Vietnamese Herbal Steam Therapies

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Xông ho’i Vietnamese herbal steam therapies

By Bruce Bentley IETNAM’S LONG COASTLINE, mountains, PART 2 IN A STEAMY SERIES thick jungles, lush plains and river deltas, to- Vgether with a tropical climate down south and There are two secular schools of traditional medical practice semi-tropical type up north, makes for a diverse mix in Vietnam. The “northern school” or thuoc bac essentially of endemic regional flora and local herbal practice. borrows the philosophy, source materials and practices of These two zones also have divergent histories, and while not wishing to overplay divisions among a traditional Chinese medicine, while the “southern school” fraternity of like people, historically each has been or thuoc nam has its roots in Vietnam. This “medicine to suit culturally influenced in separate ways. The southern southern people,” as intended by its founder, the Buddhist region has mostly been swayed by India, Cambodia, monk and physician Tue Tinh, began with a source materia and to a lesser extent Thailand and Laos, whereas big medica of native herbs and prescriptions, which included neighbour China has put an unmistakeable stamp reference to an assemblage of practical therapeutic skills. on the north. When I spoke to Dr Truong Thin, di- These, we can be confident, had already been practised rector of the Institute of Traditional Medicine in Ho for centuries by the common people of his homeland in the Chi Minh City, in 2000 about these regional distinc- tions, he said: “China, along with its complex medi- Red River Delta in northern Vietnam. Yet unlike in the north, cal ideas, has had a powerful influence throughout there has been no documentation of the vibrant repertoire of northern Vietnam, but down south, more easily practices by the people of the south, who when all is said and applied methods were readily accepted and used.” done were largely unaffected by Tue Tinh and the north. This George Coedès (1968:xv), the eminent scholar of essay will investigate the herbal steaming practices that exist southeast Asian history, confirmed: “It is significant in Ho Chi Minh City and throughout the Mekong Delta. But to note that Northern Vietnam was the only region before we get to some herbal steaming recipes, let’s first take in South East Asia whose history developed outside in the panorama of the practice's folk context. Indian influence.”

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While it is not necessary to expand further ing “poisonous” wind (sha in the Chinese n Opposite page: than I do later about this sideways shift of context) from its lodgment within the sur- artist Mr Duy Thai, influence on the south in relation to herbal face tissue with cao gio, or before drawing Ho Chi Minh City, 2000. steam therapy, it does involve sharing a sig- out deeper pathogens with cupping. Having (Bruce’s collection) nificant number of the plants particular to the need to attend to a health concern also the tropical westward zone across Asia, a invariably means initiating a change in diet, meaningful rub from Indian medical theory which is deemed to be a fundamental requi- and its various practices, plus the impact of site.1 The need to rest the stomach and offset Theravada Buddhism, the most popular faith any systemic disharmonies from a hot/cold in the south which was originally brought perspective is a virtual given. This strategy across from southern India. All have made of supporting the inside and the outside an indelible impression on the way in which at the same time not only helps to resolve southerners go about herbal steaming. the initial stage of most illnesses, but also For the fiercely determined and self-reliant guards against any pathogenic factors mov- Vietnamese, herbal steam therapy (xong hoi ing deeper internally. Personally, I would rate pronounced “shom hoy” meaning “to pen- the Vietnamese as being the most informed etrate the body with steam”), along with diet lay practitioners I have come to know. 2 (an kieng), cupping (giac hoi), cao gio (aka gua sha), massage (dam bop) and plucking Folk medical practices (giat gio) comprise a pool of folk treatments The roots of folk medicine, writes Grossman (y hoc dan toc or “common people’s medi- (1986:166), “are in the urgency of accidents cine”) devised to deal with a swath of illness, and injuries, the wounds of enemy stones pain and emergency situations in a practi- and arrows, the assault of hostile weather, cal, no-fuss way. Conveniently, and to save the attacks of frightened vicious animals. In the patient from needing to venture outside short, all external threats to survival demand after treatment, these are all best performed medicine.” This has led the Vietnamese to in the home, where there is typically at least equip themselves with some of the most one family member who has a working primordial and rational calls to therapeutic knowledge of one or more of these practices. action. Steaming engages the biological At a basic level they are all easy enough to necessity of inhalation and brings medicated accomplish, and are performed either as a vapours into the body, while elevating the stand-alone or in combination. When treat- body temperature which produces sweating ing stiff muscles for example, steaming can and releases toxins and wastes; cao gio and soften and open the skin pores before scrap- massage engage the relief brought about by

Tue Tinh advised, “Behind your In his quest to advance methods to reduce fever; garlic to combat house, a small patch of land is suf- of curing that “could be adopted fainting caused by draughts; sudor- ficient for a medicinal garden.” for ready use by ordinary people,” ifico [agents that cause sweating] (Hoang, Pho and Huu, 1993:16). He Tue Tinh promoted “treatments to treat colds; massage of the navel researched the value of hundreds such as steam baths, moxibustion, region with garlic to combat reten- of indigenous Vietnamese plants massage, poultices and others” tion of urine and constipation; mas- and wrote two books: Nam Doc according to Huong, Phu and Huu sage with ginger and beet seeds Than Hieu (The Miraculous Efficacy (1993:18). They add: in cases of indigestion; application of Southern Medicines), in which of plaster made from kapok-tree described 580 indigenous drugs “The Vietnamese people have bark and sticky rice to cure frac- in 3873 prescriptions for 10 clini- inherited from Tue Tinh a great tures; moxibustion with wormwood cal specialties, and Hong Nghia number of simple but effective against chills; infusion of tangerine Giac Tu Thu (Medical Book from medical formulas that every family peel to stop indigestion; young the Village of Hong Nghia), which still uses from generation to gener- guava buds to cure diarrhea, and abridged the indications for 630 ation: hot onion soup, steam baths so on.” herbs. with ginger and aromatic leaves

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rubbing; cupping at its most basic simulates an increasing application in countries where the mammalian reflex of sucking and draws biomedicine or modern Western medicine is unwanted agents to the surface; plucking readily available.” or pinching is a way of squeezing out an This became abundantly clear in Mel- offending intrusion; and dietary change, bourne in 2002 when a new community or the adjustment of regular eating habits health care centre was built in a heartland of (sometimes with the addition of herbs) is a numerically strong Vietnamese constituen- a behavioural trait instinctive to “higher” cy. When opened, it only took a short while animals. for government agencies to realise it was be- In most Vietnamese households, the moth- ing attended less than had been expected. er or grandmother usually performs therapy, When Vietnamese community leaders were although no strict gender divide exists, thus questioned about this, they explained that making it not unusual for men to gladly take many people treated their health concerns at on the role of caregiver. It also happens that home before seeking professional attention. Tue Tihn (Monnais, some individuals, be they female or male, de- The way that folk practices are bound Laurence, Thompson, velop a heightened curiosity and sensibility within the knit of social life is well described C. Michele and for healing and become adept practitioners by Craig (2000:703), who writes that pop- Wahlberg, Ayo (eds), who are sought out when there is a need for ular medical knowledge “exists in forms 2012: frontcover). more specialist attention. Some from rural which lay people are able to remember, ma- areas even head to the city, and examples of nipulate, and apply widely to manage their folk practice becoming professional craft in- everyday lives”. Furthermore, “practical log- clude many of the practitioners in Ho Chi ics” are “formed by the demands of everyday Minh City who peddle their bicycles down household routine, and become embedded the side streets of a night-time and announce and embodied in the rhythms of daily life, themselves to apartment dwellers by shaking and in the domains of wellbeing and rela- a stick with a row of loosely attached bottle tionships of responsibility that household tops. “Come up to the third floor,” comes a carers construct and defend”. Sounding like a shout, “and bring all your steaming herbs scholar with a foothold in the social sciences, and cups!” At locations around town as well, the Venerable Phap Thang, who we met in from around midday until the early hours of The Lantern essay “Gua sha and the Bud- the next day, others can be found on bustling dhist forest monk medical tradition” (Vol. street corners, or set up in a row along foot- 12-2) remarked: “Southern people respond paths.3 All it takes is a straw mat laid on the well to what they grow up with because they ground, with equipment ready to go. So while relate to it. It is a pity that professionals don’t Roy Porter (1997:36) correctly describes folk acknowledge treatments that people can do medical practices as founded “upon coher- for themselves; they think their medicine is ent conceptions of the body and of nature stronger but our medicine from the south is that are rooted in rural society,” nowadays, also very effective and practical.” even for urbanised Vietnamese, both in their homeland and throughout those countries The family where many from the south have found new In Vietnamese society, no other institution homes since 1975 and the fall of Saigon (now plays a more important function in the Ho Chi Minh City), the juxtaposing reality life of the individual than the family and (considered by some) remains that despite the ancestral line. In this worldly setting, modern Western health care being increas- ethics, duty and responsibility are expected ingly accessible, they prefer and continue and meritorious virtues that construct with treatment methods that they relate to harmonious relations in the present, ensure and find effective. Findings from the World continuity into the future and foster Health Organisation (Zhang, 2000:v) sup- on-going allegiance and comfort for the port this thesis on a broader platform: “The deceased. In contrast to its oft-cited emphasis popular use of traditional medicine [includ- on otherworldly affairs, the Abbot Thich ing folk medicine] continues to expand glob- Phoc Tan, of the Quan Minh Temple in ally and this pattern is not restricted to poor Melbourne, informed me of a Buddhist tenet economic regions of the world, but includes that regards the family as more important

