Northern California, Oregon, and the Sandwich Islands

by Charles Nordhoff

There is a store, kept by the Board of Health, the articles in which are sold for cost and expenses. The people receive a good deal of money from their relatives at home, which they spend in this store. The Government also supplies all the lepers with clothing; and there is a post-office. The little schooner which carried me back to Honolulu bore over two hundred letters, the weekly mail from the leper settlement.

For the bad cases there is a hospital, an extensive range of buildings, where one hundred patients lay when I visited it. These, being helpless, are attended by other lepers, and receive extra rations of tea, sugar, bread, rice, and other food.

Almost every one strong enough to ride has a horse; for the Hawaiians can not well live without horses. Some of the people live on the shore and make salt, which you see stored up in pandanus bags under the shelter of lava bubbles. When I was there a number were engaged in digging a ditch in which to lay an iron pipe, intended to convey fresh water to the denser part of the settlement.

Such is the life on the leper settlement of Molokai; a precipitous cliff at its back two thousand feet high; the ocean, looking here bluer and lovelier than ever I saw it look elsewhere on three sides of it; the soft trade-wind blowing across the lava-covered plain; eternal sunshine; a mild air; horses; and the weekly excitement of the arrival of the schooner from Honolulu with letters. There is sufficient employment for those who can and like to work—and the Hawaiian is not an idle creature; and altogether it is a very contented and happy community. The Islander has strong feelings and affections, but they do not last long, and the people here seemed to me to have made themselves quickly at home. I saw very few sad faces, and there were mirth and laughter, and ready service and pleasant looks all around us, as we rode or walked over the settlement.

And now, you will ask, what does a leper look like? Well, in the first place, he is not the leper of the Scriptures; nor, I am assured, is the disease at all like that which is said to occur in China. Indeed, the poor Chinese have been unjustly accused of bringing this disease to the Islands. With the first shipload of Chinese brought to these Islands came two lepers "white as snow," having, that is to say, a disease very different from that which now is called leprosy here. They were not allowed to land, but were sent back in the ship which brought them out.

The Hawaiian leprosy, on the other hand, has been known here for a quarter of a century, and men died of it before the first Chinese were brought hither. The name Mai-Pakeh was given it by an accident, a foreigner saying to a native that he had a disease such as they had in China. There are but six Chinese in the Molokai leper settlement, and there are three white men there.

The leprosy of the Islands is a disease of the blood, and not a skin disease. It can be caught only, I am told, by contact of an abraded surface with the matter of the leprous sore; and doubtless the familiar habit of the people, of many smoking the same pipe, has done much to disseminate it.

Its first noticeable signs are a slight puffiness under the eyes, and a swelling of the lobes of the ears. To the practiced eyes of Dr. Trousseau these signs were apparent where I could not perceive them until he laid his finger on them. Next follow symptoms which vary greatly in different individuals; but a marked sign is the retraction of the fingers, so that the hand comes to resemble a bird's claw. In some cases the face swells in ridges, leaving deep furrows between; and these ridges are shiny and without feeling, so that a pin may be stuck into one without giving pain to the person. The features are thus horribly deformed in many instances; I saw two or three young boys of twelve who looked like old men of sixty. In some older men and women, the face was at first sight revolting and baboon-like; I say at first sight, for on a second look the mild sad eye redeemed the distorted features; it was as though the man were looking out of a horrible mask.

At a later stage of the disease these rugous swellings break open into festering sores; the nose and even the eyes are blotted out, and the body becomes putrid.

In other cases the extremities are most severely attacked. The fingers, after being drawn in like claws, begin to fester. They do not drop off, but seem rather to be absorbed, the nails following the stumps down; and I actually saw finger-nails on a hand that had no fingers. The nails were on the knuckles; the fingers had all rotted away.