Thai Herbal Medicine: Traditional Recipes for Health and Harmony

APPENDIX 1. Wetchasueksa Phaetsatsangkhep Translated by Tracy Wells

Translator’s Introduction

The following is a partial translation of the first volume of a Thai medical text called The Study of Medicine, Summary of Medical Science (Wetchasueksa phaetsatsangkhep เวชศึกษา แพทย์ศาสตร์สังเขป), a three-volume set published by the School of Traditional Medicine at Wat Phra Chetuphon (commonly known as “Wat Pho” or “Wat Po”). Compiled in the mid-19th century, and first published in 1909, it is a summary of the main texts that form the theoretical foundation of Thai Traditional Medicine (TTM). This text was originally used as a teaching aid in schools where TTM was being taught alongside Western medicine. It is still being used in traditional medical schools in Thailand today. As TTM becomes more well known outside Thailand, there is increasing interest in the history, theory, and practice of this healing art. It is important that the main texts related to the practice of TTM be translated and used as the foundation for understanding TTM theory, since they are an integral part of the tradition.

Stating that skillful medical practitioners must have knowledge of four primary matters, this particular text is divided into four main sections: Pathogenesis of Disease, Identification of Disease, Pharmacology, and Administration of Treatment. Each of these sections offers an opportunity to become familiar with the vocabulary and basic concepts of TTM. Although some sections contain detailed descriptions, often, the text reads more like an outline. This is due to the fact that, traditionally, this material would have been handed down orally. Therefore, a text such as this was probably originally intended to serve as a memory device that would aid students in recalling key concepts encountered while studying directly with a practitioner. This sort of direct experience is the only way to develop a thorough understanding of the concepts presented in the text and to begin to appreciate their practical applications.

As for this translation, my main goal was to stay as true as possible to the source material. The integrity of the original text’s outline structure is for the most part maintained. All of the main sections are numbered according to the system used in the original. However, some subheadings and lists contained within the body of the text that do not have numerical designations in the original are numbered here for the sake of clarity. Additionally, some of the longer lists were converted to table form for the same reason. I have also added footnotes for explanatory purposes that do not appear in the original. I have occasionally added information that is missing from the charts or tables in Volume 1 of the source text, when such information can be found in other volumes; those instances have been noted. The inclusion of any other material that does not appear in the original text is indicated by the use of editor’s brackets.

There are several challenges inherent in any translation such as this, the largest being to find the right balance between translating word for word (where the inherent meaning often gets lost) and translating for meaning (where the original wording may be sacrificed). I mostly opted for the latter, although I did try to keep as much of the original wording as possible—especially for vocabulary specific to TTM. The first time certain specialized terms appear, I included a translation in all of the pertinent languages—English, romanized Thai, Thai, and, occasionally, Pāli. In these instances, the Thai script was romanized following the Royal Thai General System of Transcription and the Pāli terms were spelled in accordance with the spelling given in the Pāli Text Society dictionary. Thereafter, these terms are referred to only in English, capitalized in order to indicate that it is traditional medical terminology.

There were several additional complexities encountered in this translation, mostly having to do with the names for various diseases and plants. As much as possible, I tried to avoid using modern medical interpretations of the various diseases mentioned in the text, instead choosing to define medical terms by the meanings that traditional practitioners most likely used at the time this text was compiled. With regards to the various medicinal components mentioned in the text, scientific and English common names are given when available. However, these names may be misleading, since often there may be one plant with several names, or several different plants may all have the same name. This is probably due to the names of plants mentioned in the text being transferred to other plants with similar properties at some point when the original plants became more difficult to find or became extinct. I used several references, including Thai dictionaries, government publications, and university databases, to try to ascertain the most appropriate names for the plants referred to in this text. I also consulted with Wit Sukhsamran, a practitioner of TTM, and relied extensively upon his experience with the the plants and how they are used medicinally.

What has been omitted from this translation should also be mentioned here. I chose to omit many of the remarks concerned with Thai language usage throughout the piece as this translation is chiefly aimed at non-Thai speakers. Since a large portion of the original Preface deals with various issues of semantics, I have cut most of it; however, I did retain a translation of the four main category headings, because they offer a succinct overview of the content found in the rest of the text. A list of 82 formulas for medicine and a set of ethical guidelines for medical practitioners have also been left out of this translation. Aside from these omissions, which have been marked with […] in the translation that follows, all of the content contained in the major sections of the main body of the original text is included below.

Late in the production of this translation, I became aware of a 1979 article on TTM by Jean Mulholland that contains material similar to that found in the Wetchasueksa text. I did not consult that article in the preparation of this particular translation for two reasons. First, the information cited in the article draws from several different TTM manuals, including a set of guidelines for examination in TTM theory and pharmacy, as well as several classical textbooks of traditional medicine and pharmacy. While that material bears a resemblance to the material found in the Wetchasueksa text, its presentation in the article does not strictly follow the outline structure of this particular text. Second, while most of the main sections included in the Wetchasueksa text are mentioned in the article, there are several subsections that are omitted. The translation I have prepared, on the other hand, specifically aims to reflect the format and content of the original Wetchasueksa text by keeping the structure of the source material as intact as possible.

It is my deepest hope that this translation will be of some benefit as a reference for those with an interest in TTM. However, I am not a physician in either the traditional or modern sense of the word, and the material presented here is not intended as a substitute for consulting a trained physician, since all matters regarding health require medical supervision. Also, any mistakes or misinterpretations that may lie herein are completely my own and should not in any way reflect upon my teachers, the teachings, or the tradition from which they come.

I would like to thank all of my Thai language teachers, especially the teachers at University of Wisconsin-Madison Southeast Asian Studies Summer Institute (SEASSI), as well as Narisa Naropakorn. I am also thankful for my Thai massage teachers—both near and far—for nurturing my initial interest in the traditional healing arts of Thailand. And special thanks go to Wit Sukhsamran, who spent countless hours patiently going over minute details of this text with me. Despite a busy schedule, he was always willing to answer questions or shed light on particularly challenging passages. His many contributions are not individually cited throughout the translation. Instead, I will just hope it suffices to say that this translation would not have been possible without his help.

Most importantly, credit for this translation must be given to Thailand, Thai tradition, and the Thai people, whose recognition of the importance of texts such as this has ensured that the wisdom of this traditional knowledge is imparted to each new generation of TTM practitioners.

WETCHASUEKSA PHAETSATSANGKHEP

The Study of Medicine, Summary of Medical Science

Preface

[…]

Medical practitioners who will be skillful in treating disease must know about four primary matters:

1. Pathogenesis of Disease [literally, “origin of disease”]

2. Identification of Disease

3. Pharmacology [literally, “medicinal substances for treating disease”]

4. Administration of Treatment [literally, “appropriate medicine for correctly treating a specific disease”]

1. Pathogenesis of Disease

The Pathogenesis of Disease is divided into four aspects:

1. Elemental Causative Factor (that samutthan ธาตุสมุฏฐาน)

2. Seasonal Causative Factor (utu samutthan อุตุสมุฏฐาน)

3. Age Causative Factor (ayu samutthan อายุสมุฏฐาน)

4. Time Causative Factor (kanla samutthan กาลสมุฏฐาน)

1.1. Elemental Causative Factor

The Elemental Causative Factor refers to the place where the Elements become established, with the Elements being divided into four groups:

1. Earth [Element] Causative Factor (pathawi samutthan ปถวีสมุฏฐาน)

2. Water [Element] Causative Factor (apo samutthan อาโปสมุฏฐาน)

3. Wind [Element] Causative Factor (wayo samutthan วาโยสมุฏฐาน)

4. Fire [Element] Causative Factor (techo samutthan เตโชสมุฏฐาน)

Altogether, there are 42 Elemental Causative Factors, or as they are also called, the Four Elements of Earth, Water, Wind and Fire, which are further explained below.

Earth Element (pathawi that ปถวีธาตุ), Twenty Types

1. Hair of the Head

2. Hair of the Body—i.e., eyebrows, mustache, beard

3. Nails—fingernails and toenails

4. Teeth—incisors, canines, and molars—20 primary teeth, 32 permanent teeth

5. Skin—According to the texts, it is understood to mean the exterior covering of the body that has three layers: thick skin, middle skin, and outer skin. But, in reality, skin such as that in the mouth is one more type of skin called wet skin.

6. Muscle—layers of round muscle tissue and flat muscle tissue throughout the body

7. Tendons, Ligaments, Blood Vessels, and Nerves1

8. Bone—cartilage and bone

9. Bone Marrow

10. Kidney

11. Heart

12. Liver—[meaning] liver and pancreas

13. Membrane [i.e., fascia]2— connective tissue throughout the body that has the ability to be elastic and flexible

14. Spleen

15. Lungs3

16. Large Intestine

17. Small Intestine

18. Undigested Food4—undigested food in stomach

19. Waste—waste coming from the small intestines, in the lower intestines, excreted through the anus

20. Brain and Spinal Nervous Tissue

[…]

Water Element (apothat อาโปธาตุ), Twelve Types

1. Bile (pittang ปิต์ตํ), divided into two kinds: – Bound Bile (phattha pitta พัทธปิต์ต)—bile in the gallbladder – Unbound Bile (aphattha pitta อพัทธปิต์ต)—bile outside the gallbladder that flows into the small intestines

2. Mucus (semhang เสม์หํ), divided three ways: – Mucus in the Neck and Head (so semha สอเสมหะ) – Mucus in the Chest (ura semha อุรเสมหะ) – Mucus that is Below the Navel to the Anus (khut semha คูธเสมหะ) 5

3. Pus

4. Blood (lohitang โลหิตํ) 6—arterial blood and venous blood

5. Sweat

6. Fat

7. Tears

8. Oil—oil, sebum, or lymph

9.  Saliva

10. Nasal Mucus—clear fluid in nose and throat

11. Synovial Fluid—joint lubricant

12. Urine

Wind Element (wayothat วาโยธาตุ), Six Types

1. Wind that Moves from the Feet to the Head, or from the stomach to the throat, as in belching, etc.

2. Wind that Moves from the Head to the Feet, or from the small intestines to the anus, as in flatulence, etc.

3. Wind that Moves in the Abdomen, outside the digestive tract

4. Wind that Moves in the Intestines and Stomach

5. Wind that Moves Throughout the Entire Body (lom ลม) 7

6. Wind that is Inhaled and Exhaled—breath

Fire Element (techothat เตโชธาตุุ), Four Types

1. Fire that Warms the Body, maintaining regular body temperature

2. Fire that Makes a Feeling of Heat, creating a sense of unrest that makes it necessary to bathe and be fanned 8

3. Fire that Causes Aging and Decay

4. Fire that Digests Food

The names of the Twenty Earth Elements, Twelve Water Elements, Six Wind Elements, and Four Fire Elements that have been outlined [above] are the places where disease becomes established. This occurs when the Four Elements (that tang si ธาตุทั้ง ๔) become altered or deviate from a natural state (wikan วิกาล). This is explained in the classical texts Khamphi that wiphang (คัมภีร์ธาตุวิภังค์) and Khamphi roknithan (คัมภีร์โรคนิทาน).

