They believe that medicine has power to counteract the deranged elements, and restore them to a healthful equilibrium. The origin and practice of medicine they believe to have been supernatural. Their medical books declare that the father of medicine was so privileged, that wherever he went, every individual member of the vegeto-medical kingdom was sure to summon his attention, and speak out, revealing its name and medical properties; and since the days of miracles have passed away, the science is only now to be acquired by following closely the original medical books.
They have four classes of medicines, each calculated to counteract the disturbances caused by each of the four elements. The modus operandi of each individual class is supposed to be as various as the specific diseases. For instance, medicine for wind in the head is quite different, and acts differently from medicine for wind in the bowels. A sternutatory snuff, a wash for the head, a patch or plaster, may dispel the wind in the head, whilst it will require a carminative to allay the storm in the bowels. It is believed that wind of every kind may not only be expelled from the body by way of the esophagus and rectum, but also by the pores of the skin, and all the secreting organs of the body. It may hence be drawn off by suction; as cupping, poultices, bleeding, and scarification. They also attempt to drive the surplus wind from one part of the body to another part where it may be wanting. If the disease arise from a deficiency of wind, they try to raise an artificial breeze in the system by appropriate medicines. Giddiness is supposed to arise from a deficiency of wind blowing upward upon the brain, and the upper part of the skull becomes a vacuum. They consequently fill the stomach as full as possible with food, and put the patient to bed, and he will awake quite well. If there is a want of heat, they produce artificial heat; and if there is too much, they employ a refrigerating treatment. If there is too much water, they try to draw it off by drastic cathartics. In all their treatment they employ opposites.
Their medicines are derived chiefly from the vegetable kingdom, and from those kinds too which are indigenous to their own country. Some few articles are brought from China, and sold by the Chinese apothecaries. Barks, roots, leaves, chips, fruits, and herbs, constitute the great bulk of their materia medica. They also employ some articles belonging to the animal kingdom, such as bones, teeth, sea-shells, fish-skins, snake-skins, snake's galls, urine, birds' eyes, &c. They have also a few from the mineral kingdom, such as stones, saltpetre, borax, lead, antimony, sulphate of copper, table salt, sulphate of magnesia, and rarely mercury. They have a few gums also, of which aloes and gamboge are the chief.
But few articles of the vegetable kingdom however, escape enlistment in the war against disease. They depend more upon great combinations, than upon the power of a single ingredient, and consequently scores of kinds, or ingredients, often figure in a single dose. Dr. Bradly says he has seen one instance in which one hundred and seventy four ingredients were employed in one prescription, and the whole to be taken at three doses. The work of preparing medicines is therefore onerous. Vegetable combinations are used chiefly in a state of decoction or infusion. They frequently speak of a patient having taken four or five pots full—a pot holding from two to four quarts. They knew nothing of tinctures until European physicians came amongst them, and they are slow to adopt them.
After such a system, it may readily be supposed that their physicians are in keeping with it. They are wholly self-taught, or, more properly, untaught. They have nothing like medical colleges, or a system of medical discipline. They are like too many in our own country who rush into the study of medicine without a sufficient literary or scientific education upon which to base a medical education, and thus prostitute a noble profession. Without a correct knowledge of their own language, they read a few of their medical manuscripts, and start out for a patient, following the manuscript very closely in their treatment. Should they get a patient who is pretty sick, and he recover in spite of their treatment, their reputation is made. The reputation once made seldom wanes, for the physician's tongue helps him out of a great many scrapes. If he loses a patient, the spirits or some other insurmountable object have always been in the way.
It is seldom however, that a man professes to be a general practitioner; they turn their attention to specialities. One will be renowned for fevers, whilst another will have a reputation in cases of small-pox. The Siamese physicians are held in great esteem by the people, an esteem but little less than that offered to princes and nobles, but of a different kind. That given to the latter is a kind of servile reverence, but the former is a true esteem. They have two general classes of physicians, viz., the royal physicians and the people's physicians. The former class are appointed by the King to practice in the palace, and amongst the princes and nobles, and receive a small salary from the royal treasury. The latter class are self-appointed, and receive no regular salary, but depend upon their fees for their living, and as a general thing make it pay better than the other class. A common physician of reputation is frequently promoted to be a royal physician.
They have also another kind of doctors who profess to cure certain kinds of diseases by shampooing and manipulating. They are well versed in the locality of the muscles, tendons, and blood-vessels. They gently press these points, and when one is tired and weary, it has a soothing effect, and produces sleep, and in some diseases it may prove beneficial. I have found it very beneficial at times of great weariness and lassitude.
The common physicians are always employed by the job, and always on the condition, no cure no pay. Sometimes, if the disease is chronic, and but little hope of recovery, they stipulate to pay a certain sum in case of an alleviation of the disease, and so much more in case of a permanent cure. A bargain is always struck by the patient himself, or by his friends, before the physician takes charge of the case. Sometimes, if a doctor sees his patient is going to die, and he be the loser, he will take "French leave" without giving the friends any notice whatever of his intentions. Generally however a more honorable course is pursued, and the doctor gives up the patient, and releases the friends from all obligations, and they are at liberty to call another doctor. The physician is thus changed frequently, several times before death or recovery, each new one putting in for a higher bid. They have also a kind of domestic water treatment, by copious bathing, which in many cases is far more beneficial than their nostrums.
They are also great people for recipes, and many of the temples have these recipes inscribed by scores upon the walls, and upon little marble tablets, for the benefit of the poor, and all others who wish to use them. The king frequently makes merit by having these recipes thus inscribed. The following one for small-pox, will serve as a specimen:
"One portion of conch-shell; two kinds of aperient fruit, one portion of each; two kinds of sour leaves, one portion of each; one portion of asafoetida, one of borax, one of ginger, nine kinds of pepper, including the hottest, a portion of each; four kinds of cooling roots, a portion of each; one of an astringent root; four kinds of drastic cathartics, including the fruit and leaves of the croton plant, one portion of each; one of rhubarb, and one of Epsom salts. Boil in three measures of water until it be diminished to one measure of the decoction. Then squeeze out the oily parts, dry, and pulverize. A woman may take the weight of thirty cents in silver, and a child may take the weight of seven and one-half cents in silver. It will purge off everything in the bowels."