LEPROSY NOT HEREDITARY
The opinion of students of the disease is now almost universal—that leprosy is communicated by contagion, and by contagion alone, though it has not yet been determined how the contagion is communicated. Very few of the nurses and doctors in leper asylums acquire the disease, and, except in one doubtful instance, every attempt to inoculate man and the lower animals with theBacillus lepræhas failed. It may be that the leper-germ is sterile except in certain phases of the disease, and that only in favourable conditions in the recipient's health, combined with intimate contact with the leper, can the disease take hold.
Modern opinion, therefore, holds that leprosy is contagious, and, in a sense, hereditary also in so far as it tends to cling about certain families whose members show a constitutional readiness to receive it. I have dwelt upon this opinion at some length in order to show that this is precisely the view which the Fijians themselves take of the disease. A man is said to come of akawa ni vukavuka(leprosy-stock), which implies no disgrace except among the highest families, and if he develops the disease his misfortune is regarded as one of the family traits as inevitable as the shape of his nose. At the same time he is believed to have the power of infecting others (not necessarily by actual contagion), and he was generally made to live alone or with other lepers, at a distance from the village. In Tonga the contagious nature of leprosy was fully recognized, and the lepers were isolated on separate islets or uninhabited parts of the larger islands. It is there a grave breach of good manners to apply the word leprosy (kilia) to any one in polite society, and many ingenious shifts are resorted to in order to express the meaning without using the word. In the session of the native parliament of 1891, when a member of the upper house was discovered to be suffering from the disease, and a resolution to assign an island to himas asylum was passed, I covered myself with shame by unwittingly pronouncing the forbidden word after other speakers had been skirmishing round it for fully half-an-hour after this fashion—"Havea's friends were pining for him at home, and therefore it was but right that he should be excused further attendance at the house; nay, more, to the westward lay many delightful little islands which Havea was longing to visit, where his every wish would be gratified, and where—well—the prevailing wind would blow pleasantly from them to him, and he would be supremely happy."
The Fijians are no exception to other primitive races in believing that neither death nor disease can overtake a man naturally. Their first reflection on seeing the condition of the patient is, "An enemy hath done this!" their second, that the enemy must be discovered and punished, and his malignity neutralized by counterspells. It is not a logical theory of infection, because in their simple creed it is generally not necessary that the infecting agent should himself be suffering from the disease. But in the case of leprosy, as in their laws for the sexual abstinence of parents and for securing the sanitation of villages, they arrive at right conclusions from wrong premises. Leprosy, they argue, is inherent in certain families, therefore the evil spirit of leprosy, which is their equivalent for contagion, is a sort of family retainer, ever obsequious to the commands of his hereditary masters. And, since a living spirit must live somewhere, certain stones in various parts of the country are pointed out as his shrines, and are hedged about with a tabu that is never in danger of infraction, inasmuch as to touch them is to meet Gehazi's fate. The existence of these stones was discovered by Dr. Bolton Glanvill Corney, C.M.G., the Chief Medical Officer of Fiji, who is not only the principal authority on all medical questions in the Pacific Islands, but has a very accurate knowledge of the Fijian language and character. He has visited and described the stones himself, and has elicited from their owners on the spot such traditions concerning them as they still remembered or cared to tell.
STONES THAT IMPART LEPROSY
Until within the last few years there were three leper stoneson the river island of Tonga near the mouth of the Rewa river. One, called Katalewe, was vested in a family called Navokai, now living at Navasa village, but formerly of Nankavoka (the Skull), a deserted entrenchment that lies back from the river-bank behind the present site of Mbulu village. Two miles distant is a second stone, called Toralangi, who is said to be stillin situ, though Dr. Corney did not actually see him. The third stone, known as Ratu, was missing from his former position, the cleft between two buttresses of andawatree, and, although to the consternation of the native bystanders Dr. Corney was bold enough to dig up the ground in the hope of unearthing him, he was not to be found. This is the less to be regretted since Ratu was a peculiarly active little stone. When the Notho warriors were storming Nankavoka village, one of them unwittingly dropped hismasi, which lighted upon Ratu. It is said that he became a leper in consequence. The leper woman Mereani, wife of the chief of Navasa, who had her plantation within a few yards of Ratu, is said to have acquired the disease by working in his neighbourhood.
