CHAPTER XVI.

THE LEPER SETTLEMENT.

WHEN

THEN you arrive in Honolulu, you are warned and with no apparent reason, that leprosy is a word not to be mentioned in polite society. Leprosy exists, as is well known, though almost exclusively among the natives. The whites occasionally contract it, it is supposed, by inoculation, where there is abrasion of the skin; but only those whose systems have been vitiated by dissipation seem susceptible to the taint, although there are again exceptions where the apparently healthy are attacked. The latter instances, I have been told, are exceedingly rare. Leprosy seems to defy all ordinary rules, both in the manner of its appearance and development. Leprous parents have children who are free from the disease and in whom it never appears. A man on Molokai married in succession two leprous women, both of whom died and both of whom bore seemingly healthy children. The husband did not himself contract the disease. I had a conversation with an intelligent young physician connected with the Hawaiian Board

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of Health relative to the Receiving Station which is located at Honolulu. It can always be visited by special permit from the Board of Health, which is not difficult to obtain. There were eleven hundred cases then on Molokai, and probably a few among the natives on the other islands which had not been apprehended. The most careful surveillance was exercised, and every precaution was taken to isolate patients as soon as the disease presented itself. This it had been difficult to do. The Hawaiians are a peculiarly affectionate race, and the removal of the sick to Molokai is a parting which must be as final as the death which it foreshadows.

It is one of the sheriff's official duties carefully and regularly to inspect the natives and report to the Board of Health those whom he believes to be suffering from the disease. To facilitate this work each island is divided into Sanitary Districts, which are carefully patrolled. When cases are apprehended, they are taken into custody and brought to the station. They are then examined by the surgeons in charge. This is a delicate task, for occasionally the apparent symptoms are deceptive. If the board of five examiners are all of the opinion that the patient is a leper he is sent to Molokai. If there is doubt he is examined at intervals until a decision is reached.

"The natives are seemingly without the slightest fear of the disease," said my informant.

"I have

1893.]

FIRST SIGNS OF LEPROSY

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seen the sound eating out of the same bowl of poi with a leper who had lost two or three fingers. The evidence of leprosy did not excite their fear any more than it affected their appetite. They will hide the sick in their huts, or take them up into the mountains, where they can be kept out of the way and more securely concealed for many months. When they are taken into custody and sent away, their friends gather at the dock to bid them farewell, and it is a heart-rending scene. They express their sorrow in poignant lamentation - a national wail which is so harrowing that I avoid hearing it whenever it is possible. No matter how far the disease may have advanced, though it may have attacked the nose and lips, it sometimes requires official interference to prevent the friends and relatives kissing and embracing the lepers who are to be sent into banishment, and whom they know they will never see again.'

"How does the disease first show itself?"

"By discoloration - white spots on the lower limbs usually. Then there is a depression of the muscles between the thumb and index finger - a wasting that continues until all the fingers bend backward, shrivel, and drop off. The face also takes on a bluish pallor. Blotches appear upon the forehead above the eyes, which assume an abnormal appearance. The lobes of the ear are frequently much elongated until amputations are necessary, the dis

eased portion being sometimes four or five inches in length. Eruptions that do not heal are another form, and the lips become drawn and pitted, with hard swellings over the brows, and the nose is reduced to a shapeless mass; it is often eaten entirely away. This also happens to other portions of the face. Strangely enough the patient does not always suffer, and there are many instances where the terrible disease is said to be entirely painless. The lepers. are maintained on Molokai at the expense of the Government. Comfortable houses have been furnished them and unlimited poi, and apart from the separation from their friends and families, to which in time they become reconciled, their lot is not considered one of unmixed misery."

The Hawaiians are a light-hearted people, and find amusement in every diversion that offers. Their songs and their love of flowers are a natural instinct, and they are like children in the simple joyousness which evinces itself in their manner and in their smiling countenances. Grief does not rest heavily upon them, and the bereavement which follows everlasting separation from home and friends finds speedy consolation in the formation of new ties. Their friends, in turn, similarly console themselves when they are bereft. Upon arriving at Molokai the lepers are permitted to found new families- dreadful as it Leprosy is a statute ground of divorce. And in this land of death there are speedy betroth

seems.

1893.] CHEERFULNESS OF THE LEPERS.

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als, marrying and giving in marriage, and some births, although not many, as leprous women seldom have children. The children remain in Molokai unless there is reason for the authorities to believe they are free from the taint, when they are permitted to go to any one of the other islands or are cared for at government expense at the "Kapiolani Home" in Honolulu, until they become of age. I have characterised these leprous marriages as dreadful, but in reality they are little worse than the perpetuation of vice and hereditary degeneracy and physical disability which is permitted without restriction in all civilised countries. Dr. R. Oliver is now the resident physician - a terrible existence, one may well believe, in this literal Valley of the Shadow of Death. The presence of disease, however, does not affect the inhabitants, who are well fed and well clothed, and who here, as elsewhere, crown their disfigured and ghastly heads with flowers. Dogs and horses are allowed them, apparently, without limitation. They take no thought for the morrow, and they have no cause to feel anxiety as to wherewithal they shall be fed and clothed. Food in abundance and clothing and shelter are theirs as long as they live; and, although doomed, they probably reason logically enough that, even in this event, their lives may be extended beyond that of the apparently sound and able-bodied whom they have left behind them.