Medicine Amongst the Maoris, in Ancient and Modern Times
Part III. — The Present Condition of The Race
The Present Condition of The Race
The census has been taken from time to time by the Government, but owing to the many difficulties besetting the task, the earlier ones can only be taken as approximate. The numbers given are:-
It will be seen that owing to many causes already mentioned, the population in 1871 fell as low as 37,502. The last census taken in 1906, shows that there has been an increase. Though many are disinclined to accept the increase to the full extent that the figures would seem to show, it can at least be assume that the rapid decrease of the earlier decades of European contact, have been stayed. If the present population is compared with that of over ten years ago, it is an undoubted fact that the population has materially decreased. There are tribes and sub-tribes sadly diminished in numbers and the number of dwelling houses in the villages has lessened. But if the present is contrasted with the last few years, then I am confident that, whilst a few villages still show a decrease and others are practically stationary, the majority show a steady if somewhat slow increase of births over deaths. People are apt to think of the fine old chiefs whose deaths cause large assemblies to gather and to forget the children whose numbers are increasing. Though the adult population may be less, this is more than compensated for, from the numerical standpoint, by the increased number of children.
The factor that change of environment has played in the causation of disease has been mentioned. The primary biological conditions of food and. housing have been materially changed. The present village sites in many cases are unsuitable and sufficient attention to subsoil draining has not been paid. Buchanan's researches have shown that phthisis has a definite relation to damp and retentive soils. The moisture and contamination of the soil also bears upon the causation of diarrhoea, rheumatism, enteric and other diseases which now attack the Maori to a great extent.
The original unfloored dwelling houses when situated upon a high, dry, well-drained site, was immeasurably superior to the same type of dwelling on the site mentioned above. The method of sleeping on the floor has its evil effect. The crowding together of several families into a common sleeping house with little or no ventilation, leads to the ready dissemination of disease. Dr. Mackenzie* has noted the effect upon children of overcrowding and the improvement in physique as the number of rooms in the houses increase. Until recently all the Maori dwelling houses were of the one-roomed variety. Since the establishment of the Health Department great attention has been directed to improvement of building site and house construction. The ancient materials consisting of various grasses and flags have been abandoned in favour of sawn timber. Here again there was a source of danger in that many of the houses were built without being properly finished and lined. They were cold and draughty and often inferior to many of the old rush houses. These imperfections are being gradually corrected.
Through lack of sanitation the surface wells were often contaminated and enteric was endemic in many villages.
The change of food, seems in one direction at all events, to have affected the race. In examining the skulls from burial caves and battlefields, one is struck with the marvellous soundness of the teeth. Though many are worn down almost to the alveolus through page 90chewing hard substances, there is little sign of actual decay. Amongst the present generation however decayed teeth are common and the Maoris themselves realise that their teeth are not so good as those of their ancestors. But they have not yet reached the degree of decay prevalent amongst the Europeans. Amongst the children attending the Native Schools and varying in age from 5 to 15 years, I found in the Taupo district that 40 per cent had absolutely sound teeth.
* The Medical Inspection of School Children. by Leslie Mackenzie.
In the feeding of infants, ignorance in the preparation of the European feeds results in a high infant mortality. Patent foods and condensed milk are used now where the mother's breast was the only source of nourishment in ancient times. Patent foods and even mixtures of flour and water are often used with the mistaken idea that being European foods they are superior to the mother's milk..
The use of flannellette and other unsuitable material is prevalent. The proper adjustment to the changing seasons has not been mastered by many. Sleeping with the clothes on and neglecting to change when damp and wet are still sources of danger to the health.
Physique of the Race.
The physique of the Maoris was greatly admired by the early navigators and settlers. It is to be regretted that anthropological measurements were not made to enable us to contrast them with the present and prove whether physical deterioration has taken place as a result of civilisation. Early settlers and the elder Maoris unite in asserting that deterioration in height and physique has taken place. They say that the number of tall athletic looking people so common in the early days are now scarce, but then the people as a whole are less in number. We are faced by the same difficulties that presented themselves to the Royal commission on Physical Deterioration in England — lack of data.
