Thai Traditional Medicine Vol2

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2. Posture. A person should alternate among the four postures — standing, walking, sitting, lying down — equally. But if one does not do so, and instead departs from the natural balance — standing too much at times, walking too much at times, sitting too much at times, lying down too much at times — this causes the tendons in the body to depart from their original normal state, and sickness and illness arise. This is called "disease arising from posture."

3. Heat and cold. Whether a person is exposed to excessive cold or excessive heat — for example, having been in a hot place and then soaking a long time in cold water, or having been in a cool climate and then going out into the sun, or going into a place with hot, stifling air, or being exposed to rain or dew more than is normal — such things are a cause of sickness and illness arising. This is called "disease arising from heat and cold."

4. Abstaining from food, water, and sleep. When it is time to eat and one cannot eat, when one wants to drink water and cannot, when it is time to sleep and one cannot sleep — whether from necessity or from going against the natural order — the condition of having to endure and bear such deprivation is a cause of sickness and illness arising. This is called "disease arising from abstaining from food, water, and sleep."

5. Holding back stool and urine. Normally, when it is time to pass stool or urine, but one holds it in and lets the time pass far beyond what is proper, this causes the body to become disordered from its original normal state, and the elements (dhatu) in the body become disordered along with it. When this happens, sickness and illness arise. This is called "disease arising from holding back stool and urine."

6. Overexertion. Doing excessive physical activity, or hanging/swinging and running, jumping, and leaping beyond one's bodily strength, or working with the mind — using the mind too much — such things cause the organs in the body to move abnormally

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sickness and illness arise. This is called "disease arising from overexertion of the body."

7. Sorrow and grief. A person afflicted with suffering from various causes becomes sorrowful and grieving, to the point of forgetting the happiness and comfort once enjoyed. One can no longer eat or sleep properly; even food that once had good flavor loses its taste, or is neglected altogether. When this happens, the fluid that nourishes the heart, once clear, becomes turbid, or dries up, and sickness and illness arise. This is called "disease arising from sorrow and grief."

8. Anger. A person of angry temperament, lacking mindfulness to hold himself back, will quarrel, brawl, strike and beat others — sometimes even punching and injuring himself. When this happens, sickness and illness arise. This is called "disease arising from anger."

End of Section 1.

Section 2 On Knowing the Names of Diseases

The names of the various diseases — such as the common cold, cough, fever, wind-illness, black pox, red pox, chickenpox, smallpox, and so on — are all merely conventional names assigned by physicians. A doctor treating a patient must know that when a patient has such-and-such symptoms, it is called by such-and-such a disease name. In truth, the names of the various diseases have already been established by the masters in the medical treatises.

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The name of a disease is a conventional name, established by attending physicians in order to make it recognizable that a disease of such-and-such a name has such-and-such symptoms, and a disease of this name has these symptoms — for the convenience of applying medicine to treat it.

But in the Dhatuvibhang treatise and the Rokanithan (disease-origins) treatise, no disease names are given at all. They speak only of the elements (dhatu), saying that such an element is disordered, or such an element is disordered, or has broken down in some particular respect — from which arise the various symptoms and categories. In truth, sickness is nothing other than this: the four elements, which are subdivided into 42 [components], become disordered or break down, and this is what causes human beings to suffer various illnesses. If disease names were to be given strictly according to the truth, they would have to follow the names of the 42 elements — for example, "hair-disorder," "body-hair-disorder," "nail-disorder," "tooth-disorder" — because what the treatises call "disease" is simply that disorder of the element itself.

If one wishes to abbreviate the names of diseases to fewer categories, there are only 5 names. In the Khrinamananthasut [Pali sutta name as printed], they are named according to the seat of the disease among the five faculties: cakkhu-roga, disease of the eye, one; sota-roga, disease of the ear, one; ghana-roga, disease of the nose, one; jivha-roga, disease of the tongue, one; kaya-roga, disease of the body, one.

Diseases of the eye are conventionally named: red eye, sore/weeping eye, cataract, eye-hemorrhoid (pterygium), and so on.

Diseases of the ear are conventionally named: deafness, dullness of hearing, discharging ear, having a "spirit" in the ear.

Diseases of the nose are conventionally named: nasal hemorrhoid (polyp). Diseases of the tongue are conventionally named: small tongue, numb tongue, having a lump on the tongue. Diseases of the body are divided into 2 categories: exterior disease, disease outside

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disease outside the body, one category; antaroga (internal disease), disease inside, one category. External diseases are conventionally named: ringworm, tinea, yaws, warts, leprous scale, leprosy, and various sores appearing on the outside of the body, and so on.

Internal diseases are conventionally named: fever, a chronic mass, a hardened abdominal mass, wind-illness, a rash-condition, colic/stabbing pain, dysentery, a knotting ailment, and so on — because these diseases arise in the five faculties, namely the eyes, ears, nose, tongue, and body, and so these disease names were conventionally assigned. Physicians afterward came to use these names one after another, down to this very day.

The names of diseases cannot really be taken as fixed and certain, because they are merely conventional names for what is the same disease. People of the South call it by one name, people of the North call it by another name, and the treatises call it by yet another name — in truth it is the same disease. There is no need to try to correct this matter; a physician should simply defer to local village usage, and that is acceptable.

An important point, by way of advice: one studying to become a physician should first learn to recognize fatal fevers with accuracy, and only then learn to treat them. Important fevers such as "Fever of the North," "Poison Fever," and "Spotted Fever" — which the ancients called "Taksila Fever" and which is now called plague — should be studied with accuracy, because a physician's reputation is made or lost quickly, on account of how these fevers, once treated, result mostly in either recovery or death.

End of Section 2.

Section 3 On Knowing Medicines for Curing Disease

To "know medicine for curing disease" means to know all the various substances that can be brought together and compounded into medicine for curing an arising disease. This knowledge must extend fully to 4 matters, namely:

1. Knowing the medicinal substance itself. 2. Knowing the properties of the medicine. 3. Knowing that medicinal ingredients bearing different names are, together, called by one same name. 4. Knowing how to compound medicines that are mixed according to various methods. "Knowing the medicinal substance" means knowing 5 things [as printed], namely: knowing its form, knowing its smell, knowing its taste, and knowing its name among the three categories of medicinal substances, which are:

a. Plant substances — one should know the trees, grasses, and vines. b. Animal substances — one should know the parts of animals. c. Mineral substances — one should know the various minerals.

a. As for plant substances, one should know that such-and-such a plant has a certain taste, form, flowers, stamens, fruit, seeds, sapwood, heartwood, resin, roots, and bark, of such-and-such a kind. The categories of grasses and vines should be known in the same way.

b. As for animal substances, one should know the parts of animals — for example, fur, hide, tusks, ivory, rhinoceros horn, teeth, molars, hooves, bone, and bile — having such-and-such form, color, smell, and taste, belonging to an animal of such-and-such a name.

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c. As for the various minerals, one should likewise know fully their form, color, smell, and taste — for example, sulfur, camphor, saltpeter, blue vitriol (copper sulfate), and suphanthan (a gold-tin alloy), each having such-and-such form, color, smell, and taste.

As for "knowing the properties of medicine," the masters set forth three medicinal tastes as the basis: cooling medicines, one category; hot medicines, one category; and mild/subtle medicines, one category. Cooling medicines are those containing leaves of cooling taste, flower pollen, and animal horn — the "nine tusks" (neaw-khiao) — or medicine that has been charred to charcoal and then compounded, such as Ya Maha Nin and Ya Maha Kan, used to treat disorders along the line of the Fire element (tejo), for example. Hot medicines are those containing benjakun (the five roots), tri-kathuk (three peppers), and hatsakhun, such as the yellow medicine used to treat disorders along the line of the Wind element (vayo), for example. Mild medicines are those containing kot-thian, agarwood (kritsana), kalampak heartwood, khon-dok, chalut, and archangel, such as the fragrant medicine (ya hom) used to treat disorders of the blood, and the like.

In another account, it is said that medicine has 9 tastes, namely:

1. Astringent taste — for healing/binding. 2. Sweet taste — for permeating through the flesh. 3. Intoxicating/poisonous taste — for counteracting poison. 4. Bitter taste — for treating disorders of the blood and bile. 5. Pungent-hot taste — for treating wind disorders. 6. Oily taste — for treating disorders of the tendons. 7. Fragrant-cooling taste — for nourishing the heart. 8. Salty taste — for permeating through the skin. 9. Sour taste — for corroding phlegm.

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In the treatises, the masters speak of only 5 tastes, but some masters say a bland taste should also be added, for treating disorders of phlegm.

Furthermore, the masters classify according to the four elements: when such-and-such an element is disordered, one must use medicine of such-and-such a taste to properly treat the disease, as follows:

1. Disease arising from disorder of the Earth element (pathavi-dhatu) responds to astringent, salty, sweet, and oily tastes. 2. Disease arising from disorder of the Water element (apo-dhatu) responds to bitter, sour, and intoxicating/poisonous tastes. 3. Disease arising from disorder of the Fire element (tejo-dhatu) responds to mild and pungent-hot tastes.

Students who wish for more detailed knowledge should consult the treatise on medicinal properties (Sappakhun Ya), for it would be beyond the scope to set it all out here.

As for "knowing medicinal ingredients that bear different names but are together called by one name," the masters have arranged these into groups, as will be given here by way of example:

Duka — Group of 2 Ingredients

Dve-gandha: root of bunnak, root of masang. Dve-ti-gandha: flower of bunnak, heartwood of bunnak, root of bunnak, flower of masang, heartwood of masang.

Tika — Group of 3 Ingredients

Tri-sukhon: root of foreign cinnamon, root of Thai cinnamon, root of young phimsen tree. Tri-phala: samo-appaya, samo-phiphek, makham-pom (Indian gooseberry). Tri-kathuk: black pepper, deepli (long pepper), ginger.

Tamra Phaet Songkhro (Physician's Compendium)

Sara Tri: root of cha-phlu, root of chet-mun-phloeng, vine of sakhan. Thara-thip Tri: aerial root of the weeping banyan, root of ratchaphruek (golden shower tree), root of makham-thet. Suphala Tri: samun-waeng, heartwood, thep-thalo wood. Phaladhatu Tri: root of kathue, root of phlai, root of takhrai (lemongrass). Sapholohitphala Tri: deepli, root of kaphloe, root of black pepper. Katthawat Tri: fruit of the greater rew (cardamom), fruit of nutmeg, clove. Kanlaphit Tri: root of krachai (fingerroot), root of kha (galangal), root of kaphrao (holy basil). Thipparot Tri: kot-kadook, kalampak, khon-dok. Yanarot Tri: areca-nut pith, neem root, boraphet vine. Phet Tri: root of huang-chorakhe, ratchaphruek leaf, rong-thong (gamboge). Chanphalamkua [as printed]: kot-namtao, samo-appaya, rong-thong. Kesonthet Tri: young bee-hive bark, pollen of both kinds of lotus. Ammarittaya Tri: root of makok, root of kluai-teep, root of kadom. Rattakula Tri: black cumin, coriander fruit, fresh ginger. Thulawasa Tri: fruit of horaphan-thet, fruit of kawan (cardamom), fruit of ratchadat. Phala Tri: fruit of cha-phlu, root of deepli, root of makam-khruea. Bataphala Tri: chet-mun-phloeng, root of kaphrao, boraphet. Watapala Tri: fruit of sakhan, root of kha, root of black pepper.

Chatukka — Group of 4 Ingredients

Chatukala-dhatu: sweet flag (wan-nam), root of chet-mun-phloeng, root of khaen-klaen, root of nom-sawan.

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Chatuthipphakhantha: root of cha-oem-thet (foreign licorice), root of maklam, flower of phikun, khing-khraeng. Chatuphalathika: samo-appaya, fruit of samo-phiphek, fruit of makham-pom, fruit of samo-thet.

Chatuwaraphala: root of ginger, kalampak, foreign cinnamon, kot-hua-bua.

Banchaka — Group of 5 Ingredients

Benjakun (the Five Roots): root of cha-phlu, vine of sakhan, deepli, ginger rhizome, root of chet-mun-phloeng. Benjakun-phon-chat: root of kok-rang-ka, water chestnut (haeo-mu), root of ya-chan-kat, root of prao. Benja-mun-noi (Lesser Five Roots): both kinds of ya-klet-hoi, root of ra-hung-daeng, root of ma-khuea-khuen, root of ma-euk. Benja-mun-yai (Greater Five Roots): root of matum (bael fruit), root of kham-yai, root of phekha, root of khaen-traen, root of khat-fan. Benja-lok-wichian: root of ma-dua-chumphon (cluster fig), root of khontha, root of thao-yai-mom, root of ya-nang, root of ching-chi. Benja-lothika: red sandalwood, white sandalwood, chamot sandalwood, phusi heartwood, maha-sadam.

Sattaka — Group of 7 Ingredients

Sat-khao (Seven Horns): buffalo horn, cow horn, deer antler, gaur horn, ram's horn, goat horn, serow's horn. Pramaeha [formula]: kan-bit plant, both kinds of stinging nettle, cardamom fruit, kot-kadook, foreign wax-apple fruit, tri-phala-wasang.

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Nawaka — Group of 9 Ingredients

The Nine Tusks: pig's tusk, bear's tusk, tiger's fang, rhinoceros tusk, elephant's tusk (using ivory), rabid dog's tooth, dugong's tusk, crocodile's tooth, serow's tusk

Thasaka — Group of 10 Ingredients

Thasakala-phala: fruit of both kinds of rew (lesser and greater cardamom); fruit of both kinds of coriander, namely phak-chi-ra and phak-chi-lom; both kinds of licorice, namely foreign licorice and Thai licorice; both kinds of amber, namely golden amber and fish-dropping amber; both kinds of cinnamon, namely foreign cinnamon and Thai cinnamon.

Besides what has already been described, ingredients are also named according to further fixed sets (phikat), as follows:

The Five Metals: root of thong-kwao, root of thong-lang-nam, root of thong-lang-bai-mon, root of thong-phan-chang, root of thong-lohng. The Seven Metals: uses the 5 ingredients above, and adds root of phak and root of ton-bai-thong, making 7 in all. The Nine Metals: uses the 7 ingredients above, and adds thong-khruea plant and champa-thong, making 9 in all. The Five Kot: kot-hua-bua, kot-so, kot-khemao, kot-chiang, kot-chulalampha. The Seven Kot: uses the 5 ingredients above, then adds kot-kadook and kot-kan-phrao, making 7 in all. The Nine Kot: uses the 7 ingredients above, then adds kot-phung-pla and kot-cha-da-mangsi, making 9 in all.

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Special Kot: uses the 5 ingredients above, then adds 3 more: kot-ka-kling (or kaking), kot-kakkra, kot-namtao.

The Five Thian: black thian, red thian, white thian, unhusked-rice thian, grasshopper-eye thian. The Seven Thian: uses the 5 above, then adds 2 more: thian-yaowaphani, thian-sattabut. The Nine Thian: uses the 7 above, adds 2 more: thian-takop, thian-kletho. Special Thian: uses the 5 above, then adds 3 more: thian-lot, thian-khom, thian-klaep.

The Five Water-Lotuses: bua-sattabut, sattaban, thin-chong, chongkolani, nilubon. Special Lotuses: both kinds of bua-luang (red and white), sattabongkot (red and white), bua-phuean, bua-khom.

The Five Hora: hora-amrit, hora-mik-singkhli, hora-thao-sunak, hora-bon, hora-dueai-kai. Special Hora: hora-phak-kut, hora-khao-niao, hora-khao-nuea, hora-khao-krabue, hora-bai-klom, hora-mahura.

The Five Salts: rock salt, salt phik, salt wik, foam salt, sea salt.

These names and fixed sets of medicinal ingredients must be studied and memorized with accuracy by one training to be a physician, so that upon encountering them in the treatises where the masters have set them down, one will recognize them. But the fixed sets of ingredients

...are very numerous indeed; to set them all down here in full would be beyond what is possible. Therefore I recommend that the student should consult the treatise on the properties [of medicines] and on constitutional diagnosis, in order to gain broader knowledge going forward. 4. Knowing how to prepare medicines that are compounded and used according to various methods — the author gives examples as follows:

1. Medicine pounded into powder, then rolled into pills and swallowed. 2. Medicine pounded into powder, then ground fine and dissolved in water to drink. 3. Medicine chopped into pieces, put in a pot with water added, boiled, and the liquid poured off to drink. 4. Steeped medicine: soaked in plain water or liquor, then the liquid poured off to drink. 5. Medicine dissolved with alcohol, then dripped into water [to drink]. 6. Medicine burned to ash/lye, the ash soaked in water, then the water poured off to drink. 7. Medicine roasted or freshly parched, pounded into powder, ground fine, dissolved in water with various diluents, and drunk. 8. Medicine distilled to obtain its condensate ("sweat-water"), such as liquor, for example. 9. Medicine compounded, then placed in a container to be inhaled/smelled. 10. Medicine compounded, then ground fine and put into a snuff tube, such as snuff medicine. 11. Medicine cooked with oil, then put into a tube to blow onto the mouth of a wound. 12. Medicine compounded, then lit, the smoke used, blown through a tube onto the mouth of a wound or the base of a boil. 13. Medicine compounded, then rolled into a cigarette and smoked. 14. Medicine compounded, then boiled and the water held in the mouth and rinsed [as a gargle]. 15. Medicine compounded, then boiled and the water used for bathing.

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16. Medicine compounded, then boiled and the water used to soak [the affected part]. 17. Medicine compounded, then boiled and the water used to wash/rinse. 18. Medicine compounded, then boiled and the steam used to fume the patient. 19. Medicine compounded, then used as a smudging/fumigating medicine. 20. Medicine compounded, then applied [as a rub]. 21. Medicine compounded, then made into a compress ball. 22. Medicine compounded, then used as a suppository. 23. Medicine compounded, then boiled and the water used as an enema.

There is a question:

Trees and roots, minerals, and the organs of animals — each of these already possesses properties that cure various diseases. Why then must they be combined together to make medicine again? The answer is: what is said is indeed true, but the reason for bringing them together to compound into medicine is so that they may assist one another, becoming a medicine with the potency and power able to cure disease. They must therefore be combined in greater and lesser proportions. If used singly, the potency of the medicine is not sufficient to cure the disease, and the disease does not heal. Some [ingredients], if used alone, become merely food — for instance, water chestnut (haew) and water caltrop (ka-chap) — eaten alone they are simply food. For this reason they must be combined. Once combined, it becomes necessary to give them various names, for the convenience of use, so that they may be matched appropriately to the disease — for example: Ya Hom Nao Wa Koat, Ya Hom Inthajak, Ya Leuang Hom, and so on.

End of Category 3

Category 4

Knowing which medicine cures which type of disease _______________

This category contains knowledge that is detailed and very important. If one does not study it thoroughly enough to become truly skilled, one cannot be a physician. For every remedy that the masters have laid down for patients to take has, without exception, the property of curing illness — this has already been proven. If the physician understands the matter thoroughly and gives the medicine to the patient and it cures him, the merit is boundless. But if one merely learns that something is "a medicine" and gives it to the patient [without proper knowledge], and the medicine does not match the disease, it causes the patient to suffer great pain, or may even cause death — the fault [in that case] is immense.

Therefore, before explaining which medicine should cure which type of disease, I will first give an account of the method of examining an illness, at least in brief outline, because the method of examining the illness is the essential foundation for prescribing medicine. If the diagnosis of the illness is wrong, the prescribing of medicine will be wrong as well. Determining with certainty what disease a given patient has depends on the eye and skill of the physician, who must take care to arrive at the truth. To truly know, one must investigate thoroughly, inquiring into causes and effects until they are fully accounted for. Once it is certain what disease the patient has, one then forms an opinion as to how to treat it, and which remedy should be used for the disease to be cured. If the diagnosis is wrong, it is like a person who has lost their sight walking without knowing the way — all subsequent treatment goes wrong as well. This is why I stated at the outset that the step of examining the symptoms of the illness is the essential foundation; a physician's skill comes from this very art — that is, correctly predicting the illness more often than being wrong. The method for examining an illness will be given here as a guide for thinking, but the forming of an opinion [in each case]...

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...forming an opinion by adapting and examining in full detail must depend on how the matter unfolds, and on the examiner's own quickness, sharpness, and skill. The principles to be set down are as follows:

Method of Examining an Illness

Principle 1: Asking about the patient's circumstances

1. Where does [the patient] live? What is the patient's terrain/region like — for [determining] the regional constitution? 2. What nationality is the person? — to know their customs and behavior. 3. Where was [the patient] born? — for the regional constitution. 4. What is [the patient's] age? — for the age-based constitution. 5. In what year, month, and day was [the patient] born? — in order to know the elemental origin. 6. What is [the patient's] occupation/livelihood? (One should also ask about the diet of people in that community.) — for examining contributing causes. 7. What is [the patient's] family situation? Ask about father, mother, children, wife/husband — for examining lineage and the path by which the disease may have arisen. 8. What is [the patient's] conduct? Ask about opium smoking, drinking, and other habits — for finding contributing causes. 9. What illnesses has [the patient] had before?

Principle 2: Asking about the disease

1. When did [the patient] first fall ill? Ask the day and time the illness first began — for [determining] the seasonal constitution, the climatic constitution, and the duration/age of the disease.

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2. What was the cause that made [the patient] ill? Ask about the time before falling ill — for examining the contributing cause and effect. 3. What were the symptoms when [the patient] first became ill? 4. How did the symptoms then proceed in sequence? 5. What treatment and care was given, in sequence? 6. How did the symptoms then change? 7. What are the symptoms like on any given day — in order to know, within each watch/hour, which factor causes the most harm — for [determining] the seasonal/time-based constitution? 8. At the time of examination, what does the physician observe with his own eyes, and what significant understanding does he form?

Principle 3: Examining the body

1. What is [the patient's] bodily form like? 2. What is [the patient's] strength like? 3. What is [the patient's] state of mind and mood like? 4. What is [the patient's] degree of suffering like? 5. How does the pulse move? 6. How does [the patient] breathe? 7. Examine the heart. 8. Examine the lungs. 9. Examine the tongue. 10. Examine the complexion/skin. 11. Examine the specific site of illness, such as a wound, for example.

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Principle 4: Examining the body [continued]

1. Take the temperature [with a thermometer]? 2. Examine the sweat? 3. Examine the stool — both by asking and by inspection? 4. Examine the urine — both by asking and by inspection? 5. [Examine] the patient's diet and food intake? 6. Examine the voice? 7. [Examine] the patient's sleep? 8. [Examine] internal sensations? 9. [Examine] sensations in the mouth and throat? 10. [Examine] external sensations?

The principles stated above need not all be examined — it depends on what the examiner requires. Even matters other than those mentioned, if they ought to be examined, must also be examined. This ultimately depends on how the causes and effects connect to one another, and on the physician's own judgement. Once enough has been found through examination to form an opinion, one then determines:

1. What symptoms does the patient have; what type and name of disease is it? 2. What is the origin from which that disease arises, as its root cause? 3. By what method should a disease like this be treated, so as to properly match the disease? 4. What medicine has properties able to cure this type of disease? One should then form an opinion on how to treat the disease, in the following order: Examine the affliction — that is, what are the patient's symptoms like, what is the constitutional cause, and what is the proportion formula [phikat]?

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For a person born in this region, what is the constitutional cause, and what is the proportion formula? For a person of this age, what is the constitutional cause, and what is the proportion formula? For one who falls ill in this season, what is the constitutional cause, and what is the proportion formula? From the onset of the illness up to this point, having changed in the sequence described, what is the constitutional cause, and what is the proportion formula? Taken together, what [function] is impaired, and what type and name of disease is this called? Once such causes are seen, one should use that principle to examine: from what cause did this illness arise — that is, what is deficient, what is in excess, or what has been disturbed/struck — that has given rise to this derangement — merely in order to find the way to treat it. Once this is seen, one should consider which remedy has the property to cure which [symptom], in what proportion — how much or how little — and at what time it should be taken; thus medicine is prescribed according to the characteristics of the disease present, going forward.

Before speaking of medicines, I wish to first describe the elemental origins associated with a person's year, month, and day [of birth], to enrich the knowledge of the student, as follows:

For the year [of birth]

1. A person born in the Year of the Rat (chuad) — Water is the element of origin. 2. ... Year of the Ox (chalu) — Earth is the element of origin. 3. ... Year of the Tiger (khan) — Wood is the element of origin. 4. ... Year of the Rabbit (thao) — Wood is the element of origin. 5. ... Year of the Dragon (ma-rong) — Metal is the element of origin. 6. ... Year of the Snake (ma-seng) — Fire is the element of origin. 7. ... Year of the Horse (ma-mia) — Fire is the element of origin.

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8. A person born in the Year of the Goat (ma-mae) — Metal is the element of origin. 9. ... Year of the Monkey (wok) — Iron is the element of origin. 10. ... Year of the Rooster (ra-ka) — Iron is the element of origin. 11. ... Year of the Dog (cho) — Earth is the element of origin. 12. ... Year of the Pig (kun) — Water is the element of origin.

For the month [of birth]

1. A person born in month 5, 9, or 1 — Fire is the element of origin. 2. ... month 6, 10, or 2 — Earth is the element of origin. 3. ... month 7, 11, or 3 — Wind is the element of origin. 4. ... month 8, 12, or 4 — Water is the element of origin.

For the day [of birth]

1. A person born on day 1 or 7 — Fire is the element of origin. 2. ... day 2 or 5 — Earth is the element of origin. 3. ... day 3 — Wind is the element of origin. 4. ... day 4 or 6 — Water is the element of origin.

On the properties of medicines that treat the elemental humor-groups when in excess (kamroep), deficient (yon), or impaired (phikan)

1. If the Tejo (Fire) element is in excess, take sakhan 1 part, dipli 2 parts, cha-phlu 3 parts, khing 5 parts, chet-mun-phloeng 8 parts, samo-phiphek 16 parts — treats excess of the Tejo element. 2. If the Tejo element is deficient, take dipli 1 part, cha-phlu 2 parts, sakhan 3 parts, khing 8 parts, chet-mun-phloeng 16 parts — treats deficiency of the Tejo element.

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3. If the Tejo element is impaired, take cha-phlu 1 part, sakhan 2 parts, dipli 3 parts, chet-mun-phloeng 5 parts, samo-phiphek 8 parts, khing 16 parts. 1. If the Vayo (Wind) element is in excess, take cha-phlu 1 part, chet-mun-phloeng 2 parts, dipli 3 parts, phrik-thai 4 parts, sakhan 8 parts, samo-thai 16 parts, dried khing as needed — treats excess of the Vayo element. 2. To treat deficiency of the Vayo element, take chet-mun-phloeng 1 part, dipli 2 parts, cha-phlu 3 parts, samo-thai 8 parts, phrik-thai 8 parts, dried khing as needed — treats deficiency of the Vayo element. 3. If the Vayo element is impaired, take dipli 1 part, cha-phlu 2 parts, chet-mun-phloeng 3 parts, sakhan 4 parts, samo-thai 8 parts, phrik-thai 16 parts, dried khing as needed — treats impairment of the Vayo element. 1. If the Apo (Water) element is in excess, take dried khing 1 part, sakhan 2 parts, chet-mun-phloeng 3 parts, dipli 4 parts, cha-phlu 8 parts, makham-pom 16 parts, phrik-thai as needed — treats excess of the Apo element. 2. If the Apo element is deficient, take sakhan 1 part, chet-mun-phloeng 2 parts, khing 3 parts, makham-pom 4 parts, dipli 8 parts, cha-phlu 16 parts, phrik-thai as needed — treats deficiency of the Apo element. 3. If the Apo element is impaired, take chet-mun-phloeng 1 part, khing 2 parts, sakhan 3 parts, cha-phlu 4 parts, makham-pom 8 parts, dipli 16 parts, phrik-thai as needed — treats impairment of the Apo element. 1. If the Pathavi (Earth) element is in excess, take phrik-thai 1 part, khing 2 parts, chet-mun-phloeng 3 parts, sakhan 4 parts, dipli 8 parts, cha-phlu 16 parts, [continued on next page]

142 Watthana Panich Press

[continued from previous page] ...with triphala (tri-pha-la, three-fruit formula) mixed in an appropriate amount — treats excess of the Pathavi element. 2. If the Pathavi element is deficient, take dried khing 1 part, chet-mun-phloeng 2 parts, phrik-thai 3 parts, cha-phlu 4 parts, sakhan 8 parts, dipli 16 parts, triphala mixed in appropriate amount — treats deficiency of the Pathavi element. 3. If the Pathavi element is impaired, take chet-mun-phloeng 1 part, phrik-thai 2 parts, dried khing 3 parts, dipli 4 parts, cha-phlu 8 parts, sakhan 16 parts, triphala mixed in appropriate amount — treats impairment of the Pathavi element.

The ancients had a method for calculating the elements

To know which element is deficient or lacking, [proceed] as follows: If one wishes to know which element is deficient or lacking, set down that element's number — namely: Earth 20, Water 12, Fire 4, Wind 6. When one wishes to examine a particular element, set that number down, add the person's age to it, and whatever the result, multiply by 3 and divide by 7. If the remainder does not reach the full element-number — for example, if for the Earth element the result is only 15–16 or similar — this is called "deficient" (yon). If the remainder is zero, this is called "impaired" (phikan). But it has traditionally been held that if the remainder is zero, [the patient] is likely to die. Whether this is truly so, the student should test and observe for themselves.

On the medicines that treat impairment of the four elements, as follows

The Earth element, 20 [aspects]

For the twenty aspects of the Earth element, mostly the same remedy is used, as follows: 1. A medicine called Tri-chawa-sang, which treats the Pathavi (Earth) element — that is, impairment of the brain, bones, and spleen. Take kra-thiam 1, bai sadao (leaf) 1, bai khon-thi-so 1, plueak tuen-bet (bark) 1,

Handbook of Medical Assistance 143

[continued] ...ben-cha-kun 1, phon-chan 1, dok-chan 1, kra-wan 1, kan-phlu 1, tri-kra-tuk 1, each in 1 part; plueak kan-krao 2 parts; plueak sa-mun-waeng 3 parts; both types of chan 1 part each; all three types of samo 1 part each; ground into a powder and dissolved in honey to be taken.

