Siam: Its Government, Manners, Customs, &c.

by N. A. McDonald

CHAPTER VIII.

THEORY AND PRACTICE OF MEDICINE

When we consider that amidst all the light which the latter half of the nineteenth century sheds upon the subject, the theory and practice of medicine amongst western nations are still enveloped in darkness, and are constantly changing, it is not to be wondered at that a nation like the Siamese is almost wholly in the dark upon such a subject. The Rev. D. B. Bradly, M.D., the oldest missionary in Siam, and who for many years practised medicine in Bangkok, has prepared an abstract of the Siamese "Theory and Practice of Medicine," which was published in the Bangkok Calendar of 1865, and from which the abstract which I shall give at present is mainly taken.

The Siamese believe the human system to be composed of four elements—water, air, fire, and earth, and that disease is simply a derangement in the proportions of these elements. They believe also that all nature is constituted in the same way, and that the elements without, are continually operating upon the elements within the body, producing health or disease. For instance, if fire from without enters the body in undue proportions, it will derange the healthy equilibrium of the same element within, and will produce one or more of the diseases into which fire enters, such as fevers, measles, small-pox, &c. Each element is supposed to have its season of influence to produce disease, just as the fruits of the earth have their seasons. Their medical books, and common parlance, both say that in such and such months, wind produces most disease, and in such and such other months, fire produces most, and so with all the other elements. The internal elements are also supposed at certain times to become deranged from causes wholly internal. For instance, one of their theories in regard to apoplexy is, that the internal wind blows from all parts of the body upon the heart, with such force that it is often ruptured, and death immediately ensues. The other theory is, that the wind has fled, and left a vacuum in the upper story, and it must be forced back again, if a cure is to be effected.

All diseases are produced either from an excess or diminution of one or more of the four elements; and, according to their theory, wind produces more disease than any, or all of the other elements combined. If you ask any Siamese what is the matter with him, in nine cases out of ten, he will answer, "Pen lom"—it is wind, or disease produced by wind.

Their theory also teaches that all vital motions of the body are primarily produced by wind taken into the system by inhalation, as wind enters a bellows, and proceeds to the heart, and the heart by its expansions, invites it into the body, and then, by its own power it passes to all parts, and is the approximate cause of all internal circulation.

There are two grand divisions of internal wind, viz., that above, and that below the diaphragm. Strictures in the chest, headache, epilepsy, and apoplexy, are produced by wind beating upward. Colic, flatulency, inflammation of the bowels, &c., are caused by wind from above beating downward.

It is seldom however, that disease runs its course without involving two or more of the other elements. For instance, in case of a common boil, the wind first drives the blood from all quarters into the locality of the disease, where it stagnates, being invested by wind. Secondly, the water from the blood consequently settles in that place, as water in a tea-kettle before the fire is applied. Thirdly, the internal fire having nothing to drive it away, acts upon the water, and heats it to scalding. And, fourthly, the earth, inclusive of the crassiment of the blood, which had stagnated, and other solid matter in the locality, become diseased from great heat, and are consequently decomposed and melted down into matter. Anasarca, or general dropsy, belongs to the water-class, and is produced by the watery parts of the blood settling under the skin, and among the muscles, causing the parts to puff outward. But water is not the sole cause; there is also a diminution of fire. If fire had been present in due proportions, it would have dried up the surplus water, as the sun dries up the dew.

In the hot season, heat from without combines with heat from within, and produces an unhealthful degree of heat in the body, and causes disease of the fire-class. In the rainy season too much water is absorbed into the system, filling intensely the natural vacuum in the upper part of the head, and produces disease of the water-class. The earth produces disease through her mists and vapors. Cholera is supposed to arise from this source.

They also believe that spirits, good and evil, have great power over the elements, and have much to do in producing disease. They are consequently held in continued dread of them, and use every means to propitiate them. They never start on a journey, or enter a forest where fevers prevail, without first making an offering to the spirits.