The Changing Face of Ethnomedicine in Hiv a Oa, Marquesas Islands a Thesis Submitted To
UNIVERSITY OF HA"/A/I UBRARY NEW PLANTS, NEW DISEASES, NEW PRACTICES: THE CHANGING FACE OF ETHNOMEDICINE IN HIV A OA, MARQUESAS ISLANDS
A THESIS SUBMITTED TO THE GRADUATE DIVISION OF THE UNIVERSITY OF HAWArI IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF SCIENCE
IN
BOTANICAL SCIENCE (BOTANY)
DECEMBER 2005
By Liloa Makinney Dunn
Thesis Committee:
Will McClatchey (Chairperson) David Webb Mark Merlin We certify that we have read this thesis and that, in our opinion, it is satisfactory
in scope and quality as a thesis for the degree of Master of Science in Botanical
Science (Botany).
" 1IIIIIIIIIIIIIIIIIIIIIfIlili I 10 002605464 ~_ UNIVERSITY OF HAWAII '" HAWN THESIS COMMITTEE Q111 .H3 no. 4015
II ACKNOWLEDGMENTS
I would first like to acknowledge and dedicate this work to the late mayor of
Nuku Hiva, Monsieur Lucien" Taaroa" Kimitete, who was the first to open the door to the Marquesas for me. During my first field trip to the Marquesas, both Debora and Lucien Kimitete took me in and made me feel like this was my home. Both he and I planned on collaborating on a book that would document Marquesan Traditional medicine, but his untimely death put those plans on hold. I plan to continue with this work and his vision and would like to dedicate all my work in the Marquesas to his name. I would like to thank my thesis committee members for their guidance through this project, Dr. David Webb, who single handedly got me into the Botany program and who without I wouldn't have done what I have done today, Dr. Mark Merlin, for his insights and stories and particularly the Chairperson, Dr. Will McClatchey, who was excited about the work I was doing like it was his own and who helped me grow as an ethnobotanist. I would also like to thank the National Tropical Botanical
Garden especially Dr. David Lorence, who hired me on as a Research Technician for the Marquesas Flora project which help facilitate my own research in the Marquesas through multiple trips to the islands and the collection and identification of voucher specimens. I am also indebted to Dr. Paul Cox who gave me inspiration and direction and who always had time for my questions. The same gratitude I would also like to extend to our research team on the floral project, Steve Perlman, Ken Wood and Jean
Yves Meyer for putting up with an ethnobotanist. Others not to be forgotten for all their help include: Dr. Kim Bridges of the University of Hawai'i, and Dr. Diane
Ragone of the National Tropical Botanical Garden. The Marquesas is often referred
III by people in Tahiti as "Les lies Sauvage" or the Savage islands, which is so far from the truth of the true nature of these people. Fenna 'Enata or Henna 'Enana, translated roughly as the Land of Men, is how they like to be referred as, not savages.
I have met so many people on these islands and all of them were gracious enough to welcome me into their homes, families, and their reality. I would like to acknowledge all of them, island by island. On Nuku Hiva, Debora and the Kimitete
Family, Teiki Kimitete, Rose Corsier, Mme Mahi Tamari'i, Mama Nini, and Fiu Job.
On Ua Pou, Toti Teikiehuupoko and Pascal Erhel Haatuuku. On Fatu Hiva, Tia
Ihopu. On Tahuata, Edwin and Fati Fi'i. On Hiva Oa, I would like to thank the following: Toto Rives, Upu Mataiki, Tahia and Lucien Mataiki, Teiki Richmond and all the workers at the Service Development Ruale, Andre and Antonina Tessier. Most importantly, I want to extend my aloha to the following people who willingly shared their knowledge about Marquesan medicine which is traditionally a family secret passed down through the generations: Mme Tahia Mataiki, Mme Tahia Medula,
Mme Paea Tohetaatua, Mme Lamekeu, M. Henry Heita'a, M. Tanaoa, and Mme
Rereao Mataiki. With their help, we have initiated the steps to preserve their knowledge for the future generations of Marquesan children.
IV TABLE OF CONTENTS
ACKNOWLEDGMENTS ...... iii-iv
LIST OF TABLES ...... viii
LIST OF FIGURES ...... ix
PREFACE ...... x-xii
CHAPTER 1. INTRODUCTION ...... 1
a. Research Goals ...... 3-4
CHAPTER II. THE MARQUES AS ISLANDS ...... 5
a. Setting ...... 5-6 h. Biogeography & Floristic ...... 6-7 c. Polynesian Plant Introductions to the Marquesas Islands ...... 8-10 d. The Polynesians ...... 10-11
CHAPTER III. MARQUESAN ETHNOMEDICINE: PRE TO EARLY CONTACT PERIOD ...... 12
a. Early Sources in Marquesan Ethnomedicine ...... 12-15 h. Healers and the Concept ofTapu ...... 16-18 c. The Tahuna ...... 18-21 d. Disease Causation ...... 22-23 e. Disease Categories...... 23-40 f. Medicinal Plants ...... 40-48
CHAPTER IV. MARQUESAN ETHNOMEDICINE: TRANSITIONAL PERIOD ...... 49
a. Healers ...... 49 h. Causation ...... 50 c. Population Demographics & Diseases ...... 51-59 d. Medicinal Plants ...... 59-74 e. Conclusion ...... 74-75
CHAPTER V. MARQUESAN ETHNOMEDICINE OF HIV A OA: TODAy ...... 76
a. Introduction ...... 76 h. Materials & Methods ...... 77-78 1. Identification of Informants ...... 78-79 2. Informed Consent ...... 79-80 v 3. Interview Fonnat...... 80 4. Infonnal and Unstructured Interviews ...... 80-81 5. Semi-Unstructured Interviews ...... 81-82 6. Follow-Up Participant Interviews ...... 82 7. Voucher Specimens ...... 83-85 c. Results ...... 85 1. Infonnants ...... 85-90 2. Disease Causation ...... 90-91 3. Remedies and Disease Categories ...... 91-102 4. The Phannacopoeia ...... 102-122 d. Discussion ...... 122 1. Healers and Healing ...... , ...... 122-124 2. Disease and Causation ...... 124-128 3. The Phannacopoeia ...... 128-132 c. Conclusions ...... 133-137
Appendix I. Gods of Ancient Marquesas ...... 138-139
Appendix II. Plants Used in Marquesan Ethnomedicine and Their Apparent Distributional Status: Pre to Early Contact ...... 140-141
Appendix III. The Preparation ofMii in the Marquesas Islands: Then and Now...... 142-144
Appendix IV. Plants Used in Marquesan Ethnomedicine and Their Apparent Distributional Status: Transitional ...... 145-148
Appendix V. Infonned Consent Exemption Fonn from the University of Hawai·i ...... 149-151
Appendix VI. Questions Used in the Semi-Structured Interviews with Infonnants T.M. and R.M ...... 152-153
Appendix VII. Definition of Disease and Ailment Categories ...... 154-164
Appendix VIII. Data Sets Showing Relationships between Healers and the Diseases They Treat...... 165-166
Appendix IX. Marquesan Medicinal Plants ...... 167-185
Appendix X. A List of Prohibited Items Observed During the Healing Process ...... 186-187
Appendix XI. Marquesan Medicinal Voucher Specimens ...... 188-191
VI Appendix XII. Plants Used in Marquesan Ethnomedicine and Their Distributional Status: Today ...... 192-193
Appendix XIII. Data Sets Showing Relationships Between Healers and the Different Plant Species They Used ...... 194-196
Appendix XIV: List of Medicinal Plants Cited in This Research ...... 197-201
References ...... 202-209
VII LIST OF TABLES
1. Summary of the Marquesan Native Flora...... 7
2. A List of Cultural Plants Introduced to the Marquesas Islands by Early Polynesian Settlers ...... 8
3. Diseases and Ailment Categories of the Marquesas (Lesson, 1981) ...... 27
4. Disease and Ailment Categories of the Marquesas (Delmas, 1927) ...... 36
5. Disease and Ailment Categories of the Marquesas (Handy, 1923) ...... 37
6. Plants Used in Marquesan Ethnomedicine: Pre to Early Contact Period ...... 44-46
7. Population Figures in the Marquesas between 1834 and 1983 ...... 53-54
8. Plants Used in Marquesan Ethnomedicine: Transitional Period ...... 60-66
9. Plants Used in Marquesan Vaginal Astringents ...... 70
10. Demographic Information of Interviewees ...... 86
11. Example of Two Healer's Recipe for Apau Fati...... 88
12. Example of Two Healer's Recipe for Apau Parari ...... 88
13. A List ofthe 30 Disease or Ailment Categories Elicited in the Interviews ...... 92
14. Disease and Ailment Categories and the Healers Who Treat Them ...... 98-99
15. Plants Used in Marquesan Ethnomedicine Elicited During Interviews ...... 1 02-1 07
16. Examples of Different Tiheke Recipes ...... 114-115
17. Equivalent Names for Marquesan and Tahitian Disease/ Ailment Categories ...... 127
18. A Comparison of Medicinal Plant Use Across Eastern Polynesia Based on Whistler (1992) ...... 130-131
V11l LIST OF FIGURES
I. Map of French Polynesia (Florence, 1997) ...... 5
2. Map of the Marquesas Islands (Motteler, 1986) ...... 6
3. Map of the Island of Hiva Oa, Marquesas ...... 13
4. Medicinal Plants and Their Distributional Status - Pre to Early Contact Period ...... 47
5. Medicinal Plants and Their Distributional Status - Transitional Period ...... 73
6. Light Bulb Plant Drier...... 84
7. Plant Drier Set with Cinder Blocks and Pareo (s) ...... 85
8. Dendrogram Showing the Relationship between Healers and the Diseases They Treated ...... 100
9. The Relationship between the Healers and the Diseases Categories ...... lOI
10. Shade Structure for Rorippa sarmentosa ...... 108
II. Ta 'Ima Pi - One Handful ...... 110
12. 'Initi I Pouce - A Segment of a Digit...... 11 0
13. Marquesan Medicinal Plants and Their Distributional Status- Today ...... 117
14. The Relationship Between Healers and the Species Used in Marquesan Ethnomedicine ...... 120
15. Reciprocal Averaging Ordination Plot Showing the Relationship Between Healers and the Species Used in Ethnomedicine ...... l22
IX PREFACE
I would like to begin by saying that this research represents only a fraction of the knowledge present in the Marquesas regarding traditional plant medicines and therefore cannot be considered a definitive work. Nevertheless, it is also important to note that very little has been written about Marquesan plant medicine since the early explorers, missionaries, scientists, and naturalists first began to visit these islands from 1595 of first contact through the 20th century. That information, in itself is incomplete, and a lot has changed regarding medicinal plant use since those early observations. This brings us to my interests in the Marquesas, and in particular
Marquesan plant medicine. My interest in culture and cultural uses of plants got started early on as an undergraduate in the Hawaiian Studies program, before I knew about the field of ethnobotany. I have always been fascinated with the amount of knowledge that the Hawaiians had of their natural environment. In my view, every
Hawaiian was an ancient scientist being biologist, botanist, chemist, and agriculturalist all wrapped into one. Each native had an understanding of their environment that was extensive. Since this revelation, I have tried to understand everything I could about Hawaiian ethnobotany. In my last year as an undergraduate,
I came to realize the potential of understanding culture and plants through the field of ethnobotany, and quickly focused my attention on some of the different topics within ethnobotany: house construction, tattooing, medicine, farming, and classification.
When I started to look at inter-cultural relationships between different Eastern
Polynesian cultures, I saw patterns offamiliarity that were so intriguing to me.
x I had been traveling to French Polynesian since I was about 14 years old to visit my Dad who moved there some 30 years ago. Early on, the connections between Hawaiians and Tahitians were obvious in terms oflanguage and culture. It had seemed that some of the few things that made them different, besides a time gap, were how Polynesians adapted to their different island environments successfully, and who the different western nations that first colonized these islands were. Ra' au
Tahiti or Tahitian plant medicine is still an important part of the health care system in many rural areas in Tahiti's outlier islands and even in Tahiti itself. The efficacy of this medical system has been tried and true over the millennia and it continues today despite the more recent introduction of a superior western medical knowledge in the islands. As I delved more deeply into this subject I realized that both the Hawaiians and Tahitians had well developed pharmacopeias that had been evolving over the last thousand years or so. In fact, there was also a relatively large body of published literature representing both cultures.
French Polynesia is made up of four or five distinct cultural groups, one of which is centralized in the Marquesas Islands. This cultural group first became familiar to me through the reading of the literature on Polynesian migrations and settlement patterns. One of the basic questions asked about Polynesians are: who are the Polynesians, where did they come from, and when? Because of the close cultural affinity between Hawai'i and Fenua 'Enata (i.e. the Marquesas in the southern dialect) as Polynesians, I was naturally drawn to this area. As I gathered more information about the unique Polynesian culture of the Marquesas, I noticed that there was not a great deal of information regarding their ethnobotany, namely their
Xl traditional plant medicine. This was when my journey began. I believed the
Marquesas would be a great place to conduct research, and being familiar with
Polynesian cultures growing up between Hawai'i and Tahiti, I thought I would be able to move tbrough tbese islands witb relative ease. I brought with me the skills of an ethnobotanist while having the cultural insight of a Hawaiian. My main weakness was language competency. I have studied Hawaiian and Tahitian, but I am by no means fluent in either. I managed to work tbrough my basic understanding of these languages including French, which is spoken throughout tbe islands. If a more complete study of Marquesan ethnobotany were to be undertaken, I believe two factors to be essential. First, I would like work more closely with native collaborators. Secondly, I would want to live there for no less than a year and become fluent in tbe different dialects ofthe archipelago. Because of time and financial constraints, tbis research is admittedly limited. It is a partial understanding of a vast body of knowledge regarding traditional medicine retained by the
Marquesan elders.
xu CHAPTER I. INTRODUCTION
As human beings migrated to the far comers of the earth, they brought with them a set of plants and animals that would help them survive in their new environments. Both plants and animals were either intentionally or unintentionally transported in these movements to new areas. Along with these "transported landscapes", humans have continued to modify the new environments they inhabit to suit their needs. These processes have occurred during the last 10,000 years and continue today as human populations have spread into almost every habitable areas of the world. In the last 100 to
200 years increasing communication between the disparate parts of humanity has allowed development of a globalized culture that is less reliant upon local resources and less interested in the plants and traditions of the past. The trend toward globalization has had ill effects on both the environment and indigenous cultures ofthe world. These negative effects are often times irreversible. Because the forces of globalization have contributed to the cultural erosion of many non-Western societies, attempts must be made to stem the deterioration of cultural knowledge. Traditional medicinal knowledge has been undermined by the influences of Western medicine and Western culture in general. Not unlike biologists who work to conserve native plant and animal species, societies must also learn to conserve native or traditional knowledge systems pertaining to plant medicine.
Almost every culture in the world has developed a traditional medicinal system based on the flora and fauna that surrounds them. If the particular plant or organism was important to them in healing, these items were often brought with them as they moved around. The concepts of health, sickness, disease and death are more or less universal to
1 every human. The ability of a culture to respond to problems regarding health is essential to their ability to survive. Similar to the development of agriculture, traditional medicine ensures longevity and balance between the forces of nature and the spiritual realm. As do modern scientists today who develop and test their theories, so did early man with his natural environment. The testing of plants, animals, and every other animate and inanimate object as sources for food, medicine, house construction, clothes, tools and fire making made early man inquisitive as scientists of today. In every culture, a traditional knowledge base has built up over thousands of years through a process of trial and error of the things in the natural environment that has helped us as humans to survive, like any other organism, to guide our progeny into the next generation. In fact, most foods and spices that we have today were probably developed first as a medicines that later became incorporated into food items (Etkin, 1986). Medicine along with other modern innovations, have allowed humans to increase their life span. Up until modern times, most of the medicines employed by cultures around the world were based on their knowledge of healing plants. It is only recently with advancements in modern science that pharmaceutical companies have been able to create medicines from artificially synthesized molecules in a laboratory setting. The fact remains however that, most of our knowledge regarding medicine is based on plant knowledge accumulated over the centuries by indigenous societies. This knowledge has been exploited by certain pharmaceutical companies as shown by the fact that there are roughly 89 plant-derived drugs currently used in the Western world for treating a variety of illnesses (Balick et at.,
1996).
2 Our ability to overcome sickness and disease with the use of medicine is one of
the hallmarks of human civilization. Like other great cultures, the Polynesians brought
with them, through their spread across the Pacific, knowledge of plant medicines. They
transported plants that were important for food, medicine, clothing, and ceremony as they journeyed to the far reaches of the Eastern Pacific. They also came across a whole new
set of plants unfamiliar to them, and were able to incorporate them into their medicinal
practices. The fact that Tahitians, Hawaiians, and Marquesans still practice a form of
traditional medicine is a testament to its efficacy in treating sickness and disease. Even
with the significant advancements made by western medicine, many Polynesian cultures
still rely heavily on plant medicine. This is true for much of the 2nd and 3rd world nations
where 70-80% of the people rely on herbal medicine based on their traditional medical
knowledge (Farnsworth & Soejarto, 1991).
Research Goals
My research focused on the ethnomedicalliterature of the Marquesas and
interviews conducted recently in the islands. Based on journals and the writings of early
explorers from their first contact with the Polynesians of the Marquesas Islands, I
established baseline data about what ethnomedicines were used in the early days of first
contact, through the post-contact period, to the present. The information regarding
ethnomedicine at the time of Western contact in the early part of the 19th century was
spotty and incomplete, but it does provide some information as to which plants were
being employed to treat particular diseases of that time. Based on the literature of
Marquesan ethnomedicine, I will show how Marquesan medicine has changed over time.
With the introduction of new plants and new diseases, healers in the Marquesas have had
3 to change their ways of healing. The Marquesan medicinal system has changed reflecting the introduction of new plants and diseases. Based on field research carried out between the years of 2002 and 2004 in the Marquesas on the island of Hiva Oa, I will describe and evaluate the development of Marquesan ethnomedicine from the early period of
European contact to the modern era. This research will show that Marquesan ethnomedicine is not a static body of knowledge and application but a dynamic, evolving system that changes with the challenges of new diseases, health issues, and newly arriving plants. This research will answer questions regarding the existence and efficacy of traditional medicine by Marquesan people, and how their traditional medicine has evolved over time. In answering these questions, many other questions will also be answered regarding Marquesan ethnomedicine such as the usage of medicinal plants and remedies, preparation techniques, and disease categories.
4 CHAPTER II. THE MARQUESAS ISLANDS
The Marquesas Islands, which will be now referred to as the Marquesas, are located in the politically delineated area of French Polynesia which also includes the
Society Islands, Tuamotu Archipelago, Gambier Islands, and Austral Islands (Figure I).
Each of these archipelagos represents distinct cultural groups that are united under one political flag.
140'
Nulcu 1fMI- .u& Hut.. u. PoU HiY.o. .. " C' Tahumt"; MohotIIni ul" ", p ~ I. • fltuHiva DES MARQUISES
• • TItlItaID
DE LA socliri H,,..he,lIIII• •
MorurOi • Mlllglr.vl An GAMBIEII .... ?c _____""':::.;. km ,Mamtiri ORSTQM·LCA Figure I. Map of French Polynesia (Florence, 1997) The Marquesas are referred to by the indigenous people as Henna 'Enana in the Northern dialect and Fenna 'Enata in the southern dialect. This archipelago consists of twelve relatively small islands situated in the southeastern Pacific Ocean between the 5 latitudes ofT 53' and 10' 35' S and the longitudes of 138' 25' and 141' 27' W (Wagner & Lorence, 1997). These islands were fonned over a stationary volcanic melting anomaly or "hotspot" some 6 million years ago (Eiao) with the youngest of the islands dated to approximately 1.3 MY (Fatu Hiva) (Brousse et at., 1990). Out of the twelve islands, only Nuku Hiva, Ua Pou and Hiva Oa have peaks over 1200 m high (Wagner et al., 1997). Hatutaa II ~otu One C? 80 S Eaio MARQUESAS ISLANDS {".. o 50 I I Motulti SfATIITE MILES '" "-' t NukuHivaO OuaHuka ()ua Pou I.. Fatu Huku HivaOa~ 100 Tahuat~ \Mohotani .-:- -.- . FatuHival) Figure 2. Map of the Marquesas Islands (Motteler, 1986) All these islands are small and rugged with no coastal plains or developed reefs (Wagner et at., 1997). The largest of the islands are Nuku Hiva with a total area 0[340 Ian' and Hiva Oa at around 315 Ian' (Florence, 1997). There are six inhabited islands in 6 the Marquesas, including Nuku Hiva, Ua Huka and Ua Pou in the North and Hiva Oa, Tahuata and Fatu Hiva in the South (See Figure 2). Floristically, these islands have evolutionary histories similar to other isolated volcanic islands in the Pacific. Biological diversity is influenced, if not largely determined, by the islands distances from other land masses, size of the islands, elevation, age of the islands, competition, immigration and extinction rates (Florence et al., 1997; MacArthur and Wilson, 1967). The native flora of the Marquesas is comprised of 84 families, 184 genera, and 352 species, which 47% are considered endemic [Table 1]. There are only 3 endemic terrestrial plant genera, Pelagodoxa Becc (Areceae), Lebronnecia Fosberg (Malvaceae) and Plakothira Florence (Loasaceae), and no endemic fern genera (Florence et al., 1997). Table 1. SUMMARY OF THE MARQUESAN NATIVE FLORA. Adapted from Florence et al. (1997) updated by author from recent species checklist and surveys. %Sp. Group Families Genera Species Endemism Pterdiophytes 24 51 110 21 Dicots 52 105 192 62 Monocots 8 28 SO 42 Total 84 184 352 47 The total for naturalized and cultivated species including the Polynesian introductions (as of October 2004) is around 493. Of the 493 introduced plant species, roughly 265 or 54% are naturalized in the wild. Thus, alien species presently comprise the bulk of the species diversity in the Marquesas. 7 Table 2. Polynesian Plant Introductions into the Marquesas Islands. Whistler (1991), Smith (1979, 1981, 1985, 1991), Wagner et al., 1999) and current species checklist of the NTBG's Marquesas Flora Project. 1. Casuarina equisetifolia L. [Casuarinaceae]: toa 2. Calophyllum inophyllum L. [Clusiaceae]: temanu 3. Ipomoea balatas (L.) Poir. [Convolvulaceae): kuma'aruma'a 4. Benincasa hispida (Thunb.) Cogn. [Cucurbitaceae]: hue puoo 5. Cucumis melD L. subsp. agrestis (Naudin) Greb.) [Cucurbitaceae]: katiufatiu 6. Lagenaria siceraria (Molina) Standi. [Cucurbitaceae]: hue 7. Aleurites moluccana (L.) Willd. [Euphorbiaceae] : 'ama 8. Inocarpusfagifer (Parkinson) Fosberg [Fabaceae]: ihi 9. Tephrosiapurpurea (1.) Pers. var. purpurea [Fabaceae]: kohuhu 10. Barringtonia asiatica (L.) Kurz [Lecythidaceae]: hutu II. Hibiscus rosa-sinesis 1. [Malvaceae]: koute 'enana/' oute 'enata 12. Artocarpus altilis (Parkinson) Fosberg [Moraceae]: mei 13. Broussonetia papyrifora (L.) Vent. [Moraceae]: ute 14. Syzygium malaccense (1.) Merr. & Perry [Myrtaceae]: kehika IS. Piper methysticum J.R. Forst. & G. Forst. [Piperaceae]: kava/'ava 16. Gardenia taitensis DC. [Rubiaceae]: tia' e 17. Morinda citrifolia 1. [Rubiaceae] : noni 18. Solanum viride G. Forst. ex Spreng. [Solanaceae] : porohito 19. Cordylinefruticosa (1.) A. Chev. [Agavaceae] : ti 20. Alocasia macrorrhizos (1.) G. Don [Araceae]: kape I'ape 21. Amorphophallus paeoniifolius (Dennst.) Nicolson [Araceae]: teve 22. Colocasia esculenta (1.) Schott [Araceae]: ta' 0 23. Cocos nucifera 1. [Arecaceae]: 'ehi 24. Dioscorea alata 1. [Dioscoreaceae]: puauhi 25. Dioscorea bulbifera L. [Dioscoreaceae]: hoi 26. Dioscorea pentaphylla L. [Dioscoreaceae]: utau 27. Tacca leontopetaloides (1.) Kuntze [Dioscoreaceae]: pia 28. Musa paradisiaca L. [Musaceae]: meikal mer a 29. Musa troglodytarum 1. [Musaceae]: huetu 30. Saccharum officinarum 1. [Poaceae]: til 31. Schizostachyum glaucifolium (Rupr.) Munro [Poaceae]: kohe 32. Curcuma longa 1. [Zingiberaceae]: 'eka / 'ena 33. Zingiber zerumbet (L.) Sm. [Zingiberaceae]: 'eka pu'jf'ena pu'j There are around 33 species of Polynesian introduced plants [Table 2]. Looking at the totals for both native and non-native species, introduced species presently outnumber native species by over 100. These numbers are subject to change as new data 8 from the Vascular Flora of the Marquesas project (NTBG) continues updating the species lists. Since people are periodically introducing new alien species and it is increasingly unlikely that un-described new species will be found, the ratio of alien to native species is likely to continue to expand. The importance of knowing the current species diversity is integral to a study on Marquesan traditional medicine. There are two problematic plants that need to be further justified in order for them to remain on this list of Polynesian plant introductions. They are Calophyllum inophyllum and Solanum repandum. Whistler (1991) questions whether Calophyllum inophyllum is native over its Polynesian range or just a Polynesian introduction. Because of the importance of this species in the material culture of the Marquesas, it is listed in Table 2 as a possible Polynesian introduction. Solanum repandum Forst.fhas an unclear origin, although Forster's type is said to have been collected on Tahuata, Marquesas Islands (Smith, 1991). According to the Smithsonian Marquesas Flora Project Webpage (http://rathbun.si.edulbotany/pacificislandbiodiversity/marquesasflora), Solanum repandum is listed as indigenous, occurring only on the islands ofNuku Hiva and Fatu Hiva. Other botanists (Smith, 1991; Whistler, 1991) seem to disagree that S. repandum is native to the Marquesas. It may be that this plant is originally an introduction from South America as its closest relative Solanum sessiliflorum Duval occurs in tropical America (Whistler, 1991). In fact, both S. repandum and S. sessiliflorum are so similar that they maybe con-specific (Whalen et al., 1981). Based on this evidence and the fact that S. repandum is always associated with human activities and is not found in undisturbed areas, this plant was probably introduced (Whistler, 1991). Whistler (1991) believes that this species, because of its wide distribution, is an early Polynesian introduction. There is 9 also the possibility that S. repandum was introduced from South America by early Spanish explorers of the Mendaiia -Quiros expedition in 1595 (Smith, 1991; Whalen et aI" 1981). This is debatable. It is hard to imagine that it was introduced by early Spanish explorers whom only traveled in the southern islands and yet it is found on Nuku Hiva in the north and only Fatu Hiva in the south. Because there is no known use for this plant by the native people of the Marquesas, it may have been an unintentional introduction from South America as Polynesians probably brought different cuttings and seeds from there to the Marquesas. It may just be that the seeds of S. repandum were mixed up with seeds of some other solanaceous species. For the sake of this thesis, I will accept the delineation by the Smithsonian Flora project that S. repandum is indigenous and not a Polynesian introduction. The Polynesians A recurring question regarding the history of Polynesian is where did this cultural group come from? The cultural grouping that characterizes Polynesia traditionally occupies islands from Aotearoa (New Zealand) in the southwest, to Rapa Nui (Easter Island) to the far east of the Pacific and reaches an apex north to Hawai'i. This is known as the Polynesian triangle. There are also some island groups outside the "triangle" referred to as Polynesian outliers that lie on the fringes of Melanesia which are also culturally Polynesian. There are some 18 of these Polynesian outliers including Anuta, Bellona, Wallis & Futuna, Kapingamarangi, Rennell, and Tikopia (Kirch, 1985). The history of the Polynesians stretches back to groups of sea-faring colonists known as the "Lapita people" who sailed from islands of Southeast Asia into Melanesia and beyond. A specific type of pottery with elaborate designs and presumably a proto-Austronesian 10 language typified this group, who sailed in their voyaging canoes into the archipelagos of the central Pacific some 4,000 years ago. Evolving from their Lapita ancestors in the western archipelagos of Fiji, Tonga, and Samoa, this culture had a common language, social organization, religion, land tenure, subsistence strategies and technology (Kirch, 1985). The Marquesan people themselves are descended from these ancient Polynesian voyagers who worked their way from Western Polynesia, Tonga or Samoa, toward the eastern Pacific in search of new lands and adventures. Based on archaeological evidence, the earliest known cultural assemblages are from occupational sites in the Marquesas in Ha'atuatua, Nuku Hiva (Kirch, 1985). Many of those in the field of Polynesian archaeology disagree on the settlement dates of the Marquesas Islands because of the limited radiocarbon dating that has been done to date. Those who do agree place the initial settlement of the Marquesas around the second century Be (Kirch, 1985). Subsequently, the Marquesas became the source area for Polynesian voyages to Hawai'i, New Zealand, Easter Island and Tahiti (Sinoto, 1970). Whatever the exact dates of initial settlement prove to be, it is certain that the Marquesas was settled very early on allowing a distinct culture to develop and flourish early on. The people in the Marquesas developed knowledge of medicines based on the plants that they brought with them and ones they found on the islands. The ethnomedicine of the Marquesas was and still is rich, as will be shown in the subsequent chapters of this writing. 11 CHAPTER III. MARQUESAN ETHNOMEDICINE: PRE TO EARLY CONTACT PERIOD The goal of this study is to examine how ethnomedicine has changed in the Marquesas Islands from pre-contact times to present. The evolution of the medicinal system reflects how Marquesan healers have had to deal with the introduction of new diseases and how they have incorporated new plants into their materia medica. The ever changing face of Marquesan medicine will be described with evidence I garnered by creating a baseline of what traditional Marquesan medicine looked like and how it has changed over the years. I will also discuss how the medicinal system has evolved based on contemporary evidence derived from a series of interviews conducted by this author on the island of Hiva Oa. The baseline data was gathered from literature, including both published and unpublished documents pertaining to Marquesan ethnomedicine. The first time period discussed is from pre-contact to approximately the 19th century, and is what I referred to as the "Pre to Early Contact Period". This was a time when outside influences were just beginning to affect the native culture and a lot of the knowledge regarding the native medicinal system was still connected to the pre-contact era. If change had been occurring, it must have been slow during these early years of contact. Those who did document the medicinal system during this time must have known that this was probably a glance into the past medicinal system. Some of these early sources included J .R. Forster from Cook's H.M.S. Resolution (circa 1774), William Pascoe Crook (resided in the islands between 1797 and 1798), Charles Stewart (circa 1829), F.D. Bennett (circa 1835), Reverend Robert Thomson (arrived around 1838), Reverend P. Mathias Garcia (1840's), Dr. P.A. Lesson (circa 1844), Edelstan Jardin (resident between 1855-1856), Pierre Eugene Eyriaud des Vergnes (resident between 1868-1874), Pere Pierre Chaulet 12 (circa 1870's), Charles Lewis Clave! (resident between 1881-1882), Reverend P. Simeon Delmas (1886), and Louis Frederic Tautain (resident between 1881-1882). Other sources include two historians: Greg Dening (1980) and Louis Rollin (1929). There have been many visitors who have commented on the Marquesan people and their culture, but few discussed much about diseases, healthcare or medicinal plants. H.".1MmI P(J/nt. \ K;l,Ilclu o IOU! -----.-~---=====::.:.-~ Figure 3. Map of the Island of Hiva Oa, Marquesas Herbal medicine practiced today in the Marquesas is, in all probability, different from what it was before European contact. Medicinal systems of all cultures are subject to change and are not static throughout time. Change is often due to socio-environmental and epidemiological factors such as the introduction of new plants, new ideas, new diseases and worldviews. Understanding what the pre-European Marquesan medicinal system looked like is rather difficult and there are very few sources that exist that may lend any insight. The Marquesas was first discovered by the Spanish explorer Mendaiia in 1595, who named these islands after the Marquess de Mendoza, who at that time was Viceroy of Peru. This early expedition could have been a source of vital information on Marquesan plant medicine at that time. Unfortunately, their stay in the islands was short and they left no detailed record of medicinal plant use in the Marquesas. Two hundred years later these islands were visited by Captain James Cook in 1774, whose stay of five 13 days was hardly long enough to gather information about Marquesan plant medicine. Due to this large time gap between Mendaila' s arrival and Cook's arrival, it is hard to say how much the first contact forever changed the Marquesas. The introduction of new diseases may have had the most significant impact on the Marquesan medicinal system, yet we may never know what diseases these were that had been introduced by Mendafia and Cook's crew. Afterwards, the islands were visited by whaleboats and commercial schooners, carrying explorers, naturalists and sandalwood hunters. Between the years 1800 and 1825, over ninety ships visited the Marquesas (Dening, 1980). Over the next seventeen years, roughly 200 ships visited the islands opening the archipelago to the outside world and ending its relative isolation in the Pacific Ocean. These early visitors to the Marquesas may have served as sources of medicinal plant information, but for the most part these people were untrained observers who lacked knowledge of the native languages and were only in the islands for short periods oftime (Whistler, 1992). Missionaries that traveled to the Marquesas, the first of which were the London Missionary Society in 1797, are also sources for inquiry. There are a few published and unpublished documents containing incomplete information on medicinal plant uses, yet for the most part, these missionaries were more expert at evangelizing than at documenting the herbal plant use of the native people. Had they seen or experienced the use of herbal remedies, they were probably more interested in spirit possession and religious healing (Cox et al., 1991). Another source for information on Marquesan herbal plant use is ethnologist E.S. Craighill Handy who served on the Bayard Dominick Expedition to the Marquesas from 1920-1921. Though a trustworthy and thorough source, Handy's contributions do not 14 truly represent pre-European knowledge regarding plant medicine. Between the "re discovery" of the Marquesas by James Cook in 1774 and the arrival of this expedition, some 146 years offoreign influence had already occurred, possibly changing the knowledge base of Marquesan herbalism. By the time anthropologists and ethnologists visited the islands in the 1920's much of what was known about traditional medicine had been lost andlor modified in the minds of the natives (Whistler, 1992). Consequently, what I attempted to do is in this chapter is to "re-create" the Marquesan medicinal system based on what is already known of other closely related Polynesian cultures, and what is recorded in the literature. There has been some debate about the origin of Polynesian herbalism involving the external versus internal applications of medicines (palmer, 2004). Those medicinal systems in which the use of medicinal plants is strictly external are thought to be less sophisticated. Some have argued that because there is a general lack of documentation of Polynesian herbalism, that Polynesian medicinal systems where not highly developed to include plants (Whistler, 1992). This perspective maintains that healing of diseases usually included just spiritual-type faith healing through spirit possession, incantations and sacrifices. They don't discount the use of plants in healing, but maintain that it was restricted for external injuries such as wounds, rashes, sprained ankles, and infections (Palmer, 2004). Citing early Christian missionaries, these critics point to the fact that most of what was documented during these times was native beliefs in witchcraft and sorcery (Cox et al., 1991). Of course, these missionaries were more interested in religious healing than plant medicines and lacked the botanical and linguistical experience to properly document native medicines (Cox et al., 1991). There is a wealth 15 of evidence that proves the existence of a pre-contact Polynesian medicinal system that includes a "similarity between different medical traditions within Polynesia, Polynesian belief in the endemic nature of their healing traditions, and the fact that a majority of plants used medicinally in Polynesia are not used in other parts of the world (Palmer, 2004)". The only true sources that may give us insight into pre-contact Marquesan medicine would have to come from the Marquesan people themselves. Unfortunately, since Western contact there have been dramatic shifts in their knowledge base resulting from the introduction of new knowledge. This, along with the loss of the traditional knowledge stemming from de-population from foreign diseases, makes it hard to pinpoint an accurate description of their medicinal system. This loss was accentuated by the fact that Marquesan people had no writing system and all knowledge was transmitted orally from one generation to another. As the experts in herbal remedies died off, so did that knowledge. The introduction of new diseases also must have changed the medicinal system as healers were faced with the challenge of curing new foreign illnesses. These are dynamics we have faced when trying to pull information out of the early literature in re-creating the pre-European traditional medicinal system of the Marquesan people. Healers The role of healers in the Marquesas has changed tremendously from pre-contact times to now. There are many factors that have contributed to their changing roles in Marquesan society. The arrival of non-Marquesan people (i.e. Europeans, Americans, Asians and other Pacific Islanders) undermined their belief system and their worldview. Possibly, the role change from psycho-spiritual healer to plant herbalist stemmed from 16 the native's adoption of Christianity. These new ideas may have shifted their understanding of why certain people got sick and why others didn't and consequently, what needed to be done to treat illness. The concept of tapu is universally present in Polynesia, and for the Marquesan people their belief system was intrinsically tied into the notion of tapu. Dening (1980) states that to know the tapu was to know the social map ofTe Henua [Marquesas]. Contemporary use of the word tapu is defined as something that is off limits or it can also be used to delineate a property boundary. Early visitors to the islands probably saw the tapu as something irrational as they failed to understand how its tenets functioned within the society with inconsistencies seemingly everywhere. An example of how tapu manifested itself in everyday life is described in the following quote by Dening (1980): "Sometimes whole species ofplants and animals would be tapu. Kava, bonito, squid, turtle, cocks, red-coloured hogs, different things in difftrent valleys, permanently or temporarily, to all or some were tapu .... Men and women eating together was, ofcourse, tapu, but there were also foods that only men ofequal rank could eat together and other foods that could be eaten only by first-born women. ... Things that fell from the body or passed through it were carefolly guarded. Hair that fell or was cut was secreted in sacred places, the lice eaten. Women would never stand over a cooking place. They would never step over what had been carried above a man's shoulder or had been lifted over his head. ... " These few examples are basic, but useful in understanding why early observers may have failed to fmd reason in the system oftapu. To the Marquesans themselves, the idea of tapu was a process of making a thing or person sacred, thus distinguishing them from another thing or person (Dening, 1971). In the majority of the cases it was in reference to the haka'iki or chiefs whose ability to rule and exert power in their family, tribe, valley or island came from this notion of tapu or sacredness. In short, the tapu was a religious system that tied every fabric of Marquesan society together. It was not simply 17 about dietary restrictions or who slept where, but a system designed to keep order in an often chaotic and unpredictable world. Tahuna In Marquesan society, there were tuhuna or specialists and there were also tau'a who were similar to shamans, sorcerers or prophets. There were many kinds of tuhuna and they specialized in everything from canoe building to tattooing to fishing. One of the most important and prestigious of the tuhuna were the tuhuna 0' ono who carried out temple ceremonies and rituals at the me' ae or Marquesan religious temples, such as sacrifices and funerals. The tuhuna 0' ono also preserved traditions such as songs, chants, sacred prayers, and genealogies (Dening, 1971; 1980). There were the tuhuna tatihi or native surgeons and tuhuna fainu (called tuhuka haika in the North-East island group) who administered herbal remedies (Handy, 1923). In the Marquesas, there was another group of people who through divination could find the causation of an illness and those who prepared and administered herbal medicines (Handy, 1923). The ones who were the diviners were called tau'a and they were a class of powerful people in traditional Marquesan society. These tau'a were completely distinct from the tuhuna, although their roles did overlap in the curing of sickness and disease (Crook, 1797; Dening, 1971). These tau'a were both male and female and either became tau'a thru heredity means or because the gods chose them to become tau' a with the latter often considered more potent (Crook, 1797; Handy, 1923; Thomas, 1990). The tau'a were both mediums to the gods and even considered gods themselves (Dening, 1971, 1980). The ones who were recognized as gods walking amongst men were called tau'a atua (etua) and they were fewer in number with only a couple on each island (Dening, 1971). 