2. Another remedy that treats the Pathavi element — that is, impairment of the fascia, the belly, and the lungs — take hae-wu-mu 1, faek-hom 1, bai sadao 1, ya-tin-nok grass 1, kra-bao 6, kan-phlu 1, phon-chan 1, dok-chan 1, phro-hom 1, kot-so 1, kot-khema 1, dok-bun-nak 1, both types of chan 1, dok-krung-khema 1, phon-phak-chi 1, dok-phak-pot 1, ne-ra-phu-si 1, phon-en 1, dang-luet 1 — taken in equal parts, ground and formed into blocks, dissolved with foreign flower water, musk, and camphor, together with the water of both sandalwoods, and taken.

3. Another remedy that treats the Pathavi element — that is, impairment of the spleen, heart, and liver — take cha-mot 1, phim-sen 1, dok-krung-khema 1, phon-en 1, ready-compounded ruesi-prasom 1, plueak tuen-bet 1, bai sadao 1, bai sa-niat 1, ob-choei 1, ya-tin-nok grass 1, all three samo 1, makham-pom 1, lam-phan 1, kot-so 1, bai kra-wan 1, dok-bun-nak 1, phro-hom 1, dok-phak-pot 1, all five pollens (kesorn thang ha) 1, dok-kham-thai 1 — taken in equal parts, ground and formed into blocks, dissolved in sandalwood water and taken.

4. Another remedy that treats the eight aspects of the Pathavi element — that is, impairment of the hair, body hair, nails, teeth, skin, flesh, tendons, and bones — take bai-rak leaf 1, bo-ra-phet 1, hua-hae-wu-mu 1, chi-ra-ka-ri 1, unripe ma-tum fruit 1, rock salt (kluea sin-thao) 1, kra-thiam 1, faek-hom 1, kok-lang-ka 1, cha-em-thet 1, kot-so 1, kot-kan-phrao 1, tri-kra-tuk 1, plueak-ton-tuen-bet 1, samo 1, bai sadao 1 — taken in equal parts,

145 Watthana Panich Press

[continued] ...ground and dissolved in honey to the size of a jujube fruit; taken morning and evening.

5. Another remedy that treats two aspects of the Pathavi element — that is, impairment of the large intestine and small intestine — take bai sadao 1, bai sa-niat 1, chet-mun-phloeng 1, plueak muk-man 1, hua-hae-wu-mu 1, kot-phung-pla 1, phon-phak-chi 1, samo-thai 1, samo-phiphek 1, makham-pom 1, rak-tong-taek 1, faek-hom 1, bo-ra-phet 1, phon-ka-dom 1, kra-thin-daeng 1, dried khing 1, khrai-khruea 1, ya-tin-nok grass 1 — taken in equal parts, boiled with pomelo-flower water, or with liquor, or with plain water as suitable. When about to take it, mix in sugar; taken, it cures fever of the three humors and heals the two aspects of the Pathavi element.

6. Another remedy that treats two aspects of the Pathavi element — that is, impairment of "old food" and "new food" [digestion] — take the shell of the hoi-khom snail 1, the shell of the hoi-khraeng cockle 1, red phaeo-daeng vegetable 1, phon-chan 1, dok-chan 1, kra-wan 1, kan-phlu 1, ka-ra-boon 1 — taken in equal parts; loose (husked) black pepper in an amount equal to all the other ingredients combined; ground and dissolved in honey; taken, it cures.

7. Another remedy that treats the Pathavi element — that is, impairment of the membrane within the brain — take sakhan 1 baht, cha-phlu 1 baht, dried khing 1 baht, unripe ma-tum fruit 1 baht, samo-thai fruit 1 baht, samo-phiphek fruit 1 baht, samo-thet fruit 1 baht, phak-chi fruit 1 baht, krit-sana 1 baht, chan-thet 1 baht, makham-pom fruit 1 baht, phi-lang-ka-sa fruit 1 baht, hua-hae-wu-mu 1 baht, rak-khat-mon 1 baht, kok-lang-ka 1 baht, bo-ra-phet 1 baht, dipli 1 baht; boiled and taken, it cures the Pathavi element — that is, it heals excess of the membrane within the brain.

8. This remedy for headache: take both types of cha-em 1, cha-mot 1, phim-sen 1, foreign cinnamon (ob-choei-thet) 1, chan-thet 1, plueak khon-tha 1, kot 1, bai-sami leaf 1, phon-phak-chi 1, khing 1 — taken in equal parts, ground fine; used as snuff to cure headache [text continues beyond this page]

Once the membrane inside the brain has recovered from its disorder, compound this poultice medicine accordingly. Take phak nok (ผักหนอก) 1 [part], a small amount of fresh khing (ขิง, ginger) 1, hua hom (หัวหอม, shallot) 5 bulbs, thian dam (เทียนดำ) 1, white saltpeter earth (ดินประสิวขาว) 1; grind and apply as a poultice on the head — in the cold season apply it generously; in the hot season take bai sania (ใบเสนียด) 1, sesame seed (งาเม็ด) 1, thian dam 1, white saltpeter earth 1; grind and poultice the crown of the head so that the brain-swelling subsides quickly. This also cures pain from blood flowing from the nose and along the hairline, and cures the vomiting of blood. Once you have made it, do not doubt it. During the rainy season, take ya nam dap fai (หญ้าน้ำดับไฟ) 1, thian dam 1, phlai (ไพล) 1, hua hom 1, phikun flower (ดอกพิกุล) 1, phak khuang (ผักขวง) 1, bai hang nok yung (ใบหางนกยูง) 1, fong sam yan (ฟ้องสามย่าน) 1, white saltpeter earth 1; grind and poultice to cure headache and nasal congestion.

End of the Earth Element.

The Fire Element (เตโชธาตุ), Four Disorders

As for the Fire Element called "Parinamaggi," its disorder is: (1) it causes heat in the chest and heart; (2) it causes swelling of the hands and feet; (3) it causes a cough that becomes a wheeze, and causes the belly to swell and distend with nausea. To cure this, take phak phraeo daeng (ผักแพรวแดง) 1, kot so (โกฐสอ) 1, kot khema (โกฐเขมา) 1, chaem thet (ชะเอมเทศ) 1, makham pom (มะขามป้อม) 1, pro hom (เปราะหอม) 1, rak sawat (รากสวาด) 1, ya rang ka (หญ้ารังกา) 1, in equal portions; grind and dissolve in cow's milk or hot water. Taken, it cures the Fire Element called Parinamaggi when it breaks down.

The Fire Element called "Parithaihakki," its disorder is: it makes the hands and feet cold, the pulse fails to move, or the pulse beats only weakly at one or two points. Sometimes it causes [illegible] to become watery, yet the interior stays hot, requiring water to be sprinkled on continually without stopping. Sometimes, once it has turned cold, it then...

...sweat pours out like grains of cooked rice. To cure this, take: burnt rhinoceros horn 1 part, burnt crocodile tooth 1 part, heartwood of saem thale (แสมทะเล) 1 part, phon chan (ผลจันทน์) 1 part, hua haeo mu (หัวแห้วหมู) 1 part, rak khat mon (รากขัดมอน) 1 part, garlic 3 parts, pepper 5 parts, burnt freshwater-snail shell 1 part, burnt albino-buffalo horn 1 part, burnt cockle shell 1 part, wai ta moi or wai ta kha (หวายตะมอย/หวายตะค้า) 1 part; grind finely and dissolve in hot water mixed with camphor (พิมเสน). Taken, it drives the fire element so that heat spreads through to the very tips of the feet and hands, and the pulse can move throughout the whole body.

This formula for severe sweating: cut a young branch of nang kum (นางกุ่ม), peel off its bark, then scrape out the pith clinging to the trunk — 1 [part]; thua phu fruit (ผลถั่วพู) 1, liquor-yeast flour (แป้งสุรา) 1, chalk (ดินสอพอง) 1, thian dam 1, and add camphor generously. Mix these together, grind finely, then rub over the patient's body. The sweating will stop and the body's heat will come out.

This formula for thirst, which causes internal heat and panting: take burnt sang nam (สังข์หนาม) 1, lotus root (รากบัวหลวง) 1, phun chin (ผุ่นจีน) 1, burnt rang ma ra (รังหมาร่า) 1, a lump of cinnabar (ชาด) 1, phikun flower 1, sarapi flower (ดอกสารภี) 1, bunnak flower (ดอกบุนนาค) 1, lotus stamen 1, camphor (กรับูร) 1, rak salot nam (รากสลอดน้ำ) 1, rak khan song (รากคันทรง) 1, claw of a sea crab (ก้ามปูทะเล) 1, white saltpeter earth 1, in equal portions; grind finely and form into pills. Dissolve in fresh flower-water; both drink and spray it on, to cure heat, cure thirst, and stop the sweating.

The Fire Element called "Chiranaggi," its disorder is: the Lord of Death sends his messenger to coax and lull the life of every creature, both women and men. When life is about to leave the body it produces various distortions: it makes the forehead tighten; the eyes, having gone blind, see again; the ears, having gone deaf, hear again; the nose, having lost its sense of smell, smells again; the tongue, having lost taste, tastes again; the body, touched by something and feeling nothing, feels again...

...shifting back and forth in this way, still uncertain, but life has not yet gone out — it is merely cracked already. To cure this, take bo raphet (บอระเพ็ด) 1, phon philangkasa (ผลพิลังกาสา) 1, phak phraeo daeng 1, phon muk man (ผลมูกมัน) 1, bai yang sai (ใบย่างทราย) 1, in equal portions; make into a powder, dissolve in honey mixed with chueak khao mok (เชือกเขามวก) vine or cow's milk. Taken, it cures the Fire Element called Chiranaggi when it breaks.

The Fire Element called "Santappaggi," its disorder: whenever it breaks, the patient must die at once. No physician whatsoever is able to cure it.

End of the Fire Element, Four [Disorders].

The Wind Element (วาโยธาตุ), Six Disorders

The wind called "Utthangkhamavata," when it breaks, makes the patient thrash about, the hands and feet flailing wildly, causes the body to keep turning over and over, causes restlessness and distress, causes frequent yawning and belching. To cure this, take kot so 1, kot khema 1, phon ratchadat (ผลราชดัด) 1, phon saraphat phit (ผลสาระพัดพิษ) 1, ma waeng fruit (both kinds) 1, ching cho root (both kinds) 1, phon chan (ผลจันทน์) 1, mace (ดอกจันทน์) 1, thian dam 1, thian khao (เทียนขาว) 1, asafoetida (มหาหิงคุ์) 1, in equal portions, made into powder; dissolve in pomelo juice or lime juice, or cow's milk; it cures the wind Utthangkhamavata when it breaks.

The wind called "Adhokamavata," when it breaks, prevents the hands and feet from being lifted, causes aching in every joint and bone, causes intense pain. To cure this, take muk luang bark (เปลือกมูกหลวง) 1, pepper 1, dried ginger 1, bai salot kin long (ใบสลอดกินลง) 1, wan nam (ว่านน้ำ) 1, hua haeo mu 1, ya rang ka 1, phak phraeo daeng 1, samo thai (สมอไทย) 1, rak khrai khruea (รากไคร้เครือ) 1, in equal portions; make into powder, dissolve in dark cow's urine or in som sa (bitter orange) juice.

Taken, it cures the wind called Adhokamavata when it breaks.

The wind called "Kutchisayavata," when it breaks, causes stomach pain, causes the belly to swell and distend, causes gurgling noises, causes pain in the chest, causes faintness and distress, causes pain that surges up and down. To cure this, take asafoetida 1, lamphan daeng (ลำพันแดง) 1, dee pli (ดีปลี, long pepper) 1, seed from within a sawat (สวาด) pod 1, ratchadat fruit 1, chaem thet 1, kot so 1, kot khema 1, bai yang sai 1, krung khema (กรุงเขมา) 1, in equal portions; make into powder, dissolve in honey or hot water. Taken, it cures the wind called Kutchisayavata when it breaks.

The wind called "Kotthasayavata," when it breaks, makes food smell foul, causes vomiting, causes a lump in the chest, causes stabbing pain and tightness in the chest. To cure this, take chaem thet 1, jet mun phloeng (เจ็ตมูลเพลิง) 1, rak tong taek (รากตองแตก) 1, large ching cho root 1, dried ginger 1, lamphan daeng 1, sifted pepper 1, bai naat (ใบหนาด) 1, camphor (กะเบูร) 1, bai salot kin long boiled in salt water and sun-dried 1, in equal portions; make into powder, dissolve in cow's milk or hot water, or cow's urine. Taken, it heals.

The wind called "Angkhamangkhanusarivata," when it breaks, causes the hearing-nerve to tighten so a person cannot hear speech, and causes something like a stone to hang out of the eyeball; causes the hands and feet to ache, both shins and legs to ache as if the bones would break; causes pain along the spine as though possessed by a ghost; causes alternating fits of heat and cold; causes nausea and vomiting; is an "empty wind"; makes food taste of nothing. To cure this, take phak pet (ผักเป็ด) 1, phak sian phi (ผักเสี้ยนผี) 1, phak khraat (ผักคราด) 1, ya rang ka 1, coriander fruit (both kinds) 1, mustard seed 1, chongkolani flower (ดอกจงกลนี) 1, sa khan (สะค้าน) 1, watermelon seed 1, in equal portions; make into powder, dissolve in honey and hot water or in liquor. Taken, it heals.

The wind called "Assasa-passasa" can never break. This wind is the elemental wind that drives the breath in and out. Whenever the breath ceases entirely to move in and out, that is what is called death. No physician can remedy it at all.

End of the Wind Element, Six Disorders.

The Water Element (อาโปธาตุ), Twelve Disorders

Disorder of the bile: it makes the afflicted person lose all awareness. To cure this, take thian dam 1 baht, thian ta takkataek (เทียนตาตั๊กแตก) 2 baht, ma sang bark (เปลือกมะซาง) 2 baht, khai nao bark (เปลือกไข่เน่า) 2 baht, thepthalo (เทพทาโร) 2 baht, thian khao plueak (เทียนเข้าเปลือก) 2 baht, crocodile bile 1 baht; make into powder, grind and form into sticks, dissolve with flower-water and camphor. Taken, it cures delirious raving and madness.

This formula for diarrhoea: take phon chan (ผลจันทน์) 1, phon benkani (ผลเบ็ญกานี) 1, ma kham kro bark (เปลือกมะขามเกราะ) 1, lac (ครั่ง) 1, pomegranate rind 1, mangosteen rind 1, benzoin (กำยาน) 1, ta mun fruit (ผลตะมูน) 1, peel/rind (ผิว) 1, in equal portions; make into powder, grind and form into sticks, dissolve with pomegranate-rind water. Taken, it cures the diarrhoea.

Disorder of the phlegm: causes alternating fits of heat and cold, causes periodic fever, sometimes causes bloody stool. To cure this, take phak chi la fruit (ผลผักชีลา) 1, lamphan (ลำพัน) 1, muk luang bark 1, bitter gourd (น้ำเต้าขม) 1, kadom (all five parts) 1, khilek heartwood (แก่นขี้เหล็ก) 1; boil down from 3 [measures] to 1. Give this to drink first to cure the underlying affliction, then compound the further medicine for the phlegm.

To cure disorder of the phlegm, first boil a medicine to cleanse the underlying affliction. Take a handful of tamarind leaf, a handful of som poi leaf (ใบส้มป่อย), a handful of fang sen (ฝางเสน), a bundle of thaowan priang (เถาวัลย์เปรียง), hua haeo mu 1, shallot 7 bulbs, samo thai in a quantity equal to the patient's age...

Boil down from 3 [measures] to 1, add Glauber's salt (ดีเกลือ) according to whether the patient's constitution is heavy or light, then give the dysentery medicine, and treat whatever else remains.

This formula for dysentery arising from disordered elements: take phon benkani 1 baht, phon chan 1 baht, lac 3 baht, edible clay (ดินกิน) 1 baht, mangosteen rind 1 baht, thian dam 1 baht, cardamom (กะวาน) 1 baht, clove 1 baht, takian resin (ยางตะเคียน) 1 baht, borax (น้ำประสานทอง) 1 baht, kaffir-lime rind 1 baht, opium (ผิ่น) 2 salueng, ma muang ka lon fruit (ผลมะม่วงกะล่อน) 1 baht, ma kham khop bark (เปลือกมะขามขบ) 1 baht, both kinds of see siat (สีเสียด) 1 baht each; make into powder, place it inside a pomegranate fruit, coat it with a layer of cow-dung, and roast it over a husk-fire until cooked. Remove the coating and grind it together with the pomegranate; form into sticks, dissolve with phlai-water or clear limewater. Taken, it cures cramping pain, cures putrid blood or phlegm. If it does not stop, take the medicine for disorder of the bile [described earlier] to treat next, then compound the "element-uniting medicine" for the patient to drink.

To make the element-uniting medicine, ask the patient in what year, month, and day he or she was born, and whether it was the waxing or waning [of the moon]. Once told, consider which elemental season this falls under. Take the medicine proper to that elemental season and set it as the principal ingredient. Then reckon back to the day, month, and season in which the patient was conceived, and take the medicine proper to that element and season, combining it with the medicine proper to the element at conception, making two formulas together. Then add both kinds of sandalwood, agarwood (กฤษณา) 1, chalut (ชะลูด) 1, phikun flower 1, bunnak flower 1, sarapi flower 1, lotus stamen 1, khon dok (ขอนดอก) 1; boil and drink; it heals.

Disorder of pus: causes forceful coughing, causes the body to waste away severely, makes food taste of nothing; it often becomes an abscess of the belly, of three kinds. To cure this, take...

Red-ant nest 1 nest, ma ka leaf (ใบมะกา) 1 tamlueng, thian dam 1 tamlueng, samo thet (สมอเทศ) 1 tamlueng, rak tong taek 1 tamlueng, shallot 1 tamlueng, long turmeric (ขมิ้นอ้อย) 1 finger-length; boil down from 3 to 1, add Glauber's salt according to the patient's constitution being heavy or light — first cleanse the harmful matter, and the medicine proper to the element may then also be compounded for the phlegm. If one does not wish to compound that formula, take muk luang root (รากมูกหลวง) 1, ratchadat fruit 1, the three pungents (ตรีกะฏุก) 1, turmeric (ขมิ้นอ้อย) 1, rak kaphang hom (รากกะพังโหม) 1, hua khao khao (หัวข้าวเข้า) 1, dried shallot 1, in equal portions; make into powder, dissolve in hot water or liquor; taken, it heals.

Disorder of the blood: it is spoken of as "evil blood." Physicians hold it to be epistaxis-fever, because the blood becomes agitated. If the blood "breaks," it produces various poisons: sometimes causing headache, causing the eyes to redden with threads of blood, causing dizziness of the head, causing heaviness in the forehead. If it erupts on the outside it forms rings of red, green, and yellow, then produces further poisons, causing the tongue to stiffen and the jaw to lock. Physicians hold this to be rakasat-fever, namely: pan dam, pan daeng, sai fa fat, chom prasat, khao mai noi, khao mai yai, hong rathot, pleo fai fa, prakai dat, prakai phloeng, dao rueang, fong samut, maha mek, maha nin, lamlap phloeng, fai lam thung — [these arise] because the blood breaks and spreads out over the outer skin. As for the interior, it likewise produces various poisons: sometimes causing bloody stool, sometimes causing vomiting of blood, sometimes the blood rushes in and seizes the heart, causing madness, confusion, and restlessness, causing delirious raving, so that the patient has no awareness at all. Physicians hold this to be "blood sannibat," since it originates from the blood. Sometimes it causes heat, sometimes cold; sometimes it makes the hands and feet clench in spasm; sometimes it causes difficulty urinating or defecating; sometimes urine appears red, yellow, or even black in colour. All this arises from disorder of the blood alone. As for disorder within the water element...

...reaching two, three, four, or five kinds [of disorder combined] at once, it can no longer be cured at all — the patient must die within three days. But if the disorder is confined to only one, two, or three kinds, treat and observe first. For blood-poison that spreads out to the exterior, use fever medicine and "great-black" medicine (ยามหากาฬ) to treat it; do not use pungent, hot medicines — this ailment responds only to medicines that are cooling, mild, fragrant, astringent, or bitter in taste; treated so, it will heal. As for blood-poison acting within the chest, causing bloody stool and vomiting of blood, use the medicine for "lak-pit-lak-poet" and the medicine for atisan (dysentery) to treat it next. If that is not enough, use the medicines from the Water Element treatise to treat it further. The medicines in this element-treatise cure only the water element, that is, disorder of the blood.

Medicine called Patophathikhun

Take bo raphet 1, red-eyed galangal (ข่าตาแดง) 1, ka chai (กะชาย) 1, mustard seed 1, both kinds of khanthon (ขันทน์) 1 each, mature ma waeng (มะแว้งต้น) 1, chanthana (จันทนา) 1, hua haeo mu 1, phlai 1, rak khat mon 1, sa khan 1, rak cha phlu (รากช้าพลู) 1, chuk rohini (จุกโรหิณี) 1, son thet (สนเทศ) 1, krung khema 1, muk luang bark 1, rak tong taek 1, fragrant vetiver (แฝกหอม) 1, agarwood 1, ka lam phak (กะลำพัก) 1, chalut 1, khon dok 1, the three myrobalans 1, cinnamon 1, phikun flower 1, bunnak flower 1, sarapi 1, lotus stamen 1, in equal portions; boil down from 3 to 1. If a purgative effect is desired, add Glauber's salt according to the patient's constitution. It cures fever arising from the blood during the hot season.

Medicine called the Great Gathering for Great Sannibat

Take jet mun phloeng 1 baht, kot so 1 baht, kot phung pla (โกฐพุงปลา) 1 baht, kot kraduk (โกฐกระดูก) 1 baht, kot hua bua (โกฐหัวบัว) 1 baht, kot chula lampha (โกฐจุฬาลำพา) 1 baht, kot chiang (โกฐเชียง) 1 baht, kot so thet (โกฐสอเทศ) 1 baht, dee pli 1 baht, fruit of...

...young ma tum fruit (มะตูมอ่อน) 1 baht, kawan leaf (ใบกะวาน) 1 baht, kawan fruit (ผลกะวาน) 1 baht, clove 1 baht, rak tong taek 1 baht, fragrant vetiver 1 baht, ma kham pom 1 baht, kadom fruit (ผลกะดอม) 1 baht, bo raphet 1 baht, rak khon tha (รากคนทา) 1 baht, fig root (รากมะเดื่อ) 1 baht, horapha fruit (ผลโหรพา) 1 baht, ya nang root (รากหญ้านาง) 1 baht, ra yom (ระย่อม) 1 baht, pisanat (พิศนาด) 1 baht, the three fruits (ตรีผลา) 1 baht each, philangkasa fruit 1 baht, phaya mun lek (พญามูลเหล็ก) 1 baht, ya klon (หญ้ากล่อน) 1 baht, khok ka sun (โคกกะสุน) 1 baht, agarwood 1 baht, ka lam phak 1 baht, chalut 1 baht, khon dok 1 baht, foreign cinnamon (อบเชยเทศ) 1 baht, samun waeng (สมุลแว้ง) 1 baht, thepthalo 1 baht, young galangal (ข่าต้น) 1 baht, chuk rohini 1 baht, phon en (ผลเอ็น) 1 baht, chalut flower 2 salueng, lime flower 2 salueng, kaffir-lime flower 2 salueng, khat khao flower (ดอกคัดเค้า) 2 salueng, kannikan flower (ดอกกรรณิการ์) 2 salueng, kaeo flower (ดอกแก้ว) 2 salueng, lotus stamen 2 salueng, kham thai flower (ดอกคำไทย) 2 salueng, double jasmine flower 2 salueng, jasmine (มะลิลา) flower 2 salueng, bua phueun flower (ดอกบัวเผื่อน) 2 salueng, bua khom flower (ดอกบัวขม) 2 salueng, lin chong flower (ดอกลินจง) 2 salueng, chongkolani flower 2 salueng, white lotus flower 2 salueng, red lotus flower 2 salueng, sattabut (สัตตบุษย์) 2 salueng, sattaban (สัตตบรรณ) 2 salueng, sattabongkot (สัตตบงกช) 2 salueng, santawa flower (ดอกสันตวา) 2 salueng, tap tao nam flower (ดอกตับเต่าน้ำ) 2 salueng, water-hyacinth flower (ดอกผักตบ) 2 salueng, yisun flower (ดอกยี่สุ่น) 2 salueng, ka thum na flower (ดอกกะทุ่มนา) 2 salueng, hang nok yung flower (ดอกหางนกยูง) 2 salueng, la hung flower (ดอกละหุ่ง) 2 salueng, lam chiak flower (ดอกลำเจียก) 2 salueng, ratchaphruek flower (ดอกราชพฤกษ์) 2 salueng, sarai flower (ดอกสาหร่าย) 2 salueng, maha hong flower (ดอกมหาหงส์) 2 salueng, champa flower 2 salueng, kadangnga flower 2 salueng, sarapi 2 salueng, phikun 2 salueng, bunnak 2 salueng, mak lam flower (ดอกมะกล่ำ) 2 salueng, orchid flower 2 salueng, phutthachat flower (ดอกพุทธชาด) 2 salueng, all five thian (เทียน) herbs 1 baht each, thao yai mom root (รากเท้ายายม่อม) 1 baht, phum riang root (both kinds) 1 baht each, coriander fruit (both kinds) 1 baht each, prakham fruit (ผลประคำ)...

...buffalo bile 1 baht, all five kinds of khilek (ขี้เหล็ก) 1 baht each, ya nguang chang flower (ดอกหญ้างวงช้าง) 2 salueng.

As for all 100 of these ingredients: when grinding and compounding them, add civet, camphor, python bile or cobra bile, wild-ox bile, soft-shell-turtle bile, and crocodile bile; form into pills. Use whatever vehicle-liquid suits the illness. This medicine, because it is a gathering of every important ingredient assembled together, is able to cure 96 kinds of disease, and is therefore named the Great Gathering for Great Sannibat. Its value is set at one chang of gold.

The Green Medicine of the Great Brahma

Cures disorder of the blood, which causes heat throughout the whole body like flame, causing restlessness with total loss of awareness. This medicine cures it completely. Take khi non leaf (ใบขี้หนอน) 1, sami leaf (ใบสมี) 1, ching cha chali leaf (ใบชิงช้าชาลี) 1, khilek leaf 1, phak khet leaf (ใบผักเค็ด) 1, khae daeng leaf (ใบแคแดง) 1, round-leaved thonglang leaf (ใบทองหลางใบมน) 1, ma fueang leaf (ใบมะเฟือง) 1, phum riang leaf (both kinds) 1, nom phichit leaf (ใบนมพิจิตร) 1, phaengphuai leaf (ใบแพงพวย) 1, pepper leaf 1, bitter-gourd leaf 1, bip leaf (ใบบีบ) 1, bitter-melon leaf (ใบมะระ) 1, ya nang leaf 1, thao yai mom leaf 1, nam dap fai leaf 1, ra ngap leaf (ใบระงับ) 1, kham lueng tua phu leaf (ใบคำลึงตัวผู้) 1, phrommi leaf (ใบพรหมมิ) 1, [illegible] leaf 1, mak phu leaf (ใบหมากผู้) 1, mak mia leaf (ใบหมากเมีย) 1, camphor leaf (ใบพิมเสน) 1, san phra leaf (ใบสันพร้า) 1, neem leaf 1, thua rae leaf (ใบถั่วแระ) 1, bo raphet leaf 1, thaowan duan (เถาวัลย์ด้วน) 1, turmeric 1, white sandalwood 1, in equal portions; grind and form into pills. Use whatever vehicle-liquid is suitable for the illness, both drinking it and spraying it on; it cures agitated blood.

Medicine called Adunwitthan

Cures the poison of epistaxis-fever from an agitated water element. Take civet 1, camphor 1, agarwood 1, ka lam phak 1, khon dok 1, cha mot chiang (ชะมดเชียง) 1, chalut 1, saffron (หญ้าฝรั่น) 1, gold amber (อำพันทอง) 1, kot hua bua 1, pro hom 1, both kinds of sandalwood 1...

These medicines, taken 2 salueng weight each: krung khema 1, benzoin 1, chanthana 1, horapha fruit 1, klet hoi thet (เกล็ดหอยเทศ) 1, lotus stamen 1, bua phueun 1, chongkolani 1, sattabut 1, bunnak flower 1, en thet fruit (ผลเอ็นเทศ) 1, coriander fruit 1, jasmine flower 1, kadangnga flower 1, phikun flower 1, kot khema 1, neem leaf 1, ya rang ka 1, ma tum root 1, kawan leaf 1, kawan fruit 1, phak bung luam (ผักบุ้งล้วม) 1, white butterfly-pea flower 1, both kinds of chaem (ชะเอม) 1, both kinds of nerapusi (เนระภูสี) 1, ngueak pla mo leaf (ใบเหงือกปลาหมอ) 1 — these medicines taken 1 baht weight each; python bile 1 salueng, wild-ox dung (มูลโคเถื่อน) 1 salueng. Grind these medicines and form into sticks, dissolve in flower-water; both drink and spray it on; it cures the poison of every kind of fever, however great in number. If the poison acts internally causing diarrhoea, add a pinch of phuen (ผื่น) and it heals.

The Great Mahasamit Medicine

This medicine covers every kind of poison — the poison of epistaxis-fever, of rakasat-fever, and of every kind of sannibat. Take gold amber 1, civet 1, camphor 1, nutmeg (จันทน์เทศ) 1, agarwood 1, ka lam phak 1, kot chiang 1, kot hua bua 1 — all these taken 2 salueng weight each; red sandalwood 1, krung khema 1, nutmeg fruit 1, mace (ดอกจันทน์) 1, kawan fruit 1, clove 1, prik hom (พริกหอม) 1, dried ginger 1, dee pli 1, jet mun phloeng 1, red amber 1, fragrant vetiver 1, hua haeo mu 1, neem leaf 1, ya tin nok (หญ้าตีนนก) 1, nerapusi 1, sattabongkot 1, nilubon (นิลุบล) 1, chongkolani 1, bua phueun 1, bua khom 1, jasmine 1, phikun 1, bunnak 1, sarapi 1, champa 1, samo thai 1, samo phiphek (สมอพิเภก) 1, ma kham pom 1, thian dam 1, thian khao 1, thian daeng (เทียนแดง) 1, thian ta kop (เทียนตากบ) 1, thian ta takkataen (เทียนตาตั๊กแตน) 1, kadangnga flower 1, kot khema 1, kot nam tao (โกฐน้ำเต้า) 1, kot phung pla 1, kot kan phrao (โกฐก้านพร้าว) 1, stamen of...

