Traditional Cambodian medicine

Traditional Cambodian medicine ( km, វេជ្ជសាស្រ្តបូរាណខ្មែរ, ALA-LC: ) comprise several traditional medicine systems in Cambodia.

Healers and herbalists of Cambodian traditional medicine are collectively referred to as ''Kru Khmer'' ( km, គ្រូខ្មែរ, link=no). There are many regional variations of the practice and herbal knowledge of traditional medicine within Cambodia. Traditional Cambodian medical practices are widely used in Cambodia.

Even though health is among the Cambodian government's five most important issues, the healthcare system in the country is inadequate and people in more remote villages in the provinces have difficulty obtaining health care. This situation is reflected in many developing countries and, in part for this reason, the World Health Organization (WHO) is promoting the use and preservation of knowledge of several traditional medicines in many of these areas across the globe, including Cambodia.

Because of the ethnic Chinese and ethnic Vietnamese populations of Cambodia, traditional Chinese medicine and traditional Vietnamese medicine are also practiced and represented in the country.

Techniques and culture

Practitioners of traditional Cambodian medicine are called ''Kru Khmer'' (or alternately ''kru khmae'') (គ្រូខ្មែរ) meaning "Khmer teachers", and the teacher-student aspect between practitioner and patient is of central importance to the consultation. ''Kru Khmer'' specialise in several categories, such as bone setting, herbalism or divining. Various animal parts, minerals and tattoos are sometimes involved.See ''Kru Khmer'' (p.52 f) in ''Medical Identities''. In the framework of traditional Cambodian medicine, the supernatural world can both cure and cause illness and therefore the definitions between what is medicinal and what is spiritual is often blurred.See the TRAFFIC report.

Khmer traditional medicine share with Chinese traditional medicine three explanatory models of disease: supernaturalistic theory, naturalistic theory, and maintenance of a hot-cold (yin-yang) balance. Four forms of therapy are delivered by medical and para-medical personnel: spirit offerings, dermabrasion, maintaining hot-cold balance, and herbal medicines.

The knowledge of Khmer traditional medicine is mediated from teacher to teacher. Each ''Kru Khmer'' answers to his individual teacher, called ''Kru Khom'', through a spiritual connection, even after the death of his ''Kru Khom''. There are intricate rules and rituals involved in this relationship.

Khmer traditional medicine used to rely on written texts, or palm-leaf manuscripts, since the 9th century, stored and studied at the many temples across the former Khmer Empire. However, during the Cambodian civil war and the following Khmer Rouge regime, virtually all historic scholarly texts and philosophical literature in Cambodia were destroyed, including many Khmer medical manuscripts.

To understand the profession and practice of the ''Kru Khmer'' in more detail, the profession may be divided into a number of sub-classifications, each tied to a specific method, affliction of attention and/or service provided.

* (or ) ( or ) means "medicine combiner" and comprise traditional herbalists.
* (or ) ( or ) means "broken" (or "bone connector"). These are bone-setters using various herbal concoctions in bandages.
* () are diviners and fortune-tellers. Methods range from astrological charts and mantras to herbs and blowing ().
* () means "charmer" and these ''kru khmer''s makes "love medicine" or charms to be used for general luck.
* () are diviners with permanent access to some special spirits. They are supposed to divine the course of certain diseases and sometimes use herbs too.
* () are sorcerers said to cause illness or inflict evil upon people. Broadly despised and feared in traditional Cambodian culture and viewed as evil themselves, no would admit to be or practise . To cure evil inflicted by one would need the help from a , , or a Buddhist monk.
* (or ) ( or ) meaning "body enterer", are possessed spirit mediums, often female. They are able to perform diagnosis or exorcisms.
* Buddhist monks plays a role in the practice of traditional Cambodian medicine, as they perform exorcisms, mostly preventive exorcisms.
* () are midwives who, under the guidance of a personal spirit, performs nursing and ritual assistance for mother and child during and after delivery.

Individual ''Kru Khmer'' healers may perform several roles altogether.