Katalewe was described to Dr. Corney as having been (for he exists no more) "about the size of a large orange or small shaddock, very round and smooth, ash-coloured, homogeneous in substance, and unlike any other stones in the neighbourhood," which, being soft alluvium deposited on old mangrove swamps, is singularly free from stones. So potent was he that the creeping stems of plants withered or turned aside as soon as they came within the radius of his poison, and a patch of ground surrounding him, about the size of a sponge-bath, was always destitute of vegetation. None knew whence he came. As long as tradition ran he had been vested in the Navokai family, now extinct but for Karolaini, a married woman about forty years of age, living at Lukia. This woman told Dr. Corney that her father, Totokea, long since dead, was a leper, and that she developed the disease in childhood. She had lost all the phalanges of three of the toes of her left foot, and had besides an extensive patch of anæsthetic skin on the right thigh. A "wise woman" of Bureitu hadtreated her for leprosy, and she had observed tabus on and off for some years. By the time she was old enough to marry the disease had ceased to make any advance; the stumps of the toes were healed; she could walk without lameness; and the patch on the thigh had begun to regain its natural colour. After marriage there was no return of the disease. Dr. Corney examined her, and found sensation to be perfect all over the patch, and the left foot perfectly sound except for the loss of the toes. She was quite convinced that her leprosy was hereditary, and did not result from contagion, and that she would have died of it but for the ministrations of the "wise woman" of Bureitu. She had two children (the eldest about nine when Dr. Corney saw them), and both were healthy.
THE CURSE OF KATALEWE
Katalewe's owner (taukei ni vatu), that is to say, the senior member of the Navokai family, could harness the power of the stone to his own needs if he had an enemy to injure, or to his own profit if other people had enemies and were willing to pay for his services. It was not necessary that the doomed person should himself be made to touch Katalewe; it was enough if the victim's clothing, or hair, or scraps of food he had been eating were laid against the stone with suitable prayers by thetaukei ni vatu. The victim would then develop leprosy, but the mode of operation was not the same with all the leprosy stones, as will presently appear. It remains to relate the fate of Katalewe, who has now lost all power to harm. There came to Mbulu a pious enthusiast to represent the Wesleyan Church, a certain Sayasi, a native of another village. "Hors de l'eglise; point de salut," was his motto, and, Katalewe's natural protectors having died out in the direct line, he laid violent hands upon the unprotected stone, and carried him home in derision for his wife to use like a paper-weight for keeping down the mats she was plaiting. When not in use he was thrown with the other weights into the fire hearth, where he fell a prey to the consuming element and crumbled away to powder among the yam-pots. He did not leave the indignity unpunished. The poor iconoclast not long afterwards had his mind racked bythe indiscretions of his wife, divorced her, and found himself ostracized by his fellow-pastors in consequence, and finally, a broken man, he relinquished his cure, and returned to his native village, where death soon afterwards put an end to his sufferings. From this tragic story one fact is patent—that Katalewe was made of limestone, and since there are but two kinds of limestone in Fiji, coral and dolomite, and coral would have been immediately recognized by the people of Tonga village, it is evident that Katalewe must have been a fragment of dolomite washed down from the head-waters of the Rewa river, and polished smooth by the action of the water. A stone so unusual in the delta would naturally be an object of remark; it might be taken to decorate the grave of a dead leper, and, when time had obliterated all other traces of the grave, tradition would still cling about the stone—the one feature of the forgotten grave that would survive to catch the eye of successive generations. As the graves of ancestors are the vested property of their descendants, so the leper stone, and together with the Djinn that was believed to inhabit it, would belong to the seed of the original leper for ever.
In Noikoro, near the chief village of Korolevu, almost in the centre of the great island of Vitilevu, Dr. Corney found another leprosy stone, called simply Na Vatu-ni-Sakuka (the Leper-stone), a large basaltic rock having upon it natural markings in which the natives see a resemblance to the leprousmaculæon the human skin. Among the Vunavunga people to whom it belonged, and who formerly lived near to it, there are several bad cases of leprosy. The stone was vested formerly in one Mbativusi (Cat-tooth), a leper, but on his death it passed into the hands of Rasambasamba, hisvasu,e.g.a man whose mother belonged to Mbativusi's family, and to his children. Their family is called Nakavindi, and the elder of the Nakavindi family, beingex officioproprietor of the stone, is held to have the power of conferring leprosy upon whom he wishes. His dreadful powers are, of course, invoked secretly: the offended person comes to him with a root ofyankona, whale's teeth, bark-cloth, or mats, praying him to impart the disease to hisenemy. The leper-priest lays them on the stone with incantations (veivatonaki) for a successful issue. Then, returning home, he drinksyankona, and in blowing the dregs from his lips and moustache, cries as his toast—"Phya! Uthu i au!" which, being interpreted, is "Phya! May his face be as mine!"i.e.leprous; and speculation would run high as to who was the object of the curse. When the curse failed there was, as in all similar public impositions, an easy way out. No doubt Elijah slew the priests of Baal because he knew that in five minutes they would have been ready with a plausible excuse for their failure to call down fire from heaven. The leper-priest could always plead the inadequacy of the offering (which, of course, became his perquisite), and ask for more, or decline to make a second trial. All the leading men of the Nakavindi family, which, be it remembered, is only a collateral branch of the original proprietors of the stone, have leprosy in its most terrible form.