White lotus stamen 1, red lotus stamen 1 — all these taken 1 baht weight each; python bile 2 salueng. Grind all these medicines and form into pills, dissolve in flower-water; both drink and spray it on; it cures sannibat of seven kinds, and cures every manner of feverish poison completely.

The Universe-Sky-Covering Medicine

Cures the poison of all kala-fevers, and every sort of poison whatsoever — such as kala-poison both inside and outside the body, causing oppression of the heart/mind. Of the 700 kinds of kala-poison that have not yet risen up to cause harm, but lie coiled in the heart and in the liver and lungs, and lurk hidden within the skin — the poison of phi dat, phi hua diao, and tan sang alike — take this medicine to cure them. Excepted only are [afflictions from] deeds of the distant past and deeds of the present life; apart from those, it heals completely. Physicians should hasten to prepare this formula and keep it ready for use; only then will one be able to subdue all 700 kinds of kala-poison. Take: tiger fang 1, bear fang 1, boar tusk 1, sawfish rostrum-spine 1, stingray spine 1, rhinoceros horn 1, elephant ivory 1, deer antler 1, kui-deer antler (เขากุย) 1, goat horn 1, sheep horn 1 — all these should be charred; wai ta kha 1, wai ta moi 1, jet phangkhi (เจ็ตพังคี) 1, sangkoni (สังกรณี) 1, sattabut flower 1, sattabongkot 1, sattaban 1, lotus 1, bua khom 1, bua phueun 1, chongkolani 1, phikun 1, bunnak 1, sarapi 1, double jasmine 1, champa flower 1, kadangnga flower 1, agarwood 1, ka lam phak 1, camphor leaf (ใบพิมเสน) 1, flaked camphor (พิมเสนเกล็ด) 1, krung khema 1, borax 1, all five kot herbs 1 each, all five thian herbs 1 each, nutmeg fruit 1, mace 1, cardamom (กระวาน) 1, clove 1, samun waeng 1, [fungi:] het ka thin khao (เห็ดกะถินขาว) 1, het ka thin phiman (เห็ดกะถินพิมาน) 1, het ma phrao (เห็ดมะพร้าว) 1, het kan (เห็ดกาล) 1, het ngu hao (เห็ดงูเห่า) 1, het ma kham (เห็ดมะขาม) 1, het mai rang (เห็ดไม้รัง) 1, het mai daeng (เห็ดไม้แดง) 1, het tap tao (เห็ดตับเต่า) 1, all five hua maha kan (หัวมหากาฬ) 1 each.

Handbook of Curative Medicine — page 157

These 65 ingredients: take equal parts, [illegible], grind and roll into pills. Vary the water vehicle according to what best suits the disease being treated. This remedy is said to be used for fevers of the rainy season (vasanta ritu), that is, the rainy season.

Medicine named Nanthai Kraiwat

Cures the poison of a fever that causes convulsions, a stiffened tongue and locked jaw, and shaking through the whole body, and cures poisons of various kinds. To treat it, take: python bone 1, banded-cobra bone 1, snakehead-fish jaw 1, elephant tusk 1, rhinoceros molar 1 — roast these until charred. Then add: Hua Bua costus 1, So costus 1, Kraduk costus 1, black caraway-seed 1, sweet-basil fruit 1, coriander fruit 1, refined borax (prasan thong) 1, cardamom leaf (bai pimsen) 1, sanphra-hom leaf 1, phak-wan leaf 1, water-thonglang leaf 1, winged-bean root 1, male ivy-gourd root 1, bunnak flower 1, phikun flower 1.

These 20 ingredients, taken in equal parts, made into a fine powder, ground and formed into sticks. Dissolve in rice-rinse water or flower water as suits, mixing in snake bile and cardamom (pimsen). Taken, it cures indigestion, cures convulsions, cures dullness/stupor, cures a stiffened tongue and locked jaw; taken internally and also rubbed on the body, it cures — most excellent indeed.

Maha Kamlang ("Great Strength") Medicine — Royal Textbook

Cures hunger, panting, and exhaustion where no strength remains, when the patient is close to death; this royal remedy was therefore compounded and offered up. Take: winged-bean root 1, lotus seed 1, lotus root 1, fresh water-chestnut 1, fresh water-caltrop 1, bitter-lotus rhizome 1, faded-lotus rhizome 1, ya-nang vine root 1, galangal 1, agarwood 1, khon-dok (fragrant heartwood) 1, licorice 1, musk 1, both kinds of cinnamon (om-choei), Hua Bua costus 1, Chiang costus 1, fragrant cyperus (proh hom) 1, bunnak flower 1 — [continues on next page]

158 — Watthana Phanit Press

[Continuing the Maha Kamlang formula:] lotus stamens 1, bitter-lotus 1, faded-lotus 1, chongkolni-lotus 1, phikun flower 1, sarapi flower 1, jasmine 1, sattabut-lotus 1, sattabongkot-lotus 1, krung-khema 1, ampan-thong 1, chamot-chiang (musk) 1, cardamom (pimsen) 1.

These 32 ingredients, ground and rolled into pills, are dissolved in flower water; when taken, mix in rock sugar. It cures poison that oppresses the chest and heart, and cures exhaustion and hunger with no strength left — taken, it cures.

Medicine named Chit Maha Wong

Cures a numb/bitter throat, a numb tongue, a numb mouth, and coughing. For this remedy, take: mai-klam tree root 1, mai-klam vine root 1, ma-kham-pom (emblic myrobalan) root 1, nerapusi 1, deer antler 1, sambar antler 1, rhinoceros horn 1, elephant tusk 1, both kinds of sandalwood, refined borax (prasan thong) 1.

These 11 ingredients, taken in equal parts, ground and rolled into pills, dissolved in honey, and applied — it cures.

Medicine for heat and delirium

Take: bitter caeter-bark 1, khan-song root 1, bitter pekaa-bark 1, bael-fruit (ma-tum) root 1. Boil and drink — it cures.

Medicine named Suriya Chan ("Sun and Moon")

Cures the poison of head-heat (kamdao) and of the pestilential poison that produces various afflictions, which physicians commonly call "northern fever," "typhoid-like fever," and "sannibat fever" (a compound fever of all three humours) alike. Take: red sandalwood 1, white sandalwood 1, both kinds of muak-vine 1, khukha 1, maha-sadam 1, white pla-lai-pheuak root 1, ya-nang root 1, phik-khao root 1, ivy-gourd root 1, sa-lot-nam root 1, both kinds of phum-riang root, khongkha-deuad 1, meuad-khon 1, phung-dor root 1, mong root 1, root — [continues on next page]

Handbook of Curative Medicine — page 159

[Continuing the Suriya Chan formula:] rabid-dog-repellent (ka-thung-ma-ba) root 1, lotus stamens 1, deer antler 1, elephant tusk 1, sambar antler 1, rhinoceros horn 1, tiger fang 1, crocodile fang 1, rhinoceros molar 1, elephant molar 1.

These 27 ingredients, taken in equal parts, ground and rolled into pills, cure every kind of feverish poison entirely.

The Great Pot Remedy

This remedy belongs to the Royal Textbook, for curing disorders of head-heat (kamdao) and disorders of the water element that produce poisons of various kinds. It cures the poison of smallpox and of the "head-down ghost" and "small-head-with-nowhere-to-rest ghost" fevers, which have the form of maize kernels or of green- and black-bean seeds, and which work their poison in the liver and gall-duct, causing jaundice from vegetable matter, and poison that oppresses the heart in various ways. Let the physician compound this remedy to cure it. Take: khongkha-deuad 6 salueng, sae-ma-thalai 6 salueng, yah-tai-bai leaf 2 baht, khi-lek heartwood 1 baht, man-pralai 6 salueng, rayom 3 salueng, khrai-khruea 1 baht, wan-ron-thong 2 salueng, wan-kip-raet 2 salueng, black phaya-rak 2 baht, white phaya-rak 6 salueng, nerapusi 6 baht, northern maha-sadam 1 baht, southern maha-sadam 1 baht, kai-hai root 1 baht, the "five roots" medicine, each 1 baht, khamin-khruea 1 baht, swamp-eel-vine 1 baht, black-palm root 1 baht, ground-fig root 1 baht, kan-krao 1 baht, pru heartwood 1 baht, teak wood 1 baht, sakkhi 1 baht, the triphala fruits, each 2 salueng, fragrant sandalwood 3 baht, wood flesh 2 baht, nutmeg fruit 2 salueng, mace flower 2 salueng, clove 1 salueng, foreign cinnamon 6 salueng, foreign licorice 1 baht, Thai licorice 1 baht, kamphaeng-chet-chan 1 baht, red tum-ka 1 baht, white tum-ka 1 baht, red ma-khang 1 baht, white ma-khang 1 baht, ka-dom fruit 1 baht, bunnak flower 1 baht, lotus stamens 1 baht, sarapi 1 baht, sa-khan 1 baht, cha-phlu root 1 salueng, root — [continues on next page]

160 — Watthana Phanit Press

[Continuing the Great Pot Remedy list:] phung-kae 1 salueng, meuad-khon 1 baht, fragrant vetiver 1 baht, red khui 1 baht, white khui 1 baht, phayakha root 1 baht, red sandalwood 1 baht, katang-bai 1 baht, phak-khao root 1 baht, nang-nun root 1 baht, phung-dor root 1 baht, sappan wood 2 baht, chalut 2 salueng, long pepper (dee-plee) 1 baht, dragon's-blood resin (leuad-raet) 1 baht, lac resin 1 baht, safflower (dok-kham-thai) 1 baht, Chinese safflower 1 baht, fon-saen-ha 1 baht, hang-nok-kaling 1 baht, pho-prasat 1 baht, ratchamanop 1 baht, cheuak-khao-nang vine 1 baht, khukha 1 salueng, the five Goht costus roots, each 3 salueng, mueng-kleua-leuad 2 salueng, ruak-wood root 1 baht, kamlang-wua-thaloeng 1 baht, maha-la-lai 1 baht, single-rooted phaya-rak 1 baht, chandana 6 salueng, sa-lot-nam root 2 baht, the five Thian (candle-seeds), each 3 salueng, red thao-wan-priang vine 1 baht, la-wa pestle-wood 1 baht, seven-buffalo kamlang-krabue 1 baht, white creeping-grass 1 baht, both kinds of phum-riang root, each 6 salueng.

These 68 ingredients: add refined saltpetre (san-khuen-ko) 2 salueng, place it at the bottom of the pot, boil and drink. It cures every kind of poison and disorders of the water element that produce various poisons, all cured completely. Let the physician observe carefully: of this water-element disorder, not one person in a hundred survives. If this medicine is taken for 5 to 10 days, the disturbed blood within the chest will surface as black-red or green blotches that emerge on the skin's surface; the physician should then continue treatment — some survive, some die. If the blotches do not surface on the outside, do not treat at all — that person will certainly die.

Disorder of sweat: this causes heavy sweating, makes the body cold and pale, numb and tingling all over, exhausted with no strength remaining. To treat it, take: chetmun-phloeng (plumbago) root 1, So costus 1, coriander fruit 1, dried ginger 1, long pepper 1, young bael fruit 1, kum-nam bark 1, water-thonglang root 1, winged-bean root 1 —

Handbook of Curative Medicine — page 161

These 8 ingredients, taken in equal parts, boiled down from 3 parts water to 1: taken, it cures heavy sweating.

Rub-on Medicine for Sweating

Take: shallot 1, liquor yeast-cake 1, chalk powder (din-so-phong) 1, meuad-khon root 1, winged-bean root 1, sapodilla seed 1.

These 6 ingredients, taken in equal parts, ground and rolled into pills, dissolved in flower water and taken. It prevents sweating and numb, tingling skin, a pale body — it cures dulled, shrunken skin completely.

Disorder of subcutaneous fat: the symptoms resemble a blood disorder, causing eruptions in rings across the skin's surface, sometimes bursting into clear fluid, causing burning and stinging pain with force. To treat it, take: red Malabar-spinach 1 part, red ka-meng leaf 1 part, thua-re leaf 1 part, black candle-seed 1 part, white candle-seed 1 part, kan-krao bark 7 parts, northern kao-yen medicine 7 parts. Boil and drink — it cures.

This remedy is applied externally: take red Malabar-spinach leaf 1, or red ka-meng leaf, uncooked rice 1, turmeric-vine 1, chalk powder 1; pound and rub on the body — it cures.

Disorder of the tears: this causes the tears to fall heavily and then dry up; the eyeball then becomes like the flesh of a longan fruit. To treat it, take: khonthisor root 1, sen-yuet root 1, young bael fruit 1, dried ginger 1.

Take equal parts, boil down from 3 parts to 1, and give to drink; then compound a further medicine as eye-drops.

Take: the stone within the head of a snakehead fish 1, orange stone (hin-som) 1, ban-lang-sila stone 1, cardamom (pimsen) 1; grind and use as eye-drops. If tears are present, that fever/condition will be cured; if there are no tears at all, it cannot be treated.

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162 — Watthana Phanit Press

Disorder of subcutaneous fluid: this causes it to burst and spread throughout the whole body, turning the body and the eyes yellow — except that the urine and stool do not turn yellow; one textbook, however, states that the urine and stool do turn yellow. Sometimes it causes purging and vomiting like foam. To treat it, treat first with the "one-dose astringent" medicine; if it does not stop, first purge the clear fluid (lymph), and only then compound a medicine to restore the elements. Take: tri-katuk (the three pungents) 1, triphala 1, terminalia fruit 1, cha-phlu root 1, dried galangal 1, sa-khan 1, nutmeg fruit 1; take equal parts, grind finely, and dissolve in bitter-gourd-leaf water or unripe-banana water as suits. It cures the disorder of subcutaneous fluid.

Disorder of the saliva: this causes a numb mouth, a numb throat, sticky saliva, and sometimes small growths rising on the tongue and in the throat, producing various poisons. To treat it, take: both kinds of sandalwood, nutmeg fruit 1, mace flower 1, wan-kip-raet 1, wan-ron-thong 1, soap-nut fruit (prakham-dee-khwai) 1, thon-dee root 1, terminalia fruit 1, So costus 1, Khema costus 1, python bile 1.

These 12 ingredients, taken in equal parts, ground and dissolved in lime juice as the vehicle, applied and also taken in an amount the size of a jujube fruit; then a further lozenge medicine is compounded. Take: rhinoceros molar 1 part, elephant molar 1 part, rhinoceros horn 1 part, tiger fang 1 part, dugong tusk 1 part, gall-nut fruit 1 part, nutmeg fruit 1 part, young jambolan leaf 1 part — roast these until charred; refined borax (prasan-thong) 2 parts, both kinds of catechu, 4 parts each; grind finely, take unripe areca-nut water as the vehicle, grind and roll into pills. Rub with clear lime-water mixed with unripe areca-nut water and use as a throat-swab — it cures.

Handbook of Curative Medicine — page 163

Mouthwash medicine

Take: takhian bark 1, khat-mon leaf 1, jambolan bark 1, sugar-palm frond 1, sa-lot-nam bark 1, pomegranate leaf 1, mai-klam-tree bark (one textbook says kra-tam-tree bark instead).

Take equal parts, boil with a good amount of salt added; hold in the mouth and rinse — cures in due time.

Disorder of nasal mucus: this causes pain within the brain, blurred and running mucus, headache, and dizziness. To treat it, compound a fumigating medicine. Take: ya-nam-dap-fai leaf 1, black candle-seed 1, shallot 1, white saltpetre 1, roasted cotton-seed 1, betel leaf 1, turmeric-vine 1; grind with liquor and fragrant oil, and fumigate the crown of the head for 3 days — it cures.

If it is still not cured, compound an inhalant medicine. Take: shallot 1, lime powder 1, refined tin-borax 1, cardamom (pimsen) 1, equal parts; grind finely and use as snuff, or wrap in fine white cloth and inhale — it cures.

Then compound a medicine to be taken internally. Take: sa-khan 1, cha-phlu root 1, chetmun-phloeng 1, dried ginger 1, young bael fruit 1, fragrant vetiver 1, Thai terminalia 1, foreign terminalia 1, coriander fruit 1, agarwood 1, fragrant sandalwood 1, emblic myrobalan fruit 1, proh-hom 1, sweet flag (wan-nam) 1, lotus stamens 1, bunnak flower 1; take equal parts, boil down from 3 parts to 1, and drink — it cures the disorder of nasal mucus.

Disorder-fever of the joints: this usually causes aching in the joints as if the bones were about to come apart, causing stiffness and tightness in every joint; it is very difficult to cure, because it lies within the bone, but one should take medicine to treat it and let the outcome follow one's own merit and karma. Take: Kadook costus 1 part, [Goht —continues]

[Continuing the joint-fever formula:] kat-kling 1 part, Kadkra costus 3 parts, vetiver root 1 part, ma-had heartwood 2 parts, pru heartwood 2 parts, terminalia fruit 2 parts, sakkhi 2 parts, beuai fruit 2 parts, ma-dan root 2 parts, python bone 2 parts, meuad-khon 2 parts, sam-siao 2 parts, sam-san-dan 3 parts, pepper 3 parts, ginger 3 parts, khontha root 5 parts, kao-yen medicine 10 parts, pradong-kho root 2 parts (that is, long-pepper root); these 15-part [sic] ingredients are boiled and given to drink — it cures.

Disorder of the urine: this causes the urine to become abnormal — coloured red or yellow like turmeric, sometimes white like rice-rinse water, causing painful, obstructed urination, swelling of the groin, and sometimes obstruction of the urinary passage with growths within the urine, causing the urinary disorder to vary in different ways. To treat it, take: sa-khan 1 part, young bael fruit 1 part, fragrant vetiver 1 part, terminalia fruit 3, coriander fruit 1 part, land-caltrop (khok-kra-sun) 1 part, nut-grass tuber 1 part, cha-phlu root 2 parts, chetmun-phloeng 4 parts, long pepper 4 parts, ginger 5 parts, kao-yen medicine 10 parts, both kinds of sandalwood, 1 part each, red sugarcane 3 joints; crush and place into the pot, boil down from 3 parts to 1, and drink — it cures.

Decoction for painful, obstructed urination

Take: tamarind leaf, 1 handful, som-poi leaf, 1 handful, lime leaf, 1 leaf, shallot, 3 bulbs, alum 1 salueng, white saltpetre 1 salueng, a lump of palm sugar broken into 4 pieces, together with one piece from the western side [of the lump]; boil and drink to bring on urination. If it does not come, treat further according to the Treatise on Urinary Disease.

Here ends [the chapter on] disorders of the water element. ———————

Handbook of Curative Medicine — page 165

The Treatise on Diagnosis by Origin (Samutthan Winitchai)

———————

[This is the opening homage, in the traditional Pali-with-Thai-gloss style — each Pali phrase in parentheses is followed by its Thai gloss.]

(Ahaṃ) I, (abhivandiya) having paid homage (buddhaseṭṭhaṃ) to the Blessed Buddha, the most excellent one — (ca) and, (ahaṃ) I, (abhivandiya) having likewise paid homage (dhammaṃ) to the Scriptural Teaching and the nine supramundane states of the Dhamma — (ca) and, (abhivandiya) having also paid homage (saṅghaṃ) to the community (uttamaṃ) of noble (Ariya) monks — (pavakkhāmi) shall now expound (ganthaṃ) the treatise (vejjapakaraṇaṃ nāma) called the Physician's Manual, (lokahitaṃ) which is of benefit to the world. (Ayaṃ ratanapaṇāmo) This act of homage to the Triple Gem (mayā) has been performed by me, (kato) (sirasā) with head bowed, (sakkaccaṃ) in true reverence, (paṭivāraṇatthaṃ) so as to ward off entirely (antarāye) every kind of danger and misfortune, (asesato) leaving nothing remaining. (Ācariyo) The teacher, (racayitvāna) having deliberated and reflected, (dīpayati) has now set forth (vinicchayapabhedaṃ) the classifications of diagnosis, (uttamaganthaṃ) [composing] this excellent (pavaraṃ) and noble treatise (dhātusamuṭṭhānanāma) named "Dhātu-samuṭṭhāna" (Origin of the Elements), (hitasukhāvaḍḍhanatthāya) so as to increase benefit and happiness (nānālakkhaṇasañjānanena) through knowledge of the various characteristics (rogasamuṭṭhānānaṃ) of the origins of diseases, (anekapabhedānaṃ) which are of many kinds, (uppannānaṃ) that shall arise (lokānaṃ) among the beings of the world (anāgate) in time to come. (Idaṃ samuṭṭhānavinicchayaṃ) This Samuṭṭhāna-vinicchaya (paramparāyabhedaṃ) has its classifications (ācariyajānamā) handed down by the teachers, (pasuddhiparamparāya) through the unbroken succession of the learned —

166 — Watthana Phanit Press

[Continuing the homage and preamble:] — of former times. (Tujjānaṃ) [This treatise] is difficult for people to understand. (Hoti) There exist (vejjabhedā) divisions among physicians: (avijāni) some do not truly understand (imaṃ samuṭṭhānapakaraṇaṃ) this treatise on origins, (yujjhanti) yet they compound (bhesajjāni) medicines (rogupasamanatthāya) in order to suppress disease, (samuṭṭhānapabhedanakhena) merely by the outward classification of where it arises, (roganidānānaṃ) among the causes of disease. (Samuṭṭhānarogo) A disease arising (ekaci samuṭṭhānena) from any one origin (pavaḍḍhanto) increases (hetumūlaviññāṇena) through not knowing the root cause, (kevalaṃ eva) purely and simply. (So puggalo) That person (ābādhiko) becomes afflicted, (bāḷhagilāno) unable to rise or sit, (dukkhito) in suffering, (atekiccho) beyond cure — (hoti) so it happens. (Aparaṃkāraṇaṃ) There is (atthi) also another reason (puna) besides this. (Ahaṃ) I (pavakkhāmi) shall now explain (catudhātuvavatthānaṃ) the determination of the four elements (pabhedakālavasena) by the power of their divisions in time — (dhātusamuṭṭhānavavatthānaṃ) that is, the determination of the origin of the elements, (catubbidha) which is of four kinds: (dhātusamuṭṭhānañca) element-origin, (utusamuṭṭhānañca) season-origin, (āyusamuṭṭhānañca) age-origin, and (kālasamuṭṭhānañca) time-origin. (Ye vejjā) Whatever physicians (vicāraṇatā) give careful consideration (bhogajāsamuṭṭhānaṃ) to the part from which a disease arises, (catusamuṭṭhānadhātūnaṃ) among the elements having these four origins, (vipassamānā) and perceive clearly, (yojayaṃ) and thereby compound (bhesajjaṃ) medicine (kevalaṃ eva) truly in this manner — (te vejjā) such physicians, [if they do so] without [understanding this treatise], (micchāñāṇavejjā nāma) are called "physicians of false knowledge."

Handbook of Curative Medicine — page 167

(Ye vejjā) But whatever physicians (vicāraññātasamanuāgatā) are endowed with careful consideration and understanding, (yojentā) and apply (bhesajjavidhānaṃ) the correct method of medicine (taṃ rogupattiṃ) so as to make the very arising of that disease (antaradhāpesuṃ) vanish entirely — (te vejjā) such physicians (seṭṭhañāṇavejjānāma) are called "physicians of excellent knowledge." Here ends the Pali portion.

(Ācariyena) The teacher who composed this treatise called the Samuṭṭhāna Vinicchai, dealing with the fourfold category of the classification of origins, which the Pali text itself did not elaborate upon in its various particulars, [wrote this] in order to be of benefit to physicians who come after, in the hope that they should know the classifications of the origins of every disease as they arise in due sequence. This Treatise on Diagnosis by Origin is the very measuring-scale of all the treatises of the medical sciences, the foundation and the great and preeminent authority — a treatise of such profundity that no person can easily fathom it.

If any physician has not studied this treatise and yet prescribes medicine, he cannot truly treat the disease correctly, because he does not know this category of origin-classification; such a physician is called a "physician of false knowledge," because he succeeds only by chance guesswork, without being bound to the correct medical classification. But the physician who possesses careful judgement, deliberation, and learning in the medical sciences, and who studies this Treatise on Diagnosis by Origin until true wisdom is attained, will then prescribe medicine in accordance with the origin-classification appropriate to the disease, because he truly knows this category of origins; such a physician is therefore called a "physician of excellent knowledge," in the sense that he knows more than other physicians, and does not err in any part of the whole treatise of the medical sciences, according to what has been laid down, so that he shall not go astray hereafter.

Next will be set forth the four categories of the classification of origins, namely: the element—

168 — Watthana Phanit Press

[Continuing:] element-origin, season-origin, age-origin, time-origin. These four kinds of origin physicians should study and understand clearly within the Great Classification of Origins, which is the foundation of the domain of disease and the domain of all physicians.

As for "origin": it concerns the origin of the four elements, beginning with the fire element (tejo-dhatu) and ending with the earth element (pathavi-dhatu), as follows. The classification of the fire-element origin is the basis of the "four fire-times" (chatu-kala tejo); when these go awry they become movement or disruption in nature, depending upon bound bile, free bile, and fever-heat (kamdao), these three being the primary causes within this fire-element category of origin, one category.

2. The classification of the wind-element origin is the basis of the "six wind-times" (cha-kala vayo); when these go awry they become movement or disruption in nature, depending upon heart-wind, sinew/joint-wind, and diffuse wind (sumana), these three being the primary causes within this wind-element category of origin, one category.

(3) The classification of the water-element origin is the basis of the "twelve waters" (thawathot-apo); when these go awry they become movement or disruption in nature, depending upon oral phlegm, chest phlegm, and bowel phlegm, these three being the primary causes within this water-element category of origin, one category.

(4) The classification of the earth-element origin is the basis of the "twenty earths" (wisati-pathavi); when disordered they become movement or disruption in nature, depending upon the heart, undigested food, and faeces, these three being the causes and primary factors within this earth-element category of origin, one category. These four categories together form one group of the Great Classification of Elemental Origins; physicians should retain this knowledge.

Next will be shown the category of the season-origin: concerning the origin by season, three seasons [subdivided into] six, as follows — the hot-season origin, the rainy-season origin, and the cool-season origin; this makes three seasons, one season being four months, three seasons making one year. As for the origin—

Medical Textbook Compendium, p. 169

As for the six seasons: the summer basis is one, the spring basis is one, the rainy-season basis is one, the autumn basis is one, the cool basis is one, and the cold basis is one — these are the six seasonal bases; one season is 2 months, and six seasons make one year. The teachers divide this specially out of the three [main] seasons so that physicians will know it by the character of the days where they overlap and interlock, as found in the Treatise on Diagnosis of the Elements, the Middle Elements chapter. Here it will speak only of the bases as a start, namely:

(1) The summer-season basis is the allotment of the pitta (bile) basis as its cause.

(2) The rainy-season basis is the allotment of the vata (wind) basis as its cause.

(3) The cool-season basis is the allotment of the semha (phlegm) basis as its cause. This is the allotment of the three seasonal bases in brief, as follows:

(1) The summer basis is the allotment where pitta basis and vata basis combine as the cause.

(2) The spring basis is the allotment where pitta basis and vata basis combine as the cause.

(3) The rainy-season basis is the allotment where vata basis and pitta basis combine as the cause.

(4) The autumn basis is the allotment where vata basis and semha basis combine as the cause.

(5) The cool-season basis is the allotment where semha basis and vata basis combine as the cause.

(6) The cold-season basis is the allotment of semha basis and pitta basis combining as the cause. This is, in brief, the allotment of the group of six seasonal bases. Now it will go on to explain—

[gathering mark: 1/22]

p. 170

Elaboration on the three bases, taking them first, as a beginning.

1. As for the summer basis: it runs from the first day of the waning moon of the 4th month to the full moon of the 8th month — one seasonal basis — being the allotment of pitta (bile); but it is not the case that it fills the whole 4 months. It is divided specially into three portions, as follows:

(1) From the first day of the waning moon of the 4th month to the 10th day of the waning moon of the 5th month is the position of the "bound pitta" basis. Bound pitta does not act by itself; it depends on any one of the four seasonal-fire groups, combining with the bound-pitta basis, for the reason that it is its "owner." If one is to treat it, one should not let the original be lost, as a foundation, according to the allotment.

(2) From the 11th day of the waning moon of the 5th month to the 5th day of the waxing moon of the 7th month is the position of the "unbound pitta" basis. But unbound pitta is not present in full measure; unbound pitta acts together with the season of fire, mixing together. If one is to treat it, one should not let the original be lost, according to the allotment.

(3) From the 6th day of the waxing moon of the 7th month to the full moon of the 8th month is the position of the "kamdao" (heat/fever) basis. Kamdao is not combined with any single one of the seasonal-fire groups, because kamdao pervades generally throughout all three bases — bound pitta, unbound pitta, kamdao — and it is said that the body becomes whole because of kamdao, and the body fails to be whole because of kamdao. If one is to treat it, one should not let kamdao be lost, according to the allotment. The teachers therefore established that within these 4 months lies the determination of the summer basis's kamdao, because kamdao is the flame of wind, blood, and phlegm, and of all the bases together, whose failing or not failing depends on that basis as its nourishment, truly bringing about growth or decline, exactly as stated in the allotment.

2. As for the rainy-season basis: it runs from the first day of the waning moon of the 8th month to the full moon of the 12th month — one seasonal basis — being the allotment of vayo (wind); but it is not the case that it fills the whole 4 months. It is divided specially into three portions, as follows:

Medical Textbook Compendium, p. 171

(1) From the first day of the waning moon of the 8th month to the 10th day of the waning moon of the 9th month is the position of the "heart-wind" (hathai vata) basis. But heart-wind does not act by itself; it depends on any one of the season-of-wind groups, combining as the heart-wind basis, for the reason that it is its "owner." If one is to treat it, one should not let the original be lost, according to the allotment.

(2) Furthermore, from the 11th day of the waning moon of the 8th month to the 5th day of the waxing moon of the 11th month is the position of the "piercing-wind" (satthaka vata) basis, acting half by the season of wind and half combined together. If one is to treat it, one should not let the original owner be lost, according to the allotment.