Medical practitioners know the place where disease becomes established according to the condition or symptoms (akan อาการ) of the Four Elements, as well as the Medicinal components (tua ya ตัวยา) that cure disease, as categorized in the text Khamphi roknithan. Here, only the names of the Four Elements are given, since this is just a summary.

When the 42 Elements become altered or deviate from a natural state, they are divided into three groups of Elemental Causative Factors:

1.  Bile (Th. pitta ปิตตะ; Pāli pitta) ⁹ Disease-causing Factor: Sickness due to Bile

2.  Mucus (Th. semha เสมหะ; Pāli semha) Disease-causing Factor: Sickness due to Mucus

3.  Wind (Th. wata วาต; Pāli vāta) Disease-causing Factor: Sickness due to Wind

When all three groups of Causative Factors come together, it is called Combined Disease (sannibatika aphatha สันนิบาติกาอาพาธา)—that is, sickness due to the offenses (thot โทษ) coming together (sannibatสันนิบาต).

These three groups of Causative Factors frequently become altered or deviate from a natural state. When there are abnormal seasonal variations, the three groups of Causative Factors become altered at that time. This will be explained further next.

1.2. Seasonal Causative Factor

Sickness can arise when the seasons change; therefore, the seasons are a cause of disease. The classical medical texts divide the seasons in three ways: “Three Seasons,” “Four Seasons,” or “Six Seasons.”

Three Seasons

Hot Season (khim ha ruedu คิมหะฤดู or khim hanta ruedu คิมหันตฤดู)	1st day of waning moon of 4th month, to 1st day of waning moon of 8th month 10	– Causes heat – Rainy and cold weather mix – Fire Element is the Causative Factor, [specifically] 11 Fire that Warms the Body
Rainy Season (wasanta ruedu วสันตฤดู)12	1st day of waning moon of 8th month, to 1st day of waning moon of 12th month	– Causes coolness – Cold and hot weather mix – Wind Element is the Causative Factor, [specifically] Wind that Moves in the Abdomen, outside the digestive tract
Cold Season (hemanta ruedu เหมันตฤดู)	1st day of waning moon of 12th month, to 1st day of waning moon of 4thmonth	– Causes coldness – Hot and rainy weather mix – Water Element is the Causative Factor, specifically Mucus, Blood

With the change of seasons, there are variations of hot and cold weather mixing together. This [fluctuation] causes humans to become ill—due to the relationship of the outer Elements and the bodily Elements being unequal. When one season follows the other, the seasonal variation causes the internal bodily Elements to become irregular. When the circulation of [bodily] Elements does not keep pace with the season, then illness will occur.

Four Seasons

One year is divided into four seasons. Each season is three months.

First Season	1st day of waning moon of 4th month, to full moon of 7th month	Fire Element is the Causative Factor
Second Season	1st day of waning of moon 7th month, to full moon of 10th month	Wind Element is the Causative Factor
Third Season	1st day of waning moon of 10th month, to full moon of 1st month	Water Element is the Causative Factor
Fourth Season	1st day of waning moon of 1st month, to full moon of 4th month	Earth Element is the Causative Factor

Six Seasons

One year is divided into six seasons. Each season is two months.

First Season	1st day of waning moon of 4th month, to full moon of 6th month	Illness caused by Fire Element, [specifically] Bile, Body Heat (kamdaoกำเดา)
Second Season	1st day of waning moon of 6th month, to full moon of 8th month	Illness caused by combination of Fire Element, Wind Element, Body Heat
Third Season	1st day of waning moon of 8th month, to full moon of 10th month	Illness caused by Wind Element and Mucus
Fourth Season	1st day of waning moon of 10th month, to full moon of 12th month	Illness caused by Wind, Mucus, Urine
Fifth Season	1st day of waning moon of 12th month, to full moon of 2nd month	Illness caused by Mucus, Body Heat, Blood
Sixth Season	1st day of waning moon of 2nd month, to full month of 4th month	Illness caused by Earth Element, Combination of Blood, Wind, Body Heat, Mucus

1.3. Age Causative Factor

Age Causative Factor is divided into three phases.

Phase	Age	Causative Factor
1. Early Age (pathommawai ปฐมวัย)	Birth–16 yrs.	Water Element—specifically Mucus, Blood
	– Birth–8 yrs.	Mucus is the Dominant Element (chao ruean เจ้าเรือน), with aspects of Blood
	– 8–16 yrs.	Blood is the Dominant Element13, with aspects of Mucus
2. Middle Age (matchimawai มัชฌิมวัย)	16–32 yrs.	Water Element—specifically two parts Blood, and one part Wind
3. Old Age (patchimwai ปัจฉิมวัย)	32–64 yrs.	Wind Element
	64 yrs. and up	Wind Element is Dominant Element, with aspects of Water, specifically Mucus, Sweat

1.4. Time Causative Factor

Time Causative Factor is divided into four periods during the day and four periods during the night.¹⁴

First Period	dawn–9 AM	Water Element is the Causative Factor, specifically Mucus
	dusk–9 PM
Second Period15	9 AM–noon	Water Element is the Causative Factor, specifically Blood
	9 PM–midnight
Third Period	noon–3 PM	Water Element is the Causative Factor, specifically Bile
	midnight–3 AM
Fourth Period	3 PM–dusk	Wind Element is the Causative Factor
	3 AM–dawn

1.5. Geographic Causative Factor

Following what has already been said—that is, the four Causative Factors that contribute to disease as listed above—according to the classical medical text Khamphi samutthan winitchai (คัมภีร์สมุฏฐานวินิจฉัย), one additional Disease-causing Factor is the region where one is born or where one resides. Therefore, region or habitat is categorized here as a Geographic Causative Factor (prathet samutthanประเทศสมุฏฐาน).

Wherever one resides, the Elements that are established within the body become accustomed to the environment or atmosphere of that region. Changing habitats or environments—for example, moving from highlands to lowlands or from hot climates to cold climates—can cause one to fall ill if not acclimated to the new environment. People who move from the seaside to the highland forest, or vice-versa, may get sick, which really is just due to the unfamiliar water or unfamiliar atmosphere. It is really nothing but the Elements being unfamiliar, even if the person has lived in the new environment for a long time. The mud can occasionally be polluted, which is why this particular disease arises. Medical practitioners of all sorts will therefore recommend going to an unpolluted place to recover. Due to these reasons, region or habitat is categorized as a Causative Factor that contributes to the occurrence of disease.

Geographic Causative Factor, Four Types

Birthplace	Region	Causative Factor
1. Highland, upland	Hot Region (prathet ron ประเทศร้อน)	Fire Element
2. Rocky, desert-like terrain	Warm Region (prathet un ประเทศอุ่น)	Water Element, [specifically] Bile, Blood
3. Wetland	Cool Region (prathet yen ประเทศเย็น)	Wind Element
4. Saltwater wetland	Cold Region (prathet nao ประเทศหนาว)	Earth Element

Characteristics of Symptoms

The diseases that occur in humans arise in the 32 Parts of the Body (akan samsipsong อาการ๓๒)¹⁶—that is, the Hair of the Head, Hair of the Body, and so on. When a disease occurs in any part of the body, it is called by that part of the body followed by the word Distortion (phikan พิการ). This describes the Causative Factor, referring to the origin of the disease. When any one of the bodily Elements of Water, Wind, or Fire becomes irregular, it gives rise to disease.¹⁷ That part of the body is then called Distorted, which indicates the Causative Factor. The examination of the Causative Factors in order to identify the illness and the factor that gives rise to the disease is done by way of investigating the Elemental, Seasonal, Age, Time, and Geographic Causative Factors that have been described above. When a doctor applies a remedy, the remedy must accurately follow those Causative Factors. But, when a doctor examines a patient with certain symptoms, understands that it is a particular disease—i.e., a cold (wat หวัด), Wasting Disease (kasai กษัย), fever (khai ไข้)—and applies a remedy according [just] to the name of the disease, it is not accurately following the characteristics of the Causative Factors. This is because the name is [just] a conventional name that doctors have called the disease throughout the generations. But diseases that are rarely found, or something with similar symptoms, might be called different names by different doctors. If you are going to accurately apply a remedy, you must consider the Causative Factors. In the classical text Khamphi that wiphang, the conventional names for diseases are not used; instead, diseases are called by the Causative Factor. For example, when symptoms of disease in the liver are observed, it is called Distortion of the Liver; in the lungs, it is called Distortion of the Lungs; when disease is due to Mucus, it is called Distortion of the Mucus. This allows students of medicine to know the symptoms accurately.

The symptom characteristics describe the main Causative Factor, which is a tool for the doctor who is listening carefully during an examination. The types of diseases that humans most often have are in three groups—that is, disease that occurs due to Bile, disease that occurs due to Mucus, and disease that occurs due to Wind, as has already been explained in the [section on] Elemental Causative Factors.

