Traditional and herbal medicine in the cook islands

Journal of Ethnopharmacology, 13 (1985) 239-280 Elsevier Scientific Publishers Ireland Ltd.

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Review Paper

TRADITIONAL

AND HERBAL MEDICINE IN THE COOK ISLANDS

W. ARTHUR WHISTLER Pacific Tropical Botanical Garden, P.O. Box 340, Lawai, Kauai, HI 96765 -..

(U.S.A.)

Summary The modern day health care system in the Cook Islands is a combination of neo-traditional ways and Western medicine. The practice of “Maori medicine” is widespread in the Cook Islands, with native healers using a variety of herbal medicines and traditional practices to treat many of the common ailments affecting the people. After a historical review, the current methods of preparing and administering herbal medicines are discussed, followed by a -discussion of what is commonly called “ghost sickness (mahi tupupahu) in the islands. Included is a list of the 49 plants most commonly used in native cures, with information on how often and for what they are used. Also included is a glossary of Maori terms for the various ailments with -which the healers are familiar.

Introduction The Cook Islands lie in the center of Polynesia more or less midway between Samoa and Tahiti. The archipelago, which is spread across the vast expanse of the Pacific Ocean between a latitude of 8” and 23” S, and a longitude of 156” and 167” W, consists of twelve inhabited and three uninhabited islands. Geologically and geographically, these fall into two groups .- the southern Cooks, consisting of Rarotonga, Mangaia, Aitutaki, Atiu, Miti’aro, and Mauke, are all “high islands”, and the northern Cooks, consisting of Pukapuka (Danger Island), Tongareva (Penrhyn), Manihiki, Rakahanga, Nassau and Palmerston, are atolls. The total land area of the 15 islands is about 240 km2. The largest (64.3 km2) and highest (652 m) of the 15 is Rarotonga, upon which is located the capital of Avarua. Nearly half of the archipelago’s nearly 18,000 inhabitants reside on Rarotonga, and about half of these have migrated there from the outer islands. The people inhabiting the islands call themselves “Maori”, a term which will be used hereafter to designate the Cook Islanders but not the native 0378-8741/85/$15.05 0 1985 Elsevier Scientific Publishers Ireland Ltd. Published and Printed in Ireland

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New Zealand Polynesians who go by the same name. The Cook Islands belong to the Eastern Polynesian cultural complex, and were discovered and colonized from the Society Islands over a thousand years ago. An exception to this is Pukapuka which was probably colonized from either Tokelau or Samoa to the west, and possibly the islands of Ma’uke, Miti’aro, and Atiu (Moeka’a, pers. commun.) colonized from Manu’a (Samoa). The European discovery of the Cook Islands was apparently made by Pedro Mendana who visited Pukapuka in 1595. The next recorded contact was not until over 175 years later when Captain James Cook landed on Atiu. The Bounty mutineers apparently “discovered” Rarotonga in 1789, but the first significant Western contact did not come until 1823 when Tahitian missionaries from the London Missionary Society (L.M.S.) arrived, followed 4 years later by their English mentors from the L.M.S. station in the Society Islands. After a long period of colonial rule, the islands attained internal self-government in 1965, but remain closely associated with New Zealand. Methodology During a literature review on Polynesian herbal medicine, the author found there was a dearth of information about past and present medical practices in the Cook Islands. To remedy this deficiency, a 3-week field research trip to the Cook Islands was organized and executed in 1984. This research was carried out from 29 February to 22 March, and the islands of Rarotonga, Aitutaki and Atiu were visited. This was the author’s third trip to the Cook Islands, but the previous two were related to ongoing studies on the Polynesian flora, and no ethnobotanical work was carried out on those occasions. During the investigation, 13 Maoris who either used or were familiar with herbal medicines were interviewed. These people were located by word of mouth, and with hardly an exception, they were willing to impart all they knew of their medicinal lore. Most of them could speak English, but in a few cases interpreters were utilized. These interviews resulted in the compilation of 502 remedies, as well as a wealth of related information. In order to avoid confusion, the Maori names of the medicinal plants and ailments were used and recorded during the interviews. Prior to the trip, the author had compiled a checklist of the Maori plant names of the Cook Islands and another of the flora. This was usually sufficient to identify the plants used, but sometimes the names were not uniform among the informants, and several other names were new to the author. Voucher specimens were collected for many of the plants, and these are in the private collection of the author which is stored at the Botany Department of the University of Hawaii. In Hawaii, the notes were transcribed and organized. These were then compared to the extremely useful work of MacKenzie (1973) for the Cook Islands, and Aitken (1930), Panoff (1966), Hooper (1978), Lemaitre (1978) and Grepin and Grepin (1980) for Tahiti and the Austral Islands

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where the medical practices are very similar to those in the Cooks. The translations of the names of the Maori ailments are based on interviews with Dr. Metua Terita’iti and the cited literature. Historical

background

Very little is known about the pre-European traditional methods of healing. Although evangelists from the London Missionary Society were living on Rarotonga as early as 1827, their pursuits were religious rather than scientific, and little of the native customs was recorded. An exception to this, however, was W.W. Gill, an astute observer and naturalist whose work (1866 and 1885) is the best source about the ancient Maori culture. Even so, he included little more than passing reference to the original healing practices. Another useful source was E.H. Lamont who was shipwrecked and stranded for several months on Tongareva in 1853. Although we have few contemporary accounts of it, the Maori medical practices were undoubtedly very similar to that found elsewhere in Eastern Polynesia, particularly to those of Tahiti. Like other Polynesians, the Maoris believed (and still do to some extent) in the concept of mana, a supernatural power or efficacy, or perhaps better described as a force of nature, that is unequally distributed among people, as well as in animals, plants, spirits and even in some inanimate objects such as stones. The other concept related to mana is tapu, which has entered our language as taboo. Tupu is a supernatural concept of sacredness or prohibition, but only the latter sense has been given to our borrowed English work. The opposite of tapu is noa, i.e. profane and not sacred. In the pre-European culture and to a modified extent even today, an extensive set of tapus regulated the relationships among the people as well as between the people and their gods. The relationship between mana and tapu is that if a person commits an offence against the gods or society, i.e. he breaks a tapu, then his mana would be lost or diminished, or more precisely, it would be taken away by the gods. This loss of mana leaves the person open to illness and misfortune. The pre-European Polynesians believed that ailments were of two sorts natural and supernatural. Those ailments whose origin was obvious, such as broken bones and cuts, were usually considered to be natural and were treated by natural means. However, even some accidents or other ailments whose causes were obvious were sometimes considered to be the work of some malevolent spirit or god. Those ailments whose cause was not obvious were usually deemed to be caused by the gods, either because of mischief (which could be sent by sorcerers using black magic) of some spirit, or as a retribution for the person (or even someone in his family) having broken some tapu. Because tapu were always being broken, it was not hard to attribute nearly any ailment to some infraction. Healing was mostly in the hands of the priests who were known as Euruatua (Savage, 1962). The healing of natural ailments, such as massage and setting

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of broken bones, may, however, have been in the hands of specialists known as ta’ungu. The word ta’unga means specialist or expert, and there were many types of them including the priests (who specialized in consulting with the gods) and healers specializing in setting bones and in massage. However, since most ailments were believed to have supernatural origins, healing was largely by supernatural means, and was mostly in the hands of the priests who were believed to be able to intercede with the gods. The priesthood was a profession, and those people seeking treatment had to pay for the services of their priest. On Tongareva, Lamont (1867, p. 272) described how a chiefly friend of his went to another island for treatment: This place was much resorted to by the natives of all the group; but as the old priest’s fees were considerable, it was only by those whose means were most abundant. Although the incantations employed by this Polynesian Aesculapius were similar to those used by brethren who had not the same reputation, his cures were said to be much more certain.

Nowadays, as will be explained later, just the is not a profession and payment is not usually Healing was largely by intercession with the scribed the belief in the supernatural causation

opposite is the case - healing required. gods. Gill (1876, p. 70) deof sickness:

In heathen times, no one was supposed to die a natural death. The friends took a present of fish and taro to the priest of the particular deity whom the sufferer worshipped, and inquired why he was sick. The reply usually given was the breach of idoletiquette, or the shedding, not of innocent, but of related blood. As the pedigrees of the entire clan, in all their remote ramifications, were perfectly familiar to the priest, he could be at no loss for an answer. Sometimes the sickness was on account of the sins of the parents or uncles.

Contrary to popular opinion, herbal medicine, at least to the extent it is used today, is a relatively new thing to the Maoris and the rest of the Polynesians. The principal means employed by the healer-priest was chanting, and when herbs were used, it is most likely these were believed to be repellent to the spirits causing the illness and would chase them out. Although purges of coconut oil or coconut cream were widely resorted to in the Cook Islands (at least by the mid-1800s) and the rest of Eastern Polynesia, the use of medicines taken internally was almost certainly introduced by Westerners, particularly the missionaries. According to Gill again (p. 69) The only medicine ever known or used in heathen times was cold water and shampooing. Latterly, this practice of anointing the affected limbs with cocoa-nut oil has been introduced, as well as the use of a great variety of vegetable compounds, many of which are highly deleterious. , . . The modern practice of drinking pure cocoa-nut oil as a purgative has proved extremely fatal to the natives. No argument will prevent their resort to this favourite but dangerous remedy. Native doctors reduce their patients to mere skeletons with their medicines, and then quietly say, ‘Your disease is quite gone. All that you have to do is to fatten yourself up again.’ In many cases the patient has gone too far to rally.

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This dearth of aboriginal herbal remedies was also noted by Te Rangi Hiroa (Sir Peter Buck) on Tongareva (1932), Manihiki and Rakahanga (1932a), Mangaia (1938) and Beaglehole and Beaglehole (1938) did not even mention the use of herbs in their discussion of the medicinal practices on Pukapuka. In a discourse on some of the plants of Tongareva and Manihiki, Linton (1933) incidently noted the medicinal uses of only two plants. The widespread use of herbs to heal ailments is mostly a result of contact with the Western world. Shortly after the Cook Islands were opened up by the Europeans, a series of epidemics swept through the islands. In 1831, Buzacott (1866) reported an epidemic which killed all the leaders of the group agitating against Christianity, which, of course, he believed to be more than coincidence. In 1846, an epidemic of scrofula hit, followed by whooping cough in 1848, mumps in 1850, influenza in 1851 and measles in 1854. These epidemics had a disastrous effect upon the population. The Polynesians had been raised in isolation from the Western world, and many of the ailments which were considered to be minor childhood ailments to the Europeans were devastating to the defenceless Polynesians. The L.M.S. missionaries were frequently trained in the rudiments of medicine, and had a supply of some of the basic medicines that in those days were known or at least thought to be effective. During the 1846 scrofula epidemic, Buzacott (p, 106) reported the use of “liquor arsenicalis and hydriodate of potash ointment” to treat the afflicted. Despite the rudimentary state of European health care in those times, some of the medicines seemed to the Maoris to be very effective, and with the concomitant loss of the native gods, the concept of healing took a drastic turn. Because of this perceived superiority of Western medicine, the Maoris soon took to herbal medicines as a duck takes to water, and the native practitioners even started inventing many native remedies of their own. The demise of the traditional Polynesian medical system based primarily on its supernatural cures was hastened by the missionaries. Since the religion and the medical system were so intimately related, to destroy the first was to destroy the second. And those practicing the second could almost certainly be accused of believing in the first. In 1879, the missionary-influenced council of Ariki passed a law aimed at eliminating the heathen practice of medicine (Mackenzie, 1973a, p. 4): No one is allowed to ask someone to use magic to cure a sick person or to find out if a man or woman is a thief or for any other reason. If a man or woman does this they will he fined $5.00. The man who uses magic will be fined $10.00”.

This law probably had little effect other than to drive the adaptable native healers underground. The newly accepted religion, however, had a greater effect. After accepting the Christian God, the Maoris had little difficulty in adding Him to the causes of sickness, and instead, malevolent gods, spirits or ghosts (ti@Zjxrhu) of ancestors, which were not entirely contradictory to Christianity, were still believed to have the power to induce illness when people broke tupu or were otherwise offensive to the Maori sense of decorum.