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than the individual in deciding the best should be avoided. course to take when a member is confronted n Therapeutic practices are like bequeathed with illness. Arthur Kleinman (1980:306), family heirlooms. By acting upon recom- the prominent cross-cultural researcher mendations and instructions, the ancestral and psychiatrist, further proposed: “It may line is reinforced and good fortune is fos- appear strange to some to consider the family tered now and into the future. as a ‘practitioner’ ... but considering that 73 n It is deemed a duty for the older generation per cent of all sickness episodes are treated to pass on what they know to be important solely in the context of the family, there is for the health and wellbeing of the next gen- nothing all that strange about looking upon eration. In an interview in Melbourne, Mr the family as practitioner. Indeed, in most Minh Tien explained, “The elderly like to societies it would appear to be by far the stick with their culture and spread that way most active form of clinical practice.” Other of thinking and going about things to the cross-cultural studies identify mothers and younger generation. Sometimes the young grandmothers as the most important health firstly adopt Western ways, but from around care providers of lay healing (Finerman, 30 years of age onwards they tend to go back 1989: 25) and “most sources estimate 70 to and get to know their original culture.” 95 per cent of all health care is domestic —not professional—and women provide In 2002, I conducted a survey of 103 first- nearly 95 per cent of all domestic care” generation Vietnamese Australian students, n Bruce Bentley vis- (Clark, 1998:159). comprising 62 females and 41 males aged 16 ited Vietnam in 1990 to All naturalistic folk medical practices to 19, about their opinions on home-based investigate traditional throughout the world share a number of treatments. Their responses indicated their Vietnamese medical practices, and returned defining characteristics. Some that are espe- attitude was very positive. Nearly every per- 10 years later, this time cially pertinent to the Vietnamese include: son had been treated at home by a parent, accompanied by the and 90 per cent found it was effective and de- Abbot Thich Phuoc Tan n Knowledge is transferred mostly by ob- sired to learn more. In other formal surveys who translated and helped servation and practical instruction from and informal conversations I recorded, when 4 organise meetings. In one generation to the next, in contrast to asked, “Why do you prefer using folk medi- 2002 he conducted a scholarly medical systems, which all have a cal methods?” replies such as, “it is a family 12-month research project formal written record and a classificatory in- tradition,” “they are effective,” “they are good for the Department of dex. Such information may in some cases be for many illnesses, so a doctor is not neces- Health Services (Victorian written down, but it is unpublished. As one sary,” and “I like it because I can do it for Government) titled Folk interviewee put it, “There’s no need, people myself and my family” were common. “They medical practices in the already know how to do it.” We may find as cost no money,” also featured, of course! Vietnamese commu- well that some folk medical knowledge such nity. Bruce is a registered as recipes, formulas, practices and cooking Buddhism and medicine Chinese herbalist and acu- instructions can be jealously guarded and Another major influence is Buddhism. puncturist with an Honours stay the sole property of a particular family. Its diffusion along maritime trade routes degree in the Sociology n These practices are not usually carried out from India to the shores of southern of Health and Illness and a with any intention of financial gain. They Vietnam, some time between 300 and 600 Masters degree in Health are part of the sharing and helping exchange AD, guided the spread of medical ideas. Studies, with units in the within the community. Favours or gifts how- Zysk (1991:6) expresses this eloquently: social history of medicine ever may sometimes be given in return. “Any understanding of the social history and medical anthropol- n The manner of learning about health, how of Buddhism is incomplete without a full ogy. He remains a student illness comes about, the course of its detri- elucidation of Buddhism’s involvement in of the Venerable Phap Thang. ment to the body and how it is best treated the healing arts.” To capture this jewel of Visit: healthtraditions.com. simply accrues, almost inconsequentially, as the heart, the Venerable Thich Phuoc Tan au for info on cupping, an integral part of the socialisation of the in- found among the Buddhist sutras (“The gua sha and traditional Words of the Enlightened Ones”) numerous dividual. There is commonly an element of Thai massage workshops. contempt held for this process by those who references to the virtues of medicine and Facebook: facebook.com/ have studied formal medicine and who may kindly translated the following verses from HealthTraditions. Email: encourage (for their advantage) the notion Vietnamese. In the “Earth Store Bodhisattva 5 [email protected] that folk practices are devoid of merit and Vow Sutra” (Kinh Dia-Tang Bo Tat Bon) it Phone: 03 9555 2985.

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makes clear that: “To help in overcoming perfect sense that the home be the ideal place Ancient and sickness gives the helper unfathomable to receive steaming, because following treat- universal merits.” Likewise in “Rulebook for ment it is not in the interests of the patient Bodhisattva Candidates” (Kinh Pham-Vong) to venture outside when the skin pores are On September 15, it is revealed: “In the eight ways of earning open and liable to be further penetrated by 2015, news came of the merit, caring for the sick comes first,” and aggravating factors such as wind and other discovery of a Bronze in “Rules for Monks and Arhatship” (Luat climatic effects. Age stone structure on Tu-Phan) we find the sublime communiqué: Each temple maintains its dispensary of the island of Westray, “It is better to make an offer of assistance herbs in a variety of ways. From January to in the Orkney group off to a sick person before an offering to the March each year, when the weather is dry, the coast of Scotland. Buddha.” monk-herbalists often spend several weeks Rod McCullagh, Deputy In discussion with Ms Hong Buu Lien in on gathering trips to the mountains and Head of Archaeology Melbourne, she said, “In Vietnam I spoke to jungles. These herbs are then sorted, laid out Strategy at Historic some wandering monks (sukhac thuc) about to dry under the sun and put in bags and Scotland, said about the find: “This is a beauti- steaming, because we all know they know a stored. Each temple also maintains a herb fully preserved site with lot about it.” I asked Phap Thang if he had garden, which is important because in the lots of tantalising clues seen monks in the forest doing herbal steam- southern and folk traditions, fresh herbs are pointing to its use as an ing. He replied, “Yes, they used their begging always preferred to dried herbs. “Fresh herbs important building, cen- bowl to boil the herbs,” and laughed. “A bowl have something that the dry herbs lack, and tral to the community can be used for many things: to cook food, although you can preserve some of the ben- who built it.” He has boil water, make the steam sauna, the list efit by drying, it’s still not the same,” says good reason to believe goes on! They boil up herbs and place the Phap Thang, adding, “The only reason why it “may have been used steaming bowl on the ground, sit beside it we dry herbs is when they are not available as a sweat house for and use their robes to cover themselves from close-by.” Another proportion comes from healing and cleans- head to toe.” local people who donate what they grow in ing…” because, “early their own gardens or find in nearby fields. analysis work suggests Health care and the temple People who live far away help by giving spe- the building is likely to Throughout Asia many Buddhist temples cial herbs that grow in their surrounds to be a ‘burnt mound’, operate as free traditional medical centres and truck drivers who can pass by the temples which generally com- herbal dispensaries. In Vietnam, “pagodas, as and drop them off. In keeping with tradition, prises a fireplace, water places of worship and community events, the Venerable Thich Phuoc Tan said, “the tank and a pile of burnt are natural places where health services Communist government has encouraged stone. Through experi- are offered to the public. A feature of these people in the countryside to grow herbs in mentation and refer- pagoda-based clinics is the medicinal plant their gardens and city folk to grow them in ence to medieval Irish garden, which serves to educate the public pots at home, so they can have them on hand literature, experts have about plants used for common illnesses” to treat themselves.” In Melbourne too, many been able to deduce (Dung and Bodecker, 2001:401). In the people grow herbs for this purpose. that stones were roast- south they often display a sign saying “Folk ed on a hearth before being placed into the Medicine Clinic” (Y Hoc Dan Gian). Poisonous wind as a cause of illness tank of water, bringing Treatments are performed by monks who George Foster, the founder of ethno-medicine, the water to a boiling have been trained either in formal colleges a sub-discipline of medical anthropology, point and producing or by an apprenticeship to a master. They described folk medical practices as based lots of steam” (www.his- are often the only places where people can on “prevailing causality beliefs, which toric-scotland.gov.uk). In receive formal herbal treatment and acu- form the rationale for treatment” (Foster, a harsh windswept place puncture. But being busy places open seven 1983:21). This is entirely true of all the like Westray 4000 years days a week, and frequently seeing 200 to naturalistic Vietnamese folk therapies, ago, one can only begin 300 people a day, has them, beyond excep- and any discussion on southern and folk to imagine how much tional circumstances, too pressed for time to medicine falls short without highlighting sanctuary and glad- be able to carry out practices such as herbal the detrimental effects that wind has on ness the sauna gave. It steaming, cao gio or cupping. This is well ac- the body. Its significance is explicit with is the latest in a series cepted however, since everyone knows a fam- steaming being regularly described as of related finds dotted ily member or neighbour who can do them. “causing sweating so the wind can get out”. throughout Scotland... Nevertheless, herbal formulas are often given This helps explain why people enjoy herbal to people to take home and steam. It makes steaming and feel refreshed afterwards. The