Accounts from Native sources give the height of some of their ancestors as seven, eight and nine feet but these giants have never been discovered in burial waves. Dr. Thomson* who saw a great deal of the Maoris estimated their height as 5ft. 6¼in. but his work contains so many inaccuracies that I do not consider his estimate correct. It is too low. Youths of 15 at the Native Schools return an average height of 5ft. 5in. and as the height if the boys from 10 years upwards exceeds that of European children, I am inclined to think that the adult Maoris on an average were as tall if not taller than the adult Europeans. In this they would only be complying with the racial standard, anthropologists returning the height of the Eastern or brown Polynesians as a little below that of the Patagonians. Thus in Richet's "Dictionnaire de Physiologie".
I hope later on to set up anthropometrical standards for the Maori. At present I give Measurements taken from Maori school children in the Taupo district together with some taken at St. Stephens School, Auckland. About 200 were measured and I give page 92the figures for what they are worth. They are compared with measurements taken by Dr. Purdy of European boys at Auckland schools and with Tasmanian figures.
|Age.||Tasmania.||N. Z. (European)||Maori.|
|7-8 yrs.||3ft.-8.05.||3 .10.|
|12-13 yrs.||4ft.-6.35.||4ft.-9.||4 .10.|
It will be seen that N.Z. boys, European and Maori, are taller than Tasmanian boys. In N.Z. itself the European boys are taller in the earlier years but at 12 the Maoris surpass them.
Maoris are supposed to have longer bodies and shorter legs than Europeans. Exact measurements are needed. Whilst I think that proportionally this is true, the appearance is exagerated by the greater development of the Maoris In the buttocks, thighs and calves.
* New Zealand by Dr Thomson.
|5 - 6||381bs.||-||431bs.|
|6 - 7||43.5||-||49.|
|7 - 8||47.||-||53.|
|8 - 9||51.3||-||60.|
|9 - 10||55.3||-||68.|
|10 - 11||59.8||70.||76.|
|11 - 12||66.1||77.||80.|
|12 - 13||70.6||79.||84.|
|13 - 14||78.4||87.||103.|
|14 - 15||82.3||98.||116.|
|15 - 16||93.7||110.||128.5|
From the above table it will be seen that Maoris are far heavier than Tasmanian boys and considerably in excess of N.Z. boys who live in the same country but have advantages which should make them heavier, if the racial element had no influence upon weight. At the ages of 10 and 11, when the N.Z. boys are taller the Maoris are heavier. That the difference in the older ages is not due entirely to superiority in height, is shown by the fact that the Maori boy of 13 whilst 5ft. in height weighs 105 lbs. whilst the N.Z. boy of 14 and of the same height 5ft. weighs 98 lbs. or 5 lbs, less than the Maori. The Maori boy of 14 whilst 1.75 inches shorter than the European boy of 15, weighs 6 lbs. more. I cannot see what makes the difference except race.
In physique, the men may not reach the chest and arm development of the most muscular Europeans, but on the average the muscular development of the loins, thighs and lower leg are much superior.
The woman are much heavier than European woman. Some tribes such as the Whanganui would be little, if at all, inferior to the men in weight.
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.
|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.|
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 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 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.
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
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:-
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.
* Report to chief Health Officer
|London Schools (Kerr)||44.3 %|
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
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.
