Ka Wai Ola - Office of Hawaiian Affairs, Volume 1, Number 10, 1 December 1984 — He Mau Ninau Ola [ARTICLE+ILLUSTRATION]

He Mau Ninau Ola

(•■■•■•■■•••■•*•(«•■■■■ •••■■■•■• ■■••■■■•••■•••*■•■•■■■•••■■*•■■•••■••••■ ■••••« Some Health Questions

by K.ekuni Blaisdell, M.U.

Q: E kauka, I was disappointed in your eolumn last month. I thought you would write about Hawaiian medicine. My Tutu cured my cousin of TB with watercress and 'alaea. Please print directions for such a cure. A: E kala mai(pardon).

Pololei no'oe (you are correct). I did not include medicinal plants in my references to Hawaiian medieine last month, so I weleome your ninau. 1 do not know of a leko (watercress)-'alaea "cure"for ma'i 'aiake (tuberculosis). However, 1 do know a man, whom 1 shall eall Mr. L., who told me three years ago he had used such a preparation fora mea ma'i(patient) who was alleged to have ma'i 'aiake. 1 am sending you Mr. L.'s name and address so that you may ask him directly for details. The reasons for my indirectness should become evident as you read on. Mr. L. told me that his patient recovered from kunu (cough) and piwa (fever). However, he could not give me information on the chest X-ray, skin test, and sputum examinations of his mea ma'i before and after therapy, or whether such a "cure" had been demonstrated in other patients with proved ma'i 'aiake. This case illustrates differences in concepts of disease and management with changing times. We po'e Hawai'i (Hawaiians) need to become more ma'a (experienced) in these matters. In times of old, before the first foreigners eame in 1778, there was no tuberculosis in Hawai'i nei. Therefore, there could not have been treatment for ma'i 'aiake before Capt. Cook, and any "Hawaiian medieine" for this contagious disease must have been postCook. We know that on Aug. 29, 1779, six months after his departure from Hawai'i, Capt. Charles Clerke, who succeeded Cook as expedition eommander. "died of consumption whieh he had been laboring under ever since he left England." ("Consumption" was one of the old names for TB because the disease appeared to "consume"the body). We presume that Clerke. and perhaps others of Cook's seamen, introduced this infection to our nati\e kupuna, for not long thereafter, numerous cases appeared among po'e Hawai'i. I say "appeared," but we should bear in mind that in the living person, the diagnosis of TB, until the late 1800s, was based on a non-specific combination of progressive kunu, usually with bloody sputum, and body-wasting, with oeeasional piwa. and changes in lung sounds by physical "\laori," from Pg. 6 Kaua'i and stay with kumu hula Roselle Bailey and with Hokulani Cleland. Mueh has been done to foster ties between the two cultures. Many Hawaiians will eall them "cousin". Indeed. the cultural similarities are many. Office of Hawaiian Affairs delegates were hosted in the Waikato area in a cultural exchange a few years

examination. Using these diagnostic criteria, ma'i 'aiake ("lung-eating sickness") became the leading cause of death among us po'e Hawai'i. Until modern times, no lapa'au (treatment) was regularly effective. Numerous therapies were promoted. These ranged from tea, coffee, tobacco, aleohol and opium, to vomiting, purging, bleeding, blistering, high altitude, fresh air, exercise, rest and varieties of foods and medications. In Hawai'i with the overthrow of na kapu in 1819, the official abolition of the kahuna system, the destruction of na heiau, the traditional 'oihana lapa'au (Hawaiian medical profession) went underground. Ancient Hawaiian medicine was ineffective against haolediseases, suchas ma'i 'aiake. Haole medications were thought to be effective, but they were difficult to procure from abroad, and were too pipi'i (expensive) for na maka'ainana. As most haole medicines were also derived from plants, native medical practitioners used newly-introduced shrubs, and especially food plants, like leko (watercress), mixed with conventional 'alaea, to treat serious haole illnesses like ma'i 'aiake. Since the course of tuberculosis was often fluctuating, those who felt better, even if briefly, were hastily termed "cured." Those who worsened, went on to other therapies. In recent years, we have learned that any treatment, if it is not harmful, is more effective than no treatment, as long as the patient wants to get well, and he seeks treatment from a trusted person who also wants him to get well. This is the "plaeeho effect." Although non-specific, it is significant, and it probably accounts for most of the "successful," non-specific "cures" of the past, and some even today. In 1882, eight years after King Lunalilo died of presumed ma'i 'aiake, Koeh in Kelemania (Germany) discovered the bacterial cause of tuberculosis, and devised methods for confirming the diagnosis by staining and culturing the bacillus from infectious material, such as sputum from the lungs. In 1907, detection of the dread disease was further simplified by the tubereulin skin test. Bv 1936, mass chest X-ray filming permitted screening for TB, identifying many victims who had no symptoms. Finally, the discovery of streptomycin in 1944, provided specific and truly curative antituberculous drugs, so that ma'i 'aiake is now readily controlled onee it is diagnosed. Thus, given a patient with clearly-documented ma'i 'aiake, 1 am obligated as a licensed M.D. to prescribe the most effective agent for this dangerous illness. Leko-'alaea is not such an agent, and that is why I cannot "print directions for such a cure." ago. Kenneth Brown's Project Waiaha has also spearheaded exchanges. Recently, the Princess T omai of the Waikato people completed hula studies with the late hula master, Maiki Aiu Lake and her daughter. Coline. Word has been received here that Ariki Nui, Te Atairangikahu, of Waikato. has named her granddaughter after beloved ali'i. Princess Po'omaikalani

Kawananakoa. Many would ask: Why go to New Zealand for answers? The danger would be for us to pattern ourselves after the Maori. However, both of our cultures are fighting for survival and a resurgence of our traditions. With mutual support, we ean better foster and grow in our Hawaiian spirit, 'ike, na'auao, and energy. Aloha kakou e na mamo o Hawai'i! Here is our opportunity to open our hearts to a people who have often opened up their marae and homes to us as travelers in their aina aloha.