18 The divinity of the tau'a atua would not be complete without the recognition of the people, and they had to prove their power with effective sorcery and true prophesy (Dening, 1980). The tau' a were able to diagnose through divine possession, thus finding the reasons why the patient was sick and how to remedy the problem (Handy, 1923). Called pae' a on the island of Hiva Oa, these tau' a were able to make the god or spirit, who was responsible for an illness, enter through their own mouths and inhabit their bodies thus allowing them to prophesize the cause and cure of the sickness (Handy, 1923). With the tihoka or descent of the god into the tau'a, a divine possession took place marked by violent convulsing behavior such as contorted facial expression and incoherent mumbling (Crook, 1797; Handy, 1923; Thomas, 1990). When possessed by a god or spirit, the tau' a would call out to them in his or her natural voice and the tau' a would then answer back in a different voice, that of a god or spirit. This sort of possession would take place only in the dark (Thomson, 1978). These sorcerers were skilled in both the spiritual and human realms and were able to cure (or even kill) through prayer and also through the use of herbal medicine. These sorcerers also had the ability to transfer sicknesses to enemies showing their inter-connection between both human and spiritual worlds. The etua or god would communicate with the tau'a through divination showing the causes of the patient's ailments and how to cure them. This was more symbolistic in nature and healing the sick began with psycho-spiritual rituals of incantations, exorcisms and the conversing with etua. This process was usually followed by a vigorous massage of the effected area and a herbal remedy, but nothing was healed or cured without the proper propitiation to the gods that included certain sacrifices at the altar (Dening, 1980; Thomas, 1986; Thomson, 1841). 19 Similar to the different kinds of tubuna, there were also different types of tau' a. Two important types oftau'a were recognized in the Marquesas. One of them was called the tau'a nani kaba who would use sorcery to harm and even kill the intended victims (Dening, 1971; Handy, 1923; Thomas, 1986). This was achieved by securing a piece of clothing or better yet the saliva or excrement of the intended target and packaging it up in coconut fronds or leaves and wrapped in coconut sennet. This was called the momo or kaba (Dening, 1971; Thomas, 1986). The momo was then hung at the me' ae or buried in a secret place where the tau' a would recite chants to Tupa' amo, the god who brings sickness and death to enemies (Dening, 1971; Thomas, 1986). This practiced usually resulted in the victim's death or severe illness. Often the family of the targeted victim would try to find the buried momo or pay the tau' a to reveal its whereabouts in order to reverse the curse. The tau'a would do this if the payment was sufficient (Thomas, 1986). Another sorcerer who captured souls was called the tau' a umuko. The sorcery that they used was quite powerful in catching souls of enemies. Their methods differed from that of the tau'a nani kaba in that these tau'a used the ta'o (Colocasia esculenta) or kape (Alocasia macrrorhiza) leafto hold some water into which he or she would stare until he saw the soul of the intended target (Dening, 1971; Thomas, 1986). Once the tau' a umuko captured the soul of the person in this leaf, he or she would quickly tie it up and bury it bringing illness and even death to the unsuspecting individual. There were female tau' a who were called upon to facilitate childbirth through incantations, but only to those families who could afford the services (Crook, 1797; Thomas, 1986). In fact, the economic survival of the tau'a came from gifts of food and other prized items in 20 exchange for their services. Often victims of sorcery bought their way out of trouble by showering the tau' a with gifts (Dening, 1971; Thomas, 1986). The tuhuna would also use sorcery like the tau' a, but their main skills were in medicinal plants and surgery (Dening, 1971). When it was time to prepare and administer herbal remedies, the tuhuna fainu was called upon (Handy, 1923). The term tuhuna fainu translates to someone skilled in the preparation of herbal potions or beverages. According to Handy (1923), these healers lived under such constraining tapu (s) that they could not even feed themselves and had someone else feed them. They were also only permitted to work on one patient at a time and if for some reason they stumbled or fell on their way back from gathering plants, they would have to go back and do it all over again (Handy, 1923). There also existed in the Marquesas the practice of surgery. Marquesan surgeons were called tuhuna tatihi and they specialized in the setting of fractured bones, dislocated joints, and trepanoing, although there has been a lack of physical evidence supporting the trepanoing claim (Handy, 1923; Houghton, 1977; Rollin, 1974). The following description gives us a good idea of how the tahuna tatihi practiced their art (Porter, 1970 [2]: 33). "Whenever the skull is cracked, the bone is laid bare, and the fracture traced to its end where a small hole is drilled through the skull to prevent the crack going any farther ... If there are any loose pieces ofbones, they are carefully laid in their places, the wound is bound up with certain herbs... " According to a native informant, fractured skulls were also repaired by using pieces of the hard endocarp of the Cocos nucifera fruit (Handy, 1923). Handy (1923) believed that massage was little practiced in the Marquesas except for in the treatment of rheumatism for which scented coconut oil was employed in massages. 21 Disease Causation Depending on what was being treated, there were essentially two types of causes of Marquesan illness. The more obvious causes included wounds inflicted during warfare; accidents resulting in broken bones or scrapes and other injuries whose causes were apparent (Whistler, 1992). Those ailments that had no apparent physical cause such as madness, epilepsy, or internal disorders were attributed to the supernatural (Whistler, 1992). In Marquesan thought, there was a belief in the divine causation of illness (Rollin, 1929). Diseases that appeared suddenly were often attributed to some sort of sorcery or a mischievous god. These diseases were called mate no te atua which means sickness from the gods (Crook, 1797; Dening, 1980; Thomas, 1986; Thomson, 1841). There existed in the Marquesan cosmology a group of gods known for tormenting people as a sort of entertainment for themselves (Delmas, 1927). There were also many gods associated with life, death, disease and sickness in the Marquesan cosmology (see Appendix 1. Gods of Ancient Marquesas). In some cases these gods could inflict sickness on people as punishment. Childhood diseases and sicknesses were attributed to the works of the vebine bae, which are ghost or phantoms (Rollin, 1974). Children could also contract illnesses from evil influences through or because of their parents or close relatives (Handy, 1923). Those people who came down with a sickness that resulted in their death were often seen as being punished for breaking a tapu (Bailleul, 2001; Handy, 1923). In fact, the causation for most diseases was usually attributed to the breaking of a tapu or to a seizure brought on by a deity (Dening, 1971; Sheahan, 1955). The disease called kovi, which has been roughly translated as a type ofleprosy, struck those who became defiled by female menstrual blood or broke a specific tapu (Dening, 1980; 22 Handy, 1923; Rollin, 1974; Thomson, 1841). Those who partook in the eating of sacred foods that had been designated tapu by a priest could end up with a mysterious ailment. Madness would strike those who partook in the eating of a tapu fruit (Rollin, 1974). One example of causation of disease from breaking of a tapu can be seen in the disease known as puku. This involved a sort of abscess or ulcer that developed in those people who ate a sacred fish of the gods or priests. Another example is that of the disease known as kaha, a sort of dropsy that struck those who used a certain tapu fruit (Crook, 1797; Lesson, 198 J). As we will see in the next chapter, some of these causes for disease relating to tapu would be preserved some 150 years later. The ailment called takoke was thought to be attributed to the simple presence of foreigners in the islands (Lesson, 1981). Disease Categories Because of the isolation of the Polynesians to the outside world, most of those infectious diseases that devastated much of Europe and Asia didn't exist in Polynesia (Whistler, 1992). The Polynesians were a healthy and vigorous people. Many navigators and early explorers commented routinely on this fact in their travels across Polynesia. During Cook's second voyage through the Marquesas, George Forster commented that he never saw a single deformity or ill proportioned man (Fleurieu, 1969). Even some early missionaries commented on how "their diseases are few [and] I have indeed hardly observed the appearance of any; and they [Marquesan] are as yet happily free from that fatal malady which has made such ravages in the Society Islands" (Wilson, J 799). The isolation that had at first allowed for Polynesians to avoid the infectious diseases of the Old World would ironically also lead to their ultimate downfall once they were introduced into the islands. Once introduced, these diseases wrought havoc throughout 23 the previously isolated islands of Polynesia. Because I'm trying to elucidate the diseases and ailments of pre-contact Marquesas in this section, I have tried to only consider those disease/ ailments that were present in the Marquesas before European contact. I have, however, discussed the importance of the new ailments introduced after contact, because of the way they helped to shape and change the pre-contact medicinal system. This subject will be considered at length in the next chapter. I will try to show both pre and post contact disease categories, follow how they have changed through the years and consider if they still exist at all based on the research. It is rather unclear as to what kinds of diseases and ailments were in the Marquesas before the arrival of the first Europeans in 1595 and again with Captain Cook in 1791. We have a better grasp of those diseases that were introduced after European contact, many of which had devastating effects on the native population. The problem here is identifYing what diseases may have been present in the Marquesas prior to Western contact. Taking a look into the early literature to find words associated with sickness and diseases, and then trying to extrapolate what may have occurred in the Marquesas before the arrival of Westerners, may be useful method in attempting to tackle the problem. A very interesting issue arises however, when trying to determine what kinds of diseases were left during the first contact with the Spanish in 1595. If in fact some diseases were deposited there in 1595, it could be assumed that the Marquesan population was inoculated before the arrival of later introduced diseases in and after Cook's arrival in 1791. The Marquesan people, essentially, would have had a couple of hundred years of selection (and misery) gaining resistance to the new diseases which would arrive after 1791. Of course, this analysis is speculative and not without its flaws. 24 This immunity would probably not have protected them from other diseases introduced after 1791 but would have reduced the impact of later reintroduction. What we need to deal with is what we actually know or can reasonably infer from the literature. What diseases and ailments did pre-European Marquesans face? Certainly, they had their share of non-infectious ailments such as blindness and deafness (Whistler, 1992). Some have speculated the existence of certain infectious diseases such as yaws, tetanus, and filariasis (elephantitis) in Polynesia prior to Western contact (Whistler, 1992). In Hawai'i, pre-contact ailments included osteoarthritis, rheumatoid arthritis, osteophytosis, tuberculosis, osteomyelitis, spina bifida and gall stones (Kirch, 1985). The possible existence of leprosy, elephantitis and tuberculosis in the Marquesas prior to European contact has also been put forward by some scholars (Martin et al., 1996; Trembly, 1997; Vigneron, 1989). Having based their assumptions simply on the fact that there is a native word for leprosy, kovi leaves this idea open for argument. Kovi was a native disease category characterized by skin scurfy and contracted limbs, and may not be what we know as leprosy. These symptoms were often associated with excessive use of kava and may have been mis-identified as leprosy (Lesson, 1981). Leprosy, as we know it, will be discussed in greater detail in the next chapter as will elephantitis or filariasis. One of the earliest references in the Marquesas to disease and illness comes from William Pascoe Crook, a young missionary who resided in the archipelago for many years. Crook (1797) mentions a disease that produced a thick scurf all over the skin and another that led to the fmger and toes of the afflicted to become contracted. The latter was thought to be caused by contact with female menses, i.e the breaking of the tapu. Crook (1797) also mentioned a kind of dropsy (caused by the eating of a forbidden fruit), 25 blindness, boils, urinary problems that he called "stone and gravel", quite possibly kidney stones and finally a disorder resembling the "itch" characterized by pustule breakouts between the fingers. In 1774, J.R. Forster of Cook's H.M.S. Resolution stated that there was no venereal disease in the Marquesas (Sheahan, 1955). Stewart in 1829 mentions the existence of the "itch", quite possibly a ringworm infection, and Bennett in 1835 noted no elephantitis but did notice people with goiter, an enlargement of the thyroid gland (Sheahan, 1955). The Reverend Robert Thomson, who arrived in the Marquesas around 1838, is another source for information regarding the diseases and ailments that existed in the islands during this time. He mentions the disease called kovi in which he described it as a species of leprosy attributed to a tapu violation (Thomson, 1841). Another disease to which Thomson (1841) gives no name is described as one that emaciates the body giving it the appearance of someone who has tuberculosis, yet it doesn't affect the lungs. Thomson (1841) also mentions that many natives suffered from dropsy and that rheumatism and cutaneous diseases were prevalent. Interestingly, he states that while prevalent in other parts of the Pacific, elephantitis was relatively unknown in the Marquesas (Thomson, 1841) In his memoirs Reverend P. Mathias Garcia, who was present in the Marquesas in the early 1840's, commented on how few diseases originally afflicted the native people and how the diseases present at that time were not widespread (Garcia, 1843). Describing Marquesans as healthy people, Garcia (1843) noted that the few diseases present in the islands were usually afflictions ofliver and lung, rheumatism, eye problems (conjunctivitis), cutaneous eruptions, certain types ofleprosy and abscesses. 26 Specific native names were also mentioned such as fefe or bebe (elephantitis) and kovi (leprosy), in which limbs literally rot off. Another important source on diseases or ailments present in the native population around the year 1844 are the notes of Dr. P.A. Lesson (1981) who listed over 24 maladies he encountered in the Marquesas [Table 3]. Considering this list, it was difficult to decipher the old medical tenns and even more challenging in trying to figure out if these diseases/ ailments were present in the Marquesas before Western contact. Table 3. Disease and Ailment Categories of the Marquesas (Lesson, 1981). Name Description Kaba edema Vai-nere elephantitis of the leg Takoke rheumatism; gout Hi dysentery Moteo a cutaneous skin affliction Pubeva a sort of lichen Puna a sort of lichen Kobua common acne Kopara a kind of Ecthyma Ki'ilKaba described as a brown sunspot Tate a species of Pityriasis Kopana small pustule on skin Hikanui phthisisl consumption (TB) Komai-too (Komai nui) hypertrophy of the genitals Puviil Enone/ Kikomooa hypertrophy of the clitoris Pua-ubi falling ofthe vaginal womb Pao te toe ulcer on the outer vaginal organs Kai-eva poisoning Kavai-ua asphyxiation from strangulation Hana-ua fatal childbirth Mate-kaba disease where the stomach is hard Kokoti colic Paoe typhus Mate i te kopu species of meningitis 27 Out of the 24 diseases and ailment categories listed in Table 3, I have delineated which ones may have existed in the Marquesas prior to contact and which of those are possible post-contact introductions. Naturally, some of these "diseases" or "ailments" can be eliminated from Table 3, because they are common ailments that are human induced, or occur naturally in any human population. There are of course some which are associated directly with western introduction. Those ailments that are human induced include the following: kai-eva (poisoning), kavai-ua (asphyxiation by strangulation), and possibly mate-kaha (a disease in which the stomach turns hard). Lesson (1981) defmes kai-eva simply as poisoning. Without giving any other specifics, it is not known if this is a kind of fish or food poisoning or a poisoning with a malicious intent. Interesting though is the use of the word eva which is used in the Marquesas to describe the tree species Cerbera manghas, a well known plant with toxic fruit often taken by people who wish to commit suicide. Translated from the original French, kavai-ua is defined by Lesson (1981) as asphyxiation by strangulation, clearly not an ailment in the traditional sense, but a human-induced action motivated by purposeful human intent. The disease or ailment called mate-kaha was described by Lesson (1981) as a disease in which the stomach turns hard like a rock with the eyes convulsing without crying. Lesson (1981) questioned whether this might also be due to some kind of poisoning. The list includes ailments that occur naturally with in any human population such as hana-ua or fatal childbirth. This is a phenomenon that mayor may not have any direct pathology associated with it. It may be death caused by complications during childbirth such as blood loss, most likely related to complication during delivery such as blood hemorrhaging resulting in the death of the women. 28 This list is dominated by ailments of the skin or skin diseases. Anyone of these could be pre- or post-contact introductions. The introduction of new foods, lifestyles and forms of hygiene may have played an important role. It is possible that once rare skin ailments have become more common due to such changes. The fIrst one of these is kohua or common acne. Common acne is often caused by abnormal flaking within a hair follicle causing oils and other body fluids to drain out forming what we know today as a pimple (Acne, 2005). The next skin disease is called moteo, a cutaneous skin affliction. The two skin ailments called puheva and puna are both a kind of lichen described by Lesson (1981) as "un lichen accompagne d'un fort prurit"and "une sorte de lichen ou mieux psoriasis", respectively. These two skin diseases could possibly be what are known as either LC or LP. LC or Lichen sclerosus (aka lichen sclerosis) is a chronic inflammatory dermatosis that results in white plaques with epidermal atrophy resulting in a painful skin condition that typically affects the vulva, penis, and anus (Meffert, 2005). LP or Lichen planus is an immunological mediated reaction that affects the upper extremities, mucous membranes and genitalia resulting in a cutaneous eruption (Chuang, 2005). The next skin affliction is called kopara and has been described by Lesson (1981) as a kind of Ecthyma. Known as a deeper form of impetigo because it goes into the dermis tissue, ecthyma is an ulcerative pyoderma of the skin caused by a type of streptococci (Davis et al., 2005). The terms kii, kiia and kaha were described by Lesson (1981) in the original French as an "I'ephelide hepatique", which at first glance looks like something that has to do with the liver. Upon further examination, the French word "I' epbelide" is defined as a small brown spot on the skin resulting from sun exposure and aging usually found on the tops of peoples hands (Ecthyma, n.d.). The skin ailment 29 known as tate was described by Lesson (1981) as a species of Pityriasis or a common papulosquamous skin rash. There are many species of Pityriasis that includes P. lichenoides, P. rosea, P. alba, P. rotunda and P. rubra pilaris and it is unknown as to which species Lesson (1981) originally described. The skin ailment known as kopana was described by Lesson (1981) as a skin ulceration developing in the legs and buttocks that eventually left no part of the body free of the disease. I was unable to find any western counter-part for this particular skin ailment. Although not mentioned in Table 3, Lesson (1981) also describes other skin related ailments that included an ailment called ephelide caratee in French for which I could find no further information. It is possible, if not quite likely that this ailment is closely related to the kii, kiia, and kaba skin diseases because it also involves an "ephlf/ide" or sun spot. Lesson (1981) also mentions a type of venereal disease like Treponema or yaws which some researchers (Kirch, 1985) have argued was endemic to Polynesia. Lesson (1981) also lists psoriasis (related to kava abuse); bubu (a boil); common eczema; lupus (manifested in the form of skin ulcerations on the face and arms, possibly Discoid Lupus); erysipelas (another kind of subcutaneous skin eruption characterized by a shiny red swollen area of the skin accompanied by fever with the possible causative agent, a Streptococci, entering through a break in the skin) and rupia (a skin eruption, possibly venereal in origin) all of which were skin diseases mentioned by Lesson (1981). Table 3 contains other diseases or ailments that may have existed in the Marquesas prior to Western contact. One ailment in particular, called kaba was attributed to eating a "forbidden" fruit. The illness was described by Lesson (1981) as a sort of dropsy caused by the eating of this tapu or forbidden fruit. Dropsy is an older medical term for edema, which is defined as a collection of fluids in any serous cavity or 30 subcutaneous tissue resulting in the swelling of the particular tissue or organ (Edema, 2005). From Table 3, other ailments that afflict all humans no matter their geographical area include komai-too, puvii I enone I kikomooa (one that is given three names), and pua-uhi. Komai-too is defmed by Lesson (1981) as a type of hypertrophy or an excessive development of an organ or part, which in this case specifically refers to a person's genitals. A related ailment given three different names ofpuvii I enone I kikomooa, was translated by Lesson (1981) from the French to describe the condition of clitoral hypertrophy. This is a condition in which the clitoris becomes enlarged due to an enzyme in a condition called congenital adrenal hyperplasia (Clitoral Hypertrophy, 2005). Congenital adrenal hyperplasia is attributed to several autosomal recessive disorders in which there is an enzyme deficiency in the synthesis of cortisol or aldosterone (Wilson, 2005). This genetic disorder mayor may not have been present in the native population prior to Western contact. The last ailment called pua-uhi was described by Lesson (1981) as a condition wherein the vagina or womb has fallen. The medical term for this is massive vaginal eversion or can also be referred to as vaginal vault prolapse (Adam, 2004). This is a problem that could afflict any adult female in a population. It is possible that all these diseases or ailments were present in the Marquesas prior to Western contact; however, further investigation into pre-contact diseases and ailments in the Marquesas and Polynesia at large is warranted. lbis deeper analysis may change the status of some of these diseases and ailments. Lesson's (1981) list also includes some diseases and ailments which can not be certain existed in the Marquesas prior to western contact. An established specialist in this field should be consulted in a further inquiry. Those illnesses whose origins are 31 questionable include the disease called paoe which was defined by Lesson (1981) as a very bad sickness, probably typhus, with symptoms that included bleeding from the mouth, eyes and nose. Typhus is an infectious disease carried by rat fleas and lice (Levy, 2004). Areas with poor sanitation combined with high population densities of rats and mice are more susceptible to out breaks of typhus. Prior to Western-contact, only the Polynesian rat (Rattus exulans) was naturalized in the Marquesas having close associations with human habitation areas. Another questionable disease or ailment in terms of its existence in pre-contact Marquesas is the one Lesson (1981) called takoke. Explained by Lesson (1981) as a certain kind of paralysis in the upper or lower limbs, takoke was thought to stem from either rheumatism, gout, or what he called myetite, possibly something known as MT or myiflite transverse or Transverse Myelitis. Transverse myelitis is a kind of neurological syndrome caused by the inflammation of the spinal cord due to the abnormal activation of the immune system, which can occur in isolation or in the setting of another illness (Transverse Myelitis, 2004). Lesson (1981) also thought takoke may be caused by a species of beriberi although he could not say for sure. Attributed to the presence of the foreigners, takoke afflicted people of all ages, although some believed that it was specific to just those that drank the alcohol received from whalers (Lesson, 1981). Another questionable pre-contact disease is dysentery, called hi in Marquesan. Dysentery is caused by the ingestion of bacteria in food or water which can cause the inflammation of the intestines resulting in severe diarrhea with bloody feces (Dysentery, 2005). It is unknown whether or not the bacteria causing dysentery was present in pre-contact Marquesas. The disease called mate i te kopu was thought to be a species of meningitis (Lesson, 1981). Meningitis is a disease in which 32 there is inflammation of the membranes covering the brain and spinal cord caused by bacterial, viral, or fungal infections, chemical agents and even tumors cells (Meningitis, 2005). It is unknown, even to Lesson (I 981), if what he saw in Marquesas was in fact meningitis and if it was a common disease in the pre-contact period. Diseases and ailments that are possible post-contact introductions include vai oere, described by Lesson (I 981) as elephantitis of the leg, which is now referred to as filariasis. Interestingly enough, Lesson (1981) also notes the existence of two forms of elephantitis in the Marquesas: the elephantitis of the Arabs and the elephantitis of the Greeks both given the Marquesan names offefe' e or keke' c. Other obvious post-contact diseases or ailments included hikaoui (phthisis/ consumption) and pao te toe (ulceration on the outer vaginal organs). The disease called hikaoui (also spelled iikanui in another paragraph) is defined as consumption which is an older medical term for tuberculosis (Lesson, 1981). The disease pao te toe was described by Lesson (1981) as an ulcer on the vulva or outer vaginal organs. There is an ulceration relating to the female genitalia called cancro ids which is a sexually transmitted genital ulcer disease and also Chlamydia which can cause genital ulcers (Crowe et al., 2005; Lorek et al., 2005). There are many ailments associated with female genitalia which I do not have the time or a full description of symptoms to discuss here. Other diseases and ailments observed included influenza, kovi (a form of leprosy), rheumatism, and various venereal diseases such as syphilis (Lesson, 1981). The last disease to be discussed in Table 3 is kokoti. Lesson (I 981) gives the definition of kokoti as a "colique" or in English, colic. There are many forms of colic including baby colic, renal colic and Devon colic (lead poisoning), so it would be hard to pinpoint the exact one he was referring to. Looking up the term 33 "colique" in the French dictionary, it is also defined as a stomachache or gripes (Mansion, 1950). The term gripes is an older term defined as to seize, grasp or vex, irritate and also to cause pinching and spasmodic pain in the bowels of intransitive senses (Gripe, 2003). This condition could simply be just a stomach ache. Dr. Charles Louis Clavel, a resident in the Marquesas from 1881-1882 is another source for information on the diseases and ailments found in the islands during that time. Clavel (1885) separates internal diseases from external diseases. Under the heading of internal diseases he lists the following: smallpox, tuberculosis (although he mentioned that it was rare compared to its occurrence in Tahiti), bronchitis, pulmonary emphysema, gastro-intestinal inflammation, mesentery adenopathy, acute peritonitis, jaundice, urinary disorders, cardiac palpitations, cardiac hypertrophy, muscular rheumatism, rickets (rare in the Marquesas), dystrophic diseases including eczema of the scalp, conjunctivitis, abscess, colds, scrofula (tuberculosis of neck lymph glands), various vaginal discharges and illnesses of the nervous systems including tetanus and "madness" (Clavel, 1885). Clavel (1885) also notes alcoholism as a common disease in the Marquesas, an insight probably well ahead of its time. Under the heading of Diseases of the Skin, Clavel (1885) lists the following: vitiligo, chronic dermatitis attributed to kava drinking, intertrigo and prurigo (over exposure to sun), urticaria or hives resulting from insect bites or sensitivity to shellfish, and eczema or impetigo (patita) (Clavel, 1885). C1avel (1885) also recognized the existence of two forms ofleprosy (a tuberculosis form and a non tuberculosis form), elephantitis (bebe), syphilis, common arthritis, fractures, and various tumors. Under the section entitled "Various Diseases", Clavel (1885) lists various ailments such as lipoma (benign soft tissue tumors), acne, cysts, conjunctivitis, sty, and 34 cataracts. During his stay in the Marquesas, he did not observe any fonns of scarlet fever, measles, typhoid fever, dengue, dysentery, rheumatoid arthritis, or albinism (Clavel, 1885). Although Clavellists many diseases, it is likely that many of them were not present in the Marquesas prior to contact, and if they were, they were types of diseases or ailments common to all humans. It may be that these diseases could only be detected by a trained medical doctor and the Marquesans themselves did not recognize them as problems because the symptoms were not apparent. These could include: smallpox, tuberculosis (questionable), pulmonary emphysema, gastro-intestinal inflammation, mesentery adenopathy, acute peritonitis, jaundice, cardiac palpitations, cardiac hypertrophy, and scrofula (tuberculosis of neck lymph glands). Examples of diseases that Clavellisted that may have been in the Marquesas prior to contact include cutaneous skin diseases like patita (impetigo) and others, arthritis, rheumatism, bronchitis, pulmonary emphysema, gastro-intestinal inflammation, urinary disorders, dystrophic diseases including eczema of the scalp, conjunctivitis, abscess, colds, various vaginal discharges and illnesses of the nervous systems including tetanus and "madness" (Clavel, 1885). Like Lesson, the Reverend P. Simeon Delmas also observed and took note of diseases and ailments present in the Marquesas during his mission around the year 1886. Though not a medical doctor, his contributions must be taken into consideration. He listed 20 disease and ailment categories with the native name and the western medical equivalent (Table 4). 35 Table 4. Disease and Ailment Categories of the Marquesas (Delmas, 1927). Native Name Description bapu a cough bekei, henei, benei asthma pa'atita small venereal wound near mouth ukako venereal ulcer, if it is not cancer ko atua syphilitic tumor kea thrush pata pustules matapua, matapo blind; one-eyed putui deafness moboi (north), kovi (south) leprosy; elephantitis tutu, neo madness, furious, frenzy paka,pueva itching of the skin pueva prurigo; scabies; itching karokaro smallpox; measles bautete TB, dengue, influenza pokoko a special name ofTB kamaii a synonym ofhautete ivi hao rheumatism veavea another synonym ofhautete puku abscess of all sizes An analysis of Table 4 reveals again the concept that there are certain diseases and ailments that are common among all human populations. These include bapu (a cough), hekeil heneil fenei (asthma), matapua/ matapo (blindness), putui (deafness), tutu! neo (madness) and ivi hao (rheumatism). It is unknown whether these problems were caused by genetic aberrations or were symptoms resulting from the introduction of foreign pathogens. The native name for smallpox or measles, karokaro, was a result of foreign introduction (See discussion on smallpox in Chapter IV). The diseases called mohoi or kovi are more problematic. They are defined as leprosy or elephantitis, both of which are post-contact disease introductions (discussed in detail in the next chapter). It 36 may be that these tenus once referred to the particular skin ailments found in those who abused kava, i.e dry and! or scaly skin. There also seems to be a few ailments in Table 4 that refer to venereal diseases which manifest themselves as skin aftlictions. These include pa'atita (venereal sore around the mouth) and ko atua (syphilitic tumor). There is also ukako which has been defined as a profound venereal ulceration. Similarly as in Table 3, there are also a number of skin ailments. These include ke'a (thrush), pata (pustules), paka or pueva (an itching of the skin), pueva (scabies) and puku (abscess) (Delmas, 1927). The definition for the disease bautete is given as phthisis, dengue or influenza. Phthisis is an older medical tenu no longer in use which refers to a disease characterized by the wasting away of the body or tuberculosis of the lungs (Phthisis, 2003). It would be virtually impossible to figure out which one of these diseases is actually hautete, as these are three completely different diseases with differing causes. Delmas (1927) also lists kamaii and veavea as synonyms of hautete and pokoko as a special name for phthisis. Table 5. Disease and Ailment Categories of the Marquesas (Handy, 1923). Native Name Description bapu colds bekei asthma pa'atita cold sores of mouth, nose, genitals ukako venereal ulcers uua venereal blotches ko atua bubo (inflamed lymph gland! groin) ke'a thrush pata pimples/ pustules mata po blindness putu'i deafuess 37 Another significant manuscript which lends insight into the diseases and ailments of the day is authored by Pere Pierre Chaulet, a medical doctor and Catholic priest who lived in the Marquesas for a short time in the early part of the 18th century. This document is housed in the Catholic mission in Nuku Hiva, and although I was unable to examine this manuscript, Handy (1923) was able to look at it and write about some of his fmdings, possibly basing some of his conclusions on the work ofPere Pierre Chaulet. Handy (1923) lists 10 diseases or ailments that were present in the Marquesas before European contact (Table 5). Another source for information possible on pre-contact diseases comes from Dr. Louis Rollin who, in the 1930's, was the military medical doctor and administrator in the Marquesas archipelago. Rollin (1974) writes that the ancient Marquesans were relatively free of disease and that the usual causes of death were old age, accidents, warfare or sacrifice. Disease only became common once the barriers had fallen between tribes and hostilities ceased (Rollin, 1974). The diseases and ailments that were known to them included bronchitis (bapu), asthma (bekei), impetigo (pata), prurigo (paka), abscesses (puku),.leprosy (mohoi, koovi), blindness (matapo), deafness (putu'i), arthritis (ivi bao), and acute mania (tutu, neo) (Rollin, 1974). Some of these same diseases and ailments were listed in Handy's (1923) work, and it may be likely that Rollin found them, as did Handy, in references from the Pere Pierre Chaulet manuscript. It is clear there were many diseases and ailments introduced into the Marquesas after Western contact. Those diseases and ailments that did not result (directly) from western contact, but that existed in pre-contact Marquesas are discussed in the following paragraphs. Clavel (1885) is certain that ailments like pulmonary emphysema, gastro- 38 intestinal inflammation, bronchitis, urinary disorders, dystrophic diseases including eczema of the scalp, conjunctivitis, various vaginal discharges and illnesses of the nervous systems including tetanus were all examples pre-contact diseases and ailments. Certainly, diseases and ailments like the common cold or cough (hapu), asthma (hekeiJ heneiJ fenei), blindness (matapua/ matapo), dropsy (kaha), deafness (putu'i), madness (tutu! neo), dysentery (hi) and rheumatoid arthritis (ivi hao) were all pre-contact ailments. Skin diseases that existed in pre-contact Marquesas included: common acne (kohua), a cutaneous skin aftliction called moteo, skin lichens (puheva and puna), deep impetigo (kopara), sunspots (kiiJ kiia/ kaha), skin rash (tate), skin ulceration (kopana), boils (huhu), thrush (ke'a), and scabies or prurigo (paka or pueva). Pre-contact ailments that are problematic to categorize include patita, pata and pa'atita. The disease called patita has been defined by Clavel (1885) as a type of eczema or impetigo. The word pata has also been defined as impetigo (Rollin, 1974), pimples or pustules (Handy, 1923), and pustules (Delmas, 1927). The apparently closely related word pa'atita has been defined by others (Delmas, 1927; Handy, 1923) as a venereal sore around the mouth or cold sores of the mouth, nose and private parts. The word pa 'atita is defined in the Marquesan dictionary as an infected opening (Dordillion, 1904). It may be that the words patita, pata and pa'atita were all older native names referring to various diseases of the skin including impetigo, pustules or infected sores. With the introduction of venereal diseases, some of the older native terms were then used to describe these new diseases which had similar superficial symptoms to that of the indigenous skin ailments. Thus, all these native terms describing skin diseases were present in pre-contact Marquesas with pa' atita later being used to describe venereal 39 disease. This is also probably true for the native disease called kovi or mohoi, whose symptoms included skin scurfy and contracted limbs and was thought to be cause by kava abuse (Lesson, 1981). When leprosy was introduced by Chinese laborers in the 1860's (Dening, 1980) and began to spread, the terms kovi or mohoi may have been transferred to describe this newly introduced disease. This transference of names may have also occurred with the native word fefe or hehe and their variances (fefe'e, keke'e). These names were used by early observers (Clavel, 1885; Lesson, 1981) to describe the condition known as elephantitis which was unknown in pre-contact Marquesas. It may be that the terms fefe and hehe were used to describe common skin ailments that existed in pre-contact Marquesas. Medicinal Plants The relative absence of medicinal plant knowledge in the early literature makes it very difficult to write a section on pre-contact medicinal plants. It is known that pre- contact healers incorporated herbal remedies in their healing process, but to what extent they did this is unknown. Early observers in the Marquesas commented on remedies that often included the external application of herbs, rubbing or massage, and the use of a strict diet in the healing process (Garcia, 1843). In reference to these early healers, Thomson (1841) writes: " ... they generally prescribe some herbal medicine, or ifthe patient be sufferingfrom a wound apply some leaves, in the use ofwhich they seem to place more cOIifldence." Early Marquesan healers employed many different plant parts as well as several different techniques in the processing and application of their herbal remedies. The plant parts used included leaves, seeds, flowers, fruits, roots, and bark. Based on the early literature of Christian (1910), Clavel (1885), Jardin (1862, Lesson (1981), and Rollin 40 (1974), these healers processed the prescriptions in varying ways including juicing the fresh plant material, making poultices and massage oils from the fresh plants, and even using vapor or steam baths to facilitate the entry of the remedy into the system. They also incorporated the use of strict diets and purgatives into the healing process. Healing in this traditional society was an elaborate process often involving large amounts of ritual accompaniment, including, but not limited to prayer and chant. It should then come as no surprise that some of the preparation and application techniques of particular remedies were highly involved. In one documented process for example, a person with a particular bad case of bronchitis was initially painted with a yellow dye and given a hot herbal tea colored blue (Rollin, 1974; Eyriaud des Vergnes, 1877). On the second and third day, the patient was painted green using crushed leaves and given a hot herbal tea colored red (Rollin, 1974; Eyriaud des Vergnes, 1877). On the fourth day, an operation called tipo was performed wherein heated stones were placed in a circle around the patient's chest (Rollin, 1974; Eyriaud des Vergnes, 1877). Prayers and incantations to the gods were consistent throughout the process. In this example, we can plainly see the amount of ritualization that could accompany anyone remedy. Another example of this kind of highly ritualized application of a medicinal remedy can be observed in the casting away of evil spirits. Tau'a would braid a pu'u or coconut cord with seven knots along the strand. The last knot on the braid was cut off and the other six bumed with the ashes mixed with water that had been aromatized with the flowers of Hibiscus rosa sinensis (Rollin, 1974). This beverage was ingested and used as a preventative medicine against the harmful actions of evil spells, which could bring about disease or even death. 