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Instead of relying on the largess of the missionaries to cure all their ills, many of which had no real remedy in those days of primitive Western medical practice anyway, a new tradition of herbal medicine developed. The Maoris could see how the missionaries were able to cure diseases with medicines, so it is not hard to see how they could have developed their own theories. What evolved is an amalgam of their own traditional concepts and the new Western ideas to which they were exposed. Some of the remedies were strictly local in origin, but many were imported from the outside world - particularly from Tahiti where there was renewed contact after centuries of relative isolation. To the Western way of thinking, some of the medical practices seem to be without logical merit, but the contradictions are in the Western eyes only, for the Maori system of causation of illness is still largely different from Western concepts, as will be explained in the next section. The missionaries and their more zealous converts continued to try to suppress the practice of herbal medicine, probably in their belief in its intimate connection with the discredited but still latent pagan beliefs. The Constitution Act of 1915 contained a law prohibiting the practice of native medicine: Everyone is liable to six month’s imprisonment who pretends to exercise or use any kind of witchcraft, sorcery, enchantment, or conjuration, or undertakes to tell fortunes. Also everyone isliable to six month’s imprisonment who sets himself up to cure disease by the use of potions from locally-grown herbs.

This law succeeded in driving the healers underground, but seems to have had little effect on their survival if their popularity today is any indication. Although the law is still on the books, it is rarely enforced. The Health Department has taken a more positive approach to the efforts of the healers, and as long as the practices are not actually injurious to the health of the patient, they are condoned and even discreetly employed. Maori concepts

of sickness and health

The term maki, which is usually defined as “sickness”, actually has a broader meaning, i.e. being in a state of ill health, either from sickness or injury. It has two subdivisions - maki tangatu which refers to all natural -sickness and accidents, and maki tupupaku which refers to supernaturally -induced ailments, usually sickness, but sometimes injuries as well. Maki tupapaku is alternately called maki Maori, which indicates one pecularity of the illness -it does not normally affect thepapa?? (Europeans). While Westerners would try to subdivide the term on the basis of the nature of the injury or sickness itself, the Maoris think more in terms of its origin. To Westerners, a broken leg is a broken leg, but to the Maoris it may be a leg broken in a natural fall, or it may be a leg broken because of the actions of supernatural powers. The latter type of broken leg is more complicated and has to be treated with additional medicines to counteract the effects of the tiipcipaku.

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Also, the Maori concept of illness has a much broader basis than the Western concept. The former encompasses not just the physical health care, but all social interactions as well. Maoris have known for centuries that interpersonal conflicts can be the cause of illness, and consequently there is a non-medicinal healing aspect which involves the resolving of domestic and social troubles before the person can be healed. This concept is certainly pre-European in origin, and has been reported throughout Polynesia. It usually involves the ailing person confessing the sin which has led to his malady, or if it is caused by the malice of others, then the members of the family are assembled so that they can confess and repudiate any malice they may have against the afflicted person. In Hawaii, this healing process, which is called ho ‘opono ‘pono, is still practiced. The Samoan variation of it is called a tautoga, and is likewise used in healing. In Pukapuka, Beaglehole and Beaglehole (1938) describe the use of a general confessional to bring to light any concealed sins that may be retarding the recovery of the afflicted person. Although this was originally a facet of their old religion, it is secular enough to be compatible with Christianity. In any case, the restoration of social harmony is central to the Maori ideas of healing sickness. The category maki tangata is in the realm of folk medicine and semi-specialist healers, while mahi tupapaku is best treated instead by the ta’unga. Maki tangata can be divided into two basic types, although the Maoris themselves may not consciously make this subdivision. First there are the physical injuries that result from accidents - burns, cuts and broken bones. This category has no general name, and each ailment is named separately. The other type is true sickness, which is considered to be natural, even though the causes are not always understood. In Western medicine, the emphasis in curing is upon identifying the exact nature of the illness and determining its specific treatment. The Maoris, however, approach it fromthe opposite side. The emphasis is on the remedies (vai-rZkau) rather than illness. In the diagnosis, the healer examines the patient, and if the symptoms fit one of his or her uai-rckau, then treatment is initiated. It is the medicines which are well known, and the ailments which are not. The Maori diagnosis is an imprecise matter and the symptoms rather than the actual causes are often the focal point. Unrelated ailments sometimes have similar symptoms, but the Maori medical system, which is weak in this kind of diagnosis, often does not distinguish the causes from the effects. Although the Maoris uniformly believe in the healing properties of herbs, even the healers seldom profess to understand how their medicines work. They have learned the precise remedies, down to the exact dosage, from their relatives, often through several generations, but they do not concern themselves with how the medicines work. Also, they cannot give any specific effects that can be attributed to the components of the uai-rckau, except to some herbs or plant substances used as purges. Consequently, some herbs, such as pua’ikao (Leucas decemdentata) are found in a wide variety of

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remedies, without anyone being able to relate exactly what they do. Nevertheless, the Maoris put great faith in these remedies handed down to them by their ancestors, and have an implicit faith in the healing value of herbs. Sometimes a shotgun approach is used, in which a large number of herbs are combined together into one remedy. The most complex remedy recorded during the research consisted of eight ingredients, but the average number was probably two to three. In Tahiti, however, the average number of components in their rC’au appears to be higher, and up to 40 different ingredients have been reported in some. Systems of health care in the Cook Islands Two different disciplines of medicine currently coexist in the Cook Islands, sometimes complementing each other, sometimes clashing. The one most familiar to Westerners, which is called Western medicine, is represented by the Health Department, the main hospital on Rarotonga, and smaller hospitals or clinics on the outer islands. The main hospital is situated on a hillside at ‘Arorangi, and is staffed by one or more New Zealand-trained papa% (Europeans) or Maori physicians, and a larger number of medical practitioners who have graduated from the medical school in Fiji. Assisting them are a large number of staff nurses who work in the hospitals, and district nurses who visit the schools and clinics. The hospitals and clinics in the outer islands are usually staffed by a medical practitioner on a rotation basis, and by one or more nurses. The traditional medicine (which, as was explained above, is not so traditional) consists of three different levels. First, there is what may be called folk medicine - the use of herbal medicines that are commonly known, and which can be used by anyone at any time without the assistance of healers. It is common knowledge that the leaves of piripiri (Bidens pilosa) can be chewed or mashed and applied in emergencies to knife wounds. Likewise, the juice of poro ‘iti (Solanum uporo) is a well known remedy for treating -muna (ringworm). The second level is that of the healers, at least three kinds of which may be distinguished. Some of these healers specialize in setting bones, some in the traditional Polynesian massage (maoro), and the rest in the use of herbal medicines. This latter category of healers is the main subject of this research. The third level is that of the ta’unga. As was explained above, the term ta’unga refers to many different types of experts or specialists, but nowadays when the term is used, it is usually in reference to the psychic healers who, with or without the use of herbs, heal ailments which have a supernatural (or perhaps psychosomatic) component rather than being strictly organic. The herbal healers of the second level may have some of the same medicines as the ta’unga, but differ in the origin of their knowledge. The healers do not claim to have supernatural powers - their medicines were learned from relatives and ancestors, and only occasionally will they develop an entirely new

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remedy. Although their powers are of this world (but are commonly believed to be given by God), it is common knowledge that their medicines will not work if prepared by others without the permission of the owners. The ta’unga, however, has a spirit (uaerua) who helps him with his diagnosis and choice of remedies, usually by speaking through the ta’unga during a trance. The methods of the herbal healers and the ta’urzga will be discussed in more detail in the following two sections. The practice

of herbal medicine

Much of the practice of herbal medicine is in the hands of semi-specialist healers. The practitioners belonging to this occupation apparently have no particular name, probably because so many people practice folk medicine that the boundary between the work of the semi-specialists and the use of folk medicine is indistinct. They are sometimes called tu’urzgu, but this is a misnomer because the term more correctly applies to the psychic healers or shamans who are the inheritors of the tradition of the priests of the old Maori and Polynesian polytheistic religion. Although MacKenzie (1973) calls the practitioners of herbal medicine “pharmacists”, the term “healer” seems more appropriate and will henceforth be used here. Most of them are women which is the usual practice in Western and much of Eastern Polynesia. The different healers have a wide range of knowledge. Some know only a few remedies which they dispense only on occasion, while others have a vast pharmacopoeia and are in constant demand. For the most part, however, the healers specialize in a few remedies or in a few broad classes of ailments. Most of those interviewed during the study related about 30-40 remedies they used or at least were familiar with. Because most of the Cook Islands were discovered and colonized from the Society Islands not much over a millenium ago, the languages are still similar enough to be mutually intelligible. Although relatively isolated over much of that time, there has been a renewed contact during the European era, which may account for the similarity of the medicinal practices in the two archipelagos. Many of the healers who were interviewed had a parent or grandparent who was Tahitian. Additionally, there is a village on Tahiti called Patuto’a which is inhabited by Maoris, mostly from the island of Atiu. The land was purchased by contract workers from Atiu, Ma’uke and Miti’aro who were working on the island of Makatea mining phosphate (Moeka’a, pers. commun.), so there is a close link between Atiuans and Tahiti. On Rarotonga, healers from Tahiti and the outer Cook Islands are held in great repute. Most of the remedies known by the healers are learned from one or more relatives and are passed on from generation to generation within the family. These remedies are “owned” by the individual or his family, and it is common knowledge in the Cook Islands that these medicines will not be effective if used by others without first obtaining permission from the owners for their use. This stricture is not very prohibitive, however, for the healers often give

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permission to others for use of their remedies on specific occasions or even in perpetuity. The same practice is reported in Tahiti by Lemaitre (1978) who noted that some medicines are owned (i.e. they are proprietary medicines), but that they can be given along with their mana to make the medicine effective, while other medicines are part of the folk medicine that has been relegated to the public domain. The other common way remedies are “learned” is by dreaming. Many of the healers reported they or their ancestors learned one or more of their remedies in dreams. One informant told of having a dream in which an unidentified “big man” told her how to make a tuberculosis medicine for her ailing sister. In the dream, she remembers walking around to pick the specific plants, and back at home the man showed her how to mix them. When she awoke, she prepared the medicine and took it to her sister. Three weeks later, the sister was released from the sanitorium, presumably cured. As often as not, the remedy will be given in the dream by a relative. It is likely that these dreams may occur when the healer is worried about some relative or acquaintance who is sick, but some informants reported that only in the dream did they learn that the person was sick. One informant related that on one occasion when her child was sick, she tried to have a dream to find a remedy for the ailment. She succeeded in having the dream, but it was more of a nightmare in which an unknown woman scolded her for trying to obtain her remedies that way. A similar dichotomy of the proximate origin of remedies is reported from the nearby Austral Islands by Aitken (1930, p. 85): There appear to be two classes of remedies, the most important class includes a large number of medicines, the preparation of which is fairly well standardized according to formula or recipe. The second class includes remedies suggested by accident or incident, perhaps by a dream of the ‘doctor’ or of the patient, perhaps by some curious coincidence in connection with the disease or with an act of ‘doctor’ or patient.

