Maka told me how Ina, like the Phœnix, renews her youth—but not by fire, by a dip into the sea. When I asked him who created Tangaloa he puzzled a moment, then said, “He was the son of the Unknown God. And nobody will ever know who created God.”
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The prevalence of leprosy on the Cook Islands interested me impersonally, as a medical investigator; as a human being it interested me because of an unpleasant incident which threatened to wreck my plans for the Central Medical School.
Twenty years before my first visit there Dr. Maui Pomare made a leprosy survey and took some interesting notes. Penrhyn Island was a notorious type case; five per cent of the inhabitants were afflicted when I saw it in 1926. On Penrhyn the great Maori physician looked into the local history of the disease and found that a Penrhyn Islander who had lived with a leprous woman in Samoa brought it back with him in 1885. Forty-four cases stemmed from this man; over a course of twenty years thirty-one of them had died, for leprosy is a slow killer. One boy came down with itch, was declared “unclean” and shut away with a real leper for many miserable years. When the sick man died his companion buried him. Pomare found that this boy showed no trace of leprosy.
At that time lepers were isolated on the rim of Aitutaki as well as on Penrhyn, where through fear of the disease they received no medical or surgical care, and scarcely any food. Once a month a whaleboat would dump rations on the beach. The only contact the sufferers had with the outside world and their families was a few words shouted to the boys in the boat, lying safely offshore. An inlet on Penrhyn lagoon, connected with the main island at low tide, had become a trash-heap for lepers.
Pomare wrote:—
The poor unfortunates do not get enough to eat. There will be no need to ask for a volunteer keeper, as we have already an unrecognized Father Damien, in Meka and his young wife, who volunteered to live on the island in order to be near their adopted son. I really do not know what would have happened to these unfortunate British subjects if Meka had not volunteered. He does all the fishing and looks after the sufferers; for this he receives no recognition from the civilized world in either funds or praise. Perhaps when the great Master will call His own He will say unto him, “Good and faithful servant, enter into the rest of the Lord.... Greater love hath no man than this, that a man lay down his life for his friends.”
World-wide experimentation has shown us very little of the etiology of this disease. The cause of infection remains almost as mysterious as the cause of cancer; but unlike cancer it is definitely contagious. For thousands of years it has been treated with chaulmoogra oil, taken by mouth, which showed better results than any other drug, but was so nauseous that an adequate dose was impossible. In 1900 Dr. Victor Heiser, working at Manila, gave it in injections intramuscularly, and made the first step forward in the long history of the disease. Today modified chaulmoogra oil is the chosen treatment.
Conventionally, we shrink away from leprosy. Biblical stories of the “unclean” and lurid passages from popular novels like Ben Hur have played upon the imagination until we have given leprosy leadership among the bogies. Among primitives, where the treatment is not understood and the extremities gradually slough away, growing so anesthetic they do not respond to the touch of a red-hot instrument, the picture is unpleasant. But the disease is so leisurely that it takes years for it to arrive at its final horrifying aspect. To the experienced physician diagnosis in the early stages is a matter of routine, and the modern method is simple. Today, if I were forced to choose, I would rather have leprosy in an early stage than tuberculosis. But the world was slow in taking up preventive work. Isolation and treatment were everything until recently when the American Leper Association began to study the mode of leprosy’s transmission. They could only find a few old men who knew anything about the disease, so the Association had to train young investigators to look into the causes.
Its transmission is a knotty problem. We know that infection is general in leprous communities, but how does it infect? Medical martyrs have tried to infect themselves by wearing leper’s clothes and sleeping in leper’s beds, but these tests have brought no results. Natives have lived with leprous women for twenty years without contracting the disease, but Pomare found forty-two cases that had been conveyed to Penrhyn Island by a man who had lived with a leprous woman. There is a theory that it is acquired in early infancy and does not manifest itself until later life, under circumstances favorable for the disease. But what are favorable circumstances? Nobody seems to have found out.