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steam causes a sweat, which in this case is der par. In this condition, the body’s regular called “poisonous water” because it contains exterior defence at the skin level is compro- wind, which has blocked the points at the mised in its ability to resist further incoming surface, so afterwards you feel relaxed and exogenous (mostly wind) influences. This is at the same time more spirited and energetic. because when wind is in harmony with the Other therapies spell out the same. Cao gio three other elements, it can successfully co- means “to scrape out the wind,” and plucking ordinate the opening and closing of the skin (giat gio) means “to pull out the wind”. There pores. In a balanced healthy state, the balance exists no specific word for a cupping mark, or between the macro (natural) world and the for the marks produced by cao gio—they are microcosm (inside the body) has the defen- manifestations of resolved illness or injury sive skin level able to function at an optimal coming to the surface and are simply referred range of responsiveness. to as “wind”. When there is already too much wind pres- Phap Thang perus- In professional northern school parlance, ent in the body, and particularly when it has ing the WHO book on when wind (phong) causes pain or illness, it is become locked in for too long at a deep level, Vietnamese medicinal described as phong ta, or “evil wind” (xie feng) the inability of this protective opening and herbs, with a pomelo in in the same manner that its malevolent na- closing activity to function properly allows the foreground. ture is described by both lay people and TCM more wind (and other pathogenic factors) professionals in China. In everyday southern to enter easily and “bed down” with what is Vietnamese speak however, it is called gio doc already an overabundance. When this situa- (pronounced “yaw,” as in “saw,” doc), which tion occurs, people are prone to serious and means “poisonous wind”. An esoteric dis- sudden concerns such as stroke. cernment has “poisonous wind” as noxious, Evidence gleaned from surveys and ques- yet an entirely natural phenomenon, where- tionnaires I conducted among Melbourne’s as “evil wind” conjures up religious conno- Vietnamese community revealed that a tations, as it associates with Buddhist ideas large proportion of respondents believed concerning karma and health. An evil wind that wind caused illness. In response to the problem occurs because of a preordained or question, “Do you believe that poisonous karmic reason, and causes a person to suffer wind can cause pain and illness?” posed to illness spontaneously and for no rational rea- 325 Vietnamese people living in the western son. This then is attributed to the mind and region of Melbourne, 73 per cent of respon- can be resolved only by paying homage to the dents answered “yes,” and only 8 per cent Behind Phap Thang Buddha. In the scheme of things, poisonous replied “no” (Bentley, 2002). Not surprisingly, is a young Bodhi tree wind is superficial and transitory compared the exact same percentage of people who be- growing beside a white to evil wind, which can reside within the re- lieved in the ability of wind to cause illness statue of the wheel of incarnated mind and manifest in the body also thought that traditional therapies were karma. The Buddha for many lifetimes. Alternatively, evil wind effective against it. sat under such a tree can be caused by harmful spirits and needs Many Vietnamese also think that the cli- at the moment of his to be dealt with by exorcism or another sha- mate being colder, windier and more liable Enlightenment. Bodhi manic recourse. This type of intervention is to change quicker in Melbourne than it does leaves can be added to called Thuoc Tay. in Vietnam means that folk practices are even steaming formulas to For most Vietnamese, environmental poi- more important here, and they opt to treat increase the strength of sonous wind is held to be the cause for a themselves more regularly than even when all herbs. smorgasbord of health issues including living in Vietnam. Mr Tai Cao, who is active in (Photos taken by Bruce) common cold, influenza, muscle aches and Vietnamese community affairs in Melbourne spasms, and Bell’s palsy (to name a few). agrees: “Having the experience of living in a What is more, wind can enter the body and hot climate in Southern Vietnam, the older disrupt the regular equipoise of the wind generations know that sweating is good for (air) element, and disrupt the balance of the them. They stayed healthy and didn’t catch three others, being fire, water and earth. This colds like they do here. That’s why the people excess of the wind element literally “opens I know use steaming (and cao gio) even more the gates (pores)” to further illnesses. In than back in Vietnam.” He added: “Sweating southern folk medical thinking, for one to is known as a natural process to eliminate get sick requires the body to be already un- wind from the body.”

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Structure, materials and practice pipe (30 to 75 cm wide) was inserted into this Nowadays the vast majority of people circular opening and connected to the sauna. The body has a way perform steaming by simply boiling herbs If the bamboo was thinner than the size of of letting the steam in a metal pot and covering themselves with this hole, then clay reinforced with dried shav- a blanket. Yet it was not always quite this ings, cut from the base of a rice plant, were know where it has ‘‘ basic. As a boy growing up in the Mekong mixed together and packed to fill the gap. It a problem because Delta, Phap Thang remembers sitting in his took only 24 hours for it to set and hold tight. during treatment the village sauna when he had a common cold. The rice shavings bound the clay in the way areas of discomfort He stayed inside for 10 minutes, whereas lime helps to make cement. The pot was sup- give a special feeling the adults would stay inside for 15 to 20 ported above a fire on a metal tripod. of relief. This is the minutes. “There were many throughout the With lament, Phap Thang remarked, “These xong ho’i way. south,” he said, “but sadly it seems almost days, most people take the simpler and easier all have disappeared over the past 40 to 50 steaming option.” Herbs are boiled in a large years.” During his numerous visits back to pot for 15-20 minutes to release their proper- Vietnam, he has often asked about them ties. The person then disrobes and sits on a in the many villages he has called on, but small stool beside the pot, covering up with has rarely discovered one. Villagers say, “we a blanket. Inside this canopy, the lid of the don’t have the time to build them any more. pot is carefully opened to allow a sufficient We just cover up with a blanket.” Just last amount of steam to escape and permeate this month, Phap Thang returned from a month closed-in area. Care needs to be taken in case in Vietnam, and told me he happened to see the lid is released too quickly, otherwise the from the window of his bus a couple of signs heat of the steam or the fragrance of the mix- in villages telling people to stop by and enjoy ture can be overwhelming. He said his moth- a herbal sauna. He said it appeared they were er taught him that the safe way to control offering a free service. the amount of steam released was to place The frame for the Vietnamese village herb- his hand over the edge of the pot and slowly al sauna is constructed in the same way as open it a little: “If the steam is too fierce, it the ubiquitous Southeast Asian village chick- will scald your hand and certainly bother the en coop, only bigger. It usually measures 1.5 body. So wait a little while and try again.” metres wide and 1.2 to 1.4 metres in height, Accordingly, if the sauna becomes too hot and can accommodate four people in one sit- or the aroma overbearing, it is easy enough ting. Interlaced strips of bamboo are woven to leave the sauna or poke one’s head out to into a dome shaped structure and covered dilute the atmosphere and take a “breather”. with hardy coconut palm leaves. An opening It is important that once a slight sweat has is cut, so once inside the occupant can reach been achieved, it is time to cease treatment. out, receive a pot of steaming herbs and pull Copious sweating is ruled out, because this the leaves across to keep the steam from es- only drains the body, whereas a light sweat caping. is enough to open the pores and push out Coconut leaves can last for about five years the surface pathogen. In addition, steaming before needing to be replaced. These leaves is usually performed only once, or possibly are held firmly in place by threading thin again the next day. It should be done as soon strips of twine made from coconut bark. as the person feels unwell and when a patho- Some houses in the south are still construct- gen, such as wind, is still at the surface. If a ed with a support weave of twine that comes longer period of time goes by before steam- from this versatile tree. ing, the success will be reduced because the Some saunas are fitted with a bamboo pipe wind has been given time to penetrate deeper. connecting a pot of boiling herbs outside the This does not mean, however, that steam- sauna to the inside, as described in “The Thai ing is contraindicated. It still has the benefit herbal sauna” (Bentley, 2015:22). Vietnam has of clearing the breathing passages and mak- an ancient clay pot-making tradition. As a ing the person feel relaxed. Once completed boy Phap Thang remembers large pots with the patient immediately dries off. They can curved sides and a lid, with a specially de- take a warm shower six to eight hours later. signed hole made about three quarters the Cold water is never an option at any stage of way up on the side. A hollowed out bamboo illness.

