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signs of nutritional deficiencies, such as rickets and scurvy, are apparent in the osseous materials. 17/

Evidence of metastatic cancer to the bony spine has been seen in one pre-contact specimen, 18/ but no obvious cases of neoplasm were described in Cook's journals.

Trauma from accidents or intentional violence was probably the most common class of ailments, as recorded in writings, 19/ and as observed in skeletal remains. 20/ "Poisoning" may have been due more to psychic effects 21/ than to direct pharmaceutical toxicity, because the pre-contact islands apparently had no lethally poisonous plants. 22/ The only type of chemical self-abuse known in old Hawaii was "kava debauchery," described among some ali'i in Cook's journals. 23/

Mental illness was described in the form of two natives who were "wrong in their senses" in Cook's journals. 24/ This single passage contrasts with frequent other references to the islanders being "social, friendly, hospitable, humane," "blessed with frank and cheerful disposition," and "mild and agreeable, not easily excitable," 25/ which support the views of subsequent foreigners that the natives were adept at coping with stress. 26/

Congenital-hereditary disorders were apparent to Cook's men in a young man "born with neither feet nor hands," another "born blind," and two dwarfs. 27/ Four cases of club foot were found among the 1,117 precontact persons buried at Mokapu. 28/ The described defects were probably related to inbreeding. The survival of these malformed natives beyond infancy counters the later claims by missionaries that infanticide was traditional and widely practiced. 29/ Cook's journals record the Hawaiians as being "totally unacquainted with [Tahitians'] horrid custom of destroying their newborn infants." 30/ The natives prized physical beauty and practiced body molding of the infant and child. 31/ Some degree of infanticide of the severely deformed newborn may have been practiced, but there were no illegitimate births in the modern sense, and generally every child was he pua (a flower) to be cherished, assuring continuity of the heritage and race. 32/

Medical Beliefs and Practices

Health and illness were another example of the all-pervading dualism of the early Hawaiians' belief system, like sky and earth, sun and moon, male and female, mind and body, and life and death. 33/

Wellness was maintaining mana, quantifiable energy, which was both inherited and acquired. Proper balance of mana was promoted by harmony with oneself, with others, and with the gods and nature, through continuous communication with the spiritual realm and correct thought and action. 34/ The kapu (taboo), established by the kahuna (priests), sanctioned by the ali'i, and enforced by all, fostered self-discipline and responsibility in personal hygiene, health-promotion, illness-prevention, public sanitation, and respect for nature, which was the domain of the gods. 35/ Illness was loss of mana from dysharmony, such as from violation of a kapu, offending a god, or ill-thinking. 36/

The elderly were esteemed. Death after a meaningful life was welcomed as a reuniting with one's ancestors in the eternal spiritual realm and completion of a recurring cycle of rebirth and transfiguration into kinolau (non-human forms) or reincarnation into other human forms. 37/


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