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Ethnology of Tokelau Islands

Sickness

Sickness

Beliefs

The Tokelau people believed that sickness was caused by malicious gods or the infraction of tapus. According to Turner (32), there was a specific disease-making god. Only by making presents of mats to his priest were the sick able to recover. The priest then prayed to the god and massaged the affected part of the sick person with coconut oil. This cure was evidently to be accomplished through spiritual power imparted by the god, for Turner (32) says:

He used no particular oil. When he sat down he called some one of the family to hand him some oil and, dipping his hand in the cup, passed it gently over the part two or three times.

When an epidemic, kuanga mai aitu (sickness from the gods), spread rapidly or ringworms afflicted more than the usual number of people, they believed that the gods of other islands had sent the sickness upon them. By page 70 a decree of the chief and priests the village united in driving the sickness from their island. First, each person of the village collected a few feathers and a segment of coconut husk which he burned out to make a rude model canoe. Then they assembled at the far end of the village from the beach and commenced a drive toward the sea. With sticks and spears they rushed through the village, hurling their weapons at everything they came to, piercing old bowls or coconuts, upturning rocks and logs about the houses, and beating any object till they came to the water's edge. Here they set up the feathers as sails in their model canoes and launched them into the sea, supposedly carrying on board the spirits that had inflicted the epidemic. By this pantomime and magic the sickness that had been sent to them was passed on to another island.

In each community there were medicine men (matai fau) and assistants (fofo) who were not priests or prophets of gods. They treated the sick according to prescribed methods based on theories of what took place in the body when particular symptoms showed. This lore was handed down from parent to child and is still practiced today by descendants of the ancient native doctors. All the people have a general knowledge of household remedies and freely practice massage with coconut oil to remove soreness and bodily pains. But doctors are relied upon in any serious trouble because of their greater knowledge.

The chief doctor's medical kit included: a set of lancets (nifomanga), shark teeth lashed to light sticks for opening ulcers and cutting away flesh; a bottle of coconut oil (niulolo); and a few leaves, roots, and pieces of bark. These medicines were usually procured from the bush and prepared as they were needed.

Treatment

Massage

Massage with coconut oil is the general treatment for all pains and soreness. After strenuous work or when a person is exceedingly tired, it is customary to have two young girls or boys of the house massage (lomilomi) and pummel (tukituki) the whole body. In sickness from any cause the aching part is rubbed. Aside from the relief that massage usually gives, it is believed that pain and fever can be rubbed out. Soreness moves into other parts of the body from the stomach through the arteries and veins, and by massage can be pushed back.

Massage for a feverish headache is intended to carry the fever out of the head, through the neck, and back into its seat in the lower abdomen. The doctor commences by rubbing the neck in a downward motion with the tips of his fingers over the jugular vein. He then works on the forehead, com- page 71 mencing with his fingers deep in the eye socket and against the bridge of the nose and stroking upward and outward across the eyebrows and temples. The stroking is continued upward and outward, gradually moving higher from the center of the forehead until the hair line is reached. Then the massaging moves to the “center of the head”, a point measured from the tip of the nose to the point on the top of the skull by stretching the thumb and tip of the second finger. With thumbs pressed on this point, the massagist rubs with his finger tips down the sides of the head and up the occipito-parietal suture and down again over the occiput into the neck, rubbing this part well. In the next step he rubs the back muscles along the spine until he reaches the small of the back. Here he rubs across the sacrum “putting the fever back into its place”. He finishes by cauterizing the two muscles that run from the back of the neck to the shoulder.

Soreness in the arm and shoulder is supposed to be centered in the scapula (ivi sa). Pressure applied with the thumbs to the center of this bone and a few inches down on the arm from the shoulder is thought to relieve the pain. This is followed by cauterization along an artery in the axillary region, through which the pain is supposed to pass into the arm. For inflammation and swelling in the axillary region, common in the beginning of filariasis, a ring of five spots is cauterized, surrounded by lighter burns. If pain is located in the upper arm, the elbow is cauterized twice on the inside and once on the outside. For a pain in the forearm, the wrist is cauterized three times in a line on the back and again on the inside.

Soreness in the chest is removed by massage and cautery. Rubbing begins at the shoulders and moves along the clavicle to the breast bone and then along the intervals between each rib, massaging away from the breast bone to carry the soreness into the back. Finally pressure is applied by the hands over the diaphragm.

Earache is treated by massaging along the anterior border of the mastoid process, along the lower mandible away from the ear, and then over the rim of the ear to the auricle, which is pulled several times to extract the pain which has been forced into it.