Distorted Earth Element Causative Factors

(samutthan pathawi phikan สมุฏฐานปถวีพิการ)

Distortion of:	Symptoms:
Hair of the Head	Painful scalp; loss of scalp hair
Hair of the Body	Painful skin; loss of body hair [i.e., folliculitis]
Nails	Pain at nail; loss of nails; pus at nails [i.e., nail infection]
Teeth	Severe gum infection; abscessed molar causing pain at the tooth root; cavity
Skin	Itchy skin; rough or brittle skin; burning skin
Muscle	Flesh that is rash-like and burning; flesh that is mole-like or wart-like; [flesh] that is bruised or has dark marks
Tendons, Ligaments, Blood Vessels, and Nerves	Feeling emotionally tied-up, anxious, or faint; [feeling] weak or empty [i.e., bodily discomforts]
Bone	Affliction at the bones [i.e., bone disorders]
Bone Marrow	Thickening of bone marrow; beriberi (nepcha เหน็บชา, lit. “numbness and tingling”)
Kidney	Hot and cold shivers; Wasting Disease
Heart	Bad mood; touchiness; anger
Liver	Enlarged liver; soft or weakened liver; liver abscess; bruised liver
Membrane	Depletion in the lungs; thirst; drying of tissue in the pleura [i.e., tuberculosis with progressive anemia] (ritsiduang haeng ริดสีดวงแห้ง)
Spleen	Physical obstruction in chest; tightness in chest; abdominal distention; fatigue
Lungs	Thirst; sensation of warmth in the chest; serious asthma or gasping for breath; very serious disease of the lungs
Large Intestine	Diarrhea; feeling of tightness or firmness in abdomen; constriction of the intestine
Small Intestine	Burping and yawning; bloody stool; an unfocused or cloudy look; extreme soreness at waist; sharp, shooting bilateral abdominal pain; sensation of heat in the stomach; burning-like sensation from abdomen to throat [i.e., heartburn]; foul-smelling stool with pus
Undigested Food	Diarrhea; abdominal discomfort; nausea; hiccups
Waste	Irregular stool; disturbed digestion; diseases such as hemorrhoids (ritsiduang ริดสีดวง)
Brain and Spinal Nervous Tissue	Hearing loss; unfocused or cloudy vision; unclear speech; inability to move

Distorted Water Element Causative Factors

(samutthan apo phikan สมุฏฐานอาโปพิการ)

Distortion of:	Symptoms:
1. Bile a. Bound Bile b. Unbound Bile	a. Delirium b. Pain in head; internal feeling of heat; hot and cold shakes; yellow eyes; yellow urine; fever
2. Mucus a. Mucus in Neck and Head b. Mucus in the Chest c. Mucus below the Navel to the Anus	a. Sore throat; dry throat; asthma b. Physical wasting; abdominal rigidity; burning in throat; depletion in lungs c. Mucus or blood in stool
3. Pus	Loss of appetite; emaciation
4. Blood	Fever; delirium; incoherent speech; red urine; small inflamed elevations on skin or rashes; birthmarks that are black or red; Toxic Diseases (kanla rok กาฬโรค)18
5. Sweat	Dizziness; internal feeling of coolness; easily upset or depressed
6. Fat	Skin rash in a circular shape; burning skin; skin that is hot to the touch; secretions of lymph or yellow sebum
7. Tears	Filmy covering over eyes; teary eyes; watery eyes; cataracts
8. Oil	Yellow skin; yellow eyes; diarrhea
9. Saliva	Sore throat; pimples or bumps on tongue
10. Nasal Mucus	Pain in the head; unfocused or cloudy vision; nasal drip
11. Synovial Fluid	Joint pain; bone pain
12. Urine	Urine that is white, yellow, black, red

Distorted Wind Element Causative Factors

(samutthan wayo phikan สมุฏฐานวาโยพิการ)

Distortion of:	Symptoms:
1. Wind that Moves from the Feet to the Head	Tremors in the hands and feet; sensation of heat in the abdomen; agitation; yawning and belching; excess of Mucus
2. Wind that Moves from the Head to the Feet	Inability to lift arms and legs; fatigue or stiffness in the joints
3. Wind that Moves in the Abdomen, outside of intestinal tract	Rumbling or gurgling in the abdomen; faintness or dizziness; fatigue or stiffness in the joints
4. Wind that Moves in the Intestines and Stomach	Discomfort in chest; abdominal discomfort; vomiting; nausea; fermented odor
5. Wind that Moves Throughout the Entire Body	Blurry vision; dizziness; bilateral pain in upper thigh area; pain in spine; dry heaves; inability to eat; fever with chills
6. Wind that is Inhaled and Exhaled	Inability to get a deep breath; short or shallow breathing

Distorted Fire Element Causative Factors

(samutthan techo phikan สมุฏฐานเตโชพิการ)

Distortion of:	Symptoms:
1. Fire that Warms the Body	Clamminess
2. Fire that Makes a Feeling of Heat	Stiffness in ankle and wrist joints; sickness in lungs; cough; soreness on palms of hands and soles of feet; abdominal rigidity; nausea
3. Fire that Causes Aging and Decay	Lack of sensation in body; inability of the tongue to perceive taste; hearing loss; forehead tension. These symptoms may be intermittent.
4. Fire that Digests Food	Feeling of heat both internally and externally; cold hands; cold feet; perspiration

[Behaviors that Contribute to the Origin of Disease]

Having already mentioned the five Causative Factors, now the behaviors that contribute to the origin of disease will be mentioned in brief. Humans should behave in such a way that does not violate the body. The following are considered to be violations of the body. Violations occur via:

1. [Food]: Food is the most important way to take care of the body. Carelessness with what is consumed [consists of] eating too much, not eating enough, eating spoiled food or food that is supposed to be thoroughly cooked but is not cooked all the way, and eating at an inappropriate time, i.e., by eating food at breakfast that is normally consumed in the afternoon. The consumption of food in this manner disturbs the Elements in the body. This is called: Disease Arising from Food.

2. Body Movements or Posture: There are four body positions that should be alternated between: sitting, lying down, standing, and walking. Any movement or posture done to excess will not use the body’s Tendons, Ligaments, Blood Vessels, and Nerves in a way that encourages variety. The Tendons, Ligaments, Blood Vessels, and Nerves will deviate from a normal position, causing disease to arise. This is called: Disease Arising from Body Movements or Posture.

3. Hot and Cold: Disease can be caused by going from a hot place to an overly cold place; going from the shade into full sun without protection; going from the open-air to a muggy place; going into the rain and getting thoroughly soaked. This is called: Disease Arising from Hot and Cold.

4. Being Deprived of Sleep, Food, or Water: Not sleeping at night; not eating at mealtimes; not drinking when thirsty. Enduring deprivation causes disease. This is called: Disease Arising from Being Deprived of Sleep, Food, or Water.

5. Suppression of Defecation or Urination: Restraining bowel movements or urination results in an over-accumulation and fluctuation from what is normal. This abnormality can cause the Elements in the body to fluctuate also, which can cause disease. This is called: Disease Arising from Suppression of Defecation or Urination.

6. Overexertion: Overexertion is lifting, carrying, hauling, or dragging things that are too heavy for your level of strength. Running, jumping, or overly vigorous exercise vibrates and moves the organs more than usual and displaces them. Working or thinking in an overly focused way can wear you out and use all of your strength, which can cause disease. This is called Disease Arising from Overexertion.

7. Extreme Sadness: People suffering from excessive sadness have forgotten how to find joy in things that used to be pleasurable—the utmost being when food no longer has any flavor. Then the Nutriment (namliang น้ำเลี้ยง) in the body that is bright and clear becomes turbid and muddy, ultimately drying up, depleting the body and causing disease. This is called: Disease Arising from Extreme Sadness.

8. Extreme Anger: People who are always angry do not have the clarity of mind to control their temper, which takes a toll on the physical body. Lack of self-control is neglectful of the body, is self-defeating, and allows disease to arise. This is called Disease Arising from Extreme Anger.

2. Identification of Disease

Medical practitioners must know the names of diseases.¹⁹ When patients have symptoms of an illness, many practitioners will identify the disease by saying “you have a cold, a cough, a fever, a disease of Wind,” and so on. And there are many other names of diseases that are explained in the classical medical texts.

These names of diseases have been given so that practitioners can determine that when patients have symptoms like this, then it is this disease; with symptoms like that, then it is that disease.

However, in the classical text Khamphi roknithan, the name of the disease is not just stated as such. Instead, the name of each Element is given and then followed by the word “Distortion” or “Permanent Break (taek pai แตกไป)” which causes the various symptoms of illness. Therefore, these diseases exist when the 42 Elements become Distorted or Broken, which is the reason that humans become sick.

If a disease is to be named strictly according to the facts, then the 42 Elements must be in the name of the disease. For example: Distortion of the Hair of the Head Disease, Distortion of the Teeth Disease, Distortion of the Mucus Disease, Distortion of the Blood Disease, and so on. The word “Disease” in this case means the Element that is Distorted.

If a disease is to be named concisely, then there would be just five ways to name the disease, based on the origin of disease in the five sense organs, that is:

1. Diseases of the Eye (chakkhu ro kho จักขุโรโค)

2. Diseases of the Ear (sot ro khoโสตโรโค)

3. Diseases of the Nose (khan ro kho ฆานโรโค)

4. Diseases of the Tongue (chioha ro kho ชิวหาโรโค)

5. Diseases of the Body (kai ro kho กายโรโค)

Sense Organ Where Disease Occurs	[Examples of Disease]
Diseases of the Eye	Eyes that are red; eyes that are watery; eyes that have chronic sores
Diseases of the Ear	Deafness [literally, “ears that are deaf”]; hearing loss [literally, “ears that are deficient”]; ear abscess
Diseases of the Nose	Nose sores
Diseases of the Tongue	Tongue that is fissured; tongue ulcers
Diseases of the Body – Diseases of the External Body (phahit tha ro khoพหิทธโรโค)	Fungal infection of skin [i.e., tinea versicolor or ringworm]; malignant or nonmalignant chronic ulcerated sores [i.e., cancerous or noncancerous growths]; tropical infection of the skin [i.e., yaws]; leprosy; ulcerated sores
Sense Organ Where Disease Occurs	[Examples of Disease]
Diseases of the Body – Diseases of the Internal Body (anta ro kho อันตโรโค )	Fever; [diseases of] Wind; abdominal rigidity; localized abdominal rigidity; abdominal discomfort; stomach discomfort; dysentery; severe diarrhea; tuberculosis

Diseases cannot just be called by a single name since there are names that are given that may vary according to the village or the region. For example, a disease may have the same symptoms, but Northerners may have one name for it, Southerners may have another name, and the classical text may have a different name—even though it is the very same disease. It is not the names of the diseases that need to be amended, rather it is the responsibility of the practitioner to listen carefully and adapt when healing disease within that particular population.

