We have been able to ascertain from ancient records that Traditional Thai Medicine, traditional Chinese medicine and the Indian Ayurvedic originated about 5,000 years ago and were developed from a blend of both diagnosis and therapy concepts. These origins came about mainly from the spiritual sources of Buddhism which began in India and which is still today the official religion of Thailand. A further cause can be found in the similarities of the botany of the Indian subcontinent. The Kingdom of Siam which in 1939 at the start of World War II changed its name to Thailand – Land of the Free – and thereby declaring its neutrality was known in the 19th century in Europe as 'Rear-India’.

During its many thousand years old history and particularly during the European colonial era, Thailand has never been colonized and has thus escaped the influence of Western powers. Furthermore, an historical intermingling of Thai and Chinese peoples began and continues uninterrupted to this day. India was however, an English colony until about the middle of the last century, and even China bowed to the political and commercial influences of the Western leaders.

This blending of two peoples and their ethnic medicines came about more through power politics than for reasons of spiritual need. This is quite clearly explained by the association of the Indian elements of belief in Buddhism with the strong ethnic components of the holy teachings from India of Buddha Siddhartha, which are demonstrated in the architectural forms of antique buildings (Wat Arun) up to the more recent Ayuttaya stupas and represented in the present day temples (Wats). Not only the architecture, but also the cultural arts are marked by the influence of Indian aspects.

Thailand is still a highly religious state in which the leaders of its belief stand above the king in the national hierarchy. Right up until the last century, this form of ethnic medicine was almost exclusively the reserve of the citizens of Thailand. Dispensed by monks and also by academic healers, it was the only form of cure, which was available to the people. It was a kind of medicine, which in a Western sense, a commercially 'poor’ but happy people could afford. The traditional values of the old Western world – Europe – reigned over the domains of health and the curing of sickness as well as the Christian ideals and religious edicts represented demands for hygienic and healthy preventative measures such as the Friday fast etc.

Indeed in the old worlds of both the West and the East the clerics were those who steered the culture of curing. Healing methods, health care, and also reparation medicine for the social illnesses of the last century triggered in Thailand by western lifestyles and food are more similar to the treatment concepts of Indian Phytotherapy but having a clear independence on botanical substances, which are exclusively indigenous to Thailand.

The limits of Ayurvedic, which loosely translated means 'Long life’, are explained as follows:

Diagnostic and systematic treatment and the way of regarding sickness and lifetime remain more intrinsic to the traditional Thai medicine than the original teachings of India, the manual -meridian and acupuncture - of Chinese origin, and their practitioners. In conclusion it can be said that TMM has retained and developed the best of both of the ancient concepts.
The geographical situation of Thailand in between the two cultural areas, its climatic tropical features such as relatively dry coastal regions, hilly jungle and mountains with tropical rain forests and regions of tropical continental climate which experience winter night frost are the factors which give rise to the unique Phytotherapy of Thailand. Thus according to the Thai pharmacopoeia, the land enjoys over 15,000 species whereas Europe can boast only about 3,000. Asia and the Far East have always been the lands with the longest tradition of plant cures, due not only to this vast range of available varieties, but also to the fact that the people consume far greater quantities of plants and vegetables in their daily diet, and Thailand plays here a far more important role than was previously realized

India's Ayurvedic versus traditional Thai medicine:

From an historical point of view, the Ayurvedic is not traditional Indian medicine, being rather more the result, as in China, of empirical experience of the origins of ethnic and folks medicine out of the practice of the traditional healers and their basic roots and knowledge.
With its multitude of folk groups and what for us are often incomprehensibly complex forms of treatment, China has developed its tradition which while the Chinese were always a commercially talented people, has now been marketed in the West for quite some time
The fascinating success, which manual forms of diagnosis and treatment of the meridians by traditional Chinese medicine has had on diseases, which by western definition are classed as incurable (cancer) by academic medicine, cannot be denied. This has now found recognition in the western schools of medicine. It is however rare for us to bend to the great significance of the spiritual essence of these cures, as the Chinese texts which are available to us are extremely difficult to interpret.