The greatest factor which retards the progress of the Maori in health matters, is the influence of the past. Though every tribe is under the influence, more or less, of Christianity, though tapu and makutu do not loom so large upon the horizon and there are Native Schools throughout the land, the Maori has not altogether divorced his mind from the terrors of the past. The parents and grandparents of the present generation, are influenced by the teaching and current opinions held in the days of their youth. They were taught that certain diseases which afflicted the Maori had a purely Maori etiology. Though Rewharewha, Karawaka and many diseases were introduced by the European, there are others again which afflict the Maori only. The mana and tapu of the ancients has not been altogether obliterated by the invading White man. The European bible and the God of the missionaries though accepted, have not been entirely successful, as yet, in ousting the Maori 'atuas.' Though the ritual and ceremonies of propitiation have vanished, the fear of the gods of disease still lurks at the back of the Maori mind. Though the great nature gods and the powerful gods of battle are forgotten, the caeco-demons which afflict man with disease are still remembered. The reason is not far to seek. War and the old sacred observances which were governed by the higher gods are of no use in the present social system but disease is ever present. As Tozer remarks in his 'Highlands of Turkey', "It Is rather the minor deities and those associated with man's ordinary life that have escaped the brunt of the storm and still exist in the dim twilight of popular belief". Though many Maoris who have received a smattering of education, will laugh with Europeans at their old beliefs, when sickness comes, when the vitality is lowered and the mind depressed, old beliefs and teachings heard in childhood's days from the lips of the aged, loom up in the sick man's fancy and exert a potent influence. It is the seniors and the old men and women who minister to the patient. Let the disease be chronic or the page 103 first bottle of European medicine fall to give marked improvement, then the sages shake their heads and say, "If this were a European disease it would be amenable to the European medicine. But the medicine has no effect, therefore it must be a Maori disease". The patient hears and the suggestion takes effect. He becomes worse. The European medical is abandoned and a tohunga is sought. If the illness is of a minor nature and the tohunga does not bring on pneumonia by dipping the patient in the stream and keeping him shivering on the bank whilst he exorcises the atuas, the patient will recover aided by the peace of mind which comes with the knowledge that he is on the right line of treatment. The counter-suggestion takes effect. Then the mana of the tohunga spreads throughout the land with the result that the percentage of cases diagnosed as "mate Maori" (Maori disease) is increased. The European doctor will be called in less. Where the patient is suffering from typhoid or something serious he likely die but the astute tohunga can always assign something done or undone by the patient or attendants as an excuse for the failure of his infallible line of treatment. Where a tohunga commences work in a district, revival of belief in magic and witchcraft takes place. Old men have told me on hearing of the projected visit of a tohunga, to keep him away. Although they believed that the diseases now afflicting the Maori were ordinary diseases, the remedies for which must be sought from the doctors, yet if the tohunga were allowed to come, the temptation to consult him would be irresistable. Therefore they wished the temptation kept away. They could not trust themselves.
Fear of Mate Maori.
The fear of the past finds expression in the term "mate Maori" (Maori disease). It is the retention of the old idea that disease gods punish infringement of tapu by attacking the transgressor. In these cases the Maoris say it is useless to consult a European doctor. Medicine will not drive the demon forth. The hara or sin must be diagnosed, page 104and the demon exorcised are the patient can recover. There are many things which help to keep the Maori version of disease before the people.
As we have said before, chronic cases which have defied European treatment for some time, come to be regarded as Mate Maori. The Maori is impatient when dealing with disease. He expects a speedy recovery or immediate signs of improvement. He believes that when the tohungas were treating disease the signs of recovery were seen immediately during or immediately after the consultation. He expects this celerity to continue in the case of the European tohunga. If he is disappointed, as he often is, he says the patient is suffering from Mate Maori.
Where there is a tubercular taint in a family, he is apt to accuse Mate Maori as the cause. Where the symptoms of a demon are well recognised as in tubercular bone disease he has no hesitation in affirming that it is a mate Maori such as "toketoke".
Where there is delirium and the patient raves about crayfish or lizards attacking him, the diagnosis is again made according to ancient teaching. If a relative dreams of particular animals which are known to be the 'aria' of tribal gods, the fear of 'mate Maori' again takes root. I have seen many such cases.
I saw a case of hysteria where the woman foamed at the mouth and made violent on muscular movements whenever I approached. She called for her father. This was looked upon as a typical case of mate Maori. It was the demon in possession who caused the struggles when the doctor approached. The woman called upon her father as he could expel the tribal demon.
Chronic cases, fatal cases, heriditary ailments and most of those which cannot be explained to him, the Maori regards as 'Mate Maori' or diseases peculiar to himself alone.
The idea of 'atua kahukahu' forming from abortions still prevails. A Maori woman at a European hospital had an abortion. She was greatly alarmed lest it should not be properly buried and so become a malignant caeco-demon. Many of the atua kahukahu page 105of more modern times have as an aria, the pig, horse, sheep or ox of recent importation.
Coincidences in time are looked upon as cause and effect. The following case serves to illustrate this.