Dr. Corney found another leper stone lying in the silt of a small stream, Nasova creek, about a mile and a half from the village of Nankia, in the Sawakasa district. Part of its surface was rough, and the smooth portion was interrupted with three ripplings or corrugations which the natives calledvakalawarikoso. The village where the family to which the stone belonged was living proved to be a leprous centre from which the disease appeared to be radiating to the other villages in the neighbourhood. As this stone appears to have neither history nor malign influence, it is possible that it owes its name to its macular markings and its situation near a leprous centre.
A GRISLY STORY
Near Walá, a village about three miles from Fort Carnarvon on the opposite bank of the Singatoka river, is another stone, or rather collection of stones, for they are described as forming a miniature cairn of red stones like jade. As the cairn stands within the burial-ground of part of the Walá village, it may be actually a grave. The natives are very reticent about it; I lived for more than a year in almost daily intercourse with the Walá without hearing of it, and Dr. Corney, who went to see it after hearing of it from the Mbuli of the district, was adroitly put off the scent by his native guides. He learned its history under somewhat dramatic circumstances. Being called one day to examine a number of native prisoners recently admitted to the prison in Suva, he found that one of four lepers among them gave Walá as his native village. With the permission of the Superintendent of Prisons, he took the young man to the hospital in order to question him at leisure, and there, with the unknown terrors of prison discipline before his eyes, his reticence gave way. The gist of his replies to Dr. Corney's questions as taken down at the time was as follows:—"My name is Namanka; I come from Walá, but my family belongs properly to Talatala in Vaturu. They left Talatala in heathen times when Vaturu was burned out by the enemy, and took refuge at Sambeto, but my father and mother fled to the hills and settled at Walá, where we have lived ever since. I have one brother older than myself, and he, my father, and my mother are all lepers. My father was Kuruwankato; he died a few months ago at Keyasi, whither he had gone for treatment for leprosy. His hands were withered and contracted, there were ulcers and blisters upon them, he had lost his fingers and toes, and had patches upon him that had lost all feeling. He had no brothers; I have no uncles, and no leprous relations except my father, mother and brother. My father was the first to show symptoms. This was the way of it. On a certain day, several years ago, we all went out into our plantation, and left the house empty. Not even a child was left to keep the house. I was but a small boy at the time, but I often accompanied my parents to the plantation. When we returned in the evening we saw that the Sakuka (the Leprosy) had crossed our threshold. He had entered by the end door, and had crawled to the hearth, and there in the ashes of the hearth we saw the prints of his hands and his feet, the prints of leper hands (mains-en-griffe) and toeless feet like hoofs. Thus we knew that the Sakuka had put his mark upon our house, and wondered which of us was to be the first. We knew that we should be lepers, being thus marked for it by the Sakuka, and my father was the first, my mother next, and I was last of all.The Sakuka is a stone, red like a patch of leprosy, red like red paint. It is in five or six pieces, heaped together. Sometimes a piece is missing from its place at Navau. I have been at the burial-ground myself when a piece was missing, and have seen that it was so. Vasukeyasi is proprietor of the stone; he is not a leper, but Kaliova, who also has a vested right in it, is. Vasukeyasi is priest of the stone, and he can move it to infect a person with leprosy, and so compass his death. I do not know what forms or ceremonies he uses when he would do this, but it is a sort ofkaitha(witchcraft). When I said that the Sakuka marked our hearth I meant the spirit of the stone which is obedient to Vasukeyasi. The thing is true; there is no doubt about it. I do not know the origin of the stone; it is an ancient institution. I have told you all that I know about it."
In this grisly story we have the essence of the belief in leper stones. The cairn of strange red stones set up in a burial-ground can be none other than a tomb, probably the tomb of a leper. The spirit of the dead man haunts the site of the grave, and his eldest descendant is his priest. His priest can conjure him forth in corporeal shape to crawl into the house of a person whom he has foredoomed to leprosy. This, of course, is no explanation of themain-en-griffein the ashes on the hearth. That episode may have been a coincidence or it may have been a lie; but that a family of healthy aliens came to live in the neighbourhood of a leper stone, and were infected one after the other by means which every native believed to be the malignant ministrations of the priest, was indubitable fact. And if we smile at his theory of infection, let us remember that it is logical reasoning as compared with our own in his eyes, and that he can point to more lepers in support of his plan of infection by incantation than we can adduce as the result of inoculation with thebacillus lepræ.