(3) Furthermore, from the 6th day of the waxing moon of the 11th month to the full moon of the 12th month is the position of the "sumana" basis; it is not combined with any single one of the season-of-wind groups, because this sumana pervades generally throughout all three bases — heart-wind, piercing-wind, sumana — and it may cause restlessness because of sumana, or prevent restlessness because of sumana. If one is to treat it, one should not let the sumana basis be lost, as a foundation, according to the allotment. The teachers therefore established that within these 4 months lies the determination of the rainy-season basis, that is, the basis of wind, namely sumana, because this sumana is the pillar of the basis, whose failing or not failing depends on this basis as its nourishment, truly able to bring growth or decline, exactly as stated in the allotment.

3. As for the cool-season basis: it runs from the first day of the waning moon of the 12th month to the full moon of the 4th month — one seasonal basis — being the allotment of phlegm; but it is not the case that it is full for all 4 months. The teachers divide it specially into three portions, as follows:

(1) From the first day of the waning moon of the 12th month to the 10th day of the waning moon of the 1st month is the position of "so-semha" (stomach phlegm); it does not act by itself, but depends on the season of moisture, that is, water and fire descending and combining, as the so-semha basis, for the reason that it is its owner. If one is to treat it, one should not let the original be lost, according to the allotment.

p. 172

(2) Furthermore, from the 11th day of the waning moon of the 1st month to the 5th day of the waxing moon of the 3rd month is the position of the "chest phlegm" (ura semha) basis, acting half by the season of moisture and half combined together. If one is to treat it, one should not let the original owner be lost, according to the allotment.

(3) Furthermore, from the 6th day of the waxing moon of the 3rd month to the full moon of the 5th month is the position of the "fecal phlegm" (khut semha) basis; it is not combined with any single one of the season-of-moisture groups, that is, water, because this fecal phlegm pervades generally throughout all three bases — stomach phlegm, chest phlegm, fecal phlegm — and it may make the body whole because of fecal phlegm, or fail to be whole because of fecal phlegm. If one is to treat it, one should not let the fecal-phlegm basis be lost, as a foundation, according to the allotment. The teachers therefore established that within these 4 months lies the determination of the cool-season basis, being the basis of phlegm, namely fecal phlegm, because this fecal phlegm is the pillar of the basis, whose failing or not failing depends on that basis as its foundation of nourishment, truly able to bring growth or decline, exactly as the teachers have set down clearly as the allotment within the bases of the three seasons. This concludes this portion.

From the first day of the waning moon of the 4th month to the full moon of the 8th month is the allotment within the summer basis of kamdao, divided into three parts as follows: bound pitta 40 days, unbound pitta 40 days, kamdao 40 days. From the first day of the waning moon of the 8th month to the full moon of the 12th month is the allotment within the rainy-season basis of wind, divided into three parts as follows: heart-wind 40 days, piercing-wind 40 days, sumana 40 days. From the first day of the waning moon of the 12th month to the full moon of the 4th month is the allotment within the cool-season basis of phlegm, divided into three parts as follows: so-semha 40 days, chest-phlegm 40 days, fecal-phlegm 40 days. Each group covers 4 months, that is 120 days, as the allotment of the bases: hot, rainy, cold; hot, cold, rainy. These three bases together total 360 days, 12 months, divided into 3 seasons, each season having—

Medical Textbook Compendium, p. 173

4 months make one grouping, as stated above. Following this, it will elaborate further on the six seasonal bases.

That is: from the first day of the waning moon of the 4th month to the full moon of the 6th month is one season, namely the summer basis, being a time of heat and restlessness, a "flowing" period, the allotment of pitta basis and semha basis combined; but it is not the case that it is pitta for the whole season. It is specially divided into three parts, as follows:

(1) From the first day of the waning moon of the 4th month to the 5th day of the waxing moon of the 5th month is the district of the bound-pitta basis, but it is not fully agitated; it depends on the semha basis being strong, combined in one part, while unbound pitta is strong, combined in 2 parts, making 3 parts total. The four seasonal fires mix in and strike, causing the bound-pitta basis, the master of the house, to become agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment.

(2) Furthermore, from the 6th day of the waxing moon of the 5th month to the 10th day of the waning moon of the 5th month is the district of the unbound-pitta basis, strongly agitated; the semha basis is medium, combined in 1 part, kamdao is strong, combined in 2 parts, making 3 parts total. The four seasonal fires mix in and strike, making unbound pitta, the master of the house, even more so. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment.

(3) Furthermore, from the 11th day of the waning moon of the 5th month to the full moon of the 6th month is the district of the kamdao basis, strongly agitated; the semha basis is weak, combined in 1 part, unbound pitta is strong, combined in 2 parts, making 3 parts total. The four seasonal fires mix in and strike kamdao, the master of the house, making it extremely agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment. This concludes one seasonal basis of 2 months, namely the mixture of summer and cold-season [elements], as determined here.

p. 174

2. Furthermore, from the first day of the waning moon of the 6th month to the full moon of the 8th month is one season, the spring basis, being a place of joy, because it is the time when flowers bud and bloom — the allotment of the bound-pitta basis and the vata basis combined; but it is not the case that it is bound-pitta for the whole season. It is divided by allotment into remaining bases, three and three, as follows:

(1) From the first day of the waning moon of the 6th month to the 5th day [of the waxing moon] of the 7th month is the district of the unbound-pitta basis, combined with vata basis in 2 parts, unbound pitta combined in 1 part, making 3 parts total. The four seasonal fires strike, making the bound-pitta master of the house become agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment.

(2) Furthermore, from the 1st day of the waxing moon of the 7th month to the 10th day of the waning moon of the 7th month is the district of the bound-pitta basis, [combined with] vata basis 2 parts, kamdao combined 1 part, making 3 parts total. The four seasonal fires strike, making unbound pitta, the master of the house, become agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment.

(3) Furthermore, from the 11th day of the waning moon of the 7th month to the full moon of the 8th month is the district of the kamdao basis, combined with vata basis in 3 parts; the unbound-pitta combination should not be treated. In this season the four seasonal fires mix in and strike kamdao, the master of the house, making it agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment. This concludes one seasonal basis of two months, namely the mixture of spring and rainy-season [elements] — 2 months and 2 months. Together, the bases mentioned here make 4 months; they are arranged as one group, by the allotment of the kamdao-basis group as the cause.

3. Furthermore, from the first day of the waning moon of the 8th month to the full moon of the 10th month is one season, the rainy-season basis, because rain falls abundantly — the allotment of the vata basis and the bound basis combined; but it is not the case that it is vata for the whole season. It is divided specially into three parts, three and three, as follows:

Medical Textbook Compendium, p. 175

(1) From the first day of the waning moon of the 8th month to the 5th day of the waxing moon of the 9th month is the district of the heart-wind basis, combined with the bound-pitta basis in 1 part, piercing-wind combined in 2 parts, making 3 parts total. The six seasonal winds mix in and strike heart-wind, the master of the house, making it agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment.

(2) Furthermore, from the 6th day [of the waxing moon] of the 9th month [onward] is the district of the piercing-wind basis, combined with the bound basis in 1 part, sumana combined in 2 parts, making 3 parts total. The six seasonal winds mix in and strike piercing-wind, the master of the house, making it agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment.

(3) Furthermore, from the 11th day of the waning moon of the 9th month to the full moon of the 10th month is the district of the sumana basis, strong; the pitta basis is weak, combined in one part, piercing-wind in 2 parts, making 3 parts total. The six seasonal winds mix in and strike, making sumana, the owner of the basis, agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment. This concludes one seasonal basis of 2 months, namely the mixture of rainy-season and spring [elements], as determined here.

4. Furthermore, from the first day of the waning moon of the 10th month to the full moon of the 12th month is one season, the autumn basis, because it causes living beings to shiver and feel unwell, not at ease — the allotment of the vata basis and the semha basis combined; but it is not the case that it is vata for the whole season. It is specially divided into three parts, as follows:

(1) From the first day of the waning moon of the 10th month to the 5th day of the waxing moon of the 11th month is the heart-wind basis, combined with the semha basis in 2 parts, piercing-wind combined in 1 part, making 3 parts total. The six seasonal winds mix in and strike heart-wind, making it agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment.

(2) Furthermore, from the 6th day of the waxing moon of the 11th month to the 10th day of the waning moon of the 11th month is the district of the piercing-wind basis, combined with the semha basis in 2 parts, sumana combined in 1 part [text continues on next page]...

p. 176

...making 3 parts total. The six seasonal winds mix in and strike, causing piercing-wind to become agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment.

(3) Furthermore, from the 11th day of the waning moon of the 11th month to the full moon of the 12th month is the district of the sumana basis, combined with semha basis in 3 parts; the piercing-wind combination should not be treated. The six seasonal winds mix in and strike sumana, the master of the house, making it very agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment. This concludes one seasonal basis of 2 months, namely the mixture of autumn and cool-season [elements], each basis 2 months and 2 months. Together, these two bases mentioned here make 4 months; arranged as one group, this is the great allotment of the vata-basis group as the cause, as follows.

5. Furthermore, from the first day of the waning moon of the 12th month to the full moon of the 2nd month is one season, the allotment of the cool-season basis, because dew falls — the allotment of the semha basis and the vata basis combined; but it is not the case that it is semha for the whole season. It is specially divided into three parts, as follows:

(1) From the first day of the waning moon of the 12th month to the 5th day of the waxing moon of the 1st month is the district of the "so-semha" basis, combined with vata basis in 2 parts, chest-phlegm combined in 1 part, making 3 parts total. The season of water mixes in and strikes so-semha, the master of the house, making it agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment.

(2) Furthermore, from the 6th day of the waxing moon of the 1st month to the 10th day of the waning moon of the 1st month is the district of the chest-phlegm basis, combined with vata basis in 2 parts, fecal-phlegm combined in 1 part, making 3 parts total. The season of water mixes in and strikes the owner of the basis, that is, chest-phlegm, making it agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment.

Medical Textbook Compendium, p. 177

(3) Furthermore, from the 11th day of the waning moon of the 1st month to the full moon of the 2nd month is the district of the fecal-phlegm basis, strong; the vata basis is weak, combined in one part, chest-phlegm strong, combined in 2 parts, making 3 parts total. The season of water mixes in and strikes fecal-phlegm, the owner of the basis, making it agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment. This concludes one seasonal basis of 2 months, namely the mixture of summer and autumn [elements], as the bases are determined here.

6. Furthermore, from the first day of the waning moon of the 2nd month to the full moon of the 4th month is one season, the cold-season basis, because the air is very cool — the allotment of the semha basis and the pitta basis combined; but it is not the case that it is semha [for the whole season]. It is specially divided, in elaboration, into three parts, as follows:

(1) From the first day of the waning moon of the 2nd month to the 5th day of the waxing moon of the 3rd month is the district of the "so-semha" basis, combined with the pitta basis in 1 part, chest-phlegm combined in 2 parts, making 3 parts total. The season of water mixes in and strikes so-semha, the master of the house, making it agitated. If one is to treat it, one should not let the original basis-owner's 3 parts be lost; treat by mixing according to the combination, per the allotment.

(2) Furthermore, from the 6th day of the waxing moon of the 3rd month to the 10th day of the waning moon of the 3rd month is the district of the chest-phlegm basis, combined with the pitta basis in 2 parts, fecal-phlegm in 1 part, making 3 parts total. The season of water mixes in and strikes chest-phlegm, the master of the house, making it agitated. If one is to treat it, one should not let the original owner's 3 parts be lost; treat by mixing according to the combination, per the allotment.

(3) Furthermore, from the 11th day of the waning moon of the 3rd month to the full moon of the 4th month is the district of the fecal-phlegm basis, combined with the pitta basis in 3 parts; the chest-phlegm combination should not be treated. The season of water mixes in and strikes fecal-phlegm, the master of the house, making it agitated. If one is to treat it, one should not [let it be lost]...

[gathering mark: 1/23]

p. 178

...the original basis-owner's 3 parts should not be lost; treat by mixing according to the combination, per the allotment. This concludes one seasonal basis of 2 months, namely the mixture of cold-season and summer [elements], each basis 2 months and 2 months. These two bases together make 4 months, arranged by determination into one group within the great allotment of the semha-basis group as the cause. This exactly completes the six seasonal bases, amounting to 12 months. If arranged as 3 seasons, each season gets 4 months, 4 months [each], one year, as the teachers have set down as follows:

The summer basis divides into three as follows: bound-pitta basis 20 days, unbound-pitta basis 20 days, kamdao basis 20 days.

The spring basis divides into three as follows: bound-pitta basis 20 days, unbound-pitta basis 20 days, kamdao basis 20 days.

The rainy-season basis divides into three as follows: heart-wind basis 20 days, piercing-wind basis 20 days, sumana basis 20 days.

The autumn basis divides into three as follows: heart-wind basis 20 days, piercing-wind basis 20 days, sumana basis 20 days.

The cool-season basis divides into three as follows: so-semha basis 20 days, chest-phlegm basis 20 days, fecal-phlegm basis 20 days.

The cold-season basis divides into three as follows: so-semha basis 20 days, chest-phlegm basis 20 days, fecal-phlegm basis 20 days.

Each group is 2 months, that is 60 days, as the allotment of the bases: hot, cold, rainy; hot, cold, rainy. All six of these bases total 360 days, likewise 12 months, divided into 6 seasons, each season 2 months, making one year, as stated here.

Following this, [the text] will demonstrate the group concerning the age-basis — the diseases that arise according to the great allotment — for the young child, the middle-aged, and the elderly, continuing next. If...

Medical Textbook Compendium, p. 179

Any person who would be a physician should know the group concerning the age-basis of disease, as stated further ahead in the allotment. As for a child, however born from its mother's womb, once it has lived one day and onward, it lies within the allotment of phlegm, which is the determinant of its affliction. Once it reaches the midpoint of its lifespan, it lies within the allotment of the bound basis, which is the seat of its affliction. Once it has passed into the final stretch of its lifespan, it lies within the allotment of the vata basis, which is the seat of its affliction. If the physician recognizes these three conditions within the group of age-bases of disease, he should then compound medicine to match the basis as described above.

(1) Furthermore, as for any person born from the mother's womb, from the age of one day onward up to 16 years is the determined period: whatever basis the affliction may be in, phlegm is the master of the house, mixing into all the bases; if it is to cause harm, it has more strength than all the other bases.

(2) Furthermore, for a person whose age has passed 16 years up to 30 years, this is the determined period: whatever basis the affliction may be in, the bound [basis], as owner of the basis, mixes into all the groups of bases; if it is to cause harm, it has more strength than all the other bases.

(3) Furthermore, for any person whose age has passed beyond 30 years, up until the end of the natural lifespan, this is the determined period: whatever basis the affliction may be caused in, vata, as owner of the basis, mixes into all the bases; if it is to cause harm, it has more strength than all the other bases.

If the physician thoroughly understands these three conditions of the disease-basis group, he should then compound medicines according to the age of the disease appropriate to the basis-allotment; that physician will then be able to make the disease and affliction perish very swiftly indeed. And these three age-bases have not yet been elaborated in the text as to which of the phlegm, bound, or vata basis comes first...

p. 180

...whether in the middle or toward the end, and however much strength the afflicting basis will have, has not yet been made clear beforehand in the great allotment.

(1) The revered teacher therefore states in the text that from age 16 downward [i.e., birth to 16] is the age of phlegm, having a strength of 12 degrees as its measure. If any disease or affliction arises during this age-basis, phlegm should be taken as the primary basis, exactly as stated in the allotment.

(2) Furthermore, from age 30 downward [i.e., 16 to 30] is the age of the bound [basis], having a strength of 7 degrees as its measure. If any disease or affliction arises during that age-basis, the bound [basis] should be taken as the primary basis, exactly as stated in the allotment, as follows.

(3) Furthermore, from the end of the lifespan downward [i.e., 30 to the end of life] is the age of vata, having a strength of 10 degrees as its measure. If any disease or affliction arises during this age-basis, vata should be taken as the primary basis, exactly as stated in the allotment.

(1) In one account, the teachers restate it to make it elaborately clear: if any person falls ill at an age within the semha basis, semha should be taken as the primary and vata as the final.

(2) If any person falls ill at an age within the vata basis, vata should be taken as the first and the bound [basis] as the final.

(3) If any person falls ill at an age within the bound basis, the bound [basis] should be taken as the first and semha as the final.

These three bases are not fixed in place; they proceed forward and in reverse, not being constant, adjusting according to the age of the disease, by the allotment, as follows.

Thus a question arises, asking: it has been stated that the semha basis has a strength of 12 degrees, the bound basis has a strength of 7 degrees, and the vata basis has a strength of 10 degrees — this seems proper; but as to whether the age-basis and the strength-basis correspond to each other...

It is not so. Because when age matches an already diminished [bodily] strength, could it truly correspond to what has just been said? The answer is: yes, it is as stated regarding the age-based origin (samutthana). The teacher classifies age so as to give three causal periods: early life, middle life, and late life. These three are the basis of the aforementioned samutthana, so that the physician may compound remedies appropriate to these periods of age. As for the strength of the samutthana, the teacher classifies the strength of the disease that will arise according to the various types of samutthana, so that the physician should know, within the fixed measure of disorder, how much strength that samutthana holds. If a physician is unclear about these three strengths at any time, he will not know the strength of the fever at that time.

For this reason they are described mingled together within the age-samutthana group, in the hope of making clear, within a fever's course of 30 days — what physicians customarily call sannibat (compound) fever. But it is not only that: the strength of the samutthana does not simply follow age in fixed proportion. If a disease arises during any samutthana period whatsoever, one should set bile (pitta) samutthana as the first and wind (vata) samutthana as the last — that is, counting from the first day the fever strikes as the fixed starting point, according to the strength of each samutthana: bile has a strength of 7 degrees, phlegm has a strength of 12 degrees, wind has a strength of 10 degrees; combined, the three total 29 degrees with a remainder of 1, which need not be counted since it represents degrees already spent between past and future. If counted fully it would be 30 degrees, that is, one month. This is classified to make the disorder clear — namely, when they gather together it is called the sannibat group. Whenever the strengths of these three samutthana mingle together, it is properly named the fixed measure of the sannibat group; if they have not yet come together at some moment, it is not yet named the fixed measure of the sannibat group at that moment — because the mingling of all three together, whether reaching or falling short of the fixed measure, will not go further. Furthermore, as for the strength of the bile samutthana, disease arises: from the day the fever strikes, counting from 1 degree up to 7 degrees is the fixed measure, proceeding without retreating or abating; the next day it becomes 8 degrees, falling within the phlegm [period].

...samutthana. In disease, bile mingles in by 2 parts, until reaching 12 degrees combined; the combined bile-and-phlegm samutthana [totals] 19 degrees as the fixed measure, proceeding without retreating or abating; the following day it becomes 20 degrees, falling within the wind samutthana. In disease, bile still remains mingled in by 1 part, phlegm mingled in by 2 parts, until reaching 10 degrees combined; the combined bile-and-phlegm samutthana [totals] 25 degrees as the fixed measure, proceeding without retreating or abating; the following day, 10 degrees, and then it falls into the sannibat [period] described in the various treatises, with the primary sannibat as its final stage — physicians should examine and study this thoroughly to make it clear. In this samutthana treatise it is stated that, as for the great fixed-measure samutthana group that will arise according to age, the disease [course] is here summarized according to method — this concludes only this much.

Next, continuing in the samutthana group, it will be shown regarding the time of day when the [humors] mingle and become aggravated within the fixed periods of night-watches and day-hours altogether: that is, one day has 12 hours, one night has 12 watch-hours, divided into 3 and 3, forming 6 samutthana divisions likewise. Namely: from dawn until the 4th hour is one samutthana; from the 5th hour until 2 o'clock in the afternoon is one samutthana; from 3 o'clock in the afternoon until dusk is one samutthana; from dusk until the 4th night-watch is one samutthana; from the 5th watch until the 9th watch is one samutthana; from the 8th watch until dawn is one samutthana. Day and night thus form 6 samutthana, divided as follows:

(1) From after dawn until the 4th hour is the office in which the fixed measure of phlegm acts.

(2) From the 5th hour until 2 o'clock in the afternoon is the office in which the fixed measure of bile acts.

(3) From 3 o'clock in the afternoon until dusk is the office in which the fixed measure of wind acts. The night is likewise divided as the day, according to this fixed schedule.

As for these three periods of samutthana, they apply generally throughout the whole group of diseases. If any disease arises during any elemental samutthana period whatsoever, one should set phlegm as beginning at the time after dawn, as the starting point, according to the fixed measure stated.

(1) One rule: as for phlegm becoming aggravated — whether in the morning, or after eating food, or at dusk — these are the governing periods in which the phlegm samutthana acts.

(2) One rule: as for bile becoming aggravated — whether at midday, or when food has not yet been digested, or at midnight — these three are the governing periods in which the bile samutthana acts.

(3) One rule: as for wind becoming aggravated — whether in the afternoon, or when food has already been digested, or during sleep — these three are the governing periods in which the wind samutthana acts. Physicians should keep this fixed measure in mind so as to prescribe medicine appropriate to the time — the period during which the samutthana becomes aggravated — according to the fixed measure stated here.

It is also stated that phlegm, bile, and wind samutthana act according to the times described above, which agrees with what is stated in the various medical treatises; but this cannot yet be taken as an absolute standard, because the samutthana described is, by nature, not yet fixed within a single time — the three disease-disorders that mingle together form a mixed category. Physicians should understand, in the method of samutthana, that disorder has 3 divisions: single disorder as one category, double disorder as one category, and triple disorder as one category — 3 categories thus. [The text] will now describe the single-disorder samutthana category first.

(End of Volume 1 of the Samutthana Vinicchai)

(1) From after dawn plus a quarter-hour until 1 o'clock: phlegm samutthana is the owner, acting for 2 parts; wind, near dawn, mingles in and acts for 1 part. Wind's mingled strength ends; from 2 o'clock until 3 o'clock, phlegm acts fully throughout the samutthana, with no mingling of anything at all. But from 3 o'clock until 4 o'clock, phlegm the owner of the samutthana acts for 2 parts, while bile, in the daytime, mingles in and acts for 1 part. This is the fixed measure of the phlegm samutthana in the morning, beginning at 4 o'clock.

(2) One rule: from 4 o'clock plus a quarter-hour until 5 o'clock, bile samutthana is the owner, acting for 2 parts; phlegm, in the morning time, mingles in and acts for 1 part. But from 5 o'clock until 6 o'clock — which astrologers call noon, that is, midday — until 1 o'clock in the afternoon, bile the owner of the samutthana acts fully, with no mingling of anything. But from 1 o'clock plus a quarter-hour until 2 o'clock in the afternoon, bile the owner acts for 2 parts, while wind, in the evening time, mingles in and acts for 1 part. This is the fixed measure of the bile samutthana in the daytime, beginning at 4 o'clock.

(3) One rule: from 2 o'clock in the afternoon plus a quarter-hour until 3 o'clock in the afternoon, wind the owner of the samutthana acts for 2 parts, while bile, in the daytime, mingles in and acts for 1 part. Bile's strength ends; from 4 o'clock in the afternoon until 5 o'clock in the afternoon, wind the owner acts fully throughout the samutthana, with no mingling of anything whatsoever. But from 5 o'clock in the afternoon until 6 o'clock in the afternoon — which astrologers call dusk, that is, the end of one day — wind the owner acts for 2 parts, while phlegm, in the evening time, mingles in for 1 part. This is the fixed measure of the wind samutthana in the evening, beginning at 4 o'clock. One rule: from dusk onward until the 12th night-watch — which astrologers call dawn, that is, the end of one night — it is not further described, since it divides into 3 samutthana mingled in the same manner, without deviating from the pattern of the daytime.

Thus it is complete, forming 6 samutthana altogether, classified as the group of single-category disorder samutthana, fixed measure, one set, as recorded thus:

(1) One rule: as for the moving (chalana) samutthana of double disorder — from after dawn plus a quarter-hour until 1 o'clock, phlegm the owner of the samutthana acts for 1 part, while wind, near dawn, mingles in and acts for 2 parts. But from 1 o'clock until 2 o'clock, phlegm's action rises to 2 parts, while wind's mingled action diminishes to only 1 part; wind's strength ends. From 2 o'clock until 3 o'clock, phlegm the owner acts for 2 parts, while bile, in the daytime, mingles in and acts for 1 part. From 3 o'clock in the afternoon until 4 o'clock, phlegm recedes, acting for only 1 part, while bile's mingled action rises to 2 parts. This is the fixed measure of phlegm in the morning period, one samutthana, beginning at 4 o'clock.

(2) One rule: from 4 o'clock plus a quarter-hour until 5 o'clock, bile the owner of the samutthana acts for only 1 part, while phlegm, still lingering from the morning, mingles in and acts for 2 parts. From 5 o'clock until 6 o'clock, that is noon, bile the owner's action rises to 2 parts, while phlegm still lingers, mingling in for only 1 part; phlegm's strength ends at 6 o'clock, that is noon. From noon until 1 o'clock in the afternoon, bile the owner acts for 2 parts, while wind, in the evening time, mingles in for 1 part. From 1 o'clock until 2 o'clock in the afternoon, bile the owner recedes, acting for only 1 part, while wind's mingled action rises to 2 parts. This is the fixed measure of bile in the daytime period, one samutthana, beginning at 4 o'clock.

(3) One rule: from 2 o'clock in the afternoon plus a quarter-hour until 3 o'clock in the afternoon, wind the owner of the samutthana acts for 1 part, while bile, still lingering from the daytime, mingles in and acts for 2 parts. From 3 o'clock in the afternoon until 4 o'clock in the afternoon, wind the owner's action rises to 2 parts. [printed marker: 1/29]

...while bile still mingles in and acts for only 1 part; [bile's] strength ends. From 4 o'clock in the afternoon until 5 o'clock in the afternoon, wind the owner of the samutthana acts for only 2 parts, while phlegm, in the evening time, mingles in and acts for 1 part. From 5 o'clock in the afternoon until 6 o'clock in the afternoon, that is dusk, wind the owner recedes, acting for only 1 part, while phlegm's mingled action rises to 2 parts. This is the fixed measure of the wind samutthana in the evening period, one samutthana, beginning at 4 o'clock. Both day and night are likewise divided into 6 samutthana altogether, classified as the group of moving samutthana of double disorder, one set, as recorded thus:

(1) One rule: as for the mixed (phinna) samutthana of triple disorder — from after dawn plus a quarter-hour until 1 o'clock in the morning, phlegm the owner of the samutthana acts for 1 part; wind, near dawn, mingles in and acts together for 4 parts; bile, in the daytime, mingles in and acts for only 1 part. From 1 o'clock in the morning until 2 o'clock, phlegm the owner's action rises to 2 parts, wind recedes and mingles in for only 3 parts, bile's mingled action rises to 2 parts. From 2 o'clock in the morning until 3 o'clock in the morning, phlegm the owner acts for only 2 parts, wind mingles in and acts together for 2 parts, bile's mingled action rises to 3 parts. From 3 o'clock in the morning until 4 o'clock in the morning, phlegm the owner recedes, acting for only 1 part, wind's mingled action recedes to 1 part, bile, in the daytime, mingles in and acts for 4 parts. This is the fixed measure within the phlegm samutthana group, beginning at 4 o'clock.

(2) One rule: from 4 o'clock in the morning until 5 o'clock in the morning, bile the owner of the samutthana acts for 1 part, phlegm mingles in and acts for 4 parts, wind mingles in and acts for 1 part. From 5 o'clock in the morning until 6 o'clock, noon, bile the owner of the samutthana acts for 2 parts, phlegm mingles in and acts for 3 parts, wind mingles in and acts for...

...2 parts. From 6 o'clock, noon, until 1 o'clock in the afternoon, bile the owner of the samutthana acts for 2 parts, phlegm mingles in and acts for 2 parts, wind mingles in and acts for 3 parts. Continuing until 2 o'clock in the afternoon, bile the owner of the samutthana acts for 1 part, phlegm mingles in and acts for 1 part, wind mingles in and acts for 4 parts. This is the fixed measure within the bile samutthana group, beginning at 4 o'clock.

(3) One rule: from 2 o'clock in the afternoon plus a quarter-hour until 3 o'clock in the afternoon, wind the owner of the samutthana acts for 1 part, bile, in the daytime, mingles in and acts together for 4 parts, phlegm, in the evening, mingles in and acts for only 1 part. From 3 o'clock in the afternoon until 4 o'clock in the afternoon, wind the owner's action rises to 2 parts, bile recedes and mingles in for only 3 parts, phlegm's mingled action rises to 2 parts. From 4 o'clock in the afternoon until 5 o'clock in the afternoon, wind the owner acts for only 2 parts, bile still mingles in and acts for 2 parts, phlegm increases to 3 parts. From 5 o'clock in the afternoon until 6 o'clock in the afternoon, that is dusk, wind the owner recedes, acting for only 1 part, bile recedes and mingles in for 1 part, phlegm increases and mingles in, acting for 4 parts, as the fixed measure. This is the fixed measure of the wind samutthana group in the evening period, one samutthana, beginning at 4 o'clock. Both day and night are likewise divided as described previously, combining together to form 6 samutthana; this is classified as the group of mixed samutthana of triple disorder, one set, according to what is recorded, ending only at this point. It is also stated that these three periods of disorder-samutthana described above do not become fully fixed within the exact interval of a night-watch-hour-quarter-hour, because this timing of samutthana varies according to the course of the sun-deity as it proceeds through the twelve zodiac signs, which cannot yet be taken as an absolute standard, because it does not clearly appear here; it is set forth in that treatise, the Khamphi Angkhaphayop Thatu Banchok [Treatise of the Bodily-Element Groups]. The teacher-master has drawn it out...