41 There are known pre-contact remedies, recorded in the early literature, that were also used into the early times of western contact. Sugar cane (Saccharum officinarum) was used in the remedy called pupuna, which was used to treat thrush in young infants and also used in a remedy for dysentery (Lesson, 1981; Rollin, 1974). A remedy called heka was used to treat various skin diseases including puna and tate (Lesson, 1981). This remedy included the grated rhizomes of the 'eka (Curcuma longa) mixed with coconut oil which was applied directly on the problematic area (Lesson, 1981). Another remedy used to treat certain venereal diseases also used the grated rhizome of the 'eka (Curcuma longa) (Lesson, 1981). Venereal diseases were probably one of the first major diseases introduced into the Marquesas, and healers had to quickly adapt remedies into their repertoire to deal with them specifically. The cooked fruit of the noni (Morinda citrifolia) was used to treat syphilis as well was an unknown plant called papakoutu (Jardin, 1862; Rollin, 1974). A beverage made from the macerated roots of the kava (Piper methysticum) was used in the treatment of gonorrhea (Clave!, 1885). There were also plants used in treating bruises and contusions. An ointment called puama was composed of the grated 'ama (Aleurites moluccana) kernels and used to heal contusions or bruises (Rollin, 1974). The green fruit of the tuava (Psidium guajava) was used as an anti-inflammatory for bruises and contusions and also as an astringent and anti-dysenteric (Rollin, 1974). Massage or rubbing (friction in French) was also an important component in native remedies. Massage was often done with the use of oils. Often the base of these medicinal massage oils were derived from clarified coconut oil called huhe (Decker, 1980; Rollin, 1974). Added into the huhe were different medicinal plants that would 42 often be massaged into problematic areas. Painful rhewnatism was often treated by massage using medicinal oil containing terepota (Brassicajuncea) and vapor baths using the leaves of the native puabi (Santalurn insulare) (Lesson, 1981; Rollin, 1974). Medicinal massage oils were also made from the mabi (Rorippa sarrnentosa), and the pakihi (Oxalis corniculata) and were employed in rubbings (Clavel, 1885; Rollin, 1974). Plants were also used in making bandages and splints for wounds and fractures. In the case of a fractured or broken bone, the hard wood of the toa (Casuarina equisetifolia) was made into a splint for broken bones and the leaves of the mr 0 (Thespesia populnea) would be plastered onto fractures like a bandage, using an adhesive mixture which included the milky sap of the mei (Artocarpus altilis), and the juice and sawdust of an unidentified species of Euphorbiaceae called ko'u'ima (Rollin, 1974). Other bandages could also be fashioned out of noni (Morinda citrifolia) leaves that were heated and then soaked in coconut oil to dress wounds (Rollin, 1974). Bandages were also formed from pieces of tapa, bark cloth made from the 'outi (Broussonetia papyrifera) (Clavel, 1885). Wounds were cleaned using the leaves of the tutu (Colubrina asiatica) which were passed through a flame to soften them and then applied to the wound, bringing out the infection (Rollin, 1974). Similarly, an infusion made from the leaves of the auvakakina was used to wash wounds (Rollin, 1974). Rollin (1974) does not give a scientific name for this plant, but does write that it is in the Rhamnaceae family. Thus, the exact identification of this particular plant remains unknown. In one Marquesan dictionary, the word au vakakina is identified as Spondis dulcis (Dordillion, 1904). It is possible that Rollin (1974) was confused regarding the correct identification for this plant. A medicinal salve made from the flowers ofhau (Hibiscus tiliaceus) 43 called apakau was used to dress wounds (Rollin, 1974). Healing of wounds was also hastened by using the grated bark of the kaepu (Sida rhombifolia) (Rollin, 1974). It is evident that the Marquesan people knew the benefit of herbal remedies that would induce certain purgative effects such as vomiting or diarrhea. There are stories of people who have tried to commit suicide by eating the very poisonous fruits of Cerbera manghas. If this person chewed the fruit, it would bring about certain death. If the person swallowed portions of the fruit whole, then a tau' a would be called in to cure the person before the fruit was fully digested. The tau' a would formulate a purgative that contained the flowers of the 'oute (Hibiscus rosa-sinensis) causing the patient to vomit out the poisonous fruit (Crook, 1797). Another purgative beverage composed of coconut water (Cocos nucifera) and a liquid excreted by a certain shellfish was given to infants on their third day of breast feeding, probably to induce "the runs", serving as a laxative (Clavel, 1885). Other plants used either as a purgative or laxative included the upere (Ricinus communis), vaioata (Tamarindus indica) and terepota (Brassicajuncea) (Rollin, 1974). Table 6. Plants Used in Marquesan Ethnomedicine - Pre to Early Contact Period. Scientific Name Native Plant Part Treatment (8) Sources Name Usneasp. akia kiva'o whole plant fevers Rollin (1974) (Lichen) Colocasia ta'o leaves dental pains Rollin (1974) esculenta (Araceae) Cocos nucifera 'ehi liquid purgative; served as Clavel (1885) (Arecaceae) endosperm; medium for many coconut oil recipes Saccharum to ? dysentery, thrush Lesson (1981); officinarum Rollin (1974) (Poaceae) ! 44 Table 6. (Continued) Plants Used in Marquesan Ethnomedicine - Pre to Early Contact Period. Scientific Name Native Plant Part Treatment (8) Sources Name Curcuma fonga 'eka rhizome skin diseases (puna, Lesson (1981) (Zingerberaceae) tate); venereal diseases Sonchus pota ? medicinal plant Jardin (1862) oleraceus (Asteraceae) Brassica juncea terepota ? purgative, counter- Rollin (1974) (Brassicaceae) irritant, rheumatism Rorippa mani, mahi, whole plant rheumatism; Jardin (1862); sarmentosa massage oil Clavel, Rollin (Brassicaceae) (1974) Cordia tou leaves medicinal Christian subcordata (1910) (Boraginaceae) Ipomoea alba mahati seeds purgative Jardin (1862), I (Convolvulaceae) Rollin (1974) Afeurites fruit (inside contusions Rollin (1974) , mofuccana ama kernel) (Euphorbiaceae) Ricinus ? purgative Rollin (1974) communis upere (Euphorbiaceae) Erythrina leaves headaches Jardin (1862), variegata kenae Rollin (1974) (Fabaceae) Senna ? leaves purgative, tumors, Jardin (1862), occidentalis distension (stomach) Rollin (1974) (Fabaceae) Tamarindus fruits laxative Rollin (1974) indica vaioata (F abaceae) . Tephrosia branch genital diseases; Jardin (1862), purpurea var. kohuhu mosquito repellant Rollin (1974) purpurea (Fabaceae) Abutilon grandifolium or ? bark wounds Jardin (1862) A. hirtum) (Malvaceae) 45 Table 6. (Continued) Plants Used in Marquesan Ethnomedicine - Pre to Early Contact Period. Scientific Name Native Plant Part Treatment (s) Sources Name Hibiscus rosa- flower internal problems Jardin (1862), sinensis koute 'enata Rollin (1974) (Malvaceae) Hibiscus flower emollient Jardin (1862); tiliaceus hau toto Rollin (1974) (Malvaceae) Sida rhombi/olia kaepu bark wounds Jardin (1862); (Malvaceae) Rollin (1974) Psidium guajava tuava fruit anti-inflammatory; Jardin (1862); (Myrtaceae)_ astringent Rollin (1974L Oxalis ? internal maladies Rollin (1974) corniculata pakihi (Oxalidaceae) Piper roots gonorrhea Clavel (1885) methysticum kava (Pi peraceae) Colubrina tutu leaves wounds Jardin (1862); asiatica Rollin (1974) (Rhamnaceae) Morinda noni leaves, fruit bandages; treatment Rollin (1974); citri/olia for syphilis, abscess; Jardin (1862) (Rubiaceae) used to dissolve immunoblaste lymphadenopathy Santalum puahi ? ? Lesson (1981) insulare (Santalaceae) Sapindus kokuu fruits medicinal oil Christian saponaria (1910) (Sapindaceae) Physalis konini leaves headaches Jardin (1862), peruviana Rollin (1974) (Solanaceae) Table 6 is a compilation of28 medicinal plants that may have been used in pre- contact times through the early contact period. This list was generated compiling the early literature written by those Europeans and other foreigners who were present in the 46 Marquesas during the early first contact periods. It is clear that some of these plants such as pota (Sonchus oleraceus), terepota (Brassica juncea), upere (Ricinus communis), Senna occidenlalis, vaioata (Tamarindus indica), Abutilon grandifolium, A. hirlum, kaepu (Sida rhombifolia), tuava (Psidium guajava), pakihi (Oxalis corniculata), and konini (Physalis peruviana) are in fact post-contact introductions, and were consequently not used in the native pharmacopoeia of pre-contact Marquesas. These sources often only gave a brief or vague description of the medicinal uses of these plants. Many different plant fOillls were used as plant medicine, ranging from lichens to flowering plants. Medicinal Plants and Their Distributional Status: Pre to Early Contact -Endemic 4% o Indigenous 25% - Modem 39% Polynesian IntTO 32% Figure 4. Medicinal Plants and Their Distributional Status - Pre to Early Contact Period. A total of28 species of plants were compiled from the literature and these plants were organized according to their distributional status (Appendix Il). Of the 28 species listed in Table 6 only one plant is considered endemic, Santalum insulare or puabi. In 47 the Marquesas, there are two endemic varieties of Sandalwood species: Santa/urn insulare var. deckeri and Santalum insulare var. marchionense. It was unspecified in the literature as to which endemic variety this sandalwood was, but both are endemic so it doesn't change the percentages given (See Figure 4). There were a total of 7 indigenous species or 25% of the total species listed in Table 6. The indigenous species are: akia kiva'o (Usnea sp.), mahi (Rorippa samentosa), tou (Cordia subcordata), kenae (Erythrina variegata), hau (Hibiscus tiliaceus), tutu (Colubrina asiatica), and kokuu (Sapindus saponaria). Of the total, nine of these plants or 32% were Polynesian introductions. These include: ta'o (Colocasia esculenta), 'ehi (Cocos nucifera), to (Saccharum officinarum), 'eka (Curcuma longa), 'ama (Aieurites mo!uccana), kohuhu (Tephrosiapurpurea), koute 'enata (Hibiscus rosa-sinensis), kava (Piper methysticum), and noni (Morinda citrifolia). Looking at Figure 1, the post-contact introductions or modem introductions comprise the rest of the 28 plant species, with a total of eleven species or 39%. These post-contact introductions include: pota (Sonchus oieraceus), terepota (Brassicajuncea), mahati (Ipomoea alba), upere (Ricinus communis), Senna occidentalis, vaioata (Tamarindus indica), Abulilon grandifolium or A. hirtum, kaepu (Sida rhombifolia), tuava (Psidium guajava), pakihi (Oxalis cornicuiata), and konini (Physalis peruviana). These plants may represent some of the earliest plant introductions into the Marquesas, occurring shortly after contact times. 48 CHAPTER IV. MARQUESAN ETHNOMEDICINE: TRANSITIONAL PERIOD This chapter will focus on the effects of contact on and the subsequent pressures for change with in Marquesan ethnomedicine. In Chapter III, I delineated the first time period, from pre-contact through the 19th century as the "Pre to Early Contact Period". This chapter specifically deals with the medicinal system which evolved from pre European contact through post-contact. This transitional time period begins around the late 19th century and continues up until the time of this research. Sources become more dependable as scientific inquiry escalates and more scientific expeditions are undertaken into the islands. One of these sources included the Bayard Dominick Expedition (1920) out of Honolulu, Hawai'i. This expedition sent out various researchers like E.S. Craighill Handy and WiIIowdean Handy (ethnologists), Ralph Linton (archaeologist), and F.B.H. Brown (Botany). I will further other discuss elements that helped influence this transitional period, including the introduction of new plant species, and the decline in the Marquesan population resulting from the introduction of new diseases. Healers In terms of the traditional medicinal system, healers had to adapt to the new ideas, plants and diseases that were introduced after contact. The roles of healers must have changed as they incorporated new plants and ideas into the battle of new diseases. This change coupled with the introduction of Christianity affected the traditional role of men as healers, and may have by this point in time made them a thing of the past. The need for a spiritual healer was replaced by a Catholic priest, whereas the role of women as herbalist increased due to the vacancy of healers, either spiritual or medicinal. During this time, there were still those who practiced the ancient forms of healing passed down 49 to them from previous generations. These people played a minor role and were most likely forced underground in terms of practicing their art. Herbalism did not die out and probably continued unaffected from the pre-contact times through this transitional era and beyond. Many herbalists were probably women as the role of men healers shifted toward the church, thus these women became the ones who preserved the knowledge regarding medicinal plants use. Causations The causes of introduced diseases into the Marquesas are clear from an epidemiological view. They were mainly viral, bacterial, or fungal. The Marquesan people looked at disease through their own cultural spectacles. That cultural perspective still linked causation of disease with the breaking oftapu and sorcery (Dening, 1980). The subsequent de-population from introduced diseases was interpreted as something connected to religion and the breaking of the tapu (Bailleul, 2001). During this transitional period, older diseases were attributed to the gods, where as new diseases like small pox and influenza were attributed to the hao' e or white immigrants and visitors to the islands (Delmas, 1927). At this time foreign remedies were also looked at with skepticism by the natives. In one instance, there was a fatal disease introduced by the French and when their doctors offered a remedy they were shunned by the natives whom had no confidence in their medicine (Lesson, 1981). Foreigners observed that poor sanitation, lack of sufficient medicines, and reduced resistance due to alcohol abuse all contributed to the relative ease with which these epidemics swept through the islands carrying natives to the graves by the thousands (Rallu, 1992). 50 Population Demographics and Diseases When examining a culture's medicinal system, understanding population demographics at the time of contact with the outside world and subsequently, gives us important insight into the decline of medicinal knowledge, ways how that culture might have dealt with the new diseases, and means of incorporating new plants in the fight against new diseases. First contact with the Western world came in 1595 with the arrival of Mendana in Tahuata. Estimates from this voyage were of 400 people living in one valley with a total population around 55,000 by extrapolation (Suggs, 1966). In April of 1774, Cook's Resolution circumnavigated the islands of Hiva Oa, Motane, and Fatu Hiva and made landing on Tahuata (McArthur, 1968). Total population estimates given by G. Forster from this voyage for the southern islands were about 50,000 and his father J.R. Forster thought the population to be around 100,000 (Agniel, 1998; MacArthur et al., 1967; Vigneron, 1985). Here an interesting question arises that would be very difficult to answer: how different were the population demographics in the year 1595 compared to that of 1774 when Cook arrived in the islands? This question is asked because it is probable that Mendaila introduced some diseases in 1595, and with the introduction of the Marquesas to the rest of the world with Cook's arrival, there was certainly a new set of diseases introduced at that time. Were the Marquesan people the second time around, more immunized and thus better prepared for the new diseases? Marchand, who visited the islands in 1791, estimated the population to be around 19,000 for the southern group with an extrapolated total population for the archipelago of between 32,000 and 65,000 (Suggs, 1966). In 1799, William Pascoe Crook gave an estimate of 90,750 total inhabitants for the archipelago (Agniel, 1998). He came up with this figure by taking the 51 number of warriors for each island and applying a multiplication coefficient of3.75 and coming up with his grand total (Agniel, 1998). Interestingly, early population estimates were based on Marquesan sources who also stated their population figures in terms of the number of warriors thus skewing the data because one did not know what portion of the population were in fact warriors (Suggs, 1966). MacArthur et al. (1967) states that none of the population estimates before 1800 can be taken seriously in terms of true accuracy in population projections. Jean Adam de Krusenstem who arrived in Taiohae, Nuku Hiva in May 1804 gave an estimate of 12,000 for that island (Bailleul, 2001; Suggs, 1966). By extrapolating this population, a figure of 70,000 is given for the archipelago (Suggs, 1966). In 1813, David Porter estimated there were 19,200 warriors in Nuku Hiva (Suggs, 1966). By extrapolating that figure a population exceeding 200,000 is determined for the archipelago (Suggs, 1966; Vigneron, 1985). Handy (1923) estimated that the population at the time of contact fluctuated between 50,000 and 100,000 while his colleague Ralph Linton (1923) gave an estimate of only 20,000. Extensive archaeological studies and research into native traditions and historical documents estimate the peak population, in the 1780-1790 periods, to be about 100,000 (Suggs, 1966). Kirch's (1996) estimate which is also based on both ethnographic and archaeological evidence falls well below Sugg's with about 35,000 for the archipelago. The demographic evidence given by Kirch (1996) includes models and equations for natural population growth which are more convincing then the estimates of others. Given all these conflicting estimates it is difficult to say how many people lived in the Marquesas at the time of contact and the years following contact. At the high end we have Sugg's estimate of 100,000 and at the low end we have Kirch's estimate of 35,000. Due to the difficulty in applying an exact 52 number to the population, I will assume that the Marquesan population was somewhere between 35,000- 100,000 people shortly after contact. Based on more reliable demographic studies (Table 7), it is clear that the population declined markedly between 1842 and 1856 and continued to decline throughout the 19th and early 20th centuries. As demographic statistics become more reliable we see a drop in the population after the 1800s'. Table 7 is based on population figures compiled from 3 different sources between 1834 and 1983 (Agniel, 1998; Suggs, 1966; Vigneron, 1985). Table 7 illustrates a dramatic decline in the population between the early 1800's and the early 1900's. Using the median ofthe two estimates (35,000 & 100,000) equaling around 67,500 people in the 1780s, 54 years later in 1834 there is a decline in the population of over 60%. By 1921, when the population bottomed out at 2,094 the population had declined by over 80%! This is a drastic example of de- population within a native community. This high mortality rate was due directly to the impact of foreign diseases on a native population which lacked the immunity to withstand them (Rallu, 1992). The effects of diseases are not only immediate, but they are also long lasting. Low fecundity rates and sterility are some side effects of these diseases which would significantly keep populations at lower densities over the generations. Table 7. Population Figures in the Marquesas between 1834 and 1983. Source Year Population 1) L.M.S. 1834 27,000 2) Dupetit-Thouars 1842 20,200 3) Jouan 1856 12,550 4) Lawson 1867 7,411 5) Eyriaud 1872 6,250 6) Official Census 1881 5,776 7) Clavel 1882 4,865 8) Official Census 1887 5,246 53 Table 7. (Continued) Population Figures in the Marquesas between 1834 and 1983. Source Year Population 9) " 1905 3,500 10) " 1911 3,116 11) " 1921 2,094 12) " 1926 2,255 13) Clavel 1931 2,282 14) Official Census 1946 2,968 15) Etat Civil 1956 4,180 16) INSEE 1983 6,548 The de-population of these islands did not go unnoticed by Westerners. Christian (1910) warned that the "population ever waning, and waning so fast that, unless the process be checked, within a generation there will not be one native left of Marquesan name". In contrast to comments from early visitors of what fine physical specimens the natives were, visitors to the islands in the early part of the 20th century commented on how "few are physically sound or free from serious disease of some kind (Handy, 1923)." Why were the people of the Marquesas and others in Polynesia so susceptible to these new diseases? There are many factors that contributed to the decline of the Marquesan population. These include disease, opium and alcohol abuse, warfare, depletion of resources, cultural erosion and out-migration (Robarts, 1974; Suggs, 1966). First and foremost, the natives lacked the general immunity to introduced diseases. If the native population had been exposure to these diseases over time, there would have been selection for resistant genes providing them immunity. The introduction of diseases into a non-immune population resulted in a steady decline in the population (Rallu, 1992). 54 Secondly, in regards to venereal diseases, the cultural outlook on sex as something freely given and received may have contributed to the spread of these infectious agents. These diseases came quite literally by the boatload with different epidemics and diseases sweeping through the islands, from the period immediately following contact up through the 20th century. Exposure to these diseases had an immediate and disastrous effect on the native population. The first diseases to have such a catastrophic effect were most likely venereal diseases such as syphilis, which may have been introduced by Mendaila in 1595. Although this carmot be substantiated (Agniel, 1998; Suggs, 1966), one author called syphilis "un cadeau des equipages de Mendaila" or a gift ofMendaila's crew (Rollin, 1974). J.R. Forester, on Cook's voyage in 1774, stated in his journal however, that there was an absence of any venereal disease in the Marquesas upon their arrival (Sheahan, 1955). Though it is possible that this same expedition may have introduced venereal diseases, Suggs (1966) did not seem to agree. Suggs (1966) argued that venereal diseases were not introduced with the arrival of the H.M.S. Resolution as Cook noted "only a few friendly women were found in a small settlement". Though this may have been the case, it only takes one friendly woman! In spite of his own argument, Suggs (1966) believed that the European explorers may have been responsible for the introduction of venereal diseases to the islands (Suggs, 1966). There is definitely no agreement amoung these authors to which explorers actually introduced venereal diseases into the Marquesas. The Marquesan word papaa, ironically, means both sailor and venereal disease suggesting that the natives knew who was responsible for the introduction of venereal disease (Dening, 1980). By 1840, syphilis and gonorrhea had already taken hold in the islands spreading throughout the archipelago (Suggs, 1966). 55 These venereal diseases had both immediate and lasting affects on the natives who initially contracted them, and on to those whom they were passed on in subsequent generations. While syphilis and gonorrhea reduced the life span of those who contracted them, these diseases also destroyed fetuses, reduced fertility, and led to sterility with in the population, making it even more difficult for the population to recover (Standard, 1989; Suggs, 1966). As far as TB is concerned there is mounting evidence that it may have been present in Hawai' i prior to European contact. This is based on evidence from skeletal remains that display the vertebral pathology consistent with TB (Trembly, 1997). IfTB was present in Hawai'i prior to European contact, was it also present in the Marquesas prior to European contact? The only evidence that suggests this may be true is based on a photograph of pre-contact skeletal remains from the Hane dune site in Va Huka that "appear" to have osteoarthritis, which is also consistent with TB (Trembly, 1997), but Martin et al. (1996) has stated that TB was a post -European introduction to the Marquesas. Other significant Polynesian island groups, such as Rapa Nui (Easter Island) and Aotearoa (New Zealand) eshowed that pre-contact skeletal remains did not show the lesions consistent with TB (Trembly, 1997). Historically, it is a Tahitian named Tama who has been attributed with introducing tuberculosis into the Marquesas in 1791 (Rollin, 1974). Other infectious diseases that passed through the islands included dysentery in 1845, an unknown type offever called "fievre de Californie" in 1850, and influenza in 1854 which passed through the three islands (Va Huka, Va Pou, and Nuku Hiva) in the north (Agniel, 1988; Lesson, 1981; Rollin, 1974). One of the worst epidemics to hit 56 these islands was called la variole or smallpox. Small pox was introduced to Nuku Hiva, around 1863, by infected Marquesan natives who had been taken from their islands by Peruvian slavers years earlier and whom returned on the ship Le Diamant on its way back from South America (Agniel, 1988; Clavel, 1885; Rollin, 1974). They unknowingly introduced smallpox, which was subsequently introduced to Ua Pou where it wiped out over one-quarter of the population, leaving some valleys with only one survivor (Kirkpatrick, 1983). This small pox epidemic was restricted mainly to the northern islands ofUa Pou and Nuku Hiva, while Ua Huka also in the northern group was surprisingly spared along with all islands in the south (Clavel, 1885). Typhoid fever was believed to have existed in the Marquesas, but its impact on the native population can not be substantiated (Clavel, 1885). It is without a doubt that influenza, typhoid, small pox, syphilis and other venereal diseases were all post-European introductions (Martin et al., 1996). Between the years of 1791 to 1864, over 80% of the population in the Marquesas was decimated from TB, typhoid, influenza, and smallpox (Martin et ai, 1996). Physicians of the time reported that the main cause of death in the islands were from dysentery, TB and other respiratory diseases (Rallu, 1992). Some researchers believed that elephantitis may have been endemic in the Marquesas prior to Western contact because of the existence of the Marquesan word fei fei, which has been loosely translated to mean elephantitis (Martin et al. 1996). The assumption by Martin et al. (1996) that elephantitis was already in the Marquesas based soley on the existence of the native word fei-fei is quite a stretch and not good science. The term fei-fei was translated in some of the early literature to mean elephantitis. Elephantitis is caused by the parasite Bancroftianfilariasis (Wuchereria bancrofti) which 57 is transferred by mosquitoes not present in the Marquesas prior to contact. According to Dening (1980), the mosquito responsible for the transmission of the parasitic worm Wuchereria bancrofti was brought by foreign ships in the 1830's, thus filariasis (elephantitis) could not have been in the Marquesas prior to that. Early travelers to these islands noted how prevalent elephantitis was on other Pacific islands, yet was virtually unknown in the Marquesas (Thomson, 1841). This supports the case made that filariasis was a post-contact introduction into the Marquesas. Leprosy or Hansen's disease is thought to have been introduced by Chinese laborers brought into the Marquesas to work on cotton plantations in the 1860' s (Dening, 1980). Within 20 years, leprosy was quite common throughout the archipelago. For example, in the valley of Anaiapa on Hiva Oa there were 18 lepers out of 173 total individuals whom inhabited the valley. In addition, the incident rate of leprosy was 4.11 % in 1884 throughout the whole archipelago (Clavel, 1885; Dening, 1980; Martin et ai., 1996). Leprosy was still present in the Marquesas up to the 1950' s with 17 known lepers in the islands (Sheahan, 1955). Other significant epidemics took place well after the turn of the century despite the fact that foreign physicians and medical supplies were getting into the Marquesas. These included an influenza outbreak in 1923 concentrated in the southern group of islands (Rollin, 1929), and a measles outbreak in 1949 (Sheahan, 1955). Over half of all adult deaths on Nuku Hiva between 1918 and 1929 were attributed to consumption or tuberculosis (Valenziani, 1940). During the 1950' s as more researchers visited the islands, accurate data on diseases, epidemics, and deaths became more apparent. Sheahan (1955) noted that the main diseases and treatable ailments present in the Marquesas were tuberculosis, venereal diseases, elephantitis and leprosy, 58 with the main causes of death attributed to tuberculosis, bronchi-pneumonia, and accidents such as drowning and bums. The American archaeologist Dr. Robert Suggs, whose research into Marquesan sexual behavior in the late 1950's, documented many common sexually transmitted diseases of that time along with some remedies. Suggs (1966) gives the general term for venereal diseases as mate 'uapu or street sickness. Three types of venereal disease were recorded by Suggs (1966): mimi hati or broken urine (gonorrhea), hao' ehi or white man's discharge (Granuloma Inguinale or Lympho Granuloma Vernerum), and pa'atita, which is known as syphilis. Of these, the most common venereal disease was gonorrhea, with syphilis being only a minor phenomenon (Suggs, 1966). Zepernick (1972) lists fifteen diseases, hygiene and first-aid categories that were treated with traditional medicine. These are not traditional categories and are artificially grouped by the author himself. His categories were based on the literature from Brown (1935), Handy (1923), Linton (1923), and Suggs (1966). These categories included wounds, insecticides, ulcers, boils, abscess, skin care, attending the hair, gonorrhea, menstruation, hygiene for female genitals, pregnancy, release of the after birth, the treatment toward the release of the after birth, treatments for newborns, genital hygiene for young girls, aphrodisiacs, and general weakness (Zepernick, 1972). In the next chapter, as the results of the interviews are analyized, we will see if these same categories forwarded by Zepernick compare to the categories elicited in the interviews. Medicinal Plants The transitional period in Marquesan medicine was most likely a time for testing, evolving and trying out new remedies and newly arriving plants. This was also a period 59 of increased westernization as these islands opened up to the rest of the world and became an official colony of France. Handy (1923) noted that "little is remembered today of the manner of professional practices [traditional ethnomedicine], although natives still make use of some of their old remedies, most of them, however, like the rest of their culture, having been forgotten". During the Bayard Dominick Expedition (1921-1922), the Bishop Museum sent out botanists Forrest B.H. Brown and Elizabeth D. Brown to the Marquesas Islands to survey the flora. This source, published in the form of a flora, has contributed to our understanding of those plants used medicinally by Marquesans of that time. More often than not, botanists will try to include usage of plants in their manuals or floras. Brown (1931, 1935) and Brown et al. (1931) attempted to apply native names and uses of plants in their treatments including medicinal uses. Table 8. Plants Used in Marquesan Ethnomedicine - Transitional Period: Scientific Name Native Name Plant Part Treatment (s) Source (s) (s) Reference Lycopodium kekeevae- ? medicinal Brown (1931) cernuum moa (Lycopodiaceae) Nephrolepis kaka'a hue leaves medicinal slave Suggs (1966) acutifolia for wounds; (Nephrolepidaceat:) astringent Nephrolepis kakaahua/ ? medicinal Brown (1931) hirsutula autapa mei (Nephrolepidaceae) Microsorum paamoe/ ? medicinal Brown (1931) scolopendria maapuaa/ (polypodiaceae) oumoo Cordyline fruticosa tJ ? medicinal Brown (1931) (Agavaceae) Amorphophallus teve arcidjuice medicinal Brown (1931) paeoniifolius (Araceae) 60 Table 8. (Continued) Plants Used in Marquesan Ethnomedicine - Transitional Period. Scientific Name Native Name Plant Part Treatment (s) Source (s) (8) Reference Cocos nuciftra 'ebi I'ebi liquid liquid medium for Brown(l93 I ); (Arecaceae) vaio'e I'ebi endosperm, medicines; Suggs (1966) pakanaia fleshy heartburn, kidney endosperm problems; vaginal coconut oil, astringents sap Pelagodoxa enu !vabane liquid medicinal Brown (1931) henryana endosperm (Arecaceae) Ananas comosus ba'aboka ! immature abortifacient Suggs (1966) (Bromeliaceae ) fa'aboka fruit Cladium mokuautoto stem medicinal Brown (1931) nukuhivense (Cyperaceae) Cyperus moutona mo'u tona inflores. internally for Brown (1931) (Cyperaceae) various illnesses Kyllinga brevifoUa baiki ? medicinal Brown (1931) (Cyperaceae) kubane. okiobina. maniania Musa paradisiaca meika! green medicinal Brown (1931) (Musaceae) mei'aI tissue? mei'a puapual mei'a pa'a fatulmei'a ta'aivao , Liparis clypeolum autabi whole plant; burns or Brown (1931) (Orchidaceae ) flowers and inflammation; stem indigestion Erianthus to kakabo! panicles substituted for Brown (1931) pedicellaris to kakaboa! sugarcane III (Poaceae) kaipeka medicines; headaches, colds Saccharum to kua! to ? medicinal Brown (1931) officinarum kakamau (poaceae) Curcuma longa 'eka rena rhizomes medicinal; Brown (Zingerberaceae) prolonged (1931); Petard menstruation (1986); Suggs (1966) 61 Table 8. (Continued) Plants Used in Marquesan Ethnomedicine - Transitional Period. Scientific Name Native Name Plant Part Treatment (8) Source (8) (8) Reference Cyathula prostrata patokomata ? medicinal Brown (1935) (Amaranthaceae) !tokomata / tabetabevai ! teepeeimata Achyranthes aspera mobo ki'o, branch vaginal Suggs (1966) var. aspera moki'o astringents (Amaranthaceae) Asclepias urururu vai ? medicinal (Hiva Brown (1935) curassavica kirata Oa) (Apocynaceae) Ageratum meie parari ! flowers, medicinal Brown (1935) conyzoides mei rore! leaves (Asteraceae) putara Bidens cordi/olia beato stems, medicinal Brown (1935) (Asteraceae) leaves, flowers Bidens pilosa ti whole plant poultice and Brown (1935) (Asteraceae) dressing for cuts Bidens polycephala beato whole plant medicinal Brown (1935) (Asteraceae) Sigesbeckia niou leaves, poultice for sores Whistler orientalis flowers and wounds (1992) (Asteraceae) Sonchus oleraceus pota! mei ? medicinal Brown (1935) (Asteraceae) pota Heliotropium touti manou ? medicinal Brown (1931) marchionicum /pokea (Boraginaceae) Cordia subcordata tou leaves medicinal, Brown (Boraginaceae) menstural (1935); Suggs problems (1966) Rorripa sarmentosa mani!mabi whole plant headaches, Brown (1935) (Brassicaceae) ! mabimabil rheumatism, aumoriaumo expelling evil ri spirits during childbirth Carica papaya vi inana/vi sap of male used as poultice, Brown (Caricaceae) Oabu tree sores and wounds (1935); Whistler (1992) 62 Table 8. (Continued) Plants Used in Marquesan Ethnomedicine - Transitional Period. Scientific Name Native Name Plant Part Treatment (s) Source (s) (s) Reference Benincasa hispida huepo'o stems menstural cramps, Suggs (1966) (Cucurbitaceae) irregular menstural cycle Cucumis anguria katiu stems menstural cramps, Suggs (1966) (Cucurbitaceae) irregular menstural cycle Lagenaria siceraria hue I bue pulp of the applied to sores Brown (1935) (Cucurbitaceae) maoi fruit Momordica pupuruvi ? medicinal Brown (1935) charantia (Cucurbitaceae) , Aleurites ama sap from thrush, skin Brown moluccana green fruit, disease, diuretic, (1935); (Euphorbiaceae) leaves, bark obstetrics; Handy gonorrhea; (1923); vaginal Petard (1986); astringent; salve; Suggs (1966) casting out spells; prolonged menstrations Chamaesyce hirta eaea I ? medicinal Brown (1935) (Euphorbiaceae) heahemael feemata Bauhinia monandra pine I fau leaves juice applied to Brown (1935) (Fabaceae) kina (mature) sores - healing agent Caesalpinia bonduc keaho stems menstrual cramps, Suggs (1966) (Fabaceae) irregular menstrual cycle Canavalia rosea pitae I leaves medicinal Brown (1935) (Fabaceae) piritai Erythrina variegata au kena leaves