For stiffness in the neck the massagist kneads and rubs the neck muscles downward, continuing the pressure along the inner border of the scapula. At the end of each stroke he holds his fingers down and pulls the skin taut, keeping the cause of the soreness from reëntering the neck. When he has completed the massage, he cauterizes the stiff part of the neck in three places. A sore throat is relieved by massage and drinking the juice of coconuts heated on an oven.

Hydrocele in the scrotum, caused by filaria, is not infrequent among the men. To relieve the enlargement the scrotum is massaged until it breaks. Massage is also employed to enlarge the scrotum, in some cases even drawing page 72 it as far down as the knees. This is believed to be a relief and to cure it from further swelling.

The new-born child is massaged daily by some woman of the house and by the mother as soon as she is able. The chief purpose is to make a well-shaped body with straight limbs. Especial attention is paid to the head and nose to insure natural formation, although the bridge of the nose is often pinched to make it high. No attempts are made to change the natural shape of the occiput or to flatten the alae of the nose, as is practiced among the Tongans. The child is carefully laid on one side and then on the other to avoid flattening one side of the head more than the other. The buttocks are shaped to give them full roundness, and the genitals massaged to make them well formed and to prevent swelling of these parts in later life. This is an attempt to avoid the advanced symptoms of filarial infection. It is also done to older children who continue to wet their mats after an age when the habit should be overcome. The anus is gently pressed in during the early months of life to prevent a dropping of that part in old age.

A broken bone is set by careful massaging. It is wrapped in a soft padding of puka leaves encased in a pliable young sheath (taume) of a coconut blossom. This splint is removed every two days and the fracture rubbed lightly with coconut oil, after which the limb is wrapped in a fresh sheath.

Cauterizing

Ringworm (pita) (Tinea imbricata), which is known throughout the islands to the south as “Tokelau ringworm”, was introduced into Tokelau by an infected Gilbertese named Peter who came to Fakaofu on a whaling ship. The native name of the disease, pita, is taken from his name. It is rampant in the islands and covers the entire body of many natives. A second form of ringworm (lafa) blackens the skin. Tane, common also in Samoa and Tonga, leaves light pigmented spots on the affected parts of the body. These three forms of skin disease are treated in the same manner. The ringworm is first rubbed with coconut oil and then burned off with a wick made by chewing a piece of pandanus root to loosen the fibers and twisting it into a small rope after it has dried.

Sores that manifest themselves in yaws are sometimes cauterized by wicks, but usually they are scalded. A coconut shell cup with a small perforation at the base is filled with boiling water and placed over the sore. The hot water dropping on the sore reduces the inflammation.

For lung trouble in which the patient breathes rapidly and with difficulty, the upper abdomen is cauterized. Nine burns in three vertical rows are made under the ribs; the first between the base at the breast plate and the navel, and a row on each side. Each spot is cauterized twice. The doctor page 73 feels with the flat of his hand, and if the affliction appears to be deep in the chest, judged by the throbbing in the patient's back, cauterization is applied along the spine. The first burn is made just below the neck over the cervical vertebra, the second the width of four fingers below it, the third the same distance below the second. Cautery is applied at two points on either side of the juncture of the sacrum and lowest lumbar vertebra; one burn is made on the back of each knee and ankle. It is believed that an artery (ua) runs from the head to the foot and if the line of this is followed with cauterized spots, the flow of the ailment can be stopped.

Medicinal Treatment

Wounds are washed out with water and covered with a ball of maile leaves which have been previously chewed and mixed with saliva. If the wound bleeds profusely it is covered with taususu leaves as a styptic compress and is then bandaged with narrow strips of plaited kie pandanus.

Abscesses are brought to a head with hot compresses of nonu leaves cut into small pieces and wrapped in the fibrous stipule (kaka) of a coconut leaf. The compress is dipped into heated coconut oil and gently pressed around the eruption to force out the pus. A little of the compress is left on the head of the abscess while the massaging and pressing is continued. When the sore is in the proper condition it is opened with a shark's tooth lancet, tapped by the operator with a light stick.

Headaches are cured by massaging the head and applying an ointment made of eight buds of the maile tree and a young root of fala pandanus, the thickness of a man's finger and half an arm in length, pounded in a coconut shell cup (ipu).

Earache is relieved by pouring into the ear and then drawing out an extract made from the bark of the tausunu.

The growth over the conjunctiva of the eye, usually the result of irritating an eye infected with conjunctivitis, is scraped away with leaf stems of lau puka. For conjunctivitis and other inflammations of the eye an extract is secured by squeezing the scraped pulp of a coconut leaf midrib. The outer surface of a young leaf is removed and the fibrous pulp is scraped into a receptacle. The juice or sap is expressed through the clothlike stipule of the coconut leaf.