Traditional Medicine in Bangkok, Thailand

Abstract

Analysis of locational characteristics and accessibility of 230 Thai and Chinese traditional-medicine clinics in Bangkok, Thailand, focuses on relationships of clinics to city zones, subpopulations, and biomedical facilities. Patient distributions of eight traditional-medicine practitioners are studied in terms of their specialty, areal extent, and possible distance decay. Practitioners tend to locate in inner-city zones and in areas with a high percentage of commercial or built-up land. Traditional medicine is declining in Bangkok in the face of competition from biomedicine. M ORE than half of the population of the world relies on traditional medicine for health care. This reliance is prominent in developing countries. Yet the geographical aspects of traditional medicine are relatively unknown. The research reported here focuses on the geography of traditional medicine in Bangkok, Thailand. The statistical basis of the study was 230 traditional-medicine clinics, their site features, and their accessibility to patients. The distribution of these clinics was compared with that of biomedical facilities and in terms of Thai or Chinese ethnic affiliation. A small sample of traditional-medicine practitioners was used to examine how distribution of patients varies by specialty and by area as well as to isolate possible effects of distance decay. MEDICAL PLURALISM IN THAILAND In Thailand traditional medicine, which is prescientific, coexists with biomedicine or clinical medicine, which is based on the principles of natural science. Biomedicine was introduced to Thailand in 1828 by Presbyterian physician-missionaries from the United States and became well established during the reign of King Chulalongkorn (1868-1910). The first Thai medical school, opened at Siriraj Hospital in 1889, initially taught both traditional medicine and biomedicine; however, fourteen years later instruction in traditional medicine was discontinued. Currently, biomedicine, strongly supported by the Thai government, dominates health-care delivery in the country. A shortage of qualified personnel and facilities as well as their maldistribution has created serious problems in delivery of biomedicine. Although very little information is available on the use of traditional medicine, it is an important form of health care in Thailand. Many Thais, if not most of them, consult both traditional and biomedical practitioners. Traditional medicine may be divided into professional and nonprofessional categories. In Asia the most important professional traditional systems are ayurveda, established in India, and Chinese medicine. Two types of * DR. TECHATRAISAK is an assistant professor of geography at Ramkhamhaeng University, Bangkok 10240, Thailand. DR. GESLER is an assistant professor of geography at the University of North Carolina, Chapel Hill, North Carolina 27599-3220. This content downloaded from 157.55.39.209 on Sat, 14 May 2016 06:22:19 UTC All use subject to http://about.jstor.org/terms TRADITIONAL MEDICINE IN BANGKOK traditional medicine, Thai and Chinese, are important in Bangkok. The Thai variation evolved from ayurveda and is believed to have come from India with the spread of Buddhism. This variation conceives of the body as composed of four elements that must be kept in balance: earth, water, wind, and fire. Most cures emphasize symptoms and their relief, to the near exclusion of diagnosis and inquiry into disease etiology. Medicines play a very important role in treatment. Practitioners of Thai medicine are usually pharmacists; some also use spells, incantations, holy water, and other magical or religious cures. Chinese medicine has also been practiced for many centuries in Thailand, usually in principal towns and cities where the Chinese are concentrated. The Chinese pharmacopoeia consists of many medicines made from herbs, leaves, or other natural substances. Like their Thai counterparts, practitioners of Chinese medicine may be generalists or may specialize in treatments such as bone-setting, acupuncture, massage, cures for mental illness, and magical or religious healing. They believe that health results from harmony between the dual forces of yin and yang and emphasize the concept of life energy and a physiology with five elements: wood, fire, earth, metal, and water.