Dr. Corney heard of two other leper stones—one at Navitiviti in the Mbure district, Ra province; the other near Mbukuya, fifteen miles north of Fort Carnarvon. There may be others in Vanualevu and elsewhere.
DROPSY STONES
Two instances of stones sacred to other diseases have been met with by Dr. Corney. One of these is situated near Narokovuaka, on the Wainimbuka branch of the Rewa river, and the other in the Tonga district, the home of Katalewe, the leper stone. They are both calledvatu-ni-bukete-vatu(dropsy stones). Abdominal dropsy is generally termedmbukete wai(water pregnancy), but when very tense it becomesmbukete vatu(stone pregnancy). The latter term is also applied to abdominal tumour, which, though a rare disease among the Fijians, is occasionally met with. In neither case does the stone appear to take an active part in imparting the disease to which it is sacred. Probably it was the menhir of some chief who died of the disease, or some fancied similarity to the symptoms of the disease was noticed in its shape.
It must not be supposed that the natives as a whole have as matured a theory to account for the dissemination of disease as might be gathered from the foregoing account of the leper stones. Few of them have turned their thoughts to the subject; even the youth who described the visit of the "Sakuka" had not speculated upon what motive the proprietor of the stone could have had in letting loose his horrible familiar upon the unoffending family. His reasoning went no further than this: that they had leprosy, and he supposed that it was the leper stone that did it. It was only when Dr. Corney asked the question that the youth remembered that the leper-priest had the power of conferring the disease, and that he thought of connecting the fact with his own case. So with the doom that overtook the iconoclast teacher; the natives related his destruction of Katalewe and his subsequent fate as totally unconnected episodes. The occult powers of Katalewe were so much a commonplace of their lives that, when Dr. Corney translated his notes to them, they were astonished that any one should think it worth while to collect the scattered fragments of information they had given him into a connected narrative.
It is, therefore, scarcely correct to say that they hold decided views upon the manner in which leprosy is transmitted. Most of them would say that they had never thoughtabout it, and if pressed for an opinion, would point to its prevalence in certain families as a reason for thinking it hereditary. Natives of places where there are leper stones believe it to be the heirloom of the family connected with the stone, or the work of the leper-priest when the disease appears in other families for the first time. But among the coast tribes there seems to be a strong suspicion that lepers breed contagion, since in many districts lepers are compelled to live by themselves in the bush. This has long been the belief of the Tongans, and it is possible that Tongan immigrants have impressed their views upon Fijians, since it is more marked in the Lau Islands, where the Tongan influence is strongest.
A painful case came to my notice in 1887 at Lakemba. A leper had been driven out into the bush, and his wife had been in the habit of taking food to him daily. Her relations, having failed to dissuade her from what they regarded as a practice dangerous to themselves, told her at last that she must choose between their society and his, for that if she persisted in visiting a leper, she would be debarred from ever returning to the village, but must live thenceforth in the woods like a wild animal. The poor woman refused to abandon her husband, and the relations came to me to ask whether she could not be legally restrained from thus cutting herself off from all that makes life worth living to a native. She was brought before me, and as soon as I had satisfied myself that she was acting of her own free-will I forbade any one to interfere with her liberty of action. The husband was described as suffering from nodular leprosy. He had been isolated, not from horror at his appearance, for men afflicted with lupus in as revolting a form were allowed to live in the village, but from fear of contagion.
In places where isolation is usual lepers conceal their condition as long as possible, and it is not uncommon to hear that so-and-so is strongly suspected of leprosy because he will never take off his shirt to work, and avoids bathing in company.
LEPERS IN ISOLATION
There are, as most people know, two kinds of leprosy,nerve and nodular. Nerve leprosy is manifested by patches of discoloration on the skin in which all sensation is destroyed, and the Fijians suffer so much from scrofulous affections that this symptom may be easily passed over. Nor is nerve leprosy, at any rate in its early stages, revolting in appearance. Nodular leprosy, on the other hand, which often attacks the face, and is far more horrible in appearance, is unmistakable, but it is less common in Fiji than nerve leprosy or a mixture of the two.
The isolation enforced by the Fijians appears to correspond with the practice of the Hebrews and Philistines, who drove the pauper lepers without the city gate, but let the high-born leper alone. Ratu Joseva, Thakombau's son, like Naaman, still maintained a household of retainers. The lot of the isolated leper in Fiji is not a very hard one while he has strength to move about. A hut is built for him in the bush; firewood is abundant; wild yams are to be had for the digging, wild fowls and pigs for the trapping; he can pick the best land for his plantation. But when the poor wretch loses the use of his legs an awful fate may await him. A horrible story is told of a leper on the Tailevu coast who had lost all sensation in his feet. Waking by his fire one morning he noticed a smell of roasting flesh, and wondered for some moments whence it came, until, when he moved himself to look out of the doorway, he noticed that the logs in the fire-place stirred, and saw that his own feet had been lying in the fire, and were burned to cinders.