It is recommended for students who are studying to be a doctor to specifically know the various characteristics and symptoms of Toxic Fevers (khai takkasila ไข้ตักศิลา). These are known as Toxic Diseases, and they are explained in the classical text Khamphi takkasila (คัมภีร์ตักศิลา) that was published in the [text] Phaetsat songkhro (แพทย์ศาสตร์สงเคราะห์). Doctors should consider these important fevers.

3. Pharmacology

Doctors must know everything about what is compounded into medicine for treating disease. In order to know the medicines, there are four aspects:

1. Individual Medicinal Components (tua ya ตัวยา)

2. Properties of Medicine (sapphakhun ya สรรพคุณยา)

3. Multiple Medicinal Ingredients (khrueang ya เครื่องยา)—mixed together [acting as a single substance] and called by one name (phikat ya พิกัดยา)

4. Methods for Compounding Medicine (kan prung ya การปรุงยา)

3.1. Individual Medicinal Components

3.1.1. Identifying Individual Medicinal Components

In order to know the Individual Medicinal Components, it is required to know five things:

– Form

– Color

– Aroma ²⁰

– Taste

– Name

3.1.2. Raw Materials for Medicine

There are three sorts of raw materials for medicine:

1. Vegetative material (phuet watthu พืชวัตถุ): plants, grasses, vines

2. Animal material (sat watthu สัตว์วัตถุ): animal body parts

3. Mineral material (that watthu ธาตุวัตถุ): various minerals

1. Plants

Plants—Flowers, Pollen or stamen, Fruit, Seeds, Sapwood or inside of bark, Resin, Heartwood, Root. Grasses, Vines

2. Animal Body Parts

Hair or fur, Skin, Antler or horn, Horn 21, Tusk, Fang, Tooth, Molar, Hoof, Bone, Bile

3. Minerals 22

Camphor (karabun การบูร, Cinnamomum camphora), Potassium nitrate, Sulfur, Copper sulfate

In order to know the form, color, aroma, and taste of a medicinal substance, you must be able to look at a sample of the real thing at a school, a garden, or other places that have fresh samples. You must study the real thing—both dried and fresh—and become experienced with it. Furthermore, plants from one region might be called one way, and then you might come across a different region calling it another way. Students must investigate in this way in order to become more experienced and knowledgeable.

3.2. Properties of Medicine

3.2.1. Three Medicinal Tastes (rot ya รสยา)

There are Three Medicinal Tastes:

1. Medicine with the Cool Taste Property (ya rot yen ยารสเย็น)

2. Medicine with the Hot Taste Property (ya rot ron ยารสร้อน)

3. Medicine with the Mild Taste Property (ya rot sukhum ยารสสุขุม)

1. Medicine with the Cool Taste Property23

Medicine made from—Leaves (that are not hot), Pollen, stamen, and pistil, “Seven Antlers or Horns,” “Nine Teeth,” Ash reduction

Examples: Great Dark Blue Medicine (ya mahanin ยามหานิล), Great Black Medicine (ya mahakan ยามหากาฬ)

For curing Fire

2. Medicine with the Hot Taste Property

Medicine made from—“Five Families,” “Three Pungents,” Hatsakhun หัศคุณ (Micromelum minutum), Ginger (khing ขิง, Zingiber officinale), Galangal (kha ข่า, Alpinia galanga, syn. Languas galanga)

Examples: All [of the medicine called] Yellow Medicine (ya lueang ยาเหลือง)

For curing Wind

3. Medicine with the Mild Taste Property

Medicine made from—Kot (โกฐ)24, Thian (เทียน)25, Eaglewood or agarwood (kritsana กฤษณา, Aquilaria crassna or Aquilaria malaccensis), Kalamphak กะลำพัก (Euphorbia antiquorum), Chalut ชะลูด (Alyxia reinwardtii), Cinnamon (opchoei อบเชย, Cinnamomum sp.), Khondok ขอนดอก (Asclepias gigantea), Sandalwood (chan thet จันทน์เทศ, Santalum album)26

Examples: All of the [medicine called] Fragrant Medicine (ya hom ยาหอม)

For curing Blood

3.2.2. Nine Medicinal Tastes

Another way to classify the Medicinal Tastes is according to the Nine Medicinal Tastes:

1. Astringent Taste (rot fat รสฝาด)	Binds
2. Sweet Taste (rot wan รสหวาน)	Permeates the tissue
3. Toxic Taste (rot mao buea รสเมาเบื่อ)	Remedies Poison (phit พิษ)27
4. Bitter Taste (rot khom รสขม)	Remedies Blood
5. Spicy-Hot Taste (rot phet ron รสเผ็ดร้อน)	Remedies Wind
6. Oily Taste (rot man รสมัน)	Remedies Tendons, Ligaments, Blood Vessels, and Nerves
7. Fragrant-Cool Taste (rot hom yen รสหอมเย็น)	Refreshes
8. Salty Taste (rot khem รสเค็ม)	Permeates the skin
9. Sour Taste (rot priao รสเปรี้ยว)	Cuts Mucus
— Tasteless (rot chuet รสจืด)	Remedies Mucus

3.2.3. Medicinal Tastes for Elemental Distortions

One more way of classifying [the Medicinal Tastes] is organized according to the Four Elements—i.e., when an Element is Distorted, which Medicinal Taste cures the disease:

Disease arising from:	Responds to:
1. Distorted Earth Element	Astringent Taste Bitter Taste Sweet Taste Oily Taste
2. Distorted Water Element	Bitter Taste Sour Taste Toxic Taste
3. Distorted Fire Element	Tasteless Cool Taste
4. Distorted Wind Element	Mild Taste Spicy-Hot Taste

Teaching these Properties of Medicine in a complete and detailed way is a difficult activity. Therefore, in order to obtain more extensive knowledge, students must study the large texts, such as the text about Properties of Medicine, Khamphi sapphakhun (คัมภีร์สรรพคุณ).

3.3. Multiple Medicinal Ingredients

[These are] mixed together [acting as a single substance] and called by one name. Categorized into groups by rank (phikat พิกัด). Examples to follow.²⁸

Two Entities Group

Name	Individual Medicinal Components	Part Used
Two Perfumes (thawekhantha ทเวคันธา)	Ironwood (bunnak บุนนาค, Mesua ferrea GUTTIFERAE)	Root
	Masang มะทราง (Madhuca pierrei SAPOTACEAE)	Root
Two Perfumes of Three Things (thawetrikhantha ทเวตรีคันธา)	Ironwood (bunnak บุนนาค, Mesua ferrea GUTTIFERAE)	Flower, Heartwood, Root
	Masang มะทราง (Madhuca pierrei SAPOTACEAE)	Flower, Heartwood, Root

