The objective of this article is to study the philosophical aspects of local wisdom in the properties of Thai traditional medicine. Through the ancient document, Thai medical manuscript and the interview with the local guru, it is concluded that Thai medical manuscript reflects two philosophical ideas. The first one is materialism which confirms the idea of four basic elements (earth, water, wind, fire) as the components of human body. The second one is pragmatism underlining the practical dimension to investigate any medicinal herbs and to create “five-medical integration principle” as well as various kind of medicine.