FOOTNOTES:[95]The greater part of this chapter is drawn from an able paper contributed to theFolklore Journal, 1895, by Dr. Bolton G. Corney, Chief Medical Officer of Fiji, who has made a special study of the subject.[96]White.[97]Manson,Tropical Diseases.[98]Voyage aux iles du Grand Ocean, par. J. A. Moerenhout. (Vol. ii, p. 156.) Paris, 1837.
[95]The greater part of this chapter is drawn from an able paper contributed to theFolklore Journal, 1895, by Dr. Bolton G. Corney, Chief Medical Officer of Fiji, who has made a special study of the subject.
[95]The greater part of this chapter is drawn from an able paper contributed to theFolklore Journal, 1895, by Dr. Bolton G. Corney, Chief Medical Officer of Fiji, who has made a special study of the subject.
[96]White.
[96]White.
[97]Manson,Tropical Diseases.
[97]Manson,Tropical Diseases.
[98]Voyage aux iles du Grand Ocean, par. J. A. Moerenhout. (Vol. ii, p. 156.) Paris, 1837.
[98]Voyage aux iles du Grand Ocean, par. J. A. Moerenhout. (Vol. ii, p. 156.) Paris, 1837.
While the decay of custom has been hastened by the introduction of new diseases, it has not been accompanied by any attempt to eradicate the old.
Chief among indigenous diseases (if diseases introduced before contact with foreigners may be called indigenous) is yaws, called by the Fijiansthoko, or by its Malayo-Polynesian name—tona, and by various dialectic modifications of that word, which is also used in Tonga, Samoa, Tahiti, and many other Polynesian islands.
The disease is but little known to the medical profession in Europe, either in practice or in medical literature. Its medical designation isFrambœsia, so called from the strawberry-like eruptions that accompany it. By the French it is called "Le Pian." In Great Britain it is now extinct, but in the Hebrides and in the south-west counties of Scotland it was met with under the name of "sibbens," or "sivvens," as late as the beginning of the nineteenth century.
THE SYMPTOMS
It is common throughout Africa, Malaysia and Polynesia. Being contagious, it was carried by means of the slave traffic from Africa to tropical America and the West Indian Islands. From the east coast of Africa and Madagascar, about 340 years ago, the Dutch or Portuguese traders carried it to Ceylon, where it still bears the name of "Parangi Lede" or "Foreigners' evil." Hamilton noticed it in Timor in 1791, saying "it seldom terminates fatally and only seizes them once in their lives."[99]Crawfurd, who wrote in 1811-1817, noticed it in Java.Dr. Martin, the able editor ofMariner's Account of the Tonga Islands, writing in 1810, was the first to recognize the identity oftonawith yaws, though he never saw the disease. But the existence oftonawas recognized by Captain Cook and numerous other visitors to the South Seas during the last and the beginning of the present century, though they were not aware of its real nature.
The premonitory symptoms of yaws are, as a rule, insignificant and obscure; the appearance of one of the sores is generally the earliest indication that a child is infected, but adults have noticed pains in the limbs, fever, restlessness, or languor. The first sore, called thetina-ni-thoko, or mother-yaw, is usually a large one about half-an-inch to an inch in extent, and is often surrounded by a group of smaller sores. It generally appears on the site of some wound or scratch, more often about the lips. Those that follow are generally developed upon some part of the body where the skin is delicate, such as the neck, the groin, or the axillæ, or in parts where the true skin joins the mucous membrane. Doubtless the lips of children are first infected owing to the child's habit of putting the hands to the mouth, the hand being the part most likely to come in contact with the virus of another child.
After an uncertain interval a crop of pabules, or in some cases blebs, begin to appear, the face and the parts already mentioned being their favourite point of appearance. If the eruption begins with blebs the case is spoken of asthoko se ni niu(cocoanut flowerthoko, from the resemblance of the eruption to a spray of the unexpanded flowers of the palm).