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Inherent benefits of herbal steaming therapy, by leaning over a bowl of mentho- As an experience, herbal steaming is enjoyed lated Vicks vapour rub mixed with hot wa- for the pleasure and comfort it brings. The ter and breathing in the vapours to clear the Steaming has the heat of the steam is calming, and united nose and chest. We Vietnamese use herbs. capacity to bolster the with herbal actives delivers a swift medicinal The beneficial effects of the vapours from body’s intelligence effect. “I like steaming because it cleans my steaming are taken into the body via the ” to act in ways that body and makes me feel refreshed,” said one nose, mouth, hair and by all the skin.” not even the best interviewee in Melbourne. This is because In addition, and most profoundly, by giving therapist can fathom. steam causes the skin pores to open, which the body a complete treatment pays credit stimulates the body to go into an excretory to the principle held by all natural therapies It is a beautiful mode and thereby facilitates the removal of that the body has an innate intelligence, and philosophy made even wastes and toxins. As David Craig (2002:118) helped along by a positive stimulus can re- better because describes, “Steam baths are primarily gain its own strength and be able, in its own it works. purgative; pathogens follow sweat out of the dynamic way, to rectify those places that body, and relief follows.” need attention. This positive way of under- A sweat fulfills a basic tenet in traditional standing healing is implicit in the purpose of medical thinking by eliminating pathogen- steaming. Phap Thang remarked, “The body ic factors such as wind and water from the has a way of letting the steam know where it body. The choice of one therapeutic method has a problem because during treatment the over another is based on which is considered areas of discomfort give a special feeling of best equipped to meet the requirements for relief. This is the xong ho’i way.” Steaming has a cure… in principle. I do know that many the capacity to bolster the body’s intelligence people simply prefer herbal steaming be- to act in ways that not even the best thera- cause it feels good. So besides being com- pist can fathom. It is a beautiful philosophy fortable and a unique way of bringing the made even better because it works. value of herbs into the body and to cause a therapeutic sweat, what else is unique about North vs South steaming practices herbal steaming? First, the herbs used in southern folk steaming Herbal steaming is ideal especially when the mostly derive locally, compared with those entire body needs treatment. It is a complete used from the materia medicas of the northern treatment that penetrates into every nook and and southern schools. Second, whereas a cranny at the same time in equal proportion; scale is used to measure the chosen herbs in unlike cupping or cao gio, for example, which a northern school formula, in the southern have difficulty getting into certain sites to school and in folk practice, quantities of treat various problems including rheumatic herbs are measured by feel. Practitioners pain locked in between bones.6 Steaming has gather up a certain amount and deliberate no such problem. Even a poultice or herbal its weight in the hand. Phap Thang said his rub applied to a pain or injury site has its ef- father had a meticulous sense for measuring fect concentrated at that region only, whereas precisely how much any given herb was herbal steaming can infiltrate the surface needed, either when making an internal geography of the entire body. Steaming can prescription to drink or when constructing a therefore relieve both generalised and specific steaming preparation. Granted it may not be muscle aches and body fatigue. Steaming is “scientific” but certainly it is a refined art. “I considered especially beneficial for wind con- always lost out when I tested to see if he got ditions because, like wind, it is not fixed and his weighing right. He’d feel for a quantity has the nature of moving around and diffus- and then I’d weigh it see if he got it right,” said ing in all directions. a disappointed Phap Thang. Thirdly, whereas In an interview in Melbourne with Mrs many roots are found in both northern and Ut Em Thi Tran, aged 51, she recommended southern school formulas in the north of the steaming for any whole body condition, in- country, they are, as a rule, excluded from cluding tiredness, fatigue, muscle aches, com- prescriptions in the regional south due to the mon cold, flu and “when everything feels influence exerted by Theravada Buddhism, stressed and causes a headache”. She said, which most southerners follow, whereas in “Anglo-Australians can relate to a similar the north, Mahayana Buddhism holds sway.

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According to Theravada principles, the Another effective measure is to mash the roots of a plant or tree should not be cut, root of the kudzu vine (san day) and mix and if so only in dire circumstances as it with a little warm water to turn into a paste. will either die or its survival be threatened. Put the paste on some material and allow For this reason, only leaves and rhizomes contact to the scald or burn for half an hour are regularly used in southern folk formulas. before removing. Perform twice daily for two However, when a condition is serious and to three days. Kudzu vine is cold, relieves requires roots, then it is acceptable to use pain and helps the skin recover. If more them, although the person doing the digging serious, seek medical attention. should spare a thought for the plant and ask its forgiveness. I pressed Phap Thang on this The plants used score, and he is convincing in his assurance In the north the climate is subtropical, that people in the south, not just monks, do whereas in the south it is hot all year round indeed pay this type of tribute: “They know and divided between dry(ish) hot and Galangal you need to care for all forms of life.” Even rainy humid hot. In the Mekong Delta, digging to get the nodes from rhizomes, such this abundance of heat and a plentiful as turmeric, galangal, zedory and ginger, is water supply makes for a rich and varied done with enough care to not jeopardise the pharmacopeia. From here on a map, if we plant. Among the recipes to come, you will were to track westward, we intersect with the note the word La in front of the Vietnamese southern thin strip of Thailand, and further name for many herbs. La means leaf. on southern-most India and Sri Lanka. Interestingly, yet to be expected, many herbs Contraindications, safety measures used in the Thai herbal sauna and herbal As the World Health Organisation (2000:1) compress (see The Lantern, Vol.12-3) are also testifies: “Long historical use of many found in Vietnamese steaming practices. practices of traditional medicine, including To determine the correlations between experience passed on from generation to herbs growing in Thailand and Vietnam, I generation, has demonstrated the safety and presented Phap Thang7 with the page-by- efficiency of traditional medicine.” However page challenge of identifying what grows Lemongrass the correct choice of herbs to treat an in Vietnam with what appears in the book individual condition is paramount to success. Medicinal Plants of Thailand (Volume 1) by The guidelines given in “The Thai herbal Saralamp, Chuakul, Temsirirkkul and Clay- sauna” similarly apply to this Vietnamese ton (1996). Each of the 189 plants tabled had follow-on. They were: ”Do not enter the a clear colour photograph of the complete herbal sauna if the following applies: during specimen, with additional close-up shots of pregnancy, fever, hypo- or hyper-tension or the leaf, flower and fruit or berry, as well as a heart disease. The herbal sauna is also not concise description of its pharmacologically recommended for hot body conditions or for assessed medicinal value. Phap Thang iden- those with fiery temperaments (excess fire tified 135 to be growing in southern Vietnam. element). Allow the body to dry off in the sun He was unsure about six varieties. or rub dry with a towel after a few minutes, and sit and relax for a while. Be sure to drink Nine commonly used herbs plenty of water (not chilled) afterwards.” in Vietnamese steaming As well, observe these extra conditions: Galangal Alpinia galangal (L.) Willd. (Viet: Round Zedory Rieng/ Ch: Da Gao Liang Jiang) n Steaming therapy is not called for if the Used post-partum by steaming the lower body is already perspiring. half of the body (to be explained). Is a neu- n If scalded, immediately douse with cold tral temperature and rebuilds the blood after running water. The basic first-aid treatment childbirth. Grows wild in the mountains and that Vietnamese people employ is to apply is also cultivated. a cold towel with ice over the affected area. Lemongrass Cymbopogon citratus (DC.) Another popular method is to cut a portion Stapf (Viet: La Sa/Ch: Xiang Mao) Illustration source: WHO, of fresh aloe vera and apply the clear inner Aromatic, refreshing and relaxing, 1990. gel directly. lemongrass is warming and benefits wind-

