Nhsc-v1-102

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nhsc-v1-102

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Diagnosis was determining the mechanism of loss of mana through psycho-spiritual communication, interviewing of the patient and his 'ohana (family), and physical examination, 38/ Treatment was restoring deficient mana through ritualistic communication with the psycho-spiritual realm of the gods, supplemented by special foods, secretly formulated herbals, physical therapy and limited surgery. 39/

Medical care for the commoner was the responsibility of the patient himself, and, if necessary, an experienced 'ohana elder. Only if the illness were serious, and expensive professional fees in hogs could be paid, did a maka'ainana engage the fastidious kahuna lapa'au (priest physician), rigorously trained at the heiau ho'ola (healing temple). 40/ The ali'i had regular access to varieties of specialty kahuna lapa'au whose rituals and practices were elaborate and extensive. 41/

The Hawaiians' autopsy observations, 42/ use of the clyster-enema, 43/ and emetics and cathartics 44/ provide evidence of beginning experimentation and scientific reasoning not found elsewhere in Polynesia. 45/

This highly-refined, holistic and preventive health system, harmoniously integrated in their social fabric, with nature about them, and their spiritual realm beyond, was never to recover from the impact of western ways.

Contact (1778 to 1893)

Depopulation

Infections: in January 1778, the arrival of the first foreigners, Captain Cook and his seamen, brought medical disaster in the form of the veneral diseases, mainly gonorrhea and syphilis, tuberculosis, other common contagious bacterial viral illnesses, as well as alcohol, gunfire, and otner forms of disrespect for the kapu, the gods, and nature. One year later, in March 1779, when these first, visitors departed, the natives could see from the sick and dead about them, that "the sliding way of death" had begun. 46/

In 1804, the diarrheal epidemic of ma'i 'oku'u (probably cholera or typhoid) killed perhaps 15,000, 47/ and convinced Kamehameha the Great that the gods did not favor his military invasion of the island of Kauai. 48/

Subsequent sporadic "catarrhs and fevers" took other lives, so that by 1820, when the first missionaries landed, the population estimate of 150,000 was half that at the time of Cook, about 40 years previously. 49/ Other outbreaks of disease occurred as follows:

  • In 1824, Kamehameha II and his sister-wife Queen Kamamalu died of measles in London. 50/
  • In 1824-1826 and again in 1832, epidemics of cough (whooping?)and measles killed thousands of

natives. 51/

  • In 1839, mumps killed "great numbers" including Kina'u, kuhina nui (regent), daughter of Kamehameha the Great, and mother of Kamehameha IV and V. 52/
  • In 1845-1849, epidemics of measles and pertussis and then diarrhea and influenza left over 12,000 dead. 53/
  • In 1840, the first case of leprosy in a Hawaiian was detected. 54/ In 1865, because

of the alarming spread of this fearsome malady, a new

-p102-

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