This origin by dream seems to be widespread in Polynesia. As was mentioned above, the Maori healers are semi-specialists - they do not make a living by healing. The Maoris believe that healing is a gift from God, a privilege, and to accept or ask for money would cause the healer to lose his power (mana). Gifts, however, are often discretely given and are usually accepted if they do not appear to be direct payment for the services rendered. Instead of money, the healers receive prestige for their services, something that is very important in the Maori culture. Treatment When a person If the ailment is nosed, the usual have the ailment

is in need of medical treatment, several options are available. a physical injury or a non-Maori illness that is easily diagoption selected is to go to the hospital, clinic, or doctor to treated. However, if it is a physical injury or illness that is

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within the realm of herbal medicine, a healer is usually preferred. Under these latter circumstances, the native healers have a definite advantage over the Western-trained doctors. Many ailments to which the Maoris are subject are believed to be unique to them and incurable with Western medicines, and the people feel more comfortable with the healer who works at home without restraints on the time he or she has for the patient. The healers have no need to advertise, primarily because they do not seek out patients, and also because they and many of their remedies are widely known in the village or district. When, for example, a person has a stomach pain known as tiipito, if he himself does not know one, friends or acquaintances will recommend a healer who is known to have an effective remedy (uai-riikau) for the malady. The ailing person will then visit the healer, or if he is incapacitated, the healer will visit him. The healer asks the potential patient questions about his ailment, and if by these symptoms it appears that the ailment can be effectively treated by one of the healer’s vui-Bkau, then treatment will begin. The plants employed in the preparation of the uai-rikau are always used fresh, never dried. In most cases, the preparations are done anew for each treatment or day of treatment. The few medicines that are stored for further use are usually ones prepared with coconut oil, such as lotions for burns and rashes. No special methods of collection are employed - anyone can collect them at any time without any particular restrictions. One exception to this, however, is that some healers do not normally prepare their herbal medicines on rainy days in the belief that the plants collected in such weather will be watery and weak. If the medicine is needed immediately, however, they may carefully dry off the collected plants and proceed. The plant parts most frequently used in herbal medicines are leaves, fruits and bark, probably in that order of frequency. Only a few trees are used for their bark, and unlike the practice in Western Polynesia of scraping the bark directly from the tree, the typical Maori method is to cut off strips of bark and crush them (tukituki or reru) using a mortar and pestle (Fig. 1). Originally the mortar was an oblong wooden bowl called a kumete, but in recent years this has often been replaced oddly enough by half of a plastic, brick-red Japanese fishing float. The pestle (reru) is usually made from stone, either of coral or more commonly of basalt, and is similar to the poi pounders of Eastern Polynesia. Sometimes a large cone shell is used instead (Fig. 2). The herbaceous plant material - leaves, stems and fruits - are crushed in the same way. Parts such as hard fruits and rhizomes are frequently grated instead of crushed, and this is usually done on a Western-style grater (Fig. 3). Some uai-rCkau require plant parts of a certain “valence”, a practice identical with that reported by Panoff (1966) from the Society Islands. Maori healers believe that the parts of some plant species have a definite male or female valence, but this sexuality is unrelated to that understood by biologists. The two examples noted during the interview were the fruits of miro (Thespesia populneu) and the leaves of the tiure m&r-i (Gardenia tuitensis). In the

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Fig. 1. Traditional method of crushing leaves using a basalt pestle (rem) bowl (humete).

and a wooden

mature mire fruit, the calyx may be entire or it may be split by the growth of the fruit whose base it encloses. A fruit with the entire type of calyx is considered to be male; one with the split type, female. Gardenia leaves with a sharp point are considered to be male, those with a blunt tip are female. In Tahiti, Panoff noted the male valence of seven-petal gardenia flowers and pointed roots of coconut palms, and the female valence of six-petal gardenias and blunt palm roots. Another unusual characteristic of the Maori pharmacopoeia is the use of equal numbers of green and yellow leaves (particularly of the tou tree, Cordiu subcordata), and equal numbers of green and ripe fruits (particularly of the nono, Morindu citrifolia), in some of the native medicines. The remedies are very specific as to how many or how much of each ingredient is to be used. Strips of bark and other countable plant parts are usually measured in small numbers, and for some reason which is not readily apparent, these numbers are usually multiples of three - i.e. three, six, or twelve. When herbs are used, the whole plants are usually employed, and these are measured in handfuls (kapurima). When sugar cane is used, it is usually measured in number of nodes @ona), which is likewise often in multiples of three. Liquids such as water or coconut water are measured in cups either the Western style cup or half-coconut shells. Further attention is sometimes given to the ingredients and the medicines. Some recipies call for coconuts that are carried rather than dropped from the

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Fig. 2. Crushing leaves using a cone shell and a half of a Japanese fishing float.

trees. Things that occur during the collection of the plant can have an effect on some remedies. One informant noted that if he is interrupted, as by an insect, while collecting herbs for a particular one of his remedies, it is a sign -that the ailment is caused by a tupupaku. Some medicines are scrutinized for signs, such as bubbling, which will indicate whether or not the medicine will be effective. As is the practice in the rest of Polynesia, the macerated plant material is then usually put into a piece of white cloth and squeezed into a container of water or, less commonly, coconut oil or cream. Formerly, and occasionally still, the fibrous mesh (kaka) found at the base of the coconut frond was used for this. At this stage, the medicine is usually ready for use. Some medicines, however, require boiling. Nowadays this is accomplished by simply heating the medicine in a saucepan over a fire or on a stove. In the old days (and occasionally

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Fig. 3. PIant material being scraped using a Western-style grater.

still), however, red hot stones were dropped into a bow1 (humete) containing the medicine which was thereby quickly brought to a boil. The principal reason for this latter method of boiling is that the Polynesians lacked any kind of container which could be put onto a fire without being consumed itself. In the case of lotions and purges made with coconut oil, the crushed plant material is added to the cream, and the mixture is brought to a boil (fried) to extract the oil containing the juice of the herbs. Besides the herbs, Maori vai-rZkau also usually contain a number of other additives. The most common of course is water. No special water is used, but it is invariably fresh rather than salt or sea water. Many vai-rifikaucontain coconut water instead of water. Almost invariably, only one variety of coconut is used for this, na uri. This practice is almost identical to that of the

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Society Islands where a single variety, known as ouiri, is used in the native medicines. Vai-rckau are occasionally sweetened with sugar cane, almost always with a red variety known as tb muramura. On Atiu, however, the variety used is called Gpi’avere, which is the same variety used in Tahiti, and is probably the same as the to muramura used elsewhere in the Cook Islands. For most purges and lotions, coconut oil or coconut cream are used instead of water. Minerals are also employed in a few medicines. Coral lime (nguika) is grated and mixed with crushed moemoe (Phyllanthus uirgatus) leaves and tuitui (candlenut) seeds in a medicine used to treat a painful ear infection and migraine-like headache known as tui. Red earth (one muramura) is employed in a few unrelated native remedies, a practice similar to that known from the Hawaiian pharmacopoeia. Western medicines and other normally non-medicinal substances are also occasionally used. Castor oil, usually mixed with crushed ti leaves and orange juice, is commonly employed as a purge in place of the usual native purges of coconut oil or coconut cream. A brand of aspirin known as “Aspro” is sometimes a part of some treatments, and formerly a medicine known as “pain killer” was used, but reportedly is now banned because of its reputed use in illegal abortions. Aitken (1930) also reported the use of “pain killer” in the Austral Islands. A powdered laundry bleach known as “Blue” is used to treat centipede bites, as are soap and even urine. Urine is also used to treat minor cuts. The uai-Ekau can be divided into two basic types - those used externally and those taken internally. The former is the less controversial of the two (even though there have in the past been several deaths of infants who were given cold rather than warm water baths), and many Rarotongan health care workers condone the use, and even believe in the effectiveness, of some of the native uai-rEkau. The most common use of the external medicines are for things like boils (EE), carbuncles (taup@, burns (pakapaka), and sores and rashes ( ‘une’une, tona and mangeo). These medicines are simply rubbed or dripped onto the affected areas. The other common method of external application is by bathing or soaking. This is usually done for sprains fractures ( ‘ati) and for ghost sickness (maki tiipCpaku). The setting of bones is commonly done by the healers using traditional methods. The fractured limb is soaked in a cold solution, or if it is in a situation where a bath is impractical, the affected place is bathed using a wet piece of cloth soaked with the uai-Ckau’ati. This method is highly respected by the Maoris, and is sometimes discreetly recommended or even used by some health care workers. This practice of soaking fractures in cold medicine is nearly identical to that used in Tahiti, and is similar to what Gill (1876) reported -the setting of broken limbs in running water -from Rarotonga over a century ago. As is the custom throughout Polynesia, massage (maoro) is extensively used, not only for fractures, but for general body aches

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and fatigue, as well as for many internal ailments. This time-honored practice has probably changed little since the beginning of the European era. -One of the most common methods of treating maki tupapaku is to give the patient a bath of one of several herbs. A bath of kiFketa or pipi (Vigna marina), and especially miri (Ocimum basilicurn), is widely believed to be repugnant to ghosts (tiipZpaku) that have either caused bad dreams in an otherwise normal person, have “possessed” the person, or have retarded the recovery from some ailment (Fig. 4). A medicinal bath is also commonly given to a woman who has just given birth, The leaves of tuaua (guava) or rara (Vitex trifolia) are boiled, and the postpartum woman is bathed in a large basin of the warm uai-rgkau to relieve any pain and help rid the body of the blood of the afterbirth (riu). As is the custom in Eastern but not Western Polynesia, steam baths are sometimes administered. This is not common today, but when it is used, either the patient wraps himself up in a mat over a bowl of medicine to which hot stones have been added, or if the vapor is only to be breathed, the patient inhales it from a cup or bowl of the boiling medicine. Internal medicines are usually drunk as potions. In the Maori way of thinking, many if not most internal ailments are caused by something bad within the body. When medicines are administered, the usual practice is to

Fig. 4. Bath of crushed leaves being administered to an ailing woman.

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give the remedy once or twice a day for 3 days, followed the next day by a strong laxative, either of castor oil or herbs dissolved in coconut oil. The purge is supposed to rid the body of whatever is causing the ailment, or to remove breakdown products after the medicine has acted upon it. The material removed by the laxative is politely called repo kino (literally, bad feces). The use of laxatives or purges probably antedates the European era in Polynesia, and was reported by Mariner to be in use by Hawaiians as early as 1807 (Martin, 1981). The Tahitians likewise believe in the value of purges, and according to Grepin and Grepin (1980), many of them consider it an obligation to have the treatment at least once a year. Less commonly, the medicines are smelled, such as gardenia flowers (tiure mZori) or grated sandalwood (a’i) for headaches. Babies are often treated differently. Some of the medicines (but not the purges) are given to the mother instead in the belief that the medicine will pass to the baby in the mother’s milk. Another unusual method of administering the uai-rZkau is to apply it to the fontanel (take). Two healers described this application for one of their medicines, but the target ailments were entirely unrelated. Although little is written about it, there appears to be a preoccupation with the fontanel by Polynesian healers, and this probably stems from aboriginal concepts of mind and body. Most of the dispensing of the medicine is straightforward with few or no rituals or restrictions. The treatment of some ailments, however, requires specific procedures. When treating tui, a headache often associated with an infected ear (possibly otitis), the uui-rZkuu is rubbed in a specific pattern around the head - a treatment that is amazingly similar among different healers. The treatment for turinga mumue (a kind of earache) involves a circular, clockwise massage around the ear; massaging in the opposite direction is believed to be ineffective. When taking some internal medicines, there is sometimes a restriction against eating hot or spicy foods, eating red colored foods, and even against wearing red clothing. MacKenzie (1973) also notes this avoidance of red colored objects in some remedies, but is uncertain as to its origin. Perhaps it is a vestige of the concept of sacred (tupu) and profane (nou) concepts of life and death that have influenced Polynesian thought since antiquity. At this point, something should be said about a number of little-understood children’s ailments known collectively as iru, the knowledge of which is rooted in Polynesian antiquity. In his dictionary of the Rarotongan language, Savage (1962) defines iru as a mark on the skin, such as a mole or freckle, without any reference to its meaning associated with illness. Throughout Polynesia, iru or ilu has the same meaning (mark on the skin), but from Samoa to at least the Society Islands, it also refers collectively to a number of childhood diseases. In Tahiti, Grepin and Grepin (1980) noted that iru is one of three broad categories of illness (the other two are he’u and f&i), and is characterized by fever and nervous symptoms in infants, as well as the blue

spot on the lumbar region which is characteristic of Oriental babies. They noted that fever, convulsions, fainting, paralysis, or simple discomfort to the infant are all connected to ira. Working in the leeward Society Islands, Hooper (1978) reported that ira there was a category of illness. Six different ira ailments were mentioned to him, the symptoms of which included such various things as red painful lips, “startling” fever at midday, discharge of pus from the ears, and facial pain on only one side of the head. Like others before and after him, Hooper could see no organizing principal that linked the ailments into a single, unified category. Lemaitre (1978), who only noted that ira is an undetectable disease in children, listed six of the 20 types he had recorded, but these are entirely different from those listed by Hooper. In Samoa, ila is also recognized as a common childhood disease. In his work on Samoan medicinal plants, McCuddin (1974) defined ila as a “general term for childhood diarrhea” and ilamea as a “red spot on the back of an infant’s head”. The latter, however, is surely incorrect; according to Milner’s dictionary (1966), it is inflammation in the region of the anus caused by diarrhea. On Niue, ila is also a commonly known childhood ailment, and one symptom of it, a reddened area around the anus, is anal thrush, accordingto one doctor interviewed on Niue. In her work on health practices in the Cook Islands, MacKenzie (1973) noted that maki ira is “a special name for illness caused by a curse - taumaa [ tauma’a], which manifests itself in various ways”. She described one kind which occurs in babies, particularly those 5-7 days old, in which the veins, especially those in their eyes, stand out blue. MacKenzie also identified ira uaru (also known as ira pupii) as a serious rash of infants. During the interviews, the author was told of seven different kinds of ira, ira inu raw, ira moe, ira ni’o, ira roto, ira ‘une, ira ‘uti and ira uaru. No informant knew all of these, and their descriptions of the types were often at variance with those given by other informants. However, there seemed to be some concensus that ira inu ranu is an ailment caused by the fetus ingesting amniotic fluid before or during birth, ira ni’o is teething problems, and ira ‘une is a skin rash or sores on the body. As MacKenzie reported, the usual symptom of ira in general was the prominence of bluish veins in the whites of the eyes and forehead, as well as excessive mucous in the stools of the infant. Ira may be the same as an ailment called pa’ao’ao by Kamakau (1964), and defined by Pukui and Elbert (1971) as a latent childhood disease. The Maori healers treat ira with both internal and external medicines. The baby is often bathed in an aqueous uai-rZkau and a little of the medicine is put into its mouth. Alternately, the mother drinks the uai-rgkau in the belief that the baby will receive its dose in the mother’s milk. Purging medicines are also commonly given to the baby, but this practice, especially when it involves the use of the maire root (Phymatosorus scolopendria), is severely condemned by the Health Department. Perhaps the most interesting thing

