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Medicine Amongst the Maoris, in Ancient and Modern Times

Incidence of Disease

page 95

Incidence of Disease.

At the present time, the various diseases are as common as amongst the Europeans or perhaps they are more common. Maoris are prone to fall victims to the miasmatic diseases, phthisis and pulmonary affections. Whether there is a racial susceptibility, it is difficult to say. The opportunity for spreading, the environment, inadequate treatment and lack of taking means to prevent sequelae, all tend to make these affections more serious amongst the Maoris. All these disadvantages would have to eliminated ere we could come to any decision as to racial susceptibility. Ceteris paribus, I consider the Maori a worse patient because of the easy manner in which contra-suggestions take affect. I give a few extracts from my health report of 1908 to Indicate roughly the incidence of disease amongst the race. from the returns supplied by medical officers and two dispensers in the Auckland, I compiled the following.

Males Females. Total.
Class I. Specific febrile or zymotic diseases.
   Order 1. Miasmatic diseases. 91. 78. 169.
   Order 2. Diarrhoeal diseases 70. 61. 131.
   Order 3. Venereal diseases 8. 2. 10.
Class.2. Parasitic diseases 18. 25. 43.
Class 3. Constitutional diseases 45. 29. 74.
Class 4. Local diseases.
   Order 1. Nervous system. 18. 16. 34.
   Order 2. Organs of special sence 42. 33. 75.
   Order 3. Circulatory system. 13. 1. 14.
   Order 4. Respiratory system 165. 114. 279.
   Order 5. Digestive system 86. 76. 162.
   Order 6. Lymphatic system 7. 3. 10.
   Order 7. Urinary system 6. 6. 12.
   Order 8. Reproductive system 2. 39. 41.
   Order 9. Locomotor system 1. 1. 2.
   Order 10. Integumentary system 50. 36. 86.page 96
Class 5. Violence. 78. 23. 101.
Class 6. Ill defined. 22. 10. 32.
722. 553. 1275.

Miasmatic Diseases, formed 13.25 % of the cases. Of these influenza, whooping cough and measles were the most prevalent in the order named. It depends however upon the epidemic constitution of the year. In some years scarlet fever has been very prevalent. Though there is still a high mortality when epidemics prevail, I am confident that in many districts the death rate is considerably lessened owing to more care being exorcised in keeping the children warm and attending to diet. The old system of universal bathing as a panacea for all the ills that Maori flesh is heir to, is now with the spread of education, happily becoming only a matter of interest only to the ethnologist who studies the past. Infection from the pharynx with subsequent otitis media is very common in the scarlatinal and measles outbreaks. Typhoid is not nearly so prevalent since the institution of health regulations. Apart from danger of contamination, the most serious danger in typhoid outbreaks is the diet. When the patient experiences the keen hunger of the third week, it is hailed by the Maoris as a sign of recovery. Whatever food the patient asks for is provided with fatal results.

Diarrhoeal Diseases contributed 10.274% of the cases. They were largely made up of two outbreaks in the Whakatane district which were due to dietetio errors in eating bad fish. The remainder were mostly young children who were improperly fed.

Venereal Diseases, Which have been such a scourge since their introduction into the country by the Europeans, are on the decline, making only 0.784% of the cases. It is a peculiar thing that whereas I have seen several cases of general paralysis, hemiplegia and paraplegia with a definate history of syphilis, I have never yet seen a case of locomotor ataxia amongst the Maoris. When we remember how widespread syphilis page 97was a few years ago and that the treatment was purely local, we expect to find the para-syphilitic affections more common and locomotor ataxia amongst them. Owing to the fact that many of those suffering from venereal troubles do not go the doctors, the % of these diseases is much higher than the figures above would indicate.

Parasitic Diseases are also decreasing. They form 3.372 % of the cases. The custom of sleeping together and sharing the family blankets has been conducive to the spread of scabies and pediculosis. Hydatids seems to be confined to the South Is. Were the hordes of Maori dogs to become infested by the taenia echinococcus, the disease would be spread amongst the Maoris.

Constitutional Diseases form 5.803 %. Rheumatism supplies the largest number of cases.

Phthisis returns were 22 cases, or 1.725 % of the total cases seen. The change in environment has allowed phthisis to make great headway. The crowding together in single rooms aids its spread. There is no doubt that the lapse in the sanitary regulations and conditions, with the change in clothing, food and work, brought about by the first contact with the Europeans, made the conditions more favourable for tuberculosis, which was kept in check by the open-air active life of the old-time Maori. The privations and starvation owing to insufficient food cultivated which followed the waikato war helped to disseminate the seeds of disease in that district until it became very widespread.

The terraced hill tops the former home of the fighting Maori, with their trenches and ditches, were practically sanatoria, whilst the constant work in procuring food, and the training in military efficiency, led to the development of a fine physique which, with the fact that very little time was spent indoors, enabled them to resist the bad effect that the bad ventilation in the houses might have produced. We can therefore understand that, though the disease existed as the records page 98of several families show, it was held in check by the conditions of life in former times. The dislocation of environment, together with the lack of incentive to work and to indulge in physical exercise, has reacted by deteriorating the racial physique.

The figures that I have at my command would show that the weak spot of the Maori is his chest. Diseases of the respiratory system give 21.882 % of the total cases seen. Of these again about 70 % consist of bronchitis. The miasmatic diseases with accompanying bronchitis are not counted in this. Dr.*Still gives the path of infection of the tubercle bacillus as through the lungs in 63.8 % of his cases at the Great Ormand St. Childrens Hospital. When we remember that the common mode of infection is by the bronchial glands which are inflamed secondarily to catarrh of the bronchi or alveolus, we will realise how prone to tubercular infection are the Maori children who suffer so much from repeated attacks of bronchitis. The predisposing effect of measles and whooping cough, which are so prevalent, owing to lack of care is a more serious matter than with Europeans. In the gum-digging industry in the North, with bad huts in the swamps and constant working in the wet, there is a large number of cases of phthisis.

