From J. Stanley Gardiner (1898), "The Natives of Rotuma," Journal of the Royal Anthropological Institute 27:491-496.
The Rotuman of the present day is singularly ignorant of even the most elementary medicine and surgery. As before pointed out (p. 468), the priests were the doctors; it was a mystery handed down from father to son with the office. When Christianity began to be taught, and white men settled on the island, the mystery was guarded still more carefully, and most of the art has unfortunately now been lost. At the present day medicines are dispensed by the Roman Catholic priests and the Commissioner, but Fijians resident on the island are very generally called in, if the patient does not recover instantaneously.
The great Rotuman cure for every pain or ache in the body is massage of a very severe nature, either with cocoanut oil or the oil of the hifo nut (Calophyllum inophyllum); usually a small quantity of the second is applied, and then the part rubbed vigorously with cocoanut oil. Cold water too for many ailments is much believed in. Recourse in fevers used to be had almost at once to cold water bandages, a piece of the native cloth often being left in the water to act as a sort of wick, to keep the whole damp and cool. The natives have no vessel in which water can be boiled, except the shell of the cocoanut, and hot water, too, is never used. It was only by threats that I could get any native to allow me to use hot water for washing any wound or sore, and hot poultices were invariably taken off immediately I left the house. Native poultices are made of the leaves of the taro and hibiscus crushed up; I was also informed by Marafu that they used to be made of dried arrowroot and the dried seed of the Tahitian chestnut, and that a certain amount of turmeric was always mixed with these. The great cure, though, for all wounds and sores is to roast them for several hours in front of a slow fire; I found the skin of one man with acute sciatica absolutely shrivelled up and burnt along the left side from this, massage having been tried first and failed. The practice of cutting the body where any pain is felt, which is common in Fiji, I never found any traces of.
The most prevalent disease in Rotuma is undoubtedly yaws, or framboesia, known generally under the Fijian name of coko, though I also heard the Polynesian name, tona, applied. It is said by the older men to have been an introduced disease in comparatively recent years. Certainly the older people of both sexes do not seem to have so many or such large scars from it as the younger generations, and on some no traces of it are to be seen. The fact, that the disease is due to inoculation, is well known to the natives, whom I have known encourage their children, when they have reached the age of about two years, to play with other children, who have the disease, in order that they may get it. Commonly the child gets exceedingly feverish, and then suddenly a number of pustular sores break out, particularly on the face, hands, and round the waist. The child may be in danger for some days after this, but usually the fever quickly dies down; the sores increase in size, and probably cover the whole of the mouth and nose, reaching a maximum in about a couple of months. They then gradually commence to dry up, and if the cure does not take place too rapidly, no further danger need be apprehended, except in combination with extraneous circumstances such as teething, etc. If the sores, when they first break out, are healed too quickly as by European antiseptic treatment, they tend to break out again in a much more virulent form, and death often supervenes, or else permanent disfigurations of the face, particularly the nose, or even blindness or lameness. The natives say that it is a growth, which has to come out, and that, if it is not allowed to do so properly, it will continue to grow in the bones and deeper tissues. If the child passes to manhood and then contracts the disease, it is generally fatal, or else leaves the man so shattered in health, that he falls a victim to the first epidemic. The child is carefully guarded for the first year and a half against the disease, and then the sooner it comes, the better the parents are pleased. No remedies are applied by the natives, but great care is taken to keep the child cool and damp, when feverish, and its bowels open; a purgative draught used to be made from the fruit of the papaw and certain leaves, but now large quantities of castor oil are sold by the stores. A person, who has once had this disease, enjoys afterwards complete immunity from it; I have seen a mother feed from her mouth a child, whose lips were all swollen with it, without any injurious consequences to herself.
Terrible ulcerations of the skin of the body and limbs, particularly the leg, are not uncommon among adults, especially women, but they seem to be easily cured before the age of from forty to fifty years; they are probably of a granulomatous nature, and are mainly due to the neglect of sores caused by dirt, poisoning from coral, etc. Such sores always at first fester, but, if carefully kept clean and open, heal in a month or two. They are very much neglected by the older people, particularly the women, are often left uncovered and encouraged to heal over quickly, only to break out later perhaps all over the limb, a putrid mass of flesh full of maggots; the mischief has probably now extended to the bone, the foot doubles up, the limb shrivels, and all hope of cure may be abandoned. Similar ulcerations also occur among women, not uncommonly about the age of forty-five, in the breasts; it is in no way of a cancerous nature, as no disease of that kind is known. For all these sores, washing daily with a strong solution of corrosive sublimate has a wonderful effect, especially if accompanied by doses of potassium iodide. I cannot resist the idea that really these ulcerations and yaws are of a syphilitic nature and give immunity from this disease, which is absolutely unknown on the island; other diseases of a venereal nature too are very rare, owing to the extreme cleanliness of the women.