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cold conditions. Use in the sauna or as a week, and underground for another week to steam inhalant by covering the head with balance the sun and earth elements in order a towel and leaning over a bowl. Breathe to use for hot or cold rheumatic types. Phap deeply through the nose for 15 minutes. Thang advises: “When steaming or as a de- For headaches and respiratory problems, to coction, if necessary use the roots plus the ease sore throat, reduce fever, to clear the leaves in an emergency to make the medicine nose, warm the lungs and alleviate acne, stronger.” The Vietnamese name then be- cellulite, and other skin problems. The finest comes Re Nhau. Drink 15-20 ml after dinner. lemongrass is cultivated in central Vietnam and exported to China. Grows like a weed in Elsholtzia ciliata (Thunb.) Hyland the south. (Viet: Kinh Gioi) Used to treat headache caused by wind-cold. Round Zedory Cucuma zedoria (Berg.) Helps alleviate itchy skin. The juice from the Rose. (Viet: Nghe) leaves can be crushed and applied topically Pomelo Has the same benefits but is twice as strong to clear pimples. A prescription for steam- as tumeric, making it the premier herb for ing to cure skin conditions can include lem- women following childbirth. Used in steam- ongrass and mugwort. Medicinal plants of ing to tonify the blood, to strengthen the Vietnam (WHO, 1989:169) notes: “The usual whole body and help rid the placenta from dose is 10 to 16g of dried plant in the form the womb. Zedory is not easy to find in the of a decoction, or 30g of the fresh plant in wild and is difficult to cultivate, making tur- the form of juice. The vapour can be inhaled meric the more popular alternative. to treat influenza, sore throat, headache and measles.” Pomelo (including Grapefruit) Citrus Grandis (L.) Osbeck (Viet:Buoi/ Ch: Hua Ju Tumeric Curcuma domestica Valet. (Viet: Hong) Nghe/ Ch: Jiang Huang) Cooling, so improves wind-heat conditions The most used ingredient in the steam sauna including common cold and flu. Use the or tent to tonify the blood and help rid the skin (green or yellow part, not the pith) and placenta from the womb. Also recommended Mugwort leaves. Use the heated young leaves to dis- to drink or eat. The rhizomes contain the perse blood stagnation and treat bruises. pigment curcumin, an essential oil (WHO, Widely cultivated as a domestic fruit. 1989:131)

Mugwort (moxa leaf) Artemisia Vulgaris Kumquat Citrus japonica (Viet: Quat/ L. (Viet:Ngai cuu/ Ch: A i Ye ) Ch: Jin Ju) Its antispasmodic properties make it effective Use the leaves and peel for wind-cold for treating muscle aches. Women can eat, conditions and to cleanse the skin. The peel drink and steam this herb after childbirth is dried in the sun and has an antibacterial to warm the womb and the entire body. Use effect and is often steamed in the house to the dried leaves to smoke or steam either half prevent the spread of illness. or the whole body. Grows wild in the mountains and cultivated for medicinal reasons. In January 2000, I had the good fortune to meet Ms Nguyen Kim Chi, who owns a small Indian Mulberry Morinda Citrifolia L. art gallery in Ho Chi Minh City. We spent Indian mulberry (Viet: Nhau/Ch: Yindu Sang) three afternoons talking about herbal steam- Has a warm thermal characteristic and treats ing, and on the second occasion I found she wind-heat cold and flu. Relaxes a sore, heavy had ordered a delivery of what she called a and painful body after hard physical work. “menu of 14 of the most popular xong ho’i The most important steaming herb to treat herbs” (la xong) from the local market, just rheumatism. The dried leaves can be bought to satisfy my interest. She said this was “a in Australia, but have 60 per cent of the po- whole list, and in any one treatment you may tency of fresh leaves. The Vietnamese use the need to use only five or six herbs”. Ms Kim root and fruit and add vodka. They bottle, also recommended adding one, or even bet- cover and place outside in the sun for one ter, three dessertspoons of white rice wine

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once the boiling of a herbal brew is complete. many herbs that are used for steaming in “The wine helps getting the benefits of the southern Vietnam are unavailable in Aus- herbs into the body,” she claimed, and in- tralia. Using what can be grown or obtained structed further: “Steam for 15 minutes. Any outside Vietnam sometimes restricts steam- longer and the body can sweat too much and ing to more simple recipes. cause tiredness. Use a thick blanket. Dry off I asked Phap Thang: “Why are some herbs very quickly and go to bed, or put on warm good for either drinking, eating or steam- clothes and stay inside—do not go outside. ing?” He replied, “With some, such as ginger You can also drink other herbs before or af- and Indian mulberry, you can do all three, ter xong ho’i to help promote a sweat; such but generally you can’t eat steaming herbs be- as a glass of warm water with three slices of cause of their strong unpalatable volatile oils ginger.” and/or their texture. Examples are lemon- Ms Kim added, “After the communists took grass (although you can drink it), eucalyptus Elsholtzia ciliata over there were no private doctors and no leaf, bamboo leaf, pomelo and other citrus chemist shops. All the available drugs and rinds.” The Vietnamese are a tremendously medical equipment was assigned to govern- industrious people and do not dismiss or ment hospitals and a few clinics. If you were throw away any part of a product that can be unwell you’d have to go and wait for hours used to advantage. before being seen. The time required was far There is a saying from the south: “If you too long, especially when there’s always work only knew, there’s a herb nearby to cure you to be done! I believe that home based treat- even when you’re dying” (Anh chet tren cay ments like steaming, cupping and cao gio thuoc ma anh khong bei). became even more popular because, besides being effective, they are so much more con- Steaming recipes venient. People were helping each other out There are many herbal steaming formulas to by going to one another’s homes to do treat- treat all kinds of health issues. Probably the ments.” quickest and easiest is to simply add a few Below is Ms Kim’s steaming menu. The first drops of eucalyptus oil and menthol or green Tumeric eight herbs are available fresh in Melbourne oil (dauh xanh, Ch: yao shan) to boiling at Vietnamese grocery stores. Unfortunately water, cover the head with a towel, lean over

Vietnamese English Functions La Xa Lemongrass Clears nose, warms lungs, promotes sweating. La Buoi Pomelo leaf or Benefits skin, promotes sweating. Grapefruit leaf La Chanh Lemon leaf Clears the breathing passages, dispels wind. La Dong Ginger leaf Warms the stomach and assists digestion. La Lot Lolot pepper Dispels wind, eases muscular pain. (Ch: Bi Ba) La Ngai Cuu Mugwort/ Dispels wind, warms lungs, stops pain and head- Moxa leaf ache. Kumquat La Thuoc Doi (unknown) Cools lungs, cools and cleanses the skin – good for pimples, psoriasis and itch. MS KIM’S STEAMING MENU La Mau Con (unknown) Treats colds and flu, reduces fever, aids digestion. La Tan (unknown) Relieves sore throat, warms lungs and clears throat. La Bach Can Eucalyptus leaf Benefits lungs and blood, clears nasal passages, eases rheumatic pains, prevents wind entering body. La Sa Huyt (unknown) Improves circulation. La Tre Bamboo leaf Cools the body, relieves heat caused by wind. (Ch: Zhu Ru) La Ngu Chao (unknown) Benefits circulation, relieves rheumatic pain.

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Ms Nguyen Kim Chi (left) at her Lan Chi Gallery in Ho Chi Minh City. Her assistant is sorting the steaming herbs brought from the market by the two women standing. They also brought some grapes as an afternoon snack. I had wandered into her shop the day before and was impressed by the art of Mr Duy Thai. With her help I managed to com- mission him to paint a series of six works on southern folk practices. His steaming painting is on the first page, and others have been featured before in previous Lantern cupping and gua sha essays. (Photo taken by Bruce.) the bowl and inhale deeply through the These herbs open the bronchial passages, nose for 10-15 minutes to clear the head and enter the lung points and diffuse into the sinuses. lung organ. Feeling cold with low energy More popular and effective still is using indicates a stronger wind presence and add- fresh herbs based on traditional methods ing at least an extra handful of eucalyptus and prescriptions. These recipes range from leaves is called for. The benefits of the vola- simple to complex, depending on the avail- tile oils from eucalyptus leaves have been ability of ingredients and the expertise of the understood in Vietnam for many decades. It person in charge. For identification and buy- has a warming effect, so how the person is ing convenience, whenever possible (or nec- presenting will determine any appropriate essary) I have listed herbs by their Vietnam- changes. If a patient is already feeling hot, ese, Chinese, English and botanical names then use only one handful of eucalyptus with recommended dosages. and five handfuls of lemon leaves. Lemon leaves have cooling properties. If the body Formula for wind-water is very cold, then use five handfuls of euca- A basic recipe for eliminating moderate wind lyptus, one handful of lemon leaves and one penetration causing cold symptoms, using handful of bamboo leaves, which are also fresh ingredients that are easily obtained: cooling. It is all about balance and harmo-

Common Vietnamese Measure Function Eucalyptus La khuynh diep 2 handfuls of Clears the head and nose, leaves benefits the lungs. Lemongrass La xa 1 handful Clears the nose, warms the lungs and promotes sweating. Lemon leaves La chanh 1 handful Clears the nasal passages and the throat.