thrush; female Suggs (1966) (Fabaceaet discharge Vigna adenantha papa stems, medicine for post- Suggs (1966) (Fabaceae) leaves partum mother; astringents; Ocimum basilicum mini whole plant arresting Suggs (1966) (Lamiaceae) premature labor 63 Table 8. (Continued) Plants Used in Marquesan Ethnomedicine - Transitional Period. Scientific Name Native Name Plant Part Treatment (5) Source (s) (s) Reference Abutilon hirtum puehul ? medicinal Brown (1935) (Malvaceae) puapua kaina! mahoitit pukepul puepul haukea Hibiscus tiliaceus fau toui I flowers, poultice for sores, Brown (Malvaceae) haulfau young cuts, boils and (1935); shoots, bark, swellings; other Handy roots medicines; (1923); Suggs gonorrhea casting (1966); out evil spells Whistler (1992) Thespesia populnea mi'o fruits medicinal; Brown (Malvaceae) vaginal (1935); Suggs astringents (1966) Artocarpus altilis mei(ma) fruits vaginal Suggs (1966) (Moraceae) astringents Broussonteia outi roots gonorrhea Suggs (1966) papyri/era (Moraceae) Syzygium kehika I bark soaked in coconut Brown malaccense kehi'a oil and used as a (1935); (Myrtaceae) purgative; Handy gonorrhea; (1923); Suggs vaginal (1923); astringents; Whistler casting out evil (1992) spells Passiflorafoetida pua maninit leaves used as a bandage Brown (1935) (Passifloriaceae) puu maninit on wounds, puu moina! bruises or cuts puka orpuu heahea! koku Phyllanthus tn'erau leaves vaginal Suggs (1966) pacijicus astringents (phyllanthaceae) Phyllanthus manono ? medicinal Brown (1935) tenellus (Phyllanthaceae) 64 Table 8. (Continued) Plants Used in Marquesan Ethnomedicine - Transitional Period. Scientific Name Native Name Plant Part Treatment (s) Source (s) (s) Reference Macropiper kava kava leaves poultices for Brown latifolium atua rava pimples; ulcers; (1935); Suggs (piperaceae ) paa vaa tua prolonged (1966) menstruations Peperomia blanda vaianu I leaves skin diseases, eye Brown var.jloribunda vaiano 1 problems, bums, (1935); (Piperaceae) anuano boils Petard (1986) Peperomia pal/ida ami ? used for Brown (1935) (piperaceae) childhood ailments , Piper methysticum ava/kava rhizome! medicinal Brown (1935) (piperaceae) putoake root Plumbago kahauta ? medicinal Brown (1935) zeylanica (Plumbaginaceae) Morinda citrifolia noni leaves, inflammation; Brown (Rubiaceae) roots, fruits gonorrhea; (1935); syphilis; Handy bandages (1923); Petard (1986); Suggs (1966) Citrus aurantifolia hitoro fruit a remedy for Handy (Rutaceae) pa'atita (venereal (1923); Suggs disease) (1966) Santalum insulare puahi wood chips ear aches Brown (1935) var. marchionense (Santalaceae) Cardiospermum komokal stems medicinal; Brown halicacabum makiipahu menstural cramps, (1935); Suggs (Sapindaceae) irregular (1966) menstural cycle Sapindus saponaria koku'u leaves, skin diseases Brown (Sapindaceae) fruits (mouth); thrush; (1935); vaginal Petard (1986); astringents; Suggs (1966) Bacopa monnieri hei otona 1 whole plant medicinal- Brown (1935) (Scrophulariaceae) hai otakal internal umu hei otonal pui viivi Physalis peruviana konioi fruits medicinal Brown (1935) (Solanaceae) 65 Table 8. (Continued) Plants Used in Marquesan Etlmomedicine - Transitional Period. Scientific Name Native Name Plant Part Treatment (8) Source (s) (s) Reference Solanum oupoo ? medicinal Brown (1935) americanum (Solanaceae) Procris vaianu I fruit disorders of the Brown pedunculata kahautal digestive tract; (1935); Petard (Urticaceae) amiuta diarrhea, colic (1986) Table 8 is list of 66 plants used either medicinally or for other healthcare purposes. This list is compiled from the literature from Chapter IV on Marquesan traditional medicine in transition. Most, if not all of these plants may have been commonly used in pre-contact times but this is not concrete. What we do know is that the plants listed here were recorded by early visitors and scientists during this "transitional" period as being used medicinally. In some instances, the plant part or what treatments the plant was used for is unknown, thus a question mark or the word "medicinal" is put into the blanks. Absent from this list is Jalhropha gossypijolia, which according to a French informant, was introduced in the Marquesas in the hope that it would help cure leprosy. The reason it was not included is because this information wasn't collaborated by a native informant. The plants in Table 8 are taken from different sources that include Brown (1931, 1935), Brown el al. (1931), Handy (1923), Petard (1986) and Suggs (1966). The descriptions and uses of medicinal plants were at often times vague, giving no specifics on how the plants were used, prepared and administered, and more importantly for what diseases or ailments they were used to treat. Ailments that were mentioned included elephantitis, rheumatism, kidney problems, thrush, skin diseases including bums, headaches, wounds, general inflammation, colds, indigestion, 66 disorders of the digestive tract, heartburn, eye problems, childhood ailments, childbirth, boils, ear aches, and concoctions used as diuretic and purgatives. Plant parts listed included flowers, leaves, roots, fruit, stems, bark and whole plants. It seems that most of the plants were processed through macerating and juicing the different plant parts. These were then taken internally or applied externally as a poultice to problematic areas. In some cases the plants were applied using vapor baths. It is hard to determine if the remedies used by their (Brown, Handy, Petard, Suggs and Whistler) informants used combinations of different plants or just one plant by themselves. The few plant combinations mentioned always included using the oil, milk and liquid endosperm of the coconut. Handy (1923) discussed native maladies and their possible causations and also a bit on medicinal plants themselves. Unfortunately, most of Handy's report (1923) appears to be based on earlier works by Dordillion and Chaulet, two unpublished documents housed in the Catholic mission in the Marquesas (Nuku Hiva). Those remedies that appear to have been elicited during Handy's work involve limited use of medicinal plants. This includes a remedy for an illness pa' atita ( syphilis) that mixes lime (Citrus aurantifolia) juice with iron rust making a sort of salve which is applied directly to the problematic area (Handy, 1923). This remedy is nearly identical to the remedy used for the treatment of the venereal malady hao' ehi or white man's discharge as mentioned by Suggs (1966). Taking a rusty iron nail (te tupu 0 te puhipuhi) with the juice of the Citrus aurantifolia (vai hitoro), mixing the ingredients up in a bottle and letting it stand for two days, whereby the liquid is applied to the open sores three times a day (Suggs, 1966). The pa'atita was commonly recorded in the Marquesas as the venereal malady syphilis characterized by cold sores around the mouth and genital areas 67 (Delmas, 1927; Handy, 1923; Suggs, 1966). Handy (1923) did record some unique remedies including two magico-medical remedies for women who were supposedly possessed by evil spirits called hanaua (fanaua). The first remedy consisted of the water of a young green coconut (Cocos nucifera) and the finely powdered pearl shell (possibly from Pinctada margaritifora) mixed well into a drinkable potion (Handy, 1923). The other remedy included bark from Aleurites moluccanna, Hibiscus filiaceus, and Syzygium malaccense along with the skin of the Musa troglodyfarum fruit. All of these parts were mashed up and the juices squeezed out with a cloth (Handy, 1923). The patient would then drink this bitter potion while the tau' a struck her head with a noni (Morinda citrifolia) leaf driving out the evil spirits (Handy, 1923). Herbal remedies were also recorded by Suggs (1966) for a number of other venereal ailments, menstrual problems, vaginal astringents, and medicines for arresting premature labor. The different plants used in the Nuku Hiva remedy called haika mimi fati (medicine for gonorrhea) included the bark of'ama (Aleurites moluccana), the bark ofkehika (Syzygium malaccensis), the roots of hau (Hibiscus tiliaceus), the roots of outi (Broussonetia papyrifora), and the fruits of noni (Morinda citrifolia). These ingredients were pounded together and mixed with the water ofthe black coconut or 'ehi ke' e ke' e (Cocos nucifora) and drunk several times a day again for three days (Suggs, 1966). A major rite of passage for boys into adulthood involved the tehe or the super incision ofthe penis foreskin. In ancient times a skilled professional called the tuhukal tuhuna tehe was employed to do this job (Handy, 1923). A medicinal salve was prepared to speed the healing and to prevent infection. This salve was made from the bark of the 'ama (Aleurites moluccana) tree and leaves ofa fern called kaka'a hue 68 (Diellia brownii = Nephrolepis acutifolia) along with other unknown plants (Suggs, 1966). The salve was then applied to the wound daily and the penis placed against a hot boulder allowing it to dry, this heat was said to have beneficial healing properties (Suggs, 1966). In another recipe, the tuhukal tuhuna tehe would take juices from fruit of the moina (un-identified herb or shrub) and put it on the wound and place the penis on a heated black stone wrapped in noni (Morinda citrifolia) leaves (Handy, 1923). Medicines were also developed in treating the umbilical cord of newborns. These medicines were designed to dry out the umbilical cord. A medicine using the leaves of the papa (Vigna adenantha) were applied to the portion of the umbilical cord still attached to the newborn causing the stump to falloff in three days (Suggs, 1966). Another medicine, similar in content and function to the one for the super incision operation, used the leaves of Nephrolepis acutifolia which applied directly to the naval acted as an astringent (Suggs, 1966). This was also believed to have beneficial effects when applied to the entire body (Suggs, 1966). Interestingly enough, Suggs (1966) also mentions the use of a type of volcanic clay or tufa powder that was also applied to the attached umbilical cord in order to draw out moisture, allowing the area to dry properly. Newborn babies whose sclera (white of the eyes) was not clearly white were thought to have an unhealthy condition in which a medicine made from the leaves of an unidentified plant called pa' a 'u was used to treat (Suggs, 1966). No preparation technique was given for this remedy however. Newborns and young infants were often afflicted with something called mate kea or thrush. One remedy for thrush included using the crushed leaves of the Erythrina variegata mixed with mil or breadfruit paste and heated for the mother's consumption (Suggs, 1966). Other plant remedies included mixing the juices of 69 the Sapindus saponaria with coconut milk or using the sap from the green immature fruit or sap from the leaves of the Aleurites moluccana (Brown, 1935). Table 9. Plants Used in Marquesan Vaginal Astringents (Suggs, 1966). Native Name Scientific Name Plants Part (s) Used tu'ei'au Phyllanthus pacificus leaves koku'u Sapindus saponaria leaves ko'i'e Cocos nucifera young fruit moho ki'o (moki'o) Achyranthes aspera var. branch aspera vaima Artocarpus altilis rna kehika Syzygium malaccense bark , ama Aleurites moluccana bark mi'o Thespesia populnea fruit Vaginal astringents are an important part of Marquesan female hygiene. The purpose of these medications is to "shrink the vaginal mucous membranes, increase vaginal muscle tone and inhibit the production oflubricatory fluids (vai to'e) and to suppress genital malordorousness" (Kirkpatrick, 1983; Suggs, 1966). These are culturally important qualification for Marquesan females as it contributed to their sexual attractiveness. Because recipes differ from island to island and even between families, 70 plants used in these recipes differ. All of the recipes given by Suggs (1966) are applied in the same fashion, that is topically (Table 9). In a recipe called vai rna, the leftover water from the rna or fermented breadfruit paste (Appendix III) is pulled from the silos and used medicinally. This water is mixed with urine and then applied to the area topically. Usage of vaginal astringents is usually discontinued around the time of pUberty. At that time, another plant remedy is applied to the labia and surrounding mucous membrane in an effort to change the color of those areas to a more culturally favored tint. It is believed to be shameful to have the labia or mucous lining of the vulva an excessively ruddy color (Suggs, 1966). The fleshy endosperm of a young coconut (Cocos nucifera) is grated and applied to the area to render a color change (Suggs, 1966). Another kind of cosmetic treatment thought to enhance sexual attractiveness was the use of'eka or 'ena (Curcuma longa) on the skin, thought to have beneficial effects on the skin and also a sexually attractive smell (Suggs, 1966). Abortions called ha'atopa i te tama or "to make the child fall (out)" was mentioned by only one source and was said to be rare (but commonly known) because children were highly valued especially in the face of such massive depopulation (Suggs, 1966). The recipe involved the use of an unripe pineapple fruit (Ananas comosus) that was grated and eaten (Suggs, 1966). This abortifacient was only effective in the first three months of gestation (Suggs, 1966). Traditional medicine pertaining to female problems also existed during this transitional time in Marquesan ethnomedicine. They developed medicines for premature labor, afterbirth and menstrua1 disorders that included irregular menstruations, cramps 71 and prolonged menstruations called katahe. For arresting premature labor, the patient would actually sit on the grated material of mineI mini (Ocimum basilicum) allowing the vapors to enter through the vagina or squat over a fire allowing the medicine to enter by smoke or steam (Suggs, 1966). A medicinal tonic fashioned from the sap of the huetu (Musa troglodyatarum) fruit or from the pounded leaves of the ketae I enatae (Erythrina variegata) would be taken internally if bloody discharges continued (Suggs, 1966). There were also a few recipes used in female menstrua1 disorders. One recipe which is actually a laxative for general menstrual disorders, uses the pounded leaves of tou (Cordia subcordata) along with two other un-identified species called pa'o and te'e mixed with coconut milk (koehi), and taken internally (Suggs, 1966). Women with irregular menstrual cycles or cramps sat on a mixture of pounded stems for three days from four of the following plants: katiu (Cucumis anguria), huepo'o (Benincasa hispida), komoka (Cardiospermum halicacabum) and keaho (Caesalpinia bonduc) (Suggs, 1966). Those with prolonged menstruations called katahe went through an elaborate process to arrest the blood flow. The following is a list of plants taken from Suggs (1966) used in this medication: the bark of the 'ama (Aleurites moluccana), the leaves of the kava kava' atua (Macropiper latifolium), the roots of an un-identified plant called puava'o, the rhizome of the 'eka (Curcuma longa), and the meat from the 'ama (Aleurites moluccana) fruit. The macerated material was gathered and put on top of a fire pit and than covered with noni leaves allowing the smoke to enter the vagina of the patient who squatted over the fire (Suggs, 1966). This was done twice a day for three days (Suggs, 1966). Marquesans also developed medicines to help evacuate portions of the afterbirth that had not exited on their own. They made a medicine from the crushed 72 leaves of an unidentified plant called pa"a"u and a separate medicine from the stems of the papa (Vigna adenantha (Suggs, 1966). Medicinal Plants and Their Apparent Distributional Status: Transitional Endemic 11 % lntro 33% o Indigenous 33% • Polynesian Intro 23% Figure 5. Medicinal Plants and Their Distributional Status - Transitional Period " Figure 5 shows graphically the distributional status of the 66 medicinal plants referenced during this transitional period (Appendix IV). Interestingly, this chart shows that there were the exact same percentages (33%) for both Indigenous and Modem plant species. This was followed by Polynesian Introductions (23%) and lastly Endemics (11%). In the previous chapter, Figure I shows the distributional status of medicinal plants in the pre to early contact time period. These figures differ slightly in that Figure I the modem introductions rank the highest (39%) followed by Polynesian introductions (32%) with indigenous (25%) and endemic (4%) species being the last two. One would assume that there would be a higher reliance on native and Polynesian introduced plants for medicine in the pre to early contact period, but this figure does not reflect that. 73 Except for the high percentage of Polynesian introductions, it seems that there is a higher reliance on modem introductions. Overall, there are also more plants being used medicinally in the transitional period as compared to the pre to early contact period, with the numbers being 66 to 28. The reasons there are more medicinal plants listed in the transitional period is that the early literature is often incomplete. Early visitors may have only documented plants they themselves were familiar with, or they were simply removed from the everyday practice of native medicine and therefore could not accurately document. In the transitional period there is an equal reliance on the indigenous flora and modem introductions, with a slight drop in the use of Polynesian introduced plants, but a higher percentage of endemics. A higher reliance on the indigenous flora and Polynesian introductions is a pattern one would expect for the transitional time period. This is where the reliance on the indigenous flora and the Polynesian plants are high, but now healers are experimenting and using newly arriving plants, thus explaining the high percentage of modem plants being used (33%). What are some of the factors that may have influenced these percentages? The botanical knowledge and inquisitive probing by early botanists, naturalists and ethnologists like E.S. Craighill Handy, F.B.H. Brown and others, increase not only the number of plant species being used medicinally, but also how these plants were being used and for what purposes. This transitional period was a very important time as the medicinal system in the Marquesas evolved and adapted to newly introduced diseases and plant species. This was an era of constant empirical testing as healers built upon the knowledge passed down to them from previous generations. This was also a vulnerable time in traditional medicine 74 as it was consistently being undennined, probably not intentionally, by forces unknown to them. Along with the newly introduced diseases and plants, other forces would help shape the medicinal system into what it is today including western assimilation, and cultural and ecological degradation. As western medicine became more readily available, the natives relied less and less on their own medicine. Since they associated all these "superior" advances with the newcomers, it was not hard for the Marquesans who still attributed sickness and death to the gods of old, to adopt western medical practices at the time, even when in retrospect those advances were probably very minor (Whistler, 1992). Their herbal remedies were probably just as effective as the western medicine of that time. 75 CHAPTER V. MARQUESAN ETHNOMEDICINE OF HI VA OA: TODAY Introduction Throughout the preceding chapters, I have discussed Marquesan ethnomedicine in the past through its transition of contact with the Western world. Today, ethnomedicine is still practiced throughout the Marquesas and in particular where this research has taken place, on the island of Hiva Oa. The problem is that fewer and fewer people are using, learning, and applying traditional medicine. One of the main factors in this decline is the general westernization of the healthcare system. This westernization ofthe healthcare system in the Marquesas has allowed the people to rely more on Western medicine and less on traditional medicine in recent times. This decline is similar to that observed in other parts of Polynesia with increasing Westernization (Cox et al., 1991). In the Marquesas, there is greater access to Western medicine than ever before. There are two hospitals, one in the north on Nuku Hiva at Taiohae and one in the south on Hiva Oa at Atu ona. There are also a series of smaller infirmaries or clinics on the outer islands of Ua Pou, Ua Huka, and Fatu Hiva. These are often visited throughout each month by nurses or medical technicians with western medical training. In a sense, there exist two medicinal systems in the Marquesas: the Western medicinal system and the traditional Marquesan medicinal system. It also appears that the Marquesas is following the same trend that occurred elsewhere in Polynesia in places like Tahiti, Rarotonga (Cook Islands) and Samoa, where patients with "western" types of illness such as diabetes or other life threatening diseases will get medical treatment from a Western doctor (Whistler, 1992). For native ailments or illness, not effectively treated with Western medicine, patients will often visit with native healers in their respective villages. On islands such as Fatu Hiva 76 and Tahuata with less access to western medicine, there is probably more of a reliance on traditional medicine. In cases where the traditional medicine is not effective, the patient is often transported by boat to the main hospital on Hiva Oa. Before I go on to discuss the results of this research, it will be important to review the different methods used in the study. Materials & Methods This research employed methods now common in many ethnobotanical studies. Drawing on different anthropological and botanical techniques, the methods used were designed to gather both qualitative and quantitative data. The most important method was long- term participant observations (Balick et al., 1996; Bernard, 1988; 2002; Martin, 1995; Spradley, 1979). Informants for this research were identified using a snowball sampling method (Goodman, 1961). This method begins by asking an initial sample of individuals to name people, in this case those who practice some form of traditional medicine. These people who are named in the second wave can be asked a similar question to yield a third wave and so on (Erickson, 1979). Unstructured and semi-structured interviews were used to conduct this research (Bernard, 2002). The data that was obtained through these methods described above allowed me to make statistical inferences about various aspects of the relationships present in the study population (Goodman, 1961). Multivariate analysis in the form of reciprocal averaging (RA Ordination) or correspondence analysis and Detrended Correspondence Analysis and Basic Reciprocal Averaging (DECORANA) were some of the statistical tools used to analyze data (Hill, 1979). These analyses were facilitated using the Community Analysis Package 3.01 (Pisces Conservation Ltd, 2004). Voucher specimens were collected to 77 represent each plant listed by each informant and for verification of the species used (Alexiades, 1996; Balick et al., 1996; Cotton, 1996; Martin, 1995). Materials used in this research included a practical plant press and drier. These were used in the Marquesas so that specimens were collected, prepared, and dried appropriately (Alexiades, 1996; Balick et al., 1996). Other materials used were a Sony Memory Stick IC Recorder (ICD MS1), which was used to record the majority of the interviews and a Sony Cyber Shot DSC-F717 which was used to take both photographs and videos of informants, plants, and habitat shots. Interviews were written in short hand in a "Rite in the Rain" All Weather Field Notebook, and then later transcribed on to a "Super Conquerant" notebook. Identification ofInformants This entire process began when I mentioned to a friend in Pape'ete, Tahiti of my intention to go to the Marquesas to do research on traditional medicine. He said that he had a cousin in Nuku Hiva who was married to the mayor of that island and would get in touch with her. After a month, I was contacted by her and she invited me to stay at their house, but warned me that not too many people practiced traditional medicine and that those who did were not always willing to talk to foreigners. This contact began the snowball or chain referral system (Bernard, 1988, 2002; Erickson, 1979) that was used to identify subsequent informants. I traveled to Hiva Oa where most of my research was conducted. I was given a name of a tattoo artist on the island of Tahuata from my connection in Nuku Hiva and an anthropologist at the University of Hawai'i who studied tattooing in the Marquesas. Since I had a long term interest in Polynesian tattooing, I decided to contact the tattoo artist and to get a tattoo. I contacted the artist and expressed 78 ---.~-...-- my interest in studying traditional medicine. However he was not personally interested in this. Fortunately, he did arrange for my housing with family members in Hiva Oa. I asked the family with whom I was staying if they knew people in the village who practiced traditional medicine, and as it turned out the older matriarch of the family responded that she and her sister-in-law knew about traditional medicine. So it was that this woman who became my fIrst informant and my cultural confIdant for all subsequent interviews. When using a chain referral system in a small population such as those in the isolated islands of the Marquesas, a signifIcant sampling size is achieved when there are no new names being mentioned. Thus, the sample is signifIcant because it is considered to be a complete set of the possible information rather than simply a representative sample. Informed Consent Informed consent is an important aspect in any ethnobotanical research (Alexiades, 1996). Cultural sensitivity is essential in building rapport with people in a close knit community. The willingness of people to participate in the research project, thus obtaining data, is contingent on the ability of the investigator to establish this rapport. Before any interviews took place, I explicitly stated to potential informants that I was a researcher from the University of Hawai'i and the main purpose of my research was to document medicinal plant use (Appendix V - Informed Consent). I also informed them that any information I received would be used to write a "book" on Marquesan medicine. Once consent was given by the informant, it was never asked for again. Initially, I thought informed consent could be established by using an informed consent sheet that would state the purpose of the project allowing them to read, and then sign as 79 '" ... - .. proof of consent. I quickly learned that it was not appropriate to use this method as the paper added confusion to my purpose. If consent was not given or an informant did not want to talk to me, the interview process was halted. Input from the informants was necessary at all levels of this investigation. Informants were asked to review all data. In order to protect their anominity, consent was asked to use real names or an alias if they preferred. Interview format The interviews that were conducted were all unstructured interviews with direct questions interjected when unclear about a subject matter. For two ofthe informants, a round of semi-structured interviews took place with direct questions constructed based on ·our previous interviews. Interviews were conducted almost always in the home of the informants and always with my informant and cultural confidant (T.M.) who acted as translator (Marquesan to French) and moderator. Interviews usually took place during the day with some interviews extending into the evening before dinner. Never was an interview done after dinner. Sometimes the informant's family members were present, but more often there was just me, informant T.M. and the interviewee. Interviews were done during four visits to the Marquesas: June 1 - 4,2002; February 12,2003; June 26- July 9, 2003; and June 24, 2004. Informal or Unstructured Interviews Because of the nature of the Marquesan people (and native peoples in general), establishing rapport is one of the most important aspects in ethnobotanical research. How this is established depends on the investigator and the host culture. Spending time with the host culture and making repeated trips to the study location is important because it 80 shows that the investigator will spend the time and money to be there and also shows that the investigator's intentions are genuine. In this research, I found the most effective means of establishing rapport to be simply sitting down with the informants and talking. The effectiveness of using unstructured interviews in building rapport is well known in the ethnographic field (Bernard, 2002). Conversations were not necessarily about traditional medicine, but served to assist them in feeling comfortable with my presence and getting to know me better. I occasionally asked about plants and medicines and more often than not we engaged in an unstructured interview (Bernard, 1988) where the informant was telling me everything they knew about plant medicine. Unstructured interviews are characterized by a clear agenda and goal of the researcher with minimum control over informant responses (Bernard, 2002). I allowed them to talk without inteljecting direct questions except when I was unclear about something. This process allowed the informant to teach me what I needed to know, which included different aspects of Marquesan traditional medicine. This unstructured interview process was very valuable to me and proved to be the qualitative source of all data elicited in the interviews. Semi-structured Interviews At the end of the unstructured interviewing stage, the data collected was processed and questions were constructed to clarify aspects of the previous interviews regarding traditional medicine. During this research, two informants were interviewed with semi-structured questioning. They were informants T.M. and R.M. and a record of the questions given in those interviews can be found in Appendix VI. One objective in these interviews was to discover how and why a particular plant is selected and used. 81 - - -_ ...... - Another objective in these interviews was to elicit the different names of diseases and symptoms and what is treated by traditional medicine and how this was done. Other aspects during this stage of interviewing including correct spelling of native names for plants, diseases and treatments. This stage of interviewing allowed me to further build a good rapport with informants and also to further build on the information gathered in the unstructured interviews. Follow-up Participant Interviews Participant interviews (Bernard, 1988) begin with "establishing rapport ... learning to act so that people go about their business as usual. .. and removing yourself everyday from cultural immersions so you can intellectualize what you've learned, put it into perspective, and write about it". Once rapport had been established between me and each informant, I engaged in participant interviews (observations). This technique is based on observing human-plant interactions (Alexiades, 1996) while learning how to do the tasks that have previously been discussed in interviews. For instance, we would work together to gather plants and prepare remedies so that I would become familiar with the actual processes involved. Through this procedure many details that were not mentioned in the informal and semi-structured interviews were observed and learned. This is the advantage of participant observation: it allows the researcher to be certain that what has been recorded is actually what happens. The beauty of this method was the hands-on learning where fine points were more clearly understood. One drawback of this technique is that one may lose objectivity. Participant observation was an ongoing process that continued throughout the field research in this project. 82 Voucher Specimens A key component to all ethnobotanical research projects is the collection and preparation of voucher specimens (Alexiades, 1996; Cotton, 1996; Martin 1995). The voucher specimen allows for an accurate identification of the plants being used and provides a "link between two bodies of information - that of the Western scientist and that of the local people (Cotton, 1996)." Voucher specimens were made of all plants used in traditional medicine, even for store bought plants such as onions that were purchased in a local grocery store. Most plants were collected by myself and sometimes in conjunction with an informant. In some cases, the informant or a younger relative would actually collect the plant and bring it back to me. This presented a problem at first because they were not bringing back the right material and not enough of it. I had to advise them about proper plant collection techniques making sure that there was enough representive material (i.e. branch with leaves, flowers and fruits if possible) to make 4 voucher specimens. If and when the plant was unknown to me, the vouchers were identified using the PTBG herbarium collections that include a wide array ofthe Marquesan flora. Specimens that were collected in the field were put into a special field press until proper pressing and drying could be done. The plant press used to dry the material was the classic wooden plant press with cardboard insertions between the specimens. The specimens were placed between newspapers. The press was then cinched using straps. The drying process almost always took place at the Service de Developpement Rurale (SDR) in Atuona, Hiva Oa. Plants were dried with a light-bulb drier constructed by employees at the NTBG for the purpose of the Marquesas Flora project. These driers consisted of a plate made of wood with 5 light bulb sockets 83 .. -~---- ... - mounted facing upward (F igure 6). It was heated by 7S watt bulbs. Cinder blocks were used to the create base for the plant presses to sit on and then everything was wrapped with a pareo or lavalava to retain heat (Figure 7). Most ethnobotanically signi ficant plants collected during this research were made into four or more voucher specimens. When materials were scarce, one to three vouchers were made. Specimens were brought back to the National Tropical Botanical Garden for processing and database entry in Microsoft Access using the Bishop Museum founat. Labels were printed from the database in the herbarium of the NTBG whose acronyms PTBG stands from the original herbarium name - Pacific Tropical Botanical Garden . • • Figure 6. Light Bulb Plant Drier Duplicates were then deposited in different herbaria with the initial set being deposited in the National Tropical Botanical Garden herbarium (pTBG). The other sets were deposited in the herbaria of Tahiti (PAP), Paris (P), Bishop Museum (BISH) and 84 United States ational Herbarium (US) if more than four vouchers were taken. These are all formally recognized abbreviations for each of the five herbaria according to the Index Herbariorum (Holmgren et al. , 1990). For each voucher collection, details of the ecology (if a native plant), locality, native name, appearance, and scientific names were recorded (Cox el al. , 1989). [ Figure 7. Plant Drier Set with Cinder Blocks and Pareo (s) RESULTS Informants in the Marquesas There no longer exists in the Marquesas those priest! healers called the tau'a umoko or tau'a nanikaha. In a more simplified form there are those who could still be considered tuhuna fainu, or specialists who prepare medicinal potions or beverages, in the Marquesas today. Marquesan infoli ll ants are few and far between in Hiva Oa, especially those who actually practice traditional medicine. In doing this research, it was 85 really hard to find informants. Although I asked many people if they knew others who practiced traditional medicine, most of people mentioned the same two or three names. Logically this suggested that the particular people mentioned would probably hold more knowledge about traditional plant medicine than others. My study showed that people in the Marquesas, especially women, had a basic knowledge in plant medicines as it pertains to external injuries, common illnesses, and pediatric care. Further more, all Marquesan mothers knew something about plant medicine used to treat the ailments of infants and young children. The snowball sampling method identified ten potential informants, but only seven consented to be interviewed. All the people interviewed for this research resided on the island of Hiva Oa. Most of the interviewees lived in the main town of Atu ona, while the other two lived in Taaoa and Puamau, smaller districts on the islands of Hiva Oa. A total of seven people were interviewed with informants T.M. and R.M. being interviewed multiple times. Table 10. Demographic Information ofInterviewees. Name Gender Age (Approx.) District T.M. Female Mid 50's Atuona M.T. Female Mid 60's Taaoa P.T. Female Early 70's Atuona M.L. Female Mid to Late 60's Atuona H.H. Male Mid 40's Atuona R.M. Female Late 60's Atuona T.T. Male 64 years old Puamau 86 Out of the seven people interviewed, only two were male. The male interviewee, T.T, from Puamau was an elderly man of 64 years. The other male interviewee, H.H., from Atu ona was a man in his early to mid 40's. Informant H.H. actually learned medicine from his mother who was known in the village as a superior healer. The other six informants were all females in their early 50's to late 60's. Healers in the Marquesas tended more often to be female than male as was the case on the island of Hiva Oa where 80% of the informants were female. All of the informants interviewed in this research received their traditional herbal knowledge from older family members. This knowledge is passed down to the younger generation, but only to those who wish to learn. Several developments resulted from these interviews. First, there was one informant, who had stopped making medicine some time ago, but was subsequently re-invigorated to practice again by my interest in the subject. She started making medicine and learning from her elders. The daughter, whose mother I interviewed extensively, initially had no interest in plant medicines, but as my interviews with her mother continued she started to express interest in learning from her mother the traditional herbal remedies. It gives me great joy to know that my interest in this subject has actually stimulated the interest of others to learn their traditional herbal remedies. There is a great sense of propriety in the creation and application of the remedies discussed by these informants and this is reflected by the fact that many of them treat the same diseases, but have differing degrees or variations in their recipes. These recipes vary in actual ingredients and amounts. 87 Table II. An Example of Two Healer's Recipe for Apau Fati. HealerM.T. Healer R.M. Apau Fati ApauFati • 8 closed flowers of tia' e (Gardenia • 6 closed flowers of tia' e (Gardenia taitensis) taitensis) ·8 young (white) rhizomes ofpapamo'o ·4 'initi ofpapamo'o (Microsorum sp.) (Microsorum sp.) rhizome • 1 Tablespoon of brown sugar ·2 Tablespoon of brown sugar • 3 'initi of water • 3 'initi of water Table 12. An Example of Two Healer's Recipe for Apau Parari. Healer M.L. HealerR.M. Apau Parari Apau Parari • I handful of young leaves of tuava • 3 green fruit of the fa' ahoka (Ananas (Psidium guajava) cosmosus) • 10 closed flowers of tia' e (Gardenia ·6 whole fruit of the vai'o'e 'ere'ere taitensis) (Cocos nucifera - green variety) for its liquid endosperm • I handful of young leaves ofva'ova'o (Premna serratifolia) • 1 "bouchon rouge"· of a young vai' 0' e 'ere'ere (Cocos nucifera - green variety) • I whole fruit of the vai'o'e 'ere'ere (Cocos nucifera - green variety) for its liquid endosperm • the word bouchon rouge may refer to the area of the immature fruit peri carp or endocarp located beneath the calyx 88 An example ofthis difference in recipes is shown in both Tables 11 and 12. Table 11 shows two healers' recipes for the ailment called apau fati. The recipe for apau parari in Table 12 shows mark difference in both plant ingredients and amounts of those ingredients. The variation in these recipes is only evident in the amounts used, while the ingredients are exactly the same. Thus, each family has a set of their own herbal remedies, with this information being passed down from generation to generation. Healers may also experiment with new plants and plant combinations based on inspiration and from dreams. Although many of the healers I talked to discounted the idea of borrowing recipes from other healers not of the same family line, I did see this happen on a few occasions where an informant incorporated recipes she had learned form a friend of a different medicinal tradition. In the Marquesas, a healer can make a medicine for a neighbor or stranger to take, but it is tapu for them to give them the recipe to make themselves. Those that may steal a recipe from some other healer and make it themselves may find that the recipe may not work or will make the patient even sicker than before. I have seen people who continue to visit a healer for treatment even though the recipe could be easily made at home. Because this person is the healer, there are certain elements other than the actual herbal formulation itself that are going into the healing process. A sort of metaphysical healing and a relationship between healer and patient is evident. Monetary compensation for herbal treatments was not evident and this may be because treatments were given to family members and friends. Some sort of compensation in the way of gifts may occur, but immediate payment, either monetary or through gift giving, was not observed. 