Three Entities Group

Name	Individual Medicinal Components	Part Used
Three Medicines that are Very Fragrant (trisukhon ตรีสุคนธ์)29	Cinnamon (opchoei thet อบเชยเทศ, Cinnamomum verum, syn. Cinnamomum zeylanicum LAURACEAE)	Root
	“Thai cinnamon” (opchoei thai อบเชยไทย, Cinnamomum bejolghota or Cinnamomum iners LAURACEAE)	Root
	Patchouli (phimsen ton พิมเสนต้น, Pogostemon cablin LABIATAE)	Root
Three Fruits (triphala ตรีผลา)	Haritaki (samo apphaya สมออัพพยา, Terminalia chebulaCOMBRETACEAE)30	Fruit
	Bibhitaki (samo phiphek สมอพิเภก, Terminalia bellericaCOMBRETACEAE)	Fruit
	Amalaki (makham pom มะขามป้อม, Phyllanthus emblicaPHYLLANTHACEAE)	Fruit
Three Pungents (trikatuk ตรีกฏุก)	Black pepper (phrik thai พริกไทย, Piper nigrum PIPERACEAE)	Seed
	Long pepper (di pli ดีปลี, Piper longum PIPERACEAE)	Fruit31
	Ginger (khing ขิง, Zingiber officinale ZINGIBERACEAE)	Rhizome
Three Strong Medicines (trisan ตรีสาร)32	Wild pepper (cha phlu ช้าพลู, Piper sarmentosum PIPERACEAE)	Root
	Plumbago (chetta mun phloeng เจตมูลเพลิง, Plumbago sp. PLUMBAGINACEAE)	Root
	Sakhan สะค้าน (Piper interruptum PIPERACEAE)	Vine
Three Celestial Waters (trithanthip ตรีธารทิพย์)	Banyan tree (sai yoi ไทรยย้อย, Ficus benghalensis MORACEAE)	Root
	Golden shower (ratcha phruek ราชพฤกษ์, Cassia fistulaLEGUMINOSAE)33	Root
	Manila tamarind (makham thet มะขามเทศ, Pithecellobium dulceLEGUMINOSAE)	Root
Three Medicines with Ambrosial Effect (trisuraphon ตรีสุรผล)34	Samunlawaeng สมุลแว้ง (Temmodaphne thailandica LAURACEAE)	—
	Fragrant heartwood (nuea mai เนื้อไม้)35	—
	God’s tree (thepphatharo เทพทาโร, Cinnamomum parthenoxylon, syn. Cinnamomum porrectum LAURACEAE)	—
Three Remedies for the Elements (triphonthat ตรีผลธาตุ)	Zerumbet ginger (kathue กะทือ, Zingiber zerumbet ZINGIBERACEAE)	Root
	Cassumunar ginger (phlai ไพล, Zingiber cassumunar ZINGIBERACEAE)	Root
	Lemongrass (takhrai ตะไคร้, Cymbopogon citratus GRAMINEAE)36	Root
Three Remedies for Having an Effect on Combined Disease (trisannibatphon ตรีสันนิบาตผล)	Long pepper (di pli ดีปลี, Piper longum PIPERACEAE)	—
	Thai holy basil (kaphrao กะเพรา, Ocimum tenuiflorum, syn. Ocimum sanctum LABIATAE)	Root
	Black pepper (phrik thai พริกไทย, Piper nigrum PIPERACEAE)	Root
Three Medicines of Fragrant Aroma (trikansawat ตรีกันสวาต)	Bastard cardamom (reo yai เร่วใหญ่, Amomum xanthiodesZINGIBERACEAE)	Fruit
	Nutmeg (chan จันทน์, Myristica fragrans MYRISTICACEAE)37	Fruit
	Clove (kanphlu กานพลู, Syzygium aromaticum, syn. Eugenia caryophyllus MYRTACEAE)	—
Three Black Poison Treatments (trikalaphit or trikanlaphit ตรีกาฬพิษ)	Finger root (krachai กระชาย, Boesenbergia rotunda ZINGIBERACEAE)38	Root
	Galangal (kha ข่า, Alpinia galanga syn. Languas galangaZINGIBERACEAE)	Root
	Thai holy basil (kaphrao กะเพรา, Ocimum tenuiflorum, syn. Ocimum sanctum LABIATAE)39	Root
Three Celestial Flavors (trithipphayarot ตรีทิพยรส)40	Costus root (kot kraduk โกฐกระดูก, Saussurea lappa ASTERACEAE)	—
	Kalamphak กะลำพัก (Euphorbia antiquorum EUPHORBIACEAE)	—
	Khondok ขอนดอก (Asclepias gigantea APOCYNACEAE)	—
Three Insightful Flavors (triyannarot ตรีญาณรส)	Betelnut palm (mak หมาก, Areca catechu ARECACEAE)	—
	Neem (sadao สะเดา, Azadirachta indica MELIACEAE)	Root
	Guduchi (boraphet บอระเพ็ด, Tinospora crispa MENISPERMACEAE)	Vine
Three Flawless Diamonds (triphetsamakhun ตรีเพชรสมคุณ)	Aloe (wan hang chorakhe ว่านหางจรเข้, Aloe vera XANTHORRHOEACEAE)	—
	Golden shower (ratcha phruek ราชพฤกษ์, Cassia fistula LEGUMINOSAE)	Pod or hull
	Rong thong รงทอง (Garcinia acuminata GUTTIFERAE)	—
Three Medicines that Cut What is Vile (trichinthalamaka ตรีฉินทลามกา)	Medicinal rhubarb (kot nam tao โกฐน้ำเต้า, Rheum palmatumPOLYGONACEAE)	—
	Haritaki (samo apphaya สมออัพพยา, Terminalia chebulaCOMBRETACEAE)	—
	Rong thong รงทอง (Garcinia acuminata GUTTIFERAE)	—
Three Golden Filaments (trikesonmat ตรีเกษรมาศ)	Fin ton ฝิ่นต้น (Jatropha multifida EUPHORBIACEAE)	Bark
	Lotus (bua luang บัวหลวง, Nelumbo nucifera NELUMBONACEAE)	Pollen
	Bael tree (matum มะตูม, Aegle marmelos RUTACEAE)	Fruit, unripe
Three Eternal Things (tri-amarit ตรีอมฤต)	Hog plum (makok มะกอก, Spondias pinnata ANACARDIACEAE)	Root
	Banana, unripe (kluay กล้วยตีบ, Musa sp. MUSACEAE)	Root
	Kadom กะดอม (Gymnopetalum cochinchinensis CUCURBITACEAE)	Root
Three Lineages Wisdom (trisattakula ตรีสัตกุลา)	Black cumin (thian dam เทียนดำ, Nigella sativa RANUNCULACEAE)	—
	Coriander (phak chi la ผักชีลา, Coriandrum sativum UMBELLIFERAE)41	—
	Ginger, fresh (khing sot ขิงสด, Zingiber officinale ZINGIBERACEAE)	—
Three Medicines for Oil, Sebum or Lymph (trithurawasa ตรีทุรวสา)	Horapha thet โหรพาเทศ (Ocimum sp. LABIATAE)42	Seed
	Cardamom (krawan กระวาน, Amomum testaceum ZINGIBERACEAE)	Fruit
	Ratchadat ราชดัด (Brucea amarissima SIMAROUBACEAE)	Fruit
Three Things for Having an Effect on Mucus (trisemhaphon ตรีเสมหผล)	Wild pepper (cha phlu ช้าพลู, Piper sarmentosum PIPERACEAE)	Fruit
	Long pepper (di pli ดีปลี, Piper longum PIPERACEAE)	Root
	Crab’s eye vine (maklam khruea มะกล่ำเครือ, Abrus precatoriusLEGUMINOSAE)	Root
Three Things for Having an Effect on Bile (tripitaphon ตรีปิตผล)	Chetta mun thet เจตมูลเทศ (Plumbago sp. PLUMBAGINACEAE)	—
	Thai holy basil (kaphrao กะเพรา, Ocimum tenuiflorum, syn. Ocimum sanctum LABIATAE)	Root
	Phak phaeo daeng ผักแพวแดง (Iresine herbstii AMARANTHACEAE)	—
Three Things for Having an Effect on Wind (triwataphon ตรีวาตผล)	Sakhan สะค้าน (Piper interruptum PIPERACEAE)	Fruit
	Galangal (kha ข่า, Alpinia galanga syn. Languas galangaZINGIBERACEAE)	Root
	Black pepper (phrik thai พริกไทย, Piper nigrum PIPERACEAE)	Root

[…]

Four Entities Group

Name	Individual Medicinal Components	Part Used
Four Medicines for Treating the Elements at Different Times (chatukanthat จตุกาลธาตุ)	Calamus (wan nam ว่านน้ำ, Acorus calamus ARACEAE)	—
	Plumbago (chetta mun phloeng เจตมูลเพลิง, Plumbago sp. PLUMBAGINACEAE)	Root
	Khaeklae แคแกล (Dolichandrone serrulata BIGNONIACEAE)43	Root
	Pagoda flower (nom sawan นมสวรรค์, Clerodendrum paniculatumVERBENACEAE)	Root
Four Celestial Perfumes (chatu thip khantha จตุทิพคันธา)	Licorice (cha-em thet ชะเอมเทศ, Glycyrrhiza glabra LEGUMINOSAE)	Root
	Crab’s eye vine (maklam khruea มะกล่ำเครือ, Abrus precatoriusLEGUMINOSAE)	Root
	Bullet wood (phikun พิกุล, Mimusops elengi SAPOTACEAE)	Flower
	Ginger (khing khraeng ขิงแครง, Zingiber officinaleZINGIBERACEAE)44	—
Four Fruits for Treating the Elements (chatu phala thika จตุผลาธิกะ)	Haritaki (samo apphaya สมออัพพยา, Terminalia chebulaCOMBRETACEAE)	Fruit
	Bibhitaki (samo phiphek สมอพิเภก, Terminalia bellericaCOMBRETACEAE)	Fruit
	Amalaki (makham pom มะขามป้อม, Phyllanthus emblicaPHYLLANTHACEAE)	Fruit
	Samo thet สมอเทศ (Terminalia sp. COMBRETACEAE)	Fruit
Four Medicines for Having an Effect on Wind (chatu wata phon จตุวาตผล)	Ginger (khing ขิง, Zingiber officinale ZINGIBERACEAE)	Root
	Kalamphak กะลำพัก (Euphorbia antiquorum EUPHORBIACEAE)	—
	Cinnamon (opchoei thet อบเชยเทศ, Cinnamomum verum, syn. Cinnamomum zeylanicum LAURACEAE)	—
	Sichuan lovage (kot hua bua โกฐหัวบัว, Ligusticum wallichiiUMBELLIFERAE)	—