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ny—just as it is in a well-constructed inter- minutes and be followed with plucking/ nal herbal formula. Too much heating, even pinching (guit gio) treatment to release Even when someone when a cold condition dominates, can take the wind-heat from the face and back of has sunstroke and the effect too far the other way, and vice versa. the neck. In accordance with the essential When you happen to live in south eastern premise of balance, even when a condition is headache, cold ‘‘ Victoria and ingredients are scarce, “you can very hot, it is prudent not to tilt the balance or icy water is not still make do with eucalyptus (70 per cent) from one extreme to the other. The hot/ recommended and lemon leaves (30 per cent),” said Mrs cold herbal ratio should be around 30/70, to because it freezes the Phan An, when we spoke about steaming at create a formula that is not too cooling. After points and tightens her bakery shop in the township of Foster. steaming for sunstroke drink a glass of warm the head and causes “My family likes steaming and we use it for water with cooling lemon juice more anxiety and ill coughs and colds. I sometimes add a small As an aside, this explains why even on a hot feeling. Instead drink fingernail knob of Vicks as well, but not so day the Vietnamese prefer to drink warm wa- much, otherwise it is too strong.” ter. When cold water enters the stomach, en- warm water, which ergy is required to bring the system back to opens and releases A cooling prescription a warm temperature. This process heats up the points. Here is a simple steaming formula to cool the body internally, which is not the desired down wind–heat (gio nong) syndromes effect. Phap Thang wisely counsels: “Even when feeling flushed, hot and feverish. Even when someone has sunstroke and headache, when treating this febrile condition, the best cold or icy water is not recommended be- formula should be 70-80 per cent cooling. cause it freezes the points and tightens the head and causes more anxiety and ill feeling. Instead drink warm water, which opens and English Viet Measure releases the points.” Eucalyptus La khuynh diep 1 handful Bamboo leaf La tre 1 handful A warming formula for wind-cold Lemon leaf La chanh 1 handful This condition is known as gio lanh and Tangerine peel Quit I whole fruit is produced by a rapid change in the Ginger leaf La gong 3-4 leaves temperature, or from swimming or being caught in the rain. The simple combination The tangerines grown in Vietnam are of the following can be very effective to smaller than those cultivated in Australia, promote a sweat at the first signs of a and have more oil in the skin and are there- common cold with mild fever, stuffy nose, fore more aromatic. Ginger leaves are added tight muscles and headache: to balance the formula, so it is not too cooling. The warming effect of ginger bulb (un- nGinger (Viet: Gung; Ch: Sheng Jiang) derground stem) is considered to be three 3-4 slices. times that of the leaves, but in most cases the n Mugwort (Ngai cuu) 1 handful. leaves are powerful enough. n Lemongrass (La xa) 1 handful. Ms Hong Luu Bien, who lives in Mel- nKumquat (Quat). Use the dried peel of bourne, recommended a similar formula one fruit and a handful of leaves made up of eucalyptus leaves, lemon leaves and the leaves and twigs of perilla (Viet: Tia Treatment for wind-water to/Ch: Zi Su Ye), which has a neutral temper- In addition to the recipe “A cooling ature and helps to increase energy. prescription” (above), comprising eucalyptus, lemongrass, lemon and ginger leaves, add Treating sunstroke fresh lemon peel (one handful) and fresh Sunstroke is also in the gio nong category pomelo or grapefruit peel (one handful) (as above) and is called sun-wind. The same to create a new formula to treat a condition herbs are used to treat this strikingly hot and called wind/water (cam mui). The primary confronting situation. Before entering the identifying symptom is a runny nose. Being sauna or steam tent, drink a glass of water caught in the rain and wind, or when wind mixed with the juice of one full lemon and (or any movement of air) affects the body, green tea. Steaming should last only five or when taking a shower can bring on this

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condition. The other symptom is a feeling of n Bong Hoa Anh Dao, 2 handfuls. cold inside with laboured breathing, possibly nPomelo or dried Grapefruit peel (Buoi), asthma. Just as wind can stiffen the muscles, 1 handful. when it enters the lungs it makes them hard nCommon Chinese arbor-vitae (Trac ba), CUPPING and breathing difficult. Grapefruit, and or 1 handful. WORKSHOPS pomelo peel, is considered especially effective for dispelling wind, softening the lung Recipe for asthma relief tissue and opening the bronchi. To prepare The following treatment plan can bring relief upping is a specialised this wind-water recipe, a handful of each to asthma sufferers. The wind “floods” the method of treatment ingredient is required. Place these in a pot and lungs and reduces the air that can be taken C that requires expert cover with 80 per cent more water. Boil for 15- in. Steaming has the action of opening the instruction, backed by 20 minutes, then simmer for 10. This formula lungs and relaxing the breathing passages, the decades of research and practice that inspired treats biomedically diagnosed common cold stimulating respiratory function and freeing us to present the world’s and asthma. Breathe in for 15–20 minutes. up the back by relieving tightness. “It works first Traditional Cupping like a spray without the chemicals,” said workshops. Steam-wind Phap Thang. Before the herbal sauna, his At Health Traditions we In the tropical south, steam-wind (can be forest monk master taught him to apply have continued on to be known as either ho’i nong or ho’i doc) is moxibustion to four points on the upper the originators of Modern produced when rain strikes hot ground and back between the shoulder blades. They have Cupping, in which new types of non-flame cupping steam rises and penetrates into the body. It is unspecified folk Vietnamese or forest monk instruments, including flexible understood to be a variation of wind because names but on close inspection correlate silicone cups, have proven the combination of rain and heat engenders precisely to the locations of the Chinese remarkably effective for a a moving dynamic that acts as an instigator acupuncture points Fei Shu (BL-13) and new range of possibilities, for a host of different maladies. Dominant Gaohuang (BL-43). including myofascial symptoms include feelings of heaviness, The way he explained the actions of these syndromes. tiredness, and lethargy with swollen painful two points was similar to Chinese accounts We trust that broadening your cupping skills through joints that feel either hot or cold, depending of their therapeutic action. Gaohuang our Master Class in on the pre-existent ruling temperature of the was noted for its strengthening effect on a Traditional East-West Cupping individual. In an interview in Melbourne weakened immune system, and by burning and Modern Cupping Therapy with Mrs Ut Em Thi Tran, aged 51, she moxa to these points, the coldness that will be a truly worthwhile and mentioned a saying “Ho’i-gio ra nguoi khoe” produces tension and tightness is eased. fascinating experience. which means, “When steam and wind are Each point should be treated bilaterally for a Go to our website to check removed from the body the person recovers.” maximum of three minutes. “Then proceed our bona fides and the host of A simple and effective formula consists of: with the sauna to sweat out the poisonous new products available at our online shop. wind that makes it difficult to breath. This Take your clinical work to a n Lemongrass, 1 handful treatment should bring very good relief and new level. n Pomelo or grapefruit peel, 1 handful have a lasting effect.” One should not stay – BRUCE BENTLEY n Mugwort, 1 handful in the sauna for longer than seven to 10 minutes. The basic prescription consists of Add to one litre of boiling water and simmer the herbs that made up the previous wind- Check out the for 10 minutes water formula, consisting of one handful of each of the following: 2016 program A warming recipe for rheumatism (and watch out for For cold type conditions, steaming warming n Eucalyptus leaves STRETCHCUPPING!) herbs are called for. Phap Thang believes n Lemongrass that due to the colder climate, there is more n Lemon leaves healthtraditions.com.au rheumatism suffered by the Melbourne n Fresh lemon peel from 1 fruit community than in Vietnam. To treat cold nFresh pomelo or grapefruit peel from one type rheumatism the following formula or both fruits is recommended. It can also be used for nIndian Mulberry (Nhau) to warm and recovery after childbirth. strengthen the body nField mint (Viet: Bac ha; Ch: Bo He) to n Nhuc Moi Xong, 3 handfuls. decongest and clear the eyes, nose and n Indian Mulberry (Nhau), 2 handfuls. breathing passages. NEW GENERATION IMPLEMENTS! AvailableThe onlineLantern at the35 Health Traditions shop feature