89 Infonnants stressed the importance of not mixing western and traditional fonns of medicines together. It is either one or the other but not both. If these two medicines are mixed it could result in worsening of the sickness or even death. The amount of illness or sickness that was treated by infonnants varied. For example, where healer T.T. listed only two illnesses that he treated, healer R.M. identified nine. All of the healers seemed to treat a varying array of illnesses, from earaches to cancer, bronchitis, and venereal diseases. None of the healers seemed to specialize in one particular type of medicine. There was no infonnant that I interviewed who specialized in anyone category such as internal diseases or spiritual sickness. The only specialization that I came across was in the case of pediatric care. Most Marquesan women who had birthed children retained this kind of knowledge. This was more common knowledge then anything else and not something just retained by specialist infonnants. The diversity of plant species and plant parts used as well as the technique of ordering and placement of plants in the making of herbal remedies also varied between the different infonnants. This idea of ordering and placement will be explained further on in this chapter. Disease Causations In Chapters III and IV, the causations of sickness and diseases were discussed in the context of that period in time. Western influences changed indigenous perspectives on disease causations. It would not be hard to say that the cause of diseases and sickness are probably a lot different than they were 100 to 200 years ago. As in modem Tahitian herbal medicine (Whistler, 1992), the infonnants I interviewed in the Marquesas focused mostly on the remedies rather than the ailment. For many of the disease or sickness 90 categories that we discussed, it was hard for the informant to tell me the exact cause of the disease. During interviews, informants would discuss their recipes which were given in binomials such as apau fati or apau epa or sometimes as a trinomial (apau vrihoa topa). The first word apau means "the medicine", whereas the second part of the binomial refers to the malady. Where there is a third word in the remedy, it is often a descriptor of that malady. While their recipes may be quite specific, the actual causes and symptoms were often vague. Informants seemed to have an understanding of some sort of germ theory in disease causation. Informants also attributed some causes to organic trauma, inadequate hygiene and improper diet. Sickness caused by supernatural agents called tupapa'u is recognized in the Marquesas, but informants played down the significance of this. When asked about tupapa' u, one informant related that although some people believe in and treat this sickness, being a Christian she herself did not believe in the existence of such a form of illness. For the most part in the traditional medicinal system of the Marquesas, the disease and sickness categories have some sort of western counterpart. Remedies and Diseases! Ailment Categories Families have their own sets of apau (medicines) for different ailments. The relationship between apau and ailment leads to a binomial (or trinomial) combination that is unique to the healing tradition (family). This results in similar ailments having different names with in different families. For example, three different healers gave three different names for a recipe to treat hemorrhoids. These were apau vrihoa topa, ko (vi'ihoa), and vi'ihoa keo. Another example is provided by recipes for what I think is equivalent to pneumonia. Again, three different healers gave different names for this one 91 ., ailment. Those names included apau vi'ihoa puta toetoe, puta mitoe, vi'ihoa JI_, and vi'ihoa tu. Ailments were discussed, in the interviews, in the form of their remedies. This means when asked what kind sicknesses a healer treats, they usually responded by giving the name of the remedy along with the recipe. Consequently, I have coupled the remedies with the diseases or illness categories. Table 13. A List of the 30 Disease or Ailment Categories Elicited in the Interviews. Native Name Western Equivelent Apau Vi'ihoa Topa Hemorrhoids Tiheke Purge Apau Fefe (cancer) Cancer Apau Mimi Ke'a Kidney stones Apau Ouma-pe Bronchitis ApauParari Irregular menstrual cycle ApauEpa External water blisters/ thrush Apau Evita'a Ligament damage Apau Fati Broken bones or contusions ApauKea Thrush Apau Puaroto Fe'etama Internal tumor Apau Taupo External skin problems Apau Vi'ihoa Puta Toetoe Pneumonia? Apau Epa - Pa'atita Venereal disease Apau Fefe Boils, infected sores ApauHea Vaginal secretion Apau Ira Toiki Infant convulsions Apau Kaki Memae Sore throat ApauM_i Sores in and around mouth area ApauMata Conjunctivitis or ocular irritation Apau Mate Fanaua External vaginal cleanse Apau Mo'opa'a Mucus buildup in throat Apau note Toto Internal vaginal cleanse Apau Tekeo Fish poisoning i.e. Ciguatera Apau Toiki Infant purge Apau Memae Puhi Kaioo Migraines resulting from sunstrokes Apau Memae te Pito Inflamed naval/ abdominal pain Apau Ve'a Heartburn or ulcer Apau mate i te puaina Ear aches Apau mate i te puo vaevae Sprained Ankles 92 The series of interviews that took place resulted in a list of some 30 diseases or ailment categories in the form of the remedy binomial (Table 13). There were those diseases or ailments that had an exact western counterpart while others were harder to define in terms of fmding a western equivalent. For example, I was unable to find an exact western counterpart for the ailment known as vi'ihoa puta toetoe. See Appendix VII for further definitions of the disease and illness categories. Results from the interviews revealed a group of ailments related by the word vi'ihoa. There are many different kinds ofvi'ihoa ailments some of which seemed to be synonyms, while others seemed totally unrelated. Initially, there was a bit of confusion regarding the term vi'ihoa, because of the seemingly wide range of sicknesses containing this word. This word vi'ihoa is defined as an excrescence or outgrowth, a polyp or hemorrhoid (Le Cleac'h, 1997; Mansion, 1950). The following remedies contain the word vi'ihoa: apau ko (vi'ihoa), apau vi'ihoa puta toetoe ....p_, apau vi'ihoa topa, apau vi'ihoa keo, and apau vi'ihoa tn. The terms vi'ihoa topa, ko (vi'ihoa), and vi'ihoa keo are synonyms and refer to the condition known as hemorrhoids. But not all of the vi'ihoa ailments can be described as a hemorrhoid or a type of outgrowth. The remaining vi'ihoa ailments are not hemorrhoidal. These are vi'ihoa puta toetoe ....p _ and vi'ihoa tu which refer to a type of soreness and coldness all over the body and is characterized by a sharp pain in the stomach region. The data also showed four illness categories that specifically amict women. These are: apau parari, apau note toto (apau parari no te vahine hopu), apau note mate fanaua, and apau he' a. Three different informants gave information regarding apau parari. Women who have parari become sick because of irregular menstrual 93 cycles and the treatment given helps to re-align this cycle. This remedy is also designed to help to cleanse the vagina and the other female reproductive organs. All three of the recipes given were made into ajuice drink. Apau note toto (apau parari note vahine hope) affects women who have recently given birth without delivering the placenta (placental dystocia). This leads to infection with symptoms that include continuous blood flow. The remedy may be used to arrest post-partum hemorrhaging and is also designed to cleanse out the womb. The treatment includes an herbal drink along with an exterior steam bath to the infected area. Like the apau note toto, the remedy known as apau mate Canaua is also taken by women who have just given birth to cleanse the vaginal area. This remedy is strictly an external cleansing that involves a steam bath and wash. The last ailment that is specific to the female gender is called apau he' a. Only one informant (M.T.) described a remedy for this ailment and she was unclear about its causes and symptoms. The only thing she mentioned was that it only afflicted women and during the treatment, they were not allowed to have sex. See appendix VII for a more in depth discussion of this ailment. As there are diseases specific to women, there are also those specific to children. These diseases include: apau epa, apau ira toiki, apau kea, apau toiki and possibly apau mJ Both apau epa and apau kea have been defined as a type of thrush with each involving different symptoms. Apau toiki and the adult counterpart called the tiheke are traditional purges or cleanses both which will be dealt with under section called Tiheke. Apau ira toiki is a group of childhood afflictions commonly treated in Tahiti and the Marquesas. Informant R.M. was the only healer who treated these ira ailments revealing four different ira categories (ira patu, ira metoe, ira niho, and ira manu). It is hard to 94 -.""* - •• - -~ ...... - find a western equivalent for the ira type of ailments which are a type of convulsions that afflict children. The ira ailments, which are common across Polynesia, may refer to the condition known as baby colic. Apau m_i is a questionable childhood ailment only because the subject was stimulated by an interview regarding apau kea which is specific to children. Two ailment categories involved external skin problems. Apau CeCe and apau taupo can be defined as infected open sores, wounds, or boils. The term feCe has many meanings in Marquesan epidemiology such as a boil, infected sore and even elephantitis (also fei-Cei). Two healers also referred to fefe as a cancer. They probably see that the external CeCe acts in the same way as the internal CeCe, a sort of infection that spreads through the body if left untreated. Another informant referred to cancer as just "apau cancer" without using the word CeCe to denote cancer. There is also what is known as apau puarotolCe' etama, which has been described by one informant to be the same as apau CeCe (the non-cancerous one), but the focus of the infection is an internal tumor. Throat ailments include apau note kaki, apau kaki memae, and apau mo'opa'a. Kaki memae, or sore throat, was mentioned by informant, T.M who gave me one recipe and I also observed her make a different remedy for a patient's sore throat. These two recipes differed in ingredients and application. The apau listed in the interview was used as a gargle for the throat while the other observed was drunk as a juice. The apau I observed her making was for an elderly woman who had a very sore throat and she sounded like she had laryngitis. In another interview a year later with the same informant she (T.M.) gave a recipe that was called apau note kaki or medicine for the throat. This differed from the other ones in that more diverse plant ingredients were used along with 95 more elaborate preparation techniques. The symptoms for apan note kaki were similar to apan kaki including chronic sore' throat, constant coughing and an inability to breathe well. T.M. described it as a kind of phlegm or mucous. This ailment seemed more similar to apan mo' opa' a which is a medicine designed to eliminate mucous or phlegm buildup in the throat region. Thus, it is hard to determine if apan note kaki is more synonymous to apan kaki memae or apan mo'opa'a. There are other diseases or ailments that are treated in the Marquesas that have close Western equivalents such as apan onma-pe (bronchitis), apan mimi ke'a (kidney stones), apan epa - pa' atita ( venereal diseases), apan mata (conjunctivitis or ocular irritation), apan tekeo (fish poisoning probably due to Ciguatera), apan ve'a (heartburn or ulcer), and apan mate i te pnaina (ear aches). In contrast, there are those ailments such as apan memae te pito that seemed to have no Western equivalent. I was only able to interview one informant once who mentioned this illness that involved symptoms of an inflamed naval. None ofthe other informants reported this illness. This ailment may refer to some sort of abdominal pain. Remedies related to organic trauma include evita'a (ligament damage), memae pnhi kaio'o or memae te po'o (migraines resulting from sunstrokes) and mate i te pno vaevae (sprained ankles). Although more than just an injury from organic trauma, the remedy called apan fati is by definition a break or a fracture. It goes deeper than this though as one informant explained that if one falls down or has some sort of physical trauma to the body leading to shock, then a medicine is taken to prevent any additional sickness from occurring. Another informant stated that in the healing process of Cati, one 96 must not drive on bumpy roads or ride on horseback, nor lift any heavy objects or be involved in any kind of hard labor as these will aggravate the fati. During these interviews, a total of 30 different diseases, illness or first-aid categories were elicited. Some of the relationships between healers and diseases were explored. Appendix VIII shows the relationship between healers and the diseases that they treated, along with the constancy rate and whether these were commonly, occasionally or infrequently treated by each healer. The top two commonly treated disease I illness I first-aid categories were apau vi'ihoa topa (hemorrhoids) and the tiheke (purge) with constancy rate of 57.1 % (common). This means that out of the seven total healers interviewed at least four of them mentioned treating or using these two categories. There were five other disease I illness I first-aid categories also designated as common with a constancy rate of 42.9%. These were apau fefe (cancer), apau mimi ke'a (kidney stones), apau 'ouma-pe (bronchitis), apau parari (irregular menstrual cycles), and apau vi'ihoa puta toetoe (pneumonia?). Out of the seven healers interviewed, three of them mentioned treating anyone of these categories. The next five disease categories which are designated as being treated occasionally by the healers are apau epa (external water blister), apau evita'a (ligament damage), apau fati (broken I fractured bones or contusions), apau kea (thrush), and apau puaroto-fe'etama (internal tumor). These disease I illness I first-aid categories fall into the constancy rate of28.6%. Only two of the seven healers treated anyone of these diseases. The last group of disease that is designated as being treated infrequently with a constancy rate of 14.3% make of the bulk of the 30 disease/illness/first-aid categories with a total of 17 are as follows: apau epa (venereal), apau fefe (infected open sores), apau hea (vaginal secretions), 97 apau ira toiki (infant maladies), apau kaki memae (sore throat), apau mai (sore in and around the mouth area), apau mata (conjunctivitis or ocular irritation), apau mate fanaua (external vaginal cleanse), apau mo' opa' a (mucus buildup in the throat), apau toto (internal vaginal cleanse), apau tekeo (fish poisoning), apau toiki (infant purge), apau memae puhi kaio'o (migraines resulting from sunstrokes), apau memae te pito (inflamed naval or possibly abdominal pain), ear aches and sprained ankles. All of these categories only have one out of the seven healers that treat anyone of them. Table 14 makes it easier to show the different healers and the diseases or illness they treated. Table 14. Disease and Ailment Categories and the Healers Who Treat Them. DiseaseslIllnessl First- Healers DiseaseslIllnessl First- Healer Aid Catee:ories Aid Catee:ories 1. Apau Vi'ihoa T.M.,R.M., 16. Apau Ira Toiki R.M. Topa P.T., T.T. 2. Tiheke T.M.,R.M., 17. Apau Kaki T.M. M.T.,P.T Memae 3. Apau Fefe T.M.,M.T., 18. Apau Mai R.M. (cancer) H.H. 4. Apau Mimi Ke'a R.M.,M.T., 19. Apau Mata M.L. P.T. 5. Apau' Ouma-pe M.T.,P.T., 20. Apau Mate T.M. H.H. Fanaua 6. Apau Papari T.M.,R.M., 21. Apau Mo'opa'a H.H. M.L. 7. Apau Vi'ihoa T.M.,R.M., 22. Apau Toto T.M. T.T. 8. Apau Epa T.M.,M.L. 23. Apau Tekeo M.L. 9. Apau Evita'a R.M., H.H. 24. Apau Toiki T.M. 10. Apau Fati R.M.,M.T. 25. ApauMemae P.T. Puhi Kaio'o 98 Table 14. (Continued) Disease and Ailment Categories and the Healers Who Treat Them. DiseaseslIllnessl First- Healers Diseasesllllnessl First- Healer Aid Categories Aid Cate20ries 11. ApauKea R.M.,H.H. 26. Apau Memae te P.T. Pito 12. Apau Puaroto- T.M.,M.T. 27. Apau Ve'a T.T. Fe'etama 13. Apau Taupo T.M.,P.T. 28. Apau mate i te M.T. puaina 14. ApauEpa R.M. 29. Apau mate i te M.T. (venereal) puo vaevae 15. Apau Fefe T.M. All of the data that was gathered during the interviews was set up in a data matrix with healers on top and the value measured on the x-axis. In the two data sets, both diseases treated by each healer and plant species used by each healer were measured. These data sets were analyzed with the Community Analysis Package 3.01 software program (Pisces Conservation Ltd., 2001). Figure 5 is a dendrogram based on the agglomerative hierarchical clustering, Ward's linkage and Euclidean distances. 99 ~------T.M. ~------R.M. ~------M.T. ------H.H. ------P.T. ,...------M. L. ------T. T. Figure 8. Dendrogram Showing the Relationship between Healers and the Diseases They Treated. Looking at this dendrogram, certain grouping can be seen. A group of healers consisting ofM.T., H.H. and P.T. are closely grouped. At the bottom of the dendrogram (Figure 8), healers M.T. and H.H. may be coupled together by the fact that they both treat two ailment categories that are commonly treated by 3 out of 7 healers. Healer P.T comes out of that same group maybe because of the fact that P.T. treats a common ailment along with M.T. and H.H. and treats two other common ailments with M.T. Healers M.L. and T.T. are coupled together as a third grouping. Both healers do not treat any diseases or ailments in common and the reason why they are coupled together is unknown. It may be that they treat the same number (3) of diseases or ailments. 100 - -- -- . - -~- ,---,. --'- ...... DECORANA Ordination Plot - disease 380 3<;, HH ~, a ;0''" 2" 260 2<, ,,' "0 , ,., ~ '" '" >20 R.M to T.1. ML P.i TM • D • • • M.T ·20 • • 50 160 150 '0' 250 300 350 40' '50 550 sOo SSQ 700 750 ~1.1 "" Figure 9. The Relationship between the Healers and the Disease and Ailment Categories They Treated. Figure 9 was generated using a DECORANA Ordination plot or a Detrended Correspondence Analysis plot that helps to summarize the relationship between healers and the diseases they treated. Some of the patterns that this graph illustrates are that healers T.M., M.T., R.M. and P.T form a loose grouping in the middle. One explanation that may show why they have this close association compared to the other healers is that they (T.M., R.M., M.T. and P.T.) all gave a recipe for the tiheke or traditional purges. They also represent the top four healers in terms of the amount of diseases or ailments they treated with T.M. treating 14 followed by R.M. (II), M.T. (8), and P.T. (7). Taking a look at the top seven common disease and ailment categories (apau vi'ihoa topa, tiheke, apau fefe (cancer), apau mimi ke'a, apau ouma pe, apau parari and apau 101 vi'ihoa puta toetoe) treated by healers, at least two of these healers (T.M., R.M., M.T. and P.T.) are treating anyone of these most common categories (Appendix XII). Medicinal Plants Informants on Hiva Oa employ medicines primarily based on the flora that surrounds them. In certain recipes, some healers incorporated non-plant materials into their pharmacopoeia such as a certain species of coastal crab, chicken organs, eggs and alcohol. The plant parts used in medicinal concoctions differ from healer to healer. A total of 36 different plant species were used medicinally by informants in this research (see Appendix IX for taxonomic descriptions and distributions of the medicinal plants used by healers in this research). Table 15. Plants Used in Marquesan Ethnomedicine Elicited During Interviews. Scientific Name Native Name (s) Plant Part (s) Treatment (s) Healers Microsorum papamokol rhizomes; apau epa, apau T.M. membranifolium papamo' o/niapa young rhizomes ouma-pe, apau M.L. (Polypodiaceae) Guvenile plantIet) (white); young fati, apau R.M. leaves; leaves w evita' a, apau M.T. I 5 lobes; niapa toiki (tiheke), P.T. = whole plant, apau kea, apau H.H. young leaf evita'a Microsorum papamoko/ young rhizomes apau epa, apau T.M. scolopendria papamo' o/niapa (white); young ouma-pe, apau M.L. (Polypodiaceae) Guvenile plantIet) leaves; leaves w fati, apau R.M. / 5 lobes; niapa evita' a, apau M.T. = whole plant kea, apau P.T. toiki, apau H.H. evita 'a 102 Table 15. (Continued) Plants Used in Marquesan Ethnomedicine Elicited During Interviews. Scientific Name Native Name Plant Part (s) Treatment Healers (s) (s) Cocos nuciftra 'ehi I'e'ehi green variety tiheke, apau P.T. (Arecaceae) (water, meat, epa,apau RM. roots); red variety fefe (cancer), H.H. (roots); meat; apaumemae T.M. immature fruit te pito, apau M.T. (taking off the ouma-pe, M.L. sepals and the apau parari, white or red meat apau kea, underneath apau vi'ihoa puta toetoe, apau vi'ihoa topa, apau ira toiki, apau toiki (tiheke) Ananas cosmos fa'ahoka green fruit apau parari RM. (Bromeliaceae) T.M. Kyllinga mutie pua vert whole plant apau memae P.T. brevifolia te pito (Cyperaceae) Kyllinga mutie po'o whole plant apau epa, R.M. nemoralis maita apau he'a M.T. eCyperaceae) Allium cepa aniani bulb apau H.H. (Liliaceae) mo'opa'a Cenchrus piripiri leaves apau fefe M.T. echinatus (cancer) (Poaceae) Sacchrum to internodal stems apau ira T.M. ojjicinarum (pounded and toiki, apau RM. (poaceae) juiced); leaves toiki (tiheke), M.T. apau epa, apau ouma pe , Curcuma Zonga ena I'eka rhizomes apau note T.M. (Zingerberaceae) kaki 103 Table 15. (Continued) Plants Used in Marquesan Ethnomedicine Elicited During Interviews. Scientific Name Native Name (s) Plant Part (s) Treatment Healers (s) Amaranthus poti'i young whole apau ouma- P.T. viridus plant wI no pe (Amaranthaceae) flowers Cordia tou bark; leaves (both apau epa, R.M. subcordata yellow and apau note M.T. (Boraginaceae) green); bark (take kaki, apau P.T. off outer layer) he'a, apau T.T. ouma-pe, apau mimi ke'a, apau vi'ihoa puta toetoe, apau vi'ihoa topa, tiheke Rorippa mahimai I mahi leaves; young apau mai, T.M. sarmentosa leaves; whole apau note R.M. (Brassicaceae) plant kaki, apau vi'ihoa topa, apau vi'ihoa puta toetoe , Ipomoea batatas uma'a I kuma'a leaves apau note T.M. (Convolvulaceae kaki ) , Aleurites ama bark; endosperm apau epa, T.M. moluccana (meat); young apau kea, R.M. (Euphorbiaceae) leaves apau mimi kea,apau toiki (tiheke), apau vi'ihoa topa Manihot manioka leaves apau vi'ihoa R.M. esculenta topa (Euphorbiaceae) Crotalaria pakokotanitani roots apau fefe T.M. retusa (Fabaceae) 104 Table 15. (Continued) Plants Used in Marquesan Ethnomedicine Elicited During Interviews. Scientific Name Native Name (s) Plant Part (s) Treatment (s) Healers Vigna adenantha papa /papa apau leaves; whole apau vi'ihoa T.M. (Fabaceae) plant topa, apau R.M. vi'ihoa puta P.T. toetoe T.T. Premna va'o va'o young leaves; tiheke, apau T.M. serrati/olia young stem (outer mimi ke'a, RM. (Lamiaceae) epidermis used); apau toiki M.L. bark (take off (tiheke), apau outer layer and parari use white part) Barringtonia hutu fruit apau CeCe, apau T.M. asiatica taupo (Lecythidaceae) Hibiscus rosa- koute 'enana / flower in bud; apau ira toiki, RM. sinensis 'oute 'enata leaves (green and apau mata M.L. (Mal vaceae ) yellow) Thespesia mi'o bark (take off apau epa, apau T.M. populnea outer layer, use toiki (tiheke), RM. (Mal vaceae) white layer apau puaroto / M.T. underneath); fe' etama, apau P.T. seeds; fruits memae puhi (green - kaio'o immature) Artocarpus mei mei paea variety apau note T.M. altilis (bark, petiole of kaki, apau R.M. (Moraceae) green and yellow vi'ihoa topa, P.T. leaves), ma, mei apau taupo, H.H. ku' ukou variety apau fefe (tige) (cancer) Ficus prolixa a'oa young aerial roots apau epa, T.M. var. prolixa - white tips tiheke, apau R.M. (Moraceae) he'a M.T. Psidium guajava tuava leaves (young) apau note R.M. (Myrtaceae) mate fanaua, M.L. apau parari, apau note toto Phyllanthus tui whole plant apau mate i te M.T. amarus puaina (Phyllanthaceae) 105 Table 15. (Continued) Plants Used in Marquesan Ethnomedicine Elicited During Interviews. Scientific Name Native Name (8) Plant Part (8) Treatment (8) Healers Syzygium kehika I kehi' a bark apau vi'ihoa T.M. malaccense topa, apau R.M. (M yrtaceae) vi'ihoa puta P.T. toetoe, tiheke T.T. Pisonia grandis pukatea I puatea leaves apau ouma-pe H.H. (Nyctaginaceae) Colubrina tutu stems apau evita' a, R.M. asiatica apauepa H.H. (Rhamnaceae) M.L. Gardenia tia 'e young flowers tiheke, apau T.M. taitensis (closed); leaves ira toiki, apau R.M. (Rubiaceae) (green and toiki (tiheke), M.T. yellow) apau epa, P.T. apau fefe M.L. (cancer), apau he'a, apau ouma-pe, apau fati, apau taupo, apau parari, apau fati Morinda noni fruits; tiheke, apau M.T. citrifolia interpetiolar puaroto I H.H. (Rubiaceae) stipules; fruits wI fe' etama, apau flowers; fruits kea (green/white ones) Citrus hitoro I citron fruit; young apau vi'ihoa T.M. aurantiifolia leaves puta toetoe, M.L. (Rutaceae) apau note T.T. mate fanaua, apau tekeo, apau note toto apau ve'a, apau kaki memae 106 --_.," __ a. _ __ " Table 15. (Continued) Plants Used in Marquesan Ethnomedicine Elicited During Interviews. Scientific Name Native Name (s) Plant Part (s) Treatment (s) Healers Citrus aurantium anani young leaves apall note toto T.M. (Rutaceae) Capsicum neva fruits apall note kaki, T.M. frutescens (red/yelloW); apau kaki M.T (Solanaceae) leaves memae, apau puaroto I fe'etama Physalis konini I kariri leaves apau note kaki T.M. angulata (Solanaceae) Stachytarpheta pua' ere' ere young leaves I apau mate i te T.M. urticifolia stems puovaevae (V erbenaceae ) Table 15 shows the plant species used medicinally along with the significant plant parts, the diseases or illness treated and the infonnants who gave the infonnation. These may include whole plants, immature leaves (muko), stems (ko'oi), flowers (pua), leaves Cau), inner bark Cililkili), seeds (kakano), rhizomes, fruits (puku), petioles (kata), roots Caka), fleshy endospenn (kiko), and liquid endospenn. Medicinal plants are gathered from fresh material, never dried, by either the healer or one of their family members. In one instance, a patient came with some non-plant ingredient (fresh eggs) in order that the healer could fonnulate the medicinal concoction. For the most part the useful medicinal plants are gathered in the wild usually in disturbed secondary forested areas, coastal areas, valley interiors or just around the villages in vacant lot areas. Some plant species were cultivated for food or ornamentation (including lei-making) and were used as medicine also. This included two varieties of Artocarpus altilis called mei kU'ukou and mei paea, both local varieties were not only cultivated as a source of food, but were also 107 -- used for their medicinal properties. Other cultivated food plants that entered into the native pharmacopoeia included Ananas comosus, Allium cepa, Ipomoea balalas, Manihol escuienfa, Cirrus aurantiifolia and Citrus sinensis. Other important plants cultivated for cosmetics or ornamentation, but also used medicinally included Curcuma longa, Hibiscus rosa-sinensis, and Gardenia lailensis. Another medicinal plant important enough to cultivate was the small herb called mahi (Rorippa sarmenlosa). One informant had actually built a structure resembling a small house to shade the herbs into which she tried to transplant small plantlets of the Rorippa into a bed of prepared soil (Figure 10). Though this species is often found naturalized in potted plants and around the garden area, it is interesting that this infonnant was actually trying to cultivate it. Figure 10. Shade Structure for Rorippa sarmentosa There seemed to be no special process or gathering techniques used by the healers in harvesting medicinal plants in the wild. More of an emphasis was placed on the preparation of the herbal remedies themselves than anything else. This will be discussed further in this chapter. 108 Herbal recipes are very specific about which plant parts are used, the growth state of the particular part and the amount of material to be used. For example in one herbal treatment called apau vi'ihoa topa or hemorrhoids, the healer required the following: • One handful of papa (Vigna adenantha) leaves • One hand-length oftou (Cordia subcordata) bark - cut into seven pieces length wise • One hand-length of kehi' a (Syzygium malaccense) bark - cut into seven pieces length wise • One egg sized ball ofm_ (fermented breadfruit paste) [Appendix III] The particular amounts of each ingredient in Marquesan herbal recipes are also usually quite specific. Certain things like flowers, seeds, and sometimes leaves are given in specific amounts, such as four flowers or fifteen leaves. Other measurements are given by the handfuls (ta 'ima pi) or by the inches Ciniti) (Figure II and 12 respectively). The word ta 'ima pi literally means one handful and informants often distinguished in their recipes between a big handful and I or small handful. This was a common form of measurement usually used for the leaves Cau) or young immature leaves (muko), stems, roots of certain species, and whole plants of certain species. The use of an index finger with each segment of the digit representing one 'initi or pouce (French) is often used in measuring the rhizomes of certain species, roots of the certain species, fresh water, coconut water, and even dosage. Coconut water was also measured by the number of fruits used. The interior bark of all medicinal plant species were measured in hand length with one hand length often being the desired amount. These Marquesan measurements are inaccurate when compared with the Western standards of scientific measurement 109 however they are quite similar in specificity to traditional measurements used by non- scientists in daily life. The amount of plant material in each recipe varied without an exact standard and depended on the size of the healer's hand. Another form of measurements is called in French the cuiller which is roughly equivalent to the tablespoon. This modem form of measurement is often used for ingredients such as honey or rum alcohol. Other forms of measurements include the pora or bowl and the metric litter. These also served as containers for mixing herbal remedies and as the container where prepared medicinal remedies were served from. Figure 11. Ta 'Ima P _ - One Handful Figure 12. 'Initi / Pouce - A Segment of a Digit Plant pacts often have further specifications such as the state in which the flowers or leaves are selected. Some examples are the closed flowers of the tia'e (ones that will open up the next day), the immature or green fruit and mature or ripe fruit of the noni, or the green fruit and the red fruit of the neva. One informant stated that the petioles from two green Copio) leaves and two yellow Caupa'a) leaves of the mei paea are used while another asked for six green leaves and six yellow leaves of the tou (Cordia subcordata) tree. In the recipe called apau ke' a, the informant made it clear the three noni fruits with 110 ~ - - :;,. the flowers still emerging must be used. Most healers thought it important to specifY the state of the plant material being used in medicinal recipes. Most of the herbal recipes involved a combination of several plant species. Once the plant material was collected the healer would process it by maceration (tukituki) in a wooden board with a stone pestle called ke' a tuki. The placement and the ordering of plant materials were also important in the processing of plants into medicines. Some informants (for instance M.T.) emphasized the placement and ordering of their ingredients. These informants also had more recipes in their repertoire. The more they knew, the more intricacies were contained in their recipe preparations. In her recipe called apau hea, M.T. was very specific that the bark of Cordia subcordata was to be pounded first, on top of the bark, the roots of the Ficus prolixa var. prolixa were then pounded and finally the flowers of the Gardenia taitensis pounded on top of both the bark of C. subcordata and the roots of F. prolixa var. prolixa. Another example of this is in her recipe called apau ouma pe where the leaves of Cordia subcordata had to be placed in an exact order. With eight yellow leaves and eight green leaves, she stacked one yellow and then one green with their petioles opposite of each other. She further stressed in this recipe that the rhizome of Microsorum sp. be placed on top of the stacked leaves followed with eight closed, young flowers of the Gardenia taitensis that were placed opposite of each other also. R.M. also emphasized the placement and ordering like M.T., in her recipe called apau epa, she emphasized that green and yellow leaves of Cordia subcordata be placed in a similar order with the petioles opposite each other. In most of her recipes, R.M. made it clear that the placement and ordering of each plant part be exactly how she stated. Reasons for this ordering and placement of plant parts are 111 unclear. I asked one informant about it and she responded that it was something that has been passed down from the tuhuka apau or medicine doctors. Herbal remedies in general can be prepared through different types of extraction methods. By far the most common way of preparing herbal treatments involved macerating the plant materials and filtering out the juices with a cheesecloth giving way to an herbal infusion. Application of herbal treatments may differ depending on the ailment and the type of remedy used. Most of the medicines are taken as internal infusions of medicinal beverages with around 70% of all recipes being administered in this fashion. Other routes include topically through bathing (2%), poultices (compress) (18%), massage (4%), or vaginally with steam baths (4%) and through the eyes (ocular) (4%). Once the apau (medicine) has been prepared, most patients are required to take the medicine for three days. In fact, all the healers (100%) in at least one of their recipes required them to be taken for three days. There is also some correlation with a couple of the informants that were interviewed with three being the amount used in their recipes. Again, all the healers (100%) in at least one of their recipes, the number three was the amount being used in their recipes. Whether it was three flowers or three leaves, three was a significant number. For some remedies the medicine is taken at night, while others are taken three times a day (morning, noon and night), and in the case of one informant the potion is sipped throughout the day. The significance of three is not fully understood and will be more completely examined in the discussion section. All informants required that after the three days of taking the apau (medicine) a restriction of certain practices such as sexual activity, eating of certain foods and drinks must be observed, including the 112 taking of a purge or tiheke. These are very important aspects in the healing process and are observed every time medicine is taken. Dietary restrictions are usually observed for one month, alternatively some informants stated for 7 or 14 days. Some examples of tapu foods and drinks are pig, goat, tuna, lobsters, citrus fruits (because of acidity), and all processed Western foods such as corned beef, ketchup, soy sauce, and soda, etc. (Appendix X). After the dietary restrictions are completed, the tiheke commences. A tiheke is defined as a purgative or to purge one's self (Dordillion, 1904). The tiheke starts usually the day after finishing of the dietary restrictions. The tiheke taken is very powerful and most of the time is taken only once. However, one informant indicated that her tiheke was taken once a day in the morning for three days followed by a good meal. Some informant's made a distinction between tiheke 'enata or native purges and tiheke hao' e or purges one can get from a Western doctor or pharmacy. There was no mention if western purges could be used in place of the traditional purge. Most informants in the Marquesas usually have a distinct recipe for their own tiheke. Informant T.M., along with giving a tiheke recipe for adults, also gave two tiheke recipes especially for young babies called apau toiki that function the same as the tiheke. One of the apau toiki recipes was for babies one month old and the other for babies two months to a year old. Both ofthese apau toiki's are also taken for three days. Informant R.M. also gave a tiheke recipe for small babies. The tiheke and apau toiki are designed to clean out the system through bowel movements thus cleaning out any of the sickness that still remains. After the tiheke regular foods can be consumed again. It is stressed throughout this process that no alcohol or cigarettes are to be consumed and sexual activity is forbidden. 113 lfany of these things are not followed exactly (thus breaking the tapu) then the healing process is stopped and the patient will become sick again. This was often stressed by the informants, who remind those who break the food prohibitions that they will become sick again. All seven informants interviewed stated the importance of the tiheke in traditional Marquesan healing, although only three of the informants gave me actual recipes (Table 16). Table 16. Examples of Different Tiheke Recipes. 1. Informant T.M. Tiheke Recipe A: Va'ova'o (Premna serratifolia): young stems 'Ehi (Cocos nucifera): the meat of three dried fruits CEhi) vaio'e 'ere'ere (Cocos nucifera): the roots ofthe green coconut variety Tia'e (Gardenia laitensis): three closed flowers Tiheke Recipe B: 'Ehi pukiki (Cocos nucifera): the roots of the red coconut variety CEhi) vaio'e 'ere'ere (Cocos nucifera): the roots of the green variety A' oa (Ficus prolixa var. prolixa): the small, young roots 'Ehi (Cocos nucifera): one coconut with water/ one coconut without water (meat is used) Apau Toiki Recipe A: Mi'o (Thespesia populnea): the young green branch is used Va'ova'o (Premna serratifolia): the young green branch 'Ehi Pukiki (Cocos nucifera): the mature and young roots of the red variety are used 'Ehi (Cocos nucifera): the cream from the grated meat is used Kokomi: a type of coastal crab 114 Table 16. (Continued) Examples of Different Tiheke Recipes. 2. Informant M.T. Tiheke A: 'Ehi 'ere'ere (Cocos nucifera): the meat of four dried fruits Noni (Morinda citrifolia): three green fruits and three ripe fruits Pia: one spoonful of commercial starch Brown Sugar: one spoonful 3. Informant R.M. Tiheke A: 'Ehi (Cocos nucifera): two fruits, one with water and one with dried meat Kehi'a (Syzygium malaccense): the bark, one hands length Tou (Cordia subcordata): the bark, one hands length Starch*: 2 spoonfuls Tiheke 2: for young babies T_ (Saccharum officinarum): stem internodes; expressed juice * I asked the healer if the Polynesian introduced pia or Tacca leontopetaloides could be used. She said that (pia mao' i) or pia rna' a would work fine. Because of the growing use of manioc (Manihot esculenta) in the Marquesas, the people here are cultivating and using the traditional pia or Tacca leontopetaloides increasingly less. There are some patterns that can be drawn from these tiheke recipes. First, all of the recipes included the use of Cocos nucifera except for one apau toiki recipe and another tiheke recipe for babies. The use of C. nucifera in the recipes is quite varied and includes the roots of the plant, the liquid endosperm or coconut water and the white meat ofthe mature fruit that is grated and turned into coconut milk. Informants were also very specific about the different varieties of coconuts being used. The' ehi pukiki or red/yellow variety was used specifically for its roots in the tiheke recipes. Beside C. 115 .