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about vai-rEkau ira remedies is that they are usually given at the new and full moon, in the belief that these are the times they are most effective, or it is when the illness manifests itself. Another Maori treatment that is of particular interest is one administered for the sting of the stonefish (no’u). Although deaths from the sting (p&Z no’u) are relatively uncommon, the pain is excruciating. Although many healers knew a remedy for this, there was little uniformity as to which plants were employed. Things like the grated fruit of nita (papaya), the sap of fipani (frangipani), the aerial roots of ‘ara (pandanus), the sap of kcpara (Timonius polygamas), the root of nono (Morinda critifolia), and the root of rtikau Papua (Derris malaccensis) are used, but none of these remedies were mentioned more than twice. Usually the injured hand or foot is soaked in the medicine, but one informant told of a remedy in which the spreading pain was literally pushed back down the arm by first soaking the opposite arm in the hot medicine! Another informant noted than his medicine was applied to the fontanel (take) instead of the injured appendage. Unlike any of the informants during the present study, Gill (1885, p. 136) noted the use of the pounded leaves of pd’ue (Ipomoea pes-caprae) and those of miro (Thespesia populnea) heated over a fire to treat puta no ‘u : “A student of mine, poisoned by the no ‘u, to whom my European medicines failed to give relief, was in my presence almost instantaneously cured by the above application”. A listing of the medicinal plants most commonly used in the Cook Islands is found in Table 1, and a glossary of Maori names of the ailments is in the Appendix. TABLE 1 THE MEDICINAL PLANTS AND THEIR USES

The number of times the plant was mentioned by the informants is included within parentheses. A’1 - Santalum insulare Bertero (14)

_--. SANTALACEAE

In the Cook Islands, this widespread sandalwood species is restricted to Miti’aro from whence the native healers usually obtain their pieces of its aromatic wood.

(1) Tui kai roro and 'OQ (6) - The grated wood is smelled by people suffering from earaches or meningitis, or often it is combined with grated ngaika (limestone) and pia starch and rubbed onto the head. (2) ‘,@‘F (2) - The grated wood is mixed with water and rubbed onto boils and other skin infections.

‘ANANI - Citrus aurantium L. (19) RUTACEAE The bark, leaves, and fruits of this common, introduced orange species is used in native medicines. (1) ‘Aka’eke (7) - Juice from the orange is commonly combined with coconut oil or castor oil, and sometimes also with the crushed leaves of rau ti taken as a laxative, The use of orange juice is probably to mask the taste of the oil. The juice of rifmene (lemon) is sometimes used in place of the orange juice.

.-

258 TABLE

1 (Continued)

(2) TEpito (3) - The young leaves are crushed with those of tnava and taken for this well-known type of abdominal pain centered around the navel. (3) RZoa (2) - A peeled orange is eaten to treat people with a fishbone caught in the throat. (4) Mimi (2) - The boiled leaves or bark are sometimes taken in treating this urinary tract ailment. ‘ARA - Pandanus tectorius Parkinson (22) PANDANACEAE Two basic kinds of Pandanus are recognized by the Maoris, the cultivated types, specifically called ‘ara, and the wild types growing near the coast (‘ara tai or ‘ara ta’atai) which are also commonly called ‘ara. It is the fruits and proproots of the coastal kind that are commonly used in native medicines. (1) ‘Aka’eke (5) - The juice from the crushed root is mixed with coconut cream, sometimes with pia starch for thickening, and fried. The resulting oil is taken as a laxative. (2) Mimi (5) - The skin of the ripe fruit, combined with things like miri leaves or grated renga rhizome, is boiled and taken internally for urinary tract ailments. ‘AU - Hibiscus tiliaceus L. (18) MALVACEAE The flowers, bark, and sometimes the roots of the beach hibiscus are used in Maori medicines. (1) ‘,!?‘a and taupe (5) - The flowers are chewed or mashed, and applied with or without coconut oil to boils, carbuncles and cuts. The flowers are used similarly in Tahiti. (2) ‘Ati (4) - A solution of the grated bark combined with the crushed bark or husk of nii is used to soak fractures and sprains. AVA - Ficus prolixa Forst. f. (12) MORACEAE The native Polynesian banyan was formerly known as Zoa, which is its current name in most of Western Polynesia. Only the hanging aerial root tips are used in Maori medicine. (1) ‘Aka’eke (5) - The crushed root tips are combined with coconut cream, occasionally thickened with pia starch and fried. The resulting coconut oil is taken as a laxative in serious diseases like cancer. The root tips are also commonly used in native medicines in Tahiti, but for treating entirely different ailments. (2) Miiriri (2) - A solution of the crushed root tips is rubbed onto filarial swellings on Aitutaki. II--

Inocarpus fagifer (Parkinson) Fosb. (6) LEGUMINOSAE The leaves and bark of the aboriginally introduced Polynesian chestnut are occasionally used in Maori medicines, but the plant is more highly esteemed for its large, edible seed. (1) Zra ni’o (4) - A solution of the crushed bark or leaves is given as a drink and a bath for infants who have problems with or during teething.

MYRTACEAE KA’IKA - Syzygium malaccense (L.) Merr. & Perry. (27) The aboriginally introduced Malay apple is valued throughout Polynesia for its highly esteemed, edible fruit and its widespread medicinal uses. On Atiu, it is called ka’ika makatea. (1) Kea (17) - A solution of the crushed leaves, or to a lesser extent, the macerated bark, is taken alone or sometimes combined with k6ki’i for treating thrush in infants.

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TABLE

1 (Continued)

The plant is similarly used in Western Polynesia, but in Tahiti the ailments treated with it are entirely different. (2) Eiruaki (2) - A solution of the bark is sometimes taken to induce vomiting. COMBRETACEAE KAUARIKI - Terminalia catappa L. (6) The tropical almond is probably an early European introduction to the Cook Islands, but there is another related native species which is now very uncommon. Kauariki has widespread but varied use in Polynesia, and in the Cook Islands it is only of minor importance as a medicinal plant. (1) ‘Ati (2) - The crushed leaves, along with other medicinal plants, are mixed with coconut oil or coconut cream and rubbed onto sprains, fractures, or muscle pains. MALVAC EAE KAUTE ‘ENUA - Hibiscus rosa-sinensis L. (9) The aboriginally introduced red hibiscus (ha&e) is widely cultivated as an ornamental. The only type used in Maori medicine, however, is the ‘enua variety, one with small double red flowers. The adjective ‘enua usually indicates a native or aboriginal plant, but this cultivar is probably a European introduction, and may be the same as the ‘aute ‘u ‘umu used medicinally by the Tahitians. (1) Ira varu (2) - The flowers and sometimes the leaves, with or without with tiare mgori leaves as well, are boiled in water or fried in coconut cream, and taken internally, given as a bath, or massaged onto a baby who has this ill-defined ailment. Similar medicines, also with tiare leaves, are used to treat several ira ailments in Tahiti. (2) Abortion (2) - Infusions of the flowers are believed by some Maoris to be effective in inducing abortion.

KAVA MAORI (KAVA) -Piper methysticum Forst. f. (13) PIPERACEAE The aboriginally introduced kava was used primarily in preparing the kava drink used in ceremonies and as a mild narcotic throughout Polynesia. Nowadays, however, its use for these purposes is restricted mostly to Fiji, Samoa and Tonga. Medicinally, the Maori healers use the grated root for their remedies, or perhaps more commonly, import the powder from Fiji. (1) Mimi and mimi t?itua (12) - The kavasolution, sometimes prepared with crushed miro and/or nono fruit, is taken for urinary tract ailments and its associated back pains. This is, no doubt, related to its known diuretic properties. In the Cook Islands, as well as in Hawaii and Samoa, it was or still is used to treat another kind of urinary tract ailment, gonorrhea. OXALIDACEAE K6KI’I - Oxalis corniculata L. (14) The wood sorrel is an aboriginally introduced weed which has probably long been used in Polynesian medicines. (1) Kea (7) - A solution of the crushed leaves, alone or frequently with ko’ika leaves, is commonly used to treat thrush in infants, and is employed similarly in Tonga and Tahiti. In Tahiti, it is also used for arero ma’s, a mouth swelling which the Tahitians uniquely believe will result in a “double tongue” (ranula) if not treated. (2) Kea tona (3) - A solution of the leaves, combined with ka’ika leaves and pus’i&o, is used to treat this ill-defined ailment of infants. (3) Ira (2) - The plant is used in combination with other herbs to treat the ira which exhibits bluish veins on the forehead and in the whites of the eyes.

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1 (Continued)

KOPU’I - Zingiber zerumbet (L.) J.E. Smith (9) ZINGIBERACEAE The aboriginally introduced wild ginger was widely used in olden times for several minor purposes, but nowadays is mostly employed in native medicines. Several related names are used for the different gingers in the Cook Islands, kCp7, kCQZ’enua, kaopu’i and k@pu ‘i, but it is not clear which ones refer to the several cultivated species and which ones to the wild ginger. (1) To’e tupu and to’e topa (4) - A solution of the grated rhizome, alone or mixed with other herbs, is used internally or rubbed onto hemorrhoids and prolapsed rectum. Elsewhere in Polynesia, it is used for other, unrelated ailments. KURU - Artocarpus altilis (Parkinson) Fosb. (19) MORACEAE The aboriginally introduced breadfruit has long been a major food source throughout most of Polynesia. The Maoris also use the leaves and sap for medicinal purposes. (1) TCpito (11) - A solution of the crushed young leaves (kao) and sometimes the petioles (hata), and/or tiare mZori leaves, is used to treat this common abdominal pain centered around the navel. It is used for the same ailment, called he’s tupito, in the Society Islands. (2) A’ei (3) - Asolutionof the leaf ashes, often with the juice from banana (meika) stems, is rubbed onto this skin rash (shingles). Elsewhere in Polynesia, the sap is commonly applied to rashes, pains and sprains. (3) ‘Ati (2) - The sap is sometimes applied to a broken limb or injured muscles or joints to dry and serve as a soft cast. POLYPODIACAEAE MAIRE --- Phymatosorus scolopendria (Burm.) P. Serm. (18) Two types of this maire are distinguished by the Maoris, maire kakaru (kakara = fragrant), the thin-leaved, fragrant one used to make ‘ei (leis), and maire tiitue-puaka, the common, native (?), thick-leaved, non-fragrant one used in medicines. (1) ‘Ouiri (3) - The crushed rhizomes, alone or combined with other herbs, are used to make medicines for several serious, internal ailments such as fistula. Combined with the rhizomes of another fern, Davallia solida (metua pua’a inTahitian) is a very common medicine in the Society Islands: it acts as a purge, which is so much a part of the healing process in Eastern Polynesia. (2) Zru (6) - The rhizomes and leaves are used alone or mixed with other medicinal herbs to treat some kinds of ira, either taken internally or as a bath. SCROPHULARIACEAE MAPUA -. Limnophila fragrans (Forst. f.) Seem. (4)? This is probably an aboriginal weed which has become increasingly rare, and in fact, was not even seen during the study. Its medicinal uses are, however, reported from Atiu and Aitutaki. Although it has never been collected in the Cook Islands, the name mapua is this species in Tahiti.

