Nicholas Senn.

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the jungles in impregnating the flower of the
vanilla-bean and gathering fruits, wounds prone
to infection with the tetanus bacillus are of fre-
quent occurrence.


Malarial diseases are comparatively rare, al-
though the plasmodium-carrying mosquitoes are
numerous and aggressive, and children in the
country districts are nude^ and the men limit their
clothing to the wearing of a loin-cloth. No case
of typhoid fever has been known to have orig-
inated in the island. For this there exists a sat-
isfactory explanation. The exemption in this
island from this disease, so widely distributed
over the entire part of the inhabited globe, is
due entirely to an abundant supply of the purest
drinking water supplied by the numerous moun-
tain streams. Nearly all the inhabitants live on
the coast, near the outlet of a brook or stream,
where, consequently, there is no danger whatever
of v/ater-contamination. I found three cases of
typhoid fever in the Military Hospital, members
of one family, who had been brought there from
one of the neighboring atoll islands.

Varicose veins, varicocele and hydrocele are
very common. The absence of anything like a
large ulcer in many cases of large and numerous
varicose veins of the leg, I attributed to the
toughness of the skin of the bare legs. Venereal
diseases are widespread throughout the entire
island, and more especially in Papeete and the
near-by larger villages. For over a hundred years
the natives have suffered from this scourge
brought there by the European sailors and ad-
venturers. Syphilis has been transmitted from


generation to generation until it has contamin-
ated the major part of the population, for

The gods visit the sins of the fathers upon the
children. Euripides.


The wickedness of a few brings calamity on all.

PuBLius Syrus.

The length of time the disease has existed
among the natives has established a certain
degree of tolerance or immunity, as it pursues a
comparatively mild course, as I found very few
instances of the ravages of the remote results
of syphilis. I saw only one case of saddle nose,
caused by tertiary syphilis.

Leprosy is not as prevalent as in the Hawaiian
Islands, but isolated cases are found in nearly
all the islands belonging to this group, being more
prevalent in some than in others. Segregation
has never been attempted. The lepers mix freely
with the members of their families and neighbors,
and are not shunned by any one. I was informed
that many of the lepers, much disfigured by the
disease, seek an island where many of these un-
fortunates have founded a colony for the purpose
of escaping from public gaze. There, away from
relatives and friends, they spend their short span
of life and await patiently the final relief which
only death can bring.


O Death, the Healer, scorn thou not, I pray.
To come to me; of cureless ills thou art
The one physician. Pain lays not its touch upon a
corpse. ^SCHYLUS.

Elephantiasis in its worst forms has taken a
firm hold on the natives, especially the inhabitants
of the near-by island of Moorea. There this dis-
ease can be studied in all its stages, from a slight
enlargement of one of the extremities to colos-
sal swellings, which, when the upper and lower
extremities are affected at the same time, make it
necessary for the patient to crawl on his hands
and feet in dragging himself from place to place.
Regarding elephantiasis as it exists in Tahiti and
the other islands of the French colony, I will
make use of a few extracts taken from a valuable
paper on this subject by Dr. Lemoine, recently in
charge of the Military Hospital, and published in
one of the government reports. According to
this author, who has seen much of this disease in
Tahiti and surrounding islands, it may affect
most regions of the body, and not infrequently
makes its appearance as an acute affection with
all the symptoms characteristic of lymphangitis,
including quite a violent continued remittent
form of fever, which lasts two or three months.
The acute form is, almost without exception,
complicated by synovitis of the joints of the
affected limb, which he regards as almost pathog-
nomonic of the disease, differentiating it from


ordinary forms of lymphangitis. After the sub-
sidence of the acute symptoms and in the chronic
form the disease is essentially a chronic lymph-
angitits, accompanied by marked enlargement of
the veins. According to his observations the
regions most frequently involved are the lower
extremities, external genitals, and lastly, the
hands and forearms. Three years ago I was
given an opportunity to see at the hospital and
poorhouse at Antigua, West Indies, ninety cases
of elephantiasis, and not in a single one of them
did the disease affect the upper extremity, while
in th» French colony of the South Seas this is
not infrequently the case. I do not know that
a satisfactory explanation has ever been given
why the disease should behave so differently in
fixing its location in the two groups of islands.
Lemoine, as well as other writers on elephan-
tiasis, has seen the disease become stationary by
the removal of the patient to a colder climate.
Europeans become susceptible to elephantiatic
infection after a prolonged residence in tropical
countries where the disease prevails.

Lemoine does not agree with Manson, who
believes that elephantiasis is caused by the
Filaria sanguinis, and is suspicious that the essen-
tial parasitic cause is a yet undiscovered microbe.
He made blood examinations night and day of
patients under his care, and was unable to con-
stantly detect the filarise in their embryonic state



in the peripheral blood, and consequently claims
that the presence of filaria in the organism is not
an infallible diagnostic indication, and that their
abundance is not proportionate to the intensity
of the disease. The fact that the elephantiatics
improve in colder climates he regards as another
proof that filariasis is not the essential cause of
the disease.

