Allen: David, can you tell me a little about your background so our readers have a frame of reference?

David: I live in Hawai'i and work as a medical practitioner here. I practice and teach all five branches of traditional Chinese medicine: Acupuncture, herbal medicine, massage, diet, and qi gong (Chinese "yoga").

These days I spend my time commuting between the Big Island and Maui. On the Big Island I teach at the Traditional Chinese Medical College of Hawai'i and work at 'Awapuhi Health Sanctuary as an educator and practitioner. 'Awapuhi is a beautiful retreat facility where we offer customized residential health programs. We also have classes in traditional Chinese and Hawaiian medicine, herbal medicine, and provide wholistic health care. Periodically, some of my my Hawaiian teachers show up and share their knowledge. On Maui I do native rainforest restoration and work with my private students. We receive no funding except the time and money contributed by people who understand that this is our last chance to save what we love.

Over the years, plant medicine has grown to be my main passion, and this is my primary involvement now, including writing and teaching about plant medicine.

For the last ten years I've been studying Hawaiian medicine. When I first arrived here, in 1989, no one would teach me local medicine because of my Caucasian upholstery, but I am a very tenacious guy, and eventually I became friends with Keoki Sousa, who introduced me to many of my Hawaiian teachers.

I don't practice Hawaiian medicine. As far as I'm concerned that is a job for the Hawaiians. But I do teach and use Hawaiian principles in my practice, and I am concerned with preserving the ancient knowledge.

Allen: I think it was the fates testing you to see how serious you really were to learn Hawaiian Medicine.

David: Well I think there are a lot of different factors. There is considerable resentment and suspicion of Haoles, which is understandable given the history of Hawai'i nei. I'm a bit unusual in that I don't have a lot of liberal guilt in me but I do have a deep and genuine appreciation of indigenous culture, particularly Hawaiian culture.

Another factor is that many people come and go as dilettantes, but few are willing to be in this for the long haul. As Woody Allen once said "90% of life is showing up." Hawaiian culture traditionally values watching and imitating without asking too many questions. "Don't ni'ele!" (Don't be nosey!) In Chinese culture it's the same way. Students don't ask questions. I was studying and meeting with my Hawaiian teachers for 5 years before I ever opened my mouth. (Laughs) This is definitely counter-intuitive to me and a totally different approach from how we learn in the West.

Allen: I was fascinated by your web site at http://www.medicineatyourfeet.com/ There is quite a lot of really interesting information there.

David: Thanks; it's a work in progress. Right now actually it's due for a face lift.

Allen: Have you written any books about plant medicine? If so what are the names and where can they be bought?

David: I have a work in progress called "Medicine at your Feet: Healing Plants of Hawai'i". It should be finished within the year. Another book I'm co-authoring is a cookbook called "Kitchen Alchemy: Herbs as Food, Food as Medicine". The cookbook should be done in the next 12 months, however we're going to be selling each chapter as a brochure as they are finished. We have chapters on depression, hepatitis, diabetes, insomnia, fatigue, anemia, low sex drive, and lots more.

All these can be purchased by emailing me at doktorkitsch@hotmail.com or through our website http://www.medicineatyourfeet.com

Allen: I am curious, you studied both traditional Hawaiian and Chinese medicine, what would you say are the major similarities?

David: Both Chinese and Hawaiian medicine are inductive and inclusive medicines, as opposed to Western medicine, which is deductive and exclusive.

Western medicine wants to find and isolate that damned molecule that's screwing up the works. This is both the strength and the weakness of Western medicine.

Inductive medicine is not as concerned with the molecule as it is the tissue and organ that it rests in. Beyond that it is concerned with the person, the emotions, the home, the family, the environment, the whole universe. This is both the strength and the weakness of "holistic" medicine.

Both Hawaiian and Chinese medicine are indigenous earth-centered medicines that have what the Daoists call a "View", that is a perspective through which one can live one's life. With a View one can cook a meal, build a house, fight a war, make love, and raise a family, all from a single unified perspective. Traditional cultures often have a View, a single unified explanation of the universe.