(1) Toe’e tupu (2) - A solution of the leaves is sometimes used as a bath for treating hemorrhoids. In Tahiti, Parkinson (1771) reported “the juice of this plant, mixed with several others, they use as a plaister to cure any sort of wounds”. (2) Riu - A solution of the crushed leaves is sometimes used as a drink or bath in treating postpartum problems in women. MUSACEAE MEIKA - Muss paradisioca L. (13) The banana plant is commonly used in native Maori medicines as well as being a major source of food. The fruit, sap, and leaves are used in medicines. (1) A ‘ei (3) - The juice of the crushed stems is applied to the cutaneous sores associated with shingles (Herpes zoster). The sap of the mountain plantain, uFri_ (Muss

261 TABLE

1 (Continued)

troglodytarum), with or without the ashes of kuru leaves, is used for a similar purpose (2). (2) Ira ni’o (2) - The crushed stems of meika and leaves of i’i are given as a drink and bath to babies having problems during teething. LABIATAE MIRI - Ocimum basilicurn L. (23) There are three species (one with two varieties) of Ocimum in the Cook Islands, all of them European introductions, but the one most commonly used in medicines is a variety of Ocimum basilicum called miri kutekute, miri muramura, or miri kura on the different islands. This variety has a widely branching, reddish inflorescence. The other variety and the other two species are sometimes used in the same ways as miri murumura. (1) Mimi (10) - A solutionof miri leaves, with or without other herbs, is used boiled or unboiled to treat urinary tract infections. (2) Muki tEppaku (9) - A solution of miri leaves is used as a bath to chase away ghosts who have possessed someone. The same treatment is sometimes taken by a person who has just had a bad dream.

MIRO -- Tkespesiapopulnea (L.) Sol. (17) MALVACEAE The fruits and bark of the miro are used in a number of native medicines. Native healers often recognize two types of miro fruits, one with a split calyx at the base, which is considered to be “female”, and one with the calyx intact, which is considered to be “male”. In cases where this distinction is made, equal numbers of the two types are used. (1) Mimi and mimi t?itua (6) - The crushed fruits, along with nono fruits, and often grated kava root and tou leaves as well, are used to make a potion for treating urinary tract ailments and associated pains. (2) Pu’a roto (3) - The fruits of miro, along with nono fruits and yellow and green leaves of tou, are used to prepare a potion taken for abdominal swellings. Miro fruits are similarly used for pu’u roto in Tahiti. (3) Ni’o mZriri (2) - A solution of the miro bark and that of ‘au is used to treat babies for ailments associated with teething. MOEMOE - Pkyllanthus uirgatus Forst. f. (7) EUPHORBIACEAE An aboriginally introduced or perhaps native herb used only for medicine. A similar weedy species of the same genus was pointed out by one source as being the medicinal one, but that species is a recent European introduction. (1) Tui (4) - A solution of crushed moemoe leaves, tuitui nuts and grated nguika (limestone) is used to treat this severe earache or headache, The medicine is put onto a cloth and rubbed from the chin across the face to the back of the head, then from the chin around the two sides to the back of the neck. In the Society Islands, moemoe is used to treat a similar or identical ailment known there as ira tui. (2) Turinga mamae (2) - Crushed moemoe is mixed with warm coconut oil and rubbed clockwise around the ear for ear infection. Rubbing in the opposite direction is believed to be ineffective. The same treatment is used in Tahiti for ear infections. NTTA - Car& papaya L. (13) CARICACEAE The introduced papaya is esteemed for its fruit, and is widely used in native medicines. Many of these medicines appear to have been derived from elsewhere. hTtii is sometimes called UT nTth or UTpuaka on the outer islands. (1) ‘&? and taupF (4) - The green fruit is grated, mixed with coconut oil, and rubbed onto boils and carbuncles.

TABLE

-

1 (Continued)

--___(2) Motu and tona (2) - The same preparation as above is used for treating cuts and sores. This medicinal use is widespread elsewhere, and its effectiveness may be due to the proteolytic enzyme papaine present in the plant. (3) Toketoke (1) - The seeds eaten whole are used to treat infestations of intestinal worms. A similar use has been reported from Samoa, Tahiti, and as far away as the West Indies.

NON0 -Lorinda citrifolia L. (21) RUBIACEAE The aboriginally introduced Indian mulberry was one of the most widely used of Polynesian medicinal plants, and was also valued as a famine food and dye plant. The fruits and occasionally the roots are used in Maori medicines. (1) Mimi and mimi txtua (6) - An infusion of the fruits and those of miro, occasionally combined with green and yellow tou leaves or grated kava, is used in treating urinary tract ailments and associated pains. (2) ‘Ua roto and pu’a roto (6) - The fruit is used with any of several other medicinal plants in treating diaphragmatic hernia and other abdominal swellings. The nono fruit is also used to treat pu’a roto in Tahiti, (3) PutiF no’u (2) - A solution of the grated root is applied to the top of the head (take) in treating stings from the stonefish (no ‘u). In Tahiti, it is the fruit that is used for this purpose, and it is applied directly to the sting. PALMAE NU - Cocos nucifera L. (12) In addition to their numerous well-known uses, coconuts are also commonly employed in native medicines. The water of the nut, particularly the variety known as nii uri is used as a medium for many medicines. Herbs are added to coconut cream and the mixture is fried to obtain the oil widely used as a laxative (‘aka’eke). Additionally, the bark and husk are sometimes used for what is believed to be their own healing properties. (1) ‘Ati (4) - The grated bark or crushed husk is combined with ‘au bark in water and used to soak fractures and sprains. (2) firiri (3) - Different parts of the palm are used in medicines for treating filariasis. SOLANACEAE ‘6PORO - Capsicum fru tescens L. (9 ) The chili pepper was an early European introduction which is now commonly used in cooking and occasionally in medicines. The medicinal uses of its leaves are similar to those of poro (Solanum nigrum) and poro’iti (Solanum uporo). (1) %‘F (5) - The mashed leaves are mixed with coconut oil and applied in a circle around a boil. Similar treatment is reported throughout Polynesia. CONVOLVULACEAE PAPATI Ipomoea littoralis Bl. (7) The use of this native morning-glory is restricted to medicine. (1) Zra u ti and other ira (7) - The leaves and stems are boiled and given as a bath to infants with convulsions or with bluish veins on the forehead and whites of the eyes. TACCACEAE PIA ‘ENUA - Tacca Zeontopetaloides (L.) 0. Ktze. (ll?) The Polynesian arrowroot is a native or perhaps aboriginally introduced plant once commonly used for food. Now, however, it is only occasionally utilized for its starch, and even in this the pia m&iota (cassava) has largely replaced it. Both plants are commonly called pia which leads to confusion between the two in medicine.

263 TABLE

1 (Continued)

(1) ‘Aka’eke (4) - Pia starch is commonly added as a thickener to laxatives made with coconut oil. (2) Tui kai roro and tui (3) - Pia starch is often added to medicines, possibly as a thickener, for these types of headaches. (3) Sores and burns (3) - The starch is rubbed onto these. LEGUMINOSAE PIP1 -- Vigna marina (Burm.) Merr. (7?) This native littoral creeper is very similar to, and easily confused with, Canaualia rosea when lacking flowers. On Atiu, where Vigna is called keketa pipi refers to another plant altogether. To thoroughly confuse the issue, Vigna is apparently sometimes called po’ue (= vine), the name also applied to Ipomoea pes-caprae. apparently sometimes called pb’ue (= vine), the name also applied to Ipomoea pes-

caprae.

(1) ‘Ati (3) - A solution of the crushed leaves is used to soak sprains and fractures. This medicine is also used to treat maki ttipiipaku. COMPOSITAE PIRIPIRI - Bidens pilosa L. (11) A weed of European introduction, called niroa on Aitutaki. The name piripiri is also used for other plants with sticky or burr-like seeds, and this has led to some confusion. (1) Motu (9) - The leaves are commonly chewed or mashed and applied with or without coconut oil to cuts. An identical treatment is practiced in Tonga. SOLANACEAE PORO - Solanum nigrum L. (11) The black nightshade, which is probably an aboriginal introduction to the Cook Islands, currently has little value other than for its leaves which are used in Maori medicines. On Atiu, it is called poro puaka, and on the other islands, poro is often interchangeable with poroporo. (1) ‘,!?‘B (6) - The mashed leaves, with or without coconut oil, are applied in a circle around a boil, and sometimes a drop of the medicines is put onto the boil once it has burst. Hawaiians have long used this plant to treat boils and wounds. SOLANACEAE PORO’ITI - Solanum uporo Dun. (12) The fruit of poro’iti, which looks like the tomato to which it is related, was once used as a condiment, but nowadays its use is restricted mostly to making ‘ei (leis) and native medicines. Both the fruits and leaves are used medicinally, and the latter are often interchangeable with those of poro. (1) MEG (4) - The juice from the fruit is rubbed onto ringworm infections, but nowadays people commonly obtain medicine from the hospital for this ailment. (2) ‘E’F (1) - The leaves are sometimes crushed and applied in a circle around boils, but poro and ‘oporo are more commonly used for this purpose.

PG’UE - Zpomoea pes-caprae (L.) R.Br. (8) CONVOLVULACEAE This widespread native littoral creeper is apparently used in native medicines, but the issue is confused because p6’ue also means vine, and is sometimes applied to Vigna marina. See pipi for a fuller explanation. (1) ‘Ati (5) - A solution of the leaves, with or without coconut oil, is used to soak fractures and sprains. A similar use is reported from Tahiti. LABIATAE PUA’IKAO - Leucas decemdentata (Willd.) J.E. Smith (26) This herb was probably an aboriginal weed, but nowadays is rarely found outside of

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people’s yards where it is casually cultivated. In Tahiti, its medicinal use was recorded as early as Cook’s first expedition: Parkinson (1771) noted that “the juice of this plant, mixed with several others, they use as a plaister to cure any sort of wounds”. On Atiu, it is called niiroa, similar to its Tahitian name niuroahiti. In both Tahiti and the Cook Islands, it is one of the most commonly used medicinal plants, but is rarely used by itself. (1) Kea and hea ira (5) - The crushed plant is sometimes used in remedies for thrush. (2) Kea tona (3) - The crushed plant is sometimes used in remedies for this illdefined ailment. (3) Mimi (3) - The crushed plant is sometimes used in remedies for treating urinary tract ailments. (4) To’e tupu (3) - The crushed leaves, mixed with grated hopu’i, is used in preparing a medicine taken internally or rubbed onto hemorrhoids. Vitex trifolia L. (13) RARA VERBENACEAE A native or aboriginally introduced shrub casually cultivated, but rarely found in natural areas. It is used almost exclusively for a single remedy. (1) Riu (12) - An infusion of the boiled stems and leaves is given as a drink (one cup usually) and as a bath for a woman who has just given birth, for treating postpartum pain and to remove the residual stale blood. According to Burkill (1935), the plant has diaphoretic properties, which may or may not be related to its use in the Cook Islands. RAU TT -- Cordyline terminalis (L.) Kunth (23) LILIACEAE The aboriginally introduced ti plant is valued for its edible, sugar-laden root, its showy ornamental leaves, and its medicinal properties. Ti is one of the most widely used medicinal plants in the Cook Islands. Technically, the plant should be called tTand the leaves rau ti; but mu tI is generally used for the whole plant. (1) ‘Aha’ehe (5)-The crushed young leaves (kao) are mixed with castor oil and sometimes orange juice, and used as a laxative. (2) Karaponga mamae (4) -- A leaf is tied around the neck to relieve sore throat and neck pain. (3) Puhupaha (3) - A solution of the young leaves is used to bathe burns, a practice that has also been reported from Samoa.

ZINGIBERACEAE RENGA - Curcuma longa L. (11) The aboriginally introduced turmeric has long been used as a yellow dye, a condiment, and in medicines, but today only the latter two are still practiced. (1) Mimi (5) - The grated rhizome, combined with miri leaves and sometimes ‘arc fruit, is used to treat urinary tract ailments. (2) Ivi mar8 (2) - The grated rhizome, with one or more other ingredients, is used to treat septic puncture wounds. (3) Mahi rengarenga (1) - The grated rhizome is sometimes used to treat jaundice, probably based on the yellow color the medicine and the ailment have in common.