In the next stage a soft warty excrescence, which is the matrix of the sore, pushes its way through the true skin by forcing it aside rather than breaking down its substance. On reaching the surface the granulations which form this out-growth exude a fluid which is highly contagious. It forms in time a crust or scab, the reddish appearance of which is very characteristic of the yaws eruption. If this be removed by means of oil or a poultice, the granulated surface of the sore beneath it has that resemblance to a raspberry or mulberry which has given the name ofFrambœsiato the disease. Insome cases the crust assumes a curvilinear outline, recalling the appearance of the well-known Pharaoh's serpent. These are especially seen about the corners of the mouth, the neck and the axillæ, and constitute thethoko ndinaor true yaws. In other cases they retain a circular shape on all parts of the body, and are then calledthoko mbulewaor button or limpet yaws. During the healing process they become converted into annular or horse-shoe patterns, the centre receding before the periphery.
The sores may remain for two weeks or they may persist for fully two years. Throughout the progress of the case they may number anything from one to several hundred. The commonest number is from six to twenty or thirty. Weakly and ill-nourished children take the disease more easily than strong ones. While the active symptoms seldom last for more than two months, the dormant features last much longer, and some of the tertiary consequences may appear at almost any age.
The chief ill effects fromthokoare dysentery, diarrhœa, and marasmus; sometimes the joints are implicated, even the larger ones, such as the wrists, knees and ankles, and partial paralysis may follow; pot-belly is a frequent concomitant, andtabes mesentericaare believed to follow it. In a later period of life the feet of those who have had yaws as children become affected by the disease, and on account of the thick and horny skin by which the soles of shoeless races are protected the extrusion of the growing yaw through the sole becomes an acutely painful process. Not only do the typical granulations known assuthuviandsokiforce their way through the skin, but the sole is also liable to a cracking and peeling form of excoriation calledkakatha, which is nearly as painful and is also said to be contagious. The Fijians do not recognize the connection between any of the sequelæ of yaws and the original disease, and hence perhaps the indifference with which they regard it.
MODE OF INOCULATION
An idea of the serious nature of yaws may be gathered from the cases in which it has been contracted by adult Europeans. Such cases have been numerous enough in Fiji to impress theEuropean settlers with dread and disgust. In most of these cases the disease has permanently shattered the health of the person attacked, its tertiary effects simulating those of neglected syphilis, for, while no less severe, they have proved quite as ineradicable. They are shown in permanent impairment of the digestive functions, emaciation, inflammation of the bones or joints, intractable ulceration, and marked constitutional weakness, thus producing liability to other diseases such as diarrhœa, dysentery and pneumonia, and not infrequently ending in death. From this it may be readily imagined that the consequence of yaws to native children can be anything but trivial. With Europeans as well as with natives an attack is more likely to pass off easily when contracted in childhood than when taken in adult life. The most favourable age for getting over it safely seems to be between two and three years.
Yaws is communicated by the inoculation of virus from one of its characteristic raspberry-like sores to the abraded surface of the skin of another person. But, though the natives have never discovered this for themselves, they do not, as in other diseases, attempt to explain yaws as the work of a malignant spirit. The fact is that they scarcely believe yaws to be a disease at all. They think that if a child makes a good recovery it becomes more plump and healthy than one who has never had the disease. Mothers are pleased when the first symptoms make their appearance, regarding it as the best thing that could happen to their children to set them on the high road to a vigorous manhood, provided that the disease is not contracted at too early an age. At Mbau, however, the chief women appear always to have recognized the contagious nature of yaws. They say that in former time the children of high rank were not allowed to enter the houses of common people or play with their children, and in consequence of this exclusiveness they seldom contracted yaws until they were of an age to resist its ravages. Thus some escaped it altogether, and the majority had it very mildly. Andi Alisi and Andi Ana are cases in point, so were the late Andi Kuila and Ratu Joseva. Now-a-days there is scarcely an exceptionto the rule that every Fijian child contracts yaws. Whatever may have been the case formerly, it is now quite common for children to contract the disease while suckling and teething; not infrequently before they can crawl, and even at as early an age as three or four months. When this happens the eruption sometimes recedes prematurely; this is the only danger feared by the natives, who usually attribute the recedence tondambe,i.e.incontinence on the part of the parents, or toramusu(internal injury). When the eruption recedes, as it undoubtedly does in some cases, the child becomes sickly and feverish and subject to diarrhœa, and whether these symptoms be spontaneous or secondary, death is more often the result in these cases than in others. The native treatment is purely empirical: native drugs are administered in the expectation of causing the eruption to reappear, but if the attack pursues its normal course no attempt is made to heal the eruption; on the contrary, it is intentionally abandoned to the chances of easy and plentiful development. In very severe cases natives have occasionally made application to the European medical officers; but, as a rule, it is only when the eruption has almost disappeared, and only one or two of the sores persist, that the Fijian mother will allow any interference with it. The usual native treatment in such cases is to apply a poultice of the leaves of thelewe ni sau, or some other native herb. The more modern practice is to heat a piece of rusty hoop iron red hot and to rub a cut lemon on it, and then to apply the rust-stained juice as a mild escharotic. It is said that in West Africa the natives use a decoction of iron filings in lemon juice, with the addition of ants and a portion of the pepper plant for the same purpose. As the old Fijians had no metals, it is possible that they have learnt the recipe from Europeans who have read of it.