In practical terms Chinese and Hawaiian medicines share an emphasis on diet, physical manipulation and plant medicine. Both have an appreciation for the subtle and the unseen. But while each medicine has a "View" those views are very different. Both have their own form of genius and both are extremely culturally bound. I think it takes a bit of a leap to uncover how their genius can be applied to life in the 21st century.

Allen: Is there Qi flow in Traditional Hawaiian medicine?

David: There is a combination of factors in Hawaiian medicine that resemble "Qi". Qi in Chinese can be translated as "energy" or "air". There is the Hawaiian "Ha" which is breath, but it also implies a type of power, which can be transferred from a teacher to a student, or a practitioner to a patient. The Hawaiians also have a concept called "Mana" which is a kind of spiritual power with similarities to Qi.

A lot of the biomechanics of Hawaiian bodywork (Lomilomi), martial arts (Lua), and Hula are remarkably similar to Qi gong and Chinese martial arts, with the focus on supple strength and smooth energy flow.

Allen: Does Mana flow thru any specific paths or meridians like Qi?

David: There are circuits of energy in Hawaiian healing, but they are more similar to esoteric Western healing concepts than they are to meridian theory.

Allen: Is there a difference in diagnosing problems between Hawaiian medicine and Chinese medicine? I know Chinese medicine diagnosis is based on the 5-element theory. But in diagnosis you may look at the eyes, the color tint the person is giving off, maybe the season, check the pulses etc.

David: Chinese and Hawaiian diagnostics are completely different. Chinese diagnostics is based primarily on tongue and pulse diagnosis as well as a detailed history and sign and symptom intake. Hawaiian medicine is more concerned with relationship to God, relationship to the land and relationship to family. There are also timing (calendar) considerations, as well as a diagnostic system of abdominal palpation. The abdominal palpation could be compared to Japanese hara diagnosis, but from a totally different culture.

Allen: Can you go into more detail on the calendar considerations of Hawaiian medicine?

David: In the medicine? No. As far as I know that information is probably lost. But there is a lot of current information around other activities such as fishing, planting, which gods predominate on which days etc. I'm in the process of putting a Hawaiian calendar on my web site so that people can see the right times for those activities. You can see it at http://www.medicineatyourfeet.com/hawaiineiindex.html

Allen: Would you base different treatments in Hawaiian medicine around the time of day?

David: So much information was lost after Captain Cook landed here that there very well may have been treatment protocols like that, but I'm not aware of them. Hawaiian culture, like all Polynesian cultures was an oral tradition, which means that the whole culture was memorized in chants in the minds of the elders. The Hawaiian people had very little resistance to disease, so when Western sailors landed in Hawai'i, things like cholera, small pox, influenza, and venereal disease devastated the population. When a plague hits, often the first to die are the very old and the very young. Thus in a few short years the Hawaiians lost a huge portion of their knowledge base. That period of time is called "The Horror".

Allen: When I lived in Hawaii in the late 80's I had some local friends. They would only get treated by their Kahuna. I was under the impression that treatment was by a combination of herbs and mental energy. I understand that Kahunas are very powerful people who can read a lot of things in Nature.

David: There were many specialists in Hawaiian medicine. Kahuna Aloha - A person who cures through love. Kahuna Pa'ao'ao - Pediatrician. Kahuna Ha'iha'i'iwi - Bonesetters. Kahuna Kahea - Healing from a distance. Kahuna Lomilomi - Reconstruction of the body. Kahuna 'Ana'ana - Cursing, Black Magic. Kahuna Haha - Diagnosis through palpation. And lots and lots of others.

So the treatment could be a combination of any of these, although some, like Kahea (healing from a distance), are quite rare.

Allen: What would go on in a meeting/ check up, etc. between a practitioner of Hawaiian Medicine and a patient.

