19. In Sickness and in Health

by George Weber

Primitive medicine, in the minds of many people in industrialized countries, is associated with magic mutterings, wild dancing, medicine men and general mumbo-jumbo. These cliches are even more misleading in the case of the Andamanese than they are in other cases. The Andamanese did have medicine men but their role was limited, there were few charms and there was little obvious ritual. Disease was regarded as the work of evil spirits to be fought by remarkably down-to-earth methods, helped along by some quiet ritual.

The early observers reported rational remedies against sickness and injury and noted the absence of ritual but they hardly ever looked (and given their times and circumstances, could not look) into the system of beliefs that was behind the rational practices that they saw. Only after the 1950s when Indian scientists started to investigate the beliefs and practices of the Onge did it become clear just how complex the beliefs were that governed so much of Andamanese behavior. It is a sobering thought, no less chastening for being well-known in theory if not in practice, that we may all observe things that take place before our eyes but see only the part we want to see or that our upbringing allows us to see.

If we set aside the religious beliefs hovering in the background, much of the traditional Andamanese medical practices are strikingly rational and curiously modern. No doubt, the observant Andamanese knew as much about the human body as they knew about the medicinal plants around them. Snakebite, for example, was treated in what has been called an incipient immuno-biological approach or anti-body therapy: the affected limb was tied with a tourniquet of lianas and the site of the bite cut out. A snakeskin was then applied to the wound together with some snake fat, followed sometimes by scarification and burning out of the wound.

Cruel and barbarous as Andamanese attitudes often were towards strangers, towards members of their own local group relations were marked by kindness. Old people, the incurably sick and children were all looked after with great care and attention. No Andamanese group recognizes "useless" members of their society and no-one is neglected or left alone to die as long as they stay within their own local group. This is even so today.

Medicine as practiced by one of he world's most technologically primitive people could not be other than simple. Portman in the late 19th century recognized this when he reprinted an early description by Mr. Corbyn of Andamanese medicine with comments of his own (here marked in italics) added:

They suffer most from coughs and cold, ague, fever, and severe headache. It is thought that their "tattooing" is for a sanitary purpose, for they always wish to do it to their People when they are suffering form any illness. (Mr. Corbyn confounds the "bleeding" which is done in sickness to relieve inflammation, and "tattooing" which is for ornament only - M.V.P.). As a remedy for illness it is a very barbarous and cruel one. (No doubt, but what would the doctors in Europe fifty years before have said to Mr. Corbyn for this remark - M.V.P.).

Among Great Andamanese human skulls, among Onge human lower mandibles (all most likely ancestral) were carried around tied to the wearer's neck with string. According to the Andamanese themselves, such a necklace was a sign of respect towards their ancestors but they also thought that the bone ornaments gave protection against evil spirits and disease. While the jawbone among Onge had an important medical function (besides much else), the function of the skull among Great Andamanese is much more obscure. It is difficult to believe that the Great Andamanese, who otherwise regarded human bones as a major defence against disease and treated animal skulls with considerable reverence, should have carried around ancestral skulls merely as decorative souvenirs without any practical medical or spiritual function as has been claimed. In view of the role that human bones played among the much better documented Onge, it is likely that they had a similar role among the Great Andamanese (see Chapter 13 "Clothes, Clay, and Beautycare"). The borders between beauty and medicinal care in body paint, scarification or the wearing of human bones among Andamanese is extremely fuzzy, both among Andamanese and outside researchers. To the Andamanese the distinction simply does not matter.

Andamanese girl wearing an ancestral skull - for beauty and for health. (Picture taken by Radcliffe-Brown, ca. 1906).

 

The chauga-ta, a charm made of human (more rarely of animal) bones to heal and ward off disease among Onge.

The Onge exhumed the bodies of buried relatives after all flesh had decayed to make ornaments of the remaining bones. These were kept in a special basket and moved with the family as it ranged seasonally over the hunting territories. In case of sickness, the bones were taken out of their basket and worn by the sick person.. Among Onge a human jawbone was taken out of its basket at a death. From the funeral feast until the following full moon, the chief mourner wore such a jawbone. Unlike the Great Andamanese, however, the Onge did not wear their ancestral jawbones without a specific reason and did not give them away as gifts, retaining a much clearer distinction between decorative and magic functions.

