Thai Massage and Thai Medicine Diagnostics & Treatment in Thailand

Published | Updated February 11, 2019

Thai Massage and Thai Medicine Diagnostics & Treatment
The basic principle of every branch (including Thai massage) of Thai Traditional Medicine is the knowledge of the Four Body elements, their functions and their interrelations which affect health or illness of the individual. In Thailand, the Four Body elements are regarded as the foundation of the body and the foundation of life.

Diagnosing diseases according to the Four Elements take many years of practice to develop. Traditionally, Thai apprentices studied under competent teachers for decades before they were considered to be healers.

However, some basic guidelines concerning the Four Elements can be outlined:


Earth represents the structural organs and constitutes the physical fundamentals of the body. Imbalance of the Earth element would manifest as symptoms of the organs associated with the Earth element.

Some examples would be: skin disease, bone disease, tumors, and other “solid” disorders.


Water represents all liquids, phlegm and semi-solids flowing and being absorbed by the body. The water element resides in the earth element and requires the wind element for movement.

Imbalance of the Water element would manifest as symptoms of the organs associated with the Water element such as blood disease, eye disorders, renal disease, venereal disease, bladder or urinary tract infection or stones, diabetes, and any diseases manifesting in abnormal urine or other liquid discharge.

Wind (Air)

Wind represents energy that controls movement in the activities and functions of the body: upward wind, downward wind, abdominal wind, wind in the bowels, wind in blood circulation, wind penetrating all over the body and respiration (breath). Constitutes lightness and circulation throughout the body.

Imbalance of the Wind element would manifest as symptoms of the organs associated with the Wind element such as pneumonia, cough, mucous congestion, tuberculosis, bronchitis, other respiratory infections, fainting, dizziness, and arthritis. The Wind element is considered to be the most important element in promoting mobility, strength, longevity, and vitality.


Fire represents vital heat energy that warms the body, heat-up or burn. Consists of heat and life energy. Fire has the nature to burn, to destroy, to transform and to produce and radiate life energy. Fire relates to the other elements as it assists the wind and water element to flow with the right temperature. Fire keeps the earth element warm to maintain the body organs in a healthy condition.

Imbalance of the Fire element primarily manifests as diseases of the heart and circulatory system.


A complete picture of the organ system involved in the disease should be developed by asking questions, observing symptoms, and palpating the body of the patient.

The Ayurvedic system of tridosha is frequently used to assist in diagnosis. For those already familiar with the tridosha system, this can be easily incorporated into Thai diagnosis by remembering that excessive Vata corresponds to excess of the Air element; excessive Pitta corresponds to excess of the Fire and Water elements; and excessive Kapha corresponds to excess of the Earth and Water elements.

Other common diagnostic techniques such as phrenology, reflexology, tongue diagnosis, and pulse diagnosis are also used by Thai healers, although they originally belong to traditional Chinese medicine and are later additions to the Thai system.

After the affected organ system is identified, the Thai healer would determine whether the disorder is manifesting as excess or depletion.

Excess is typically accompanied by tightness, swelling, strong sharp pain, fever, skin eruptions, redness, fullness, high blood pressure, fast pulse, high body temperature, and radiation of symptoms in an outward direction. The excessive patient usually expresses anxiety, tension, irritability, shortness of temper and breath, and insomnia.

Depletion, on the other hand, is typically accompanied by atrophy, emaciation, lack of appetite, dull aching pain, paleness, gauntness, emptiness, low blood pressure, slow pulse, low body temperature, and concentration of symptoms in an inward direction. The depleted patient usually feels weakness, dizziness, fatigue, sleepiness, and nausea.

After diagnosis, the Thai healer will treat the patient to either stimulate or soothe the particular organ (system). Naturally, the sort of treatment will also depend on the specific healer and his or her specialty in either spiritual healing, massage or nutrition.

We should keep in mind the above points, but should also recognize that even in conventional medicine, diagnostic skill can sometimes be an art rather than a science. Symptoms can often appear as a mix of excess and depletion, and can appear in more than one organ system.

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