CHILDREN PURPOSELY INFECTED
The Fijians do not claim to have any positive remedy for the cure of yaws, nor, indeed, do they desire any. They are satisfied that native medicines suffice to "drive out" the eruption if it has prematurely receded, and that if they do not succeed in such cases the child will die. The great body of the people cannot be made to grasp the idea of inoculation.While some admit that yaws can be caught from one person by another, others assert that the cause is intrinsic and that every Fijian child must, or ought to, develop it, and that it is solely a Fijian disease about which white men are naturally ignorant. In Mathuata the "wise women" administer medicines to bring on the disease in cases where children do not readily contract it. They believe that the occurrence of yaws in a child of a proper age—from two to six years—is a good augury for the future physical strength and mental vigour of the subject, and they think that persons who escape its contagion will grow up stupid, clumsy, and dull (dongandonga), and useless mentally and physically. The fear of contracting disease in adult life, when it affects the patient far more severely than in childhood, disposes the Fijian mother to look favourably on the acquisition of the disease in infancy. They are, indeed, far more anxious that their children should contract yaws than are the uneducated mothers of English factory towns that theirs should contract measles. The desire of getting over inevitable diseases during childhood is the same in both cases, but the Fijians have less excuse, for yaws is not only a far more virulent disease than measles, but it might be far more easily stamped out if the Fijians could be disabused of the idea that it "grows out of the child." In the days of slavery, from commercial considerations, the West Indian planters insisted on segregation in yaws-houses, and were partly successful in keeping the disease under control. But as soon as the West Indian negro was emancipated and permitted to revert to his own careless life, the disease began to gain ground very rapidly.
It is impossible to estimate the mortality directly due to yaws. In the yaws-hospitals of the West Indies the mortality amounted to less than the annual death-rate of the islands. When it occurs during the first year of childhood in Fiji it is almost invariably fatal. Indirectly, there can be no doubt that it is sapping the vitality of the whole native race. Some authorities—Hutchinson, for example—hold that it is possibly syphilis modified by race and climate. Syphilis is practicallyunknown among the Fijians, but although there are many points of difference that prove the two diseases to be distinct, it is highly probable that, from its close relationship to syphilis, yaws has an enervating effect on the child-bearing functions of the native women.
Though it would now be extremely difficult to stamp out the disease, much might be done to keep it under if the natives could be convinced of its contagious nature. In the mountain districts of TholoTinea desquamans, orTinea imbricata(Tokelau ringworm), which infected nearly 25 per cent. of the native population a few years ago, has now so far yielded to the efforts of the people themselves that it has been almost entirely stamped out in some of the provinces. As soon as they were convinced of its contagion, and understood that the Government would supply remedies to those who chose to pay for them, they buckled to the work in earnest, and needed little driving by European officials.
FOOTNOTES:[99]A Voyage round the World in H.M.S.Pandora, by Mr. George Hamilton, surgeon. Berwick-on-Tweed, 1792.
[99]A Voyage round the World in H.M.S.Pandora, by Mr. George Hamilton, surgeon. Berwick-on-Tweed, 1792.
[99]A Voyage round the World in H.M.S.Pandora, by Mr. George Hamilton, surgeon. Berwick-on-Tweed, 1792.
The tubercular taint in the Fijians, though less marked than among some of the Polynesian races to the eastward, is sufficient to influence the vitality of the race by impairing its power of resistance to other diseases, both in children and adults. It is seen in the form of phthisis, strumous ulcerations, chronic bone diseases, and most commonly as strumous ulcerations of the face, nose, pharynx, or throat, which is named tubercular lupus. More rarely it appears astabes mesentericain infants, tubercular peritonitis, and tubercular disease of the internal organs.
All these forms of tuberculosis are more common in the windward parts of the group, in Kandavu and in Thakaundrove, where the Tongan admixture is strongest; they are less common in Western Vitilevu and in the mountain districts, but even in these, where the Melanesian blood is purer, tubercular disease is far from uncommon. Half-castes are especially tainted with struma in all its forms, and from this it would appear that the Fijian does not bear crossing with the European, for while the negro-Fijian half-caste is usually healthy, the English Fijian cross is peculiarly subject to phthisis, lupus, and chronic disease of the bones.