The Indian Ayurvedic is an 'academic’ school medicine. It requires a technical high school major and a stiff entrance exam followed by a nine semester course of study after which comes a one-year internship. These highly demanding requirements for qualification have been the rule since one can remember. For traditional Thai medicine similar conditions have only been in practice again for a few years and this is due to reasons of health and social politics. It is only during the last decade that Thailand has looked back on its folk medicine in broader detail, and it is in this sphere that the author, as one of the very few concerned and qualified western medical practitioners, has been able to contribute to this initiative. This 'rediscovery’ has taken place due to the spread of western health politics reaching Thailand since the Vietnam war. Thus the class of leading medical personnel and specialists has almost without exception been trained in the USA. This group of 'opinion leaders’ which was largely recruited from rich Thai families brought a wave of antibiotics into the land which created more damage than aid to social health. At the same time, these doctors as well as the American trained pharmacists installed a pharmaceutical lobby in the country. The result being that there are now over 400 firms producing drugs in Thailand, but without their own research facilities. All the medication found on the market in western countries is now being produced as cheap generics at low labor costs and in quantities that are far superfluous to requirements. This leads not only to a drop in prices of these sometimes-necessary products, but also to an excessive use. Finally, this increases the budgetary demands on the health services to excessive levels, as it does in Europe, and the government has had to seek alternative measures. Due to the very liberal approach, in comparison with West, to press and television advertising in Thailand where legislation is slow and constraints have yet to be imposed, and due also to the OTC (Over The Counter) availability of medicines which are freely displayed on supermarket shelves, and for which also legislation has not yet imposed any prescription requirements, it has become a habit to treat every little complaint with a pharmaceutical product. Not only has this incurred the aforementioned economic problems, but worse, it has also led to an overall drop in the standard of general health in the country. Thus the way was laid open to reconsider the old values of herbal medicine and traditional cures.

The significance of TTM in social medicine

With the aid of the state, an institutional Primary Health Care system was initialized with regard to research into the medicinal herbs being used, whereas in European faculties whose emphasis is on pharmaceutical training, traditional medicine was left to slumber like a 'Sleeping Beauty“. Compared to Europe, those completing their studies in the pharmaceutical colleges of Thailand were however aware of the sometimes dangerous interaction between the substances used since time immemorial in traditional medicine with those of the modern European drug concerns. Almost without realizing it, Thailand had made an enormous step forward in the knowledge of the combined effects of long-term medication with products developed in western laboratories.

This is particularly valid in the field of western social diseases such as fat based disorders and their resulting complaints – cardiovascular, insult, the ever-increasing diabetes, allergic reactions and respiratory disease. Cardiovascular complaints are rapidly on the rise in Thailand due to the steady increase in the adoption of western life styles.

The Primary Health Care System is bringing the citizens of Thailand closer to the plants that are capable of combating the increasing social and degenerative diseases with little or no recourse to pharmaceuticals. This initiative is being financially supported by the royal family and is known as the 'King’s project’.

Also new is the "Home Garden Program“ which calls upon the people to cultivate the medicinal herbs, which have been well researched and tested and are known to be free of contraindications. They are being asked to grow these in their gardens and even on their balconies or verandas and in so doing, this self-medication can avoid unnecessary trips to the drug store and help to reduce the government’s health cost burden. The state is investing heavily to promote this scheme, which has already shown to have considerably reduced the deficit of the health care system. A milestone in this development was the introduction by government of the 30 baht hospital law in 2002.

This 30 baht law was of course strongly contested by the pharmaceutical lobby at first but was finally passed with success. Thirty baht is roughly equivalent to € 0.75 – the advantage can clearly be appreciated in Thailand where the average salary is 15,000 baht per month.

This 30 baht hospital law means in effect that every Thai citizen, whatever his financial situation is, has access to hospitalization or outpatient treatment irrespective of the type of health problem, whether it is long term, chronic, life endangering or incurable such as cancer or HIV. Obviously excluded from the system is dental and cosmetic surgery. The nation health service contribution is calculated at 3% of the gross salary and is retained at source each month. This 30 baht plan is also available to unemployed persons, farmers and the great number of people who have no health insurance. In a country where a form of social security is a relatively new concept, this represents an enormous achievement in health care, and one, which European ministries of health would not dare to consider.

Bypass surgery, organ transplant down to the smallest surgery is carried out lege artis and the ratio of hospitals to the population and its standard of living compares favorably with that of any western country. The application of personal responsibility by each citizen has made this cost saving act possible by their having rapidly recognized the importance of returning to their traditional cures and health awareness, beginning with sensible diets and preventative health measures. They have understood that this means using the medicinal herbs, which have been carefully researched and are known to be highly effective. In urban areas where the fresh products are not so easily available, they can now also be readily obtained in their prepared and dried forms.

Modern western medicine and empirical medicine do not only sensibly complement each other but they also demonstrate by Thailand's example which possibilities are available to us to improve the economic situation of health care systems and encourage progress from a medical point of view without 'medicine transfer’.

Until recently, diagnosis concepts and Fare-Eastern therapies were polarized by even the most learned of doctors according to where they came from and empirical medicine - ethno-medicine – was regarded as practice for cranks and outsiders. From the standpoint of alternative and complementary medicine however, classical western academic methods were considered narrow minded and slave to the pharmaceutical industry. Although these misunderstandings and grievances have still not been entirely put to rest, they will probably soon belong to the past as Western and eastern ideologies are making progress in their mutual approach.

Why do we in the West still know so little about traditional Thai medicine?

This is due to social and political conditions and their causes. From the previously mentioned fact that Thailand has never been colonized throughout its history – the translation of 'Thailand’ is 'Land of the Free’ – the knowledge of its ethnic medicine never became so widespread, unlike in India and China, which were influenced by the
West, it was practically never exported.