There is a consensus of opinion among the natives that coughs, colds, pleurisy, and pneumonia have been introduced to the island in this century. This is scarcely likely, but from trustworthy testimony I think there has been a great intensification of them in recent years, due to changes in the mode of life. Undoubtedly, though, phthisis has been introduced in quite recent years; it is a disease of the nature and duration of which the people are absolutely ignorant. I saw myself on the island six cases of it, all in a more or less advanced stage; three were women who had borne children, a fourth was a woman about twenty-two years of age, and the other two were boys of from seventeen to nineteen. Both of the latter cases were in Malaha, where the disease is especially prevalent, owing undoubtedly to the cold damp land breezes at night, its villages being protected to a large extent from the trade winds; I found also in Malaha two undoubted cases of goitre, a disease which I do not remember to have seen in any other district.
Tokalau ringworm (Tinca desquamosa?) was very prevalent formerly in the island, but, owing to European methods of treatment, has now become uncommon. In early stages it is readily destroyed by iodine, but chrysophanic acid is quicker, better, and more effectual in the later stages. Besides this, the skin often shows more or less ramifying patches of a lighter tint, but without any desquamation. In some cases these yield to the same treatment, and are, I think, due to a different Tinea or some other parasite; in other cases they are perhaps the after-effects of the regular Tokalau ringworm. The only native method of treatment is massage with oil, especially after bathing in the salt water.
Fevers of a malarial nature are not uncommon on the island, but they are much confused with the fevers which always accompany elephantiasis; they are especially prevalent on the leeward side. They are certainly distinct from the fevers of elephantiasis, though this disease usually quickly supervenes and is considered as the result of them. I saw two cases of such fevers, the patient in one case having had them for about two years, and in the other case for longer than he could remember, but in neither case were there any visible signs of elephantiasis. I saw two cases, too, among children of what seemed to me to be mild typhoid fevers; the two houses were within a stone's throw of one another.
Elephantiasis is certainly the worst disease that the adult Rotuman has to contend with; it affects the Europeans in the island equally as much as the natives. It attacks the men in particular, at least 70 per cent over the age of forty years having it in a more or less virulent form; of women over the same age I should think not more than 20 per cent are affected. Among the men it takes the form in particular of elephantiasis scroti. Of twenty-eight men, fifteen had it in the scrotum alone, nine in the scrotum and legs, three in the scrotum, legs, and arms, and one in the arms only. I never saw any cases among men where the legs were affected without the scrotum also being enlarged. The scrotum does not, as a rule, grow to a very large size until the man gets old, probably owing to the fact that it is usually kept bound up by cloths. When it becomes too large, recourse is had to lancing with a shark's-tooth lancet. In the old days, too, the same instrument was, according to Marafu, used to remove the scrotum, the operation being performed in front of a huge fire and taking about two days. The legs and arms, too, used to be cut right down the surface, the cicatrices being supposed to prevent them from swelling further. Among the women the disease is not nearly so prevalent, but it seemed to me that usually both arms and legs were affected. I saw one case of the form, known as pudendi. From the way it was spoken of, I do not think it is of exceedingly rare occurrence on the island. The second attack of the fever usually comes about six months after the first; then the attacks increase until perhaps they occur for a short period fortnightly, after which they gradually decrease in frequency. There is a distinct increase in size of the organs affected after each attack. Inquiries as to the origin in individual cases gave me such replies as "A night's fishing on the reef," "Sleeping in the bush," etc.; most could give no cause or only supernatural ones.
Periodical epidemics of bad eyes pass over the island; the cornea gets clouded, and sight is considerably impaired. A few drops of sulphate of zinc twice a day in the eyes usually effect a speedy cure; the native remedy is the raw juice of a certain tree with large palmate leaves. Cases of blindness from this disease are now quite common owing to neglect.
Serious diseases other than the above, except such as are of an epidemic nature, are almost unknown. Dysentery passed through the island in 1882, but does not seem to have made a permanent lodgment; constant requests, on the other hand, are made for opening medicine, and doses of four ounces of castor oil are often necessary to give relief. Among the women the menstrual period is often accompanied by headaches, nausea, and amenorrhoea, or stoppage of the menses. In many cases, though, I believe, these are due to native medicines, possibly preventative, administered by the old women.
The lancets are made with the pointed or serrated teeth of the shark, as desired, tied firmly on a slightly flattened piece of wood, about the size of a pencil, the tooth never being bored. The point of the tooth is pressed on the gathering it is desired to open, and then hit sharply by a piece of stick to drive it in. Broader teeth, with serrated edges, were used similarly mounted for operations in which cutting was required.
It may be interesting to note that I examined the blood of eight males, in six of whom I found the Filaria sanguinis hominis; the other two were boys, aged about sixteen and nineteen.