Traditional Treatment: Mavaeua & Tapitopito

Ancient Treatment of Unclosed Fontanels: Too Advanced for Modern Civilization?

Collecting Tongan medicinal plants was never an easy task, especially for a child who was just learning how to count, but looking back into those experiences, I am grateful that I did see them being used for the benefits of others. One of those experiences that I can recall was the collection of a funny looking, stemless plant, Centella asiatica L., commonly known as tono. Tāpitopito and mavaeua are two different types of diseases occur in babies, who are treated with this plant, tono. Tāpitopito is a Tongan name given to a condition of newborns in which there is hollowness around and discharge from the umbilical area. Similarly, mavaeua is a Tongan name for unclosed fontanel’s which may become hardened if not treated, resulting in other complications, deform head and/or sometimes death.

The leaves of the tono plant were bounded with a small volcanic rock on top of a much bigger one and both the juices and the smashed leaves were applied topically on the area that is affected, around the navel (pito) area or where the unclosed fontanels are located. Further, the leaves and the juice were sometimes mixed with the leaves and juice from the Oxalis corniculata plant, commonly known as kihikihi.

These two plants, tono and kihikihi, have shown their efficacy, and their potencies, in treatment of tāpitopito and mavaeua for over two thousands of years among our people and other Polynesian. That is real human clinical trial, unlike the double cross-over placebo control clinical trial of our time. Those plants worked, then and still are. We must continue to use them for sometimes Western medicine cannot cure these diseases and/or fall short in its promises, especially when side effects are taken into considerations. Consequently, we cannot, and should not, question the wisdoms of our ancestors but hold them up as heroes for our time, even in this great country. Concomitantly, we must share these types of treatments, and other treatments like these, with the younger generations. Do you think that our ancestors’ practice of medicine has proven to be superior to those of our days? You be the judge!

However, one must ask the question if he or she is curious enough, why were those plants effective, and they still are, in treating these two diseases? I believe that part of the answers come from science. It has been shown that the tono plant has wound healing, antibacterial, antifungal, anticancer, and antiviral (Yoosook et al., Phytomedicine, 2000 Jan;6(6):411-9) and anti-inflammatory effects (Medicinal Plants of the South Pacific). As such, this plant’s anti-inflammatory, antibacterial, and antiviral and wound healing effects are responsible, at least in part, for its health benefits shown in the treatment of tapitopito and mavaeua. Interestingly, the cosmetic industries are “mining” this plant because of these health benefits for the skin while the dietary supplement industries are “mining” for its anti-inflammatory.

On a side note, this plant (tono, an extract was used) have been investigated and evaluated for its effects on leprosy (kilia) and found to be effective (Medda et al., Indian J Biochem Biophys. 1995 Jun; 32 (3):147-51). It seems like to me that we have a lot of medicinal plants in Tongan that could have been used if we have known to help us during that time of trouble.

In like manner, the kihikihi plant has also been shown to have hypoglycemic (good for treatment of diabetes-suka), antihypertensive (lowers high blood pressure-toto mau’olunga), chronotropic effect (affecting the heart rate-māmalie pē vave ‘a e tā ‘o e mafú), wound healing and brain stimulant (Hussin et al., Food Chemistry 100 (2007) 535-541), antibacterial properties, antioxidant (Medicinal Plants of the South Pacific). These health effects indentified from other researches, at least in part, verified the efficacy and potency of these plants and further support the rationale for “why” our ancestors were using them. But more importantly, why we should continue to use them because they passed these koloa, and other wisdoms to us.

Gout Diseases: The Enemy of So Many Polynesians

The legend of Maui’s discovery of the art of making fire in Polynesia can be a great asset to all of us. This legend should be told to the younger generation in the years to come so that they know where they come from as they look to the future. It can serve as a reminder of how great our ancestors were and how bright our future can become. It can give us the courage to make our own circumstances when one is not readily available. Perhaps it can also show us the way to solve some of our health problems. One of the biggest health problems to face Polynesians in the world today is gout diseases.