...and set it down here, in this Samutthana Vinicchai treatise, in a brief summary only, so as to instruct physicians to be clear, so they may reason and investigate by inference, with wise discernment, seeing truly into the sphere of the zodiac and the sphere of the various samutthana. Then they will come to see the disease disorders that vary and change, and will be able to compound accurately the medicine that treats the disease, in accordance with the great fixed measure of all the samutthana. As for the four samutthana — element, season, age, and time — the samutthana described so far — one should not yet take any single one of these samutthana alone as the standard, because they are mutually dependent upon one another; it is not that they will vary according to the samutthana as a whole taken separately. It is only through contact/impact that the three disturbed (moving) samutthana of disorder arise. Beginning from that time-samutthana, the teacher has drawn it out and classified it as the time-samutthana of disorder. If one is to compound medicine to treat according to the three time-samutthana of disorder, as shown previously, it is proper to do so; then one treats according to the sequence of all the samutthana afterward. Physicians should all know according to the fixed measure stated. It has been stated regarding the four samutthana previously, but the aggravation and diminished disorder within them has not yet been made clear. The teacher-master therefore expounds a special method of samutthana, following the course of the sun as it proceeds through the sphere of the zodiac, as a fixed schedule, as follows:

(1) As for the sun residing in the signs Aries, Leo, Sagittarius — these are the Fire (Tejo) signs.

(2) As for the sun residing in the signs Taurus, Virgo, Capricorn — these are the Earth (Pathavi) signs.

(3) As for the sun residing in the signs Gemini, Libra, Aquarius — these are the Wind (Vayo) signs.

(4) As for the sun residing in the signs Cancer, Scorpio, Pisces — these are the Water (Apo) signs.

(1) From the first day of the waning moon of the 5th month until the full moon of the 5th month is the fixed period when the sun is in Aries. The Fire samutthana becomes aggravated, causing bound bile disturbance as the cause.

(2) From the first day of the waning moon of the 8th month until the full moon of the 9th month is the fixed period when the sun is in Leo. The Fire samutthana diminishes, causing unbound bile disturbance as the cause.

(3) From the first day of the waning moon of the 12th month until the full moon of the 1st month is the fixed period when the sun is in Sagittarius. The Fire samutthana becomes disordered, causing feverish-heat disturbance as the cause. These three samutthana are the fixed measure of the Fire sign, stated according to this method as follows:

(1) From the first day of the waning moon of the 5th month until the full moon of the 6th month is the fixed period when the sun is in the sign Taurus. The Earth samutthana, the governing element, becomes aggravated, causing heart-related disturbance as the cause.

(2) From the first day of the waning moon of the 8th month until the full moon of the 10th month is the fixed period when the sun resides in the sign Virgo. The Earth samutthana diminishes, causing digestive-tract disturbance as the cause.

(3) From the first day of the waning moon of the 1st month until the full moon of the 2nd month is the fixed period when the sun is in the sign Capricorn. The Earth samutthana becomes disordered, causing stool/excretory disturbance as the cause. These three samutthana are the fixed measure of the Earth sign, stated according to this method as follows:

(1) From the first day of the waning moon of the 6th month until the full moon of the 7th month is the fixed period when the sun resides in the sign Gemini. The Wind samutthana becomes aggravated, causing heart-wind disturbance as the cause.

(2) From the first day of the waning moon of the 10th month until the full moon of the 11th month is the fixed period...

...when the sun resides in the sign Libra. The Wind samutthana, the governing element, diminishes, causing weakened-strength wind disturbance as the cause.

(3) From the first day of the waning moon of the 2nd month until the full moon of the 3rd month is the fixed period when the sun resides in the sign Aquarius. The Wind samutthana becomes disordered, causing sumana [a wind-type] disturbance as the cause. These three samutthana are the fixed measure of the Wind sign, stated according to this method as follows:

(1) From the first day of the waning moon of the 7th month until the full moon of the 8th month is the fixed period when the sun resides in the sign Cancer. The Water samutthana becomes aggravated, causing sediment-phlegm disturbance as the cause.

(2) From the first day of the waning moon of the 11th month until the full moon of the 12th month is the fixed period when the sun resides in the sign Scorpio. The Water samutthana diminishes, causing chest-phlegm disturbance as the cause.

(3) From the first day of the waning moon of the 3rd month until the full moon of the 4th month is the fixed period when the sun resides in the sign Pisces. The Water samutthana, the governing element, becomes disordered, causing foul-phlegm disturbance as the cause. These three samutthana are the fixed measure of the Water sign, thereby completing the full twelve zodiac signs according to the schedule across the 12 months. That the samutthana becomes aggravated, diminished, or disordered is here made known in summary, because it is not to be found within this Samutthana Vinicchai treatise itself; it is set forth in that treatise, the Khamphi Angkhaphayop Thatu Banchok. The teacher-master has drawn it out and set it down here as follows.

Furthermore, as for any person who would study to become a physician: let him study all the medical treatises, and be thoroughly certain of these three [aspects] — primary, middle, and final elements — so that he may be truly proficient regarding the elements. [Otherwise he is] like a person with sighted eyes walking along a path with no rail to hold. If any physician has not studied these various treatises, that person is like...

...a person with blind, darkened eyes, walking without seeing the way, and without anything to hold onto for support. Such is this medical science: it is difficult to gain insight and understanding in medical science when a physician does not know the proper method of a physician — how then could he compound medicine to relieve a patient's suffering in that way? But whichever physician possesses discerning wisdom and studies the treatises in fine detail until it is clear and certain, will then come truly to see the group of disease-samutthana that arise in a person, and will be able to compound medicine to cure that disease, achieving victory very swiftly indeed. What has been said here, from beginning to end, has not yet made clear the characteristics, symptoms, and categories [of disease], since these have not been elaborated here; they exist in the various Chandasat treatises. This treatise concerns only the group of the great fixed-measure samutthana, which varies according to element, season, age, and time — this samutthana physicians should regard as foundational knowledge, so as to be clear about the disease group and the fixed measure of remedies — namely: Triphala, Trikatuk, [and] Benjakul — for treating the four samutthana groups described above. Physicians should take note according to this method. And going further ahead, one should consider the remedies as fixed within the great fixed-measure samutthana group as shown. In what follows, the fixed measure of remedies for the samutthana group will be shown in detail, continuing thus; but the section on Benjakul will be addressed first, as the starting point. As for the nature of Benjakul, it is stated in the Benjasapphakhun [Five Properties] treatise that there were once 5 hermit-sages who gathered together, each partaking of one of 5 kinds of roots, having differing properties, whose virtues could not be counted or measured. And so these 5 [sages/roots] were combined together into all 5 ingredients, in a proportion not found within the great fixed measure; being equal portions of substance, it thus received the designation "Benjakul, equal-portion" — which is indeed fitting. It cures ordinary elemental disease very excellently. But although this treatise's claim about it is indeed true, it is still not fully accurate within the sphere of samutthana and the whole group of elements. The teacher-master therefore explains this at length...

...according to the Pali text, as follows: it is explained that the body of all persons is the seat of the samutthana group; samutthana is the seat of the elements; the elements are the seat of the disease group; disease is the seat of [what is caused by] food — thus. If one is to treat, one should treat starting from the samutthana group as the foundation, in the sense that samutthana is the taproot of all diseases. The teacher therefore divided Benjakul into a group of 3 and a group of 3, and inserted pepper in as one more, making 6 — because pepper treats the wind group; no other substance's property surpasses pepper in treating wind. The teacher-master therefore incorporated it into the Benjakul, and it thus received the following designation:

(1) Namely: pepper 1, dried ginger 1, long pepper 1 — these three are the Trikatuk, within the fixed measure for the spring season.

(2) Namely: plumbago root 1, sakhan (Piper) 1, chaphlu root 1 — these three are the Trisan, within the fixed measure for the winter season.

(3) Namely: Thai myrobalan 1, belliric myrobalan 1, Indian gooseberry (ma-kham-pom) 1 — these three are the Triphala, within the fixed measure for the summer season. These are classified to treat the disease-samutthana group of the 3 seasons, as follows:

(1) Namely: belliric myrobalan 1, dried ginger 1, plumbago root 1 — these three treat the fixed measure of the bile samutthana.

(2) Namely: Thai myrobalan 1, pepper 1, sakhan 1 — these three treat the fixed measure of the wind samutthana.

(3) Namely: Indian gooseberry 1, chaphlu root 1, long pepper 1 — these three treat the fixed measure of the phlegm samutthana. These should be compounded according to proportion, as will be shown further ahead. Furthermore, the teacher then classified the medicinal groups within the samutthana group — namely Triphala, Trikatuk, and Trisan — these three, gathered together and combined, so as to make clear the fixed measure, leading gradually on to [the section on] Benjakul.

That is: black pepper 1, dried ginger 1, plumbago 1, sacan 1, cha phlu 1, long pepper 1. This remedies [disorders] within the group of elements and seasonal bases, on the principle that the elemental and seasonal bases are interlinked — that they cannot be separated from one another is because they depend upon and support each other. One must therefore compound the 'five roots' (bencha-kun) according to the prescribed proportions. When an element is in excess, deficient, or disordered, the remedy is as follows, and this is proper:

(1) If Fire (Tejo) is in excess, take: sacan 1, long pepper 2, cha phlu root 3, ginger 4, plumbago 8, belleric myrobalan 16 — for the excess-fire basis.

(2) If Fire is deficient, take: long pepper 1, cha phlu root 2, sacan 3, belleric myrobalan 4, dried ginger 8, plumbago 16 — for the deficient-fire basis.

(3) If Fire is disordered, take: cha phlu root 1, sacan 2, long pepper 3, plumbago 4, belleric myrobalan 8, dried ginger 16 — for the disordered-fire basis.

(1) If Wind (Vayo) is in excess, take: cha phlu root 1, plumbago 2, long pepper 3, black pepper 4, sacan 8, chebulic myrobalan 16, dried ginger mixed in — for the excess-wind basis.

(2) If Wind is deficient, take: plumbago 1, long pepper 2, cha phlu root 3, chebulic myrobalan 4, black pepper 8, sacan 16, dried ginger mixed in — for the deficient-wind basis.

(3) If Wind is disordered, take: long pepper 1, cha phlu root 2, plumbago 3, sacan 4, chebulic myrobalan 8, black pepper 16, dried ginger mixed in — for the disordered-wind basis.

(1) If the Water (Apo) basis is in excess, take: dried ginger 1, sacan 2, plumbago 3, long pepper 4, cha phlu root 8, Indian gooseberry 16, black pepper mixed in — for the excess-water basis.

(2) If Water is deficient, take: sacan 2, plumbago 1, dried ginger 3, Indian gooseberry 4, long pepper 8, cha phlu root 12, black pepper mixed in — for the deficient-water basis.

(3) If Water is disordered, take: plumbago 1, dried ginger 2, sacan 3, cha phlu root 4, Indian gooseberry 8, long pepper 16, black pepper mixed in — for the disordered-water basis.

(1) If Earth (Pathavi) is in excess, take: black pepper 1, dried ginger 2, plumbago 3, sacan 4, long pepper 8, cha phlu root 16, Triphala mixed in — for the excess-earth basis.

(2) If Earth is deficient, take: dried ginger 1, plumbago 2, black pepper 3, cha phlu root 4, sacan 8, long pepper 16, Triphala mixed in — for the deficient-earth basis.

(3) If Earth is disordered, take: plumbago 1, black pepper 2, dried ginger 3, long pepper 4, cha phlu root 8, sacan 16, Triphala mixed in — for the disordered-earth basis. As for this Earth-basis group, it draws only on the great physical elements found in the scripture of the fivefold bodily constituents, which concerns the sun's reckoning through the zodiac signs, forming the months of the seasons, inseparably linked, arranged into 4 seasons, each season 3 months, following the order of these 4 elements set forth here, so that physicians may easily understand the group of bases. For here it is stated only as the great reckoning of the bases, three and three — that is, the Fire, Wind, and Water bases — but this Earth basis is classed as an inherently active/changeable category, and so it does not appear within that great reckoning. Physicians should understand it by the following principle:

If one is to make the 'clairvoyant five-roots,' take plumbago — leaf, root, and flower — 4 of each; sacan — leaf, root, and flower — 6 of each; dried ginger — leaf and flower —

...root and rhizome, 10 of each; cha phlu — leaf, flower, and root — 12 of each; long pepper — leaf, flower, and root — 20 of each. This remedies [disorders] in the group belonging to the 'clairvoyant' elements.

If one is to make the 'tenfold five-roots' (dasa-bencha-kun), take: dried ginger 1, plumbago 1, sacan 1, cha phlu root 1, long pepper 1, 10 parts of each. This reckoning belongs to the element of the nine bodily doors, which is found in the scripture of the fivefold bodily constituents; the compilers added in the tenth, the female organ, combining them to make 10 — hence it is called the 'tenfold five-roots.' If one is to make the 'great reckoning of the five-roots,' take: plumbago 4, sacan 6, dried ginger 10, long pepper 20, cha phlu root 12. This reckoning is set according to the strength of the elements, and serves generally throughout the whole group of elemental bases without exception; hence it is called the reckoning of the five-roots.

(1) If one is to make the 'sixteenfold five-roots' (solot-bencha-kun), take: dried ginger 2, plumbago 4, sacan 6, cha phlu root 8, long pepper 16.

(2) One [version]: take plumbago 2, sacan 4, cha phlu root 6, long pepper 8, dried ginger 16.

(3) One [version]: take sacan 2, cha phlu root 4, long pepper 6, dried ginger 8, plumbago 16.

(4) One [version]: take cha phlu root 2, long pepper 4, dried ginger 6, plumbago 8, sacan 16.

(5) One [version]: take long pepper 2, dried ginger 4, plumbago 6, sacan 8, cha phlu root 16. All these 5 formulas are called the 'sixteenfold five-roots,' on the principle that when each ingredient's amounts are added together they come to 36 parts each. By this reckoning it remedies [disorders] in the group of age-related bases, because the compilers took 36 parts of each. The remedy substances are named according to this reckoning, in which age 16 is taken as the beginning and 36 as the end, as stated previously. Physicians [should]...

...are not to be made by the reckoning of 16 parts for all 5 formulas [together]. One should consider which basis — among element, season, age, or time — the illness falls under, and with which of the 16 [proportions] it should be treated by means of this 'sixteenfold five-roots'; one should then compound it according to the sixteen-part reckoning as the compilers have prescribed, and this will be proper.

(1) If one is to make the 'tenfold five-constituents' (dasa-bencha-khan), take: dried ginger 1, cha phlu root 2, sacan 3, plumbago 4, long pepper 5.

(2) One [version]: take cha phlu root 1, sacan 2, plumbago 3, long pepper 4, dried ginger 5.

(3) One [version]: take sacan 1, plumbago 2, long pepper 3, dried ginger 4, cha phlu root 5.

(4) One [version]: take plumbago 1, long pepper 2, dried ginger 3, cha phlu root 4, sacan 5.

(5) One [version]: take long pepper 1, dried ginger 2, cha phlu root 3, sacan 4, plumbago 5. All these 5 formulas are called the 'tenfold five-constituents,' meaning that when added together, each comes to 15 parts by the reckoning. It remedies [disorders] in the group [connected with] the four elements combined with the faculty of insight, in accordance with the reckoning as stated here.

Next will be shown the great reckoning of Triphala and Trikatu.

(1) As for Triphala: if treating a phlegm-basis [disorder], take: chebulic myrobalan 4, belleric myrobalan 8, Indian gooseberry 12.

(2) If treating a bile-basis [disorder], take: Indian gooseberry 4, chebulic myrobalan 8, belleric myrobalan 12.

(3) If treating a wind-basis [disorder], take: belleric myrobalan 4, Indian gooseberry 8...

chebulic myrobalan 12. These 3 together are called the reckoning of the Triphala basis.

(1) As for Trikatu: if treating a phlegm-basis [disorder], take: black pepper 4, dried ginger 8, long pepper 12.

(2) If treating a bile-basis [disorder], take: long pepper 4, black pepper 8, dried ginger 12.

(3) If treating a wind-basis [disorder], take: dried ginger 4, long pepper 8, black pepper 12. These 3 together are called the reckoning of the Trikatu basis. As for both Triphala and Trikatu, they are not specific to any one basis alone, but serve generally throughout the whole group of bases; physicians should judge what is fitting between them and then compound accordingly, following the principle the compilers have prescribed.

Furthermore, as for the character of the bases, they cannot go beyond three, yet the matter is not fully settled, since there remains a dispute within the elemental group concerning the Earth basis — [namely] whether a fourth is added beyond the three, as mentioned. Because it is not stated clearly here, [we note]: the heart, the stomach, and the faeces — these three are classed as the Earth basis, drawn from the category of the 'inherently active.' Whether one compounds Triphala or Trikatu to treat within this Earth basis, in the scripture the compilers combine them in equal parts, because Earth is the foundation of all the bases, as is stated in the Scripture of the Chalana-Sangaha; physicians should understand it by this principle.

Furthermore, as for the character of the reckoned proportions of remedy substances, the compilers set them down in 3 grades: the baht-grade, the salueng-grade, and the fueang-grade [traditional weight units], and one should determine by the strength of the proportion — whichever proportion is fitting, take that as the base, and increase or decrease accordingly within that great reckoning. Furthermore, whatever illness arises, in whatever basis it arises, and whatever remedy formula is to treat it — whether the text of the formula includes Triphala or Trikatu, or both Triphala and Trikatu together — one should consider [these] within the group...

...basis and group of illness — whichever triad is fitting, use that triad, compounded and added according to the reckoned proportion. If only Trikatu is present and Triphala is not, but the group of illness and its basis calls for Triphala, then one should make up Triphala to fill the reckoned proportion, and reduce the Trikatu specified in the formula text according to the proportion. If the group of illness and basis calls for Trikatu, then one should make up the Trikatu specified in the formula text to fill the reckoned proportion; the Triphala not present in the formula text — if it should be added, add it according to the reckoning; if it should not be added, do not add it — but do not thereby spoil the basis being treated as the foundation. If the formula text contains both Triphala and Trikatu, but the illness and basis call for one or the other, having considered, one should increase or decrease according to the reckoned proportion as said before. Furthermore, whatever remedy substance the compilers have set down in whatever formula, and it is to be used to treat a group of illness and basis not covered by that great reckoning, the physician should compound it following the principle the compilers have laid down, but must not thereby spoil its medicinal virtue — the baht-portion being the greatest and the fueang-portion the least: reduce where it should be reduced, increase where it should be increased, omit where it should be omitted, retain where it should be retained, entirely according to the illness and its medicinal virtue as the guiding principle — but do not thereby spoil the basis, that is, the Triphala or Trikatu; the physician should compound according to the reckoning that fits the basis of that illness, blending it in following the principle stated here.

Furthermore, as for Triphala, Trikatu, or the five-roots, if preparing by decoction, compound to the full baht-portion; if preparing the salueng-portion, compound by the method of making a powder; if preparing by the method of admixture, compound to the full fueang-portion; if preparing by the method of reduction, reduce by half the admixture portion — this is proper.

(1) One principle: if treating the hot-season (khimhan) basis, take Trisan 4 parts, Triphala to the full reckoned portion, Trikatu half a portion.

(2) If treating the spring (wasan) basis, take: Triphala 4 parts, Trikatu to the full reckoned portion, Trisan half a portion.

(3) If treating the cold-season (haiman) basis, take: Trikatu 4 parts, Trisan to the full reckoned portion, Triphala half a portion, as the compilers have prescribed. Next, the reckoning of the Kot [roots] and Tian [seeds] will be given, as follows:

If there are 5 Kot, namely: Kot So 1, Kot Khema 1, Kot Hua Bua 1, Kot Chiang 1, Kot Chulalampha 1 — this is the reckoning of the 'Five Kot.'

If there are 7 Kot, namely: Kot So 1, Kot Khema 1, Kot Hua Bua 1, Kot Chiang 1, Kot Chulalampha 1, Kot Kraduk 1, Kot Kan Phrao 1 — this is the reckoning of the 'Seven Kot.'

If there are 9 Kot, namely: Kot So 1, Kot Khema 1, Kot Hua Bua 1, Kot Chiang 1, Kot Chulalampha 1, Kot Kraduk 1, Kot Kan Phrao 1, Kot Phung Pla 1, Kot Chatamangsi 1 — this is the reckoning of the 'Nine Kot.'

Beyond these there are also: Kot Kattra 1, Kot Kaklin 1, Kot Namtao 1 — these 3 are 'special Kot.' The physician should judge as is fitting whether to mix them into any formula, entirely according to what the illness and the [desired] medicinal virtue indicate.

Furthermore, if there are 5 Tian, namely: Tian Dam (black) 1, Tian Daeng (red) 1, Tian Khao (white) 1, Tian Khao Plueak (unhusked rice) 1, Tian Ta Takkataen (grasshopper-eye) 1 — this is the reckoning of the 'Five Tian.'

If there are 7 Tian, namely: Tian Dam 1, Tian Daeng 1, Tian Khao 1, Tian Khao Plueak 1, Tian Ta Takkataen 1, Tian Yaowaphani 1, Tian Sattabut 1 — this is the reckoning of the 'Seven Tian.'

If there are 9 Tian, namely: Tian Dam 1, Tian Daeng 1, Tian Khao 1, Tian Khao...

...husk 1, Tian Ta Takkataen 1, Tian Yaowaphani 1, Tian Sattabut 1, Tian Klet Hoi (shell-scale) 1, Tian Ta Kop (frog-eye) 1 — this is the reckoning of the 'Nine Tian.'

Beyond these there are: Tian Lot 1, Tian Khom (bitter) 1, Tian Klaep (husk) 1 — these 3 are 'special Tian.' One should judge as is fitting whether to blend and mix them into any formula, entirely according to what suits the illness.

Furthermore, the reckoning of the 5 water lilies will be given: Sattabut 1, Sattaban 1, Lin Chong 1, Chongkonlani 1, Nin Bon 1 — this is the reckoning of the 'Five Ubon.'

Beyond these there are: 2 kinds of Bua Luang (great lotus), 2 kinds of Sattabongkot, Bua Phuean 1, Bua Khom 1 — these 6 lotuses are 'special lotuses,' to be compounded into any formula entirely as fitting the illness according to the medicinal virtue stated.

Furthermore, the reckoning of the 5 salts will be given: Kluea Sinthao (rock salt) 1, Kluea Phik 1, Kluea Wik 1, Kluea Pho 1, Kluea Samut (sea salt) 1 — this is the reckoning of the 'Five Salts.'

Beyond these there are: Kluea Sunchala 1, Kluea Yaowakasa 1, Kluea Wichu 1, Kluea Dang Khli 1, Kluea Suwansa 1, Kluea Kadang 1, Kluea Samut 1 — these 7 salts are 'special salts.' If they are to be compounded into any formula, judge only according to what fits the illness, following the medicinal virtue stated.

Furthermore, the reckoning of the Hora [roots] will now be given. If there are 5 Hora: Hora Ammarit 1, Hora Mik Singkhli 1, Hora Bon 1, Hora Thao Sunak (dog's-paw) 1, Hora Dueai Kai (cock's-spur) 1 — this is the reckoning of the 'Five Hora.'

Beyond these there are: Hora Phak Kut (fern) 1, Hora Khao Niao (sticky rice) 1, Hora Kha Krabue (buffalo horn) 1, Hora Kha Nuea 1, Hora Bai Klom (round leaf) 1, Mahora 1, Mahura 1, Mangahora 1 — these 8 are 'special Hora,' to be compounded into any formula...

Physicians should judge entirely by what is fitting to that illness. This is set out in the Scripture of Diagnosis by Bases, Book 2, concerning the temporal basis as the final great reckoning; it ends here, in summary, at this point.

The Scripture of Diagnosis by Bases, a compendium of medical science, is complete and ends here.

THE SCRIPTURE OF THE CHALANA-SANGAHA

'Ādito ganthaṃ karoti' [Pali, glossed as:] 'From the beginning he composes the treatise' — This is truly [the work of] the sage Āchīvaka Komārabhacca, who composed the Scripture of the Chalana-Sangaha. In it he classifies the four kinds of excretory elements, which become disordered and mixed with poison, occurring amid the great convergences [of disorder], aside from the various other convergences, beginning with the first convergence and ending with the 'twice-broken' convergence. As for the character of these elements, it is the color of the stool — black, red, white, or green — whether mucoid, oily, foamy, or watery, whether containing blood or not; occurring 2, 3, 4, 5, 6, 7, or 8 times a day, whether by day or by night — yet this shall not be reckoned as belonging to the category of dysentery or filth. As for the types of excretory elements aside from the various dysenteries, beginning with the dysentery category and ending with the 'premonitory-sign dysentery' — [this scripture] classifies the disordered elements constituting the excretory great convergence, set down here as a standard for physicians, who should know with certainty the characteristics to be described hereafter. As for the character of these 4 kinds of elements, they arise in connection with the Earth (Pathavi) group — that is, excess, deficiency, or disorder — having the reckoning of the basis as their cause; that is to say, whether a person is ill or not ill, and the stool that comes out is black, red, white, or green, having a form like chicken droppings, cat droppings, or tortoise droppings, or being coarse or fine — having such characteristics, according to that type...

...there are 15 kinds, namely: causing abdominal pain, inability to eat, vomiting, sleeplessness, being poisonous, difficulty urinating or defecating, causing a bearing-down pain, numbness throughout the body, aching in every joint and limb, causing agitated heat, incessant delirious speech, heat and thirst, causing the body to waste away mixed with three kinds of pallor, causing tightness and oppression in the chest, causing pain in the flank and belly — these 15 kinds of affliction constitute the excretory great convergence, mixed together. This is because the great physical elements converge within the group of afflicted bases, three and three, thereby causing excess, deficiency, and disorder in various ways, according to the 8 planets and the Sun-deity residing in the twelve zodiac signs — this sets forth, in brief, the meaning to clarify the character of the excretory elements. Hence there arises the question: by what cause do the 15 kinds of affliction, and the great physical elements converging three-and-three within the group of bases, produce excess, deficiency, and disorder? The answer is: the great physical elements of the bases are: bound bile, unbound bile, and vapor — these 3 are the reckoning of the Fire (Tejo) basis group; the heart-organ, the seven organs, and 'sumana' — these 3 are the reckoning of [another] basis group; phlegm-of-the-head, phlegm-of-the-chest, phlegm-of-the-stool — these 3 are the reckoning of the Water (Apo) basis group; the heart, the stomach, and the faeces — these 3 are the reckoning of the Earth (Pathavi) basis group. But this Earth basis alone does not become an 'inherently active' category; only when any one of the [other] three bases becomes an inherently active category does the Earth basis also gain in strength, and all the bases become more excessive than before — because Earth is the foundation of the ground of all illnesses, and is that which supports, sustains, and nourishes illnesses so that they flourish, as described. It is named the 'great convergence,' that is, the great group of convergence, because the four elemental bases are all complete in sequence as has been described. Physicians should understand and give importance to the group reckoning of the bases and the great physical elements, complete in their categories, in brief. Furthermore, it is recorded that, as to the character...

The various afflictions that arise, of 15 kinds, as already stated, are grouped into a class having 6 characteristics, as follows: firstly, the condition that produces various disorders mixed with the 'wind that follows the body's limbs and channels'; secondly, causing abdominal pain and pain in the flank and belly — the affliction of Bitkhat, Santhakhat, and Ratkhat, which prevents the normal state, mingling together like entwined vines; thirdly, causing inability to eat and vomiting — the affliction of 'Bingkhla' acting; fourthly, causing heat, thirst, agitation, and incessant speech — the affliction acting within the 'sumana,' causing excess, disturbing the heart so it becomes unsettled and not normal; fifthly, causing sleeplessness and seizing as poison — the affliction of paralysis-wind acting throughout, [affecting] the 'sumana' whether in excess, deficiency, or disorder, none being normal; sixthly, difficulty urinating or defecating, and causing tightness and oppression in the chest — the affliction of 'kutchi-saya-wat' and 'kotha-saya-wat' in excess, blowing within the intestines abnormally. This is the class belonging to the group of the bodily elements, giving rise to 6 characteristics as described.

Now will be shown the character of the excretory elements, as to how they become variously disordered: it is because the stool is spoiled by the 'kotha-saya-wat' wind failing to cleanse away the discharge and phlegm in the intestines so it falls away, becoming crusted matter clinging to the intestinal lining, mixed together with the stool. When it travels through the intestinal channel, the channel ruptures and blood appears; sometimes small pustules arise around the rim of the anus causing pain, burning, and gnawing sensations; sometimes they arise at the beginning of the intestine near the passage of the faeces — producing symptoms like a severed finger of gut, or a spreading gut condition, and in a pregnant woman [this can cause] miscarriage. If the physician does not understand and is not clear on the explanation of the excretory elements, then it gets called by various assumed names — sometimes called 'dan thao,' sometimes 'mutkhat,' sometimes 'stone-discharge,' sometimes 'kasai klon,' sometimes 'hemorrhoids,' sometimes 'filthy dysentery' — all these names given are mistaken as to the true nature of the illness...

...that is not [so] — it is merely the habit of physicians, [but] to take it as certain would not do; one should rather rely with confidence on this Scripture of the Chalana-Sangaha, and this is proper. And afflictions of this kind arise from the category of 'filth,' but they do not reach the level of 'filthy dysentery,' because filth is [merely] a contaminant within the root of all illnesses, as has been described.