History

The exact origins of traditional Khmer medicine (TKM) remains unclear, but it is believed to have been founded and formalised from the Nokor Phnom period (Funan era) to the 9th century, during the Angkorian period."''History of medicine''", by Prof. Iv Chan, p.70-76, published in 2010. It is influenced by Ayurveda (traditional Indian medicine) and traditional Chinese medicine. These foreign frameworks and practices were mixed with local beliefs and superstitions to create the foundations of TKM. The temple of Neak Poan is believed to have been the central temple for Khmer medicine during the Angkorian era. Jayavarman VII, who reigned c.1181–1218, ordered the construction of 102 hospitals ('halls devoid of disease' or ) throughout his realm.

Khmer inscriptions investigated by French archeological researcher George Cœdès in the early 20th century, confirmed the existence of 15 hospitals (out of Jayavarman VII's 102 hospitals) across the kingdom. Those 15 hospitals are:

Inscriptions in these hospitals describe the number of medical staff and their different roles such as hospital managers, drug combiner staff, water boiler staff, drug grinders and drug distributors. An inscription in Sai Fong has become the most renowned quote of King Jayavarman VII: ''"Diseases of the people make him more painful than his own illness."''

Prasat Chrey ( Khmer: ប្រាសាទជ្រៃ) and Prasat Lek 8 (Number 8 temple) ( Khmer: ប្រាសាទលេខ៨) are temples in Sambor Prei Kuk that were previous hospital chapels during the Chenla era. Inside the hospital chapels, ground or smashed traditional herbal medicines extracted from plant trunks, roots and leaves were mixed with purified water. The drug liquid was then poured over a Shiva Linga to enhance the effectiveness, after which it flowed from the Linga base through the outside part of the chapels via a drainpipe connected to the north side of the buildings. Here, patients, who were waiting outside the hospital, finally received the drug liquid.

The knowledge and practice of TKM was written down on palm-leaf manuscripts, written in the pali language, and stored in temples all over the empire. Most of these original Khmer medicinal manuscripts are thought to have been destroyed in the Cambodian civil war, but some still exists and they represent some of the most reliable sources to the origins of TKM.See "''Cambodians and Their Doctors''", p.129-33.

Surviving ancient Khmer medical texts shows a considerable systematization of medical knowledge, but an institutionalized Khmer medical system with associated doctrine-based practices, did not survive into the modern age in Cambodia. Scholars and historians have long wondered what happened to this grand medical tradition and the 13th century is considered a crucial tipping point in the history of traditional Khmer medicine. The gradual decline of the Angkorian Empire and the religious shifts to Theravada Buddhism appears to have affected the original medical culture greatly. The Siamese conquest of Angkor is not thought to have destroyed the medical traditions, but rather appropriated the medical knowledge and preserved it as Thai instead of Khmer. The French colonial era is also thought to have affected and prevented the rise of the ancient Khmer medical tradition. Unlike India for example, where dialogue and knowledge exchange between initial colonialists and Indian doctors took place, the colonial presence beginning with the 18th century in Cambodia was almost instantaneous and the French demanded and relied upon Western medicine from the very start, abolishing the local Cambodian medical traditions altogether. The following independence and warring upheaval of Cambodia during the civil war, the Khmer Rouge regime and the Vietnamese occupation, all continued this suppression of medical traditions, in particular the spiritual aspects. This centuries-long pressure fragmented the Khmer medical tradition, sometimes with local reinventions emerging.

Historically, three sub-categorizations of the ''Kru Khmer'' profession have been noted: ''kru pet'' ( Khmer:គ្រូពេទ្យ), ''kru thnam'' and ''tmup''. ''Kru pet'' were the most revered and theoretically educated. They studied the palm-leaf manuscripts in temples and were mostly found around the royalty's residences and temples, less so among the general population. ''Kru thnam'', who were herbalists without much interest in religious aspects, were much more numerous and to be found throughout the country. ''Tmup'' were sorcerers. These general categorizations are still in use in Cambodia today, but the ''kru pet'' class is nonexistent.

Notable Kru Khmers

''Kru pet'' hermits have always been glorified and venerated in the Khmer culture for their kindness of saving human and animal lives. Statues were made to pay respect to ''kru pet'', like the hermit sculpture on Phnom Santuk mountain, and hermitages or temples dedicated to ''kru pet'' were built such as Maha Rusey ( Khmer: មហាឫសី) hermitage on Phnom Da

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