Tahiti, the island paradise

by Nicholas Senn

GROUP OF TAHITIAN CHILDREN

In a number of cases extirpation of the infiltrated enlarged lymphatic glands was followed by decided improvement, and in the case of a Tahitian the improvement remained at the end of three years. He has also operated on a number of cases by partial excision of the mass, first on one side of the limb, then on the other, with decided benefit to the patient in most of them. In some cases deep incisions through the entire thickness of the indurated mass afforded relief and resulted in diminution of the size of the swelling. He relates the details of the case of a native, fifty years old, the subject of elephantiasis of the lower limbs, that he operated on in two stages several weeks apart, removing first a large section from the anterior and later from the posterior part of the swelling, and as shown by the accompanying illustrations in the report depicting the condition of the limbs before and after operation, with an excellent result. However, in some of the cases the benefit thus derived did not last for any considerable length of time.

In making the excision, the superfluous skin is excised with the underlying indurated tissues, and the skin margins reflected for some distance in order to create sufficient room for a more liberal removal of the deep tissues. In one case, that of a woman thirty-eight years of age, the patient died two weeks after the second operation. Death was attributed to loss of blood and the debilitated condition of the patient when she entered the hospital. In another case, a Tahitian, thirty-five years old, affected with elephantiasis of all limbs and the external genitals, he operated successfully on one of the arms, the seat of an enormous swelling below the elbow. The excised mass weighed fifteen kilograms. Owing to the large size of the swelling, the operation proved one of great difficulty, and on account of the tension incident to the approximation of the margins of the flaps the sutures cut through and the wound ultimately healed by granulation. At the second operation nearly the entire mass was removed, with the result that the wound finally healed after a prolonged suppuration and the patient was relieved of the incumbrance caused by the great weight of the swelling. The relief afforded induced the patient to request additional operations for the removal of the swellings involving other regions of the body, but as the surgeon soon after left the island his desire could not be gratified.

The climate of Tahiti is not congenial for pulmonary and rheumatic affections, as the atmosphere is too moist. It is admirably adapted for patients the subjects of nervous affections in all their protean forms. The quietude, balmy air and pleasing surroundings are the best therapeutic agents to secure mental rest and refreshing sleep. It is in the treatment of such affections that a trip to Tahiti can not be too strongly recommended.

THE KAHUNA OR NATIVE DOCTOR

For centuries the practice of the healing art was largely in the hands of priests. They ministered to the body as well as the soul. Their practice was purely empirical and the surgery, even of the most skilled, rude and often brutal. The human mind is very much inclined to look upon disease and the methods used to effect a cure as something mysterious. Even at this late day many people who are well educated and who in everything else seem to possess a liberal amount of good common sense, have very strange ideas in regard to disease and the means employed in treatment. Promises to cure and a liberal expenditure of printers' ink render them an easy prey to mysterious methods. All races and all tribes have always had among them men and women in whom they confided in case of accident or disease. Very often priesthood and medicine were combined in the same person. Among the ancient Tahitians the chief was at the same time priest and medical adviser. The American Indians had their medicine-men, the Tahitians and other South Sea Islanders their Kahuna. It is very interesting to know something of the early practice of medicine and surgery among the Tahitians. Captain Cook gives them great credit from what he saw of their surgery:

They perform cures in surgery, which our extensive knowledge in that branch has not, as yet, enabled us to imitate. In simple fractures, they bind them up with splints, but if part of the substance of the bone be lost, they insert a piece of wood, between the fractured ends, made hollow like the deficient part. In five or six days, the rapooa, or surgeon, inspects the wound, and finds the wood partly covered with the growing flesh. In as many more days, it is generally entirely covered; after which, when the patient has acquired some strength, he bathes in the water, and recovers.

In speaking of medicine he says:

Their physical knowledge seems more confined; and that, probably, because their diseases are fewer than their accidents. The priests, however, administer the juices of herbs in some cases; and women who are troubled with after-pains, or other disorders after child-bearing, use a remedy which one would think needless in a hot country. They first heat stones, as when they bake their food; then they lay a thick cloth over them, upon which is put a quantity of a small plant of the mustard kind; and these are covered with another cloth. Upon this they seat themselves, and sweat plentifully, to obtain a cure. They have no emetic medicine.