TAINOKA - Cassytha filiformis L. (4) A native, leafless parasitic vine of coastal medicinal value.

LAURACEAE

regions,

of little

use other

than occasional

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(1) Zra ‘uti (2) - A solution of the crushed leaves is used to treat this infant’s ailment characterized by convulsions or twitches. TAMANU - Calophyllum inophylium L. (11) GUTTIFERAE A well-known native or aboriginally introduced littoral tree. The English name is reportedly Alexandrian laurel, but this has never been heard by the author. (1) Skin ailments (7) - A solution of the leaves crushed or broken in seawater is used as a bath for ‘we or ‘une’une (sores), tona (sores), and mange0 (rashes). In Tahiti and Samoa, the leaves, bark and large seed are used for the same purposes. RUBIACEAE TIARE MAORI - Gardenia taitensis DC. (37) Because of its showy, fragrant flowers, the aboriginally introduced Tahitian gardenia is the most highly esteemed of the ornamental plants. Additionally, its flowers, and to a lesser extent, its leaves, are used in more native medicines than any other Maori plant, but only occasionally is it employed by itself. Its use in so many varied remedies may be because of the aroma its flowers impart to the medicine, or as one source told the author, because of its “catalyst” action. The flowers are also commonly used to scent coconut oil (‘akari manongi) used in many medicines. The flowers are used in remedies for ira ailments such as ira ‘uti, ira (1) Zra (8) uaru and kea ira. In Tahiti, many remedies for ira also include tiare flowers. (2) ‘Oa (3) -The flowers, or sometimes the leaves, are smelled to alleviate the symptoms of this kind of headache. In Tahiti, Nadeaud (1873) noted a similar value for treating migraine, where the head is immersed into a bowl of water scented with the flowers. NYCTAGINACEAE TIARE MOE - Mirabilis jalapa L. (7) The four o’clock is an ornamental plant introduced in European times. Its flowers, roots, and leaves are sometimes used in Maori medicines. (1) To’e kura (2) - The root (kiko) is grated into water or coconut water and rubbed onto the rash caused by anal thrush. APOCYNACEAE TTPANI - Plumeria rubra L. (5) The European-introduced plumeria or frangipani is a popular ornamental because of its showy white or pink flowers used for making ‘ei (leis), and it is also employed medicinally . (1) J’utzTno’u (2) - The sap or scraped bark is applied or bathed onto a wound from the sting of the stonefish (no’u). (2) Other stings (2) - The sap is applied to stings of wasps and bees, and to the bite of centipedes.

TIPORO - Citrus Zimon (L.) Burm. F (7) RUTACEAE The juice of the roughskinned lemon is used in several Maori uai-riikau and these appear to have been derived from Western concepts of medicine and health. The juice of the common lemon (rEmene) is sometimes substituted for it. (1) Mare and karaponga mamae (4) - The juice, combined with things like eggs, milk, or sugar, is taken for coughs and sore throat. TOA - Casuarina equisetifolia L. (16) CASUARINACEAE The ironwood is probably an aboriginal introduction to the Cook Islands, but is naturalized on the shores and lower slopes of the interior. In addition to its hard wood, it is valued as a medicinal plant.

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(1) Kea (6) - A solution of the grated inner bark is rubbed or dripped into the mouth of an infant with thrush and mouth sores (?). The bark is used similarly in Western Polynesia. (2) Mimi and mimi tcttua (3) - A solution of the grated inner bark is given to people suffering from urinary tract ailments and associated back pains. (3) ZZruaki (2) - A solution of the grated inner bark is swallowed to induce vomiting. CRUCIFERAE TOATOA ‘ENUA - Rorippa sarmentosa (DC.) Macbride (4) This Polynesian cress is an aboriginal introduction, and was probably once a common weed of taro patches, but is now uncommon. Previous sources have misidentified toatoa’ enua as Lindernia crustacea, which is correctly called tiitae tcrea. (1) To ‘e tupu (2) - A solution of the crushed leaves is taken internally or administered as a bath for hemorrhoids. A nearly identical treatment is commonly practiced in Tahiti. BORAGINACEAE TOU -- Cordia subcordata Lam. (13) Cordia is probably an aboriginal introduction and is highly valued for its durable and attractive wood. The leaves, usually in equal numbers of green @7) and yellow (para) ones (typically six of each), and occasionally the roots, are used in native medicines. (1) Pu’a roto (4) - A solution of the leaves, miro fruit (usually an equal number of “male” and “female” ones), and nono fruit are taken internally to treat abdominal swellings. (2) Mimi and mimi tiitua (3) - A solution of the leaves, miro fruits, and nono fruits is taken for urinary tract ailments and the related pain. The combination of yellow and green tou leaves with miro fruits is used in numerous Tahitian remedies. MYRTACEAE TUAVA Psidium guajaua L. (19) The introduced guava tree is valued for its fruit, but the young leaves (kao) are also commonly used in native medicines. (1) Riu (9) - An infusion of the leaves is given as a drink (usually one cup) and a bath to women who have just given birth, to relieve postpartum pain and to rid the body of the residual stale blood. (2) TEpito (2) - A solution of the leaves with those of ‘anani is taken for this kind of abdominal pain. (3) Motu (2) - The chewed leaves, with or without coconut oil, are applied to cuts. A similar use is reported from Tahiti and Hawaii. EUPHORBIACEAE TUITUI - Aleurites moluccana (L.) Willd. (9) The seeds of the candlenut tree were formerly used for candles or torches, but nowadays they are valued only for their use in a few native medicines. (1) Tui and tui hoi roro (4) - A medicine made from the crushed seeds, moemoe, and grated ngaika (limestone) is used in a massage for these types of earaches and headaches. In Tahiti, the nuts are used in medicines for the same ailment (tui he’u).

TUTAE TBREA -~~Lindernia crustacea (L.) F. Muell. (5) SCROPHULARIACEAE This small herb is probably native to the Cook Islands where it was once a common weed of wet taro patches, but nowadays is increasingly uncommon, possibly because of its inability to compete with introduced, faster growing, taller weeds. (1) Ira (3) - The crushed plant is sometimes used alone or combined with other

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medicinal plants for treating some childhood iro ailments. It is one of the most commonly used Tahitian medicinal plants, and finds its way into some of the ira remedies there as well. (2) Infection of the navel (1) - The use of crushed Gtae tcreea and ti’apito (Ophioglossurn petiolatum Hook.) related by one source on Atiu is identical with one published by Petard from Tahiti. BARRINGTONIACEAE ‘UTU - Barringtonia asiatica (L.) Kurz (6) The fish-poison tree is probably native to the Cook Islands, where the grated seeds were formerly (and occasionally are still?) used to poison fish in the lagoon. Now, however, its use is restricted mostly to native medicines, mostly obtained from the grated seed. (1) Pakupaka (5) - The grated seed is mixed with coconut cream and rubbed onto bums. AMARANTHACEAE VA’INE’ARA - Amaranths gracilis Desf. (9) This weedy amaranth is probably a European introduction, and its uses are restricted to native medicines. (1) Pakapaka (4) - The crushed plant, with or without other herbs, is mixed with coconut oil and applied to burns. (2) Mimi and mimi tZtua (4) - The crushed plant is part of several remedies for urinary tract ailments and back pain.

VT KAVAKAVA - Spondias dulcis Parkinson (13) ANACARDIACEAE The aboriginally introduced Polynesian plum or vi-apple is valued for its fruit as well as for medicinal uses. (1) Kea (7) - The crushed leaves, alone or combined with other medicinal herbs, is given to children with thrush. A similar use is reported for vi bark in Samoa. (2) Mimi (2) - The leaves are sometimes a part of remedies for urinary tract ailments.

The ta’unga The ta’ungu form an important part of the traditional health care in the Cook Islands. These psychic healers or shamans are the inheritors of the mantle of the t7iuruatua, the priests of the old Maori religion. In pre-European times, these priests were the primary healers of internal ailments, as well as of many of the injuries, either accidental or intentional. With the demise of the Maori religion, the role of the tu’ungu changed drastically, but because of their acute understanding of their people who were still imbued with traditional superstitions, they retained much of their status if not their power. Since their old gods proved to be false in the face of Christianity, the tu’ungu lost their power of healing with intercession and incantations. Although to be good Christians, the Maoris had to abandon their pagan gods, they did not forsake their belief in spirits and ghosts, the existence of which was not contradictory, at least in their eyes, to the Christian teachings. Since the Maoris

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-still largely believe in spirits, or tupapaku, those who could intercede, or at -least communicate with, the tupapaku have been accorded status and power. In addition to their communion with the spirit world, most of the ta’unga absorbed the new and pervasive concepts of the healing properties of plants and became herbalists as well. Today there are few ta’unga left in the Cook Islands. Many have moved away to New Zealand, and many others have died without bequeathing their powers to others of the family. During the field study, only a single ta’unga was interviewed, and that one lived on one of the outer islands. Reportedly, none remain on Aitutaki, but a few are still to be found on Rarotonga. The ta’unga specialize in maki ti’ip?ipaku, ghost sickness. Although it is perhaps the most interesting of the Maori ailments, it is very poorly understood by outsiders. Although it plays such an integral part in the thinking of the people, its importance, has perhaps been overstated. While everyone who was asked could relate an interesting story, few had seen more than one or -two cases of maki tupapaku, and perhaps knew of a few others by hearsay. -There are two kinds of maki tupapaku, one is a physical illness, the other is a “possession”. During the interviews with the healers, a number of stories -about maki tupapaku were collected, and many of these cases show common elements. There are apparently two variations of physical illness, one affecting the newborn, the other affecting adults. The Maoris commonly believe that their ancestral spirits watch over their lives, and occasionally mete out punishment for behavior which is contrary to the social mores, probably a vestige of the idea of breaking a tapu and the consequent supernatural punishment. Nowadays, however, this punishment is administered by a tiipapaku of the family, or if none of these are apparent, possibly from God. During the interviews, however, all of the cases related were caused by tiip6paku. -A common way that maki tupapaku affects infants is a sudden, unexplained ailment which appears to be life-threatening, but when the infant is taken to the hospital, doctors frequently can either find nothing wrong, or can, but are unable to effectively treat it. If the family believes the illness -may be caused by a tupapaku, they will then visit a ta’unga to try to determine its cause and remedy. The ta’unga will, by various means that will be elaborated upon below, make a diagnosis. -The most common cause of maki tupapaku in babies is the anger of a deceased ancestor, who is trying to take the baby away in punishment for wrongdoing by the family. Some examples would be useful at this point: (1) A child was sick with a recurring high temperature, and the doctors could not diagnose the cause. The foster parents who were raising the girl then went to a ta’unga who diagnosed the problem as the tiipapaku of the deceased grandmother angry at the way they were mistreating the child. (2) A child was sick with a high temperature, but when taken to the hospital, its temperature would return to normal, only to rise again later. So

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the parents went to a ta’unga who diagnosed the problem as the husband having an affair with another woman. The husband, who contritely confessed that this was the case, terminated the affair, and the child was cured. (3) A doctor posted to one of the northern atolls had his nine-month-old son suddenly sicken with a high temperature. He immediately treated the child (with aspirin and a cooling bath), and on the recommendation of others, went to seek the advice of a woman who was well known as a healer. Although he did not know it at the time, the woman was apparently a ta’unga who could communicate with tiiplipaku. When he found her, she acted very gruff, her eyes were bloodshot, her face was angry, and she spoke in an altered voice. She apparently already knew what he had come for, and said that he was induced to leave the house because the ancestors of the baby, from both sides, were angry about the way he and his wife would argue about the baby (e.g. one would blame the other when the baby cried), and consequently they wanted to take the baby away from them. However, she said not to worry, because her spirits were watching over the child. When the doctor returned home, the baby was better. To add a final interesting touch to the story, that evening at dusk, while the woman and the mother were tending to the child in the bedroom, the doctor and the husband of the woman, who were sitting in the living room, saw an unfamiliar chicken come in the door, head straight down the hall, and stand looking in the bedroom for a few minutes. It then retraced its steps and exited through the door. In puzzlement, the doctor went to the door, but the chicken had utterly disappeared! (4) The son of a Maori scholar suddenly sickened early one morning, his face became contorted, he wouldn’t eat, and he was crying. The father rushed his two-week-old child to the hospital, but the doctor was unable to determine the problem. The doctor then took the man aside and recommended that he visit a ta’unga, a suggestion that brought anger to the disbelieving father. However, despite his misgivings, his family persuaded him to visit a certain ta’unga. The woman got out a deck of cards, and when she laid them down one by one, was able to diagnose the problem the child had been named improperly. The naming of a child is a very important part of Maori custom, and according to the socially accepted norm, a certain woman of the family on this occasion was supposed to be the one to supply the name. For some reason, however, the name selected for the child was given instead by the slightly younger twin sister of the woman, leading to the displeasure of the family ancestors. The still-skeptical father was then sent to a healer, who took him into the forest to find a particular herb (Macropiper latifolia, a native species of wild kava). Upon returning, however, the healer refused to make the medicine because the ta’unga had said to administer the uari-riikau warm, but the healer’s remedy was only effective when used cold. In continuing disgust, the father returned home to find the baby still afflicted. After conferring with the family members,