Five Entities Group

Name	Individual Medicinal Components	Part Used
Five Families (benchakun เบญจกูล)	Wild pepper (cha phlu ช้าพลู, Piper sarmentosum PIPERACEAE)	Root
	Sakhan สะค้าน (Piper interruptum PIPERACEAE)	Vine
	Long pepper (di pli ดีปลี, Piper longum PIPERACEAE)	Fruit45
	Ginger (khing ขิง, Zingiber officinale ZINGIBERACEAE)	Rhizome
	Plumbago (chetta mun phloeng เจตมูลเพลิง, Plumbago sp. PLUMBAGINACEAE)	Root
Five Families Having an Effect on the Elements (benchakun phon that เบญจกูลผลธาตุ)	Umbrella plant (kokrangka กกรังกา, Cyperus alternifolius CYPERACEAE or Cyperus digitatus CYPERACEAE)	Root
	Nut grass (haeo mu แห้วหมู, Cyperus rotundus CYPERACEAE)	Bulb46
	Ya channakat หญ้าชันกาด (Panicum repens GRAMINEAE)	Bulb
	Pro เปราะ (Kaempferia sp. ZINGIBERACEAE)	Bulb
	Tao kiat เต่าเกียด (Homalomena truncata ARACEAE)	Bulb
Five Small Roots (bencha mun noi เบญจมูลน้อย)	Ya klet hoi หญ้าเกล็ดหอย (Desmodium triflorum PAPILIONOIDEAE)	—
	Ya klet hoi หญ้าเกล็ดหอย (Hydrocotyle sibthorpioides UMBELLIFERAE)	—
	Castor oil plant (rahung daeng ระหุ่งแดง, Ricinus communisEUPHORBIACEAE)47	Root
	Cockroach berry (makhuea khuen มะเขือขื่น, Solanum aculeatissimumSOLANACEAE)	Root
	Ma-uek มะอึก (Solanum stramonifolium SOLANACEAE)	Root
Five Large Roots (bencha mun yai เบญจมูลใหญ่)	Bael tree (matum มะตูม, Aegle marmelos RUTACEAE)	Root
	Longan (lamyai ลำใย, Dimocarpus longan SAPINDACEAE)	Root
	Pheka เพกา (Oroxylum indicum BIGNONIACEAE)	Root
	Khaeklae แคแกล (Dolichandrone serrulata BIGNONIACEAE)	Root
	Khatlin คัดลิ้น (Walsura trichostemon MELIACEAE)48	Root
Ten Roots (thatsa mun yai ทัศมูลใหญ่)	Collection of “Five Small Roots” and “Five Large Roots” put together	—
Five Lightning Bolts (bencha lok wichian เบญจโลกวิเชียร) 49	Maduea uthumphon มะเดื่ออุทุมพร (Ficus glomerata or Ficus racemosaMORACEAE)	Root
	Khon tha คนทา (Harrisonia perforata SIMAROUBACEAE)	Root
	Thao yai mom ท้าวยายม่อม (Clerodendrum petasites LABIATAE or Tacca leontopetaloides TACCACEAE)	Root
	Ya nang หญ้านาง (Tiliacora triandra MENISPERMACEAE)50	Root
	Ching chi ชิงชี่ (Capparis micracantha CAPPARIDACEAE)	Root
Five Refreshing Things (bencha lo thi ka เบญจโลธิกะ)	Chan daeng จันทน์แดง (Dracaena loureiri AGAVACEAE)	—
	Chan khao จันทน์ขาว (Tarenna hoaensis RUBIACEAE)	—
	Chan chamot จันทน์ชะมด (Aglaia pyramidata MELIACEAE)	—
	Bat flower (neraphusi เนระพูสี, Tacca chantrieri TACCACEAE)	—
	Mahasadam มหาสดำ (Cyathea podophylla CYATHEACEAE)	—

Seven Entities Group

Name	Individual Medicinal Components	Part Used
Seven Antlers or Horns (satta khao สัตตเขา)	Water buffalo (khwai ควาย)	Horn
	Sumatran serow (lian pha เลียงผา, Capricornis Sumatraensis)	Horn
	Deer (kwang กวาง)	Antler
	Cow (wua วัว)	Horn
	Bison (kathing กะทิง)	Horn
	Goat (phae แพะ)	Horn
	Sheep (kae แกะ)	Horn
[Things for Treating] Urinary Disease51 (parameha ปรเมหะ)	Konpit ก้นปิด (Stephania hernandifolia MENISPERMACEAE)	Stem
	Indian nettle (tamyae tuaphu ตำแยตัวผู้, Acalypha indicaEUPHORBIACEAE)	—
	Tamyae tuamia ตำแยตัวเมีย (Laportea interrupta URTICACEAE)	—
	Cardamom (krawan กระวาน, Amomum testaceum ZINGIBERACEAE)	Fruit
	Costus root (kot kraduk โกฐกระดูก, Saussurea lappa ASTERACEAE)	—
	Rak thet รักเทศ (Gluta sp. ANACARDIACEAE)	Fruit
	“Three Fruits”52 without seed	—

Nine Entities Group

Name	Individual Medicinal Components	Part Used
Nine Teeth (naowa khiao เนาวเขี้ยว)	Hog (sukon สุกร)	Tusk
	Bear (mi หมี)	Fang
	Tiger (suea เสือ)	Fang
	Rhinoceros (raet แรด)	Horn
	Elephant (chang ช้าง)	Tusk
	Wolf (sunak pa สุนัขป่า)	Fang
	Manatee (pla phayun ปลาพะยูน)	Tusk
	Crocodile (chorakhe จรเข้)	Tooth
	Sumatran serow (lian pha เลียงผา, Capricornis Sumatraensis)	Tooth

Ten Entities Group

Name	Individual Medicinal Components	Part Used
Ten Families with Effect (thosa kula phon ทศกุลาผล)	“Small cardamom” (reo noi เร่วน้อย, Amomum villosumZINGIBERACEAE)	Fruit
	Bastard cardamom (reo yai เร่วใหญ่, Amomum xanthiodesZINGIBERACEAE)	Fruit
	Coriander (phak chi la ผักชีลา, Coriandrum sativum UMBELLIFERAE)	Fruit
	Water celery (phakchi lom ผักชีล้อม, Oenanthe javanica APIACEAE)	Fruit
	Licorice (cha-em thet ชะเอมเทศ, Glycyrrhiza glabra LEGUMINOSAE)	—
	“Thai licorice” (cha-em thai ชะเอมไทย, Albizia myriophyllaLEGUMINOSAE)53	—
	Amber (aphan thong อาพันทอง)	—
	Ambergris (aphan khi pla อาพันขี้ปลา)	—
	Cinnamon (opchoei thet อบเชยเทศ, Cinnamomum verum, syn. Cinnamomum zeylanicum LAURACEAE)	—
	“Thai cinnamon” (opchoei thai อบเชยไทย, Cinnamomum bejolghota or Cinnamomum iners LAURACEAE)	—

Additional Groups

Name	Individual Medicinal Components	Part Used
Five Metals (bencha loha เบญจโลหะ) 54	Bastard teak (thong kwao ทองกวาว, Butea monosperma LEGUMINOSAE)	Root
	Thong lang nam ทองหลางน้ำ	Root
	Thong lang bai mon ทองหลางใบมน (Erythrina suberosa LEGUMINOSAE)	Root
	Snake jasmine (thong phan chang ทองพันชั่ง, Rhinacanthus nasutusACANTHACEAE)	Root
	Coral tree (thong long ทองโหลง, Erythrina fusca LEGUMINOSAE)	Root
Seven Metals (satta loha สัตตโลหะ)	The “Five Metals,” plus two additional items:	—
	Winter squash (fak thong ฟักทอง, Cucurbita moschata CUCURBITACEAE)	Root
	Painted copper leaf (bai ngoen ใบเงิน, Acalypha wilkesianaEUPHORBIACEAE) 55	Root
Nine Metals (naowa loha เนาวโลหะ)	The “Seven Metals,” plus two additional items:	—
	Thong khruea ทองเครือ (Butea superba LEGUMINOSAE)	Stem
	Champa thong จำปาทอง (Alangium kurzii ALANGIACEAE)	—
Five kot (bencha kot เบญจโกฐ)	Sichuan lovage (kot hua bua โกฐหัวบัว, Ligusticum wallichiiUMBELLIFERAE)	—
	Kot so โกฐสอ (Angelica dahurica UMBELLIFERAE)	—
	Kot khamao โกฐเขมา (Atractylodes lancea ASTERACEAE)	—
	Angelica (kot chiang โกฐเชียง, Angelica sinesis UMBELLIFERAE)	—
	Sweet wormwood (kot chula lampha โกฐจุฬาลัมพา, Artemisia annua COMPOSITAE)	—
Seven kot (satta kot สัตตโกฐ)	The “Five kot,” plus two additional items:	—
	Costus root (kot kraduk โกฐกระดูก, Saussurea lappa ASTERACEAE)	—
	Kot kan phrao โกฐก้านพร้าว (Picrorhiza kurroa SCROPHULARIACEAE)	—
Nine kot (naowa kot เนาวโกฐ)	The “Seven kot,” plus two additional items:	—
	Kot phung pla โกฐพุงปลา (Dischidia rafflesiana ASCLEPIADACEAE)	—
	Kot chada mangsi โกฐชฎามังสี (Nardostachys jatamansiVALERIANACEAE)	—
Special kot (kot phiset โกฐพิเศษ)	The “Nine kot,” plus three additional items:	—
	Nux-vomica (kot kakling โกฐกะกลิ้ง, Strychnos nux-vomicaLOGANIACEAE) 56	—
	Pellitory (kot kakkra โกฐกักกรา, Anacyclus pyrethrum ASTERACEAE)	—
	Medicinal rhubarb (kot nam tao โกฐน้ำเต้า, Rheum palmatumPOLYGONACEAE)	—
Five thian (thian thang ha เทียนทั้ง ๕)	Black cumin (thian dam เทียนดำ, Nigella sativa RANUNCULACEAE)	—
	Garden cress seed (thian daeng เทียนแดง, Lepidium sativumCRUCIFERAE)	—
	Cumin (thian khao เทียนขาว, Cuminum cyminum UMBELLIFERAE)	—
	Fennel (thian khao plueak เทียนข้าวเปลือก, Foeniculum vulgareUMBELLIFERAE)	—
	Dill (thian ta takkataen เทียนตาตั๊กแตน, Anethum graveolensUMBELLIFERAE)	—
Seven thian (thian thang chet เทียนทั้ง ๗)	The “Five thian,” plus two additional items:	—
	Ajowan (thian yaowaphani เทียนเยาวพานี Trachyspermum ammiUMBELLIFERAE)57	—
	Anise (thian sattabut เทียนสัตตบุษย์, Pimpinella anisum UMBELLIFERAE)	—
Nine thian (thian thang kao เทียนทั้ง ๙)	The “Seven thian,” plus two additional items:	—
	Caraway (thian ta kop เทียนตากบ, Carum carvi UMBELLIFERAE)	—
	Psyllium (thian klet hoi เทียนเกล็ดหอย, Plantago ovataPLANTAGINACEAE)	—
Special thian (thian phiset เทียนพิเศษ)	The “Nine thian,” plus three additional items:	—
	Thian lot เทียนหลอด (Vernonia anthelmintica COMPOSITAE)58	—
	Thian khom เทียนขม (Foeniculum sp. UMBELLIFERAE)	—
	Thian klaep เทียนแกลบ (Foeniculum sp. UMBELLIFERAE)	—
Five Lotuses (bua nam thang ha บัวน้ำทั้ง ๕)	Sattabut สัตตบุษย์ (Nelumbo sp. NELUMBONACEAE)	—
	Sattaban สัตตบรรณ (Nymphaea sp. NYMPHAEACEAE)	—
	Lin chong ลินจง (Nymphaea sp. NYMPHAEACEAE)	—
	Chong konlani จงกลนี (Nymphaea lotus NYMPHAEACEAE)	—
	Nilubon นิลุบล (Nymphaea cyanea NYMPHAEACEAE)	—
Special Lotuses (bua phiset บัวพิเศษ)	Bua luang khao บัวหลวงขาว (Nelumbo sp. NELUMBONACEAE)	—
	Bua luang daeng บัวหลวงแดง (Nelumbo sp. NELUMBONACEAE)	—
	Sattabongkot khao สัตตบงกชขาว (Nelumbo sp. NELUMBONACEAE)	—
	Sattabongkot daeng สัตตบงกชแดง (Nelumbo sp. NELUMBONACEAE)	—
	Bua phuean บัวเผื่อน (Nymphaea nouchali NYMPHAEACEAE)	—
	Bua khom บัวขม (Nymphaea sp. NYMPHAECEAE)	—
Five hora (hora thang ha โหราทั้ง๕) 59	Hora amarit โหราอมฤต	—
	Hora miksingkhli โหรามิกสิงคลี	—
	Hora thao sunak โหราเท้าสุนัก	—
	Hora bon โหราบอน (Balanophora abbreviata BALANOPHORACEAE)	—
	Monkshood (hora dueai kai โหราเดือยไก่, Aconitum carmichaeliRANUNCULACEAE)	—
Special hora (hora phiset โหราพิเศษ)	Hora phak kut โหราผักกูด (Microlepia speluncae DENNSTAEDTIACEAE)	—
	Hora khao niao โหราข้าวเหนียว	—
	Hora khao nuea โหราเขาเนื้อ (Diplazium dilatatum ATHYRIACEAE)	—
	Hora khao krabue โหราเขากระบือ (Microlepia platyphyllaDENNSTAEDTIACEAE)	—
	Hora bai klom โหราใบกลม	—
	Hora mahura โหรามหุรา	—
Five Salts (kluea thang ha เกลือทั้ง๕)60	Salt mixed with milk kluea sin thao เกลือสินเธาว์ 61	—
	Salt mixed with honey kluea phik เกลือพิก	—
	Salt mixed with alcohol kluea wik เกลือวิก	—
	Salt mixed with sesame oil kluea fong เกลือฟอง	—
	Salt mixed with cow urine kluea samutthari เกลือสมุทรี	—
Special Salts (kluea phiset เกลือพิเศษ)	A type of salt 62 kluea sunchara เกลือสุญจระ	—
	A type of salt kluea yaowa kasa เกลือยาวกาสา	—
	A type of salt kluea withu เกลือวิทู	—
	A type of salt kluea dang khali เกลือด่างคะลี	—
	Uric acid salt kluea katang เกลือกะตัง	—
	Sea salt kluea samut เกลือสมุทร	—
	A type of salt kluea suwasa เกลือสุวสา	—