We can now take a look at the meaning of ethno-medicine:

Ethnic medicine, a term from the 19th century defines folk medicine in which the art of healing has been handed down through the ages. Doctors who were interested in the medicine of the people of colonized countries who were originally considered to be primitive coined the term. The linear evolutionist opinion of the progression from primitive medicine to so called modern medicine came under fire in during the 1950’s and was finally replaced in the 1970’s by research into medical systems. The word ethno medicine has become widely used in Germany and Austria although its exact origincannot be accurately determined. Whilst in Great Britain and in the United States 'medical anthropology’ - and in France "anthropology médicale“ – is a university doctrine and field of research and have a long tradition – keyword Colonies, in Austria and the Federal Republic of Germany it has not such a long recognition as an independent subject, and in contrast to the USA and the United Kingdom it remains an interdisciplinary domain of work and study which is approached from many different foci. It is to be hoped that the member states of the European Union will introduce some standardization in this area of education.

Whereas Indochina and India were very much under the influence of their respective colonial masters, France and Britain and their Far Eastern botany and medical knowledge reached the West relatively early; this did not take place from Thailand where its traditional medicine firmly held its ground.

The author has been traveling in Thailand for over thirty years. The Vietnam war introduced many aspects of Anglo-American influence into this country and this influence is well explained in the book The Culture Shock which would assist the interested reader in understanding this rapid and sometimes unbelievable process in greater detail.
Many more changes came about through the swift development of the tourist industry, which contributes, substantially to the GDP.

It has therefore only recently become possible for western researchers to investigate Thailand’s folk medicine. The author is a member of a university team which is concerned with botanical research and which is carrying out evaluation of the traditional medicine on behalf of the Thai government. The extensive land surface, the previously mentioned great number of varieties in its vegetation and the often dissimilar traditional cures throughout the 75 million populations, present this work with a very broad challenge.

A great deal has already been achieved in the last ten years, as can be shown by the primary health care system, and the Home Garden Programs is another important step in the future of the country’s health, but a lot still remains to be done. Before we come to discuss the most important of Thailand’s medicinal herbs, we should mention and describe the great medical challenges, which lie ahead. These are practically identical with those of Europe, if not even more dramatic.

The present valence of TTM in the West

The author is a member of the Lipid forum Austriacum (www.lipidforum.at), an association of research doctors whose aim is to declare war (sic) on one of the maladies of our times which has reached epidemic proportions, namely fat based diseases and their resulting conditions (diabetes, hypertension, stroke, arteriosclerosis, heart attack etc.).

This is carried out through the further education of medical personnel in the diagnosis, prevention and early treatment of this 20th and 21st century epidemic. It is not possible in the scope of this article to address the problems of lipid diseases in depth, but we will nevertheless bear in mind some important facts and keywords.
Austria holds, unfortunately, the world record for fatal heart attack. The rate of diabetes has increased enormously and overweight, due to an uncontrolled consumption of fatty products has become Austria’s number one dietary problem.

Uncontrolled consumption does not mean a total stop in the intake of fats, but to take the right kind of fats, and then less of them. Keywords: Omega 3 fatty acids, French paradox.
Because Thailand enjoyed exemplary anti-oxidizing nourishment, a high consumption of ice and a total absence of dairy products - these were not to be found on the Thai dietary menu - for many generations the country was free of the above health problems and their fatal results. Opening its arms to the West and the increase in the volume of foreign tourism brought with them a literal flood of western foodstuffs and drinks such as milk shakes, butter, chocolate, cakes and even a school milk programs. The problems of fat related illness are not only on an alarming increase, but also because of the genetic
composition of population they are also posing a real threat to the social health of a population, which previously did not have to contend with such diseases. At the present time, Thailand now has an occurrence of diabetes and its preliminary symptoms of about 20%, compared to the 6% of Austria. There is now a need for treatment, and in the wealthier classes of Thai society in urban areas, bypass operations are now commonplace. American fast-food chains can be found in every larger town, and its youth is being seduced by clever advertising into adopting this lifestyle, and with even more success than in the West.

The health authorities here have been advocating the use of medicinal herbs for prevention and cure for quite some time already. The results of recent research and study have proven conclusively that the Thai plants are the most suitable when used together with a return to more reasonable eating habits. At this juncture, we can now examine and describe the uses and effects of some of the primary health care plants in social and degenerative diseases.

Due to the fact Thailand has so many plants which can be used in cures, as we have already mentioned, and which due to the tropical climate and higher UV radiation (see Oxidization and Anti oxidization) these herbs are far more powerful than those which are grown in the West, and have therefore been submitted to much more research on their interaction with modern pharmaceuticals. (e.g. black currant in association with lipid reducers, which recently came under fire). As space does not permit this contribution to this book to enter into finer details, we will however attempt to give sufficient consideration to the most important of these plants - with their Thai and botanical names - for the benefit of the interested reader, doctor or pharmacist.