A thousand miles on an elephant in the Shan States

by Holt S. Hallett

Polygamy among them is accounted a mark of opulent distinction, and is looked upon as a favour which has descended to them by virtue of good deeds performed in previous states of existence.

The Siamese, according to the same authority, put diseases down to disturbances in the four elements, ahpo (water), lom (wind), dacho (fire), and the earth. Water produces dropsy; wind produces rheumatism, epilepsy, apoplexy, headache, flatulency, colic, inflammation, &c.; fire produces all kinds of fevers, measles, boils, smallpox, &c.; and the earth, by its invisible and impalpable mists and vapours, induces cholera and other terrible plagues. The spirits, both good and evil, have great power over these four elements internally and externally, and can produce a multitude of bodily ailments. The people, knowing that they have accumulated much demerit in their present state of existence as well as for their sins in their innumerable previous existences, feel themselves at the mercy of these spirits, and do all they possibly can to propitiate them.

The doctors use four general classes of medicines to combat the disturbances that are caused by the four elements. These are chiefly derived from the vegetable kingdom, and from such kinds as are indigenous to their country. A small proportion of their medicines are imported from China, and purchased from Chinese apothecaries. Barks, roots, leaves, chips, orchard-fruit, and herbs, constitute the great bulk of their materia medica. Next to these they employ articles of medicine belonging to the animal kingdom, such as bones, teeth, sea-shells, fish-skins, snake-skins, urine, eyes of birds, cattle, cats, and the bile of snakes and of numerous other animals. Lastly, but less frequently, they employ articles from the mineral kingdom, such as stones, saltpetre, borax, lead, antimony, sulphate of copper, table-salt, sulphate of magnesia, and, very rarely, mercury. Besides the above, aloes and gamboge, and a few other gums and resins, are occasionally used.

The dependence of Siamese physicians, in waging war with disease, is more upon a large combination of ingredients in a prescription than upon the power of any one or two of the same. Hence they often have scores of components in a single dose. One hundred and seventy-four ingredients were counted by a missionary in one prescription, which was ordered to be taken in three doses.

They employ their vegetable combinations chiefly in the state of decoction or infusion. A common way of speaking of the quantity of medicine which a person has taken is to say that he has swallowed three, five, or more pots of it—each pot containing from two to four quarts. And a common way of paying the doctor is by the potful, from 30 to 60 cents each. The form of pills is esteemed a more select mode of administering their vegetable medicines; but as these are more expensive and troublesome to prepare, patients are charged more highly for them.

Medical practitioners in Siam are all, with rare exceptions, self-taught, or mere empirics. If a man wishes to try his fortune as a doctor he reads a native medical manuscript or two upon some kind of disease, and quickly ventures to practise, following the directions of the book. If he happens to be successful in a case, or nature has cured the person in spite of his treatment, he trumpets his triumph abroad, and asserts that he has rescued his patient from death; and the Siamese, who, with all their native cunning, are easily gulled in medical matters, credit his reports, and his fame is assured. The ignorance of the physicians is safeguarded by the fact that all the cures that take place in connection with the use of their physic are attributed to it, and all failures to cure are supposed to result from the malicious interference of evil spirits, wizards, witches, or something else beyond the power of human skill to contend against.

Physicians are paid by results; and a bargain is struck to pay so much if the patient is cured, before the case is undertaken. If the doctor appears to have done his best, and has been very attentive, the people, even in case of the death of the patient, evince their gratitude by a valuable donation, as well as by small gifts whilst the patient is being treated. It is very seldom that “a job of healing” is undertaken for less than 8 ticals (a tical is worth two shillings), or for more than 20 ticals. The price may run up to ten or even twenty times the amount of these sums, in an inverse proportion to the reduction of the hope of effecting a cure, as the disease progresses. The pledges given are always verbal; but as there is never any want of living witnesses to attest them, the successful doctor can claim their payment by law, and in case of default of money, goods, or chattels, he may seize any of the family of the patient or relations dependent upon him or her under the age of twenty, and employ the youth or maiden as his bond-slave in lieu of interest of the debt until it is paid.

Over and above the amount of the pledge, the law allows the practitioner to demand in all cases of successful treatment the customary fee, which uniformly amounts to 3½ ticals, equivalent to seven shillings in English money. This fee is called Kwan-Kow Kaya, and is divided, like its name, into two parts. The Kwan-Kow consists of a proffer of 1½ tical (three shillings) in silver, made by the patient or his friends. This forms part of the offering for propitiating the primitive teacher of medicine, the demigod Komara-pat, who is believed to exert influence in the spirit-world over diseases. A wax candle is stuck upright in a brass basin or earthen bowl, and the money is planted in the candle. Then a small quantity of rice, salt, chillies, onions, plantains, &c., is placed in the same vessel, and an incantatory form is recited over it by the physician. No Siamese doctor will enter on the treatment of a patient, however trifling the disease, without paying his respects in this manner to the father of medicine.

The second part of the fee, termed Kaya (literally, the price of medicine), is 2 ticals, equivalent to four shillings, which is the supposed legal cost of the medicines that may be given in the treatment of the case, be it little or much. The law having joined these two parts of the custom together, they must be exacted together. These two amounts remain in charge of the friends of the patient until the physician has worked the cure; and if he fails, he cannot claim the money.

Another legal method by which Siamese practitioners increase their incomes is by acting as priests to the demons who are supposed to cause disease. They take advantage of the universal superstition that the deceased spirits of mankind have power to cause, as well as cure, disease; and that they can be propitiated by offerings. The people credit the doctors with the power to tell whether these oblations are required or not; and for each time that he is at the trouble of making such offerings, he may legally claim, in case of cure, three shillings from his patient. This oblation is called Kraban, and is performed as follows: The doctor moulds little clay images, sometimes of men, women, or children; sometimes of elephants, horses, oxen, or swine; and sometimes of silver or gold coin; and places them on a little float, or stand made of plantain stalk, or leaf. Interspersed among them, he puts a little rice, salt, pepper, onion, plantain, chillies, seri-leaf, and betel-nut, and lights up the whole by placing a small candle on the stand. Thus arranged, he carries it into the street, and lays it down by the wayside; or, if the house faces the river or canal, he sets it afloat, and leaves it to take care of itself. The fee for making this sacrifice is called Soo-a Kraban.