These groups of Multiple Medicinal Ingredients must include all of the ingredients each time they are used. The names of the groups are like shorthand to save time by just having a single name [for multiple ingredients]. Those who study the topic of medicine must learn and remember the names and categories of these Medicinal Ingredients. Then, if a text refers to a medicine such as “Three Pungents” or “Five Metals,” and you don’t know exactly what it consists of, you can look in the texts Khamphi sapphakhun and Khamphi samutthan winitchai, accordingly.

3.4. Methods for Compounding Medicine

1. Medicine that has been pounded into a powder, then rolled and formed into a tablet to swallow.

2. Medicine that has been pounded into a powder, then ground into fine powder to be dissolved in a liquid vehicle ⁶³ to drink.

3. Medicine chopped into pieces and put into a pot ⁶⁴ full of water. Boil and drink only the water.

4. Pickled herbs soaked for a short time with brine or spirits. Decant the liquid for drinking.

5. Medicine soaked in alcohol. Alcohol is dripped drop by drop into water and then consumed.

6. Medicine burned into charcoal. Take the ash, immerse it in water, and decant the water for drinking.

7. Medicine burned or dry-roasted until charred, pounded into powder, and ground very finely. Dissolved in various liquid vehicles.

8. Distilled medicine refined by capturing steam, i.e. distilled spirits. Drink only distillate.

9. Medicine that has been mixed, wrapped in a cloth, then loaded into small box to be used for inhaling.

10. Medicine that has been mixed, pounded into a fine powder, then placed in a tube and blown into the nose or throat.

11. Medicine cooked with oil, which is then put into small box and dripped onto a wound.

12. Medicinal preparation heated over fire, the smoke of which is then blown onto a wound or affected area.

13. Medicinal preparation rolled into a cigarette and smoked.

14. Medicinal preparation boiled and then used as a gargle or rinse.

15. Medicinal preparation boiled and used for bathing.

16. Medicinal preparation boiled for soaking.

17. Medicinal preparation boiled for rinsing or flushing.

18. Medicinal preparation boiled for steam or sauna.

19. Medicinal preparation used for a poultice.

20. Medicinal preparation used for rubbing or anointing.

21. Medicinal preparation used as a compress.

22. Medicinal preparation used as a suppository.

23. Medicinal preparation boiled for use as an enema.

[…]

Why must vegetative material, animal parts, and minerals that are Individual Medicinal Components be mixed together? In order to assist one another in becoming medicine that is potent in curing disease, medicinal components must be mixed together in a ratio. If just one thing is used, its potency is not enough to heal illness. It changes into just being food. For example, amalaki (makham pom มะขามป้อม, Phyllanthus emblica) consumed by itself is just food. It must be mixed according to the methods described above in order to be called a medicine for treating disease.

4. Administration of Treatment

The information in this section is extremely important to be careful about. If it is not really learned and experienced, then it is impossible to be a good doctor. This is because the medicine that is to be given to the patient—all the medicines laid out in the texts as being good for curing disease—would [essentially] be lost. If speaking about the usefulness of medicine for curing disease, the benefits are endless. [However,] the practitioner who does not truly understand a medicinal component and gives it to a patient, if mistaken, can kill the patient. Hence, it said that medicine has endless benefit and is also a punishment of the greatest severity. Therefore, before explaining which medicine cures which disease, the methods of clinical examination must be explained since these methods are an important foundation for doctors in the activity of prescribing medicine. It is just one of many arts within the subject of medicine.

Once it is known what ails the patient, the illness can be treated with the method that will cure it. This is an art form and an important part of being a doctor. The texts support and help the doctor a lot. But, regarding the examination of symptoms, the texts can only describe what the symptoms are, the name of the disease, and so on. The [actual] examination of the patient and diagnosis of the problem is something that doctors do with their own eyes and ears. Caring and listening to the truth is something that is in the doctor’s heart. Being thorough is comprised of a combination of research, inquisitiveness, and curiosity, as well as doing the examination and coming to a definitive consensus about the patient being sick with [what illness] and what the reason is for that illness. After getting to the truth of the illness, then an opinion can be formed about the method of treatment.

When this is all understood, then it should be clear that if the examination is not done carefully, then the wrong diagnosis will be made. This is comparable to a person losing sight and walking around without knowing which way to go. If this is the case, then the treatment will be completely wrong from the start. Therefore, it should be obvious that the examination is truly an important part of being a doctor. Doctors who are skillful are so because of this art form—that is, the proficiency in foretelling an illness correctly more often than not. In the case of the examination, the methods can be stated, but how you think is a foundation also. Even if you have a well-reasoned view that is based on inquisitive questioning and careful consideration of all the details, the story of the patient will lead the way and the shrewdness and artfulness of the practitioner must also be relied upon. The activity of laying out such a plan within a text is difficult. The main concepts that form the foundation are explained as follows.

Examination Methods

1.  History of Patient Examination Methods

i.		Name?
ii.		Where does the patient live? What is the regional habitat like? Pertains to Geographic Causative Factor.
iii.		Nationality? In order to understand their ideology and behavior.
iv.		Place of Birth? Pertains to Geographic Causative Factor.
v.		Age? Pertains to Age Causative Factor.
vi.		How do they eat? (How do people in their village eat?) For analyzing secondary causes and contributing factors.
vii.		What is their family like? (Ask about parents, children, spouse.) For analysis of hereditary factors.
viii.		What kind of daily behaviors or personal habits do they have. Do they smoke opium, drink alcohol, and so on? For analyzing secondary causes and contributing factors.
ix.		Past diseases and symptoms.

2. History of Disease

i.		When did they fall ill? (The initial day and time.) Pertains to Time and Seasonal Causative factors, as well as the duration of the disease.
ii.		What caused the ailment? (What were they doing before falling ill?) Pertains to contributing factors.
iii.		What were the initial symptoms?
iv.		What was the progression of symptoms?
v.		What course of treatment was followed?
vi.		Symptom variance over time?
vii.		Daily symptoms? (In order to know about the severity of symptoms during the periods of the day.) Pertains to Time Causative Factor.
viii.		Observations of symptoms by medical practitioner at time of examination and how important [these symptoms] are understood to be.

3. Examination of Body

i.		What is their appearance or physique like?
ii.		How is their strength or energy?
iii.		What is their mental or emotional state?
iv.		How is the pain?
v.		How is their pulse running?
vi.		How is their breathing?
vii.		Examine heart.
viii.		Examine lungs.
ix.		Examine tongue.
x.		Examine eyes.
xi.		Examine skin.
xii.		Examine the affected area (for example, skin sores, wounds, and so on.).

4. Examination of Symptoms

i.		Temperature.
ii.		Perspiration.
iii.		Bowel movements (both ask and examine).
iv.		Urine (both ask and examine).
v.		Food consumption.
vi.		Voice or sound.
vii.		Sleep.
viii.		Internal feeling [of body].
ix.		Feeling in mouth and throat.
x.		External feeling [of body or skin].

All of this information must be analyzed, as well as anything else that becomes apparent upon further inspection.

