(Paper presented at the International Conference on the Hawaii Filipino Centennial, Honolulu, Hawaii, 15 December 2006. Also published in Hawaii Filipino Chronicle, 9-01-07, and Filipino Martial Arts Digest, 2007 Special Edition).
By Virgil Mayor Apostol
America is indeed a melting pot of migrants from all parts of the globe. They have contributed their cultural flavor to some degree. With these peoples come their unique healing practices for it is what they know and have used to heal themselves since time immemorial. Undoubtedly, the best known of these Asian and Oriental ethnic healing practices is Chinese Acupuncture that have been accepted into the mainstream across America. Japanese Shiatsu has made a name and Nuad Bo’Rarn of Thailand has already risen to popularity. Established schools on Ayurvedic medicine from India, along with its various Panchakarma therapies, is also well acknowledged.
Due to historical accounts that have influenced the psychology of the people, Filipinos have become victims of a colonial mentality that has placed neglect on our own cultural heritage in favor of just about everything “American.” Our very own traditional Filipino medical system, although very strong in the Philippines, is taken for granted here in the West. Although the younger generation may have heard of these healing practices, they are practically unknown by non-Filipinos.
In spite of this neglect, our healing traditions have survived the test of time. It is not impossible to ask someone within a Filipino-American community if they know of a traditional healer, only to be directed to Tata Berto or Apo Liding whom with their skilled touch, continue to relieve health issues from indigenous scientific and sociocultural point of views. In fact, according to a survey conducted by the National Center for Complementary and Alternative Medicine, Asian adults were more likely (43.1%) to use CAM (excluding megavitamin therapy and prayer specifically for health reasons) than white adults (35.9%) or black adults (26.2%).[i]
So why is there a decline of interest in promoting our very own healing traditions? Is it due in part to our assimilation into the American way of life? Do we believe that Western ways are superior to our own? Or is there just a lack of traditional healers?
Colonization of the Philippines
There are several factors that influence the mindset of Filipinos. One of these factors is the effect of colonization. Whenever the Spanish subjugated communities, it was required by the people to reduce their daily attire to simple drab clothing in order to identify them in a caste with restricted privileges. This scenario, having taken place in the Philippines, caused a psychological affect on how Filipinos perceived themselves. This inferiority complex exacerbated during the American regime that brought Hollywood and a foreign standard favored by Filipinos. Even to this day, this complex can be seen in local and national media in the Philippines which further influences an attitude of how Filipinos should think and look.
The erection of hospitals in the Philippines during the 16th century introduced a Western approach to illnesses and disease, giving the Filipinos an opportunity to be treated by the new elite form of medicine. The Filipinos now had the better of two worlds for they began to understand that there were elements within these two brands of medicine that were more effective for certain conditions.
The traditional Filipino medical system is composed of various specialties such as midwifery, pulse diagnosis, bonesetting, manual medicine, herbology, and adjunct forms including suction cupping, skin scrapping, herbal steam, herbal smoke, and energy medicine—all of which are backed by an indigenous science. There are also numerous forms of metaphysical healing that not only deal with the mental and emotional aspects, but also the spiritual realms. The introduction of Western medicine not only introduced the sciences of Hippocrates, but also those of Arab origin including that of Persian physician, Ibn Sina (Avicenna), since Spain was historically a Muslim country.
The form of medicine brought by the Spanish involved anatomy, physiology, chemistry, surgery, and other sciences. There was some apparent overlapping between the two medical systems such as humoral pathology—the belief in important fluids of the humors: blood, phlegm, black bile, and yellow bile. These fluids had specific characteristics such as hot, cold, wet, and dry. One of the basic concepts of traditional Filipino medicine is the principle of pasma, a Spanish loan word describing a condition caused from an imbalance of these four humoral characteristics, particularly the hot-cold syndrome.
While the Filipino medical system relatively maintained tradition, Western or “allopathic” medicine in the Philippines evolved through the centuries. Today, medicine practiced in these hospitals are high-tech with instruments ranging from x-rays to CAT scans, while former practices such as humoral pathology and even pulse diagnosis has mostly gone into oblivion.
It is interesting to note that in the Philippines, practitioners of traditional medicine outnumber practitioners of biomedicine, with at least 40,000 traditional birth attendants and 100,000 herbalists—high figures that do not even account for the thousands of manghihilots, acupuncturists, and other practitioners.[ii] In the United States, however, the reverse ratio applies in that the availability of Filipino healers is smaller than practitioners of allopathic medicine. This leaves a void in the Filipino who would rather go to a traditional Filipino healer for an ankle sprain or fever, but who would not hesitate to go to the hospital for an erupting appendix or chronic disease. Filipinos in the United States are at home with both worlds but with a limited supply of healers in the traditional Filipino medical system, going to them is rarely an option. As a result, Filipinos become assimilated into the American way of life.