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he agreed to follow the ta ‘unga’s advice - rename the child with the name from the older twin (in fact, the other name was retained as well, a compromise to all parties concerned). It was late afternoon when this was resolved, and the father then said a short prayer for all those assembled, and when he finished, the baby suddenly improved, and cried wanting to be fed! TiipSpaku are also believed to affect adults. When a person develops a sudden inflammation or swelling, sometimes when asleep, the origin is often -attributed to being “slapped by a ghost” (papaki’ia e te tupapaku). In such a case, herbal remedies are usually employed, and there is no need to consult a ta’unga. In one case, however, a healer reported that as a girl of 19, she was stricken with blindness for several months. She was taken to a ta’ungu, who attributed the affliction to the mother of the girl’s boyfriend who did not like her son going with a girl from the outer islands. The conflict was amicably resolved between the parties concerned, and when the ta’unga subsequently administered the uai-rZkau to the girl, she recovered her vision. In any case, any sudden and unexplained ailment, or one which persists despite medical -treatment, is subject to the speculation that it is being caused by a tupupaku, and a ta’unga is then consulted. -Another cause of maki tupupaku is believed to be the disturbance of marae, the sites of worship during the days of the old religion. According to Lambert (1933), a man may safely weed and plant on the site of his own ancestral marae, but not on that of another, and no one can light a fire on it -with impunity. Another interesting characteristic of maki tupupaku is that a person’s chances of contracting it are directly proportional to that person’s -belief in tupapaku, according to one knowledgeable source. Both men and women are affected with maki tiipZpaku, but perhaps a majority of the tu’unga are men - in the old days, the tZuruatua were exclusively so. -The other types of maki tupapaku mentioned above is “possession”. This is common throughout Polynesia, and undoubtedly dates to aboriginal times. Each culture in Polynesia, however, has its own variations and its own methods of treatment. As is the case of the sudden onset of illness in infants, this kind -of maki tupapaku is caused by interpersonal conflict which has led to the -intercession of a tupupaku of the family concerned. The symptoms are similar in many of the cases - bloodshot eyes, erratic behavior, speaking in an altered voice and often in a different language, incredible strength of the victim when resisting being subdued, the assumption of the mannerisms of -the deceased relative whose tupapaku is causing the trouble, and no recollection of the happenings after the possession has ended. A few examples are useful at this point: (1) A healer was visiting her son in New Zealand, when one day he returned home from work physically sick. He was’put to bed after being given aspirin and castor oil. When the woman later came into his room, it was -evident he was possessed. The tupupaku said she was the woman’s deceased sister, and had come to New Zealand on an airplane. The woman engaged

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-the tupapaku in conversation, and learned that it was unhappy because the son’s girlfriend was not taking good care of him. The woman then accused the tZpiipaku of being a devil (tiEporo) and not the sister, and -began to exorcise the tupapaku, first by reading certain sections in the Maori Bible concerning casting out devils, then by squeezing two or three places on the boy’s body, whereupon the tiipZpaku had enough and exited. The boy awoke and asked what all the people were doing in his room. (2) A teenage boy became possessed one day - he started hitting himself against the wall, he would alternately laugh and cry, his eyes were bloodshot, and he would speak in Tahitian. He was taken to a ta’unga who, during a trance which he would later not recollect, diagnosed the cause as the ZpZpaku of a deceased grandfather who was angry because the boy’s family would not give him a piece of land upon which to build his house. The boy was treated with miri (basil) leaves and perfume, went to sleep, and awoke recovered without recollecting what had happened. (3) A girl living in New Zealand visited her family back in Aitutaki. There she befriended a boy whose family had a feud with her parents. One day she was possessed and had to be held down. She spoke in an altered voice assumed to be that of her deceased grandmother, and appeared to look menacingly at the boy. The girl was then rubbed with miri leaves and was soon cured. All these examples point up the connection between maki tEpiipaku and social conflict. In each case the person is possessed either because he or one of his relatives has engaged in some action that is either socially unacceptable or is unsatisfactory to one of the parties concerned. There are several commonly known methods of treating this possession type of maki tUpEpaku. --(1) Talk to the tupapaku to find out what is wrong. If the tupapaku expresses what is bothering it, then it may leave on its own accord. In one case told to the author, the tiip7ipaku was not malevolent, but just wanted to talk to her family. (2) Accede to the demands voiced by the tiipgpaku, if any are made, and if they are reasonable. (3) Give the afflicted person a bath of miri leaves, or if these are not available, then perfume will do (unless, however, the tiipZpaku is Tahitian, according to one source). Since ancient times it has been believed throughout Polynesia that ghosts hate strong smells, and it is likely that much of the use of medicinal plants reported by some of the early observers was for repelling ghosts. (In the one case of possession seen by the author, a boy in Samoa was force-fed a solution of the leaves of Morinda citrifolia, the Indian mulberry). Sometimes kbketa (Vigna marina) or rau tt (to leaves are used instead, the latter perhaps because of its aboriginal status as a plant sacred to the gods. Instead of being rubbed with ti leaf medicine, the patient may instead be hit with the leaves. Rubbing the body with kerosene has also been reported. When these strong smelling plants or substances are applied, the possessed person tries to escape, and because of the phenomenal strength exhibited while in this state, several strong people are needed to hold him or her down.

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(4) Squeeze certain points on the body - between the big and second toe, on the temple, under the chin, in the arm pits, or the back of the knees. This -is believed to somehow hurt the tupapaku (if not the possessed person!), and - may be related somehow to aboriginal ideas of how the tupapaku enters and exits the body (typically through the toes). (5) Read certain sections of the Bible, such as Psalm 17: 17, believed to be effective in exorcising the tiip&paku, which apparently can be treated like devils if, in fact, that is not why they are. Perhaps this is a vestige of the aboriginal practice of chanting by the tzuraatua healers. -(6) If all else fails, the grave of the offended and offending tupapaku can be set afire with kerosene, an action reportedly seen by several of the informants, but uncommon now. One informant reported seeing in the northern islands a grave that was instead being desecrated by piles of rotting beche d’mer on top of it. -Maoris also believe that tupapaku can come in dreams to people other than ta’unga. Many people consider bad dreams to be an omen, and bathe themselves in a solution of miri leaves whenever they occur, a practice that was also described to the author on Niue in Western Polynesia. As was stated earlier, the main function of ta’unga is diagnosis, but many also prescribe and/or administer herbal medicines as well. The most typical one they employ is a bath of miri leaves, but sometimes they will prescribe European medicine that must be obtained at the hospital or pharmacy. Many ailments are believed to be a combination of maki tangata and maki -tupapaku, and after treatment for the supernatural part, the ta’unga may send the patient to a healer or even to a hospital to heal the physical part. The ta’unga themselves diagnose and behave in different ways, but there are many similarities in their actions. They are usually themselves possessed by a spirit called a uaerua, according to MacKenzie (1973), a term defined by Savage (1962) as a “spirit, ghost, astral body: the spirit or soul, as of man”. -MacKenzie equates the uaerua with a tupapaku. The corresponding term in Tahiti is uarua, and according to Levy (1973), this and the term tiipZipa’u are very difficult to differentiate from each other, mostly because the differences are indistinct in the minds of the Tahitians themselves. In any case, the Maori ta’unga have one or more of these uaerua who provide the actual diagnosis. In most cases, there is a single uaerua, but others have three or more. In one case related to the author, the ta’unga had three -uaerua (the source, however, used the term tupapaku instead), one was a Maori, the second was apapa’h, and the third was an Indian. The Indian, in fact, could not speak English, so when he was making the diagnosis, one of the other two uaerua had to translate! The diagnosis is usually made by the uaerua speaking through the ta’unga who goes into a trance. When patients or relatives of afflicted persons visit, the ta’unga will appear to go into a trance, and will, like those afflicted with the one type of maki tiipEpaku, speak in the tongue of the uaerua. This may be in an old dialect (particularly when the uaerua is from the northern islands) or in Tahitian, but in the example above, it was supposedly in an

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Indian dialect. Typically, the ta’unga, who does not smoke, will do so, presumably because the vaerua did so in life. The ta’ungu’s eyes typically become bloodshot, and some sources report that the ears even stick out. When the trance is finished and the uuerua has departed, the tu’ungu recollects nothing of the happenings. What impresses many people who have dealt with the tu’ungu is what they believe to be the ability of the tu’ungu to know why they have come before they divulge their problem. Another method of diagnosis is by “reading” a deck of cards. MacKenzie noted this, and although she has seen similar diagnosis among the New Zealand Maoris, she was unable to ascertain its origin. Cards, of course, are a Western introduction to Polynesia. The author has heard the same method of diagnosis described on Niue, in that case by a Samoan healer. MacKenzie reported, and the author has substantiated, that in the diagnosis, the face cards represent people in the drama. MacKenzie noted that the ace of hearts represented a baby in the case (cases?) with which she was familiar, and the author’s informant noted that the ace of spades represented death, Ta’unga are also attributed with other psychic powers as well. MacKenzie recorded that they sometimes can find lost or stolen property, a belief that was also noted by the author during the interviews. The one tu’ungu that was interviewed by the author is in her early 60s and is from one of the outer islands. As well as being a ta’ungu, she is also the only person on that island who commonly practices herbal medicine, and for this reason she is respected regardless of some of her idiosyncratic behavior. -Her uueruu (tupapahu) over most of the year is a Tahitian boy who died at the age of 16, apparently in the last century. As the tu’unga told it (through an interpreter, since she does not speak English), the spirit met a relative of hers working on Makatea Island in the 194Os, came to her island by means of a “chant”, and became affiliated with her. The spirit is in almost constant possession of her, except during the 3-week period beginning a week before Christmas and ending a week after New Year’s Day. During that short interval, he goes up to heaven to get his year’s supply of remedies from God. Although seemingly reserved when possessed by the spirit, she is even more so when he is away. During the course of the interview, the interpreter asked the uueruu to temporarily leave the woman so that the author could see what she was like by herself. To this the uueruu consented; the woman put down her head for a moment, went through a short series of convulsions or tics, and when she came out of it, she was more reserved than before, no longer smoked, and wondered what she was doing at the interview. After a few moments of the “real” personality, the uueruu was summoned back, and the tu’ungu was back to her usual behavior. Interestingly enough, the uueruu speaking through the woman acknowledged that he spoke French (the woman had not been to Tahiti, and consequently had little opportunity to learn it herself), but when asked to demonstrate this ability, declined, professing to be too shy to do so. Although she may not be a typical example of a tu’ungu, her circumstances

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were discussed in some detail because met during the study.

she was the only one interviewed

or

Conclusion The modern day health care system in the Cook Islands is a combination of neo-traditional ways and Western medicine. Although of entirely different origins, the two systems treat some of the same afflictions, and today, after the Health Department has recognized that the native system may have some merit, there is a peaceful coexistence broken only when incidents occur in which negligence is suspected. The author has seen two medical practitioners look on while a healer plied her trade, with little concern over any possible ill effects the treatment might have had on the patient, whom they judged to be merely suffering from obesity and old age. Most of the healers will only treat cases for which they believe they have remedies, and do not hesitate to send the patient to the hospital or to other healers in cases they cannot treat. Despite over 150 years of contact with the Western world, and their inclusion into New Zealand citizenship, the Maoris still retain great faith in their native healers. They perceive that while the Western system is good and has conferred many benefits upon their country, their own system is also good in many cases - cases that the Maoris feel are not adequately treated by Western medicine. The two main disciplines in the neo-traditional medicine are the psychic healing of the ta’unga, who also do diagnosis and herbal treatment of ailments induced by t@Gpahu, and the healers who use herbal medicines in treating non-psychic ailments. About 50 different herbs are commonly used in herbal medicines, and these are shown in Table 1. These appear to have three main origins, those that were developed locally, those that were brought to the Cook Islands from Tahiti by Tahitians or returning Maoris, and those taken from the folk medicine of the Western world. The majority of the herbal remedies probably fit into the first type of origin. Most of the indigenous medicines developed over the last century and a half, but a few probably antedate the European era. A total of 49 plants commonly used in Maori medicine are listed in Table 1. Of these, about 35% are native, 43% aboriginal introductions, and 22% European introductions. This compilation of the herbs used in the native medicinal practices is just a first step. Although the possibility of new and effective drugs or medicines being discovered in the native pharmacopoeia is much less than in cultures with a larger flora and a longer tradition of herbal medicine, it is nevertheless important to document their uses and practices before these disappear - something, however, that has been incorrectly predicted for decades. Armed with this list, biochemists may one day study the activity of the Maori medicinal plants and determine if it is the medicine or the doctor that is doing the healing.