Furthermore, as for the characteristics and types already made clear, they are also mixed and blended within the elements of insight and the elements of Surin-insight, forming the fourfold compounded elements, as 'dan' and 'thao,' falling within the basis-reckoning between the methods of the unfamiliar elements; this is set out in the Scripture of Elemental Diagnosis and that basis-reckoning already [discussed]. In this scripture the compilers have included only the essential substance, that is, the gist of it, sufficient as a point of observation for physicians so that they may go on to treat illness hereafter; one should consider it with full certainty according to the principle the compilers have classified here. Furthermore, whichever physician is to treat by the method of these 4 excretory elements should study thoroughly in all the scriptures of medicine so as to be accurate, and thus be capable. And in compounding any charm or medicinal preparation whatsoever, it must accord with the medical reckoning as to the category of the illness — the elemental illness, the basis illness, the age illness, the time illness, the seasonal illness, and all the congenital illnesses — only then can one treat the excretory elements, since this is a foundation above all other illnesses, ranging from the mildest illness as the first to the most residual illness as the last. If the medicine given does not clear the underlying matter, and it persists for a long time, it will transform into an unwholesome excretory-element condition, giving rise to 20 kinds of urinary discharge and 12 kinds of 'thulawasa,' becoming truly an unwholesome, filthy, elementally-disordered condition. If the medicine given is appropriate to the illness, it will subside and be cured; as to the [precise] measure, this scripture cannot determine it — it provides only the outline of the illness. Furthermore, as to administering medicine, one must not omit the three Phrom Phak formulas, which are medicines that thoroughly cleanse away the discharge and mucus/fat completely; only after that is done in full should one administer the medicine named: Atthathiwak, Butsarakhikhun, Sangkhasuwan, Mahanathi, Sappharattanathikhun,

[Continuing from the previous page] ...Maha-anantakhun, Osathamatathikhun, Maha-bidotasathikhun, Bidotasathingwat, Bidotasathikhun, Thanajak, Sangkhasuwannaphaet — these twelve remedies are recorded in the scripture on the Third-Rank Combined Humoral Disorder (Tatiyaphin Sannibat); having finished that, [the text] now proceeds in order through the disease that is a disturbance of the elements causing decline, until it is cured. Thereafter remedies are named variously for each element of the sense-faculties (indriya-dhatu), for use with the Great Elements (mahabhuta-rupa) and the elements of origin (samutthana-rupa) of that class, so that they may be complete in full. Hereafter it is stated as follows:

Remedy named "Phrahma Phak" (Brahma's Face)

Take the five Kot [aromatic roots] and the five Candles (Tian), one part each; Triphala, Trikatuk, fragrant galangal (praohom), Phon-en fruit, two parts each; nutmeg fruit, cloves, camphor, ginger, black resin-purge (ya-dam), four parts each; Yang-salat-dai purged by the standard method, twenty parts. Make into powder; use boiled moringa-mucilage water as the liquid vehicle, form into pills, and give according to strength. It purges phlegmy discharge and expels wind of the bowel, letting stagnant stool be voided and restored to normal. It excellently cures griping, colicky pain.

Remedy named "Maha Phrahma Phak" (Great Brahma's Face)

Take Kot-so 1, Kot-khema 1, Kot-bua 1, Kot-chadamangsi 1, black candle 1, white candle 1, one part each; fragrant galangal 1, Phon-en fruit 1, coriander fruit of both kinds 2, foreign basil fruit 1, two parts each; small som-kung root 1, small plao 1, three parts each; purged foreign sahatsakhun 1, ya-dam 1, four parts each; Trikatuk 1, asafoetida 1, cloves 1, camphor 1, five parts each; Thai myrobalan 8 parts; purged Yang-salat-dai 24 parts. Make into powder; use purged-Benjakul water as the liquid, form into pills, take according to strength. It purges the stool-element that has gone awry, arising chiefly from the wind-element (vayo-dhatu).

Remedy named "Mahitthi Maha Phrahma Phak"

Take Kot-kraduk 1, Kot-chiang 1, Kot-chulalampha 1, Kot-chulachet 1, black candle 1, one part each; Ratchakhat fruit 1, foreign basil fruit 1, coriander fruit of both kinds 2, two parts each; fragrant galangal 1, Samun-waeng 1... [continues on next page]

...both sandalwoods, three parts each; Trikatuk 1, asafoetida 1, ya-dam 1, purged foreign sahatsakhun 1, purged jing-jo root 1, som-kung root 1, four parts each; Thai myrobalan 1, cloves 1, nutmeg 1, camphor 1, eight parts each; purged Yang-salat-dai 32 parts. Make into powder with Benjakul decoction as the vehicle by the standard measure, form into pills, take according to strength; it purges the stool-element arising from the Great Elements, making it vanish and be cured, and purges all elemental diseases excellently. All three of these remedies are to be dissolved in honey and taken by the method given in the dosage table, whether the dose be heavy or light; the teachers praised them as being of very great virtue.

Remedy named "Atsadathiwak"

Take Bunnak flower 1, lotus stamen 1, black candle 1, two parts each; Benjakul 1, kathue 1, phlai 1, galangal 1, fingerroot 1, shallot 1, garlic 1, turmeric-oi 1, unripe bael fruit 1, four parts each; ya-dam 5 parts; foreign myrobalan 1, beleric myrobalan 1, eight parts each; Thai myrobalan 24 parts; bark of the khai-nao tree 1, lep-mue-nang root 1, ai-niao root 1, kaphang-hom 1, a handful each; five kinds of Thai chum-het, five kinds of holy basil, ten leaves of golden-shower — pound and take the juice as the liquid; boil by the method and give to drink. It cures foul disorders of the stool of the dysenteric class; cures wind of the bowel that binds and will not pass; cures colic, cures vomiting when food cannot be taken; cures abdominal pain, loosening the stool so it drops with a foul, rotten stench, three, four, five, or six times a day, and covers all cases of piles and hemorrhoids.

Remedy named "Indriya-dhatu Tejo" (Fire-element of the sense faculties)

Take the five Kot, fragrant galangal 1, Phon-en fruit 1, coriander fruit of both kinds, chaphlu fruit 1, ya-thao-nok 1, kok-langka 1, rock sugar 1, one part each; sakhan vine 1, long pepper 1, chaphlu root 1, dried ginger 1, two parts each; chetamun-phloeng root 4 parts. Make into powder, grind with flower-water... [continues on next page]

...as the liquid; grind and form into sticks, dissolve in fresh jasmine-flower water mixed with camphor (phimsen), and take to cure the fire-element of the sense faculties, which makes food eaten have no taste, leaves one hungry with no strength gained, and cures the accumulation of that fire-heat, subduing it within the "asurin" faculty-knowledge element.

Remedy named "Indriya-dhatu Vayo" (Wind-element of the sense faculties)

Take nutmeg fruit 1, mace 1, one part each; Trikatuk 1, chaphlu root 1, chetamun-phloeng root 1, four parts each; sakhan vine 1 part. Make into powder, dissolve in honey or hot water, and take to cure the wind-element of the sense faculties known as Visama-khini, Manta-khini, and Lakkha-khini; and it cures all manner of winds, cures piles with wasting and jaundice, cures wind that fills the chest, wind that shoots through the body, and wind that rises to the crown of the head; it cures all wandering winds.

Remedy named "Indriya-dhatu Apo" (Water-element of the sense faculties)

Take phut-son root 1, khat-kao root 1, pra-kham-di-krabue root 1, som-kung root 1, som-poi root 1, roots of both kinds of chum-het 1, Thai licorice 1, ebony fruit 1, holy basil 1, heart-leaf moonseed 1, black candle 1, one part each; long pepper 1, sakhan vine 1, chetamun-phloeng root 1, dried ginger 1, two parts each; chaphlu root 12 parts. Boil by the method and take, to cure the water-element of the sense faculties arising within the "asurin" faculty-knowledge element, to promote appetite and establish the well-faring element (sukkati-dhatu); it cures the five kinds of vomiting occurring within that elemental dosage.

Remedy named "Indriya-dhatu Pathavi" (Earth-element of the sense faculties)

Take Triphala 1, unripe bael fruit 1, kok-ka-om kernel 1, thepthaaro 1, kan-krao heartwood 1, neem leaf 1, sa-niat leaf 1, red tum-ka bud 1, garlic 1, one part each; sakhan vine 1, chaphlu root 1, chetamun-phloeng root 1, dried ginger 1, two parts each; long pepper 20 parts. Make into powder, use garlic juice as the vehicle, grind and form into sticks; dissolve in hot water and drink, or take with lime-orange water — it cures the earth-element of the sense faculties, which causes what is eaten... [continues on next page]

...eaten to have no taste, causing wasting and jaundice, and swelling of the hands, abdomen, and feet; it cures dysenteric, muddied stool disorder from fire turned into a "manta-khin" element, leaving one weak and hungry with no strength; and it makes the appetite and digestive fire grow, bringing normal healthy development.

Remedy named "Indriya-dhatu Prachum" (Gathering of the sense-faculty elements)

Take the five Kot, the five Candles, one part each; nutmeg fruit 1, mace 1, cardamom 1, cloves 1, two parts each; cinnamon 1, licorice 1, kan-krao heartwood 1, garlic 1, phlai 1, galangal 1, pepper 1, kok-langka 1, five parts each; unripe bael fruit 1, mook-man bark 1, som-kung root 1, nut-grass 1, heart-leaf moonseed 1, seven parts each; Thai chum-het 10 parts; chetamun-phloeng root 4 parts; dried ginger 10 parts; chaphlu root 32 parts; long pepper 20 parts; dried holy basil 52 parts. May be made into powder or boiled; take according to the dosage table to keep the Great Elements and elements of origin from going awry; it cures elemental disease and the elements of one's constitution, and cures illness arising from the four seasons and the six seasons.

Remedy named "Totsa-Benjakul" (Fifteenfold Benjakul)

Take lime powder 1 part, som-rong-raeng 1, red-eyed galangal 1, plain pepper 1, garlic 1, phlai 1, one part each; Benjakul by the standard dosage, eleven [ingredients in all]. Make into powder, grind and dissolve in ginger water, galangal water, honey, hot water, or phlai water as desired; give as a medicine that spreads through the four disturbed elements, which cause heat, restlessness, and various abnormal changes — namely paralytic wind, hemiplegic wind, twisting-jaw wind, and "Rahu-devouring-the-element" wind, among others, which make the hands and feet tremble; also colicky wind, "diamond-piercing" wind, and fire-wind, as described above.

Remedy named "Maha-Phikat Benjakul" (Great-dosage Benjakul)

Take Benjamun-lek [five iron-roots], wanli-priang, nut-grass, a handful each; Triphala, 15 fruits each; plain pepper, galangal, 4 baht each; Benjakul... [continues on next page]

...five kinds, and swelling of the whole body — swelling from pus, blood, and rising heat within the elemental disorder.

Remedy named "Thep Prasit" (Divine Success)

Take Benjakul, Triphala, the five Kot, the seven Candles, nutmeg fruit, mace, one part each; kaffir-lime peel, lime peel, bitter-orange peel, pomelo peel, two parts each; eaglewood, kalampak, chalut, khon-dok, red sandalwood, bullet-wood flower, bunnak stamen, sarapi stamen, cinnamon, five parts each; camphor, ka-chet, sappanwood, civet musk, five parts each; nutmeg-tree wood, camphor crystal (phimsen), scale [ingredient], eight parts each; jasmine flower 32 parts. Make into powder, use foreign flower-water as the vehicle, grind and form into sticks; dissolve in a suitable liquid. It cures wind within the elemental disorder — of the "birth," "movement," and "broken-element" kinds — mixed with poison at the very last stage, which falls in among the Great Concurrence (maha-sannibata). Thus concludes the account of the four kinds of stool-element disorder. Here ends the Chapter on the Compendium of Movement-Disorders (Chalana-sangaha).

Chapter: Elucidation of the Elements (Dhatu-vivarana)

[Pali homage verse, kept as printed:] "Rattanattayam namitvana vejjagantham pakasitum vejjagantham pavakkhami dhatuvivaranamakam sabbe sunantu vejja tam vejjagantham pakasitam poraniko vejjagantho sakatena pakasito dujjaniyo janatanam tasma hi sakatvina vade tam magadhikaya vejjanampi hitankaram." — [Gloss:] Having paid homage to the Three Jewels, in order to proclaim a medical treatise, I shall speak forth this medical treatise named "Elucidation of the Elements." Let all physicians hear it — that medical treatise now proclaimed. The ancient medical treatise, proclaimed [only] in verse, is hard for people to understand; therefore let it be spoken together with an exposition in the Magadhi (Pali) tongue, for the benefit of physicians as well.

Further, with hands joined in homage, I bow to the glorious Teacher [the Buddha], who is a wellspring in the world; also to the Dhamma and to the whole community of the Sangha, who are a lamp lighting the way for beings, letting them see clearly and not go astray, guiding them onto the... [continues on next page]

...path that is straight, worthy to be taken as one's refuge, sheltering the head against calamity, against every fault brought on by excessive heedlessness and sleep — by that power may all harms be warded off. [I also honour] the virtue of father and mother, the merit of teachers who taught the Dhamma, and further the virtue of kings of boundless, overflowing might; the gods, the Self-Existent One, and Indra and Brahma in every abode — may they grant wisdom and bestow their favour graciously.

For I would now speak of the matter of this treatise, handed down in the scriptures until the world's dissolution, named "Elucidation of the Elements," an illustration concerning disease and the root of every kind of sickness in all its forms, so that physicians may fix it firmly in mind. In composing this exposition of ours, ponder it with skill and be certain of it, without doubt. The medical scriptures were nearly lost, scattered and in disorder for a long time, because Mara ravaged the realm of Ayutthaya through calamity and time. The old physicians of former times died, and with them their learned skill declined and was lost; there remain only the young and inexperienced, who set up pretentious talk and claim knowledge prematurely — like a crow decked out as a swan, thinking none would say it does not compare. They twist and slight their teachers, twist the texts and boast that they excel. Knowing little, they yet speak boldly, like a jar half full of water that sloshes and splashes when carried. They pronounce on disease as right or wrong while their minds are set only on worldly gain, not fearing the sin of wrongdoing; groping blindly and stubborn of mind, they prescribe medicine wrongly and send the patient home [to die]. Some have studied a little, but what they learned is muddled and not understood; they do not know the kinds of illness that are fatal, and yet blindly attempt to cure them, boasting only of cures — so death comes upon [the patient] all the more. They know only the recipe but have not studied the types of fever; they cannot tell a curable disease from a fatal one — like a thorn that pricks in a deceptive way, not knowing how to lance it properly, not knowing how to draw out the barb. Medical science has thereby declined and been lost, leaving only scattered scraps, further worn down by dispute; those who do know have also grown corrupt, and grow careless, heedless, and contemptuous. Do not think that when a disease's signs turn back it means it is entirely cured — disease follows its own true course; a slip in prescribing medicine can bring about the very death [it was meant to prevent]. A physician whose heart is greedy for wealth will pronounce a cure near just to collect his fee — such "recovery" is no true recovery, but a corpse's glow, fading away like a fading lustre...

...like a diamond gem grown clouded and dull, which I shall restore to brightness, hoping to spread and share its light out of loving-kindness, for the sake of physicians yet to come — those of little learning and failing understanding — that they may clearly know disease, as though looking through spectacles, understanding the world's nature, all the classes of disease, the times they occur, and the hot and cool seasons; let physicians perceive it as set out below.

I pay homage to the ancient physicians who set this down; may they hear and grant leave. As for the words of the sages of former times, let the mind be firmly fixed upon them, without distorting the teaching; what is well remembered will endure, and become a lasting refuge.

I shall now speak of the four elements according to the Visuddhimagga scripture, plainly evident in the Pali, taught by the Omniscient One [the Buddha], showing the disorder of the elements in the body of a sick person. When the portion of a given element is disturbed and the disruption is severe, it makes the sick person stiff and numb, hardened and rigid; the flesh and skin shrivel and dry, becoming as hard as a log — comparable to the venomous "wood-mouth" (kattha-mukha) class of serpent, which, when it bites anyone, at once leaves that person lying rigid and rolling, like wood felled by men and scorched dry by fierce sunlight. This is the sign of disorder of the earth-element; physicians should understand it as described.

Further, as for the water-element: when derangement and darkness afflict a sick person, the body tends to rot and fester into "ghost-scabies" [a putrid skin disease]; sometimes itchy pustules appear all over the body; lymph fluid tends to run freely, carrying a foul, rotten stench, like the bite of the "putrid-mouth" creature that bites people everywhere; the poison spreads through the whole body, which tends to rot and fester into sores, with lymph seeping and oozing — this is the harm of the water-element bringing gloom and darkening. The attending physician should reflect carefully, and only when certain of the diagnosis should he prescribe medicine.

I shall now speak of the fire-element: when its disorder afflicts a person with a plague-fever [kala/black fever], it causes intense burning heat; the complexion turns entirely dull and scorched, dark and repulsive to look at; its venomous power is like that of the fierce "fire-mouth" serpent, which when it bites a person is as if fire were scorching the whole body — the disorder of the fire-element is just the same as the venom of that fierce serpent.

Further, as for the wind-element: when its disorder is far more severe than that of the other three elements, its venomous action causes the flesh to rot and collapse, breaking off in pieces as though cut by a knife without pause; the disorder of wind is like a weapon bent on cruel destruction — should it "bite" into anyone, it leaves the whole body foul and rotten. Physicians must not be careless, but should know the signs of each element's disorder thoroughly.

I shall now further set out, so it be clearly known, the months of the three seasons according to the teachers' system — hot season, rainy season, and cold season. From the first waning-moon day of the tenth month to the full moon of the eighth month, disease arising in that period is a disorder of the fire-element, with blood-disease as its chief symptom, commonly producing many kinds of harm. From the waning moon of the rainy season until the full-moon day of the twelfth month, wind-disorder grows severe and predominates over the other elements' workings. In the cold season, from the first waning-moon day of the twelfth month to the middle of the fourth month — four months making up that season — disease arising is one of phlegm colliding [with other humours], a disorder of the water-element. According to this seasonal round, these are the root causes of disease in both women and men; physicians should follow this rule and explain it fully.

I shall now speak of the four seasons in the complete system of the elements. From the fifth month to the seventh month is the hot season proper, belonging to fire. When bile becomes disturbed together with blood, illness arises from the food eaten — improper dishes and seasonings causing harm. One craves food often but it is not yet digested before being forcibly absorbed, so that one becomes suddenly full and vomits violently; the chest feels obstructed and the heart-region turns cold. Further, it causes a burning sensation in the gut, colic, dizziness and blurred vision, and wind lodging in the abdomen causing griping pain and a swollen, rumbling belly; the hands tremble upon waking, the whole body feels wretched, and breathing becomes laboured, like asthma, restless and gasping. All this, because the fire-element's bile-portion has become disordered, gives rise to this harmful wind. Should such strong symptoms appear, the physician should treat them — do not doubt that it is of the fire-element. Take look-en-lamphan-daeng [a red-veined seed], together with kot-so and kot-phung-pla, long pepper, dried ginger, mook-man bark, seed of look-chi-la, cinnamon, and sakhan vine, in equal proportion, made into powder; dissolve in [the appropriate] water and drink — it cures the disease as intended, giving a swift and lasting cure; this remedy is named "Kala-thira-saeng."

Treatise of Medical Assistance, p. 213

The Diamond-Gem [Treatise], whose clouded parts I now make bright, I shall carry forward and preserve, wishing to spread it out of compassion for physicians of the future — those whose knowledge is scant and whose learning has ebbed — so that they may clearly know disease, as though a lens laid over their sight, letting them understand the nature of the world, all the classes of disease, their timing, and the hot and cool seasons. Physicians should perceive it as told above.

I pay homage to the physicians of old who set down and transmitted this well; by the words of the sages of former times, let the mind be fixed upon it — let none stray from the teaching. Committing it to memory makes it lasting, a true place of refuge.

Now to speak of the Four Elements, according to the Visuddhimagga scripture, attested in the Pali; the All-Knowing Buddha's own teaching reveals the disordered elements of a sick person. When the earth-element (pathavī) is disturbed and turns severe, it makes the patient's body go numb, stiff and hard; the flesh and skin wither and dry, as hard as a fallen log; like a venomous serpent — of the "wood-mouth" viper kind — whoever it bites suddenly falls, rolling rigid on the ground, like a tree that has been felled and left in the fierce sun to wither dry. This is the fault of the earth element as described; physicians should recognize it as told.

Next, the water element (āpo): when deranged and darkened, it causes the sick person's flesh to rot and crumble, becoming like scabies-sores, sometimes appearing as itchy pustules over the whole body; lymph fluid flows freely, carrying a foul, rotten stench, like pus-mouthed sores that gnaw at people everywhere; poison spreads through the whole body, the flesh rotting into festering sores, lymph seeping and soaking through. This fault of the water element leaves [the body] clouded and dull; the physician must weigh it carefully, and only once certain of the diagnosis should medicine be given.

Now to speak of the fire element (tejo): when its disorder is destructive, it makes the patient burn with feverish heat and strength, the complexion trembling as if scorched, the skin turning dark and repellent to look at; its poisonous force is like the fire-mouthed serpent, a vicious snake — whoever it bites is set alight as if by fire consuming the whole body. When the fire element turns disordered, it is just like the poison of that venomous snake.

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Next, the wind element (vāyo): when its affliction is far worse than the other three elements, its poisonous symptom causes the body to rot and break apart, splitting into pieces as though cut by a knife without pause. The wind element's disorder is like a weapon bent on ruin — whatever it strikes and enters, it makes the whole self rot away. Physicians must not be careless; they should know the symptoms of the elements thoroughly.

Next I shall explain, so as to make clear the months of the three seasons according to the teachers' tradition: kimha [hot] and hemanta [cold] — from the first day of the waning moon of the tenth month until the full moon of the eighth month is kimhanta [the hot season]; disease arising in that season comes from disorder of the fire element (tejo), with blood disorders as the chief ailment, often causing many kinds of affliction. From the waning of vasanta [rainy season] until the full moon of the twelfth month, the wind element (vāyo) grows severe, flaring up worse than the combined action of the [other] elements. Hemanta, the twelfth month, from the first waning day to the middle of the fourth month — four months make up that season; disease arising in the cold season comes with phlegm colliding [with other humors], the water element (āpo) turning disordered. According to the astrological reckoning of the seasons, this is the root of disease for men and women alike; physicians should explain it thoroughly and correctly.

Speaking further of the four seasons within the complete system of the elements: from the fifth month to the seventh month is the kimhanta period belonging to tejo; [term illegible] — a blood disorder arises. It occurs on account of eating: cooked dishes and seasonings cause harm, one craves food often, and before it is digested it is forced down heavily; soon after eating one vomits with revulsion, the chest feels blocked and cold within. It also causes burning pain in the gut, stabbing pain, dizziness, wind rising in the abdomen causing griping pain and a swollen, cramping stomach; the hands tremble on waking, the whole body grows wretched, breathing becomes difficult like asthma, restless and disturbed. All this is on account of tejo; [term illegible] turning deranged, and so dangerous wind [disorders] arise. If these symptoms show themselves strongly, the physician should treat them — do not doubt that this is from tejo. [Remedy:] red "len-lamphan" root, both Kot Sor and Kot Phungpla roots, long pepper, dried ginger, mook bark, saw-tooth seed, cinnamon, and sakhan root — in equal parts, made into a powder, dissolved in water and drunk; it cures the tejo disorder as intended, and recovery is swift and firm. [This formula] is called Kala Thirasaeng.

[Note: the source image file for this page is, as far as can be determined, identical in content to the image supplied for page 93 of this chunk — the same text appears twice under two different filenames/page numbers. Transcribed and translated faithfully from what the image actually shows, without invention.] From the eighth to the tenth month, the rainy season shows its character; wind grows strong because of rich, oily food, giving rise to a wasting, jaundiced disease; one commonly feels feverish with short breath, the belly rumbles and growls, food churns up and down inside. One also yawns and belches, the eyes grow dizzy and drowsy; carefully prepared food, when eaten, has no taste; the ears feel heavy, the mouth tastes foul-sweet, blood-tinged discharge drips out, and matter comes out fully from the ears and mouth — this is the harm of wind trampling the body. Should a physician wish to cure this wind in the four months of the rainy season: fragrant vetiver-root and pepper, together with fragrant galangal and nut-grass, sweet-flag and plantain-flower pith, in equal weight measured on a balance, together with fluffy white garlic root weighed equal to all the other ingredients combined — sun-dry and make into powder, use hot water as the vehicle, drink to cure the wind; this remedy is named "Rit-charoen-di" (Well-Thriving Potency).

In the eleventh month and the first month, being a mixture of rainy and cold seasons together, the water-element grows strong because of eating food that is cold and over-sweet, against what is proper; severe water-disorder brings on twelve kinds of harm — thirst, irritability and anger as though gone mad of itself, chaotic disorder, fever with cravings, fever gnawing at the joints and bones, waking with swollen hands as a notable sign, passing blood, then coughing and wasting away jaundiced, chest obstruction, diarrhoea, griping pain with constant groaning, loss of appetite, inability to eat or sleep — all this is the vicious, deranged, and reversed disorder of the water-element, disturbing what lies within the womb-region; physicians should know it as described. Should a physician wish to cure this quickly, for water-element disorder: chetamun root, kot-so, coriander seed, long pepper, ginger, unripe bael, kok-langka, both kinds of sandalwood without fail, bullet-wood, bunnak, sarapi, and lotus flower, samun-waeng, mook-man bark, and khang-khao root together — boil in dew-measured water down to one third, without omission, and drink to cure all twelve of these water-element afflictions; the cure comes swiftly, as sudden as opening one's eyes upon waking. From the sixth month to the fourth month is marked as cold season mixed with hot season together; within these three months the harm is of the earth-element, caused by sleeping at the wrong hour, poorly regulated.

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These ten [disturbances] of the earth element (pathavī) give rise to thirteen kinds of disorder: causing one to wake and thirst for water, often feverish and uneasy, with a stabbing pain along both sides as if maddened, quick to anger; causing pain and stiffness in the neck and hands, a sweet taste in the mouth with tightness in the chest; causing loose watery stools, blocked/ringing ears, frequent urination, drooling, rumbling and distension in the belly, with groaning felt within. These ten earth-element [disorders] flare up when mixed together with one another. The physician should observe carefully what the cause of the disease is, examine it with certainty, and only then prescribe medicine according to the scriptures. If a physician wishes to quickly cure this root affliction of the earth element: neem leaf, good black cumin, the three pungents [trikatuk], costus root with the banana-stem-like variety, costus-sor root and licorice, awakening bark, rock salt, young bael fruit, Thai myrobalan, rak-tree resin, tinospora and wild taro, together with pond-moss dregs — in equal parts made into a fine powder, dissolved in honey-water and taken; it cures the earth-element affliction however severe and long-standing. Recovery is swift — have no doubt; the ruin of the disease is utterly destroyed.

Next, of the six seasons the teachers take as the foundation: the fifth month extending through the sixth is called the original kimhanta [hot] season. If illness occurs within these two months, the heat-humor increases further; the seventh affliction, if it flares violently, causes burning pain in the chest on waking, stabbing pain that prevents sleep, a griping, groaning stomach, vomiting and retching along with severe, deranged hiccupping. If the physician wishes to treat it, let it be prepared exactly as told: two sandalwoods without fail, together with nutgrass tuber and fragrant vetiver root, cockscomb grass and cardamom — all six ingredients prepared together, boiled and drunk, not made weak; it settles the heat-humor well and stops the blood [disorder]. Kimhanta and tejo, when they give rise to disease at its very root, bring ruin as great as [a landslide] — vanishing as a deer flees at the sight of a lion.

The seventh and eighth months — these two months, the teachers explain, are reckoned as the kimhanta season on account of tejo and vāyo together; kimhanta and vasanta together on account of the heat-humor, causing the blood to churn and roil within the body. When all four of these factors grow very severe, disease arises in the head, bringing a poison that disturbs sleep; the food that is eaten turns foul, disordered and disturbed; [the patient] grows delirious, losing awareness of the senses, from the affliction of blood and wild heat-humor. The physician [text continues on next page]...

Medical Compendium — 217

To bring quick relief: brapet (บรเพ็ด) and haeo mu (nut-grass tuber); take the root of pak-hom-hin, Thai myrobalan, thon-di-khu, dtin-nok grass, o-cha-chu; also dried kot-kan-phrao alone. When these are prepared and made into a powder, strain it through white cloth; boil sumun-waeng and long pepper into a liquid vehicle. This cures the season's fever when mixed in, relieves headache from wind-disorder, and any evil disorder of the blood — it can quell and extinguish them at once.

In the ninth and tenth months, called the full rainy (wasan) season: if a fever has this as its root cause, it is due to fierce, hardened wind-poison (วาโย), giving rise to a phlegm disease that clings to the chest with great severity — the chest feels weighed down as if deliberately pinned beneath something, the breath grows obstructed in the chest, and various other ailments arise. If the whole body itches with poison, and the two disorders — wind and phlegm — mix together, they become more violent than any other; the physician must at once compound remedies, and not underestimate the ingredients. Take khon-thi-so, seven leaves; Thai pepper, seven; ginger, seven pieces — pound, dissolve in hot water, and drink; this cures the rainy-season fever.

In the eleventh and twelfth months, when the seasons mix and grow more violent, called the sarot (autumn) season, blending wasan and hemant (cold season): if fever arises from wind, phlegm and urine become the key factors, with heat in the chest and breast, heat within the belly and the body itself; disease arises in the chest causing pain and swelling in many places, pain along the very spine as though it were coming loose, and sore throat. Physicians have a remedy for this — be sure to use triphala (ตรีสมอ), trik-kot-kai-khrua in sufficient measure, kot-kan-phrao leaf, neem (sadao) leaf, and garlic in equal parts; make into dried cakes, and when taking, dissolve with hot water or plain water mixed as the vehicle, and drink. This cures the disorders of the sarot season; the cruel wind will be extinguished entirely. Physicians should not slight this — compound it to suit the season.

In the first and second months — these two months being called hemant (cold season) — the water element (อาโป) grows rich and sweet, and the earth element (บิถวี) intrudes to cause hardship. If fever arises from phlegm, headache and blood mixed together appear — a great disorder indeed when it shows, worse than all others — causing pain in the spine and swelling of the waist to occur…

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…great, as though loosening and coming apart at the throat and neck, as if the three disorders (ตรีโทษ) were tearing through the flesh — the physician must think quickly and compound the medicine as is proper. Brapet and haeo mu; pounded milk-vine (นมตำเรีย), quickly gathered; hastily-gathered dtin-krip grass; kaffir lime and ginger — prepare these swiftly, sun-dry and grind into powder, mix with the juice of pouring pekha-bark; add mawaeng-khruea as the liquid vehicle. Taken, this extinguishes disease in the cold (hemant) season.

In the third and fourth months, the sisira season arrives suddenly; the earth element (บิถวี) becomes the root cause and chief lord of disease. Disease arises from blood and wind, headache mixed firmly with phlegm, deranged and aggravated, giving rise to many kinds of disorder — swelling and inflammation occur, both [eyes/ears] fill with foul-smelling pus, rotten blood falls and flows out from the ear canal. The physician should compound a remedy to treat this: take kadom fruit, garlic, phlai, sweet-flag (ว่านน้ำ), yaophani root, tumka called rern-thong, nerapoosi, sansangkarani; pound to a fine powder, then dissolve in ginger juice and drink. To treat trembling, add pepper, nine grains pounded in fully. To treat fever, take dtin-nok grass together with sandalwood of both kinds, boil into a liquid vehicle and pour out — this cures the heat as desired. To treat disordered bile-phlegm, use pomelo juice and som-sa (bitter orange) juice — this cures the disorder of the earth element, that is, of the sisira season. Thus concludes what has been said; the six seasons are now complete.