Ms Nguyen Kim Chi suggested a formula restore warmth and balance to her body for asthma sufferers from her previously very seriously and families lovingly prepare listed herbs (see “Ms Kim’s steaming menu” herbal soups and decoctions. Cold drinks Honeysuckle by itself above). These are lemongrass (la xa), pomelo and food after childbirth are prohibited. is a valuable steaming or grapefruit leaves (la buoi), lemon leaves Nowadays, the practice of herbal steam- ‘‘herb as it really helps (la chahn) and mugwort (la ngai cuu). Her ing is less common, but still important for the blood circulation directions are for the patient to lean over a many. The loss of blood and the energy ex- by its action of clean- bowl of hot steaming herbs but not to cover pended in childbirth means the body is cold ing and fortifying. Use the head with any material. Instead keep the afterwards, and the herbal sauna is one of the raw leaves. face “open” above the steam for two or three the avenues to a complete recovery. A recom- breaths. Then turn away from the steam to mended formula consists of: take in a couple of breaths of regular air before taking another two to three breaths of nIndian Mulberry Re nhau/ Yin Du Sang, the medicated steam. Continue this course 3 handfuls of action until relief is gained. nHoneysuckle Bong hoa anh dao/ Jin Yin Hua, 2 handfuls Steaming to clear menstrual clots nCommon Chinese arbor-vitae Trac ba/ The single herb Indian Mulberry (Re Bai Zi Ren, 2 handfuls Nhao) can be used to remove clots (called blood poison), or it can be combined with This formula builds blood and promotes Galangal (Rieng). The patient sits on a chair the circulation, and cleans and nourishes the with an opening in the seat to allow the whole body. Fresh is best. According to the steam to rise up and enter the vagina. She WHO book Medicinal Plants in Viet Nam is covered with a blanket, 360 degrees from (1989:67), “The leaves and fruits [of the ar- the waist down to the floor. For optimum bor-vitae] contain an essential oil, consisting results, perform once or twice a week for of L-borneol, bornyl acetate, -thujone, cam- three months. The Indian Mulberry leaves phor and sesquiterpene alcohol.” are used in southern steaming and though Perform for 10-15 minutes, three times a not as strong as the nodes or bulb are still week for one to three months. To begin with, effective. When a formula recommends the number of times per week depends on the root or underground stem nodes to be whether or not it is comfortable for her to used in a formula for a stronger effect, the be seated genus name includes the prefixre : thus the “Honeysuckle by itself is a valuable steam- stipulation for Re Nhao (Indian mulberry) ing herb,” says Phap Thang, “as it really helps indicates the bulb. Use three handfuls to one the blood circulation by its action of clean- litre of water. Steam for 15-20 minutes. Do ing and fortifying. Use the raw leaves. Do once every three days. every second day for around seven times. Re Nhao can also be dried and used like Starting with three times per week if it is moxa. For the root, Ba Ji Tian (Morindae offi- comfortable.” cinalis Radixa) can be purchased at Chinese herb shops. Steaming (or Smoking) lower body To clear away post-partum blood from the Steaming and post-partum recovery womb either steaming or smoking methods Traditional health care continues to play a can be performed. To achieve smoking the vital role in post childbirth rehabilitation for body place dried herbs on burning charcoal. most Vietnamese mothers. Notions of hot and cold are considered to be thoroughly n Zedoary (Nghe den) Warms the body and credible explanations for the changes that removes the placenta and clots from the take effect. Everyone in each family including womb. Stops vomiting and replenishes new grandparents takes the need to nourish and blood. Slice up or mash two nodes. n Tumeric (Nghe vang) Warms the body a. The root of Morinda Citrifolia L. is mentioned as and removes the placenta and clots from the being similar to Morinda officinalis How. in the Zhong womb. Use two nodes. Yao Da Ci Dian, Jiangsu Science and Technology Press, 1977, p. 507. Tumeric is considered the most valuable

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herb to drink after childbirth to build and The steam bamboo method nourish the blood. Prepare by cutting four The vacuum required to perform cupping or five slices of the raw rhizome, pour on can be achieved using steam instead of a boiling water and leave to steep with a cover flame. Although I have not seen this practice on a mug for 5-10 minutes. Drink two or performed in Vietnam, informants have said three times daily for three months. If only that it was common in market places some the powdered herb is available, drink one 40 years ago. It is known as the “steam bam- teaspoon in a cup of warm water morning boo method” (giac ho’i ong tre), and is effec- and night. tive in treating headache, tired eyes and Bell’s palsy. It is performed in Vietnam and China Formula to clean the body and restore by hill tribes like the Hmong spread through- The original commen- the strength after childbirth out the mountainous region between China tary accompanying this n Galangal (Rieng) Decongests the blood and Thailand, Laos and Vietnam. It involves photograph (below), and warms the body. Measure: 1 handful boiling bamboo cups in a herbal mix. The taken in 1962, describes n Mugwort (Ngai cuu) Cleans and deodorises herb-impregnated steam is captured in the a “Present day Sino- the womb, warms body. Measure: 1 handful culm walls as well as steam causing negative Vietnamese pharmacy n Tangerine (Viet: Quit/Ch: Gan ju) Warms pressure (vacuum) within the empty space of which will often include the body. Measure: peel from 1 fruit the cupping vessel itself. Instructions: among its remedies the application of cup- The benefits of mugwort can be admin- nBoil the bamboo cups in water or in a ping vessels made of istered by steaming, smoking, drinking or herbal formula for 15 minutes until the bamboo” (Huard, P and eating. The lower half of the body can be cup is very hot. Wong, M. 1968:105). It smoked by putting burning charcoal in a tin n Take out and shake off the liquid. was probably taken in a bucket and adding it dry. nRub the cup rapidly in the hands for a marketplace in northern Another supplementary practice still evi- few seconds to get rid of any liquid and Vietnam, and we see a dent in Vietnam is a smoke treatment called to cool down the lip and outside surface, young woman applying Nam Lua, meaning “to lie down by the heat/ while keeping the interior of the cup hot. long black bamboo cup- fi r e ”. This requires the woman staying in- nQuickly apply. The negative pressure still ping vessels that she has doors and heating her body while resting active within the cup will adhere it to the plucked from the two and sleeping on a slatted wood bed base flesh. pots filled with hot water. with a tray of smouldering wood and dried herbs mugwort, dried galangal, field mint and sliced pomegranate (to clean and protect external wind and rid the body of internal poisonous wind) underneath for seven to 10 days or even longer, like in the old days (up to 100 days).

Herbal steaming pep-up with vodka Try this when feeling tired, fatigued or to chase away those few bluesy days post influenza and common cold: n Lemongrass (La sa), 1 handful. n Pomelo or grapefruit (or both), I handful. n Vodka 150 ml (3 large Australian shots).

Mix with 15 litres of boiling water and boil for 10 minutes. Steam for 10 minutes either in a sauna or by being covered with a blanket (tent method). Afterwards, pour the fluid over the body and towel dry. You’ll feel relaxed with more energy.