Assimilation into the American Way of Life
Taking the workplace as an example of this assimilation process, we work and obtain medical insurance from our employers. Once we get injured on the job, we are sent to an urgent care facility that provides us with immediate attention. The medical provider diagnosis the condition, prescribes medications, releases us with a temporary work disability, and submits us to weeks or even months of physical therapy by which time our medical provider confirms that we are rehabilitated and gives us authorization to return to work. This is the overall scenario but there are also other factors affecting us along the way.
Getting injured is a physically and mentally stressful situation. Depending on the severity, pain can be anywhere from mild to excruciating. The medications that are prescribed can be taxing to our liver where they accumulate and add physiological stress. During the rehabilitative stage, physical therapists perform their duties. The length of time off work can also be added stress due to the fact that we may not be receiving full monetary benefits. Soon after, we get emotional stress over how we are going to pay all the bills.
Granted that we have successfully undergone rehabilitation, persistently, our injuries sometimes seem to linger. We return to our medical provider who explains that we have gone through therapy and that there is nothing more that they could do but to prescribe more painkillers and anti-inflammatory drugs.
Time and time again, I have heard this scenario from several of my clients that wished they had known of our healing methods the moment they were injured. In fact, because of the unique method to help heal impediments due to injuries, if placed within the medical model, the practitioner of Filipino manual medicine would fall ideally as a median between the medical doctor and the physical therapist. One reason is because of the no-nonsense approach to healing injuries and chronic pain – the evolutionary result of centuries of healing within a culture and society that have physical demands in order to survive. One of my philosophies is to “help the patient heal in the least amount of time.”
The mangablon or manghihilot (Ablon or Hilot practitioner) is very acute in assessing injuries. They have an uncanny ability to sense fractures and reset them before wrapping them up along with medicinal herbs and barks. Depending on the type of injury, a sprain for example, a massage therapist would not touch it because it is contraindicated in their practice, otherwise the sprain might get worse, or so they believe. Instead, this is where they would suggest the RICE approach – rest, ice, compression, and elevation.
The Ablon approach is the opposite to that of massage. A sprain would get a thorough treatment even if it sometimes means that the person would have to bite down on a stick! But what is happening is that the mangablon understands that if proper manipulation is not done right away, the viscous coating around the injury will harden and adhesions will develop restricting proper blood flow and nerve impulse, thus affecting or prolonging the healing process. There are also injuries indicative of belles or pilay, a sprain or displacement of the bones, nerves, and veins. Following such injuries, inflammation is understood to occur and must be treated in order to adjust proper setting and flow.
Filipino manual medicine is also applicable towards other types of imbalances that may lead to disease. If a cancer patient, for example, were referred by a medical doctor, the approach may include pekkel (massage) and other adjunct therapies that are geared towards balancing blood flow and detoxification. The beauty of Filipino healing practices is that they can work hand-in-hand with allopathy or osteopathy, and other healing modalities. There is a time and place for everything.
What Traditional Filipino Manual Medicine Is and Is Not
Due to regulated medical laws, not all modalities within the traditional Filipino medical system are allowed practice here in the West including midwifery (limited to obstetrician-gynecologists and licensed midwives); bonesetting (limited to orthopedic doctors, osteopaths, and chiropractors); and any type of practice that diagnoses medical conditions (limited to medical doctors in general).
One of the acceptable public practices of the traditional Filipino medical system in the West is manual medicine, granted that the practitioner has some form of state-approved certificate and is licensed to execute this practice. For Filipino healers that have neither certification nor license, their services are limited to close family and friends. They are highly proficient, nevertheless, in the art of traditional manual medicine that is used to help heal various health concerns, especially those relating to neurovascular and musculoskeletal imbalances.
Ablon is accomplished hands-on yet differs from massage, similar to how the hands-on sciences of Chiropractic, Physical Therapy, and aspects of Osteopathy also differ. The main emphasis in treatment focuses on the urat (neurovascular bundles and vessels such as nerves and veins) and pennet (tendons, sinews, and ligaments).
Both the urat and pennet are critical in the anatomical and physiological functioning of the body. The proper assessing and unique manipulation are what make Ablon effective for the nervous system that regulates and coordinates bodily activities and responses, veins and arteries that support the flow of blood, and tendons and sinews that support the structures between muscles and bones.
