The Palm leaf manuscripts are seen as documents that preserve the cultural heritage of the people. In that respect, palm leaf manuscripts have been maintained by the Eastern Tamil people for a long time. These palm leaf manuscripts can be classified into three types; literature, medicine and astrology. Literary palm leaf manuscripts include Ammanai, Drama etc. Palm leaf manuscripts related to astrology contain information such as Similarly, medical palm leaf manuscripts contain much medical information. It is noted that a medical palm leaf manuscript was discovered for in the East recently. This study is intended to introduce the structure, medical information and herbs of this palm leaf manuscript. This palm leaf manuscript has solutions for many ailments such as headaches, asthma, cough peenisam, pittam and rheumatism. There is also information on the preparation of sanjeevi legiyam. Neem, Milk, Honey Basil, etc. have been identified as having high Medicinal properties.