Case. An old man of Lake Rotoiti, a chief and an intelligent lay reader of the Native Anglican Church, complained of a pain in the right hip joint. He rejected all ideas of rheumatism and on being encouraged to give his version of the cause, he spoke somewhat as follows, 'A man who belonged partly to this tribe the Arawa, and partly to the Waikato tribe, had been living among the latter for years. Then he came with an old man of the Waikatos, to ask the Arawas to support the Waikatos in a particular political movement. They came to this village first. In the evening, the young man made clear their object and asked our support. I replied, 'My son you ask me to support the Waikatos. I think of the times gone by when the Arawas supported the Waikatos. What was the end? The Arawas left the bones of their dead bleaching on the plains of battle, through helping the Waikatos. You come to-day and ask us to again assist you. I think of the unburied bones of our dead bleaching on the plain. This is the first village and I am the first chief to whom you have spoken, but it is enough. Return to your home. The Arawas have not forgotten their dead who fell on the stricken field through espousing the cause of the Waikatos. Return to your home my son, return. "When I finished my speech which was the knell of their project, the old man from Waikato hung his head upon his breast. He never rose to reply to me but I saw his lips moving. That night I went to sleep well and strong. I had not strained myself or caught cold in any way but in the night the pain came into my right hip. That in itself would not be enough. But I had a dream. I dreamed I had in my hands a parrot snare with a long line. I was quite well before and had done nothing to get ill. But the old man from Waikato bent his head upon his breast and I saw his lips moving. That night the pain page 106came into my right hip. Then I had the dream which tells of witchcraft. This pain is a mate Maori."
I have given this case in full as it is typical of the line of reasoning usually followed. The Waikato tribes at the present day are credited with having retained the art of witchcraft. An old man of that tribe spends an evening with another tribe. His desires have been opposed and his opposer knows that his feelings will be inimical on that account. His action in not replying according to custom confirms that opinion. Then his lips are seen moving in whispered incantation. In the night the person who opposed him, has a pain in the hip. In addition to this the diagnostic dream of witchcraft is dreamt. It matters not that the dreamer's thoughts as he fell asleep were charged with thoughts of witchcraft with all its symptoms and associated ideas. From the Maori point of view, the sequence of proof is irresistable.
Thus the suspicion and fear of 'makutu' run together. When medical students can persuade themselves that they are suffering from the disease that at the moment they happen to be studying, can it be wondered at that the Maori should still persuade himself that he is suffering from 'mate Maori' or 'makutu', when the inherited fear is kept alive by popular opinion.
The fear of 'makutu' is still prevalent. Disputes in law over land are supposed to be a fruitful cause in these days. When one of a successful party in a landcourt suit dies, it is often attributed to makutu used by the losing side in the law case. My predecessor in Parliament died at the beginning of the year from phthisis but it is believed by his own tribe that he was bewitched by one of the losing claimants to a large tract of land.
In many cases the fear has become vague and ill-defined but it is no less real, There is no tribe like the Ngai-tahu of the South Island which has lost to such an extent its ancient customs and institutions through closer contact with the Europeans. Yet I have never met with such an absolute fear of makutu as exists amongst many of the Ngai-tahu when they visit the North Island where it is still supposed to be used.page 107
Another great retarding influence is the prejudice that exists against European doctors and hospitals. Amongst the majority, not so conversant with the English language, there is the barrier of speech. Then the Maori patient is garrulous and wishes to describe all his symptoms in detail and at length. The busy European practitioner cuts short the description and the Maori patient becomes offended at what he considers lack of Interest in his case. He does not return. In many cases, the ailment is a minor one and the doctor who 'pooh-poohs' the patient's idea that he is ill, loses his confidence. The Maori objects to being told that he is not ill when he knows that his condition in not normal. He immediately looks upon the doctor as an ignorant person, informs his wide circle of friends and seeks a tohunga who is more sympathetic. A subsequent visit with a mere glance at the patient which probably tells the doctor all he wants to know as to progress, is considered neglect by the patient and his friends and they will probably change or discontinue the treatment. If the doctor is well-advised he will take a few minutes time in showing that he is interested and prescribe something even if it is a placebo. The doctor who gives no medicine, even where it is not necessary, is looked upon by the Maoris as useless.