Gout used to be known as the “disease of the rich.” Now it has found its niche in the people of Polynesia in an alarming rate. So much so that it has become one of the Polynesian’s worst nightmares. In fact, almost every Polynesian that you talk to knows somebody who suffers from gout diseases. Thus, it is not uncommon to hear the howling “’oi au e kuo langa hoku va’e” as an indication that the enemy has attacked. Why are Polynesians suffering from gout diseases in an alarming rate? The answers can be as complicated as you want them to be, but I would like to suggest two major factors that have contributed to the increasing incident of gout diseases among Polynesians. One is our “Polynesian diet” and the other is our “Polynesian lifestyle.”

Polynesian diet consists mainly of kumala, talo, siaine, hopa, ‘ufi, mei, and manioke. The meat consists of lambs’ meat and New Zealand corned beef, pulu masima and chicken. This list of “Polynesian diet” is enough to stimulate your brain’s feeding center to seek out a Polynesian restaurant nearby. In all, majority of the Polynesians consumed lots of meat frequently, especially roast pigs and corned beef. While there may be no unforeseeable danger looming in the horizon to those who over consumed them on a daily basis, there is certainly an unmistakable and irrefutable causes of gout diseases in the making. One might ask how the “Polynesian diet” contributes to the development of gout.

Gout diseases resulted from the inability of our bodies to excrete the excess uric acid which is a by-product from meat consumption. The more meat we consumed, the higher the levels of uric acid produced, which leads to the kidney’s inefficiency in excreting them. Uric acid combined with other minerals in the body to form what is known as urate crystals. Urate crystals deposited in the kidney results in kidney stones, while those deposited in the fluids between the joints resulted in gout or gout-like diseases. The signal transduction pathways involved in urate crystals’ formation is a complicated one. However, in a nut shell (refer to diagram below) the enzyme known as Xanthine Oxidase is involved in the conversion of hypoxanthine to Xanthine and then to uric acid. Uric acid is easily excreted when you are young and healthy but the older we get, the harder it is for us to excrete uric acid efficiently. Hence uric acid is accumulated in the joints as urate crystals thus making the joints stiff resulting in your inability to move freely. Moreover, as the urate crystals grow between the joints, the inflammation (I) and pain (P) increases. They are usually manifested in the form of “ake” or “fufula” of the knee, wrists, motu’a va’e and the ankles to name just a few. Since Xanthine Oxidase in involved in the production of uric acid, it has become the primary target of many pharmaceutical drugs such as Allopurinol and liquid dietary supplements including TAHITIAN NONI® Juice. Allopurinol and TAHITIAN NONI® Juice both work through the same mechanisms by inhibiting the Xanthine Oxidase (XO) enzymes leading to reduction in uric acid production and ultimately reduce pain and inflammation.

Polynesian lifestyle does contribute in a lesser degree to the alarming rate of gout diseases among Polynesians especially those who live in NZ, AUS and USA. We are not engaging in enough daily physical activities, restricted by the winter weather and are using machine for most of the work that used to be done physically. We can solve this problem by going to the gymnasium to work out or just organize walking or exercise partners. We need to be more mobile, active and eagerly engage in maintaining our own health as well as those of our loved ones.

I believe, as well as others in the communities that we are eating more meat now than our ancestors had and are not taking care of our health as we should. Therefore, we are struggling with the overwhelming accumulation of uric acid beyond what our kidneys can efficiently excrete and that is why majority of us are having gout or gout-like diseases. Perhaps we should be “…eating meat sparingly…” and try to consume more fruits and vegetables to strengthen our immune system, build our antioxidant capacity so that we can wart off inflammatory diseases including gout. It is imperative that we must change the way we think and eat to include more fruits, vegetables and also increases our daily exercises so that we can obtain optimum health. Our ancestors’ diet was made “…up of at least nine-tenths of vegetable food; and it is perhaps owing to this temperate course of life that they have so few diseases among them…” (Mr. Anderson, Captain James Cook 3rd Voyage to the Pacific Islands). The healthier we are the more productive we may become. Like Maui of old who defeated the God of fire so must we, work together to defeat this enemy that has inflicted so much pain among our people.