- ---,_.. nucifera, a total of eleven other plants were used in the tiheke and apau toiki recipes. These included Premna serratifolia (stems), Gardenia taitensis (flowers), Morinda citrifolia (fruits), Syzygium malaccense (bark), Ficus prolixa var. prolixa (roots), Thespesia populnea (stems), Saccharum officinarum (stems), Aleurites moluccana (fruits), Cordia subcordata (bark), Syzygium malaccense (bark), and Microsorum spp. (rhizomes). It is interesting to note that everything from roots, fruits, flowers, rhizomes, bark and branches are used in the tiheke, but not any leaves. There is also one instance were an unidentified inner coastal crab called kokomi was used in a recipe. Other ingredients used in the tiheke recipes include starch and brown sugar. The starch is probably used for its binding qualities and the sugar to sweeten the medicine. Out of the six recipes given, four of them require boiling in the processing. This usually involves the use of starch where the ingredients are boiled for certain amount of time allowing a chemical separation to take place. The "oil" that comes to the surface during the boiling is spooned off. This oil is what is ingested in the tiheke or apau toOO. The other two recipes simply required juicing of the plant parts. There were a total of 36 plants used by informants with 26 dicots, 8 moncots and 2 pteridophytes. Voucher specimens were prepared of all of the plants mentioned by healers as being used medicinally. These were sent to appropriate herbaria as mentioned in the methods section (Appendix XI). A full description of each medicinal plant including the likely origin and geographical distribution can be found in the Appendix IX. 116 Medicinal Plants and Their Distributional Status: Today EndemicO% D mdigenous 28% Modem Intro 41% • Polynesian lntro 31% Figure 13. Marquesan Medicinal Plants and Their Distributional Status - Today The first thing that is the obvious from Figure 13 is that there is not a single endemic plant species used in the Marquesan ethnomedicine. Figure 13 graphically illustrates that of the 36 medicinal plants listed only 28% are indigenous to the Marquesas, 31 % are Polynesian introductions, and 41 % are modern introductions (Appendix XII). What becomes apparent is that there is still a heavy reliance on species intToduced in the modern era which shows experimentation and adaptation by healers to newly arriving species. This is followed by the Polynesian introductions with indigenous species following closely behind. This is very similar to the results reported in Figure 4 for the pre to early contact distributional status of medicinal plants. There is no significant difference between the two figures. Out of the 36 plants discussed by healers the top five are Cocos nucifera, Microsorum membranifolium, Microsorllm scolopendria, Cordia sllbcordala and Gardenia taitensis (Appendix XIII). The first three have a relative constancy of 85.7% 117 and are used by six of the seven informants. The remaining two species, Cordia subcordata and Gardenia taitensis, have a relative constancy of71.5% and are used by five of the seven informants. Both constancy rates of 85.7% and 71.5% are designated in the Widely Used category It makes sense that Cocos nucifera is used by every informant (except T.T.), because it is usually the liquid medium for many herbal remedies. Informant T.T. is actually the only one that varied substantially from the others in that he did not use the top three species used by all of the others. The next category "Commonly Used" has a range of constancy between 42.9% - 57.1 % with a total of nine species. The species in this category include Artocarpus altilis, Ficus prolixa var prolixa, Sacchrum ojjicinarum, Syzygium malaccense, Thespesia populnea, Vigna adenantha, Citrus aurantiifolia, Colubrina asiatica, and Premna serratifolia. Those species with a relative constancy of 57.1 % are used by four of the seven informants and species with a relative constancy of 42.9% are used by three of the seven informants. The category "Occasionally Used" includes a total of eight species and a constancy of28.6%. These eight species include Aleurites moluccana, Ananas comosus, Capsicum jrutescens, Hibiscus rosa-sinensis, Kyllinga nemoralis, Morinda citrifolia, Psidium guajava, and Rorippa sarmentosa. The "Occasionally Used" category is characterized by species used by only two of the seven healers. The last category in this analysis is "Infrequently Used" that is the largest of the four categories. This category has a total offourteen species with a relative constancy of 14.3% and is characterized by having only one out of the seven healers using each of these species. The species in this category include Allium cepa, Amaranthus viridus, Barringtonia asiatica, Cenchrus echinatus, Citrus sinensis, Crotalaria retusa, Curcuma longa, Ipomoea batatas, Kyllinga brevifolia, Manihot 118 esculenta, Phyllanthus amarus, Physalis peruviana, Pisonia grandis and Stachytarpheta urticifolia. It must be stated that these categories and percentages could be a little misleading because they only refer to those medicinal plant species that were used the most by the informants, not which plant species are the most significant. There is an important difference to distinguish here. There may be some species here that were only mentioned once by one informant, but may be an integral part of that particular remedy. The following dendrogram may help illustrate the relationship between the healers and the medicinal plant species they use (Figure 11). Reflected in Figures 5 and 6, the data that was gathered during the interviews was set up in a data matrix with healers on top and the value measured on the x-axis. This data set, plant species used by each healer, was measured. This data was then analyzed with the Community Analysis Package 3.01 software program (Pisces Conservation Ltd., 2001). Figure 11 is a dendrogram based on the agglomerative hierarchical clustering, Ward's linkage and Euclidean distances. The dendrogram in Figure 11 also produces a series of couplets with T.M. and R.M. forming one, P.T. and T.T. branching off into a couplet from M.T., with the last couplet being M.L. and H.H. 119 T.M. R.M. M.T. ~ P.T. T.T. M.L. H.H. Figure 14. The Relationship Between Healers and the Species Used in Marquesan Ethnomedicine. The first two healers that emerge from the dendrogram (Figure 14) are T.M. and R.M. Both these healers are using more medicinal plant species than any of the other healers, with T.M. using 25 species and R.M. using 19 species. These healers are also both using the top five widely used medicinal plants in Cocos nucifera, Microsorum membranifolium, Microsorum scolopendria, Cordia subcordata and Gardenia taitensis. In fact, healers T.M. and R.M. similarly use the top eleven medicinal plants (Appendix XIII). They are also the only ones who use Aleurites moluccana, Ananas comosus, and Rorripa sarmentosa medicinally. Some of the reasons why they may have such a close relationship in their medicinal knowledge may include the fact that they are both females, 120 related by blood, and live in the same village on the same street. We know that knowledge pertaining to traditional medicine is strongly matrilineal and because of this, these two women have learned from the same female relatives. Looking at Figure 11, the relationship that the P.T. and T.T. couplet forms from healer M.T. is not so clear. These two healers live on opposite sides of the island in two different villages, one of them is a female (P.T.) with the other (T.T.) being a male, and they are not related by blood if, at all. Knowing these variables, one would assume a difference in their use of medicinal species. However, they do use some similar plants in their medicinal repertoire including Cordia subcordata, one of the top five medicinal plants used in the Marquesas. These two healers also both use Syzygium malaccense and Vigna adenantha, which are also considered commonly used medicinal plants. Because they come from two totally different healing traditions, what they shared in common must be purely coincidental. The remaining couplet that forms from this dendrogram is the M.L. and H.H. Again this another case in which their relationship is not clear. They are each of the opposite sex and are as far as I know unrelated by blood. They do, however, live in the same village (Atu ona) and both use exactly nine species in their medicinal plant repertoire (Appendix XIII). More importantly, healers M.L. and H.H. are related by the fact that they both use the three top most widely used medicinal plants that includes Cocos nucifera, Microsorum membranifolium and Microsorum scolopendria. On top of that, they also both use Colubtina asiatica (Appendix XIII). Figure 12 is a Reciprocal Averaging Ordination plot that shows the relationships between healers and the different species they use medicinally. Reciprocal Averaging, like the DECORANA, illustrates the relationships between two variables. 121 RA Ordination Plot - Species_table ,.,------~~------, '. • '00 • • ., • • • • .~ . ·00 '"• • • ·~L.--,~"--,~OO--~~~~--~~--~",-~,-oo--~.,-~.~~.~~,~.--,~.--,~.--7,.--~,.--=~--~m,-7~~ ,,",,1 Figure 15. Reciprocal Averaging Ordination Plot Showing the Relationship between Healers and the Species Used in Ethnomedicine. Out of all the healers, H.H. (in the lower right hand corner) is the most distantly related to the others. This is probably due to the fact that out of the nine species he used medicinally, three of them are not used by anyone else (Pisonia grandis, Citrus sinensis, and Allium cepa). Looking at Figure 12, it is hard to draw any other conclusions of the relationships between the healers and the medicinal plants they use. DISCUSSION Healers and Healing Based on my discussions with healers on Hiva Oa, I have concluded that there no longer exists a special class of healers such as those that existed in pre-contact times. Additionally, there seems to be no evidence of specialization among the healers of today. There are however, differing levels and types of medicinal knowledge amongst the 122 healers of today. Almost every family includes a member with some degree of medicinal knowledge and there are people who know more than others. It is said that every mother knows a few remedies for common childhood sicknesses or illnesses. This sort of "over the counter" knowledge is not uncommon in the other parts of Polynesia, where both healers and non-healers are familiar with common treatments (McClatchey and McClatchey, 1999). Of all the healers interviewed for this research, most were women. Traditional knowledge regarding plant medicine is usually passed down through the females in the family. This is also consistent throughout other parts of Polynesia where knowledge of medicinal plants is strongly matrilineal and familial based rather than profit-based (Cox et aI., 1991). The herbal remedies themselves are often guarded by each family and this may be due to the fact that healers of the past were believed not only to have the power to heal, but also the power to bring death. To this day, there is still a strong sense of propriety about family herbal formulations. This "ownership" of herbal formulations is similar to Western concepts of intellectual property rights and can be observed throughout Polynesia (Cox et al., 1991). It differs from the Western model (which seeks to financially protect people or corporations), in that the ownership is intended to protect the efficacy of their herbal formulations (Cox et al., 1991). The role of gender in healing has also changed. In traditional times, both males and females could be healers, although it was the males who functioned as spiritual healers and whose reliance on plants as medicine was limited. On the other hand, it may be that females were the ones who incorporated plants as medicine in healing broken bones, cuts and scrapes while functioning more as herbal doctors whose remedies were plant based. The introduction of Christianity into the islands may have helped to create a 123 ------_... ,. .. - new role for males in the society as spiritual leaders and healers; while women continued to develop herbal remedies and to conserve the traditions of the past regarding plant medicines. New remedies are acquired through dreams, inspirations and experimentation, and even though there is a certain amount of medicinal plant knowledge transfer between unrelated families, this is often played down. However, the acquisition of new recipes through dreams is deemed more credible than trying someone else's recipes or just simply adding a new plant into already established remedies (Whistler, 1992). Disease and Causation In the Marquesas, both diseases and views concerning their causations have changed over the years, from the first-contact period to the present. In the past, diseases were either attributed to the gods or bad spirits and violations oftapu. Cox et al. (1991) gives a list of disease causations in Polynesia today that includes: illness resulting in abrogation of family responsibilities or interpersonal hostilities, violation of tapu, supernatural agents, improper diet, inadequate hygiene, organic trauma such as breaking of a leg, and finally most informants in Polynesia have some sort of concept of germ theory in disease causation. Looking at this list provided by Cox et al. (1991), some of these causations are shared currently in the Marquesas. These include improper diet, inadequate hygiene, organic trauma, possibly supernatural agents and most have a germ theory concept for causation. One of the important goals of my research was to see how well the disease/ ailment categories developed by Zepernick (1972) compared with my own data. The following fifteen diseases/illness, hygiene and first-aid categories were proposed by 124 Zepernick (1972): Wunden (wounds), Insektenstiche (insecticides), Geschwiire (ulcers, boils, abscesses), Pflege der Haut (Skin care), Behandlung der Haare (Attending the hair), Gonorrhoe (Gonorrhea), Menstruationsstorungen (menstruation), Hygiene der weiblichen Geschlechtsorgane (hygiene for female genitals), Schwangerschaft (pregnancy), Entbindung (release of the after birth), Behandlung nach der Entbindung (the treatment toward the release ofthe after birth), Behandlung des Neugeborenen (treatments for new borns), Genitalhygiene flir Miidchen (genital hygiene for young girls), Aphrodisiaca (an aphrodisiac), and Allgemeine Schwiiche - Rekonvaleszenz (general weakness). Of these 15 categories roughly 10 categories have contemporary counterparts. These include Geschwiire (ulcer, boils, abscess) - apau fefe, apau taupo, Gonorrhoe (Gonorrhea) - apau epa - pa'atita which mayor may not be gonorrhea, but is defined as a type of venereal disease, Menstruationsstilrungen (menstruation) - apau parari, Hygiene der weiblichen Geschlechtsorgane (hygiene for female genitals) - apau he'a, Entbindung (release of the after birth) - apau parari, apau note toto (apau parari note vahine hope), Behandlung nach der Entbindung (the treatment toward the release of the after birth) - apau parari, apau note toto (apau parari note vahine hope), and apau mate fanaua, Behandlung des Neugeborenen (treatments for new borns) - apau epa, apau ira toiki, apau kea (ke'a), apau toiki and possibly apau m_i. Of course, there may be some tremendous overlap here as Menstruationsstorungen, Entbindung and Behandlung nach der Entbindung are all closely related in terms of dealing with female menstruation and post-partum healing. No diseases or illness, though, fell into the categories ofWunden (wounds), Insektenstiche (insecticides), Pflege der Haut (Skin care), Behandlung der Haare (Attending the hair), 125 Aphrodisiaca (an aphrodisiac), or Allgemeine Schwiiche - Rekonvaleszenz (general weakness). Although not apparent from the interviews, but relayed to me by other Marquesan informants: they still make hygienic medicines for the genitals of young girls. This would clearly fall into the category of Genitalhygiene fiir Miidchen (genital hygiene for young girls). The importance offemale hygiene in reference to vaginal secretions and astringents is represented in this research by the herbal remedy called apau he' a. Although, I did not elicit information regarding female vaginal astringents on Hiva Oa, I know that they are used because other natives (non-healers) have routinely commented on their use. On the Islands ofUa Pou, I received information from two different informants regarding these vaginal astringents (haika mokio) and the different plants involved in making the medicine. One informant had told me that the different islands developed different herbal recipes. Disease categories were unclear and I had to look into other sources for clarifications. Included in this grouping is the once vague ailment called fati. A Tahitian source referred to fati as contusions, sprains, dislocations or fractures (Petard, 1986). Whistler (1992) defined ra' au fati in Tahitian ethnomedicine, as analogous to apau fati in the Marquesas, as a remedy for those whose illness is thought to come from an improperly healed injury. The Marquesan medicinal system evolved with the introduction of new plants, new diseases, and new ideas, and with this the names of diseases have also changed. A rare example of a disease name that has been conserved is the word fei-fei or its cognates fefe'e, fefe, or hehe that the early literature defined as elephantitis. The word fefe also came up in interviews for this research with different informants all having slightly different definitions of the word, meaning anything from a boil, infected sore, elephantitis, and even cancer. It is also 126 interesting that the cognate for this same word in Tahitian called fe' efe' e refers to elephantitis or the filariasis disease (Petard, 1984). For the most part this is the only disease term that we see conserved at all. Table 17. Equivalent Names for Marquesan and Tahitian Disease and Ailment Categories. Marquesan - Tahitian Name Marquesan - Tahitian Name 1. Apau Fati = Ra' au Fati 7. Apau Parari = Ra' au Parari 2. Apau Fefe = Ra'au Fefe 8. Apau Puaroto- Fe'etama = Ra'au Puaroto 3. Apau Rea - Ra' au Hea 9. Apau Ouma pe - Ra'au Ouma pe 4. Apau Ira Toiki = Ra'au Ira Tamari'i 10. Apau Taupo = Ra'au Taupo 5. Apau Memae te pito = Ra'au Tupito II. Tiheke = Ra'au Tahe'e 6. Apau Mata - Ra' au Mata Based on the data collected in the Marquesas, there is a closer affinity between the Marquesan medicinal system and the Tahitian medicinal system than observed in other parts of Polynesia. This is evident in the similar names the two cultures use for the diseases and ailments they treat. Out of the 30 different disease and ailment categories elicited in the interviews, a total eleven or 37% have exact Tahitian counterparts (Table 17). In other parts of Polynesia, there are also some names of diseases and ailments that are undoubtedly related. These include a group of neonatal ailments called ita in Samoa which maybe found elsewhere in Eastern Polynesia such as Rarotonga (ira), Tonga, Tahiti (ra'au ira tamari'i) and Marquesas (apau ira toiki). This group of ailments, all cognates of each other, represents an ancient concept of ailments that are still conserved 127 and treated today (Whistler, 1996). Another disease category that has a similar name in Samoan to other areas of Eastern Polynesia is the word eaea which is defined as a fungal infection such as thrush (Whistler, 1996). Cognates ofthis same word also exist in the Hawai'i Cea), Marquesas (kea), and Tahiti (ea). The Pharmacopoeia In the pharmacopoeia recorded in the Marquesas, most medicines were usually prescribed for three days. There is some evidence that the application of a medicinal prescription over the duration of three days is not a modem development. For instance, Suggs's (1966) remedy for mimi hati or gonorrhea is one that is prescribed for three days. Another remedy for women with prolonged menstruations called katahe required the patient to squat over a fire pit covered with noni leaves allowing the smoke to enter the vagina two times a day for three days (Suggs, 1966). Clavel (1885) describes a remedy given to infants on their third day of breast feeding. Again, the idea of three is reiterated with the beverage being given to the infant on the third day. In Hawai'i, the period or duration for taking medicine is usually five days (sometimes four), which according to Whistler (1992) is considered a "mystical" number. In this respect, the medicinal system in the Marquesas may share a closer affinity to the Tahitian system that also requires the patients to take the medicine for three days (Whistler, 1992). In the Cook Islands, medicinal plant quantities are measured in multiples of threes (Whistler, 1992). The concepts of dietary restrictions and purges are not new developments in Marquesan ethnomedicine and pre-date contact times. Dietary restrictions are common throughout Polynesia and are frequently included in Polynesian herbal treatments (Cox et 128 ai., 1991). These prohibitions may stem from the ancient tapu religious system that included food restrictions or may derive from modem health considerations (Whistler, 1992). Those who did not observe the tapu on certain foods and failed to respect the prohibitions set forth by the healers were often left uncured (Kirkpatrick, 1983). An example of a type of purgative remedy comes from Clavel (1885) who describes a purge given to infants to induce "the runs", a laxative of sorts. Purges play an important role in the medicinal system of Tahiti where it is called ra' au tahe' e (Petard, 1986). In Hawai'i, the native term I_'au hO'onah_ means an herbal laxative and they are still important in the Hawaiian healing tradition (,Ohai, 2001). The preparation techniques for herbal remedies have also remained consistence from pre-contact times till today. Healers, then and now, still prepare and apply herbal remedies in varying ways including juicing fresh plant material, making poultices and massage oils from the fresh plants, and the use vapor or steam baths to facilitate the entry of the remedy into the system (Christian, 1910; Clavel, 1885; Jardin,1862; Lesson,1981; Rollin ,1974) The medicinal plants used by healers contemporarily are different from the plants used in the two other time periods discussed in the previous chapters. The plants used today differ from informant to informant, and informants are in part influenced by what knowledge has been passed down to them from their parents, and what plants are available from the local flora. There also must be some traditional knowledge concerning medicinal plants that traveled with the Polynesians as they colonized the Eastern Pacific. If this is so, we would see these species conserved in other parts of Polynesia today. 129 Table 18. A Comparison of Medicinal Plant Use Across Eastern Polynesia Based on Whistler (1992). Scientific Name HAW RARO SAM TAH Aleurites moluccana • • • • Allium cepa Amaranthus viridus • • Ananas comosus Artocarpus altilis • • • • Barringtonia asiatica • • Capsicum frutescens • • • • Cenchrus echinatus Citrus aurantiifolia • Citrus aurantium* • • • Artocarpus altilis • • • • Cocos nucifera • • • Colubrina asiatica • Cordia subcordata • • Crotalaria retusa Curcuma longa • • • • Ficus prolixa var. • • • prolixa Gardenia taitensis • • • Hibiscus rosa-sinensis • • • Ipomoea batatas • Kyllinga brevifolia Kyllinga nemoralis • Manihot esculenta Microsorum • • • scolopendria Morinda citrifolia • • • • Phyllanthus amarus Physalis angulata Pisonia grandis Premna serratifolia • • Psidium guajava • • • • Rorippa sarmentosa • • • • Saccharum officinarum 130 Table 18. (Continued) A Comparison of Medicinal Plant Use Across Eastern Polynesia Based on Whistler (1992). Scientific N arne HAW RARO SAM TAH Stachytarpheta urticifolia Syzygium malaccense • • • • Thespesia populnea • • • Vigna adenantha Table 18 is set up to allow comparison of Marquesan medicinal plants with that of other island groups in Eastern Polynesia. All the plants listed in Table 18 are ones used medicinally in the Marquesas today. The groups of islands that this list was compared to includes that of Hawai'i (HAW), Rarotonga or the Cook Islands (RARO), Samoa (SAM) and Tahiti (TAH). Table 18 is based on medicinal plants cited by Whistler (1992). The asterisk on Citrus aurantium L. is because I choose to treat this species similarly to the often confused Citrus sinensis (L.) Osbeck which may have functioned in same way in the pharmacopoeia of these medicinal systems. The first thing that stands out are the species that are used across all these island groups. These species include Aleurites moluccana, Artocarpus altilis, Capsicumfrutescens, Curcuma longa, Morinda citrifolia, Psidium guajava, Rorippa sarmentosa, and Syzygium malaccense. Out of these eight species, 50% or four of the species (Aleurites moluccana, Artocarpus altiUs, Curcuma longa, Morinda citrifoUa and Syzygium malaccense) are Polynesian introductions throughout these island groups. This suggests that the knowledge regarding the medicinal uses of these species is ancient and may have developed before the colonization of Eastern Polynesia. Two of the seven species (Capsicumfrutescens and Psidium guajava) are considered modem introductions to these islands and proved early 131 on to be significant medicinal plants. This could be a case of convergent medicinal knowledge or perhaps this medicinal knowledge was dispersed among these island groups once the plant was found to be medicinally significant. The last plant on this list is Rorippa sarmentosa and is the only indigenous medicinal plant used commonly by all the island groups. Another interesting aspect of Table 18 is that Vigna adenantha is used medicinally only in the Marquesas and nowhere else. This species is indigenous to Eastern Polynesia (Smith, 1985) and it is odd that it is not used in any of the other islands groups. Alternatively, the species called Vigna marina (Burm.) Merr. is used medicinally in Samoa, Rarotonga and Tahiti (Petard, 1986; Whistler, 1992) and it may be that the medicinal knowledge of this species was transferred to Vigna adenantha where it is used medicinally in the Marquesas. The top five widely used medicinal plants in the Marquesas include the following: Cocos nucifera, Microsorum membranifolium, Microsorum scolopendria, Gardenia taitensis, and Cordia subcordata. The two Microsorum species should actually be treated together as they are used interchangeably in the same recipes. Comparing these species with their medicinal uses in other parts of Eastern Polynesia (Table 18), we see that none of the top five species are represented throughout all the island groups (Hawai'i, Rarotonga, Samoa and Tahiti). Based on Table 18, the medicinal system with the closest affinity to Marquesan ethnomedicine is Tahiti which shares 21 medicinal plant species. This is followed by Rarotonga (18) Samoa (17), and lastly Hawai'i (9). 132 - - - - -~~ --~- --- .... ----- _.. ------.... - . Conclusions The purpose of this study was: 1) to gather ethnobotanical and historical information regarding traditional medicine in the Marquesas into a single review, 2) to track the evolution of the traditional Marquesan medicinal system through time, and 3) to describe and analyze the current Marquesan traditional medicinal system. In Chapters III and IV, I attempted to discuss information regarding traditional plant medicines and diseases in the Marquesas from historical literature. This was done by doing an extensive review of the literature found at the University if Hawai'i at Manoa's Hamilton Library. Some of the literature was also attained from sources in the Marquesas which usually consisted of older French manuscripts. Although most of the literature regarding the traditional medicinal system was reviewed, there were some sources that I was unable to obtain for examination. These were either manuscripts housed in the Catholic Missions in Nuku Hiva or documents archived in France. Fortunately, some of these manuscripts were reviewed by E.S.C Handy (1923) and possibly Suggs (1966) making it possible for me to indirectly consider this information. If a more extensive look at the early medicinal system were to be undertaken, it would be imperative to look at these other documents more closely in the places where they are housed. Tracking the evolution of the Marquesan medicinal system based on the literature proved to be a difficult task. Trying to understand what plants were being used to treat what diseases prior to and shortly after Western contact proved to be rather complicated. The diseases were difficult because I had to try and figure out which one of them were present in the Marquesas prior to foreign contact and which were introduced post- 133 contact, through the late 20th century. Surely the Marquesan people had their own set of diseases that they brought with them as they colonized eastern Polynesia and may have developed some as time went on. Some of the names of the diseases may be different, but the diseases are still the same. It is rather difficult to find disease names that have been conserved throughout time, because of the fact that different family traditions had different names for these diseases. Certainly, as the medicinal system evolved with the introduction of new plants, new diseases, and new ideas, the names of these diseases themselves have changed. Medicinal plant use has changed over time in the Marquesas through healer experimentation and adoption of newly introduced species. In Appendix XIV, I have compiled a list of the medicinal plants found in Tables 6, 9 and 15. This contains all the medicinal plants referenced in this document. Even though the Tables 6 and 9 are not totally accurate (in the sense that they were created from researching the literature), they do help us to understand what species were possibly being used medicinally. Appendix XIV shows that some species were conserved through the three time periods of pre contact, the transitional period, and present day. The nine species that have been conserved through time include Aleurites molucanna, Cocos nucifera, Cordia subcordata, Curcuma longa, Morinda citrifolia, Physalis peruviana, Psidium guajava, Rorripa sarmentosa, and Saccharum ojJicinarum. Of these nine species, a total of five are Polynesian introductions, two are considered native (Cordia subcordata and Rorripa sarmentosa), and two (Physalis peruviana and Psidium guajava) are post-contact introductions. These are probably the most important plants in the Marquesan medicinal system throughout time. It is significant that most of the species they relied on over the 134 years were of Polynesian introductions. Further examination of Appendix XIV revealed some interesting correlations. It is important to note that there were ten species mentioned in the early literature as being used medicinally from the pre-contact period, but these were absent in the transitional literature of such early scientists as Handy (1923), and not mentioned in any interviews conducted for this research. They include two natives (Senna occidentalis and Usnea sp.), two Polynesian introductions (Colocasia esculenta and Tephrosia purpurea), and six introduced species (Abutilon grandifolium, Brassicajuncea, Ipomoea alba, Ricinus communis, Sida rhombifolia, and Tamarindus indica). It is hard to find an explanation for this without having all the information. This list is heavy with introduced plants which could mean several things. Perhaps those early visitors only commented on species that they themselves knew and were familiar with. Or perhaps at the time of their visitation, these newly arriving introduced species were being tested and used medicinally. There were two species (Colubrina asiatica and Hibiscus rosa-sinensis) that were found to be used medicinally early on, but then disappear in the transitional period only to reappear in the interviews of today' s healers. Colubrina asiatica is considered indigenous whereas Hibiscus rosa-sinensis is considered an early Polynesian introduction, both of which were used medicinally throughout the transitional time period, but not recorded. There were also species that were absent from the early literature but appear in the transitional literature suggesting that maybe these species were incorporated sometime after contact. These include: Ananas comosus, Artocarpus altilis, Citrus aurantiifolia, Kyllinga brevifolia, Syzygium malaccense, Thespesia populnea, and Vigna adenantha. Of these species both Artocarpus altilis and Syzygium malaccense are Polynesian 135 introductions and should have probably been incorporated into the native pharmacopoeia early in the development of their native medicines. Both Kyllinga brevifolia and Citrus aurantiifolia are post-contact introductions and it would make sense that they did not show up in the early literature. Lastly, there are species that were used from pre-contact into the transitional period, but they are conspicuously absent in today' s medicinal system. These include Sonchus oleraceus, Erythrina variegata, Abutilon spp., Hibiscus tiliaceus, Piper methysticum, Santalum spp., and Sapindus saponaria. The native plants represented in this list were not used medicinally by any of the contemporary Marquesan healers I interviewed. The one Polynesian introduced plant which may have seemed like it would absolutely be used as a medicinal plant (Piper methysticum) was conspicuously absent from the modem Marquesan pharmacopoeia. This being said, there are probably a lot factors for its disuse over the years which may include early missionary pressure to abstain, introduction of an equivalent narcotic beverage in the form of alcohol, and that natives have not been cultivating it in recent years and it has been relegated to only ceremonial uses. The fact that these plants were not mentioned by contemporary healers may be due in part to the fact that only a limited number of healers were interviewed, and also that most of the healers interviewed were interviewed only once. If! were to interview more healers and re-interview them, some of these plant species may be mentioned as being used medicinally even today. The main purpose of this research was to describe and analyze the current status of traditional medicine in the Marquesas and specifically on the island of Hiva Oa. Research consisted of interviews conducted by the author over a period of several years. 136 The interviews that were conducted produced a lot of qualitative data regarding the current status of the medicinal system. This research is not a definitive study and I encourage other researchers who have enough support and funding to reside in the archipelago for a few years, to learn the language and interview as many informants as possible throughout all of the islands. The data I have presented however does show that traditional medicine is still being practiced in the Marquesas and what is being practiced now is significantly different from what was shown in the early literature. There is less interest among the youth to learn about traditional medicine from their parents and great-grand parents. Because of this, knowledge of traditional medicine is mostly retained in the older generations. In time, as older generations pass on, traditional knowledge pertaining to plant medicine will likely become extinct. Not only are the younger generations not learning the traditional medicine, they are also adopting western medical practices and relying less on the plant knowledge of old. For the mere survival of this unique herbal practice, there must be concerted efforts made on the part of the younger generation to learn and practice this native art. The ability of this knowledge system to persevere into the future is also reliant upon intensive documentation by either ethnobotanists or better yet, Marquesans who carry on this knowledge in-situ. This is a prescription for the future generations. This preliminary work is only the first step in the documentation of traditional medicine in the Marquesas Islands. Let us hope that there are those motivated to take on projects like these to document the traditional medicinal knowledge of the Marquesas before the older generations pass on. 137 Appendix I. Gods Significant in the Marquesan Medicinal System (Delmas, 1927; Dening, 1980; Suggs, 1966; Thomas, 1986). Anoano: the goddess who inflicts madness in women Auahapuku I Auahapaku: the god and creator of syphilis Auoano: the god of epilepsy Hanaua: the goddess of pregnant women Hanake: the god who inflicts rheumatism Havake: the god of rheumatism (maybe a synonym of the god Hanake) Hupaupa: the god of the sick lkanui: the goddess of syphilis Kaiotu: the god who enters into the nose or mouth to take ones souls Kea: the god of disease in small children or the god who gives thrush Koheaki: the god of circumcision Mauavivi: flying goddess who takes children's eyes Moaki: the god of eye trouble Moiaika: goddess of childbirth Motii: the god who resurrects people who have been poisoned dead Moui: the god of circumcision Movi: the god of circumcision (probably a synonym of Moui) Neo: the god who inflicts a furious madness in men Puhinauoho: the goddess who teaches to remove sickness from bodies that [other1 gods have afflicted Tahivahive: the god of tongues who is attributed with a cyst on the tongue (glossocele) Tatakieka: the god of healing syphilis 138 Tauatehiaki: the god of sudden death in sleep Teara: the god who comes [with] suffering and crisis Teohootekua: the goddess ofleprosy Tetikipuaikanui: the god who inflects unexpected death Tikapu: the god of blindness Tokohiti: the god of place of death Tokotakoteki: the god of cripples Toopapa: the god of paralysis Tumutumutetu: the god of curing venereal diseases Tupa'amo: a god who was used to bring sickness or death upon a person Tutehoa: the god who puts back dislocated limbs Upeouoho: the goddess offalse birth labortions Vaiaki: the god of natural death 139 ---- -~ - Appendix II. Plants Used in Marquesan Ethnomedicine and Their Distributional Status Pre to Early Post Contact Period. PLANT NAME ENEMDIC INDIG POLY MODERN INTRO INTRO Abutilon grandifolium • Abutilon hirtum • Aleurites moluccana • Brassica juncea • Cocos nucifera • Colocasia esculenta • Colubrina asiatica • Cordia subcordata • Curcuma longa • Erythrina variegata • Hibiscus rosa-sinensis • Hibiscus tiliaceus • Ipomoea alba • Morinda citrifolia • Physalis peruviana • Piper methysticum • Psidium guajava • Ricinus communis • Rorippa sarmentosa • 140 Appendix II. (Continued) Plants Used in Marquesan Ethnomedicine and Their Distributional Status - Pre to Early Post Contact Period. PLANT NAME ENEMDIC INDIG POLY MODERN INTRO INTRO Sacchrum officinarum • Santalum insulare • Sapindus saponaria • Senna occidentalis • Sida rhombifolia • Sonchus oleraceus • Tamarindus indica • Tephrosia purpurea • Usneasp. • 141 Appendix III. The Preparation ofMa in the Marquesas Islands - Then and Now. Those of us who have traveled to the Marquesas extensively or even the casual visitor, have tasted what the Marquesan people call rna. This is fermented paste made from the mei or breadfruit (Artocarpus altiUs) and is still widely eaten in the Marquesas. The need to ferment and store the rna was a result of the constraints on food production (Ragone, 1991). These constraints were both environmental and cultural and were significant enough for the development of an elaborate system for conserving breadfruit in underground pits (Handy, 1923). These constraints included famine resulting from severe droughts which were frequent in the Marquesas. The fact that rnei and subsequently the rna were so important in the diets of these people, both the trees and the storage pits were often targeted and destroyed by warring tribes. Just to give you an idea on the importance of this crop the following excerpt is from Greg Dening's (1980) Islands and Beaches: "... it (breadfruit) grew on the valley floors, up the slope and deep in the valley reaches, fruiting two and three times a year... they divided their year into its four seasons, set their mathematical systems by its bundles ofcropped fruit, associated their astronomical observations with its growth and waning, sang songs to its beauty and strength, hedged around every step in its planting and cropping with supernatural protection, killed those whose misbehavior threatened it, and destroyed their enemies by destroying their trees" The ability to preserve fermented breadfruit and store them in pits allowed the people to wait out famines brought on by extensive droughts. The methods of fermenting breadfruit have changed since the early days, but it still involves fermenting the fruit pulp. The semi-anaerobic environment in these pits allows for acidification which 142 eventually reduces the fruit into a sour paste (Ragone, 1991). During harvest time, the breadfruit was picked mature, but not ripe. The skin was then removed by women using the pukava shell (Cypraea mauritiana) and the peeled fruit was laid and covered on a bed offau (Hibiscus tiliaceus) leaves (Handy, 1923; Linton, 1923).The ripening of the fruit was done artificially by inserting a stick through the top part of the fruit where the removed peduncle attaches to the fruit. This helped in the ripening process and by the next day the fruit is ready to be prepared. The following day, the pulp with the core removed was put into a temporary pit lined with coconut (Cocos nucifera) and banana (Musa paradisiaca) leaves (Handy, 1923). This allowed time for additional water to drain out and to begin the fermentation process. Next the pits were dug. These were of different sizes and functions. They were usually dug in soils with high clay content to prevent water seeping in (Ragone, 1991). Traditionally, there were household storage pits and tribal or communal pits. There were also hidden pits located high in mountain areas where enemies could not find and destroy their ma (Handy, 1923). During the first harvest in December through January, workers filled the large tribal pits along with the private pits of the ruling chiefs (Ragone, 1991). These tribal storage pits were immense silos, sometimes round or square, reaching depths up to forty feet and being twenty feet across usually located near communal meeting areas or even hidden in the hills (Linton, N.A.). The household pits were smaller and were located around or near the family compound. These pits had to wait the second harvest in April and May to be filled with the extras going into the communal pits (Ragone, 1991). They were round, roughly four feet in diameter and around three feet deep (Linton, N.A.). These pits stored enough food for a family for at least one year. All pits had earthen walls which were lined with dry 143 banana leaves and then layered over with green banana leaves (Linton, N.A.). The ma was then placed in the middle and trampled by foot until it became a solid cake (Linton, N.A.). On top of this, mats ofti (Cordylinefruticosa) were placed until the pit was filled with some short pieces of banana leaves capped with a litter of dry banana leaves completed with a layer of stones over the whole area (Linton, N.A.). The ma could be kept in these pits for fifty years and still be edible even though their nutritional levels were insignificant. The best ma was called ma tahito and was aged for about ten years and had a dark brown color (Handy, 1923). The natives of the Marquesas still prepare and consume ma, but long gone are the days oflarge communal pits or secret pits in the mountains. Because those constraints of the past that led the people to develop the technique of fermenting breadfruit are insignificant, the amount of ma being prepared is no where near their past endeavors. Gone are the days of drought induced famines and destruction of breadfruit trees and storage pits by enemy invaders. Today, fermented breadfruit paste is prepared in large plastic drums lined with plastic trash bags. Once fermented, the ma is rolled up into little balls the size of golf balls and stored in the refrigerator. The processes have changed but the results are near the same - fermented breadfruit paste aged to the taste of the Marquesan natives. 