Ka Wai Ola - Office of Hawaiian Affairs, Volume 1, Number 7, 1 September 1984 — He Mau Ninau Ola [ARTICLE+ILLUSTRATION]

He Mau Ninau Ola

Some Health Questions by Kekuni Blaisdell, M.D.

This I2th eolumn begins he mau pane (ansvvers) to he mau ninau (questions) frequently submitted, for whieh mahalo a nui to you po'e heluhelu 'imi (inquiring) readers). Q.Why were our people of old, before the haole eame, so healthy, vvhereas even now I read we Hawaiians have more sickness, in spite of modern haole medicine? Maybe we should go back to Hawaiian medicine. Pehea la? A.You are pololei (correct) in your two basic premises. According to available evidence, ka po'e kahiko (the people of pre-haole Hawai'i) were, in general, remarkably healthy. However, they were not entirely free of ma'i (ailments) as some writers have claimed. The spectrum of their maladies and some responsible factors will be further considered below in this month's eolumn. You also correctly infer that keia wa (today) we po'e Hawa'i (Hawaiians) have the vvorst heakh profile compared to the other lahui (ethnic groups) in our homeland. Auwe. The reasons are complex and shall be analyzed in detail in next month's eolumn. A return to some forms of lapa'au Hawai'i (Hawaiian medical practice) applieable to particular current heakh problems of our po'e will also be assessed in a later article. Accounts of the heakh status of our kupuna (ancestors) were first and most reliably recorded in the journals of Capt. James Cook in 1778-79. The natives were then described as "above middle size. . .strong, muscular. . ,well-limbed and proportioned." Fatness was rare and seen only in a fevv elderly women. The islanders were said to "walk gracefully, run nimbly and are capable of great fatigue." Sports, especially swimming and surfing, attracted women as well as men and ehildren. What varieties of ma'i (sickness) did they have? Infections? Metabolic disorders, like ma'i pu'uwai (heart) disease), kokopi'i (high blood pressure). mimiko (diabetes), or lumakika (arthritis)? Any ma'i 'a'ai (cancer)? Allergies like hano (asthma) or hives? A'alolo (nerve) or lolo (brain) disorders? Drug addiction? Congenital or ma'i ho'oilina (inherited) defects? The answers are "definitely no"to most severe infections, "definitely yes" eoncerning the other main classes of ma'i, and "probably yes" with respect to most specific ma'i. However, most of these ma'i

probably occurred in lower frequencies and certainly under different circumstances then, as compared to now. Trauma. such as wounds and fractures from accidents or v iolenee, were probably the most eommon class of major disorders. In regard to infections, because Hawai'i had been isolated so long from the rest ol' the Pacific and the world for perhaps over 500 years, our island kupuna were free of, and lacked immunity to, the epidemic ma'i lele (contagious infections) that were the scourge of the large continents. Capt. Cook's men brought the germs of ma'i hilo (gonorrhea). kaokao (syphilis), ma'i 'aiake (tuberculosis), and probably some viral infections, like the eommon cold. Not long thereafter, other foreign ships brought eholeia, measles, mumps, inlluen7.a, pneumonia, meningitis, typhoid, smallpox, diptheria, bubonic plague, and ma'i pake (leprosy) On the other hand, ka po'e kahiko did have some focal infections, such as "boils," described in Cook's journals. A few cases of focal bone infection extending from dental caries the abscesses are evident in he mau 'iwi kanaka (human bones), now housed in ka Hale Ho'ike o Kamehameha (Bishop Museum)alterunearthing from pre-haole burial sites at Mokapu, O'ahu. These 'iwi also provide evidence for metabolic gouty lumakika (arthritis), deforming osteo-arthritis. one case of cancer, inherited clubfoot and healed fractures. Cook'sjournals referred totvvodwarfs, a young man without hands and leet, and another said to have been born blind. Two natives werethoughttobe "wrongin their senses." "Kava debauchery" ('awadrinking addiction) among some ali'i was the sole example ol what we would now eall drug abuse. We have no conclusive documentation of atherosclerotic heart ("heart attack") or brain disease (stroke), kokopi'i, mimiko, kidney failure, chronic lung failure or hano among the people of old. However, these ma'i probably occurred to some degree because these ailments are widely prevalent among us po'e Hawai'i today, and genetic factors seem to play a role in their occurrence. Specific factors responsible for these ma'i in old vs. modern po'e Hawai'i will be discussed in next month's He Mau Ninau Ola. Meanwhile, e mau ha'awi mai i mau ninau ola, ke 'olu'olu (please continue to send in your health questions).