In traditional Hawaiian medical practice, the kahuna lā‘au lapa‘au was the
herbalist who selected and prepared plants for use as treatments. His
training and knowledge included botany, pharmacology and general medicine.
Herbal medicines are still used today, though Western medical practices
predominate. During the nineteenth century, lā‘au lapa‘au practices tended
to be passed on and nurtured within individual families. Some practitioners
have chosen to share their knowledge with dozens of outside students to help
perpetuate the traditions.

Lā‘au lapa‘au, like many non-Western treatments, addresses the individual's
health and stimulates the body's own healing mechanisms rather than
attacking the specific symptoms of disease. Using a palette of 2,500
different herbs, the practitioner tailors a prescription to the individual
patient. Treatment often includes administering a cathartic, symbolic
cleansing, steam baths and bathing in the sea. As in all things Hawaiian, a
large spiritual component suffuses all phases of the treatment. Both the
practitioner and the patient make use of meditation and prayer as they work
to restore health.

In ancient times, more than 300 plant types were used as medicines. Kahuna lā‘au lapa‘au developed a larger and more varied pharmacopoeia in the early
nineteenth century, following the destruction of the traditional religion
and its limiting dictates and the introduction of numerous foreign diseases.

The kahuna lā‘au lapa‘au gathers, plants and prepares all his own materials
according to a strict protocol. Sea salt (pa‘akai) and red soil (lepo ‘alaea)
are common ingredients. Some of the most widely used plants are:

• Pōpolo - leaf juice and berries to treat respiratory tract, skin eruptions and cuts; young leaves steeped to tone the digestive tract.
• Noni - leaves to treat bruises, boils, sores, wounds; stem bark for cuts; juice for skin eruptions; unripe fruit mashed to help bone breaks and concussion; juice of unripe fruit for cramps, arthritis, gastric ulcers, sprains, poor digestion and high blood pressure.
• Kukui - all parts of the tree used as a laxative or purge; leaves to treat swellings and bruises; nuts for external ulcers and sores; charcoal from nutshells for sore throat.
• Koali ‘awa (bitter morning glory) - juice of all parts used as a purge; bark and vine for treatment of broken bones.
• Kūkaepua‘a (itchy crabgrass) - leaves to treat stomach and intestinal disorders; leaf juice for cuts and toothache; shoots for cataracts.
• ‘Awa - extract to treat urinary problems, menstrual irregularities and respiratory congestion.
• Hau - inner bark sap used as internal lubricant.
• Hala - blossoms used as mild laxative; root juice for purges, chest pains and as a tonic (good source of vitamin C).

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