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Appendix: glossary of Maori ailments The ailments in this list were recorded by the author during the interviews. It is not, however, a complete listing of all the ailments recorded, because doubtful names used only once have been excluded. The number of times each name was used is found within the parentheses following the name. A’EI (6) - A body rash, possibly Herpes zoster (shingles), caused by a viral infection which follows the nerve roots around the body from back to front, usually on one side only. The Maoris believe that if it goes all the way around the body, death results. Also recorded by MacKenzie. ‘AKAMATE (1) - Stroke or paralysis. Called maki ‘ukamate by MacKenzie. ‘AMENE (1) - An axillary abscess, a boil in the armpit. This is also known as punua kiore. Also recorded by MacKenzie. ‘AMORE (1) - Cracks on the palms of the hands and between the fingers. ‘AT1 (22) - A fracture, which is a common ailment among the Maoris. It may also refer to things other than bones that are believed to be broken inside the body, or to improperly healed internal injuries. Recorded by MacKenzie as maki ‘ati. The Tahitian name for this is futi. ‘E’E (20) - A boil. See also umene, punuu kiore and tuupo. Also recorded by MacKenzie. The Tahitian name for it is fZf8. ‘EKE (3) - Diarrhea. Called muki ‘eke by MacKenzie. The Tahitian name of it is he’e. FUR0 (1) - Influenza. Literally, flu. Also recorded by MacKenzie. NGAO’I (2) - A sprain. IRA (12) - Apparently a general term for several ailments of babies, but there does not seem to be any uniformity of opinion as to which childhood ailments are classed as iru or how many kinds of iru there actually are. Called muki iru by MacKenzie. Also called iru in Tahiti, and ilu in western Polynesia. The types of iru that were recorded are listed below. IRA INU RANU (1) - An ailment of a newborn baby thought to be caused by the baby ingesting some amniotic fluid before or during birth. IRA MOE (2) - Some kind of baby’s ailment, possibly related to sleeping too much or too little. Literally, child’s sleep sickness. Called the same in Tahiti. IRA NI’O (4) - Ailments associated with a baby’s teething. Ni’o means tooth. Recorded by MacKenzie as muki ni’o. IRA ‘UNE (2) - An ailment of babies, probably the same as ‘une, a skin rash or itch. IRA ‘UT1 (10) - An ailment of babies characterized by convulsions or twitches ( ‘uti). ‘Uti by itself can mean tetanus or its convulsions. IRA VARU (5) - An ailment of children characterized by bluish veins on the forehead and excessive sleep, according to one source. This source noted that uuru in this sense meant eight. MacKenzie, however, noted this as a skin rash like iru pupii, an interpretation which may be supported by

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the other meaning of uaru -to scrape. In Tahiti, it means “convulsions with trembling”, according to Lemaitre. IV1 MARa (4) An infected puncture wound (such as from stepping on a fish bone), especially one on the hand or foot. This usually requires an incision. Literally, dry or hard bone. Also recorded by MacKenzie. KAKI MAMAE (5) - Sore neck. KARAPONGA MAMAE (4) - Sore throat. KEA (35) - Thrush, a common fungal mouth infection of children. Also recorded by MacKenzie. The Tahitian name for it is ‘ea. KEA IRA (2) - Possibly the same as hea. KEA TONA (3) - Extensive oral thrush with infected or inflamed throat. KIRITONA (1) -- A sty. Also recorded by MacKenzie. MANGE0 (2) - An itch or rash, such as prickly heat. MacKenzie noted that it is a rash that spreads all over the body. MAKI - General term for sickness or ailment. MAKI ‘AKAPUKU (2) - An internal swelling, possibly the early stages of a carbuncle or open, infected sore. Literally, swelling or protuberance. MAKI ‘OPT (3) - A urinary tract infection, especially gonorrhea. Also recorded by MacKenzie. The Tahitian name for it is ‘GpT MAKI RENGARENGA (1) -Jaundice and hepatitis. Recorded by MacKenzie as fiva rengarenga. Literally, “yellow sickness”. MAKI TOPAPAKU (12) - Ghost sickness, i.e. any ailment whose origin is attributed to the action of a ghost, usually that of a deceased relative. -Also recorded by MacKenzie. The Tahitian name for it is ma’i tupapa’u. MAMAE (5) - Pain. MAMAE KOPU (6) - Abdominal pain, a common ailment among the Maoris. MAMAE NI’O (1) - Toothache. Also recorded by MacKenzie. MAMAE TATUA (4) - Backache. Also called mamae tua, mamae te tua, or mohotua mamae. MacKenzie used the latter name. MARE (4) - A cough or bronchial congestion. Also recorded by MacKenzie. The Tahitian name is also mare. MARIRI (10) - A rash or inflammation, as that caused by filariasis. Also recorded by MacKenzie, and called by the same name in Tahiti. MATA MAKI (4) - Eye ailments. MATA PURA (5) - Having a foreign object in the eye. Also recorded by MacKenzie. MIMI (32) -Any ailment concerned with urination. Usually cystitis (bladder infection) which results in painful urination, but not accompanied by a discharge of pus as in gonorrhea. MIMI TATUA (7) - Pain in the back or renal area, usually associated with kidney problems. Also recorded by MacKenzie. MOTU (16) - A cut. Also recorded by MacKenzie. MmA (4) - Ringworm. Also recorded by MacKenzie. ‘OA (8) - Pain in the frontal area of the head, probably sinusitis or migraine.

Savage says that it occurs “in paroxysms usually accompanied by inflammation or fever sciatica1 pains”. MacKenzie noted it possibly as “menningitis of a sort”, and ‘oa’oa (which is probably a Tahitian rather than a Maori word) as migraine. In Maori, however, ba’oa means gladness or delight. Some informants recognize two types of ‘ou, ‘ou mu ‘unu which is probably migraine, and ‘ou miti or ‘oa tui which is a headache synchronized with the tides. OR0 MO’0 (1) - Term used by one source, apparently meaning a sore throat of some kind. Mo’o means lizard (gecko). This is probably a Tahitian rather than a Maori word, and was noted by Aitken (1930) as a sore throat. ‘OVIRI (5) - A fistula, possibly a symptom of syphyllis. MacKenzie defined it as an anal fistula. PAKAPAKA (16) -A burn. Also recorded by MacKenzie, and called pu’upu’u in Tahiti. PAKA TONA (2) - A dry scab or skin sore. PAKIA (2) - A bruise or abrasion, usually caused by a blow. PAPAKI (2) - An injury or ailment thought to be caused by the slap of a -ghost, hence, a type of muki tupupuku. PARARI (2) -- Defined by Savage as being smashed or wrecked, but the symptoms noted by one source who used this term more closely fit severe asthma. However, the word probably means miscarriage or post-partum problems as it does in Tahiti. Apparently called rumirumi on Atiu. POU A’0 (4) - Asthma or difficulty in breathing. Literally, “exhausted breath”. PU’A (5) - Described by one source as a boil with no eye, and by MacKenzie as a small painful swelling that is not inflamed, and is shiny when ready to open. On Tubua’i, Aitken notes that pu’u is an inflammation of the breast or abdomen. In Tahiti, pu’u refers to a carbuncle, abscess, or lymph node infection in the groin. It is apparently called pu’u roto on Aitutaki, which is the same name used by Panoff (1966) in Tahiti. PU’A TERE (3) - Possibly the same or similar to pu’u. PUNUA KIORE (2) - An axillary abscess, also called ‘Cimene. Literally, “baby rat”. PUPU (1) - A skin rash, sometimes scabies. Also recorded by MacKenzie. PUTA NO’U (9) -A painful puncture wound or sting from a stonefish (no’u). Also recorded by MacKenzie, and called put5 nohu in Tahiti. RAOA (3) - To choke on something or have a fishbone caught in the throat. Called the same in Tahiti. RIU (25) -- The slow or incomplete voiding of the afterbirth or blood in a woman after birth, or any problem with menstruation. Literally, “menstruation”. RUMATIKI (1) - Rheumatism. Called muki rumutiki by MacKenzie. RUAKI (l?) - Vomiting. Also recorded by MacKenzie. Ruuki toto means vomiting blood. Eruuki means an emetic - to cause to vomit. It is also called ruuki in Tahiti, and puu’i in Samoa.

TARINGA MAMAE (5) - An ear infection, probably otitis media. TAUPO (4) - A carbuncle. Also recorded by MacKenzie, and called by the same name in Tahiti. TIRA (2) - Impotence, possibly due to physical factors such as the retraction of the genitals. Also more specifically called tiru nguro and tira moe. Recorded by MacKenzie as maki tira or tira ngaro. TO’E KURA (8) - Anal thrush, often occurring at the same time as the oral thrush. The most common symptom is a red rash around the anus. Literally, “red anus”. TO’E TOPA (1) - Prolapsed rectum. TO’E TUPU (10) - Hemorrhoids, or sometimes the same as to’e topa. Recorded by MacKenzie as maki to’etupu. TOKETOKE (1) - Intestinal worms, also called toke. Also recorded by MacKenzie. TONA (6) - Scabby sores on the body, sometimes referring to yaws, which is more precisely called tona re’ure ‘u. Recorded by MacKenzie as maki tona. It is called by the name throughout most of Polynesia. TOT0 KAKE (3) - High blood pressure. TOT0 KAVA (3) - Hypertension. TOT0 VENE (2) - Diabetes. Also recorded by MacKenzie. TUI (8) - An ear infection oozing pus, and sometimes said to be the same as tui kai roro. Fever, according to Savage. In Tahiti, it means otitis, an ear infection. TUI KAI RORO (11) .- Severe headache, sometimes with nausea and high temperature. Possibly meningitis. Literally, “fever that eats the brain”. TUPITO (18) - An abdominal pain centered around the navel; very common, and sometimes quite painful. The symptom most often mentioned is a “jumping” or pulsation around the navel. Also recorded by MacKenzie. In the Austral Islands, Aitken described it as an infant’s inflamed navel. TUTAE MAR0 (3) - Constipation. Literally, “dry or hard stool”. Also recorded by MacKenzie. ‘UA ROT0 (3) - An abdominal pain caused by a diaphragmatic hernia which forms a lump under the stomach. One source, however, thought this was gallstones. Also recorded by MacKenzie. Literally, “testes inside the abdomen”. UAUA (10) - Muscle pains, neuralgia, or cramps. Called by the same name in Tahiti. ‘UNE’UNE (4) - Scabby, crusty skin disease similar to tona, also called ‘une. Also recorded by MacKenzie. Acknowledgements The author would like to express his appreciation to the Pacific Tropical Botanical Garden for the grant used for this research, Also, he is also greatly indebted to Tau Taripo, Dr. Metua Terita’iti, Dr. Teariki Tamarua and Ta’iti Marekino for their valuable help during the research and preparation of the

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manuscript, orthography. information, this paper.

and to Rangi Moeka’a for his assistance with the content and Also greatly appreciated are the others who added their valuable and the healers whose interviews are the core and substance of

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