144 Appendix IV. Plants Used in Marquesan Ethnomedicine and Their Distributional Status - Transitional Period. PLANT NAME ENEMDlC INDIG POLY MODERN INTRO INTRO Abutilon hirtum • Achyranthes aspera var. • aspera Ageratum conyzoides • Aleurites moluccana • A morphophallus • paeonii/olius Ananas cosmos • Artocarpus altiUs • Acslepias curassavica • Bacopa monnieri • Bauhinia monandra • Benincasa hispida • Bidens cordi/olia • Bidens pilosa • Bidens polycephala • Broussonteia papyri/era • Caesalpinia bonduc • Canavalia rosea • 145 Appendix IV. (Continued) Plants Used in Marquesan Ethnomedicine and Their Distributional Status - Transitional Period. PLANT NAME ENEMDIC INDIG POLY MODERN INTRO INTRO Cardiospermum • halicacabum Carica papaya • Chamaesyce hirta • Citrus aurantifolia • Cladium nukuhivense • Cordia subcordata • Cordyline fruticosa • Cucumis anguria • Curcuma longa • Cyathula prostrata • Cyperus moutona • Erianthus pedicellaris • Erythrina variegata • Hibiscus tiliaceus • Kyllinga brevifolia • Lagenaria siceraria • Liparis clypeolum • Lycopodium cernuum • 146 Appendix IV. (Continued) Plants Used in Marquesan Ethnomedicine and Their Distributional Status - Transitional Period. PLANT NAME ENEMDIC IN DIG POLY MODERN INTRO INTRO Macropiper latifolium • Microsorum • scolopendria Momordica charantia • Morinda citrifolia • Musa troglodytarum • Musa paradisiaca • Nephrolepis acutifolia • Ocimum basilicum • Passiflora foetida • Pelagodoxa henryana • Peperomia blanda var. • floribunda Peperomia pallida • Phyllanthus paciflcus • Phyllanthus tene/lus • Physalis peruviana • Piper methysticum • Plumbago zeylanica • Procris pedunculata • Psidium guajava • 147 Appendix IV. (Continued) Plants Used in Marquesan Ethnomedicine and Their Distributional Status - Transitional Period. PLANT NAME ENEMDIC INDIG POLY MODERN INTRO INTRO Rorippa sarmentosa • Sacchrum officinarum • Santalum insulare var. • marchionense Sapindus saponaria • Solanum americanum • Sonchus oleraceus • Syzygium malaccense • Thespesia populnea • Vigna adenantha • 148 Appendix V. Informed Consent Exemption Form from the University of Hawai'i. UN...V.Ra.TY OF HAWA'"I ~OIIHIIIIWI __ MEMORANDUM ..,;,\\.S ....--- \-, y. (1 ;>. .;;;~ r~~ ~~.",", ~~...... April",200] "'.~ @.k'I,""~ .. ~" -~'\. ~ ·~rJo.':~\'Jii'.... 1 S1r ''f~'\, TO; LiloaM Dunn ; __ ~ .. P~';"'t' _. ~. -:;1, .:.:c:g.• '': ~";t.~i Principal inVestigator fIi~·. .' (,,- r ~: ;:- ..... '; Depal1mentofBotany I ~': '! ~ r.:..~~_ .. :.:t..:,; -; f,;; - ~;, i, J~:i{1'1 ' .• ''''.~ I FROM: Willi~ H. Derui1e, E~1itI~ ~.z'l ~~-f"- j~' :) t Comrrutteeon HumanSItdiI$':- ,~.. ,\XU\.;j:J··'to/! "~I .. f z~ ~~, '" II ~!A..Ilt" ">1'" SUBJECT: CHS # tlO89- "Compalative;.\nal)'Sis Qf TIDtion.:d;~ m Eastcini -, "".,..J PoLyneSIa" ,,,~~ ~ l 1~~------' ,". -1':- ,\~~\., ~ ...... "'} "Tljf ~ " .(1F.--4 Your project idenufied above: WiU revieWed and bas been determlliOO to be uc:mpt frtmJ:-/ Department of Health and Human ServiceS UlIDIS)n:gulatioos, 4S"(:FR Part 46. if>''''''; if SpecificaUy, the 8Iltborily for this exemption 19'~' 4:ti--" 19t(bX2}.',· Your_~6c~e,or exemption (Optional Form 310) is enclosed. This c~.~~P4 ofCH&.,f review of this study and will be effective as of the dafe.1ihOwD till tho' certir~:*' .' ... ~.~-- An exempt status signifLes that you will not be required to submit renewal applications for full Committee review!!.'i long as that portion of yow project involVing tmman 'j"bjf'ctS remajns JJPsbanged If, during the course of YOW" project, you intend to make changes which may significantly affect the human subjects involved, yOIl should cotrtact this office for guidance prior to implementing these changes. Any unanticipated problems related to your use ofhumao subjects in this project must be prOmptly reported 1(1 the CHS through this office. This is required so that the CHS can institute or update protective measures for human subjects as may be necessary. In addition, under the University's Assurance with !he U.S. Department of Health and Human Services, the Univer.;ity must report certain situations to the federal government. Examples of these reportable situations include deaths. injuries., adverse reactions or unforeseen risks to human subjects. These reportS must be made regardless of the source funding or exempt status of your project University policy requires you to maintain as an essential part of your project records, an), OOc"\l.IDel\\s pertaining to the usc ofbumans as subject3 in your research. This includes any information or materials conveyed to, aDd. received from, the subjects, as well as any executed consent fonns, da1a and analysis results. These records must be maintained for at least three years after project oompletion or termination. IfWs is a 2S4O _ w..~. Spojdilg 262. foIono ..... _, eeerz·2300 ~'I!IO!IJSJ9.~)\l98-!iIXI7.I'a<::UT>"_{8OI!1~.WIIb.rte. __"Lldullrb M Eq<* Opp<>r\\nlyfAffmwlM>...,."", Irw1iI"';':" 149 ------Appendix V. (Continued) Informed Consent Exemption Form from the University of Hawai'i. Liloa M. Dunn Page 2 April 18,2001 I'iIDXd projcet, y,m 9hooId be aware thai these record! are subject 1£1 inspection and ~ by authorized ~lives uribe Univ=ity, S~ and Federal gllYCnUllmts. Please; goUfy !hj- gff"::C...meg yoorpm;;ct if cnmp""td We may ask Iha! you provide info1'1llllIion n:gatdll'18 your experieDces WIth hUlllllll subjects and with the CHS review ~. Upou notificatilJll, YI\! will close our files pmaining 10 yourproject. Any sOOilequmi reactivation of the proj", will ~ a new CHS appllemion. Pl~ do not he!itak to ooniac1 me if you iIIlve 1lIIY questions or rcquiB !IS5~. will be happy 10 assist you in IIIlY"".,.Y 1 <;:all. Thank you for your ~l'Iltion and effmts throughout this review process. I wish you success in this endeavor. 150 .-.... ~.., - -.."""'" Appendix V. (Continued) Infonned Consent Exemption Fonn from the University of Hawai'i. OM8"" (1)2:;.0.0,. """""",,/«_ iii ThiO...... ".,.,..onfilo_llopMrnottol-...... H.n2ns.-._ ...... ".,.,...... " ... _b>""~ 11QJ __ no~ D~~~--:.,_¥_o_·_~~~~c_==~=oo~-c.=._=.c,~------""""" .... .a.IIy· o --No ...... __ Icw ... l>'OjoIoI.l1Ils'~_I"IOI' .... ~ ...... ,._CerIIIadIonolIRB __ ~ DThIOoahfl)'lwI __... _br ... ,FlII ... __ ... .,..,....,., ______oegcoo ...... "'..",.,....'" { Dn.oldlol1r""' ..... rUIipOI"""""'".oomool_"".. not __._IRBhaII ____ ""a>tdIIIon ...., .. PI"IodI ..-bt ...... ,.""" ...... _-·""'!""'-""-_ ... _-"""3"'&-"".-. ... "._.... 1I. __oIgnn aomocIonO_ ...... ~ 100_. •• --.k£nt_ .. ""poof.)n"noo:I _ Unbaratty of Ha ..a:ll at iI.o.11OS SVi'I!/lIG!! 1'.I'!Joo'O ..... {Ml' .... «> 151 Appendix VI. Follow-up Questions Used in the Semi-Structured Interviews for Informant T.M and R.M. PART!. The following questions were constructed after a series of unstructured interviews took place with informant T.M. in order to clarifY certain aspects of Marquesan Traditional medicine that were unclear: 1. What is the difference between (apau) parari and (apau) no te toto? 2. You have used the papamo' 0 (Microsorum scolopendria) that grows around the village in many of your recipes. Can the papamo' 0 (Microsorum membranifolium) that grows up in the mountains be used as a substitution for the papamo'o (Microsorum scolopendria) that grows around the village? 3. Why is plant materials processed in a particular order? (Gave an example of hers) 4. Why are plants selected? 5. What are the symptoms of (apau) puaroto? 6. What are the symptoms of (apau) fefe? 7. What are the symptoms of (apau) tekeo? 8. What are the symptoms of (apau) mo'opa'a? 9. What are the symptoms of puta mitoe (puta toetoe)? 10. What are the symptoms of (apau) vi'ihoa? 11. What are the symptoms of (apau) feke tama? 12. What is (apau) epa? 13. What are the symptoms of the different kinds of epa? 14. What is (apau) vi'i kea? 152 PART II. The following questions were constructed after a series of unstructured interviews took place with informant R.M. in order to clarify certain aspects of Marquesan Traditional medicine that were unclear: I. Why are plants selected? 2. How do you get (apau) fati? 3. What are the symptoms ofvi'ihoa puta toetoe? 4. Who gets it? (in reference to the previous question) 5. How do you get vi'ihoa puta toetoe? 6. What is the difference between mimi ke'a and kea? 7. There are different kinds of ira sicknesses in Tahiti, are the similar kind of sicknesses in the Marquesas? 153 Appendix VII. Definition of Disease or Ailment Categories. I) Apau Epa It was explained by informant T.M. that there are many types of epa. This epa is specifically seen in young children. It has been defined in the Marquesan dictionary as a small pimple/pustule on the mouth or thrush (Dordillion, 1904). Another closely related childhood ailment is kea, which is also defined as a thrush. This ailment was treated by informants T.M and M.L. It can affect babies 2-3 months old and has been explained by informants T.M. as a small type of water blister that becomes itchy. 2) Apau Epa - Pa'atita This is another kind of epa also called epa pa' atita. Only informant R.M. mentioned this disease. The word pa' atita is defined as sores around orifices with a clear finish (Dordillion, 1904). This epa is a venereal type of malady afflicting young and old adults. Symptoms include a burning sensation while urinating. People afflicted with this may also develop sores on the skin that tum red. The informant mentioned that it can make childbirth difficult. Informant R.M. stressed that if one person in a relationship gets this disease, both have to take the medicine, not just the person infected. They are also not allowed to have sex while this is being treated, otherwise they will be exchanging the disease back and forth. Although difficult to tell for sure, this could be a sexually transmitted disease such as genital herpes, Chlamydia, Trichomoniasis or Gonorrhea. 3) Apau Evita 'a Apau Evita' a is more of an organic trauma than disease or sickness that involves ligament or muscle damage occurring in the elbows, shoulders, knees, or ankles. Two 154 informants that treat this problem are H.H. and R.M. and interestingly enough both informants use the same plants: Tutu (Colubrina asiatica) and Papamo'o (Microsorum spp.). Parts used were also the same in their recipes differing only slightly in the way they prepared it. Informant R.M., considered in this research with more expert knowledge, processed her plants in an exact ordering (see section on Ordering). Both informants were specific on the counter-clockwise direction of applying the medicine. 4) Apau Fati The ailment called Cati, on Hiva Oa, was mentioned by informants T.M. and R.M. Called bati in the northern group of the Marquesas, Cati means to break or to be broken (Dordillion, 1904; Le Cleac'h, 1997). In Tahitian traditional medicine, there is also a Cati and it is defined as bruises and contusions that may occur with or without a fracture (Petard, 1986). Informant R.M. explains that you get "Cati" when you fall down or someone punches you, or you get into an automobile or bicycle accident. It could involve a fracture, contusions or just bruises. Informant T.M. stressed the importance that for seven days there should be no work, sex, or riding in cars or on horseback because these things will aggravate the "Cati". Another informant stated that if you fall down off a horse or something like that you have Cati and must take apau Cati to prevent any sickness to occur. 5) Apau FeCe This is the first kind of CeCe and it has been described as an infected open sore on the skin. Symptoms include soreness and redness around the wound with puss associated with the wound. A Marquesan dictionary defined CeCe as a boil, carbuncle, abscess or elephantitis (Dordillion, 1904; Le Cleac'h, 1997). Called CeCe or Ce'efe'e in Tahitian 155 medicine it is also defined as an abscess or elephantitis (Petard, 1986). Infonnant T.M. explained that it is like puaroto, except that the source of the infection is on the outside of the skin rather than the inside. 6) Apau Fde (cancer) There are two kinds of fde, the one explained above and one that was explained as a cancer in the Western sense as we know it. Infonnant T.M. just called it apau cancer, while the other two infonnants (M.T. and H.H.) called it apau fefe with note that it was a cancer and not just the infected sore type fefe. Looking in the Marquesan dictionary under the word for cancer and names maki kai kiko and heke come up (Dordillion, 1904; Le Cleac'h, 1997). 7) Apau Hea There was only one infonnant, M.T., who treated hea. She wasn't specific on the symptoms and or causes of hea and I wasn't able to re-interview her to clarify this ailment. Looking into the Marquesan dictionary there are no listings for hea that correspond to a specific sickness or disease. Looking at alternate spellings for this word, the word hea'a, means stiff neck (Dordillion, 1904). Another alternate spelling could be heii which is defined as stinking or ill-smelling; or one that exhales a bad odor (Dordillion, 1904). Tahitians disease categories have a lot similarities with the Marquesan, and hea (as it is spelled) is defined as a leucorrhee (pertes blanches) (Pertard,1986). A leucorrhee (pertes blanches-white losses) is a type ofnonnal vaginal secretion, whitish in color that functions to protect against infection though the vaginal canal (Rossant et al., n.d.). This makes sense because infonnant M.T. did state that this affects only females and when taking this medicine no sex is allowed. One might think 156 .. why Marquesans would fonnulate a medicine for something that is nonnal and beneficial to the female. Female vaginal astringents are common in the Marquesas and this medicine may function as others do, to keep the vaginal area dry which is a culturally recognized attribute of cleanliness for females. 8) Apau Ira Toiki Infonnant RM. was the only one of the infonnants that brought up the condition known as ira even though I have heard about in talk amongst families especially when referring to children. The tenn ira is difficult to describe and one infonnant stated that it is a type offever or nervousness that young children get. The word ira is not found in any of the two Marquesan dictionaries available (Dordillion, 1904; Le Cleac'h, 1997). Thus we must investigate other sources that may give insight into this peculiar disease. One source calls it mate ira where it is known to only strike male children and is characterized by muscular tics in the shoulders and neck (Kirkpatrick, 1983). Looking into Tahitian sources, Petard (1986) defines the tenn ira as convulsion afflicting children. The tenn ira is also defined as an illness that includes headaches and also convulsions (Lemaitre, 1973). It may be that this condition is analogous to baby colic which displays some similar symptoms. If ira is indeed a fonn of colic, it could be related to the ailment Lesson (1981) called kokoti or colic. Infonnant RM. stated that there were six kinds of ira that fall under the heading ira toiki or the ira that afflicts children, but only went on to describe five of them. These were ira patu, ira metoe, ira niho and ira manu. For some of these the causations are unknown, but she knew the symptoms and that's what they seem to treat. The following are description taken directly out of the interviewing notes on the five different ira as described by infonnant RM. 157 Ira Patu: when the baby is lying down on its back and it always tweaks/turns its head and neck. Ira Metoe: when the babies ears, feet and legs are always cold. Ira Niho: results when babies start cutting their first teeth and characterized by incessant crymg. Ira Manu: when the baby is all tensed up with clinched fist and feet; like when you wake up the baby and surprise them, they have that scared look on their face. 9) Apau Kaki Memae Kaki memae is literally translated to as "throat sore" or sore throat. This ailment was mentioned by only one informant, T.M who gave me one recipe and another I saw her make for a patient. In another interview, she also gave a recipe that was called apau note kaki or medicine for the throat which differed from the other ones in ingredients, but is probably a synonym of the prior. Some symptoms given by the informant are chronic sore throat and coughing including not being able to breathe well. 10) Apau Kea This ailment was mentioned by informants R.M. and H.H. as being a problem that only inflicts young babies. This is defined in the Marquesan Dictionary as muguet or thrush (Dordillion, 1904). Thrush is a fungal disease caused by Candida a/Means and is a result of an unhealthy balance of bacteria and fungi in the mouth. This ailment is said to affect young babies with symptoms that include a chalky white stuff developing on the tongue, mouth and lips. Informant R.M. mentioned that if you have a child with kea, a child relative such as a cousin of relatively the same age will also get the kea. Informant H.H. gives two recipes for apau kea while Informant R.M. just gives one. 158 11) Apau Miii Mentioned only once by informant (R.M.) and stimulated by our discussion regarding apau kea, this sickness seemed to be quite similar to it differing only with the symptoms that included green sores inside the mouth area and around the lips. 12) Apau Memae te Pito This apau was only mentioned once by informant P.T. She describes the symptoms as an inflamed naval. This could be a traditional disease category, but without better understanding it is hard to define this in a western sense. Informant R.M. in her description of apau vi'ihoa puta toetoe, list one of the symptoms as a sore naval. There is a chance that these two ailments are related, but with each healer calling it a different name. Attempts were made to re-interview this informant, but because she was really standoffish and really didn't want to talk in the first place, other attempts were abandoned. 13) Apau Memae Puhi Kaioo (Memae te po'o) This ailment was described by informant P.T. as a headache or migraines resulting in a sunstroke associated with to much sun. She said that one gets this problem "every time the sun hits on top of the head and the pains come triggered by the sun". 14) Apau Mata Informant M.L. gave the remedy known as apau mata. Symptoms include inflamed red eyes, that are constantly itching and sore with lots of what we call in Hawai'i makapiapia, the sticky viscous matter that builds up in the comer of the eyes after a long nights sleep. In traditional Tahitian medicine ra' au no te mata is defined as conjunctivitis or ocular fatigue (Petard, 1986). 159 IS) Apau no te Mate Fanaua There are many medicines that pertain only to women and mate fanaua is one of them. Informant T.M. states that this medicine is taken by women who have just given birth. This medicine is designed as an external cleanse of the vaginal area which includes a steam treatment and body wash. 16) Apau Mimi Ke'a Two informants, T.M. and R.M., treated what they called mimi ke'a, which translates literally into "urine rocks" or more commonly known as kidney stones. Asked what causes mimi ke' a, informant R.M. replied that people get this because they don't drink enough water, or just drink sodas, lemonade and alcohol. 17) Apau Mo'opa'a This ailment was mentioned by informant H.H. as a medicine "pour la crachat" or for the spit. In the Marquesan dictionary, mo'opa'a is defined by the word ma'ema'e which is further defined as mucus or phlegm (Dordillion, 1904; Mansion, 1950). This medicine is probably helps to eliminate phlegm buildup in the throat. 18) Apau Ouma pe This ailment was treated by three informants in this research: M.T., P.T, and H.H. They explained that it was a respiratory problem, probably a bronchial infection such as bronchitis. Lung congestion is said to be one of symptoms of this sickness. It can affect both children and adults. Adults who smoke are especially prone to this sickness. In Tahitian traditional medicine ouma pe is also known as bronchitis (Petard, 1986) 160 -_.-.-,.--- ~ 19) Apau Parari The condition known as papari exclusively affects women. Three female informants (T.M., M.L. and R.M.) described this condition as women who have irregular menstrual cycles. Normally, each month women get their regular menstrual cycle, but those with papari have irregular cycles and will become sick because of it. It is also used to re-align the menstrual cycle after giving birth. Parari is defined in the dictionary as dry or roasted (Dordillion, 1904). This definition doesn't give to much insight into the medical problem, but the dryness may refer to the fact that these women are not having regular blood flow, thus it is considered parari or dry. Looking into the Tahitian sources for further clarification, ra'au parari is defined as a remedy for giving birth probably in reference to a medicine used after childbirth (Petard, 1986). 20) Apau no te Toto (Apau parari DO te vahine hopu) Although seemingly similar to parari, apau no te toto also known as apau papari no te vehine hopu is quite different. Informant T.M. described this as a condition when the sac or placenta doesn't exit out of the body after a woman gives birth. This can lead to a possible infection. Symptoms can include hemorrhaging and continual blood flow from the vaginal area. This medicine is designed to stop blood loss and is also good for cleaning the vagina and uterus after giving birth. In traditional Tahitian medicine, ra' au hopu parari is an external treatment for miscarriages (Petard, 1996). 21) Apau Puaroto - Fe'etama Explained to the researcher by informant M.T. as an internal sickness or maladie de dents where the boil is inside the skin such as a tumor. This was further clarified by informant T.M. as a boil in which the focus of the infection is inside the skin. This 161 '- ...... sickness is serious enough to put the body into shock if the tumors are left untreated. Petard (1986) also states that puaroto is a fibromes or various kinds of benign tumors. 22) Apau Taupo This is defined by informants T.M. and P.T. as infected sores such as boils or pustules on the skin's surface, seemingly similar to the non-cancer fefe. The abscess are usually larger than boils that develop from a deep bacterial infection that leads to a painful swelling of the skin (Carbuncle, 2005). The medicine that is used to treat this ailment is designed to pull out the puss from the wound acting as an astringent. Interestingly enough, Petard (1986) defines taupo in the Tahitian context as a carbuncle which is very similar to the Marquesan understanding. 23) Apau Tekeo The word tekeo is defined as toxic, poison, or a poisonous plant or animal (Le Cleac'h, 1997; Dordillion, 1904). Only informant M.L. gave a remedy for this sickness. Although informant T.M. didn't give a remedy for this sickness she did explain that it could be a poisoning like that from fish such as ciguatera with symptoms that include lower cardiac rhythm, diarrhea, and vomiting. It is also associated with a cold tingling feeling in the hands especially when touching things. 24) Apau Toiki Apau Toiki is literally translates into medicine for children. This is actually an internal cleanse or purge analogous to the tiheke, but designed for babies from 1 month old to young children. Two recipes were known by informant T.M. for this apau. 162 25) Apau Ve'a Only mentioned by one informant (T.T.), this ailment was described as something like heartburn or an ulcer. The informant said that when one drinks to much whiskey and the inside ofthe body gets all hot that is what ve'a is. Ve'a in the Marquesan language means hot, boil, or inflamed (Dordillion, 1904). Because the researcher wasn't able to re interview this informant, a further explanation of this ailment wasn't possible. 26) Apau Vi'ihoa Puta Toetoe This is another vi'ihoa sickness with synonyms such as puta mitoe or vi'ihoa opii and vi'ihoa tu. Informants T.M., R.M. and T.T. gave remedies for this sickness along with many of the causations and symptoms. Some of the symptoms include a sort of congestion in the chest area associated with a cough, a sore chest with soreness in the back area, knees, joints and naval area or a sharp pain in the stomach or chest. It can be accompanied with a fever and people who have this sickness usually emit a bad odor from their mouth. Informant R.M. also states that these people usually are cold all over their bodies and they seem sick and are tired all the time with no appetite. It usually affects older adults especially those who drink a lot. Informant R.M. mentions though that any body can get this sickness and they can get it by over working or remaining in wet clothes after working. These people don't change out of their wet clothes and clean up after working out or being in the water. This ailment maybe pneumonia based on some of the symptoms. 27) Apau Vi'ihoa Topa This ailment by far had the most synonyms of any of the other ailments by far. I have put all the synonyms under the heading apau vi'ihoa topa, because it best describe 163 the ailment. There are actually many different vrihoa and may seem unrelated to the western eye. The synonyms for vrihoa topa are ko (vrihoa) and vrihoa keo. All of these tenns refer to a condition called hemorrhoids. Infonnant T.M. actually referred to this as hemorrhoids in the French vernacular, while infonnants R.M. used the tenn vrihoa topa and infonnant P.T. used the tenn ko (vrihoa). Still Infonnant T.T. had a different name of vrihoa keo, but they were all essentially the same conditions. What differed beside the name was how people got the condition. One infonnant stated that the hemorrhoid can be caused by frequent constipation or from giving birth. Another infonnant stated that it can be caused by sitting down on hard surfaces like rocks or riding around in a car or truck. This will certainly aggravate a hemorrhoid, but I don't know about causing one. 28) Tiheke: This is a traditional purge that is always a part of the healing process. It is designed to give the body a final cleansing after taking medicines. All infonnants incorporate this purge into their healing process, although only a couple actually gave the recipes. See the section in Chapter 3 regarding tiheke or traditional purges. 29) Apau mate i te puaina: Referred to as a common ear ache, infonnant M.T. was the only one to give a description of the remedy. The causations of the ear ache are unknown to the researcher as the infonnant was only interviewed once and attempts to re-interview her failed. 30) Apau mate i te puo vaevae Infonnant T.M. was the only infonnant that gave a remedy for the common twisted ankle. 164 Appendix VIII. Data Sets Showing Relationships Between Healers and the Diseases They Treat. Diseases T.M. R.M. M.T. P.T. H.H. M.L. T.T. Constancy Category Apau Vi'ihoa Topa I 1 0 1 0 0 1 57.1% Common Tiheke I 1 I I 0 0 0 57.1% Common Apau Fefe (cancer) I 0 1 0 1 0 0 42.9% Common Apau Mimi Kea 0 1 1 I 0 0 0 42.9% Common ApauOumape 0 0 1 1 1 0 0 42.9% Common Apau Parari 1 1 0 0 0 1 0 42.9% Common Apau Viihoa Puta 1 1 0 0 0 0 I 42.9% Common ApauEpa 1 0 0 0 0 1 0 28.6% Occasional Apau Evitaa 0 1 0 0 1 0 0 28.6% Occasional Apau Fati 0 1 1 0 0 0 0 28.6% Occasional Apau Kea 0 1 0 0 1 0 0 28.6% Occasional Apau Puaroto Feetama 1 0 I 0 0 0 0 28.6% Occasional Apau Taupo 1 0 0 I 0 0 0 28.6% Occasional ApauEpa (Venereal) 0 I 0 0 0 0 0 14.3% Infrequent ApauFefe 1 0 0 0 0 0 0 14.3% Infrequent Apau Hea 0 0 I 0 0 0 0 14.3% Infrequent Apau Ira Toiki 0 I 0 0 0 0 0 14.3% Infrequent Apau Kaki Memae I 0 0 0 0 0 0 14.3% Infrequent Apau Mai 0 I 0 0 0 0 0 14.3% Infrequent ApauMata 0 0 0 0 0 I 0 14.3% Infrequent Auap Mate Fanaua 1 0 0 0 0 0 0 14.3% Infrequent Apau Moopaa 0 0 0 0 I 0 0 14.3% Infrequent Apau Toto I 0 0 0 0 0 0 14.3% Infrequent Apau Tekeo 0 0 0 0 0 1 0 14.3% Infrequent Apau Toiki I 0 0 0 0 0 0 14.3% Infrequent Apau Puhi Kaioo 0 0 0 I 0 0 0 14.3% Infrequent 165 Appendix VIII. (Continued) Data Sets Showing Relationships Between Healers and the Diseases They Treat. Diseases T.M. R.M. M.T. P.T. H.H. M.L. T.T. Constancy Category Apau Memae te Pito 0 0 0 1 0 0 0 14.3% Infrequent Apau Ve'a 0 0 0 0 0 0 1 14.3% Infrequent Apau mate i te puama 0 0 1 0 0 0 0 14.3% Infrequent Apau mate i te puo vaevae 1 0 0 0 0 0 0 14.3% Infrequent Count 14 11 8 7 5 4 3 Constancy 45.2% 35.5% 25.8% 22.6% 16.1% 12.9% 9.7% Category Count Common 7 71.4% 71.4% 57.1% 57.1% 28.6% 14.3% 28.6% Occasional 6 50.0% 50.0% 33.3% 16.7% 33.3% 16.7% 0.0% Infrequent 17 35.3% 17.6% 11.8% 11.8% 5.9% 11.8% 5.9% Notes: 1) Healers names abbreviated into their different acronyms. 166 Appendix IX. Marquesan Medicinal Plants. The following list of plants is based on the interviews with selected healers on the island of Hiva Oa ordered in the currently recognized phylogeny. Pteridophytes POL YPODIACEAE 1. Microsorum membranifolium (R. Br.) Ching Marquesan name: papamoko / papamo'o Ferns, terrestrial, sometimes epiphytic, erect, rhizomes short-creeping with pseudopeltate scales; lamina deeply pinnatifid, pale green, glabrous, prominent main lateral veins, with undulate margins, stipe often winged part of the way up (Bostock et aI., 1998; Nooteboom, 1997). M membranifolium has a wide native distribution from India and Sri Lanka to China and southeast Asia, Maleasia, New Guinea, Philippines, Moluccas, Australia to Fiji, Society Islands and the Marquesas Islands (Bostock et aI., 1998; Nooteboom, 1997). M membranifolium is indigenous to the Marquesas archipelago and found on all the main islands in high elevation wet forest. SYNONYM: Phymatosorus membranifolium (R. Br.) S.G. Lu; Phymatosorus membranifolium (R. Br.) S.G. Lu. 2. Microsorum scolopendria (Burm.f.) Copel. Marquesan name: papamoko / papamo' 0 Ferns, terrestrial, erect, rhizomes creeping with scattered brown to black peltate scales; fronds large up to 75 cm long with stipe as long as the blades; lamina deeply pinnatifid, rarely simple, with 5 - 10 (- 15) pairs of lobes with young plants having 167 simple fronds (Bostock et ai., 1998; Palmer, 2003). Microsorum scolopendria has a wide native distribution from tropical Africa, Madagascar, tropical islands in the Indian Ocean through continental Asia, Fiji, eastwards throughout the South Pacific, as far east as Pitcairn Is. (Bostock et ai., 1998; Palmer, 2003). M scolopendria is indigenous and common on all islands in the Marquesas Archipelago. Two healers in the Marquesas on the island of Hiva Oa used a single frond pteridophyte called niapa in some oftheir remedies. Initially, there was some confusion to which genus/species this belonged to, but after re-interviewing an informant it was cleared up. It seems that the fern known as niapa is just a juvenile form of Microsorum scolopendria. Because species M scolopendria and M membranifolium are both recognized by informants as papamo' 0 (papamoko), it can be deduced that they also recognize a juvenile forms of Microsorum species as niapa also although it wasn't specified. SYNONYM: Phymatosorus scolopendria Pic.Ser. ; Phymatosorus grossus Brownlie. Monocotyledoneae ARECACEAE 1. Cocos nucifera L. Marquesan name: 'ehi / ' e' ehi These are large trees with trunks up 30 m tall, often curved and more thickened at the base becoming thinner toward the top; leaves or fronds can get up to 6 m long or even longer; long inflorescence with both staminate and pistillate yellow flowers; fruits large drupes 20-30 cm long (Wagner et al., 1999). The origins ofthe C. nucifera is still unknown, possibly Malaysian, but it is widely distributed in tropical Oceania. A Polynesian introduction to the Marquesas Islands and still widely 168 cultivated there for the copra trade, the coconut is still an indispensable part of Marquesan culture. There are two varieties employed in traditional medicine in Hiva Oa, Marquesas Islands. One is called Cehi) vai' 0' e ' ere' ere or the green variety. The other variety is called' ehi pukiki or the yellow/red variety. The water from the vai' 0' e ' ere' ere is commonly used as a liquid medium for a variety of medicines. The oil extracted from the copra is also used in topical remedies. The roots of both the green and yellow/red variety are also used and dried coconut meat from either variety is also employed in the native pharmacopoeia. BROMELIACEAE 1. Ananas cosmosus (1.) Merr. Marquesan name: fa'ahoka These are terrestrial herbs with short-stems and leaves that are linear with spiny margins; spicate-paniculiform inflorescence; fleshy syncarpous fruit (Smith, 1979). Ananas cosmos us is widely cultivated in the Marquesas in small family agricultural plots. This species of Ananas has been widely cultivated for years in the tropics and is originally from a domesticated cultigen from the Parana-Paraguay River of South America (Smith, 1979). CYPERACEAE I. Kyllinga brevifolia Rottb. Marquesan name: mutie pua vert These are perennials with long, slender creeping rhizomes, culms remotely or closely arranged along the rhizomes, erect, 7-30 cm tall; inflorescence in a terminal 169 globose head, greenish becoming straw colored at maturity (Smith, 1979). Kyllinga brevi/olia is a naturalized weed on all the main islands of the Marquesas. 2. Kyllinga nemoralis (J.R. Frost. & G. Frost.) Dandy ex Hutch. & Dalziel Marquesan name: mutie po' 0 maita These are perennials with long creeping rhizomes, culms close together or widely spaced along the rhizome, erect, 10-45 cm tall, trigonous, leaves numerous, linear; inflorescence in a single head or spike, white turning brown at anthesis (Smith 1981; Wagner et al., 1999). It is widely naturalized in the Marquesas and found on all the main islands. It is Pan-tropical in its distribution, but relatively uncommon in the Neotopics (Smith, 1979; Wagner et al., 1999). Another species of Kyllinga in the Marquesas is Kyllinga polyphylla which is not used in native medicines. LILIACEAE 1. Allium cepa L. Marquesan name: aniani These are cultivated biennials with leaves up to 40 cm and stems up to 100 em, bulbs depressed-globose up to 1Ocm in diameter, flowers in umbels (Steam, 1980). Many cultivars of the common onion exist bcause of its extensive cultivation for the past 3,000 years (Steam, 1980). Not yet grown in the Marquesas, but widely available in stores. Probably imported from New Zealand. POACEAE I. Cenchrus echinatus L. Common or English name: Common sandbur Marquesan name: piripiri 170 ... - io- These are annual grasses with culms decumbent at the base, 25-70 cm tall, profusely branched; inflorescence a raceme with dark red to purple burs, native to the Neotropics (Wagner et al., 1999). The piripiri, as it is called by the natives because the way the bur can adhere to clothing, is now naturalized on all the main islands in the Marquesas Archipelago. 2. Saccharum officinarum L. Marquesan name: tii These are robust perennial grasses, 3-3.6 m tall, culms stout, solid, leaf blades up to 1.5 m long, sheaths tightly clasping the culms; large inflorescences plumose, dense, racemose made up of many spikelets (Smith, 1979; Wagner et al., 1999). Because of its importance in the sugar industry, Saccharum officinarum is now distributed pan tropically and is probably of Southeast Asian origin. Sugarcane was an aboriginal introduction into the Marquesas where at least 7 varieties were once cultivated (Handy, 1923; Jardin, 1862). The use of sugarcane has been replaced for the most part in the native pharmacopoeia for refined brown or white granulated sugar. For those healers who still use the sugarcane in native plant medicine, the red/purple variety is favored over other varieties. ZINGIBERACEAE I. Curcuma longa L. Marquesan name: 'ena / 'eka Herbs, erect, deciduous, 0.5 - 1.5 m tall; leaves elliptic, oblong or lanceolate, glabrous; inflorescence erect, emerging from the center of the leaf tuft, fertile bracts green, sterile bracts white and green to pink; rhizomes solitary with a dark yellow to 171 orange interior (Wagner el al., 1999). An aboriginal introduction into the Pacific and probably native to India, C. longa is naturalized in the Marquesas and uncommon on all the islands. The natives of the Marquesas still use the grated rhizomes mix with coconut oil to anoint young girls in traditional ceremonies. Dicotyledoneae AMARANTHACEAE 1. Amaranthus viridis L. Marquesan name: poti'i These are annual herbs, usually 0.3-1 m tall with erect stems, sparingly to densely branched; leaves deltate-ovate to narrowly rhombic with blades 2 - 7 cm; flowers in slender axillary or terminal paniculate spikes, green, slender; seeds dark brown to black (Smith, 1981; Wagner et al., 1999). A species of unknown origin, Amaranthus viridis is widespread in tropical and subtropical regions of the world and in most Pacific archipelagos (Smith, 1981; Wagner et al., 1999). This species is common on all the main islands of the Marquesas in low elevation disturbed habitats. BORAGINACEAE I. Cordia subcordata Lam. Marquesan name: tou These are trees up 10 m tall, leaves coriaceous, broadly ovate to elliptic; flowers in cymes, corolla orange, wrinkled; immature fruits green becoming brown and dry at maturity, subglobose to ovoid (Wagner et al., 1999). The native range for Cordia subcordata is from tropical Asia through Eastern Polynesia. There has been some discussion on whether or not it was aboriginally introduced to Eastern Polynesia or at 172 - - .. .. ,,- least to Hawai'i, because it was not a common component of native coastal habitats (Whistler, 1991). Fossil evidence from sinkhole and cave system deposits in Maha'ulepii, Kaua'i have shown the existence of C. subcordata prior to human arrival in the Hawaiian islands (Burney et al., 200 I). Thus it is widely accepted that C. subcordata is indigenous also to Eastern Polynesia. C. subcordata occurs on all the main islands of the Marquesas archipelago in coastal and low elevation areas. BRASSICACEAE 1. Rorippa sarmentosa (G. Forst. ex DC.) J.F. Macbr. Marquesan name: mahimai / mahi A perennial herb, 15-50 em high, with short stems prostrate to weakly erect; leaves forming a basal rosette, pinnately compound with 3-7 leaflets; small flowers in racemes, petals white to pale yellow or cream (Smith, 1981; Welsh, 1998). This herb is usually found naturalized in moist areas in villages, growing as weed in potted plants and waste areas. Because this herb is important in the native pharmacopoeia, there are some who cultivate it under shaded planter boxes. It is distributed from the Solomon Islands and New Caledonia throughout the South Pacific to Hawai'i, but maybe native only in its western portion of its range somewhere west of Fiji (Smith, 1981). St. John (1945) suggests that because of its value as a food and medicinal plant that R. sarmentosa could have been an early aboriginal introduction into Polynesia, but shall be considered indigenous to all the main islands of the Marquesas. 