David: An ancient Hawaiian medical practitioner was called a Kahuna. Kahuna is a word that means "expert". An expert in herbal medicine was called a Kahuna La'au Lapa'au. If someone were sick they would go to the Kahuna or elder in the family who specialized in treating illness. There are certain steps involved in using Hawaiian medicine. These are not written in stone and would differ from family to family. I'm mentioning them here only as a guideline. This is not a "cookbook" kind of healing system.

The steps are: 1) Pule - prayer 2) Ho'oma'ema'e - cleansing 3) Ho'oponopono - fixing 4) Lapa'au - medicine 5) Pani - completion

Some families would use some of these steps, other families might use different ones, and the order of the steps may change. The one thing that *never* changes is the use of prayer... before, during, and after.

Let me give you an example:

Say it's 1777, the year before Captain Cook lands in Hawai'i. An adolescent girl begins to develop wheezing, what we know as asthma, what the Hawaiians call hano. It doesn't seem to be getting better, so her parents send her to a Kupuna (elder) who practices La'au Lapa'au (herbal medicine).

The elder, (it could be a man or a woman) examines the young girl, palpates the chest and abdomen, and asks some questions. The Kupuna prays with the girl to their ancestral deity (Aumakua). The elder then tells the girl to go home and to Pule (pray) three times a day to this deity, and to return in one week. For the next week both the Kupuna and the girl pray to the Aumakua.

A week later, the young girl returns. "How are you doing?" asks the Kupuna. The girl says that she is OK, that the wheezing is a bit better, but still there. "Maika'i (fine)" says the Kupuna. "Now for the next 5 days I want you to fast and drink waikai (a combination of fresh and salt water). This is Ho'oma'ema'e (cleansing). You will go to the river mouth of the stream, where the god of fresh water (Kane) and the god of the ocean (Kanaloa) meet. As you are praying you will gather water to drink as a cleanse for the next five days."

The young woman does this cleanse which purges the colon, and returns five days later. "OK, says the Kupuna. Now we will do Ho'oponopono" (fixing). The Kupuna calls the whole family together, and everyone comes... not just mom, dad, and the kids... but uncles, cousins, grandparents, etc.. If any one person in the family is sick, then the whole family needs to address it. Through a ritualized process, they discuss their differences, their troubles, and speak from their heart. They do their "emotional laundry" and get clear with each other, and they do it in front of everyone. This can take from an evening to a week. No one leaves until the whole family is Pono ("balanced").

By now the young woman is feeling much better, and her asthma is almost completely gone..

Can you see what's happening here? Two to three weeks have passed since she first came to see the Kupuna. She is feeling much better. She has changed her thinking completely through prayer, she's changed her diet totally through fasting and cleansing, and her whole family has resolved its' emotional baggage and is in harmony.

And you know what? She hasn't even taken any medicine yet. What we would call "the medicine" - the pharmacologically active plant materials - have not even been administered, but she's already feeling much better, If she is going to heal in a significant way this is a great start.

I think that this is pure cultural genius.

Allen: Where did Hawaiian medicine come from? What are its' Origins?

David: The roots of Hawaiian medicine are hidden in antiquity, but they undoubtedly came across Polynesia with the ancestors of the Hawaiians, the Lapita People.

Like most indigenous medicines, Hawaiian medicine is a result of the interactions between spirit, people and the land. All indigenous medicines are shamanic and have many things in common. Indigenous medicine always has a laying on of hands, prayer, divination, and mystical journeying. There is always plant medicine involved, and the attention goes to the natural world for validation of the treatment. As far as I'm concerned, our relationship to a "shaman" is hardwired into our DNA. That stethoscope that we see hanging around the neck of our family doctor is a rattle. We cannot escape the significance of that.

According to legend, the first practitioner of Hawaiian medicine was Kamakanui'aha'ilono ("The big eyed messenger who pursues") who lived in Waipi'o Valley on the Big Island. He trained a chief called Lono, later called Lonopuha ("Lono with a sore"), after Kamakanui'aha'ilono cured him of a wound. Lonopuha became Ka po'o kahuna la'au mua (the first "head medical doctor"), and a famous Kahuna Haha (diagnostician). Lonopuha had a son named Pahala, who was trained by him in medicine. On his deathbed, Lonopuha asked that his son ascertain what he had died from. He saw that he had died from impacted bowels. He consulted his 'aumakua (guardian spirit) and when he saw stagnant water he knew that this was the center of Lonopuha's illness.