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


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


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


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



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

In speaking of medicine he says :

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

In referring to the few indigenous diseases
he adds :

But this was before the arrival of the Europeans;
for we have added to this short category a disease
which abundantly supplies the place of all the others ;
and is now almost universal [syphilis]. For this they
seem to have no effectual remedy. The priests, indeed,
sometimes give them a medley of simples ; but they own
that it never cures them, and yet, they allow that, in


a few cases, nature, without the assistance of a physi-
cian, exterminates the poison of this fatal disease, and
perfect recovery is produced. They say that a man
affected with it will often communicate it to others in
the same house, by feeding out of the same utensils,
or handling them, and that, in this case, they frequently
die, while he recovers; though we see no reason why
this should happen.

On his fourth voyage to the Society Islands
Captain Cook learned to what fearful extent
syphilis had spread throughout all of the islands
of the group and became aware what ravages it
had caused among the natives. On visiting new
islands he did all in his power to protect the
natives against this scourge by excluding all
women visitors from the ship and by strictly en-
joining persons known to be infected from land-
ing. On the probable effects of these new regu-
lations he comments:

Whether these regulations, dictated by humanity,
had the desired effect, or no, time only can discover.
I had been equally attentive to the same object when
I first visited the Friendly Islands; yet I afterward
found, with real concern, that I had not succeeded, and
I am afraid that this will always be the case, in such
voyages as ours, whenever it is necessary to have a
number of people on shore.

Massage as a remedial agent in the treatment
of disease originated in the Orient, and the Ta-
hitians were familiar with it and frequently made
use of it. On this subject Captain Cook can
speak from personal experience. During his stay



in Tahiti in 1777 he suffered evidently from a
severe attack of sciatica, the pain extending from
the hip to the toes. King Otoo's mother, his
three sisters and eight more women came on his
ship one evening for the purpose of giving him
treatment and remained all night to fulfill their
v/ell-meant mission. Here is the account of the
treatment to which he was subjected by the

I accepted the kindly offer, had a bed spread for them
upon the cabin floor, and submitted myself to their
directions. I was desired to lay myself down amongst
them. Then, as many of them as could get around me,
began to squeeze me with both hands, from head to foot,
but more particularly on the parts where the pain was
lodged, till they made my bones crack, and my flesh
became a perfect mummy. In short, after undergoing
this discipline about a quarter of an hour, I was glad to
get away from them. However, the operation gave me
immediate relief, which encouraged me to submit to
another rubbing down before I went to bed; and it
was so efficient that I found myself pretty easy all the
night after. My female physicians repeated their pre-
scription the next morning, before they went ashore,
and again in the evening, when they returned on board ;
after which, I found the pains entirely removed, and
the cure being perfected, they took leave of me the
following morning. This they call romee, an operation
which, in my opinion, far exceeds the flesh-brush, or
anything of the kind that we make use of externally.
It is universally practised amongst the islanders, being
sometimes performed by men, but more generally by


Tahiti is not an Eldorado for doctors. The
entire island has only eleven thousand inhabitants
and the great majority of them are too poor to
pay for medical services. The only place in
Tahiti where a doctor can be found is in Papeete,
At the time I visited the island there was only one
physician in private practice in the capital city,
Dr. Chassaniol, a retired naval surgeon, the only
private practitioner in the whole group of islands.
The bulk of medical practice is in the hands of
the government physician, always a military man
who has at the same time charge of the Military
Hospital and takes care of the sick poor, and
supervises all matters pertaining to sanitation.
The only other physicians in the island are the
naval surgeons on board a small man-of-war
almost constantly anchored in the harbor of
Papeete. The government physician is privileged
to practice outside of the hospital, and from this
source he receives the bulk of his income. As
the resident physician and the government phy-
sician are the only qualified physicians in the
whole archipelago, it requires no stretch of the
imagination to realize that until the present time
the French government has not made adequate
provisions for their subjects who require the
services of a physician.




The Tahitians have not lost their faith in their
Kahunas or native doctors, who without any
medical knowledge, practice their art. These
men, with a local reputation as healers of disease,
are to be found in nearly every village. They are
well thought of and are influential members of
society in their respective communities. Like the
medicine-men of our Indians, they make use of
roots, bark and herbs as remedial agents, and the
natives, like many of our own people, have more
faith in this mysterious kind of medication than
in modern, concentrated, palatable drugs pre-
scribed by the most eminent physician. To the
credit of these native medicine-men, it must be
said that they give to all afflicted who apply for
treatment not only their services, but also the
medicines without any expectation of a financial
reward or even the gratitude of their clients.


The military hospital at Papeete is the only one
in the French colonial possession of the Society
Islands, numbering one hundred and sixty-eight
islands and containing thirty thousand inhabi-
tants, of whom eleven thousand live in Tahiti.
As some of these islands are more than one
hundred miles apart, it is somewhat strange that
the French government has not taken earlier
action in establishing small cottage hospitals in
a number of the larger islands, as in case of
severe injuries or sudden illness the natives of
the distant islands are not within reach of timely
medical aid and the transportation of a sick or
injured person to Papeete from the far-off islands
or villages by small schooners or canoes is neces-
sarily slow and in many instances dangerous.
The Sanitary Commission now stationed in the
islands will, it is to be hoped, act promptly in
remedying this serious defect in the care of the
sick natives.