With all this evidence for at least some magic and protective powers, not to mention ancestral significance, thought to reside in human bones, the Great Andamanese custom of wearing ancestral skulls for decoration and giving them away as gifts in such rapid succession that many wearers had no idea whose skull they were carrying, strikes non-Great Andamanese as peculiar. The bones of important food animals we regarded as equally efficacious as human bones. Nor need human bones be those of an adult or of someone recently deceased. The bones of children were thought to heal as efficiently as those of the long-dead. However, dead strangers were cut up and burnt, thrown into the sea or thrown into the bushes or at best buried in unmarked shallow graves:

the body of an enemy, stranger, or captive child would be thrown into the sea or buried without further ado, as the bones would never be in request.

We find the well-developed Andamanese sense of "we" and "them" wide awake, in life as in death.

Whether the contradictory reports of the early observers regarding the significance of human bone ornaments is a result of the Andamanese sense of privacy, their sense of mischief or whether it had other reasons, we shall probably never know with final certainty.

Isolated from the outside world, the Andamanese lived, if not lives free from disease and accident, so at least lives menaced by only a few of the major killer diseases that humanity as a whole is heir to. It would be interesting to know what diseases were endemic in the Andamans before around 1800 as his could provide us with an important clue about when major diseases reached Southeast Asia. The fact that malaria was widespread among Andamanese, to the point even that they seem to have developed a certain degree of immunity against it, implies a very ancient lineage of this scourge. Diseases known to have been common in the Andamans before 1800 are, with their Aka-Bea names, (1) malaria diddirya, (2) catarrh ngirib, (3) coughs odag, (4) rheumatism mol, (5) tuberculosis, (6) pneumonia, and (7) heart disease. Oddly enough, among the Onge, the only Andamanese group that had almost certainly known some contact with the outside world before the arrival of the British, tuberculosis was unknown

The remedies available to traditional Andamanese were widely known and could be applied by anyone. There were no specialized healers or shamans with secret knowledge. Children learnt from their parents what herbs to use in what way against what ills. Some were more skilled and talented at healing than others but all but the youngest could offer help against the aches, pains and accidents of a primitive existence.

There were nevertheless medicine men - and rarely women - known in Aka Jeru as oko-jumu and in Aka Bea as oko-paiad. They were credited with powers and influence over the spirits that produced and cured disease. Their role in medicine and in healing does not seem to have been a central one, which does not mean that they were not important. They were thought capable of crippling and even killing people which laid them open to the vengeance of those who thought that they had been affected by evil magic and who might plot revenge on them. There was no clear line, nor any sort of structured education, leading to the "position" of oko-jumu. It was more in the nature of a talent that some possessed and others did not. The status of a medicine man or woman depended on how many people he or she could convince of his or her special talents. As usual in the Andamans, the matter is confused; as one observer noted around 1907:

At the present time it is no longer possible to obtain full and satisfactory information on this subject. Most of the old oko-jumu and oko-paiad are now dead. Amongst the younger men there are a few who pretend to the position, but the recent intercourse with foreigners has produced a degree of scepticism in such matters that makes it difficult or nearly impossible to obtain any reliable information as to the former beliefs from any but the very old men. To this difficulty must be added that in talking to some of the very few old men who could have given more valuable information I had to make use of an interpreter, and though they might have been willing to confide to me some of the secrets of their profession they would not do so before a younger man of their own race.

We are here interested primarily in the medical aspects of medicine men, although it must be borne in mind that such a separation of functions would seem alien to a primitive traditional society. Andamanese medicine men were seers, people in contact with the spirits. Their medical functions were incidental: they did not administer medicines, boil potions or carry out surgical procedures. Their function was, as we would say today, psychological and religious, they inspired confidence and gave advice. The Andamanese believed that in their dreams the medicine men and women could communicate with spirits and that they could persuade them to cure a sick person or to make a healthy one sick.

We have already mentioned that within the local groups, the sick, the children, the helpless, all received the best care that could be provided for them. It has been claimed that the absence of abortion or infanticide among Andamanese should be interpreted a sign of high ethical standards. This surely over-stretches a point. The generally low birth rate made any surviving baby a treasured addition to its local groups.