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Tran-Dinh. H. 2001:1) found that people who had Endnotes lived longer in Australia had begun to eat more take- 1. During the 12 months allocated to the Folk medical away type foods. This trend, it is posited, alters the practices in the Vietnamese community project, one advantages of a more traditional diet maintained by major opportunity to gather information from a older members of the community and may lead to a broad cross-section of people happened on the reduction in life expectancy. day of the Vietnamese New Year celebration at the Quang Ming Temple, Australia’s biggest Vietnamese 3. One night at 11pm, Phuoc Tan and I hailed a Buddhist temple, in the Melbourne suburb of tricycle (cyclo) and went to a grimy, seedy part of Braybrook. With the help of some interested Ho Chi Minh City to check out the nightly array of Vietnamese assistants, we distributed and a practitioners who set up their treatment mats, side questionnaire written in English and Vietnamese to by side along a street opposite a busy truck terminal. 376 people. For most questions people were required All the practitioners worked there until around 3 to tick an appropriate box or write brief thoughts. am. They were mostly doing cupping, massage and The intention was to get information about their cao gio. Many of their cliental were truck drivers interest in folk medical practices and their level of who wandered across from the depot to receive personal engagement in the six most common folk treatment after finishing their “white knuckle” drive medical practices, being steam therapy, cupping, cao delivering goods from Hanoi. It was “seedy” from my gio, diet, plucking and massage. To the question: point of view because it was apparent that without “Which therapy do you prefer to use at the first sign the companionship of the Abbot, whose distinctive of feeling unwell?” all six were featured plus two coloured robes made his elevated ranking well known, additional options, being “Western medicine” and I would have stood the chance of some unwanted “None of the above”, with room to comment on a line interest from various people lurking around. below. The most perplexing result I discovered when 4. Anthropologists and others invariably describe collating the answers to this question was that not the passing on of folk medical practices from one one person ticked the box related to dietary change. I generation to the next as an “oral transmission”. Yet pondered why? During the formal and informal dis- in my experience this is overstated. Instead (and n It was a joy to be given cussions I had with many Vietnamese people in the unfortunately) I would often rate what I have termed so many opportuni- months leading up Vietnamese New Year, most had a a “visual transmission” to be at least as common, and many people who have received such knowledge ties to connect with the lot to say about the bearing of good eating habits on health, and the need to make immediate adjustments have agreed. Mention of this has often led to a Vietnamese and their at the first sign of feeling unwell. Far from me to be smile and a knowing nod. So rather than the older southern folk medi- able to interpret this result, I consulted some mem- generation taking the time to explain the practice as cine. I am indebted to bers of the community, and even rang half a dozen of a preliminary course of action, the younger recipient all those people who the survey participants, who had written their con- is introduced to whatever practice it may be by generously shared their tact details as an option if I wanted to talk with them seeing it being performed, often with very little or knowledge, without further. In every case I got the same reply: “Changing no virtually no accompanying verbal information or instruction. This watching a procedure may happen whom this essay would one’s diet at the beginning of any illness is fundamental. It is so obvious that I felt it unnecessary to only a few times before, let’s say Grandma, decides have been an impossible tick.” It was such a lesson in the subtleties of putting that she needs treatment and says, “you’ve seen me task. They include the together a successful cross-cultural survey, although doing this before, now it’s your turn.” I would also Venerable Phap Thang, importantly, as an alternative exercise to only collat- argue that this “slack” instruction, which certainly the Venerable Abbot ing the “hard” data gathered on the day, venturing also happens with cupping and cao gio, is not up to Thich Phuoc Tan OAM, outside the formal confines of the survey gave me the scratch, and unfortunately has the (now) practitio- Mr Tai Cao, Ms Hong opportunity to realise a way of thinking that went ner less than equipped to perform the practice safely Buu Lien, Mrs. Ut Em beyond a certain “fact”—to gain a certain insight and well. In this respect, besides being omitted and already marginalised by professional medicine, folk Thi Tran, and Mr Minh that no rigid survey could adequately discover. 2. In the broader context of Vietnamese health, it is medical practice as a whole suffers. In the modern Tien in Melbourne; and world, with more choices available, this brings on the in Vietnam, Ms Nguyen significant to note that statistics on life expectancy among different migrant communities presented by likelihood of even more weakening of such practices, Kim Chi, Dr Truong Thin, the Australian Bureau of Statistics (2001) show that which should be performed safely, knowledgably the Venerable Thich Chi Vietnamese immigrants are likely to live the longest, and effectively. Then they will be able to better stand Thanh at the Linh Son with the men likely to reach more than 86 years of on their merits now and long into the future. Temple and Ms Nyugen age, compared with just over 77 years for Australian- 5. In Mahayana Buddhism, becoming a Bodhisattva Thi Hoa, who together born males. And Vietnamese women immigrants is the ultimate ambition for the aspiring devotee. A with a group of excep- can expect to live more than 88 years compared with Bodhisattva forgoes entering the bliss of Nirvana until all other sentient beings have attained tional souls provide peo- 82.5 years for Australian-born women. A research report by the School of Behaviour and Community complete Buddhahood or, as the current Dalai Lama ple with folk medicine Health Sciences at the University of Sydney titled explains, “until even the blades of grass have become treatment, with all dona- “An investigation of health behaviour change in Buddhas”. tions going to support a Vietnamese-born individuals living in Sydney, 6. There is a parallel with the common Vietnamese local orphanage. Australia” (Brock, K. Lockwood. E. Cant, B.R. and way of cupping out wind, although its effect is not as

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exquisitely exhaustive as steaming. On my first trip experiences” in Understanding and Applying Medical to Vietnam in 1990 I remember being unimpressed Anthropology. Brown, P. (Ed.). Mayfield Publishing, about cups being put literally everywhere throughout Mountain View CA, pp. 158–168 (Chapter 17). the entire back. I thought, after being mainly exposed Ceodès, George (1968) Ed. Vella, W. F. The to Chinese cupping, that these practitioners didn’t Indianized States of Southeast Asia. University of know specific points and this was a way of covering Hawaii Press. Honolulu. all bases. I called it “blanket cupping”. Later I was Craig, David (2000) “Practical logics: the shapes informed that because wind is mischievous and and lessons of popular medical knowledge and moves around it can reside anywhere and is unlikely practice – examples from Vietnam and Australia” in to be locked up only at specific points or conform Social Science & Medicine. Vol. 51(5). Elsevier. to any body mapping. Covering the whole back with cups was the way to catch it and draw it to Craig, David (2002) Familiar Medicine: Everyday the surface. Having practised this method many Health Knowledge and Practice in Today’s Vietnam. times since, I thoroughly concur, and believe it to be University of Hawai’i Press. USA. especially effective. The physical demonstration of Dung, T.N, and Bodecker, Gerard (2001) Tue Tinh: where the wind is dominant at the time of treatment founder of Vietnamese traditional medicine. The will be demonstrated by a strong, dark cupping Journal of Alternative & Complimentary Medicine. mark. In conversation with Ms Nguyen Pham in Ho Vol.7. Issue 5. Mary Ann Liebert Inc. Chi Minh City, she said: “I like to have my whole Finerman, Ruthbeth (1989) “The forgotten healers: back covered with cups because it completely takes women as family healers in an Andean Indian all the poisonous wind out. I also enjoy the feeling Community” in Women as Healers: Cross Cultural and it makes me feel relaxed.” The Greeks, Poles, Perspectives. McClain, C.S. (Ed.). Rutgers University Lithuanians and Russians also frequently perform Press. New Brunswick, NJ. cupping in this manner. For a detailed description of Foster, George (1983) “An Introduction to a Vietnamese cupping practice to draw out wind refer Ethnomedicine,” in Traditional Medicine and Health to my chapter “Cupping’s Folk Heritage: people in Care Coverage. WHO, Geneva. practice” in Ilkay Chirali’s Chinese Cupping Therapy (3rd ed, 2014). Churchill Livingstone, China. Available: Grossman, Richard (1986). The Other Medicines. scholar.google.com.au and on Google Play Books. Pan Books. Great Britain. 7. Phap Thang was the ideal person to consult, having Hoang Bao Chu, Pho Duc Thuc and Ngoc Huu spent his boyhood growing up on a fruit farm in the (1993) “Overview of Vietnamese Traditional Mekong Delta, and with his father deeply interested Medicine” in Vietnamese Traditional Medicine. The in herbal medicine. In January during the dry season Gioi (World) Publishers. Hanoi. each year, the two would trek into the mountains and Kleinman, Arthur (1980) Patients and Healers in collect leaves, barks,and various forms of lichen. In the Context of Culture: An Exploration of the his teenage years he furthered his herbal knowledge Borderland Between Anthropology, Medicine, and with the monks at his local clinic, and when he was Psychiatry. Comparative Studies of Health Systems 15 years old he was chosen by the Venerable Gaic and Health Care, No 3. University of California Minh, a learned wandering forest monk, to be his Press, Berkeley. apprentice. Phap Thang also studied agriculture at Monnais, Laurence, Thompson, C. Michele and university until his second year was interrupted for Wahlberg, Ayo (eds.) (2012) Southern Medicine for evermore by the war. Southern People: Vietnamese Medicine in the Making. Cambridge Scholars Publishing. Newcastle upon Tyne. Bibliography Porter, Roy (1997) The Greatest Benefit to Mankind: Bentley, Bruce (2003) Folk medical practices in the A Medical History from Antiquity to the Present. Vietnamese community. Unpublished report for the Harper Collins, London. Western Region Health Service. Department of Hu- Saralamp, P. Chuakul, W. Temsirirkkul, R. and man Services, Victoria, Australia. Clayton, T (1996) Medicinal Plants of Thailand. Bentley, Bruce (2015) Gua Sha and the Buddhist Volume 1. Department of Pharmaceutical Botany. forest monk medical tradition. The Lantern, Vol. Faculty of Pharmacy, Mahidol University. Amarin 12-2. Melbourne. Australia Printing and Publishing Public Co. ltd. Bangkok. Bentley, Bruce (2015) The Thai herbal sauna. The World Health Organization (1990) Medicinal Lantern, Vol. 12-3. Melbourne. Australia Plants in Viet Nam, WHO Regional Publications. n Brock, K. Lockwood, E. Cant, B.R. and Tran-Dinh. Western Pacific Series No 3, Manila. In part three of this steamy series, some H. (2001) An investigation of health behaviour Zhang, Xiaorui (2000) Forward: General Guidelines change in Vietnamese-born individuals living in Syd- for Methodologies on Research and Evaluation of Chinese “steam bamboo ney, Australia. School of Behaviour and Commu- Traditional Medicine. WHO, Geneva method” formulas will nity Health Sciences. University of Sydney Zysk, Kenneth G. (1991) Asceticism and healing in be featured, along with Clark, L. (1998) “Gender and generation in ancient India: medicine in the Buddhist monastery. other Chinese steam poor woman’s household health production Oxford University Press. Oxford. treatments.

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