1. Now to speak of the elements (ธาตุ): derangement is the root cause. When the four elements are full, if aggravated or deficient they become forceful. The physician must examine carefully, as the masters have taught, and it will be explained clearly regarding the mechanism of all four elements: aggravation and deficiency in the mass of elements are without limit, and disorders arise abundantly. Thirteen kinds of symptom follow: lice and scabies arise in plenty, a lingering low fever tends to occur, the belly rumbles and churns, causing bloating and sore throat; stomach pain does not cease, causing foul rotten-smelling blood and pus to pass; stabbing pain in the belly, an aching in the hip as though struck, resembling wasting disease (kasai); and pain within the flesh itself, numbness and swelling, the nails of hands and feet turning a greenish colour. If the physician observes symptoms of fever as described here…

Medical Compendium — 219

…this indeed; one should proceed without fear or hesitation. To purge and treat the earth element (ปถวี): garlic and kan-krao; sadao leaf and good kaphrao (holy basil) leaf; triphala and dried ginger; thepthaaro in equal measure — make into a powder, and it may be taken with pomelo juice or hot water. Disorders without limit can thereby be quelled and extinguished entirely. Also take betel-nut-like sweat-herb (เหื่อเอาอย่างทราย), long pepper and garlic, backed by sakhan and chettamun; young kadom and Thai myrobalan; dried ginger and sweet-flag — grind and quickly form into cakes; dissolve in cattle urine mixed with lime juice and give to drink promptly. This treats phlegm that causes disorder without limit; the sweating stops entirely. Physicians should not disdain or neglect this remedy — it is exceedingly good.

2. One formula: brapet, kaphang-hom, chaphlu; the three kinds of mawaeng; kat-mon root and Thai pepper; also khao-phruan vine and jing-jo bark scraped off — make into cakes with flower-water, and drink dissolved in sandalwood water, spat-drunk. This treats bile that boils without limit; it cures well — do not slight it. Evil disorders are cured entirely, of every kind without limit.

3. One formula: wild pig's gall, thulangkasa fruit, bael fruit added as appropriate, fragrant sattabut, kaphang-hom, bunnak flower, the bark of both kinds of thonglang, pomelo leaf gathered together — dry and grind into powder, then sieve carefully; use hot water as the vehicle. This treats evil blood, watery discharge and pus — every disorder of this kind must diminish and be extinguished.

4. One formula: crocodile hide, much burnt ox hide, freshwater mussel and cockle shell, rhinoceros horn all burnt together, jak-than seeds, long pepper, crisp garlic, haeo mu, myrobalan weighed neither too heavy nor too light — pound into powder and steep in hot water. This relieves stomach pain, paralysis (amphruek), and constipation, treating disorder without limit as described. Of these five formulas, if the patient is not cured, have no doubt — within five days he will surely die, exactly as stated, and this is entirely true.

Now to speak of the fire element (เตโช): when deranged and aggravated it changes thus, with these symptoms for certain — it commonly causes heat at the tips of the hands and feet, as if stung by a catfish, causing a roaring heat like fire within the belly and gut…

220 — Watthana Phanit Press

…like water boiling and surging with heat, swelling of the face and back, and swelling of the belly that will not subside, breaking out in burning, stinging bumps like small pustules all over the body which then sink back in and hide — this should be feared and taken seriously; stomach pain that is not mild, passing of mucus and rotten bloody pus. When a patient shows this, the fire element (เตโช) has become disturbed. The physician must think carefully and prepare the remedy at once: asafoetida (มหาหิงคุ์), long pepper, chettamun, sweet-flag chopped; chaphlu and pepper diligently gathered; roasted sand and thulangkasa; dried ginger and paired mawaeng; ratchadat gathered quickly; bitter, fine-smelling brapet — in equal parts, pound into powder, dissolve in red sugarcane syrup and hot water with rice-washing water added, together with cattle urine without fail — the evil ground-fire will be extinguished entirely.

One formula: asafoetida, one part as the base; sweet-flag, two parts added; chaphlu fruit, three parts; dried ginger in this proportion, as the textbook states; chettamun, six parts; kot-so, seven; Thai myrobalan and long pepper, eight parts each — gather these together, sun-dry, and the physician grinds them into powder, dissolving in cattle urine and licorice water. Taken, this cures disorder of the fire element; derangement and disease are entirely relieved. Physicians should not disdain this — this formula is exceedingly good.

One formula: kot-so, kot-khema, nutmeg, foreign tien (candle-spice), ratchadat, asafoetida, all manner of krung-khema poison, chu-ka-ro-hin abundantly, red crinum lily root truly good, mawaeng-khruea and rak-sawat root, taken with pomelo and lime juice — this cures disorders of the fire element by which divine visions are granted; it removes the disorder of the fire element entirely.

Now to treat the wind element (วาโย): when aggravated or deficient, all such conditions are relieved. Its abnormal, disordered symptoms number thirteen kinds: cramps, aching numbness in the hands, ringing and heaviness in the ears, stiffness along the spine, empty retching and chest pain, stiffness in the knees, swelling that bulges and festers, breath that becomes obstructed in the chest, cold and coughing leading to wheezing and asthma, dizziness and blurred vision — these disorders are due to derangement of wind. When the physician observes this, he should not delay, but compound the proper medicine: long pepper and fragrant vetiver (แฝกหอม), together with sweet-flag and pepper; haeo mu and wan-phrao gathered in equal proportion…

Medical Compendium — 221

…pound into a powder and dissolve with lime juice — the wind element's disorder will subside and be cured. Let the patient take it and not disdain it, as stated above.

1. One formula: bark of the great muk tree, sadot root, langka grass, sweet-flag and pepper, dried ginger, garlic, chettamun, Thai myrobalan and khrai-khruea root — dry, pound into a fine powder, and drink with cattle urine and liquor. This relieves the disorder of the wind element.

2. One formula: asafoetida, sweet-flag, sakhan, roasted sand, long pepper and licorice, kot, ginger and krung-khema — pound into a powder and dissolve in honey; also with cattle urine and licorice, ginger will quickly relieve the disorder of wind, and quell it entirely.

3. One formula: licorice, nat-grass leaf and chettamun, large jing-jo and camphor, tondi root and true long pepper, sweet-flag and sadot leaf, salt — pound into a truly fine powder, and drink with cattle urine and very hot water. This cures the disorder of wind at once.

4. One formula: long pepper, chet-phangkhi, ginger quickly sliced, brapet and hatsakhun, together with pepper and hairy basil, chettamun, kham, asafoetida, sangkarani in equal weight — pound and dissolve without fail, drink with cattle urine and hot water; rice-washing water may also serve. Vary the vehicle as needed, do not disdain it — it relieves both the mild and severe forms of wind-element disorder.

5. Another formula: phak-khrat, radish seed and coriander seed, sakhan and kan-hao herb, together with red shallot and phak-siean-phi, water-spinach and watermelon seed — pound into a fine powder, mix with cow's milk and honey as the vehicle and drink. This cures both deficiency and excess disorders of wind, and extinguishes them entirely; whoever tastes and takes this medicine will be freed of the affliction entirely.

6. One [more] element-disorder, the u-bo type: disorder in great abundance — congestion in the chest, phlegm swirling, blood turned to keh-sang-klon, obstruction of the face and weakness of the shins, tightness in the pubic region that will not ease, the lower belly often forming lumps that rise and fall like balls, passing bloody, festering discharge and constipation, heat…

222 — Watthana Phanit Press

…front and back like sent flame, a yellowing of dried-up flesh, phlegm forming when cold; in men, pain along the right side; in women, painful burning in the chest, pain along the left side that stabs and gives no ease, blood repeatedly disturbed, becoming a recurring fever — this is the disorder of the water element (อาโป) turning severe, giving rise to twelve kinds of disorder. The physician who would treat disorder rooted in the water element should compound the remedy properly, following the texts as to whether the disorder is mild or severe: bark of the great muk tree, young bael fruit, chettamun and pepper, coriander seed and sweet-flag, langka grass and bitter gourd — if fever, add kadom, ginger, jing-jo and long pepper in suitable amount; pound into powder as customary, and dissolve in cattle urine mottled with sa-kae bark. This cures disorder in the water element; derangement and disease will surely and quickly be cured — it is of great and true benefit, as the texts have stated.

1. One formula: jing-jo, together with long pepper, khao-kha tuber, kaphang-hom and pepper, ratchadat and turmeric, shallot and yaa-dam — dry and pound into powder, not too little; dissolve in a suitable vehicle of sugar and cucumber juice. This cures constipation from water-element disorder and relieves it surely, with no doubt; let the patient take this remedy — do not disdain it.

2. One formula: kot-kan-phrao, brapet cut into pieces, cucumber seed kernels, klum bark water and good sandalwood root, young bael fruit and sadot leaf — pound quickly into a very fine powder; take with hot water or liquor. This cures the named disorder of the water element.

3. One formula: trikatuk, myrobalan as stated, triphala and sakhan, together with phlai, galangal and nutmeg, in equal parts — dry and pound into powder, with banana-stem juice as the vehicle. This cures derangement of the water element — taken, it quells and extinguishes it at once.

4. One formula: great jing-jo, trikatuk and haeo mu, turmeric and khao-kha, ratchadat, krachai and phlai, kaphang-hom and brapet, galangal, ta-aeng, and Thai mawaeng, fragrant kadom-jan, together with radish and old sen leaf — in equal parts, dry and pound into powder; drink with muak-water at once. This quells and extinguishes disordered, swirling water element. (End of the Four Elements)

Medical Compendium — 223

Now to speak of the four elements as the three disorders (ตรีโทษ) proceed from their root cause: as they arise and swell, the elements become aggravated and burst forth from the body. The physician should observe that there are many categories — as many as twelve varieties. They cause the chest to retch and become dry, the body to grow stiff like a log; strong-flavoured food, and salt not properly avoided, tend to cause repeated fever; chest pain becomes severe. When food is eaten, within the belly there is a sudden unease, and as soon as one stops eating the stomach burns as if fire were smouldering in the chest; the body grows hot, agitated, and troubled; the belly swells and distends, and bruised, greenish patches appear over the whole body. The physician treating this should take triphala and garlic in full, sweet-flag with hot thong-phrai, phlai, kadom and khonthiso — dry and pound into powder, dissolved in hot water as vehicle, with ginger water to drink promptly. This cures the disorder of the three humors without limit; relief will not be long delayed and will prove beneficial. If it does not cure, do not be angered — within another five days death will swiftly follow.

Now to speak of the water element (อาโป): when it departs from proper regulation of the body, the three disorders become deranged and increasingly aggravated, showing thirteen kinds of symptom: the body itself grows wasted and dull in complexion, sweat is excessive and seeps throughout the whole frame, the face and body feel taut, appetite grows weak, there is heat and agitation of the heart, thirst and chest obstruction, rumbling wind in the belly, craving for things yet easily angered, alternating heat and cold in the chest, recurring fever as if blood were pooling, a foul, bitter taste in the mouth that turns to spicy-sweet — all these disorders are rooted in and reinforced by the water element's three-humor disorder. Whichever patient suffers this, the physician should treat him with compassion, without vexation, and explain plainly, hastening to prepare the remedy: take chettamun, the bark of the great muk and the oily muk, coriander seed, the husk of la fruit, rangka grass, young bael fruit, ginger and senīat root, sweet-flag bulb attentively gathered — pound into powder, add hot water, and give promptly to cure the water-element disorder. If it does not abate within the appointed span, life will surely waste away — within seven days death will come swiftly, in the depth of some night.

Now to speak of the fire element (เตโช): when it departs from its proper base and becomes deranged, the three disorders truly manifest in twelve distinct kinds, causing heat to rise in the belly, the gut and stomach to seethe and churn as if boiling water…

224 — Watthana Phanit Press

…beyond compare; then the hands feel numb as if dying, causing a dry cough within the throat as though hollowed at the chest. When it gnaws through the whole body, it causes emaciation and griping stomach pain, feverish agitation throughout the whole body, the interior burning like a heap of fire, dizziness and dimness of vision, a burning sensation in the gut and frequent faintness, trembling and shaking hands, a burning, twisting sensation as though smoked by fire. Fourteen kinds of disorder commonly arise through derangement and dissolution of the fire element. When the physician observes such symptoms in a patient, he should not delay — the three humors have reached the body, and disease-derangement causes great affliction. The physician who would treat this should take kot-so and luk-en, coriander seed and sweet-flag, together with long pepper and kot-phung-pla, haeo mu and wan-phrao, sakhan and dong hastily gathered, and equal parts of oily muk bark — pound into powder and take with cold water. This will surely destroy the disorder and extinguish it entirely. One formula: chaphlu fruit, jing-jo fruit, chettamun, senīat root and khrai-khruea in plenty, Thai myrobalan and rangka grass, wan-phrao, long pepper and ginger, myrobalan fruit and licorice, kaphrao leaf in equal amount — dry, pound into powder and dissolve. This cures the disorder of the fire element; when taken mixed with sugar, death will not come within seven days, this being certain.

Now to speak of the wind element (วาโย): when its foundation is broken and disturbed, derangement issues from the body just as the three humors, if deranged, produce sixteen kinds of disorder, with symptoms as the texts have gathered: an unbecoming pallor and yellowing, a wasted, sorrowful, dull complexion, a lump congesting the chest within the breast and belly, causing retching after eating, hiccups and empty belching, breathing that grows short, a sweetish taste in the mouth with frequent vomiting, heat in the chest together with pain, itching of the body with red eruptions like the colour of blood, coughing with a wheeze like asthma, heaviness and dimness of face and eyes — derangement of this kind is manifold. The physician who would cure this disturbed and disordered wind should take wan-phrao and pepper, together with haeo mu and long pepper, also galangal and sweet-flag — dry and pound thoroughly into powder, and give with hot water promptly. This cures the wind element's affliction, extinguishing it entirely. If this medicine fails to cure, the symptoms will only increase and multiply; the disease, having taken root, will sap the strength greatly and cause much obstruction; the patient will have no appetite for food, whether bland, oily, or salted — one should not…

Medical Compendium — 225

…be underestimated — within seven days and three watches, death may come. (End of the Elements' Three-Humor Disorders)

Now to speak further of a formula that reconciles the elements at their very root: when the four elements are complete but disturbed and deranged in weakness, this restores them to their former steady state, preventing further cracking or renewed aggravation, and may establish them permanently, [curing] heat, derangement and aggravated change. Take: dried ginger, kot-khema, kot-phung-pla, true kot-chiang, kot-so, black tien (candle-spice), white tien, tien-sattabut, tien-yaowapha, red tien, ripe nutmeg, fragrant nutmeg-mace of the finest quality, sumun-waeng, cardamom, clove, coriander seed, prasan-thong of bright white quality, cinnamon leaf and khrai-khruea, long pepper and fragrant pra-hom, together with khamot — combine, one part (salueng) of each; kot-kan-phrao, two parts; Thai myrobalan flesh only, weighed to one part (baht) — pound into powder, sift, and keep stored in a bottle as described. Taken, it cures accumulated phlegm: in the morning dissolved in ginger water, at midday with perfumed water as the vehicle to cure aggravated feverish headache, and in the evening with galangal water or bitter-orange water to cure wandering wind. To keep the elements permanently balanced, take it every day and night. The Benjakul formula sustains the elements; a deranged element is transformed and soothed, and wind subsides and gradually departs. It cures hiccups and vomiting — noni fruit dripped with honey; a little camphor, not too much, can suppress evil, drying wind; it cures a parched throat — take mapraang fruit as if steeped, soaked in cotton and held in the mouth, moistening the throat and clearing the voice. It cures thirst — jasmine rice; it cures choking that cuts off the voice — garlic and bitter-orange water. It purges the elements when combined with the Benjakul formula, trikatuk, and triphala, cleansing deranged elements. Fig bark and sandalwood, two kinds; take nutmeg-knot paste, apply by fire until it releases its scent sharply; benjakani fruit can cure until fully well; to stop bleeding, senīat leaf; garlic water and black tien poured together, cardamom and kawai given, wood-resin water and camphor taken — this cures fever, ends the heat entirely, and relieves the disease of painful, aggravated headache…

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…both blood and wind disorders will be extinguished and cured. Whoever partakes of this remedy and does not see its benefit will only grow more gravely ill; his own karma has broken off his store of merit — let him chant to steady his heart, and gradually the affliction will lessen. [Formula:] tien of five kinds, two salueng; garlic, one baht, sliced; thepthaaro, five baht; ten sadao leaves; bael leaf, khonthaa leaf, khonthiso leaf, khonthi-khama; trikatuk weighed without stinting; water, one part each — dry, pound and form into cakes. Drink with galangal water without fail; pain without limit in the elements can thus be quelled at once and cured.

One formula to cure the fire element: kabao fruit, wan-phrao, hulangkasa fruit dried, khrai-khruea root and rangka grass, Thai myrobalan and myrobalan fruit, chaphlu root and licorice, phak-phaeo root, fine red [herb], in equal parts, dry and pound into powder. Taken with hot water, it cures the fire element steadily and surely, curing according to intent. Thus the account of the elements is concluded in full.

Now to speak of another matter: the origin (สมุฏฐาน) as the root cause. The Buddha-jewel himself has proclaimed the threefold root of disease: bile (บิตะ), phlegm, and wind (วาตะ) as origins — these three, taken together, are the primary causes of derangement. The Omniscient One spoke, teaching the venerable Girimananda: [when] illness becomes aggravated and painful, causing bodily derangement and suffering, these four kinds of affliction, if they mix together within the same body — external disease, if it becomes deranged according to its cause, is called sannipatika (compound disorder), when phlegm and wind become aggravated together, combining according to their three kinds, is called sannibata, meeting together. Utuparinama is the name for when the three seasons change and turn awry. Visama-hara is that [affliction arising] through action and effort. Opakkamika is dislocation or injury of the limbs. Vipaka is illness arising as the fruit of past karma. These four kinds of affliction are recorded in the Girimananda Sutta, from the mouth of the Ten-Powered One [the Buddha] — physicians should observe them as stated. Of these four afflictions, to recount from the beginning: illness arising in the urinary tract from the bile-origin, [caused by] the season acting upon the body itself, causing derangement and aggravation…

Medical Compendium — 227

…spreads through the body, through such causes and symptoms, as the Sangkhaha [compendium] has recorded — stating the causes that give rise to results in the case of a person, whether man or woman: when a cause becomes aggravated, it will produce an aberrant disease, [shown by] eating hot food and disliking cold food; craving sour things without restraint; taking pleasure in spicy, hot, or fermented-sour foods; often fond of rotten things; often warming oneself by the fire without stopping; often gulping down hot water; often angry at midday; often snoring at night, waking with a start yet still snoring badly; bathing late at night; feeling hot at night and unable to sleep. These ten aberrant signs are signs of aggravation — having thus fully stated the causes, we now turn to the disease itself, that is, disorder of bile. Fifteen kinds of symptom commonly occur. Whoever has this condition commonly shudders with alternating heat and cold, becomes delirious and cannot sleep, tends to vomit repeatedly, has a dry, burning-hot throat, heat at the mouth, nose and excretions, a hot face with sweating, babbles confusedly right and wrong, raves unhappily, tends to drift into heavy confusion and stupor; the eyes become sharp, quick to notice things; the eyes turn yellow, faintly or strongly so; there is dizziness and a burning, stinging sensation on the face, causing restlessness and agitation, and [dryness of] the palate — all these as described. Physicians, have no doubt: this disease causes great affliction. The physician who would treat fever from deranged bile should use ching-cha-cha-li, young bael fruit, long pepper root, haeo mu and dried ginger — place in a pot and boil until well cooked; once cooled, let the patient drink it, and the bile-disease will be cured at once.

1. One formula: bael root, ya-klet-hoi grass and fragrant vetiver, kadom root in equal amount — boil, let cool, and drink promptly.

2. One formula: sandalwood of both kinds, kaphang-hom and a little haeo mu — boil, let cool, and pour out promptly; drink before breakfast to cure it.

3. One formula: ya-klet-hoi grass alone covers a great many [ailments] — boil and drink…

228 — Watthana Phanit Press

…this will extinguish and cure the disease; let physicians everywhere not disdain it.

4. One formula: ya-klet-hoi grass, brapet cut into pieces, ching-cha-cha-li-chin, myrobalan fruit — boil all together promptly. Once cool, let the patient drink it in — do not merely hold it in the mouth. Once relief and healing come, the derangement of bile will be entirely eliminated.

5. One formula: brapet, together with khukha vine and muak root, abundant lotus stamens, and so-root — boil promptly. When drinking, pour off only the liquid, and take it steadily and diligently. This is an especially excellent remedy, for it is said to be very effective. If it does not cure, add ya-klet-hoi grass into the medicine pot as well, to eliminate the disease of bile-derangement and cure headache.

6. One formula: khat-mon root, khi-ka root, phak-khuang, cut vine-tips of khai-yot, phi-suea plant, and ya-klet-hoi grass. This cures fever from receding bile-derangement, as the formula texts have stated.

7. One formula: myrobalan fruit, very good sadao-din, fragrant chalut prepared together as medicine — boil, let cool, and then drink. For a patient suffering from bile-derangement, give this remedy to drink; the evil disorder will be cured entirely, and it cures a hot, peppery-tasting mouth.

8. One formula: licorice vine, fragrant chalut as stated, sadao heartwood in equal amount — boil, let cool, then drink. This cures convulsive twitching; the cure is certain and sure — do not disdain it. The evil disease will be cured entirely, clearing away all impurity completely.

9. One formula: khi-ka root, ya-klet-hoi grass to reinforce it, bitter rattan root and abundant sugar-palm stalk, together with the cut tips of khao-thao vine, in equal amounts — boil and let cool, with honey dripped in as appropriate. For a patient near death, give this to drink promptly, to drive the affliction far away.

10. One formula: sugar-palm stalk, som-o fruit taken by the leaf-equivalent, creeping water-spinach…

Textbook of Medicine Compilation, page 225.

...like Phra Ruang's [remedy of] three [ingredients], tamarind-soaked crushed root, the topmost broken shoot of a trailing vine, together with layered snail-shell grass in plenty — boil it quickly to make it effective; it cures fever caused by bile-affliction, [in which the patient] tends to be drowsy, dazed, raving and muttering, thirsty and irritable, dizzy, with stabbing, twisting pain. If the disease arises from bile in this way, it must not be let run wild; the physician must hasten to investigate and treat with compassion.

11. Another royal formula, called Lokathijara-khun, cures a surging bile-fire that clouds the heart, cures griping pain from sannibat [tri-humor derangement], cures blood-and-wind disorders and fever, cures fainting fits that leave the patient drained — of each ingredient one baht, gadom seed two salueng, together with Rohini-jan, krung-khema, and phang-hom — pound and drink; have no doubt, it will surely take effect at once.

12. One more account tells of seizures: when the patient becomes deranged, foaming and drooling, the illness tends to bring on delirium and wandering, raving, sleeping in fright and startling awake; some instead grow dazed and dull. Give a purgative; if the stool passed is yellow-green, with no awareness at all — if the symptoms are as described, the physician should not hesitate or doubt that it is some other type. To treat: take candle-plant, grasshopper, unhusked rice grain, quickly-gathered mango bark, rotten eggshell, and thep-thaaro, in equal parts; grind them, mix in crocodile bile, soak flowers in a bowl, add camphor when giving it to drink — it cures madness, raving, and delirium; all wandering-mindedness is cured. The aggravated bile-affliction is cured by taking this medicine as before.

13. One part cures diarrhea: take lac-resin, nutmeg as before, gall-nut and benzoin added, mangosteen peel, taboon seed, pomegranate peel, tamarind peel; pound to powder and dry it in sunlight; [take with] pomegranate-peel water — it cures the affliction of diarrhea entirely.

14. Another account concerns the urinary element: cures cramping pain as if burning, making it flow down like water...

Watthana Panich Press, page 230.

...turmeric-colored dysentery, with griping pain, restless sleep, and a tendency toward anger with the mind burning hot — boil the medicine and give it quickly to cure the leaking of bile as described above: fragrant sandalwood, Indian myrobalan, sa-euk root, gadom, of each one baht, boraphet [tinospora] two salueng — prepare and boil down as directed, three parts reduced to one; it relieves the affliction reached, and the disorder of dysentery is cured.

15. One part cures restlessness arising from a certain fence-vegetable scattered about, causing loose, turbulent diarrhoea, causing madness as if insane, babbling with spirits and ghosts, unable even to offer alms for days. To cure it: prepare a medicine of both sandalwoods, krung-khema, kaphang-hom, and Indian myrobalan; put into a pot, set it on the stove, measure with a coconut-shell dipper, strain, and drink a single cup — it clears entirely.

16. One further formula cures the leaking of bile, of two kinds of bile-twitching, tending to bring great resentment, tending to bring deep sleep as if walking a long road and startling as though falling into a pit, causing perpetual illness, [related to] all four sannibat, the sannibat called Phutthayak said to concern the blood. The physician should hasten to prepare: triphala, sandalwood, gadom, betel-fruit, sa-euk root, fragrant sandalwood heartwood, ripe red bitter-gourd seed, and balsam-pear — give it to drink; leaking bile and twitching, and dysentery, are entirely cleared. Let the patient not doubt that the bile-affliction will fail to be cured.

Having spoken of bile, let it stop here — this concludes that section as intended. Hereafter shall be told the matter of wind [disorders] that follows. Let physicians listen, according to the manual of Sarochana, in accordance with the sub-commentary the Lord Buddha himself expounded: the origin of wind-disorders. When the derangement flares up severely, it is in the ninth and tenth months, and marked also in the eleventh and twelfth months.

If wind flares up, in the season of these four months, the affliction craves food that is spicy-hot and astringent-bitter, eating dried meat and dried fish; the mind inclines to such fondness, tends to dwell on pleasures through the long night, tends to speak of sorrowful things, sleeps and forgets...

Textbook of Medicine Compilation, page 231.

...eyes. Eating too much food, until full to the point of excessive belching, whatever is attempted never succeeds at all; the mind grows agitated and scattered, wanting to move on to something else. That wind flares up in the evening: having eaten, in the stomach it churns and digests poorly, wind rises high, stabbing and piercing, rising upward so that one cannot sleep; within the body and in the private parts it becomes a poison-wind spreading everywhere, the skin turns dark and withered, rashes break out over the whole body, stinging and itching fearfully, the body lying rigid like a log. This is because of wind — the vayo [wind] origin extends through thirteen causes and half-conditions. When wind first arises to cause affliction, the physician should examine carefully, applying attention and not being ignorant, clearly recognizing the type of wind — only then does the illness truly manifest, causing derangement when the patient falls gravely ill, shivering through the whole body. Sometimes it causes hunger; sometimes, though strength remains, it dries the throat to dust that seems to blow away, dries the mouth, causes twitching, fever tends to rise into the throat, breathing is obstructed in the chest, sleep is never quite sound, no belching or sneezing though pain persists, causing itching all over the body, aching pain in the chest, the navel and belly feeling hard, able to eat but without strength, food eaten having no taste, speech coming out unintelligibly so that words are unclear, constant unending yawning, tending to feel stabbing pain in the lower body — all these are the afflictions of vayo-derangement massing together. The physician should commit to memory these eighteen symptoms. In one condition it causes madness from vata affliction, as the teachers have said in the Sangkaha text; the symptoms of madness [arise] from the origin according to the sacred word — examine carefully and do not forget, so the two scriptures agree. As stated in the Sangkaha scripture: goosebumps and hair standing on end, causing cold and shivering chill, headache and dizziness, bodily pain without respite, distress and vexation in the heart from stabbing discomfort, unrelenting thirst, swellings forming as lumps and scattering, restlessness of body, breathing in and out obstructed, the eyes and nails turning yellow, and causing coughing...

Watthana Panich Press, page 232.

...it becomes like a cold, the mouth astringent and painful, the jaw stiff and aching, the neck wrung with pain, coughing dry — fifteen such afflictions in all, as the scriptures show. The physician should thus recognize clearly when it is a single primary affliction of wind alone, with nothing else mixed in — only wind, exactly so. One should be bold and clever, preparing medicine to treat wind alone: take cinnamon root, lime root, cha-lood, boiled, mixed with blue-lotus flower and mook-luang; drink it hot with honey dripped in — it cures the derangement caused by wind, causing it to vanish and be entirely cured, following the Sarocha section, as the masters have taught in the medical canon.

1. One part: take kamlang-hanuman, sa-khan-ha, boraphet, khi-ka root, mawaeng and makheua-khuen, black cumin, monkey's-claw fern — all nine ingredients boiled together in one pot; strain and drink promptly, and one feels refreshed at once — the fever caused by wind, with its distress, is cured.

2. One more: take boraphet together with ginger, boil and drink to relieve — cures fever caused by severe wind.

3. One more remedy: cat's-whisker plant, both kinds of mawaeng root, purslane root, boraphet as well, cinnamon root, kamlang-hanuman — equal parts, hasten to prepare and boil, drink warm, do not neglect it — the wind-fever vanishes, the burning head is entirely cured.

4. One more: tri-kadook, together with garlic as the base, take neem leaf for its virtue, in equal measure of all the medicines; dissolve in hot water, drink to cure wind-fever swiftly — measure it out precisely, do not disdain any of the ingredients.

5. One more: non-tai-yak, fragrant hot morunga root, rice-plant root together with salt, a salty preparation, khrok-khok-kasun, dried hot chili-like ginger, chettamun root with long pepper added — equal parts of all the medicines ground to powder, taken as a preparation with hot water — it has very great virtue, disperses wind in the abdomen, relieves distress of chest and heart. Let all physicians remember this.

6. One more: sattaban root, boraphet, neem leaf, mun-luang root, hasten to...

Textbook of Medicine Compilation, page 233.

