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Despair: Cultural conflict resulted in disintegration of the old social order. In 1819, despairing because the kapu were no longer effective, the Hawaiians themselves, under the leadership of Kamehameha II, Queen Kaahumanu, and High Priest Hewahewa, formally abolished these strict sacred laws that governed personal hygiene and public sanitation. 70/ Gross pollution of person, home, the land, and water followed, as described and decried by the missionaries and other foreigners. 71/ There was decline of ali'i leadership and stewardship as the chiefs sought material luxury by exploitation of the maka'ainana in sandalwood and other trade with foreigners. 72/

With alienation from the land came disruption of the 'ohana and replacement of their traditional self-reliant, ahupua'a subsistence economy by an urban market economy. The kahuna and 'ohana educational systems disintegrated. New social ills emerged, such as alcoholism, tobaccoism, vagrancy, prostitution, and the malnutrition of processed foods. Finally, there was the perception by the native Hawaiians, preached by the missionaries, of the "superiority" of certain western ways and material culture, compared to native "primitive" beliefs and practices. The stress was too overwhelming for many islanders. Some fled, like an estimated 5,000 out-migrating Hawaiians in 1850. Others despaired inwardly, lost their will to live in a haole-dominated new order that made them strangers in their homeland, as they sought the comfort of death. 73/

Inadequacy of Traditional Native Medicine for Haole Illnesses

In this period of culture shock, there evolved a makeshift, loose health care system for native Hawaiians with the following characteristics.

Although the major gods had been toppled, and the kahuna hierarchy abolished, the kanuna lapa'au remaine underground. These officially disenfranchised kahuna, plus experienced 'ohana elders, and the patient himself, continued to care for "Hawaiian illnesses" as of yore, but with some modifications. 74/

Newly-introduced plants, such as the guava and eucalyptus, were incorporated into the native materia medica. Some western notions of disease and the pharmaceutical action of herbals on body functions were adopted, therapeutic effects that were not mediated by the traditional native concept of restoration of mana. However, there was still some reliance on aumakua, or family guardians, although the senior gods had departed. 75/ As the heiau ho'ola, as well as the other heiau, were destroyed, formal training of kahuna ceased. They were replaced by more self-styled, poorly-trained or untrained "kahuna," many of whom incurred the denunciation of missionaries, other foreigners, and even some native Hawaiians. 76/

"Hawaiian medicine for Hawaiian disease" probably survived because at that time, non-Hawaiian medicine was no more effective. Psycho-spiritual aspects of native medical care merged with new beliefs, such as Christianity, sometimes confusingly so, or were abandoned so that little of the old liturgy found its way into print when the natives learned how to write. 77/

Haole illnesses, such as gonorrhea, syphilis, cholera, diphtheria, measles, mumps, smallpox, and tuberculosis, did not respond to Hawaiian medicine, and since there were too few haole physicians initially to demonstrate that haole medicine was no better, some natives tried whatever was called haole medicine. 78/