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Ascent of Haole Medicine

Haole surgery, however, was perceived as generally superior, with metal instruments, instead of bamboo or adzes, for resections, incision, and drainage of abscesses, and the techniques of suturinq and ligature to arrest bleeding and promote wound healing. 79/

Western public health measures replaced the old kapu system, but initially they, too, did not seem any more effective against the devastating contagious epidemics. Key events in this area include:

• In 1836, kuhma nui Kina'u was advised to issue the first public health proclamation — the Honolulu harbor pilot was instructed to screen all foreign-arriving vessels for smallpox and other pestilences. 80/
• In 1850, Kamehameha III created a board of Health, and the first public water pipeline carried fresh water from Nu'uanu Valley to Honolulu harbor to fill water casks. 81/
• In 1854, smallpox vaccination was made compulsory, but three smallpox epidemics followed, the iatest in 1882 82/
• In 1865, a drug law for western medications was passed and the "Hawaiian Medical Society" for haole physicians was chartered. 83/
• In 1859, the queen's Hospital, providing western medical care, was founded by King Kamehameha IV and Queen Emma. It was the first hospital for native Hawaiians, 22 years after the first of seven hospitals had been opened for foreigners. 84/
• In 1862, the first Sanitation Commission was appointed. 85/
• In 1864, burial of the dead was regulated by law. 86/
• In 1865, the first receiving hospital for lepers opened in Kalihi, in Honolulu, with the kingdom's new segregation laws. The following year, the first lepers were exiled to Kalawao on the Kalaupapa peninsula on the island of Molokai. 87/ In 1890, the population of the settlement reached a peak of more than 1,200. There was no satisfactory therapy and the annual death rate varied from 12 percent to 20 percent. 88/
• In 1866, the first insane asylum opened in Palama, Honolulu, with six patients. 89/
• In 1868, durinq the reign of Kamehameha V, a "Hawaiian Board of Health" licensed practitioners of native medicine, but certain rituals of old were proscribed, and no formal training was authorized. 90/
• In 1870, ex-missionary and ex-Prime Minister Dr. Gerrit P. Judd was authorized by the Board of Education to establish the first medical school of western medicine. Two years later, ten young native graduates were licensed to practice haole medicine, but shortly thereafter Dr. Judd had a stroke and the school was closed. 91/
• In 1873, collection of garbage and street-cleaning began in Honolulu. 92/
• In L874, King Lunalilo died of "pulmonary consumption"

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