Another great objection of the Maori to the white doctor, is his fear that the knife will be used. Ha dislikes operations even more than the average European. This dislike extends to hospitals. The patient is always suspecting something of an operative nature or objects to the hospital diet and is thus always anxious to get out. Many have run away from hospitals. The relatives do not know what is going on behind the hospital walls and readily imagine that their loved one is being dissected to satisfy the curiosity of the inquisitive white man. They page 108are thus ever ready to demand the return of the patient ere cured. Some hospitals seem to be banned by the Fates. The Whanganui Hospital in a large Maori district lost five or six operation cases on Maoris. Certainly the cases were very serious, the Maori not consenting to enter until as a last hope. Every case died and the hospital was promptly 'tapu' to the Maoris. If a Maori in that district is asked to enter the hospital, he looks upon the request as his death sentence and composes his death song. In Taranaki, Dr. Pomare saw two cases of typhoid. He ordered both to the hospital but only one went. The hospital patient died and the other recovered. Coincidences such as these convey a great significance to the Maori mind and make them the more difficult to treat.
The difficulty of carrying out treatment in the homes is often very great. The expectation of a quick recovery or signs of alleviation often leads to the abandonment of medicines ere it has had time to have an effect upon the disease. Isolation is difficult owing to the custom of relatives and friends crowding into the room round the patient. In the more backward settlements, a bed on the earthen floor in an unventilated room shared by many others, is the only one available. The non-removal of clothing and change of bedding are detrimental factors.
Feeding is another problem. Many of the homes are not able to procure the kinds of food necessary for sick persons. Patients can only get the food common in the village. Typhoid patients are given solid foods when they ask for it.
The Present-day Tohunga.
The so-called tohunga of the present day is a fraud and a quack. He has brought the once-honoured name of 'tohunga' into disgrace. In pre-European days, the tohunga was an absolute necessity but now he has outlived his use. He is a menace to the Maori community. The heriditary lines of tohungas with their rich store of knowledge in all departments of life, accumulated through countless generations, have come to an end. The present day tohunga is an absolute charlatan who works upon the credulity and superstitions of the people to acquire notoriety and acculate money. The more backward Maori districts, where doctors are scarce and sickness prevalent, offered a rich field for unscrupulous men to exploit. In many cases, the patients went to reputed tohungas, because there was no other course open to them whereby they might obtain treatment. Many deaths have been caused by exposure and dipping in the stream according to ancient custom. But the tohungas are now afraid of the law. This form of treatment has been abandoned. The various methods of treatment have been evolved and may be classified according to their connection with the ancient system.
|(a).||Religious. It is only natural that in adopting christianity, many should become faith-healers. It was simply changing the form of exorcisms used in ancient days. The new faith was grafted on to old ideas and superstitions and a compromise made. Thus one old charlatan of the East Coast used an old bible as his pharmacopeia. After repeating his incantations, he tore out a page of the bible, rolled it up and administered it as a pill. In a new cult, established by Te Kooti, fasting and prayers mingled with the ancient system of exorcising disease demons, A much later cult, introduced by Wereta, approaches the European system of faith-healing more closely. The leading district apostle of the cult sat beside the patient, laid his hands upon the afflicted part and prayed for the removal of the disease. Massage was used, hence the name of the sect 'mirimiri' (to rub). Relays of praying masseurs carry on the treatment in obstinate cases.page 110|
|(b).||Water and bathing. The efficasy of purification by bathing and sprinkling finds its modern in bathing in hot Water. By abandoning the cold water with its dangers, the tohunga thinks the law will not be able to punish him. Needless to say, the tohunga to be successful with this form of treatment, has some jargon of has own, some mystic abrocadabra, to impress the patient.|
Medicinal. A combination of (b) and medicinal treatment is used in the form of medicated baths. Each tohunga has his own particular stock of shrubs and chemicals. A very popular movement that spread throughout the North Island was the "wairakau" (infusion of plants) treatment. About a dozen different kinds of barks and leaves were boiled together and used as a bath. Though not relying so much upon the superstitions of the people, it had its objections. Practically every tohunga now has his own particular materia medica. In most cases the ordinary patent medicines are used, but the great efficasy of the tohunga's treatment lies in his being able to impress patients with the idea that he possesses mystic powers to cast out the disease demons whilst the patent medicines complete the cure. A Maori tohunga from the Whanganui river, who had been warned to stop his work by the Maori Council, approached Dr. Pomare and myself with the view of being allowed to continue his practice. He explained his system as follows. His wife was the medium of no less than five spirits of biblical origin. She treated cases of witchcraft and such cases as doctors could not cure owing to their being 'mate Maori'. She diagnosed by means of dreams. She kept patients under observation for three days. at her home during which time, smoking, swearing and anything of a sinful nature, was prohibited. Then she called upon the spirits to cast out the disease. She prayed and went through the Catholic service. She sprinkled the patient with water to wash away sin. She exhibited medicines to accelarate the cure. The husband produced a hand-bag and with an air of pride and conscious knowledge that he would certainly obtain our support, he hand-page 111ed out the following:—
Compound licquorice powder.
