Neak Poan, meaning entwined or encircled serpents, comprises a large main square pool that once flowed into four smaller peripheral square pools. In the middle of the central pool is a circular temple island encircled by two nagas whose intertwined tails give the temple its name. The connected pools represent Water, Earth, Air and Fire. The Khmer believed soaking in these pools would balance the elements in the bather, and in doing so, cure ailments.

Originally water flowed from the main pool through canals covered with carved stone block pavilions. These canals poured out of ornamental spouts into the adjacent pool. The spouts were carved in the shape of heads of an elephant, human, horse and lion. The elephant faces north representing Water, the human faces east representing Earth, the horse faces south representing Air, and the lion faces west representing Fire.

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