Pregnancy was an important and joyful time in the life of an Andamanese woman:

During pregnancy, the women eat in moderation, but delight in as great a variety of food as possible, telling their husbands day by day what to procure for them; they are also in the habit of taking as much active exercise as possible... When about to be confined, the custom is for the husband, and some of the woman's female friends, to attend on her; she is placed in a sitting posture, the left leg is stretched out, and the right knee brought up, so as to enable her to clasp it with her arms. Her husband supports her back and presses her as desired, while her female friends hold a leaf screen over the lower part of her person, and assist her, to the best of their ability, in the delivery and in the removal of the after-birth; the umbilical cord is severed by means of a Cyrena shell (now a steel blade is often used), and when the infant has been washed in cold water, its skin is gently scraped with the shell. Publicity is not courted on these occasions, as has been asserted, but all, save those whose services are required, continue their occupations as usual. Soon after the delivery, some warm water is given to the woman to drink; she is also fed some meat-gravy; after a time, should she desire it, fish, shell-fish, yams, or fruit are given her, but not meat. During the first two or three days, she remains in a sitting posture, propped up by articles arranged so as to form a couch. As might be supposed, from the active habits and unsophisticated manners of these people, their women rarely suffer much during labour and child-birth; in fact, no instances of difficult delivery are known.

A birth among all Andamanese groups was and still is a joyful and sadly uncommon occasion, surrounded by many traditions and some ritual. As usual among primitive people, the normal position of giving birth was the squat or the sitting position described above.

For tens of thousands of years the ancestors of the Negritos have lived in the jungles of Southeast Asia in areas extremely rich in medicinally-relevant plant species. It is not surprising to find that the Andamanese had a profound and intimate knowledge of the plant life surrounding them. Unfortunately, hardly any of this knowledge has come down to us. It is not that they kept their knowledge secret but that outside observers were so convinced of the immeasurable superiority of their own 19th and 20th century medicine that they too often failed to inquire.

The medicinal properties of the Andamanese flora today remain largely uninvestigated. As the international drug companies discover the pharmaceutical treasure chests that are the tropical forests of the world and as their teams are swarming out all over the world with astonishing success, it would perhaps be a good idea for the Indians to do likewise and not wait until the last jungle areas in the Andamans have been cut down by cut-and-slash farmers, loggers and coconut planters.

In the Philippines, the Aeta Negrito were held in awe for their medical skills until the early 20th century. The Andamanese had no neighbors to hold them in awe and among the Indian convicts and British jailers their skills in this respect were not in demand. Their knowledge of medicinal plants is lost and will have to be acquired laboriously from scratch again.

Surgery took second place to the application of medicines. Such procedures as are known to have been used were limited to the treatment of open wounds, the setting of broken bones and scarification. There was no circumcision, amputation of limbs or deliberate deformation of body parts.

Bandages of leaves were applied to wounds, ulcers, fractures, sprains and bruises. Before being bandaged, open wounds were washed out with hot water poured from a shell. The same shell is then applied to the wound as hot as possible to cauterize it. For lighter wounds, sea bathing was regarded as helpful to recovery. Among all Negrito groups, the Aeta and Semang as well as the Andamanese, a saltless diet was required during treatment.

Tightly-bound legs, a common treatment against pain among the Onge.

Scarification is often confused with tattooing. Although they are different techniques, they may go back to similar origins and are related to body painting. Scarification may well be a forerunner of tattooing and as such of very considerable antiquity. Tattooing (the introduction of colouring into skin layers) was not known among the Andamanese whereas scarification (the cutting of the skin with subsequent development of scar tissue, with the issue sometimes coloured) was widely practiced, both for decorative/religious as well as for medical purposes. The two purposes overlap and cannot be neatly separated. An attempt has been made to distinguish the "medical deep cut" from the decorative "shallow cut" but from the available evidence it is not clear if this distinction is valid.

Scarification: decoration, medical treatment, or both?

In medical scarification the skin was originally cut with quartz splinters, later glass shards were used whenever available. Along with scarification, a variety of medications was also used, herbal teas, hot packages, massage and other treatments chiefly designed to relieve pain. Rheumatic and arthritic pains, toothaches, ear aches, headaches, all kinds of swellings and even some epileptic fits were treated in this way, after the chauga-ta (a charm made of human bones) had not brought relief. Boils were scarified by cutting all around the swelling and afterward bathing it in chu-lnga (see below).

In the following we shall describe the traditional treatment of some aches and pains. Many seem to have been fairly successful against traditional diseases and a few were even, at least in the eyes of the Andamanese, helpful in relieving the suffering caused by the new diseases introduced after 1858. It should be mentioned here that most treatment was applied not by medicine men or women but by the nearest relatives, generally husbands or wives, of the patients.