Pulmonary tuberculosis occurs as hæmorrhagic phthisis, as acute, rapidly breaking-down pulmonary tubercle of young adults, or as chronic fibroid phthisis in older men and women. Though the returns of the Colonial Hospital do not show alarge number of deaths from this disease, it is probable that many die after returning home after a period of treatment, and in the outlying districts may die without making any attempt to get to the hospital.
Lupus, though it may make its appearance at any age, is developed most commonly at puberty, and is most destructive in its results from fifteen to twenty-five or thirty. It attacks the face, nose and neck, and it usually destroys the fauces, palate and pharynx; the soft palate is entirely destroyed, and the only remains of the pillars of the fauces are scars of cicatricial tissue. The mouth then appears as a vast cavern instead of being filled with the usual structures, and the nose may be entirely eaten away. The disease is commoner among women than among men. I remember seeing a family of high rank in Lakemba, whose women were remarkable for beauty. The sons were fine, sturdy fellows, to outward seeming quite untainted, but of the three daughters the eldest had no face, the second was marred by a depression at the root of the nose, betokening the first ravages of the disease, and the third, a girl of sixteen, was the most beautiful girl in the island. "She will soon be like the others," they told me; "they were more beautiful than she is, and look at them now!" It was comforting to notice that her impending fate did not seem to damp her enjoyment of the hour.
Strumous ulcerations of the limbs are the commonest diseases in Fiji. Thus, out of 621 cases admitted to the hospital in 1892, including people of many races and every kind of disease, there were 104 cases of "ulcers" in Fijians alone—the total number of Fijians admitted being only 246; that is to say, more than 40 per cent. of the Fijians were admitted for ulcerations of strumous origin. This disease, which the natives callvindikoso, takes the usual form of an indolent, excavated ulceration, sometimes extending down to the bone. It generally runs a slow course, and when of large size, the resultingcachexiais serious. It is generally left uncovered, or at most wrapped in a filthy piece of native cloth, and unwashed for days together—a fruitful breeding-ground for flies and parasites.
FIJIANS ARE TAINTED WITH STRUMA
To the same taint are due tubercular glandular enlargements, chronic disease of the bones, with deformity and enlargements, necrosis of the long bones, and the tuberculosis of abdominal glands, which is believed to cause many deaths among children, and not improbably also tubercular diarrhœa both in children and adults.
Yaws (thoko) occurring in children of tubercular parents is probably intensified, and children whose constitution has been weakened by a prolonged attack of yaws are more prone to die of some form of tuberculosis. It has also been noticed that adults who bear the scars of severe yaws in childhood are more prone to contract some form of tuberculosis in after-life.
The possible identity in the origin of all these diseases offers a wide and most interesting field for scientific investigation. It is but a step, for instance, from yaws to syphilis, and from syphilis to strumous diseases of bone and skin (especially those prevalent among the Pacific Islanders), and from struma to pulmonary or general tuberculosis. If such an investigation be too long delayed there is the danger that the races who furnish the material may have ceased to exist.
The undoubted facts are these:—
(1) That the Fijian race is tainted by various forms of tubercle, acquired and inherited;
(2) That the taint is more marked where there is an infusion of Polynesian or European blood;
(3) That females are more affected than males;
(4) That the disease is on the increase;
(5) That the inherent debility of the race is partly due to this taint.
FOOTNOTES:[100]I am indebted to Dr. Lynch, who has made a special study of the subject, for the medical portion of this chapter.
[100]I am indebted to Dr. Lynch, who has made a special study of the subject, for the medical portion of this chapter.
[100]I am indebted to Dr. Lynch, who has made a special study of the subject, for the medical portion of this chapter.
The necessity for bartering commodities, which is one of the earliest needs of primitive society, was met by the Fijians in an original manner. Nomad tribes, who are perpetually at war with their neighbours, and are not self-supporting, satisfy their wants by raiding and plunder; settled agricultural tribes in the same condition invent some artificial condition under which combatants may exchange their goods to their mutual advantage. Thus, in south-eastern New Guinea there are settled markets on the tribal frontier fitted with counters of saplings on which the women of either side may lay their goods and barter them without fear of molestation by the warriors, for the ground is strictly tabu, and neither side would dare to commit the sacrilege of striking a blow within its precincts.
In Fiji the natural productions of the country led to localizing of industries. No tribe, however wide its territory, was entirely self-supporting. Salt came only from the salt-pans in the mangrove swamps; cooking-pots from the clay-pits on outlying islands; the painting ofgnatuwas an art peculiar to a few; the carving of bowls and the building of canoes were the craft of the carpenter clans and no other. The comfort, if not the existence, of a tribe depended upon barter, and the form of barter devised by the Fijians accorded exactly with their passion for formal ceremonial.