173 CONVOLVULACEAE 1. Ipomoea balalas (L.) Poir. Marquesan name: 'uma'a / kuma'a These are vines with stems erect, procumbent or twining, rooting at the nodes; leaves chartaceous to fleshy, cordate to ovate, often glabrous or pubescent, margins entire or dentate to deeply lobed with acute apex; flowers solitary or in cymes, corolla lavender to purple (Wagner et al., 1999). The sweet potato has a pan-tropic distribution with its origins in South America; it is an early Polynesian introduction in to the Marquesas relatively uncommon on all the main islands. EUPHORBIACEAE 1. Aleurites moluccana (L.) Willd. Marquesan name: 'ama These are large trees, 10-20 m tall; leaves pale green from broadly ovate to rhomboid, cordate or lanceolate ; flowers are in terminal cymes; stellate hairs present on inflorescence, and on young leaves and branches (Wagner el al., 1999). Known as the candlenut tree in English, its native range is hard to determine because of its early distribution by humans, but it is presumably native to Indo-Malaysia region (Wagner el al., 1999). This tree is naturalized on all the main islands in the Marquesas. The Marquesan word' ama means light or torch. Like many other Polynesians before, the Marquesan used the oil from the nuts for lamps and strung together the nuts on a coconut leaf mid-rib for use as a sort of candle. Dyes were also extracted from these nuts and were used in tattooing and tapa making. 174 2. Manihot esculenta Crantz Marquesan name: manioka These are large herbs or shrubs, 1-3 m tall, with leaves usually palmately 3 to 7 lobed; inflorescence in terminal panicles (Welsh, 1998). This plant is native to South America and is widely cultivated in the Marquesas for its edible tubers. M esculenta was introduced into Polynesia in 1850 by Admiral Bonard (Welsh, 1998). FABACEAE I. Crotalaria retusa L. Marquesan name: pakokotanitani These are erect annual herbs, 0.5 - 1 m tall with short appressed hairs on the ridged stems; leaves are simple, oblanceolate also with short appressed hairs beneath; flowers in terminal inflorescences, petals yellow with fine purple lines near the base; fruit pods are oblong-calvate, dark brown to black at maturity (Smith, 1985; Wagner et al., 1999). Naturalized on the islands ofUa Huka, Hiva Oa, Tahuata and Fatu Hiva, C. retusa is common in disturbed habitats from coastal areas to mid-elevational areas. This species may be native to Asia or coastal shores of East Africa (Smith, 1985; Wagner et al., 1999). 2. Vigna adenantha (G. Mey.) Marechal, Mascherpa & Stainier Marquesan name: papa / papa apau These are climbing perennial herbs up to 4 m long; tri-foliate leaves; leaflets ovate to rhombic with reticulate venation; sparsely appressed pubescence present on leaflets, petioles and stems; flowers in racemes with standard white, rose, or pale purple, wings white to purple, keel white or blue; pods linear to oblong (Wagner et 175 ai., 1999). This species is Pantropical in its distribution occurring in many Pacific archipelagos (Wagner et ai., 1999). In the Marquesas, V adenentha is considered to be indigenous. There were some taxonomic difficulties in trying to determine the genus/species of this plant. The collection LOA 181 represents the specimen identified by an informant as papa apau. Tills specimen was a sterile collection thus compounding the difficulties in getting the right determination. Based on specimens contained in the PTBG herbarium at the National Tropical Botanical Garden in Kauai, it was determined by this author that LOA 181 corresponds most closely to Vigna adenentha. LAMIACEAE 1. Premna serratifalia L. Marquesan name: va'o va'o These are often trees or shrubs, up to 10m tall, with opposite, elliptic to oblong ovate or suborbicular leaves that are glabrous on top with ashy pubescence on the bottom; inflorescence are in terminal to sometimes axillary corymbs (Welsh, 1998). Its current distribution ranges from Eastern Africa to SE Asia through N. Australia and eastward into the South Pacific (Welsh, 1998). Premna serratifalia is indigenous to the Marquesas occurring on all the main islands in the archipelago from mid elevational to high elevational native and disturbed forests. This species also occurs in the Society Islands where it is widely used in native medicines. 176 LECYTHIDACEAE 1. Barringtonia asiatica (1.) Kurz Marquesan name: butu These are large trees up to 30 m tall with nearly sessile leaves clustered near the branch tips; leaf blades are large up to 40 cm long and 18 cm wide, obovate, coriaceous, glabrous; terminal inflorescence with persistent calyx lobes, glabrous; four petals, white with numerous showy somewhat purple stamens; fruit is a large 4- angled drupe, dry with persisting sepals and style (Welsh, 1998). A Polynesian introduction to the Marquesas Islands, Barringtonia asiatica is distributed from Madagascar through tropical Asia to Polynesia (Welsh, 1998). It is rather uncommon in the Marquesas archipelago occurring on all the main high islands in coastal or low elevation areas usually associated with human habitation sites. MALVACEAE 1. Hibiscus rosa-sinensis 1. Marquesan name: koute . enana I • oute . euata These are woody shrubs up to 4 m tall, leaves are alternate, broadly ovate with toothed margins; flowers are often red, showy, funnelform with staminal column (Whistler, 1992). Hibiscus rosa-sinensis 1. native range is somewhere between tropical and sub-tropical Asia (Whistler, 1992). There are many varieties of hibiscus in the Marquesas. When I first was doing my research in the Marquesas, healers would often mention the koute . enana or native hibiscus yet gave different details of what this plant, namely the flower and leaves looked like. There are no native hibiscus in the Marquesas except for Hibiscus tiliaceus 1. which is indigenous, thus it 177 was difficult to figure out the true identity of the koute 'enana. Several of the informants on Hiva Oa showed me what they called koute 'enana that was of the red, doubled variety. Thinking back on it, maybe I miss-translated the meaning ofkoute 'enana which I thought meant "native hibiscus", but would be better translated into the "Hibiscus of Man" or the Hibiscus of the Marquesas. This makes better sense since the red hibiscus is a Polynesian introduction to the Marquesas (Whistler, 1991). Whistler (! 991) notes that there were probably a few hibiscus varieties present in the islands before European contact with one of them being the short, double petal one often recognized on some islands as the original variety. 2. Thespesia populnea (1.) Sol. Ex Correa Marquesan name: mi'o These are trees up to 20 m tall, leaves are shiny, glabrous, green turning yellow, ovate to deltate ; flowers early deciduous, petal yellow with maroon spot near the base, staminal column present; immature fruit capsules green depressed-globose turning brown and dry when dehiscing (Wagner et al., 1999). Occurring in littoral habitats on all the islands in the Marquesas archipelago, Thespesia populnea is a popu1ar hardwood used in many native handicrafts. There is some disagreement to its native status in the Marquesas and other part of Eastern Polynesia. Some believe that it is a rather ancient Polynesian introduction into these areas (Whistler, 1991). Wagner et al. (! 999) give it a questionable indigenous status in Hawai'i or Polynesian introduction. In the Marquesas, Thespesia populnea is considered indigenous. 178 MORACEAE 1. Artocarpus altilis (Parkinson) Fosberg Marquesan name: rnei These are cultivated trees up to 15 m tall or more; leaves 30-60 cm long or more, thick, pubescent, coriaceous with blades ovate to oval or pinnately several lobed, sinuses narrow, lobes acute, or deeply incised; staminate spikes 15-30 em long, yellow; pistillate spikes globular to oblong ripening into a syncarp (Welsh, 1998). Breadfruit, as it is known in English, is probably indigenous to Southeast Asia and was aboriginally introduced in Polynesia (Whistler, 1991). Artocarpus altilis is widely cultivated on all the main islands in the Marquesas archipelago and is associated with human habitation and agricultural sites. The importance of breadfruit in the native culture of the Marquesas is exemplified by the 52 names or so given to the different cultivars (Le Cleac'h, 1997). The two cultivars used in native medicines in Hiva Oa are the rnei ku'ukou and rnei paea. Besides these two cultivars, the rnii or fermented breadfruit paste is also part of the materia medica. Refer to Appendix VII for a description of rnii and its preparation. 2. Ficus prolixa G. Frost. var. prolixa Marquesan name: a'oa These are trees, up to 12 m tall, with descending roots often a strangler; leaves elliptic to lanceolate-elliptic, acuminate, base rounded or cuneate; lateral nerves 6-12 pairs; synconia or "figs", stamens 1, figs subglobose, purple-black when mature (Smith, 198 I; Welsh, 1998). Occurring on all the islands in the Marquesas archipelago this indigenous fig is uncommon in native mesic forest and is also 179 associated with ancient religious sites. Ficus prolixa is distributed from Micronesia, the New Hebrides, and New Caledonia eastward to the Tuamotu, Marquesas, and the Line Islands (Smith, 1981). MYRTACEAE I. Psidium guajava L. Marquesan name: tuava These are shrubs to small trees, 3-10 m tall, leaves coriaceous, elliptic to oblong elliptic. Flowers are solitary or 2-3 in leafaxils, petals white; fruits are berries, yellow, globose, sepals persistent in fruit, pulp pink (Wagner et al., 1999). Psidium guajava is a post-European introduction to the Marquesas and is widely naturalized throughout the Marquesan archipelago. Psidium guajava is native to the Neotropics (Wagner et al., 1999). 2. Syzygium malaccense (L.) Merr. & Perry Marquesan name: kehika / kehi'a These are trees, 8-25 m tall, with flaky, grayish-brown bark; leaves are elliptic to oblong-obovate, flowers in axillary cymes on the trunk and older branches, numerous stamens, very showy, red. Fruits are berries, pink to red with white, obovoid, 10-20 mm (Wagner et al., 1999). The mountain apple is an ancient Polynesian introduction and is found throughout the Marquesas archipelago closely associated with human habitation sites, secondary forests, villages and arbrioculture sites in back of Valleys. Syzygium malaccense ranges from India through Eastern Polynesia and is native probably only to Malaysia (Whistler, 1992). 180 NYCTAGINACEAE I. Pisonia grandis R. Br. Marquesan name: pukatea / puatea These are shrubs or trees, 2-20 m tall; leaves thin, falcate, broadly elliptic to oblong or ovate with distinct lateral veins, 6-10 pairs, flowers white to greenish yellow in terminal corymbiform cymes; anthrocarp with prickles (Smith, 1981; Welsh, 1998). Considered indigenous to the Marquesas and found on all the islands in the archipelago, Pisonia grandis is distributed from Madagascar to Formosa and into Polynesia (Smith, 1981). PHYLLANTHACEAE I. Phyllanthus amarus Schumach. & Thonn. Marquesan name: tui These are semi-prostrate to erect herbs, 10-60 em tall, somewhat woody at the base; leaves, simple, oblanceolate to oblong; flowers small with pale green to white calyx lobes, capsules pale green (Smith, 1981; Welsh, 1998). P. amarus is naturalized and fairly common at lower elevations on all the major islands of the Marquesas. This species is maybe indigenous to tropical America, but it is now Pantropical in its distribution (Smith, 1981). RHAMNACEAE 1. Colubrina asiatica (L.) Brongn. Marquesan name: tutu These are weakly climbing or scandent shrubs; leaves are alternate, glossy, thin, ovate with subappressed to rounded serrated margins; flowers perfect, fruit globose to 181 --~ -~-~-----,------.... -~ .-~ ---... - ...... -- somewhat membranous (Wagner et oZ., 1999). Indigenous to the Marquesas Islands, C. asiatica is distributed in coastal and lowland habitats from eastern Africa, Indian Ocean islands, southeastern Asia, Maleasia to Australia and the Pacific islands (Wagner et oZ., 1999). RUBIACEAE I. Gardenia taitensis DC. Marquesan name: tia' e These are dioecious shrubs or small trees with shiny glabrous leaves obovate to oblanceolate or elliptic; flowers solitary in leafaxils, single or sometimes double (Welsh, 1998). Fruit are sub-globose to globose capsule, ribbed, with persisting calyx turning orange at maturity (Personal Observation). Gardenia taitensis is probably indigenous to Vanuatu and possibly to Fiji, but is most certainly a Polynesian introduction into the Marquesas (Whistler, 1991). The Tahitian gardenia is widely cultivated in all the main islands of the Marquesas and is commonly used in traditional medicine. The flowers are also to scent the pane or coconut oil, in lei making and as a landscape plant. 2. Morinda citrifolia L. Marquesan name: noni These are small trees or shrubs, 3-6 m tall; stems 4-angled with distinct inter petiolar stipules; leaves glossy, elliptic-ovate, glabrous; flowers perfect in ovoid to globose heads; fruit a syncarp, fleshy, yellowish white and soft when ripe (Wagner et oZ., 1999). M citrifolia is distributed from India to Hawai'i and is native from southeastern Asia to Australia (Wagner et oZ., 1999). It was a Polynesian introduction 182 into the Marquesas cultivated in former times and now widely naturalized throughout the archipelago. Because of the recent interest by natural product companies like Morinda, the noni is now being cultivated and exported from the Marquesas to supply the demand of fresh noni. RUTACEAE 1. Citrus aurantifolia (Christm.) Swingle Marquesan name: hitoro / citron These are small trees, 4-8 m tall with stiff, short spines; leaves elliptic to oblong ovate, obtuse or sometimes rounded; petioles winged; flowers white or pale pink and fruits ovoid or globose, greenish-yellow when ripe, very acidic (Smith, 1985; Welsh, 1998). Introduced into the Marquesas via Tahiti and widely cultivated there (possibly by Banks with the Cook expedition), C. aurantifolia is indigenous to the Malesian region (Smith, 1985; Welsh, 1998). 2. Citrus aurantium L. Marquesan name: . iinani A cultivated spiny tree to 10m tall; leaves ovate to elliptic and flowers fragrant, white petals; fruits subglobose, with thick peel, bright orange (Smith, 1985). A modern introduction into the Marquesas, C. aurantium is probably indigenous to Southeastern Asia (Smith, 1985). 183 SOLANACEAE 1. Capsicumjrutescens L. Marquesan name: neva Naturalizing suffrutescent perennial herb or shrub up to 2 m tall; leaves ovate to lanceolate; inflorescence solitary or axillary with white to yellowish corolla; fruits becoming red with different degrees of pungency (Smith, 1991 ;We1sh, 1998). A modem introduction into the Marquesas and now sometimes naturalizing, Capsicum frutescens is likely native to somewhere in South America and is now fouod throughout the New World and in all tropical and subtropical areas of the world (Smith, 1991). 2. Physalis angulata L. Marquesan name: konini / kariri These are annual herbs, 0.2-1.2 m tall, stems green, hollow and angular; leaves are simple, alternate, ovate to elliptic; flowers solitary in leafaxils with pale yellow corollas; fruits globose, berries, pale yellow (Smith, 1991; Welsh, 1998). Naturalized on all the main islands of the Marquesas, P. angulata is uocommon in disturbed habitats from sea level to mid-elevations. VERBENACEAE 1. Stachytarpheta urticifolia (Salisb.) Sims Marquesan name: pua'ere'ere These are annual herbs, coarse, 6-12 dm tall, leaf pairs decussate, blades ovate to broadly elliptic with serrate margins; spikes terminal or axillary in the upper leaves; flower corolla dark blue or purple with white stamens and styles (Smith, 1991; 184 Welsh, 1998). This species is probably from tropical America, but now a pantropicai weed on many islands in the Pacific (Smith, 1991; Welsh, 1998). Distributed in disturbed secondary habitats from low to mid elevations, Stachytarpheta urticifolia has only been documented from the islands ofUa Huka, Hiva Oa and Tahuata. I suspect that it is on the other main islands, but nobody has bothered to make a specimen. 185 Appendix X. A List of Prohibited Items Observed During the Healing Process. The following items listed here are taken directly out of interviews with different informants. Some informants were more specific as to which foods or drinks were prohibited while others were more general, thus there is some redundancy in this list. FRUITS AND VEGETABLES All citrus fruits such as Oranges (Citrus sp.) or Grapefruit (Citrus maxima) Apples (Malus pumila) Fa'ahoka (Ananas comosus) Mako (Mangifera indica) Huetu (Musa troglodytarum)* Meika (Musa paradisiaca)* MEATS Any kind of meats Any kind of big fish Any kind of red fish Any kind of crustaceans Small red fish Crabs (Toetoe) Pua'a (Sus scrofa) Keukeu (Capra hircus) Feke (Octopus sp.) - some say for one year Marlin (Makaira sp. or Tetrapturus sp.) - some informants say it is all right to eat Ono (Acanthocybium solandri) - some informants say it is all right to eat 186 --- ~ --- - Ahi (Thunnus obesus or Thunnus albacares) Aku (Katsuwonus pelamis) Vka (conunon lobster) Papahu (Caranx sp.) PROCCESSED FOODS AND DRINKS Carbonated drinks (including all sodas) Rich foods Can foods Corned beef Ketchup Soy Sauce Potato chips Lemonade Eggs OTHERS Cigarettes Salt * One healer stated that both Huetu (Musa troglodytarum) and Meika (Musa paradisiaca) can be eaten after cooking. 187 __ ~ _ _ L _____ r ___ • _~...... _~ .... _ "'...... Appendix XI. Marquesan Medicinal Voucher Specimens. Latin Marquesan Voucher Herbaria , Aleurites moluccana ama LOA 179 PTBG, US, PAP, P Allium cepa aniani LOA 499 PTBG, US, PAP, P Amaranthus viridus poti'i LOA 136 PTBG, US, PAP LOA 437 PTBG, US, PAP, P, BISH Ananas comosus fa'ahoka LOA 495 PTBG, US, PAP, P, BISH Artocarpus altilis mei LOA 178 PTBG, US, PAP, P Barringtonia hutu LOA 197 PTBG, US asiatica Capsicum frutescens pimant LOA 123 PTBG, PAP (neva) LOA 183 PTBG, US, PAP, P Cenchrus echinatus piripiri LOA 138 PTBG, US, PAP, P, BISH LOA 230 PTBG, US, PAP, P Citrus aurantiifolia hitoro LOA 190 PTBG, US, PAP, P LOA 383 PTBG, US, PAP, P, BISH Citrus aurantium anani LOA 451 PTBG, PAP, P, BISH Cocos nucifera ehi LOA 117 PTBG, PAP, P, BISH Colubrina asiatica tutu LOA 196 PTBG, US, PAP, P Cordia subcordata tou LOA 186 PTBG, US, PAP, P LOA 225 PTBG, US, PAP, P 188 Appendix XI. (Continued) Marquesan Medicinal Voucher Specimens. Latin Marquesan Voucher Herbaria Crotalaria retusa pakokotanitani LOA 121 PTBG, PAP LOA 363 PTBG, US, PAP, P, BISH, NY , Curcuma tonga ena LOA 126 PTBG Ficus prolixa var. a'oa LOA 103 PTBG prolixa LOA 221 PTBG LOA 486 PTBG, US, PAP, P, BISH Gardenia taitensis tia'e LOA 191 PTBG, US, PAP, P Hibiscus rosa- koute 'enana LOA 286 PTBG sinensis LOA 365 PTBG, US, PAP, P , Ipomoea batatas uma'a LOA 130 PTBG LOA 470 PTBG, US, PAP, P, BISH Kyllinga brevifolia mutie pua vert LOA 461 PTBG, US, PAP, P, BISH Ky/linga nemoralis mutie po'o LOA 088 PTBG,PAP maita Manihot escutenta manioka LOA 219 PTBG, US, PAP, P Microsorum papamo'o LOA 250 PTBG, US, PAP, P membranifolium LOA 458 PTBG, US, PAP, P, BISH, NY 189 Appendix XI. (Continued) Marquesan Medicinal Voucher Specimens. Latin Marquesan Voucher Herbaria Microsorum papamo'o LOA 133 BISH, PAP scolopendria LOA 220 PTBG, US, PAP, P Morinda citrifolia noni LOA 193 PTBG, US, PAP, P Phyllanthus amarus tui LOA 122 PTBG, US, PAP LOA 189 PTBG, US, PAP, P Physalis angulata kariri LOA 187 PTBG, US, PAP, P LOA 472 PTBG, US, PAP, P, BISH Pisonia grandis puatea LOA 218 PTBG, US, PAP, P, BISH LOA 489 PTBG, US, PAP, P, BISH Premna serratifolia va'ova'o LOA 097 PTBG LOA 194 PTBG, US, PAP, P LOA 477 PTBG, US, PAP, P, BISH, NY Psidium guajava tuava LOA 311 PTBG, US, PAP, P, BISH Rorippa sarmentosa mahimahi LOA 125 PTBG, PAP, P, BISH LOA 287 PTBG Saccharum tii LOA 182 PTBG, US, PAP, P officinarum LOA 312 PTBG, US, PAP, P, BISH Stachytarpheta pua 'ere'ere LOA 131 PTBG, US, PAP urticifolia LOA 192 PTBG, US, PAP, P 190 Appendix XI. (Continued) Marquesan Medicinal Voucher Specimens. Latin Marquesan Voucher Herbaria Syzygium kehi' a LOA 195 PTBG malaccense (sterile) LOA 314 PTBG, US, PAP, P, BISH Thespesia populnea mfo LOA 177 PTBG, US, PAP, P Vigna adenantha papa LOA 181 PTBG, US, PAP, P 191 Appendix XII. Plants Used in Marquesan Ethnomedicine and Their Apparent Distributional Status - Today. PLANT NAME INDIGENOUS POLYINTRO POST- CONTACT INTRO Aleurites moluccana • Allium cepa • Amaranthus viridus • Ananas cosmos • Artocarpus altilis • Barringtonia asiatica • Capsicum frutescens • Cenchrus echinatus • Citrus aurantiifolia • Citrus aurantium • Cocos nucifera • Colubrina asiatica • Cordia subcordata • Crotalaria retusa • Curcuma longa • Ficus prolixa var. prolixa • Gardenia taitensis • Hibiscus rosa-sinensis • Ipomoea batatas • 192 Appendix XII. (Continued) Plants Used in Marquesan Ethnomedicine and Their Apparent Distributional Status - Today. PLANT NAME INDIGENOUS POLYINTRO POST- CONTACT INTRO Kyllinga brevifolia • Kyllinga nemoralis • Manihot esculenta • Microsorum • membranifolium Microsorum scolopendria • Morinda citrifolia • Phyllanthus amarus • Physalis peruviana • Pisonia grandis • Premna serratifolia • Psidium guajava • Rorippa sarmentosa • Sacchrum officinarum • Stachytarpheta urticifolia • Syzygium malaccense • Thespesia populnea • Vigna adenantha • 193 Appendix XIII. Data Sets Showing Relationships Between Marquesan Healers and the Different Plant Species They Used. Plant Name T.M. R.M. M.T. P.T. H.H. M.L. T.T. Constancy Category Cocos nucifera I I I I I I 0 85.7% Widely Microsorum scolopendria I I I I I I 0 85.7% Widely Microsorum membranifolium I 1 1 1 1 1 0 85.7% Widely Cordia subcordata 1 1 1 1 0 0 1 71.4% Widely Gardenia taitensis 1 1 1 1 0 I 0 71.4% Widely Artocarpus altilis 1 1 0 1 1 0 0 57.1% Commonly Ficus prolixa var prolixa 1 1 1 0 1 0 0 57.1% Commonly Sacchrum officinarum 1 1 1 1 0 0 0 57.1% Commonly Syzygium malaccense 1 1 0 1 0 0 1 57.1% Commonly Thespesia populnea 1 1 1 1 0 0 0 57.1% Commonly Vigna adenantha 1 1 0 1 0 0 1 57.1% Commonly Citrus aurantiifolia 1 0 0 0 0 I I 42.9% Commonly Colubrina asiatica 0 I 0 0 I I 0 42.9% Commonly Premna serratifolia I 1 0 0 0 1 0 42.9% Commonly Aleurites moluccana I I 0 0 0 0 0 28.6% Occasionally Ananas comosus I I 0 0 0 0 0 28.6% Occasionally Capsicum frutescens I 0 I 0 0 0 0 28.6% Occasionally Hibiscus rosa-sinensis 0 I 0 0 0 I 0 28.6% Occasionally Kyllinga nemoralis 0 I 1 0 0 0 0 28.6% Occasionally Morinda citrifolia 0 0 1 0 1 0 0 28.6% Occasionally Psidium guajava 1 0 0 0 0 1 0 28.6% Occasionally Rorippa sarmentosa 1 1 0 0 0 0 0 28.6% Occasionally Allium cepa 0 0 0 0 1 0 0 14.3% Infreq uentl y Amaranthus viridus 0 0 0 1 0 0 0 14.3% Infrequently BarrinKtonia asiatica 1 0 0 0 0 0 0 14.3% Infrequently Cenchrus echinatus 0 0 1 0 0 0 0 14.3% Infrequently 194 Appendix XIII. (Continued) Data Sets Showing Relationships Between Marquesan Healers and the Different Plant Species They Used. Plant Name T.M. R.M. M.T. P.T. H.H. M.L. T.T. Constancy Category Citrus sinensis 0 0 0 0 1 0 0 14.3% Infrequently Crotalaria re/usa 1 0 0 0 0 0 0 14.3% Infrequently Curcuma longa I 0 0 0 0 0 0 14.3% Infrequently Ipomoea balalas 1 0 0 0 0 0 0 14.3% Infrequently Kyllinga brevifolia 0 0 0 I 0 0 0 14.3% Infrequently Manihol esculenta 0 I 0 0 0 0 0 14.3% Infrequently Phyllanthus amarus 0 0 I 0 0 0 0 14.3% Infrequently Physalis peruviana I 0 0 0 0 0 0 14.3% Infrequently Pisonia grandis 0 0 0 0 1 0 0 14.3% Infrequently Stachytarpheta urlicifolia 1 0 0 0 0 0 0 14.3% Infrequently Counl 24 19 13 12 10 9 4 Constancy 66.7% 52.8% 36.1% 33.3% 27.8% 25.0% 11.1% Cate}!ory count Widely 5 100.0% 100.0% 100.0% 100.0% 60.0% 80.0% 20.0% Commonly 9 88.9% 88.9% 33.3% 55.6% 33.3% 33.3% 33.3% Occasionally 8 62.5% 62.5% 37.5% 0.0% 12.5% 25.0% 0.0% Infrequently 14 35.7% 7.1% 14.3% 14.3% 21.4% 0.0% 0.0% 195 Appendix XIV. List of Medicinal Plants Cited in This Research. PLANT NAME PRE TRANS TODAY Abutilon grandifolium • Abutilon hirtum • • Achyranthes aspera var. • aspera Ageratum conyzoides • Aleurites moluccana • • • Allium cepa • Amaranthus viridus • A morphophallus • paeoniifolius Ananas cosmos • • Artocarpus altilis • • Acslepias curassavica • Bacopa monnieri • Barringtonia asiatica • Bauhinia monandra • Benincasa hispida • Bidens cordifolia • Bidens pilosa • Brassicajuncea • 196 Appendix XIV. (Continued) List of Medicinal Plants Cited in This Research. PLANT NAME PRE TRANS TODAY Broussonteia papyrifera • Caesalpinia bonduc • Canavalia rosea • Capsicum frutescens • Cardiospermum • halicacabum Carica papaya • Cenchrus echinatus • Chamaesyce hirta • Citrus aurantiifolia • • Citrus aurantium • Cladium nukuhivense • Cocos nucifera • • • Colocasia esculenta • Colubrina asiatica • • Cordia subcordata • • • Cordyline fruticosa • Crotalaria retusa • Cucumis anguria • Curcuma longa • • • 197 Appendix XIV. (Continued) List of Medicinal Plants Cited in This Research. PLANT NAME PRE TRANS TODAY Cyathula prostrata • Cyperus moutona • Erianthus pedicellaris • Erythrina variegata • • Ficus prolixa var. prolixa • Gardenia taitensis • Hibiscus rosa-sinensis • • Hibiscus tiliaceus • • Ipomoea alba • Ipomoea batatas • Kyllinga brevifolia • • Kyllinga nemoralis • Lagenaria siceraria • Liparis clypeolum • Lycopodium cernuum • Macropiper latifolium • Manihot esculenta • Microsorium • membranifolium Microsorum scolopendria • 198 Appendix XIV. (Continued) List of Medicinal Plants Cited in This Research. PLANT NAME PRE TRANS TODAY Momordica charantia • Morinda cUrifolia • • • Musa troglodytarum • Musa paradisiaca • Nephrolepis acutifolia • Nephrolepis hirsutula • Ocimum basilicum • Passiflorafoetida • Pelagodoxa henryana • Peperomia blanda var. • Jloribunda Peperomia pallida • Phyllanthus amarus • Phyllanthus pacificus • Phyllanthus tenellus • Physalis peruviana • • • Piper methysticum • • Pisonia grandis • Plumbago zeylanica • Premna serratifolia • 199 Appendix XIV. (Continued) List of Medicinal Plants Cited in This Research. PLANT NAME PRE TRANS TODAY Procris pedunculata • Psidium guajava • • • Ricinus communis • Rorippa sarmentosa • • • Santalum insulare • • Sacchrum officinarum • • • Sapindus saponaria • • Senna occidentalis • Sida rhombifolia • Solanum americanum • Sonchus oleraceus • • Stachytarpheta urticifolia • Syzygium malaccense • • Tamarindus indica • Tephrosia purpurea • Thespesia populnea • • Usneasp. • Vigna adenantha • • 200 REFERENCES "Acne", 2005. Emedicinehealth.com. 3 Oct. 2005. 5 Sept. 2005. Adam, Rony A. 2004. Enterocele and Massive Vaginal Eversion. Emedicine.com. 10 July 2005. < http://www.emedicine.comlmedftopi.c3323.htm>. Agnie1, D. 1998. Aux Marquises. L'Harmattan. Paris, France. A1exiades, M.N. 1996. Selected Guidelinesfor Ethnobotanical Research: A Field Manual. New York Botanical Garden. Bronx, New York. Bailleul, M. 2001. Les fles Marquises: Histoire de la Terre des Hommes, Fenua Ena/a, du XVllIeme sieele a nos jours. Ministere de 1a culture de Po1ynesie fran9aise. Pape' ete, Tahiti. Balick, M.J. and P.A. Cox. 1996. Plants, people and culture: the science of ethnobo/any. Scientific American Library. New York. Bernard, R.H. 1988. Research Methods in Cultural Anthropology. Sage Publications. Bernard, R.H. 2002. Research Methods in Anthropology: Qualitative and Quantitative Approaches. Third Edition. Altamira Press. Bostock, Peter D. and Tracey M. Spokes. 1998. Polypodiaceae, Flora ofAustralia 48: 482-484 (1998). Brousse, R., H.G. Barsczus, H. Bellon, lM. Cantagrel, C. Diraison, H. Gillou, and C. Leotot. 1990. Les Marquises (Polynesie francaise): volcanologie, geochronologies, discussion d'un modele de point chaud. Bull. Soc. Geol. France (ser. 8) 6: 933-949. Brown, F. B. H. 1931. Flora ofSouthern Polynesia. I. Monocotyledon. Bernice P. Bishop Museum, Bulletin 84. Honolulu, Hawai'i. Brown, F. B. H. 1935. Flora ofSouthern Polynesia. III. Dicotyledonous. Bernice P. Bishop Museum, Bulletin 130. Honolulu, Hawai'i. Brown, Elizabeth D. and F.B.H. Brown. 1931. Flora ofSouthern Polynesia II. Pteridophytes. Bernice P. Bishop Museum, Bulletin 89. Honolulu, Hawai'i. Burney, D. A., H. F. James, L. P. Burney, S.L. Olson, W. Kikuchi, W.L. Wagner, M. Burney, D. McCloskey, D. Kikuchi, F.V. Grady, R. Gage II, and R. Nishek. 2001. Fossil Evidence for a Diverse Biota from Kaua 'i and Its Transformation Since Human Arrival. Ecological Monographs 71 (4), pp. 615-641. 201 "Carbuncle". Wikipedia.org.2005. Wikimedia. 10 Nov. 2005. < http://en.wikipedia.orglwiki/Carbuncle>. Christian, F.W. 1910. Eastern Pacific Lands: Tahiti and the Marquesas Islands. London, R. Scott. Chuang, Tsu-Yi. 2005. Lichen Panus. Emedicine.com. 27 July 2005. IS Sept. 2005. Clavel, C. L. Dr. 1885. Les Marquisiens. Paris. "Clitoral hypertrophy." Wikipedia.org. 2005. Wikimedia 13 Nov. 2005 Cotton, C.M. 1996. Ethnobotany: Principles and Applications. John Wiley & Sons. Chichester, New York. Cox, P.A. and S. A. Banack. 1991. Islands, Plants, and Polynesians: An Introduction to Polynesian Ethnobotany. Dioscorides Press. Portland, Oregon. Cox, A.P., L. Rebecca Sperry, M. Tuominen, and L. Bohlin. 1989. Pharmacological Activity of the Samoan Ethnopharmacopoeia. Economic Botany 43 (4): 487-497. Crook, William Pascoe Rev. cira 1797. Account of the Marquesas Islands. Mitchell Library, Sydney, Australia. Crowe, Mark A. and Mark A. Hall. 2005. Chancroid. Emedicine.com. 9 July 2005. < http://www.emedicine.comldermltopic71.htm>. Davis, Loretta and Carmen Mays. 2005. Ecthyma. Emedicine.com. 8 Nov. 2005. IS Sept. 2005. < http://www.emedicine.com/derrnltopic113.htm>. Delmas, S. P. Rev. 1927. La Religion ou Ie Paganisme des Marquisiens. Paris, France. Dening, G. 1980. Islands and Beaches: Discourse on a silent land: Marquesas 1775- 1880. Chicago, Dorsey Press. Dening, G. 1971. Tapu and Haka'iki in the Marquesas 1774-1813. PhD. Thesis, University of Harvard, December. Dordillion, 1. R. Mgr. 1904. Grammaire et dictionnaire de fa langue des lies Marquises. Societe des etudes oceaniennes. Tahiti, 1999. "Dysentery". Wikipedia.org. 2005. Wikimedia. 9 July 2005. < http://en.wikipedia.orglwikilDysentery>. 202 Erickson, B. 1979. Some Problems ofInference from Chain Dala. Sociological Methodology. Jossey-Bass Publishers, San Francisco. Pgs. 276-302. "Ecthyma" , n.d. Lexique Medical. 0 I Sante.com. 4 Sept. 2005. "Edema". Wikipedia.org.2005. Wikirnedia. 10 Nov. 2005. < http://en.wikipedia.org/wiki/Edema>. Etkin, N.L. 1986. Plants in Indigenous Medicine & Diet: Biobehavioral Approaches. Redgrave Pub. Co. Bedford Hills, .Y. Eyriaud des Vergnes, Pierre Eugene. 1877. L 'archipel des iles Marquises. Paris. Farnsworth, N.R. and D.O. Soejarto. 1991 . Global imporlance of medicinal plants. In The Conservation of Medicinal Plants (ed. O. Akerele, V. Heywood and H. Synge), pp. 25-51. Cambridge University Press, Cambridge, UK. Fleurieu, Charles P.e. 1969. A Voyage Round the World, 1790-1792: Pelformed by • Etienne Marchand; [translated from the French] . New York: Da Capo Press. Flora ofAustralia. Volwne 48, Ferns, Gymnospelllls and Allied Groups. Melbourne: ABRSf CSIRO, Australia (1998). Florence, J. 1997. Flore de la Polynesiefrancaise Vol I. Edition de I' Orstom. Paris. Florence, J. and D.H. Lorence. 1997. Introduction to the Flora and Vegetation of the Marquesas Islands. Allertonia 7(4): 226-237. February. Gar9ia, Henri Mathias. 1843. Lettres sur les i/es Marquises. Chez Gaume Freres, Libraires, Paris. Goodman, L. A. 1961. Snowball Sampling. In Annals of Mathematical Statistics 32 : 148-170. Grepin, F. and M. Grepin. 1984. La Medicine Tahitienne Tradifionnelle - Ra 'au Tahiti. Les Editions du Pacifique. Pape'ete. "Gripe", 2003. The American Heritage® Dictionary of the English Language, Fourth Edition. 2003. Houghton Miffiin Company 13 July 2005 Gutmanis, J. 1977. Kahuna La 'au Lapa 'au. An Islands Heritage Book, Austral ia. Handy, E.S.e. 1923. The Native Culture in the Marquesas. Bishop Museum Press. Honolulu, Hawai' i. 203 Hill, M.O. 1979. DECORANA -- a FORTRAN program for detrended correspondence analysis and reciprocal averaging. Section of Ecology and Systematics, Cornell University, Ithaca, New York. Holmgren, Patricia K., Noel H. Holmgren, and Lisa C. Barnett (Ed.). 1990. Index Herbariorum Part I: The Herbaria ofthe World. Eighth Edition. New York Botanical Garden. Bronx, NY. Houghton, P. 1977. Trephination in Oceania. Journal ofPolynesian Society 86 (2): 265-269. Jardin, Edelestan. 1862. Essai sur l'histoire naturelle de l'archipel des Marquises, comprenant: La geologie et la mineralogie, la botanique et la zoologie. [microform]. J. B. Bailliere, Paris. Judd, N.L.M. 1997. LA 'AU LAPAAU: A Geography ofHawaiian Herbal Healing. PhD. Dissertation. Department of Geography, University ofHawai'i at Manoa. Honolulu, HI. Kirch, Patrick V. 1985. Feathered Gods and Fishhooks: An Introduction to Hawaiian Archaeology and Prehistory. University of Hawai'i Press. Honolulu, Hawai·i. Kirch, Patrick V. 1996. The Evolution ofPolynesian Chiefdoms. New Studies in Archaeology. Cambridge University Press. Kirkpatrick, J. 1983. The Marquesan Notion ofthe Person. Studies in Cultural Anthropology, No.3. UMI Research Press. Ann Arbor, Michigan. Le Cleac'h, H. 1997. Pona Te 'ao Tapapatina - Lexique Marquisien-Francais. Papeete. Lemaitre, Yves. 1973. Lexique du tahitien contemporain: tahitien-franr;ais, francais tahitien. Paris. Lesson, P.A. Dr. 1981. Notes sur les maladies des Indigenes des iles Marquises, en 1844. Bulletin de la Societe des Etudes Oceaniennes 18 (5) : 915-943. Levy, Daniel. 2004. Typhus. 10 July 2005. Medlineplus.gov. < http://www.nlm.nih.gov/medlineplus/ency/article/001363.htm>. Linton, R. 1923. The Material Culture of the Marquesas Islands. Bishop Museum Press, Bulletin 5. Honolulu, Hawai'i. Lorek, Jennifer D., S.M. Acker and P. Langenstroer. 2005. Lymphogranuloma Venereum. Emedicine.com. 10 July 2005. < http://www.emedicine.comldermitopic617.htm>. 204 MacArthur, Robert H. and Edward O. Wilson. 1967. The Theory ofIslands Biogeography. Monographs in Population Biology. Princeton University Press. Princeton, New Jersey. Mansion, J.E. (Ed.). 1950. Mansion's Shorter French and English Dictionary. D.C. Heath and Company, Boston. Martin, GJ. 1995. Ethnobotany: A Methods Manual. Chapman & Hall, London, New York. Martin, P.M.V and C. Combes. 1996. Emerging Infectious Diseases and the Depopulation of French Polynesia in the 19th Century. Journal of Emerging Infectious Diseases Vol. 2, No. 4-0ctober-December 1996. McBride, L.R. 1975. Practical Folk Medicine ofHawai'i. Petroglyph Press, Ltd., Hilo, Hawai'i. McClatchey, Will C. and Valerie E. McClatchey 1999. One-way bridges: Ethical dilemmas faced by Polynesian healers who share their knowledge. In Building Bridges with Traditional Knowledge: An Exploration ofIssues Involving Indigenous peoples. Conservation. Development and Ethnoscience. Edited by Alexandra Paul and Charles Peters. New York Botanical Garden, Bronx, NY, in press. Meffert, Jeffery. 2005. Lichen Sclerosus et Atrophicus. Emedicine.com. 13 Sept. 2005. 15 Sept. 2005. "Meningitis". Wikipedia.org.2005. Wikimedia. 9 July 2005. < http://en.wikipedia.orgiwikilMeningitis>. Motteler, Lee S. 1986. Pacific Island Names: A Map and Name Guide to the New Pacific. Bishop Museum Miscellaneous Publications 34. Bishop Museum Press, Honolulu. Nooteboom, Hans P. 1997. The Microsoroid Ferns (Polypodiaceae). Blumea 42 (1997) 261 - 395. 'Ohai, Levon. 2001. Personal Communication. Palmer, Christian. 2004. Plantago spp. and Bidens spp.: A Case Study of Change in Hawaiian Herbal Medicine. Journal of Ethnobiology 24 (1): 13-31. Palmer, Daniel D. 2003. Hawai 'i 's Ferns and Fern Allies. University of Hawai'i Press. Honolulu, Hawai'i. 205 Petard, Paul. 1986. Quelques Plantes Utiles de Polynesie Franr;aise et Raau Tahiti. Haere Po No Tahiti, Pape'ete, Tahiti. "Phthisis", 2003. The American Heritage Dictionary of the English Language. Fourth Edition. 2003. Houghton Mifflin Company 13 July 2005 Pisces Conservation Ltd. 2004. Community Analysis Package (CAP). Version 3.01. INC House, The Square, Pennington Lymington, Hants, United Kingdom. Porter, David. 1970. Journal ofa cruise made to the Pacific Ocean, vol. 1. Upper Saddle River, N.1., Gregg Press Ragone, D. 1991. Ethnobotany of Breadfruit in Polynesia. In: Islands, Plants, and Polynesians: An Introduction to Polynesian Ethnobotany. Eds. P.A. Cox and SA Banack. Pgs 203-220. Rallu, Jean L. 1992. From Decline to Recovery: The Marquesan Population (1886- 1945). Health Transition Review 2 (2): 177- 194. October 1992. Robarts, E. 1974. The Marquesan Journal ofEdward Robarts, 1797-1824. (Ed) Greg Dening. Pacific History Series No.6. The University ofHawai'i Press. Honolulu, Hawai'i. Rollin, L. Dr. 1929. Les lies Marquesas: Geographie-Ethnographie-Histoire Colonisation et Mise en Valeur. Societe D'Editions, Geographiques, Maritimes Et Coloniales 184, Blv. Saint-Germain (Vr), Paris. Rollin, L. Dr. 1974. Moeurs et Coutumes des Anciens Maoris des Iles Marquises. Stepolde - Pape'ete. Rossant, Lyonel and 1. Rossant-Lumbroso, n.d. Les leucorrhees (pertes blanches). Doctissimo.fr. 13 July 2005 < http://www.doctissimo.fr/html/sante/encyclopedie/sa_1233_ees.htm> . Sheahan, G.M. 1955. The Marquesas of the South Seas - A Study in Change. PhD. Thesis. University of Cambridge. Sheahan, G.M. 1963. Marquesan Source Material, part I. University of Hawai'i, PhD Dissertation. Sinoto, Y. 1970. An archaeologically based assessment of the Marquesas Islands as a dispersal center in East Polynesia. Pacific Anthropological Records 11: 105 - 132. 206 Smith, Albert C. 1979. Flora Vitiensis Nova: A New Flora of Fiji. Volume I. National Tropical Botanical Garden. Lawa'i, Kaua'i, Hawai'i. Smith, Albert C. 1981. Flora Vitiensis Nova: A New Flora ofFiji. Volume II. National Tropical Botanical Garden. Lawai, Kaua'i, Hawai'i. Smith, Albert C. 1985. Flora Vitiensis Nova: A New Flora ofFiji. Volume Ill. National Tropical Botanical Garden. Lawai, Kaua'i, Hawai'i. Smith, Albert C. 1991. Flora Vitiensis Nova: A New Flora ofFiji. Volume V. National Tropical Botanical Garden. Lawai, Kaua'i, Hawai'i. Spradley, James P. 1979. The ethnographic interview. New York: Holt, Rinehart and Winston. Stannard, David E. 1989. Before the Horror: The Population ofHawai'i on the Eve of Western Contact. Social Science Research Institute, University of Hawai'i. UH Press, Honolulu, Hawai'i. Steam, W.T. 1980. Allium. Pp.49-56. In T.G. Tutin et al. (editors), Flora Europaea 5 Alismataceae to Orchidaceae (Monocotyledones). Cambridge, University Press, 1964-1980. St. John, H. 1945. Revision of Cardamine and Related Cruciferae in Hawai'i, and Nasturtium in Polynesia Pacific Plant Studies 3. Occasional Papers ofB. P. Bishop Museum 18 (5):77-93. February. Honolulu, Hawai·i. Suggs, Robert. 1966. Marquesan Sexual Behavior. Harcourt, Brace & World, Inc. New York. Thomas, N. 1990. Marquesan Societies: Inequality and Political Transformation in Eastern Polynesia. Clarendon Press, Oxford. Thomas, N. 1986. Social and Cultural Dynamics in Early Marquesan History. PhD. Thesis at the Australian National University, February, 1986. Thomson, R. Rev. 1841. The Marquesas Islands: Their Descriptions and Early History. Edited by Craig, Robert D. (1978). Brigham Young University, Hawai'i Campus Press. Laie, Hawai'i. "Transverse Myelitis". 2004. Myelitis.org. 9 July 2005. < htlp:llwww.myelitis.orgloverview_en.htm>. Trembly, Diane L. 1997. A Germ's Journey to Isolated Islands. International Journal ofOs teo archaeology Vol. 7 : 621-624. 207 Valenziani, Carlo. 1940. Renaissance demographique en Oceaniefrancflise. Roma: Tipografia Consorzio N azionale. Vigneron, E. 1985. Recherches sur ,'histoire des attitudes devant la mort en Polynesie Franqaise. Doctoral Thesis. Ecole des Hautes Etudes en Sciences Sociales. Vigneron, E. 1989. The Epidemiological Transition in an Overseas Territory : Disease Mapping in French Polynesia. Social Science and Medicine 29 (8) pp. 913-922. Wagner, W.L. 1991. Evolution of waif floras: A comparison of the Hawaiian and Marquesan Archipelagos. In: Dudley, E.C. (ed.), The unity ofevolutionary biology, proceedings ofthe fourth International Congress ofSystematics and Evolutionary Biology. Dioscorides Press, Portland, Oregon, pp 267-284. Wagner, W.L., D.R. Herbst and S.H. Sohmer. 1999. Manual ofFlowering Plants of Hawai'i. Vol 1 & 2. Bishop Museum, Honolulu, HI. Wagner, W.L. and D.H. Lorence. 1997. Studies of Marquesan Vascular Plants: Introduction. Allertonia 7(4): 221-225. February. Welsh, S.L. 1998. Flora Societensis. E.P.S. Inc. Orem, Utah. Whalen, M.D., D.E. Costich, and C.B. Heiser. 1981. Taxonomy ofSolanum section Lasiocarpa. Gentes Herbarum. 12: 179-282. Ithaca, N.Y., L. H. Bailey Hortorium of the New York State College of Agriculture and Life Sciences. Whistler, A.W. 1991. Polynesian Plant Introductions. In: P.A. Cox & S.A. Banack. Islands, Plants, and Polynesians: An Introduction to Polynesian Ethnobotany. Dioscorides Press. Portland, Oregon Whistler, A.W. 1992. Polynesian Herbal Medicine. National Tropical Botanical Garden. Lawai, Kauai, Hawai'i. Whistler, A.W. 1996. Samoan Herbal Medicine: '0 La 'au ma Vai Fofo 0 Samoa. Isle Botanica. Honolulu, Hawai'i. Wilson, Thomas A. 2005. Cogenital Adrenal Hyperplasia. Emedicine.com. 15. Sept. 2005. Wilson, William. 1799. A Missionary Voyage to the Southern Pacific Ocean Performed in the Years 1796, 1797, and 1798 in the Ship Duff. T. Gillet, Salisbury Square, London. Zepemick, Bernhard. 1972. Arzneipjlanzen Der Polynesier. Verlag Von Dietrich Reimaer, Berlin. 208