Concussion treatment through Baria zasal: An exploration of Traditional Mongolian Medicine

Abstract

There is no specific treatment for concussion in modern medicine; existing treatments are limited to resting and restoring cognition. For Mongolians, seeking concussion treatment from a bariachi, an advanced practitioner of the baria zasal traditional massage therapy, is very common. The baria zasal technique has been passed down the generations for millions of years, keeping with the Mongolian nomadic culture and way of life. However, this Mongolian treatment is little known or researched internationally. Due to the lack of literature on this subject, conducting a meta-analysis or systematic review was impossible. We reviewed the literature published in Mongolian about this technique. We also searched articles published from 1 January 1921 to 20 June 2021 in PubMed using "concussion", "baria zasal", and "Bariachi" keywords. Although informal observation indicates this is a commonly sought treatment among patients, there are very few published scientific articles about the practice outside the realm of cultural anthropology. This may be due to a few reasons: the informal, semi-religious setting in which the treatment takes place makes it difficult to conduct scientific field research; concussion is a mild traumatic brain injury, making it impossible to identify changes in the brain as a result of the treatment using imaging methods and therefore difficult to verify; and lastly, baria zasal is generally uncontested as a treatment even by Mongolian medical professionals, therefore it has not been the subject of empirical debate. Moreover, it is not classified under a specific system, each bariachi having its technique. As bariachis do not receive formal training, their treatments often depend on instincts, natural talents, and personal abilities. Therefore, it is recommended to study the techniques of baria zasal of concussion to explain its enduring popularity in Mongolia and to ascertain how it interacts with standard western medical treatment.

Use of Traditional Mongolian Medicine in Children with Concussion

“…Furthermore, performing baria zasal on the head during a concussion improves certain parts of the body such as bioactive points (acupuncture points), which are activated to relax tense muscles. Furthermore, the neck range of motion and blood flow increase; pain decreases; the patient becomes more relaxed; and mental activity and the ability to bear intellectual stress are improved [ 9 , 10 , 11 , 12 ].…”

“…Furthermore, their choice to visit a bariachi for the treatment of concussion instead of western medication, or any other therapy, is independent of age, gender, or even religion. Bariachis sometimes utilize religious elements such as Dom zasal in their Baria zasal [ 12 ]. For this reason, the Baria zasal in adults might be related to placebo effects [ 16 ].…”

“…Otoch Sumbe Khamba Ishbaljir improved and updated the diagnosis and treatment of concussion, and we are using this treatment in our daily lives, but it is still not well studied [ 10 ]. In the historical and traditional medicine sutra, one of the most widely used methods of TMM is “ Baria zasal ”—mostly known as a massage treatment that is commonly used during concussion [ 9 , 12 ]. A Bariachi is an advanced practitioner of baria zasal .…”

“…Most Bariachis are not formally trained, and they often practice baria zasal based on their instincts, natural talents, and abilities. Each bariachi uses different techniques to treat concussion because bariachi are not formally trained [ 9 , 12 ]. Accordingly, Mongolian scientists have stated that the method of treating concussion has still not been developed in a certain system, has remained highly empirical, and has not been introduced to neighboring counties [ 9 , 10 , 11 , 12 ].…”

Mongolian philosophical underpinnings of well‐being: Mythology, shamanism and Mongolian Buddhism (before the development of modern nursing)

“…The secularization process of this ritual has lost its religious meaning and turned into a real act of treatment and nursing, inherited as a component of traditional folk methods. For instance, concussion treatment has been developed independently as a part of traditional Mongolian medicine under the name baria zasal (Ganbat et al, 2021), but some forms of it are registered as folk remedies under the name dom zasal (Tangad, 2020). The concussion treatment method is still widely used among Mongolians (Ganbat et al, 2023).…”