Barraud's Compound Stomachic Mixture.
Perry Davis' Pain Killer.
We questioned him on their uses, but he did not know. It was one of the spirits who directed what particular drug was to be used.
In all these forms of treatment the alledged tohunga claims that he cures witchcraft and mate Maori against which the most skilled European doctor has no power. They even profess to send on to the doctor those cases which are not of so-called Maori origin, but their diagnosis is usually in favour of mate Maori.
The above-mentioned Wereta as a routine question, inquired whether the patient's family possessed any ancient weapons or greenstone ornaments. If any were produced, he invariably diagnosed the cause of the disease as being due to the tapu of chiefs having been communicated to them. He took them away with him to remove the tapu and in every case sold them to curio collectors.
Tohungaism is decreasing owing to the Maori Councils taking steps to suppress it and an Act has been passed by the Parliament of New Zealand to suppress those who work upon the credulity and superstition of the people. There are also increasing facilities for obtaining skilled medical treatment.
What is being Done:
It is only right in telling of the present conditions of the Maori race, that brief mention should be made of what is being done to cope with disease and promote health.
|(a)||Subsidised medical men. In Maori districts, the local medical man has been susidised by the Government to give his services free to the Maoris who consult him. The object was to prevent the high mortality, to win the Maoris from the influence of false tohungas and place medical attention within the reach of the poor.|
|(b)||Native Schools. The Native School Teachers who have a great influence with the Maoris have been supplied with stock medicines by the Health Department for the commoner ailments. This is counteracted to a large extent the influence of quacks and many lives have been saved.|
|(c)||Maori Councils. In 1900, the Maori Councils Act was passed, dividing both Islands into Maori Council districts. The members of the Councils consist of leading men of influence. The Councils Act as local governing bodies and are the sanitary authorities in the Maori villages. Village Committees are formed under the Councils and to them is delegated the enforcement of the health regulations and bye-laws.|
|(d)||Sanitary Inspectors. Influential and progressive Maoris have been appointed as Sanitary Inspectors to work under the Native Health Officers in the various Council districts. Their time is entirely devoted to carrying out sanitary reforms and working in conjunction with the Health Department and the Maori Councils.|
|(e)||Maori Medical Officers of Health. When the Department of Public Health was established in 1900, attention was paid to the Maoris. Two Maori graduates in medicine have been appointed as Officers of Health to their own race. Knowing page 113the language, customs and ideas of the Maoris they were in a better position to teach the people and institute reform than Europeans would have been. By means of lectures, village visitations, treating the sick and showing the need for sanitary improvement, something has been done to break down ancient prejudice and educate public opinion
The Anglican Church has established two nursing homes amongst the Maoris in the North. European nurses with educated Maori girls live in the Maori villages and visit the sick in the neighbouring villages. The mortality in those villages has decreased considerably and the educational value to the Maoris is very great.
The following brief indications if successfully carried out should do much to improve the health of the Maori Race.
|(1).||European medical men, in Maori districts, require some knowledge of Maori ideas on the subject of disease so that, though no encouragement to perpetuate such ideas must be given, they may yet understand their patients and treat them as individual cases not as automatons.|
|(2).||The present system of health work should be encouraged until such time as the Maori people shall have advanced to such a degree that they can be put under the control of the European District Health Officers.|
|(3).||District nurses should be located in populous Maori centres to nurse the sick and teach by practical methods simple nursing and the care of infants.|
|(4).||Medical inspection of Native schools should be carried out wherever possible and breathing exercises should be introduced into all the schools.|
|(5).||Registration of deaths should be compulsory.|
Another important factor which really comes outside the scope of this essay, is the improvement of the economic condition of the race that will lead to their settlement upon their own lands as farmers and workers. This will carry improvement in their environment and render the necessities of life more easily procurable. The effect upon the health of the people would be incalculable. They would be assisted in the war against disease and would regain the magnificent physique which is their racial heritage.