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Health

'Panas Dalam' Isn't Real

Bringing you the red-hot truth on the "inner heat."
ilustrasi oleh Diedra Cavina Rahmadina

Waterfalls. Cool mountain weather. The sounds of nature. A fresh-faced woman waking from her slumber. Ah, you must be watching a commercial for some drink promising to cure your "panas dalam."

Panas dalam, or roughly, inner heat, is a term to describe what (allegedly) happens when you eat too much oily food. It's such a common illness that there are more products on the shelves that promise to relieve you of the ill-effects of panas dalam than there are flavors of instant noodles. OK, maybe that's a bit of an exaggeration. But maybe it's apt because instant noodles are a common "cause" of panas dalam too.

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These drinks present panas dalam as a minor, but annoying illness. It's the stuff like canker sores, cracked lips, hell, and even constipation that ruin your day. It's such a wide-ranging illness that almost anything can be panas dalam—a fact that makes the market for panas dalam relievers huge. It's basically the cousin of masuk angin—Indonesia's bad winds obsession.

I'm a bit obsessed with tracing the medical roots of Indonesian beliefs about health. I've investigated whether bad windsor ice-cold drinks—can make you sick. I've asked experts k there's a connection between pineapples and vaginas, snoring and death, massages and burps, and sleep paralysis and ghosts. Each time I learned a bit more about my own culture in the process.

So what did I find here? Is panas dalam a real illness?

"In the medical world, the term 'panas dalam' doesn't exist," Andi Khomeini Takdir Haruni, a doctor at the Indonesian Doctors Association, told me. "But you do get people coming in complaining that they have panas dalam. When we check said patients, normally they're having flu or some sort of inflammation."

So if it's not an illness, then what is it?

Panas dalam is a description of symptoms, not the name of an actual disease. It's basically the same thing as masuk angin—another illness that doesn't actually exist. At least it doesn't as a specific disease under the guise of Western medicine. Why? Let me actually quote myself explaining masuk angin here:

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In the West, when people feel unwell, they describe the cause. They have hay fever, or food poisoning. But here in Indonesia (and apparently the rest of Southeast Asia) we describe the feeling. So what does a cold feel like in the tropics? It feels like a bad wind.

Basically, we like to describe an illness by its symptoms. That's why a lot of "Indonesian" diseases never show up in Western medical books. Does that mean you're not actually ill? Not at all. If you're feeling sick, then you're probably sick.

But when we put a name on how something feels alone—instead of its root cause—we risk classifying a whole bunch of sicknesses as the same thing. Panas dalam can be any infection, whether by a virus or some bacteria, that makes us feel ill. Or maybe it's the flu. The only unifying theme here is that it's something that causes inflammation, and therefore feelings like part of your body is too hot.

"When inflammation happens, usually it comes with the change of mucosal resistance in the body, and one of the manifestations of this would be an ulcer or canker sore," Andi said. "It's this inflammation that we need to figure out. In Indonesia, it's commonly caused by a virus or bacteria. Usually it happens during transitional period of seasons when some people's immune systems are weaker."

So what about those drinks promising relief?

They won't cure you of a thing. See, when the name for an illness is actually a catch-all for several things that make you feel a certain way, then the likelihood of a single drink curing them all is pretty slim.

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Panas dalam relievers are basically herbal drinks packed with vitamins. They won't cure you, but that doesn't mean they won't make you feel better, thanks to the placebo effect. Asnan Furinto, a strategic marketing expert at Bina Nusantara University, told me that these drinks rely on age-old superstition and good branding to make you feel better. The drink makers tell you that this will fix your panas dalam, so, to you, it does. It's that simple.

But, medically, you're really not any better or worse than you were before you chugged that bottle of so-called relief.

"Medically speaking, it's not really an illness," Asnan said. "Masuk angin and panas dalam are exclusively used by Indonesians. In all honesty, you don't really need those products."

And these products never positioned themselves as medicine in the first place. The best thing about panas dalam relievers, much like masuk angin cures, is that they are meant to be taken when you're feeling ill and when you're feeling fine but afraid you might feel ill soon.

It's an amazing business model: Feeling sick? Drink some of this. Still feeling sick? Drink some more. Not feeling sick at all? Drink some of this so you don't feel sick later. Coke could learn a few things from these beverage companies. "Open happiness"? Try "Open healthiness" instead and watch the profits pour in.