Traditional Thai Medicine and the Four Body Elements

Published: Jul 3, 2018 | Updated: Mar 29, 2023
Written by: Marce Ferreira

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Thai Medicine, Thai Massage & the Four Body Elements

According to Traditional Thai Medicine, the human body is composed of four fundamental elements: earth, water, wind and fire. To better understand the Thai Healing Arts it’s helpful to have a grasp of the idea of the four elements behind Thai Medicine.

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But first things first: the Thai people certainly do not believe that there is literally a piece of earth, a drop of water, a breeze of wind or a flame of fire in each atom of the universe. It’s rather that each element refers to the qualities of that substance, where substances are, for instance, organs, cell tissue, processes, functions, and so on.

Substances that are solid can be said to have the qualities of the Earth element. Substances that are liquid are of the Water element. Movement is the quality of the Air element, and Heat is the quality of the Fire element.

Some basic guidelines concerning the Four Elements and the human body can be outlined as follows:


Earth represents the structural organs and is about the physical makeup and building blocks of the body. Imbalance of the Earth element would manifest as diseases or discomforts of the organs associated with the Earth element. Some afflictions could be skin diseases, bone diseases, tumors, and other so-called solid disorders.


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

Imbalances of the Water element could manifest as problems with the organs associated with the Water element such as blood diseases, eye disorders, renal and venereal diseases, bladder or urinary tract infections or stones, diabetes, and diseases manifesting in abnormal urine or other liquid discharge.

Wind or Air

Wind represents the 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). Wind represents and constitutes lightness and circulation throughout the body.

Imbalance of the Wind element could manifest as symptoms 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 and heat-up the body. It consists of heat and life energy. Fire has the nature to burn, to destroy, to transform and to produce and spread life energy. Fire relates to the other elements as it supports the Wind and Water element to flow with the proper 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, which includes health issues with our digestion, blood circulation and lymphatic system.

According to the concepts mentioned above, the organs and functions of the human body can be broken down into the following categories:

Four Body Elements

For each person, there will be one element that is more dominant than others. One’s own dominant element is basically determined by the date and month of one’s conception. This basic element of a person plays an important role with regard to one’s characteristics and appearance as well as the weak point(s) in one’s health.

The constant interaction of the four elements creates and sustains the processes of the human body. It is of vital importance, therefore, to keep the four elements balanced throughout life.

When the four elements of the body are in equilibrium, it will be healthy. In contrast, if an imbalance in these elements occurs, that is, if there is a deficit, an excess, or disability in any of the four elements, a person will become ill.

During our life, the elements go in and out of balance in a continuously changing state of health or disease. Children and the elderly are more susceptible to disease than average adults because of the delicate state of their elements.

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In children, the four elements are not yet fully mature, and in the elderly, they are weakened by many years of life. Gradually, the elements become more and more weak, and ultimately, when they are exhausted, the individual dies.

The primary aim of Traditional Thai Medicine is to promote health and longevity by maintaining the vitality and balance of the four elements. Thai Massage and its theoretical concept of Sen Energy lines and its practical application in manipulating the energy lines ( which in their turn relate to the four body elements) is one of the means or tools to reach this goal.

The secondary aim is of course “curing or treating the disease” (with for instance Thai Massage), but it’s obvious that prevention (the primary goal) will often remove the necessity of curing (the secondary goal).

The Causes of Illness

As we can read in the article Fundamentals of Traditional Thai Medicine, in the Thai system, the root cause of all illness is the imbalance between the Body, Citta, and Energy (Prana). When the three essences are balanced, the human organism subsequently enjoys health and well-being.

Being more specific, one could say that illness is caused by an obstruction of the availability, and free flow or free exchange of (life) energy (Prana), which will be usually due to a problem (malfunction) in the Physical Body or in the Citta (heart/mind) caused by an imbalance in the Four Elements.

According to Traditional Thai Medicine, this obstruction of free flowing energy can be caused by the four following factors which influence the Four Elements:

  1. Supernatural powers;
  2. Power of Nature;
  3. Power of the Universe;
  4. Power of microorganisms.

More in detail one could recognize the following aspects:

1. The four elements themselves
The imbalance in the four internal elements can be caused by a direct imbalance in the four external elements (environmental influence).

2. The seasons
Heat and cold during different seasons clearly can affect human health.

3. Age
During different periods of our lives, people are more prone to get ill from the influence of different elements.

4. Geography
As the geographic location of where one life dictates the weather and the environment, it can play a role in affecting one’s health.

5. Time
Astrologically, the sun, moon and stars continuously move, thereby influencing human life and health differently, even during different times of the day.

6. Inappropriate behaviors that can be the causes of ailments are:
• Inappropriate eating habits, that is—eating too much or too little, eating food that has gone bad, or unfamiliar food, or food that is not suitable for one’s own dominant element or diseases.
• Imbalanced postures while sitting, standing, walking, or sleeping can lead to disequilibrium of the body structure and needless worsening of health.
• Exposure to extreme weather or polluted air.
• Being deprived of food, water or sleep.
• Delayed urination or defecation.
• Overwork, over-exercise, or excessive sexual activity.
• Deep sorrow or extreme exhilaration.
• Extreme anger, or lack of equanimity.

7. Supernatural powers
Ancestors souls, powerful spirits of the forest, evil spirits, punishment from a heavenly spirit of those who misbehave.

8. Kimijati
The Thai equivalent of microorganisms (bacteria, viruses) or parasites.

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