A holistic approach addressing the mind and body through cultural and sociological perspectives
Many traditional Filipino healers heal from both a scientific (conventional, indigenous) and spiritual (religious, metaphysical) background and holistic attitude. This is especially true since the cultural roots stem from an animistic base where spirituality is high and esoteric devotees have an uncanny ability to tap into altered states of consciousness in order to obtain information.
Perhaps the earliest concept of illness causation is that they were the result of offended elemental or ancestral spirits, or through sorcery—beliefs that still exists to this day. Those that suspect illness attributed to one of these two sources prefer treatment from a traditional healer that specializes in such cases.
Within this cultural and sociological perspective, a holistic approach is needed to heal the mind, body, and soul. If, for example, one were to fall and hurt their back, a medical professional would ask questions that are “symptom-oriented” such as “where” does it hurt and come up with a diagnosis, provide physical treatment, and offer a prognosis. Whereas a traditional Filipino healer would ask questions that are “origin-oriented” such as “why” that person fell in the first place, provide physical treatment, then counsel the individual on spiritual matters relating to the physical event.
Not only would it be beneficial but crucial for us to adopt a “holistic” lifestyle. Deriving from the Greek root word, hólos, for “whole,” Taber’s medical dictionary clearly defines holistic medicine as “comprehensive and total care of a patient. In this system, the needs of the patient in all areas, such as physical, emotional, social, spiritual, and economic, are considered and cared for.” Traditional medical practices of most ancient cultures approach their patients in this manner, especially the spirituality of the patient.
Edward Fujimoto, Professor and Coordinator of the Dr.P.H. Program in Preventive Care, Loma Linda University, shares his views on spirituality in healing:
“Traditional healing arts is aptly named because the centuries of experience in the thousands of different cultures throughout the earth has demonstrated an art of healing that is still beyond the depth of knowledge that science permits. The healing arts of the past, preserved by traditional healers in diverse cultures in widespread locations today, have a unifying spiritual characteristic, which can mean various things. However, it is becoming increasingly clear that all cultures have qualities that are valued such as love, concern, empathy, joy, gratitude, trust, and faith that oftentimes are not necessarily religion-based, that are perhaps what spirituality is.
Scientific studies have only recently revealed the role of spirituality in preserving health and promoting healing, but there is much that we do not yet know.”[iii]
In my personal practice when healing the “whole” person, the following areas are considered:
Physical Level: When an imbalance, injury, or disability takes place, the practitioner of Ablon manipulates the neurovascular and musculoskeletal systems through pulling, stretching, pressure, joint mobilization, and other indigenous therapies in order to promote equilibrium.
Mental Level: The consultation process is key to understanding the thinking framework of a patient and learning of probable causes of their condition.
Emotional Level: Emotional tendencies can play a major role on the physical body. Trauma, for example, can be recorded on a cellular level and expressed through physical holding patterns. The experienced healer would facilitate the release of these patterns and associated emotions through the application of Ablon to these specific sites.
Spiritual Level: The ancient healers realized that at least 80-90% of illnesses were spiritual in nature, while the remaining 10-20% as physical. Supporting this belief is the modern saying, “Where the mind goes, the body follows.” It is therefore important to realize that peace, harmony, and humility should be attained as a way of creating a healthy environment—internally and externally.
Each of these is affected to a certain degree and it is important to address them all. For example, applying Ablon can sometimes trigger other seemingly unrelated responses like catharsis and others stemming from psychosomatic conditions that, if not caught early on, can negatively influence psychoneuroimmunological functioning.
One case I handled involved a single, middle-aged woman who developed a benign tumor in her uterus. After Ablon to the surrounding area and corresponding urat, I realized that she needed healing on other levels. After a few minutes into bioelectromagnetic healing (a form of energy medicine without physical touch), the woman suddenly burst out crying bitterly. Witnessing the emotional release, I continued with the session. Afterwards, the woman opened up conveying that she was molested as a child and how she had been holding in the trauma all these years. But after her catharsis, she felt like a heavy burden had lifted off her shoulders.
Revival and Re-introduction of Filipino Traditional Healing Practices through Formal Education and Written Works
In 1990, an important report titled, “Manghihilots: Boon or Bane to Philippine Medicine?” was written by Doctor Tyrone Reyes, M.D., along with Ofelia L. Reyes, M.D. and Consuelo B. Suarez, M.D. This pioneering study was undertaken with the goal of improving health care delivery services in the rural areas by using the following objectives: (1) determine the background, education and training, and existing diagnostic and therapeutic practices of manghihilots, (2) evaluate their perceived role in their communities, and (3) evaluate the possibility of their integration into the national health care system.