Cancer. Amongst the constitutional diseases only two cases of cancer are found, one of tumour of the pyloric end of the stomach which is marked as probably cancer, whilst the other is of the uterus. I have been struck with the comparative immunity of the Maoris from this disease.

Local Diseases.

Diseases of the Nervous System. furnish 2.6 %, but they are mostly of a minor nature. The absence of locomotor ataxia has been mentioned. Modern civilisation whilst affecting the respiratory system of the Maori, has not yet damaged his nervous system to any extent.

* Diseases of children Goodhart and Still

page 99

Diseases of the Special Sense Organs, give 5.882 %. of 75 cases, conjunctivitis furnishes 34, discharge from the ears 12, and mastoid trouble 4.

Diseases of the circulatory system, give 1.098 %. Of 14 cases, valvular disease supplies 8 cases and varicise veins 3. In my own experience the position should be reversed.

Diseases of the Respiratory System, supply by far the largest number of cases. They are comprised as follows:-

Disease Male Female Total
Nasal catarrh 28 14 42
Laryngitis 1 - 1
Bronchitis 111 82 193
Pneumonia 8 9 17
Pleurisy 3 3 6
Empyema 3 - 3
Asthma 10 5 15
Others 1 1 2
    Totals 165 114 279

Of these, brinchitis is the most common commencing from infancy upwards. The percentage of 21,882 leads us to plead for the introduction of breathing exercises into the schools.

Diseases of the Digestive System, give 12.705 % of cases. Dyspepsia constipation, gastritis, gastro-enteritis, and enteritis are the more common in the order named. Appendicitis gives only one case, whilst gastric ulcer is absent from the list. There is no doubt that lack of suitable dietary in many cases aggravates the condition. The failure of the potato crop is the cause of much trouble. The Maori is also showing a tendency to depend too much upon tinned foods. The large number of Maoris who work on the Northern gum fields do not cultivate vegetables, but subsist upon flour and tinned meats.

Disease of the Reproductive Organs, furnish 3.215 % but owing to the natural timidity of women these figures are too low. Over half the cases consist of trouble with the menses, in the majority of cases due to ignorance or carelessness. Whilst the Maori is not si badly off as the European,page 100is not so badly off as the European since "the genius of the Maori language transforms many topics tabooed by the somewhat irrational European, and allows the Maori to speak sensibly and rationally upon them", there is much need for the useful laws of physiology to be taught in the secondary girls' schools and in the parental home.

Diseases of the Lymphatic System, furnish fewer cases in the figures that my own experience would lead me to expect. Tubercular diseases of the glands of the neck are very common, and the scarring was known as "kakihura", and was stated to run in families.

Urinary and locomotor diseases furnish few cases, though tubercular bone disease is more common than the figures would indicate.

Disease of the Integumentary System, give 6.745 %. Of these, eczema impetigo and ulcers furnish the most cases in the order named. Impetigo, or hakihaki, is described in English text-books and would go to disprove the idea that the disease is monopolised by the Maori, as so many seem to think when they raise scares of the prevalence of "Maori itch" as they term it. When it finds its way into a newspaper, as happened last year, it tends to convey a false impression. As Dr. Fraser-Hurst* says, "Maoris like Europeans, have a range of skin affections, and the trouble about a popular scare is that people will not learn to discriminate between individual cases."

Children. Of the children examined by me at Taupo, the heights weights, teeth, and condition of the throat and naso-pharynx were particularly noted. The examination of the naso-pharynx gives some interesting results.

Adenoids. Dr. Harry Campbell has laid stress upon the unnecessary prolongation of pap feeding as a cause of this trouble, the normal development of the bones of the face being checked by the nonuse of the masticatory muscles. As a preventive measure, the encouragement of masticatory efforts, by giving infants after the eighteenth month, a piece of fat bacon, chicken, fish or mutton once a day is advocated in order that the teeth, jaws, and naso-pharynx may be more thoroughly developed. Now in the

* Report to chief Health Officer

page 101case of the Maoris there was no prolonged pap feeding and children were early given fish, fowl and food, which necessitated their using their masticatory apparatus. Here then is the condition advocated by Dr. Campbell and if his argument is correct, the number of cases of adenoids amongst. Maori children should be small. This is fully borne out by the examinations made. In Maori children the teeth and jaws are well formed, the palate wide U shaped and low, and the naso-pharynx roomy. This was in great contrast to European children attending the same schools where the palate was narrow and high, the teeth crowded together and often over-lapping, and the naso-pharynx small. I could only find three % of adenoids amongst the Maori children whereas it was present in five out of the ten European children examined. The figures are significant:-
Tasmania 64.28-41,55 %
London Schools (Kerr) 44.3 %
Maoris 3 %

The racial factor may of course have much to do with it, but I think the early masticatory efforts in aiding the development of the bones has, as Dr. Campbell says much to do with the small percentage amongst Maori children.

Tonsils. Tye pharynx was much cleaner than with European children and the per centage of enlarged tonsils small. There were 14 %, out of which only 5% had both enlarged. This is a great improvement upon Kerr's figures for the London Schools, 73.7 %. Certainly the Maoris have the great advantage of living in the pure country air.