Traditional Andamanese medicine was entirely symptomatic, i.e. it attacked the symptoms rather than the cause of a disease, just as most of modern medicine until very recently did - and to a fair extent still does today.

Fever was never fought by scarification but instead by preparing a bed made of the leaves of Trigonostemon longifolius, Entada scandens or other plants. Leaves of the same plants were also boiled and crushed, the resulting hot mash being rubbed on the body continuously as long as the fever lasted, with spouse, relatives and friends taking turns. The sufferer was made to breathe in the smell of the mash as much as possible and to drink vast quantities of chu-lnga. Married patients had red ochre painted on upper lips and neck. If the fever still did not get better or was accompanied by pains in the chest or head, the chauga-ta was tied tightly around the affected part. Pain was thought to be caused by evil spirits which could be chased way only by magic.

Sufferers from cold, cough and catarrh remained at home, close to the warming fire. Drinking sea water was regarded as a remedy for coughs, as was the chewing of the thick part of the long alpinia sp. leaves. The bitter juice of the plant was swallowed and the remains of the chewed parts tied around the neck of the patient. If this did not work then the same procedure was followed with the debarked stem of another plant, Calamosagus laciniosus. This medication in Aka Bea was called chu-lnga and was widely used.

Rheumatism and many kinds of paralysis of the limbs were treated with chu-lnga and the chauga-ta. If this did not help, the affected limbs were massaged and the chu-lnga mash turned into a sort of warm shampoo. If there was still no improvement, scarification was the method of last resort. It has been noted that many rheumatic attacks seem to have left their victims without the full use of their limbs after recovery.

The preferred medicine against diarrhoea was clay, kaolin-like powders or pulverized bone ash while bee larva, certain tree barks and the fruits of two trees were eaten to relieve constipation.

Pulmonary tuberculosis (consumption or phthisis) was a serious disease of the Andamanese and seems to have been with them from ancient times. One or more chauga-ta were tied tightly to the painful parts, melted bees' wax was then passed rapidly over the sufferer. The drops of hot wax falling onto the body were left there until they had worn off by themselves. A sort of massage, pressure by the hands, was also applied by members of the same sex while another attendant sucked at the skin of the patient. If all this did not work, scarification was used. The procedure for tuberculosis was employed for many other kinds of internal aches and pains.

Skin diseases were made bearable, if not cured, by the application of warmed-up stones on the afflicted parts while sufferers from sore throat had to eat ochre clay and were treated externally with hot packages. Burns were treated with the external application of cool clay.

Epilepsy was known to the Andamanese and among the Aka Bea at least it was treated by sprinkling cold water over the sufferer, followed by scarification of the brows. The Onge, on the other hand, regarded epileptics as possessed by a spirit capable of being used as an oracle. Among Onge, epileptic attacks were watched reverently by all and not treated as a disease.

Scorpions are small and relatively harmless in the Andamans so that little attention needed to be paid to their stings. Being bitten by one of the large centipedes was a different matter; their bites are not life-threatening to the average healthy adult but are so excruciatingly painful as to appear very much so to the unfortunate victims. The Andamanese thought highly of human urine as a remedy.

It is not surprising to find that very few cases are known of mentally disturbed or retarded people, hunchbacks or the otherwise physically handicapped. In the absence of infanticide, which is not known from the Andamans, afflicted children would be unlikely to survive infancy in the conditions of a primitive society. Yet it is still remarkable that there are no known cases of those genetic abnormalities that do not seriously reduce life expectancy, among them albinism (the inability to produce pigment) and polydactyly (more than the normal number of toes and fingers). Squinting, cleft palates and supernumerary teeth have not been reported while prognathism and hare-lip seem to have been rare. Only one case of erythrism (the prevalence of red in skin or hair) has ever been reported among Andamanese and that was a slight case.

Not strictly a medical subject is the Andamanese reaction to sneezing which has been described as follows

They [the Andamanese] have no peculiar ideas in reference to yawning, hiccoughing, spitting, or eructating, and hissing is unknown.

To sneeze is auspicious, and therefore regarded with favour. When any one sneezes the bystanders ask, "Who is thinking of you?" to which the person replies by naming some absent friend, or, should he be alone when he sneezes, he says, "Here I am at ---" (naming the place).

It is certainly an odd - and as far as the author is aware largely unexplained and unresearched - fact that most (all?) human cultures react to sneezing with standardized remarks, often wishes for good health ("Gesundheit", "Santé") or religious expressions ("Bless you").