[Diagnosis and Treatment]

Once a sufficient examination is done and an opinion is formed, then a conclusive diagnosis can be made:

i.		What are the patient’s symptoms, what is the disease type, what is the name of the disease?
ii.		What is the cause of the disease?
iii.		What is the correct method for treating the disease?
iv.		What are the Properties of Medicine that will effectively treat the disease?

After the examination, then an analysis to form an opinion about the method of treatment is done in the following sequence:

1.  Examination of Results

a. In a person with these symptoms, what is the Causative Factor, and what is the specific aspect of that factor?

b. In a person born in that region, what is the Geographic Causative Factor, and what is the specific aspect of that factor?

c. In a person of this age, what is Age Causative Factor, and what is the specific aspect of that factor?

d. Based on the time of illness, what are the Seasonal and Time Causative Factors, and what are the specific aspects of those factors?

e. What is the progression of the disease, what is its Causative Factor, and what is the specific aspect of that factor?

In summary, identify the disease: what is Distorted, what is the type of Distortion, and what is the name of the disease?

2.  Reason for Symptoms

What is Deficient (khat ขาด), Excessive (koen เกิน), or Conflicted (krathop krathang กระทบกระทั่ง), or exactly what causes the abnormality to surface?

3.  Course of Treatment

What type of Medicine (with what type of Properties), how much, to be consumed when, how long? Remedy to be administered following the characteristics of the disease.

[…]

Endnotes

1  In Pāli, the word used in the text, nahāru, is defined as “any sinew or ligament in the human and animal body; a tendon, muscle, nerve” (Chanthaburinarunat 1970, p. 393). The Thai words used in this context are sen เส้น and enเอ็น.

2  Alternatively, Pleura. The Thai word used in the text, pang puet พังผืด, is most commonly defined as fascia, but can also refer to a membrane. The Pāli word used in the text, kilomaka, refers to the pleura, the lungs, or the right lung.

3  In Pāli, the word used in the text, papphāsa, sometimes refers to the lungs in general and other times specifically to the left lung.

4  Also, Stomach. The Pāli word used in the text, udariya, can either refer to undigested food in the stomach or to the stomach itself.

5  Alternate spelling: คูถเสมหะ.

6  Most of the time when a medical text refers to Blood, it is strictly referring to the anatomical substance. Other times, Blood functions almost as an additional Element that contains aspects of all the Elements (particulates in blood being Earth, viscosity of blood being Water, temperature of blood being Fire, and movement of blood being Wind).

7  When referring to lom, it means movement in the whole body—muscular contractions, nerve impulses, blood movement, etc.

8  This can be interpreted to mean Fire that causes emotion or fever.

9  Although seemingly similar to terms used in Buddhist or Ayurvedic medicine, the words used here have a different interpretation in TTM than in other systems of medicine.

10 Following the Thai Lunar calendar, with the 1^st month occurring approximately in December.

11 The Thai word used in most cases to indicate the specific aspect of a Causative Factor that is contributing to a disease is the word for “ranking” (phikat พิกัด). Although absent in this case, it is implied.

12 The second volume, which is essentially a review of all the material presented in the first volume, lists the name of the Rainy Season as watsana ruedu วัสสานะฤดู, and provides the specific dates.

13 In this text, Blood is listed as the aspect of the Water Element that is dominant during the phases occurring between 8−32 yrs. However, some teachings may refer to Fire during these phases.

14 This text divides the day and night into four periods and gives these particular time frames. However, other texts may list time frames that are slightly different.

15 For the Second and Third Periods, the Disease-causing Factor listed is the Water Element—specifically Blood and Bile, respectively. Other teachings may refer to Fire during these periods.

16 The 32 Parts of the Body is a traditional way of referring to the body. It is the sum of the Twenty Earth Elements and Twelve Water Elements.

17 The Earth Element does not appear in this list.

18 This is a category of extremely grave diseases.

19 It is implied that beyond simply knowing the name of a disease, medical practitioners must be able to correctly identify particular diseases.

20 Given in Vol. 2.

21 The term used here (no นอ) is only used to describe the horn of a few animals, and has no English equivalent. It technically refers to a protuberance from the head, such as in rhinocerous.

22 The examples given in the chart are representative of the traditional categories for minerals, which are as follows: 1) minerals extracted from plants, 2) salts, 3) non-metallic, inorganic substances, and 4) metallic substances.

23 The lists given for each of the Three Medicinal Tastes are not meant to be exhaustive, but rather to give some examples of the types of medicines included in each category.

24 Kot is a category of plants, mostly in the Artemisia family. The word kot has multiple definitions—i.e., ten-million, belt, or knot-like. The latter may be the most appropriate definition in this case, since these medicinal components all bear a resemblance to something knot-like.

25 Thian is a category of plants that are all seed-like.

26 In this context, chan thet is referring to sandalwood. However, it is used in other contexts to refer to nutmeg (Myristica fragrans).

27 Anything with the Toxic Taste is slightly toxic or toxic if taken in excess. This Taste is used to treat poison and toxins in the body, including toxins arising from Bile, Blood and Mucus. It also treats animal and insect bites, fatigue, Toxic Fever, etc.

28 In the original text, the groupings in this section appear as lengthy lists. Here they have been organized into tables and listed by the name of the group, the individual medicinal components, and the part used, if specified. The individual medicinal components are spelled in Thai as they are in the text, with any alternate Thai spellings listed as footnotes. When, in a small number of cases, I have created a English common name for a plant that has none, I have based this name on a literal translation of the Thai, and have placed the common name in quotations. When the exact species is unclear, I have given the genus name with the abbreviation “sp.”

29 Alternatively, from the official dictionary of the Royal Institute of Thailand (p. 431): cardamom–leaf (krawan กระวาน, Amomum testaceum ZINGIBERACEAE), cinnamon (opchoei thet อบเชยเทศ, Cinnamomum verumLAURACEAE), and patchouli–root (phimsen ton พิมเสนต้น, Pogostemon cablin LABIATAE).

30 Haritaki is also known as samo thai สมอไทย.

31 Given in Vol. 2.

32 This grouping is also referred to as the “Three Tastes.”

33 Golden shower is also referred to as khun คูน.

34 The Thai word phon ผล can either mean “fruit” in the literal sense, or “effect,” as in “the fruit of one’s labor.” In the context of this grouping, it is referring to an effect.

35 No tree is specified.

36 Takhrai hom ตะไคร้หอม is what is actually mentioned in the text. However, this is most likely not a reference to citronella grass (Cymbopogon nardus) since it is not usually used as a remedy. I have interpreted this as referring to lemongrass, which is a common medicinal with a similar name and appearance.

37 In this context, chan จันทน์ refers to nutmeg. Nutmeg is more commonly known as luk chan ลูกจันทน์.

38 The common spelling for finger root is krachai กระชาย, although it is spelled in the text kachai กะชาย.

39 Alternate spelling: kraphrao กระเพรา.

40 Alternatively, from the official dictionary of the Royal Institute of Thailand (p. 430): costus root (kot kraduk โกฐกระดูก, Saussurea lappa ASTERACEAE), fragrant heartwood (nuea mai เนื้อไม้) and “Thai cinnamon” (opchoei thai อบเชยไทย, Cinnamomum bejolghota or Cinnamomum iners LAURACEAE).

41 Commonly referred to as phak chi ผักชี.

42 The Royal Institute Dictionary (p. 430) lists sweet basil (horapha โหระพา, Ocimum basilicum LABIATAE) here.

43 Alternate spelling: khaetrae แคแตร.

44 Ginger is normally simply written khing ขิง, and it is possible that a particular variety of ginger is meant here.

45 Given in Vol. 2.

46 Given in Vol. 2.

47 Alternate spelling: lahung ละหุ่ง.

48 Alternate spelling: katlin กัดลิ้น.

49 The word used in the text, wichian วิเชียร, translates as lightning or thunderbolt, diamond, or the earthly weapon of Indra. This grouping of medicinal ingredients is also known as “Five Crystals” or “Five Roots.”

50 Alternate spelling: ya nang ย่านาง.

51 The name of this grouping, parameha ปรเมหะ, shares a name with an ancient medical treatise on urinology.

52 See “Three Fruits” in the Three Entities Group.

53 Thai common names are not necessarily given on the basis of genus and species. For example, this plant’s name contains the word cha-em, which is Thai for licorice, not because it is related to licorice (Glycyrrhiza glabra), but because it is sweet like licorice.

54 These are plants that have the word for a type of metal, usually gold, in their Thai names.

55 The plant listed in the text is ton bai thong ต้นใบทอง. This is most likely a reference to painted copper leaf.

56 Another name for Strychnos nux-vomica is salaengchai (แสลงใจ). It is also known as “poison nut” or “strychnine tree,” and is a source of the poisonous alkaloids strychnine and brucine.

57 Alternate spelling: thian yaowaphani เทียนเยาวพาณี.

58 Alternate spelling: thian luat เทียนลวด.

59 The word hora โหรา is difficult to translate in this context. It can be translated as “astrological,” and also “hour.” Neither definition particularly relates to these plants or the way they are used for treating disease (for the most part, these plants are toxic and need to be prepared in a special way to lessen the poison). Their use is not very widespread.

60 According to the Guide to Medical Science (Ministry of Education, 2006), the “Five Salts” components are prepared using a method that involves mixing sea salt with fresh water in an earthenware pot and boiling until the water evaporates. When cooled, the resulting salt is divided into five groups and mixed with the various ingredients in a ratio of two parts salt to one part liquid. The mixture is then dried again, resulting in the salts listed here.

61 Kluea sin thao เกลือสินเธาว์ commonly means “rock salt,” but in this context it is used to refer to the salt that is produced through the process described above.

62 No information could be found describing the difference between many of these salts.

63 Vol. 1 states that the fine powder is to be dissolved in “water” (nam น้ำ). Vol. 2 uses the word “liquid vehicle” (namkrasai น้ำกระสาย). Examples of liquid vehicles include water, rosewater, tea, honey, lime juice, etc.

64 Referring to an earthenware pot (mo หม้อ) traditionally used for preparing medicines.