The Military Hospital at Papeete is an old
structure of brick and cement, situated near the
v»restern limits of the city in a large square yard
inclosed by a high stone wall, surmounted by a
crest of fragments of glass, which imparts to the
inclosure a prison-like appearance, the austerity
of which, however, is much relieved by beau-


h6pital militaire 145

tiful tropical trees, shrubbery and flowers in front
of the entrance and in the courtyard. The hos-
pital proper comprises seven buildings, only one
of which is two stories high. The hospital has
accommodations for forty beds. The officers'
rooms contain two beds each ; the remaining space
is divided into small wards for privates and
civilians. In one ward, the windows of which
are strongly barred, are kept the military prison-
ers, and another small ward is devoted to ob-
stetrical cases. The rooms and wards are well
ventilated and clean, the beds comfortable; the
hospital furniture otherwise is scanty and antique.
The drug-room is large, richly supplied with
capacious jars, mortars of all sizes, herbs, roots
and a complete outfit for making infusions, de-
coctions and tinctures, which reminds one very
vividly of an apothecary shop of half a century
ago. This department is in charge of a phar-
macist who, besides mixing drugs, does some
chemical and bacteriological work in a small and
imperfectly equipped laboratory. The operating-
room is an open passageway between two adjoin-
ing wards, and all it contained suggestive of its
use were an operating table of prodigious size
and decidedly primitive construction, and, sus-
pended from the wall, a tin irrigator, to which was
attached a long piece of rubber tubing of doubt-
ful age. The hospital is well supplied with water,
and contains a bathroom, a shower-bath and



modern closets. The hospital is in charge of the
government physician, who is always a medical
officer of the colonial troops, detailed for this
special service, usually for a period of three
years. From the official reports I gleaned that
on an average this institution takes care of about
three hundred and fifty patients a year. At the
time of my visit the number of patients did not
exceed fifteen, among them one in the prison
ward. All of the patients were the subjects of
trifling affections, with the exception of three
cases of typhoid fever sent to the hospital from
one of the atoll islands. The patients are being
cared for by three Catholic sisters and orderlies
as they are needed. The poor are admitted gra-
tuitously ; private patients pay from six to fifteen
francs a day. The hospital is beautifully located
on the principal street of the city and faces the
charming little harbor. A small private hospital
for the foreign residents and tourists is needed
here and under proper management would prove
a remunerative investment.


O Christ! it is a goodly sight to sec

What heaven hath done for this delicious land.

Byron. .

The wealth of Tahiti is on its surface. Its
moimtains are not pregnant with precious metals
nor has nature stored up in their interior material
for fuel and illumination, as none of these are
needful to make the people content and happy.
The Tahitian has no desire to accumulate wealth ;
the warm rays of the sun reduce the use of
fuel to a minimum, and the millions of glittering
stars and the soft silvery light of the moon in
the clear blue sky create a bewitching Hght at
night, which, more than half of the time, would
make artificial illumination a mockery. Then,
too, Tahiti is the land of gentle sleep and pleas-
ant dreams, where people do not turn night into
day, but rise with the sun and retire soon after
he disappears in the west behind the vast expanse
of the ocean. God created Tahiti for an ideal
island home and not as a place for get-rich-quick
methods, speculation and bitter competition for
business, for

Where wealth and freedom reign, contentment fails,
And honor lacks where commerce long prevails.




Tahiti's fabulous wealth consists in its inex-
haustible soil and the perennial warm, stimulating
breath of the tropic sun. It is the island of
never-fading verdure and vigorous and never-
ceasing vegetation. The fertile soil, the abundant
rainfall throughout the year, the warm sunshine
and the equable climate are most conducive to
plant-life and here these conditions are so har-
monious that there can be no failure of crops in
the Lord's plantation. There never has been a
famine in Tahiti, and there never will be, pro-
vided the government protects the magnificent
mountain forests — nature's system of irrigation.
Tahiti's food-supply is select and never-failing^i
and is furnished man with the least possible
exertion on his part. The bounteous provisions
nature has made here for the abode of man are
a marvel to the visitor and after he has once
seen them and has become familiar with them he
can not escape the conclusion that he is in
A land flowing with milk and honey.

Jeremiah xxxii:22.

The food products and fruits grown in the
forests without the toil of man are admirably
adapted for the climatic conditions, being laxa-
tive and cooling, and undoubtedly account for the
excellent health of the natives before the invasion
of the island by the Europeans. The island was
destined for the natives, and the natives were
suited to the island.


Man's rich with little, were his judgment true;
Nature is frugal, and her wants are few;
These few wants answer'd, bring sincere delights;
But fools create themselves new appetites.


Content with what the sea and forest provided
for them, these children of Nature lived a happy
life, free from care, free from morbid desires
for wealth or fame.

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