...take, pound into powder quickly, then take honey and clarified ghee mixed and set over fire, stir together six ingredients — the fever caused by wind is thereby entirely cured. As for the origin: in the first, second, and third lunar months, this concludes the account of [wind]; phlegm tends to be the cause, disorder of the elements working its mischief. In the cold season, disorder causes agitation; physicians should hasten to remember the causes that give rise to the affliction. [The patient] tends to eat hot food with salty, sour, and sweet flavours, delighting in what pleases the palate, fond of aroma, satisfied with things, the mood constantly shifting. Tends to eat at night, taking rice and drink in excess, tends to crave minced raw meat and enjoys eating grilled fish. Tends to dream vividly, dreaming of swimming in a pool, dreams of drinking cool refreshing water, tends to develop unsightly boils on the body, swellings appearing within the body, feeling drowsy and yawning often, tends to sleep soundly and rest comfortably. Phlegm flares up severely, causing this to occur. All this arises as an illness with phlegm as its origin, having as many as 15 symptoms: the body moves with a cold humour through it, goosebumps and hair standing on end, sleeping in a dull, clouded state as the affliction sets in, no thirst, tossing the body about, sensing day and night confusedly, stool that is greenish, and urine that is watery, the complexion pale and dull, without strength or vigour, sweating heavily from the body, tending to feel hot while alone, as if catching cold with aching pain, pleased by nothing at all, the mouth sweet as sugarcane juice — this is the effect wrought by phlegm-affliction. Physicians should understand this clearly and prepare a remedy to treat it: bael root, neem root, true cinnamon heartwood, boraphet, fragrant galangal, mawaeng root together with sweet-flag, neem-earth root, long pepper, black rohini fruit — equal parts, boil down until reduced, strain and drink to cure the phlegm-affliction.

1. One more: gadom fruit, big moke fruit, and kot-so — boil, do not...

Page 235.

...move and loosen. Pour it out and let it cool to warm, then take pepper, pound in a mortar to fine powder, sprinkle into the warm decoction, drip in honey and drink — phlegm will be quelled, lessened, and reduced entirely. Boil these five ingredients and drink; it has very great virtue.

2. One part: rice-plant root, takhlo root, yop-ba root, lot bark, rokfa root, tamarind-soaked seed, ket root — equal parts, hasten to boil and drink; drink to cure fever caused by phlegm; it vanishes with special virtue, and the phlegm-disease is relieved and cured.

3. One more: bael root, turmeric together with ha-mkrai, phak-pot and water-chestnut together, cha-bian root and cinnamon heartwood — equal parts, boil and drink at once; the phlegm falls away at once. This completes the royal formula as given in the Sarocha [section], all the medicine given.

4. One part concerns the origin-story: it tells the tale of how phlegm arises, phlegm becomes deranged, eating at the wrong time causes affliction to change, causing intermittent fever with shivering, causing true chill and trembling in sleep, sometimes with blood passing, phlegm putrefying and causing distressing sickness. The physician, to treat the intermittent fever caused by rampant phlegm, [uses]: mook-luang bark, lam-phan as appropriate, bitter gourd-shell soaked and added, coriander and gadom together with root, stem, and leaf, kheelek heartwood shaved and added — into a pot, boil together and drink; it cures the intermittent-fever affliction of phlegm, the derangement entirely relieved. Other medicines are then given, following in sequence according to the text.

5. One more, to purge the affliction of deranged phlegm: take citrus leaf repeatedly, one handful of each ingredient in full, shallot, kip-thao, priang vine shaved and piled together, and Indian myrobalan as well, in a measure equal to the patient's age — boil three parts down to one and drink, mixed with salt-bile according to the day of the [patient's] element; drink promptly whether the dose be heavy or light — it purges to relieve the phlegm.

6. One part cures dysentery caused by the affliction of severe phlegm-element: gadom seed-kernel, together with gall-nut and nutmeg, ground and mixed with lac-resin and wild honey, resin of the takian tree...

Textbook of Medicine Compilation, page 235.

...betel, both kinds of astringent tin-siat, prasan-thong together with black cumin, tamarind, bitten mangosteen peel — equal measures, pound into a fine sifted powder, insert it entirely into a pomegranate, coat it with clay [wrapped] cow-dung on the outside also, burn it thoroughly with rice-husk fire until the dung coating comes off entirely; grind the medicine with the pomegranate, form into sticks, dry day by day; mix with cassumunar-ginger water and drink — it cures phlegm-sickness, cures putrid blood-phlegm; the phlegm-affliction is entirely relieved and cured. This concludes as recounted the origin-section on phlegm remedies.

Hereafter shall be clearly told the location of the root of disease, the day and time fever arises by three modes: the wind-origin is fixed at a span of seven nights; the bile[-origin] at ten days as its term; the phlegm[-origin] at twelve days. These three origins are the approximate fixed measure. If it passes beyond that — passing beyond seven days, passing ten and twelve — according to the manner prescribed, the disease flares up greatly, without abating or easing at all; the original affliction increases and multiplies, with others mixed in — blood, wind, and epistaxis-humor, phlegm intruding to derange within. If all four afflictions occur together as described above, the condition is termed by the masters a sannibat of a given name. Because it has passed beyond its original span, the affliction may increase to two or three combined, or all four may occur together, and a fatal affliction may result from its turning awry. Because wind and epistaxis-humor arise and intrude to cause distress, phlegm and blood improperly intruding and mixing in this way, it becomes a single or dual affliction, or a triple affliction according to the disease; a quadruple affliction also occurs, and a fatal affliction may result. For this the teachers have said: sannibat is itself the danger. The physician should consider carefully and not regard the root of the disease lightly.

Hereafter shall be shown the affliction of two [humors] mixed together. Physicians should remember, as the scriptures state: the dual affliction of phlegm-and-wind tends to cause distress; the types within the body reach as many as ten conditions. The patient's body becomes damp, with sweat tending to flow continuously...

Watthana Panich Press, page 236.

...pain throughout all the bodily faculties, everywhere without exception, tending to feel constantly as if catching cold, causing heat and disturbance, sweat pouring down drenching the face, bodily strength moderate, tending to have a lingering cough constantly. Such is the type of fever recognized: phlegm mixing in and adhering causes further derangement. The physician should know this as described. If the physician wishes to treat fever caused by wind-and-phlegm, take: kamjai root, nguan-mu root, neem root, together with large phi-suea-yai root, and pan-ngu root — hasten to gather these — thulangkasa seed, cut vine-shoot together with hing bark, mook-man fruit, equal parts, pound together; after taking it, wind-and-phlegm is greatly relieved. It has great virtue, have no doubt — it cures both conditions, causing them to dry up and vanish.

1. One part: ta-suea root, mawaeng vine and makheua-mai together, sticky-rice-seedling root as well, thua-paep root and boeng-pa root; one more: rice-grain root, makheua-khuen root — hasten to find; taeng-nu root growing in the middle of the field, together with len fruit and mook-luang bark — equal parts, boil and give to drink; it cures every affliction of phlegm-and-wind entirely, causing them to vanish greatly — this remedy is very potent.

2. One part: take saek root, and also great banyan-fig, together with khruea-khao-man root, sattaban root and bitter rattan root, ngon-mu and kum-nam root, together with kotso as customary — equal parts, boil and drink; it cures both the wind and the phlegm disease.

3. One account tells of the derangement of bile-and-phlegm mixed together, causing severe derangement; the dual affliction in turmoil causes the illness to worsen and break out. The patient's mouth turns bitter, the body tends to tremble as if possessed, becoming delirious and talking deliriously, tending to feel displeased and joyless, feeling hot for a while and cold for a while, with a tendency to cough. These seven symptoms in all arise because bile-and-phlegm cause them. The physician, to treat this affliction, should prescribe the following medicine: mapraang root, fragrant vetiver, turmeric [two kinds], namnong root, mawaeng vine, makheua-khuen root of a vigorous plant — when taken it will be cured swiftly; use honey as the vehicle.

4. One part: khat-mon root, dried hot ginger together with rattan root, ching-cha-chali vine...

Textbook of Medicine Compilation, page 237.

...take mawaeng-ton root, boil; the dual affliction of bile-and-phlegm — such a type is customarily recognized to be cured, the severe aching affliction relieved. The physician should boil the medicine as described.

2. One more: take gadom, boraphet, ngon-mu-ba, krung-khema together with grass root, and grasshopper — boil quickly; cures fever caused by bile, cures phlegm mixed in, cures vomiting of bile; fever caused by poison, and boils, are cured.

3. One more: Indian myrobalan fruit, tamarind-soaked, together with phibek — cures severe affliction of bile-and-phlegm, cures the eyes' clarity of vision, causing sight to become bright at once, cures madness, relieves distressing sickness, restores the deranged elements to balance, and also cures the disease of prolapse/displacement.

4. One more: take khrin-la, together with long pepper and chettamun root, coriander seed together with white candle-plant — hasten to mix, boil, and give to drink; cures fever of bile-and-phlegm that causes sweat to pour down continuously; a swelling about to rise will surely subside entirely, and the digestive fire will gradually improve.

Now shall be told of the blood, when it becomes deranged and turns acute. The physician must not disregard or neglect this, but should thoroughly know and observe the symptoms: [the patient] tends to be despondent at heart, tends to feel feverish and restless without ease, the mind clouded and troubled, tending to be anxious and easily startled. All these symptoms — one should carefully consider how to treat, the mixing together causing decline day and night, bringing distress. The physician, to treat this, uses: kotso, chulalampha-phen, snail-shell grass, purslane together, together with euang root and neem-tree root — take the cut shoot-tip, hasten to gather and grind to a fine paste, dissolve in cold water and drink — impurity and blood-affliction vanish entirely.

1. One part: butterfly-pea root, moke-luang bark, phak-pot fruit, together with lotus stamen, bunnak flower, mathrang root, sam-sip root and kang-dang-nga, and also priang vine and ya-nang vine — boil and drink; anaemic, discoloured blood is restored and cured...

Watthana Panich Press, page 238.

2. One more: take tham-wok, both kinds of sandalwood together with fragrant vetiver, lotus stamens together, mathrang root, rokfa root, foreign liquorice, equal parts; boil, or [form into] sticks as prescribed, dissolve in flower-water, drink with red sugarcane juice and sandalwood water; cures fever caused by blood-affliction, so that the sticking [malady] is extinguished entirely; give it to drink for thirst, cures poison from spirits, cures lightness of the body, cures fever reaching the triple affliction, and also cures and relieves vomiting, cures heat and cures drowsiness. It is named Sarathijara.

3. One part: take long pepper, triphala, fine phak-pot, klao-tap-marum root, monkey-fruit root and jing-jo-luang — boil, set with honey and drink; entirely relieves the affliction of boiling bile in all its forms, [cures] the wasting sannibat, and cures swelling-disease, causing it to subside lightly.

4. One more, concerning the mixed disease of bile, wind, and epistaxis-humour blended all three together, it becomes a deranging fever: tends to cause thirst, and chest pain occurring at times, tends to cause dizziness, tends to cause restlessness, causes nasal congestion, headache and discomfort, heat in the throat and trembling of the body, together with goosebumps standing on end, giving no cheer of mind, comfort of spirit lasting but a single day. One further point: the whole body tends to ache everywhere, causing intense chill by the thousandfold — such is the fever the masters describe: the affliction of bile turned to epistaxis-humour, together with the affliction of wind massing and spreading. The physician should examine the disease to see it clearly, and prepare medicine accordingly, with the remedy prescribed as follows: take khat-mon root, mawaeng root, euang-khwai-di, boraphet, non-tai-yak — equal parts, boil vigorously over fire, and give it warm to drink; the fever caused by bile-and-epistaxis-humour, together with the severe wind within, will be utterly destroyed and vanish.

1. One more: tamarind-soaked, Indian myrobalan and phibek added, together with ratchaphruek, non-tai-yak, and red khadaeng, lime root — equal parts, boil quickly without doubting; it cures the affliction of bile turned to blazing epistaxis-humour, and the fierce force of massed wind is cured...

Textbook of Medicine Compilation, page 239.

2. One part: ching-cha-li alone, boiled without weakening its strength, dissolved with a coconut-shell measure of water, drink it promptly; cures fever caused by bile-and-wind as is customary, causing it to vanish entirely; fever caused by phlegm is also eased somewhat by this medicine.

Hereafter shall be composed [an account of] the affliction of three humors mixed together — the triple affliction, which is no light matter, blending together all three: bile, phlegm, and wind, massed and mingled to cause this condition — the great sannibat, according to the medical scriptures of old. When the causes of disease all converge together, if there is no physician to treat it, that person will die, because of symptoms such as these: causing heat and restlessness, causing pain throughout the whole body, drowsy confusion without full consciousness, coldness and shivering through the whole body, the face dazed and reeling, causing distress and dizziness; the food that is eaten steadily decreases; the face appears red, plainly like the colour of blood; the colour of the body becomes very red, like blood scattered about; pain in the throat and pain in the head, aching felt throughout, aching that spreads and flares over the whole body without comfort, no desire for rice or fish, wishing only to sleep, the tongue unusually coated, becoming stiff when curled, drooping as if yawning to sleep, alternating hot and cold, the body red and yellow in patches as though painted with turmeric dissolved as dye, the skin cracking as if scorched deliberately by fire, breathing not smooth, both inhaling and exhaling badly obstructed. Whoever suffers such a fever, the affliction reaching the triple [humors] is plainly seen — administering medicine becomes very difficult indeed. The physician should know this as described.

One [kind of] disease arises from six causes as its root: eating at the wrong time and to excess beyond capacity; one, indulging in sexual intercourse to great excess beyond measure; sleeping too much during the day is not good; not sleeping at night; one, being prone to anger, prone to anger; holding back urine and faeces beyond their proper time is a grave fault. If these six causes are scarcely present, disease...

Watthana Panich Press, page 240.

...will not surely arise. The physician should recognize these six causes that give rise to disease.

One more account: eleven prohibitions the attending physician tells the patient to observe. From the very first onset of fever, from the first day it begins, in the evening — not at dusk — the patient is forbidden to bathe, must not apply perfumed substances, must not engage in sexual intercourse, must not scrub or rub the body vigorously causing bruising and inflammation of the body; must not sleep in the daytime; heavy work must not be undertaken; must not have blood drawn from the body, as it is not good; must not shave the head, and must let the beard and moustache grow untidy; must not become angry or enraged; must not sleep exposed to sun or wind; must not eat raw or fatty food. These prohibitions must be observed and not disregarded; do not delight in disregarding the affliction — if observed, the cure will come quickly; but if one clings to stubborn views, disregards and neglects them, death draws near, the affliction worsens and flares up, the disease's calamity multiplies, becoming a fever of double affliction, and a triple affliction will indeed occur. The physician, stating this, tells the patient what must be observed.

One more account tells of the strength of disease among living beings, to be understood: according to the day one is born, the type of affliction [varies] for every man and woman. From the day of birth as an infant up to sixteen years of age, phlegm is turbulent, its derangement fiercer than anything else — this should be known. From sixteen years of age for both men and women up to past thirty, epistaxis-humour and wind become deranged, blood mingling in and acting fiercer than any other disease, nourishing [the body] like a river-stream — the physician should consider this. From thirty until old age, wind [vata] enters and predominates, like a person departing, leading the way as all afflictions come to an end; wind leads the disease, causing derangement and affliction to change. Prescribing medicine according to this schedule is simply the nature of disease, just as described.

One more: the physician should be clever, bold and unafraid, examining with his own insight, so as to be accurate and clear in mind — as for that age, there are three [stages], to be observed according to custom...

Textbook of Medicine, Compiled — 251

From early youth, through middle age, to the last stage of old age: examine clearly what the disease is, and only then compound the medicine to suit. In the first stage of life, an infant of up to sixteen days [old], the patient must not eat sweet, bitter, and sour tastes — keep to a single plain diet, and the disease will quickly cease and settle. It is a disease because phlegm has grown excited and strong and become its root cause; know this clearly and it will quickly cease, through the physician's skill with medicine. In middle age, from sixteen [years] onward, do not eat the full range of tastes — sour, astringent, and sour-salty; dose the medicine to reduce and lessen these, withdrawing rather than adding or filling up further, and the stubborn heat/nosebleed-fever will diminish, and blood trouble too will quickly be cured. In old age, from thirty years until death, forbid eating all things bitter-hot and salty-astringent; say that it is the [element of] wind that becomes excited, and disorder arises properly through the bodily elements. The physician should be skilled and prepare medicine with care and good judgement. Know these three stages well — this is the doctrine as the masters have taught — and the host of diseases will vanish like [a bird struck down] at the sight of a bow.

First, understand this clearly: taste spreads and pervades throughout the body — keep this teaching in mind, listen carefully to what is taught. Every bitter taste pervades the skin. Astringent taste pervades the flesh. Salty taste pervades the sinews and tendons. Pungent and hot tastes pervade the bones without exception. Sweet taste should properly seep into and pervade the large intestine. Sour taste pervades the small intestine. Cool, fragrant taste pervades the heart. Oily taste, in turn, pervades all the joints. Treat accordingly so that the cure comes swiftly. The physician who examines the origin of all diseases arising in men and women: when the infant is of middle stage, the origin is phlegm, which causes disturbance; where phlegm truly resides is steeping among the food within, [rising as] retching at the throat, up through the chest to the crown of the head. The physician should give medicine to purge and induce vomiting, and it is cured.

In the middle stage arises disease from bile, which resides as stated — [the seat of] bile lies above the old food. If the physician is to treat it, [the disease] from blood [and] good bile, with...

252 — Watthanaphanit Press

...use a mild, bitter-tasting fragrant medicine. For the old, on account of Wind, it gathers and settles above the passage of excretion — that is the seat of Wind. If the physician means to subdue it, use a warming medicine — "sukhumo vata vinaso" [Pali: subtle, the destruction of wind] — because a skilled physician sees it as if with his own eyes.

The physician should also examine the kind of place, of which there are three to note, according to where people are born. That is: a person born where the water — fresh or salty — and mud are abundant is said to belong to the "Kanha" [dark] country; disease there arises from phlegm and wind coursing along their paths, stronger than heat/nosebleed-fever and blood combined. The physician should compound medicine to treat the excess of wind and phlegm; when the disorder is [illegible] great, it will subside and vanish quickly.

If instead a person is born where there is gravel, sand, and heaped stone, with little abundant water — take note of this — such a place is properly named the "Sagara" [ocean] country. If the illness there is not from misfortune, it is caused by blood and heat/nosebleed-fever being stronger than phlegm and wind; remember this well. The physician gives medicine to drink that cures the blood/nosebleed-fever ailment.

Further, a person born in a country excellent for its gravel and sand, mixed with mud and patterned stone, with both fresh and salty stagnant water, is named the "common" [Sadharana] country; the type of disease there has a mingled root — mixed together with blood, wind, and good [i.e. ordinary] nosebleed-fever, and also mixed with the fault of phlegm. Every disorder may occur there, all manner of disease may appear, harder still on the body to bear. Knowing these three kinds of country well, prescribe medicine accordingly and it will be cured swiftly. The physician should hold this as a rule, certain that the disease will vanish at once.

The physician should also know fully how to give medicine to a crawling infant; examine the disease at its root, and inspect the complexion of the blood. If the patient's skin is pale, the blood tends toward a good, sweet taste; compound the medicine with pungent, hot, and bitter [ingredients], and it will be cured quickly.

Textbook of Medicine, Compiled — 253

1. If [the complexion is] pale-yellow, the blood is sour; mix in a good deal of salt, and the disease will readily and quickly be cured, since [the physician] knows the correct treatment. 2. If [the complexion is] dark-red, the blood is salty; certain medicines are forbidden in the compounding — have no doubt it will be cured quickly if examined and treated properly. 3. If a person is very dark, the blood very salty, and exceedingly cool beyond measure, then a medicine of sweet taste is fitting, and the disease will swiftly vanish.

Now to speak of the timing of fever, whose nature has its root cause: if the disease arises and grows, whatever hour it flares up strongly — causing pain, causing choking spasms, causing aching according to its nature — the physician should note that hour, for it is the root cause; knowing it as an omen cures the host of diseases so they quickly diminish and vanish, are cured quickly and their benefit seen quickly, because the physician knows the nature of the fever. From dawn until noon, if anything troubles, it is phlegm. From noon until evening, as the light of dusk gathers, it concerns the blood. From evening until deep night, wind blows strongly as is its habit. From midnight until sunrise, when dawn brightens the sky well — such is the ordinary course of the world. So it holds throughout the three [periods] — men and women in this world, young, old, and of middle age alike; the body's constitution remains ever the same, for every man and woman without exception; it is naturally so, uniformly. When disease arises there is disorder, and the elements are made to shift and change, becoming mixed and mingled together — that is when the disease turns and worsens. According to the treatises, disease is of many kinds with many symptoms; to explain according to when it occurs: if from morning until dawn again, it is like the affliction of the thraang [infant] disease, a grievous harm; if the fever proves fatal, it is a most difficult affliction. As a physician, examine carefully, fix the mind upon the time, and knowing clearly, compound the medicine and treat according to the treatises. Let the physician be compassionate toward the sick who come for medicine, and examine thoroughly, so that nothing goes wrong through carelessness. Let the physician examine and attend to the patient...

254 — Watthanaphanit Press

...with great care; do not merely skim over the fine points until dazed, straying and grasping at loose notions. Know the treatises, know the disease; know its fine points as one would know a fine thread. When the symptoms are slight, and one only keeps repeating what medicine [to give] — the treatises tell of disease, both its underlying cause and its type of fever; as a physician do not be complacent, for different fevers can closely resemble one another.

Now to speak of the types of fever: there are three categories, which may vary; they are given the names "primary," "secondary," and "tertiary" fault. If the fever is of the primary kind, caused by phlegm, the texts describe it thus: it causes chills and dread, gooseflesh and shivering, oppression in the chest and drowsiness, inability to eat, weakness and exhaustion; on waking the hands are [illegible] red, the complexion is often pale from faintness and often ashen-white, it causes vomiting and a sweet taste in the mouth — such are the symptoms as described; phlegm is the ruling cause, and one should know it by these signs.

Fever from heat/nosebleed [กำเดา] causes above all a bitter mouth, extreme heat, delirium and raving, headache as if splitting, intense thirst; the eyes and body turn yellow, the face is yellow and faintly red, the mouth, face, and eyes feel tight, the skin chaps and cracks, the poison of the fever dries the body, and one cannot sleep at night. This is the primary type of heat/nosebleed fever; observe it steadily, do not mistake it for another kind — giving the wrong medicine for this fever often causes death.

Fever from blood causes a burning like poison and urgent thirst, headache as if splitting, a red face and faintly yellow body, cracked and chapped skin on the face, meaning dried patches and a bloated belly — the blood becomes turbid and disturbed. This is the primary type as described.

Fever from wind lodged in the chest, as is customary to examine, has these symptoms among all the afflicted: when this fever flares suddenly, wind-in-the-chest is as follows — the essential primary fault: the hairs stand on end and bristle, causing chills and a cold shivering, headache and dizziness, and a tendency to anger, unwilling...

Textbook of Medicine, Compiled — 255

...to be still. It causes distress in the chest, discomfort throughout; one cannot hold the breath, [restlessness] does not let up; the belly forms into scattered lumps, the body is agitated and restless, breathing in and out is obstructed; the eyes and nails turn yellow; a hard, dry cough as with a cold; the mouth feels puckered, the jaw aches severely, the neck aches, and there is a dry cough. Fifteen [symptoms of] this fault, as the treatises describe; the physician should know clearly this primary wind-disorder fault.

Now to speak of the timing of the primary fault, to be examined: from sunrise until three in the afternoon it eases and abates; the fault [continues] into the afternoon until two "thum" [about 8 pm], when it gradually grows light and mild; the third stage, should it turn severe, lasts until the cock crows past the third watch; the fourth stage is called "mortal" — if the hour is missed, do not administer at the wrong watch. These symptoms have their names as the physicians' treatises have noted.

Now to speak of the "dual fault" [ทุวรรณโทษ], being the second [category] that produces fever: heat/nosebleed mixed with wind causes chills while lying down and shivering, headache as if splitting, a feeling of pervasive heat as symptom; one must be sprinkled with water, sweat breaks out amid restless agitation, and dizziness without ease — this nature should be noted by rule; know it well and it will quickly abate, because the medicine is given specifically for it. Phlegm and heat/nosebleed together, this second fault, cause distress: chills and cold, gooseflesh and bristling hair, chest oppression and difficulty breathing, thirst and burning restlessness, sweating and dizziness, headache and agitation — the fault of blood and heat/nosebleed, this "dual fault" as described; examine and explain it clearly, and if it changes it will quickly be relieved.

Then wind and phlegm together cause headache with streaming sweat, continual chills and shivering, and also dizziness from the heat; unable to eat — this fault, if it afflicts, the physician should strive diligently to compound the cure properly.

Then blood and heat/nosebleed, these two faults together, cause a heat like a spreading fire...

256 — Watthanaphanit Press

...headache and restlessness, sleeplessness with delirium; refusing food, though [forced] eating eases it somewhat; a craving for water and frequent thirst — this is the fault caused by blood and heat/nosebleed. The physician should observe it well. [This teaching's] excellent, distinguished merit, its renown ever spreading, its praised virtue never fading.

Here follows the medicine, together with the timing, to be explained: let all physicians' sons listen carefully and attend. For any patient in whom [the illness] flares up strongly with the fullness of suffering, from sunrise until nine in the morning, when it then lightens — this trouble is caused by phlegm; treat and relieve it: take triphala, neem leaf, and ratchaphruek leaf, with a suitable measure of yadam [dark purgative resin], gather and boil, drink in the night; the surging phlegm will, by morning, be lightened and eased.

3. For a patient [whose fever runs] from ten in the morning, easing by noon — this is disordered blood; physicians should treat it: take young bael fruit, together with white sandalwood, nutgrass tuber, hairy-foot grass, dried ginger, ratchaphruek, and mook man bark; this cures the fever from blood disorder at the ten-o'clock hour, curing it swiftly and reliably, as the medicine prescribes.

2. Fever running from afternoon until three o'clock, without doubt, is caused by heat/nosebleed causing suffering, resulting in disorder: take nutgrass tuber, terminalia bellirica fruit, dried ginger, cool fragrant sandalwood, chuk-rok, koht-phung-pla, koht-chula, rak-saniat root, hairy-foot grass, ratchaphruek, and kadom; boil to treat the fever at this hour, and it will surely subside by three in the afternoon.

3. Fever from four in the afternoon until evening dusk, as explained, is the fault of disordered wind; treat promptly with the full remedy: take Thai myrobalan, betel-vine root, dried ginger; for this ailment, long pepper and ratchaphruek boiled and given to drink cure the fever of the late-afternoon hour, arising from mingled wind entirely. Let the physician attend to this, curing the whole of this primary fault as described.

Now to speak of the "dual fault" of phlegm and wind together: the fever comes without a fixed hour...

Textbook of Medicine, Compiled — 257

...through the day it seizes and then subsides by night. [The remedy:] nutgrass tuber, chalom fruit, and fragrant vetiver — do not omit; rak-saniat root added continually; boraphet and young bael fruit, prakhamdi-khwai bark, and white sandalwood carefully measured; katom without stinting; one salueng of each without exception; triphala and sakhan, three salueng of each; sweet cool ratchaphruek flesh, two salueng, all brewed together; treat the fever with two days' abstinence and it is cured quickly, as is customary — named the formula "Pakolari," excellent and reliable at curing this seizing fault.

2. This one is named "Pakola," to be examined by day, curing the fever within a day's abstinence — the fault caused by phlegm and heat/nosebleed together, a most excellent "dual fault" remedy: triphala, dried ginger, dried ginger [again] and ma-waeng vine, boraphet and tamarind, thao-yai-mom and abundant fragrant sandalwood, ratchaphruek leaf for its scent, boiled together with makaa leaf; cures the fever within a day's abstinence — physicians, do not be foolish about it — the severe affliction is relieved, this medicine is truly excellent.

3. This one uses dried ginger, neem leaf, hairy-foot grass, krung-khemao, and fragrant vetiver, ratchaphruek and rak-saniat root, brewed and drunk though bitter; it clears away the afflicting impurity through the recurring days of abstinence; named "Phimpha Thikhun."

4. Named "Atsadangkhuli," as the masters explain, telling of medicine for when wind and heat/nosebleed cause suffering and shift the "dual fault": dried ginger and koht-so, koht-phung-pla and fine koht-chula, thian-kham and lamphan, together with long pepper and white rice-husk peel; boiled to cure both faults, when [the patient] is dull, gloomy, and worsening with pain; cured quickly as described, taken warm morning and evening, steeped and drunk.

5. This one, for heat/nosebleed and phlegm, when the water element adds to the impurity: dried ginger, nutgrass tuber to drink, hairy-foot grass and chuk-rohin, white sandalwood and khi-ka-daeng, tamarind and phlegm-clearing herb of the year, and ratchaphruek leaf — gather, boil, and drink promptly to cure.

258 — Watthanaphanit Press

6. Fever caused by the Fire [Tejo] element causes discomfort of the body's pores/hair; the triple fault turns severe — phlegm, wind, and heat/nosebleed all in turmoil: koht-so and koht-phung-pla, koht-chula and koht-kan-phrao as needed, five kinds of thian gathered together; prasan-thong and wan-nam, dried ginger and khrai-khruea root, myrobalan of excellent quality, long pepper and dark kwao bark, white sandalwood, phimsen [camphor] and musk; grind to a paste and give to drink; it clears away the impurity that has appeared, and it vanishes, easing until fully gone — named "Atsadangkhuli."

7. This one, too, should be boiled promptly, as is customary, as the masters explain: for the triple fault flaring severely with phlegm and heat/nosebleed: take khat-mon root, lotus stamens of Thawai, bunnak flower and nutgrass tuber, hairy-foot grass and khi-ka-daeng, ma-waeng root and thao-yai-mom, together with fragrant sandalwood and dried ginger, coriander seed without fail, triphala and fragrant vetiver, koht-kan-phrao and koht-chula, prasan-thong prepared in full measure; do not skimp on the ratchaphruek; all three herbs and rak-saniat root, young bael fruit placed in the pot to boil; as is customary, treat it promptly and thoroughly — the afflicting triple fault, once brewed and drunk, is entirely cured and vanishes.

8. Also, when the condition of the bodily elements is disordered and imperfect, the excellent formula "Phimpha Thikhun Khun" should be boiled and drunk promptly: take neem leaf, krung-khemao, and fragrant vetiver; koht-chula should be added carefully; hairy-foot grass and koht-kan-phrao, rak-saniat root and kadom, together with ratchaphruek and long bean leaf, dried ginger and phet-sam-hao; boil and drink, and it is cured at once, immediately.

(Here ends the Exposition of the Elements. The volume ends here.)