG 51 SUPINE MEDIAL UPPER LEG 50, 86 SUPINE POSTERIOR LOWER LEG 53 SUPINE POSTERIOR UPPER LEG 49, 88 SUPPORTED STRAIGHT LEG 58 Sushruta Samhita 11, 19, 98 T Ten Rules of the Healer. 10 Thai Ayurveda 11 Thai Massage 8, 9, 10, 11, 13, 14, 15, 19, 24, 30, 31, 33, 123, 134, 135, 136, 137 Thai Medicine Schools Anantasuk School of Traditional Thai Medicine 14, 44 Ayurved Vidyalai 25 Buddhai Sawan Institute 6, 8, 13, 102 Old Medicine Hospital 15 SomaVeda College of Natural Medicine 16 Thai Yoga Center 16 UTTS 15, 25 Wat Amperwa 25 Wat Chetuphon 6, 28, 102 Wat Po 6, 8, 13, 14, 15, 22, 23, 24, 25, 27, 28, 31, 43, 44, 102, 116, 121 Wat Po Association of Schools 14 Wat Raja Orasaram Ratchaworawiharn 23, 24 Wat Sawankholok 25 Wat Suandok 25 Wiangklaikangwan Industrial College 14, 29, 44 Thai Medicine Teachers Aachan Cha 6 Aachan “John” Chongkol Settakorn 15 Aachan Sintorn Chaichagun 8, 25 Aachan, Sintorn Chaichagun 15 Aachan Tawee 15, 25 Khruu Moh Velawong Sidtisopong 6 Khruu Pichest Bootum 15 Mama Lek Chaya 15 Moh Boonsorn Kitnyam 6, 8, 13 Phaa Khruu Anantasuk 25 Phaa Khruu Men 6, 8 Phaa Khruu Samaii Mesamarn 6, 13, 28, 33, 44, 83, 102 Phrakhru Uppakarn Phatanakit 6, 8, 44 Prakru Pipitpattanapirat 6, 34 Thai Reishi 8, 24 Thai Yoga 9, 10, 11, 13, 14, 15, 16, 18, 19, 24, 98, 123, 135 The Code of Manu 26 Theraveda Buddhism 10 Thumb pressure 40, 60, 65, 67, 68, 70, 75, 76 Tibetan 10, 23, 123 Tibialis anterior 47, 49 Traditional Herbal Medicine in Northern Thailand 10, 26, 144 Traditional Thai Massage 9, 11, 13, 14, 15, 19, 24, 30, 31, 33, 134, 135, 136, 137 Tri-Dosha 10 Tui Na 23 Twist the foot 49 Two Hand Hacking 56 U P. 153 Union of Thai Traditional Medicine Society 15 Unique Characteristics of ITTM 12, 18 V Vastis medialis 51 Vata 44, 121 Vejjavatapada 21, 144 Vietnam 26 Vinyasa 11, 12, 44 Vipassana 6, 10, 11, 143 Virgil Apostal 26 Vishnu 19 W Wai Khruu 10, 22, 44, 127 Water 10, 33, 114, 121 Wat Mahatat 7 Wat Prakeodontao Suchadaram 6 Way of the Ancient Healers 26 WHO UN DESA 25 Wind Gates 23 X Xuanzang 20 Y Ya na Ka 49 Yoga 1, 3, 9, 10, 11, 13, 14, 15, 16, 18, 19, 24, 32, 40, 42, 43, 44, 57, 73, 98, 123, 135, 136 Yoga Therapy 1, 3, 11, 13, 19, 42, 43, 73, 123 Yoga-Yajnavalkya 11 Z Zysk, Kenneth, G 21 P. 154 Additional Resources Learn more about Indigenous Traditional Thai Medicine and Thai Yoga www.ThaiMassage.Com Where to gain professional training and certification in ITTM SomaVeda College of Natural Medicine (SCNM) www.SomaVeda.Org The Thai Yoga Center www.ThaiYogaCenter.Com 5401 Saving Grace Ln. Brooksville, Florida 34602 (706) 358-8646 www.FaceBook.Com/LearnThaiYoga www.YouTube.Com/SomaVeda1 P. 155