After reading this report, I realized that their attempts to uplift and incorporate certain aspects of traditional medicine into the national health care system were indeed a challenge. Problems arose due to social, cultural, and educational backgrounds, as well as the willingness of both health professionals and traditional healers to initiate a joint effort in reaching that goal. Their report, however, is instrumental in establishing an awareness and background of two worlds that share a common goal, and the undeniable need of working in harmony and respect.
A special feature article presented in LIFE magazine read, “What we call alternative medicine is traditional medicine for 80 percent of the world, and what we call traditional medicine is only a few centuries old.”[iv] For example, a Tibetan physician practicing in the United States, informed me that traditional Tibetan medicine is the official medicine of Tibet, while allopathic medicine is considered alternative medicine.
In the Unites States, it is estimated that more than one-third of adults uses some form of CAM.[v] With such a high percentage of acceptability, people would only benefit from the revival and reintroduction of traditional Filipino healing practices through formal education and written works, but there needs to be a common understanding on how these healing practices are exposed.
The various forms of manual medicine that have been introduced and taught in America have been literally stripped of their true identity. What were once reputable forms of healing have been reduced to a mere massage suitable for the spa setting, thus conforming to the expectancy of what a massage is—a one-hour, full-body treatment. Prior to seeing me, several of my clients have initially gone to such practitioners for work on specific injuries or chronic pain only to be massaged from head to toe without any emphasis given to the original site of complaint.
Likewise, when one reviews the curriculum of various holistic healing arts institutions, one may find a wide gamut of modalities from different parts of the globe. Offering such foreign modalities is an effort for these institutions to provide ethnic teachings that Americans fancy and find exotic. Just looking at the business cards of graduates in practice will reveal that they are like jack-of-all-trades, but most of the time, master-of-none. I have been invited to teach in such institutions but have kindly declined, dreading the thought of a novice placing Ablon or Hilot on his or her business card after a few hours of class instruction, not to mention, keeping the integrity and clinical aspects of this form of manual medicine intact.
There have already been limited workshops on traditional Filipino manual medicine presented by authentic practitioners throughout North America, with its true intent to help heal impediments caused by neurovascular and musculoskeletal injuries. In the Philippines, however, the term Hilot is now being used to describe a form of “massage” that can be luxuriously experienced in world-class spas. For the sake of joining the international masses in offering a form of bodywork with an indigenous name, I strongly consider this an abuse and disrespect to the name and art of Hilot because such portrayal demeans its true identity and characteristics conforming to a mere pampering complete with candle light and soft relaxing music, with a finishing touch of aromatherapy to please the olfactory nerves.
Hilot has become adulterated and should not be categorized as a massage. A solution would be to classify a “subcategory” of Hilot with a completely different name that would then be offered within these spas. As a matter of fact, a Hilot back in the Philippines also identifies a midwife. Could you imagine going to a spa to deliver a baby?
With the dilemma of how various forms of manual medicine introduced and taught in the West are literally stripped of their true identity, I cautiously associate what I do as a Filipino form of manual medicine, practiced in a clinical setting, while uplifting its ancestral origin by calling it Ablon (as known among the Ilocanos, Yapayaos and Itnegs of Ilocos Norte) in order to continue the art’s true legacy.
Articles on traditional Filipino healing practices are emerging on the website. To my knowledge, the first instructional manual published on Hilot was co-authored by myself back in 1998. Then in 2001, a group based in Italy published a book on Hilot in the Philippines. There are also other books currently in the making by other writers. After 10 years, I have finally completed my three-volume magnum opus, the first which is to be published. The book set will be my personal contribution to the revival and re-introduction of Filipino traditional healing practices into American society and beyond.
[i] National Center for Complementary and Alternative Medicine (NCCAM). “The use of Complementary and Alternative Medicine in the United States.” Inhttp://nccam.nih.gov/news/report.pdf. Accessed 12-03-06
[ii] Sy, Peter A. (1997). “Doing Bioethics in the Philippines: Challenges and Intersections of Cultures and Medicines.” In Accessed 12-05-06. Also found in Bioethics in Asia.
[iii] Personal correspondence with Dr. Fujimoto, December 2005.
[iv] George Howe Colt, “The Healing Revolution.” LIFE magazine (September 1996).
[v] National Center for Complementary and Alternative Medicine (NCCAM). “The use of Complementary and Alternative Medicine in the United States.” Inwww.ccam.nih.gov/news/camsurvey_fs1.htm. Accessed 12-03-06.