In any life, the hour arrives when all remedies, charms and tender loving care must fail. The Negrito of the Philippines, the Aeta, regarded death as a necessity; they did not attribute magic reasons to it. Their Negrito relatives in the Andamans saw this differently, especially in the case of sudden unexpected death. Sudden death was attributed to the malign influence of erem-changaba or juruwin, spirits of the deceased. Death of sunstroke seems to have been fairly common and was thought to be caused by an invisible arrow thrown at the head of the victim by evil spirits. A rather apt picture. There was no such clear-cut attitude towards the slower and less surprising death following sickness.

The Andamanese resistance to pain was reported to be remarkably high, at least when compared to that of visiting scientists. The rapidity with which wounds healed was also thought remarkable. A general lack of what modern societies call hygiene kept the immune-system of traditional Andamanese in permanent intensive training.

The presence of flies in the jungles of Little Andaman signalled the proximity of an Onge village or of a group of Onge on the move. Flies accompanied them everywhere and as one observer reported in the early 1950s:

They never wash intentionally; the forest, dripping from every leaf, and frequent immersion in water while out hunting, take care of the problem. One must admit under the circumstances their nakedness is hygienic. A small fire is kept burning beside each bed at night for warmth, a useful precaution which I found very welcome on the many cold nights which followed a very hot day. Deprived of the fires the Onge fall ill at once, a fact which I had ample proof on several occasions when I took the Onge with me out of Little Andaman; they were provided with beds and coverings in well-constructed houses, but although none of them complained about the absence of the fires by their beds they all developed feverish chills.

And yet in their own territory I have seen them lie soaking wet all night in one of their temporary forest camps or a communal hut with a leaking roof without any ill effects, simply because they had their fires beside them.

...their cooking utensils... are never washed... dogs rush for it, putting their paws right into the drum [a cooking vessel made of empty petrol drums washed up on the beach]... when they have finished licking, the drum is shining clean and ready for use, with no washing up to do! Clouds of flies descend on the drums, packing into a black swarm all over the bottom and sides, eager to finish off the dogs' work. Sea or river water is often only a yard or two from the camp, but no one would dream of washing anything.

Once the meat or fish is cooked, it is often hung in the roof of the hut, out of reach of the dogs. The fact that the roof is dusty and covered in spiders to foul the meat, does not matter; earth and sand get in the way of the teeth, dust and spiders do not. The Onge happily eat contaminated flesh and drink water from pools in which animal carcasses are rotting or dogs are bathing and drinking.

Despite their unconcern about hygiene, the Onge occasionally do sweep out the floor of their communal huts by pushing the accumulated debris under the gap between the floor and the roof into the open where it accumulates in a ring around the hut. When the old hut has become dilapidated, it is torn down and a new one constructed. At that time the ring of debris is smoothed out across the living area and the new hut is constructed on a slightly higher level than the old one. Over the centuries, a small hill, a kitchen midden, can accumulate in this way. The sweeping out of a hut has been described by the same observer:

The sweeping operations disturb clouds of fleas and tiny beetles... about 5 mm long, which always collect under... food refuse. Hordes of fleas, invisible in the dirt on the floor but multiplying busily, are also stirred up. Fortunately there are no lice on Little Andaman... and the Onge carry no lice in their hair.

None of these pests worry the Onges, who make no attempt to get rid of them. They leave mounds of filth around their huts or in their forest camps for them to breed in, and the light covering of earth or leaves which at best cover the Onges' faeces, deposited near the camp, was never any deterrent to breeding. The Onges never dig sanitary trenches or prepare any other form of latrines, even for their permanent sites; the forest is all concealing. However, they will never defecate near, or in, a water course, even when the bed is dry, and when my men used the bed of a dried-up stream for the purpose the Onges protested to me, because the water would be contaminated. I was not disposed to contradict them.

This may not be the preferred life-style of a majority of the readers of this text or indeed of its author - but it is a life-style that has kept the Onge surviving happily until recently. For those who find the thought intolerable of leaving Onge standards unimproved, it should be pointed out that the Onge way has been that of our common human ancestors until less than 10,000 years ago and before that for many hundreds of thousands of years.

Such conditions, given an undisturbed and stable environment were clearly not deleterious to the Onge, surprising as this may seem to us. However, such conditions played a role in the rapid spread of new diseases introduced from the outside world after 1858 in the Great Andamans and again less than a century later on Little Andaman.

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Last change 12 March 2006