“Medicine is generally practiced by the priests (kahuna la‘au lapa‘au)”. The medical practice in the 1820s and 1830s was not as advanced as many people might assume. The end result of treatments by Western doctors and Hawaiian doctors were the same: purging, vomiting, sweating or managing pain. Disease was not well understood and was attributed to a mixture of outside influences and physical influences of the afflicted person. Climate, age, temperament, gender, lifestyle, and “constitution” (a subjective idea of how susceptible to disease people were) were thought to cause disease.

Remedies included changes of climate, cupping or bloodletting (in order to weaken the disease you had to weaken the patient), changes in diet, herb or plant based ingestible medications, external topical plasters, and chemicals were all part of the Western pharmacology. Dr Gerrit P Judd, a missionary, was one of the very few Western doctors in Hawai‘i that was interested in learning about Hawaiian medical practices and remedies. He hired Native Hawaiian assistants and apprentices. Over the years Dr Judd modified his practice to include Native Hawaiian ingredients in his treatments. He also published the first medical textbook in 1838, Anatomia, and founded the first medical school in the Kingdom of Hawai‘i in 1870.