This was the beginning of Hawaiian cleansing.

Allen: You mentioned the beginnings of Hawaiian cleansing. Is there more to it now days?

David: It's pretty much the same these days with cleansing as it was in antiquity. I was referring before to a historical legend as to why so much of Hawaiian medicine is centered around cleansing the colon. In Chinese medicine colon cleansing is only used in very specific conditions, not as a general treatment for everyone. The Chinese model of health is one of balance, not necessarily of cleanliness. As one of my Daoist teachers used to tell me... "It's SUPPOSED to be funky down there!"

Hawaiian medicine is much closer to the European/Thompsonian model of "Clean 'em out!" Interestingly enough there are current functional medicine models that may substantiate this approach. One of them is called "leaky gut syndrome" and current scientific research seems to confirm this ancient Hawaiian theory.

Allen: Are there any sweat lodges or that type of spiritual purification?

David: No, not sweat lodges. I've heard that there are steam vents on the Big Island, but I've never been to them. There may well have been rituals around these.

But there is a sort of "antithesis" to a sweat lodge called a Hi'uwai. This is a traditional Hawaiian purification (Ho'oma'ema'a) in which people gather at night to chant and pray. Then they go into the ocean naked and continue their chanting and prayer. It gets COLD and they stay for a long time, praying and supporting each other. I cannot speak much about this without permission from my teachers, but I can tell you that it can be intense. A very powerful experience.

Allen: Does Hawaiian medicine use only plants or does it also use different foods like fish, meat, internal organs of animals to be eaten for specific purposes?

David: There is an amazing amount of information regarding uses of medicines from the sea. I fear much of it has been lost. Auntie Alice Kuloloio knew a lot about limu (seaweed). Another of my teachers, Kaipo Kaneakua, has a phenomenal knowledge of ocean medicines. I've only scratched the surface in this area.

Allen: Does Hawaiian medicine have treatments for cancer, diabetes, and some of the newer diseases?

David: My Hawaiian teachers are adamant in their belief that plants do not heal... it's our relationship to the divine that heals. Our job as healers is to help others develop their relationship to the divine. But, there are treatments for all kinds of diseases, and each type of treatment might differ widely depending on the practitioner and the family.

Allen: Using plant medicines in Hawaiian medicine, are they used topically or exclusively internally for disease treatment?

David: Both. However, the Hawaiians didn't dry plants for future use as the Chinese did. They would gather fresh medicines each time. A Hawaiian practitioner won't have dried herbs sitting in his house. He will gather the herbs as he needs them... and then only for a single patient. And usually before sunrise.

Allen: Why? Why not any time of the day or night?

David: The Mana of the La'au, (the power of the medicine), is said to be stronger then. In Hawaiian thinking the night in many ways is more significant than the day. With the veil of daylight gone we can see what is really there... the stars... infinity.

In the Hawaiian creation chant the beginning of the universe begins in Po, the dark, sweating time. And when the body dies, the 'Uhane, the spirit, goes out the Manawa, the fontanel, meets the 'Aumakua (the ancestral guardian spirit) and is guided back to Po, to the darkness of original creation.

Allen: Are there bruise liniments in Hawaiian medicine like the dit-da jow in Chinese medicine?

David: Not liniments, but the topical uses of Hawaiian plants can be quite profound. Koli (Ricinus communis), Noni leaf (Morinda citrifolia), Laukahi (Plantago spp.), and Ha'oui (Verbena litoralis) are all used topically, along with many others.

Allen: Let's get into the origins of medicine. What are the origins of medicine as a whole? I mean how did it start?

David: Well this is speculation on my part, but I think that the role of a practitioner or healer is that of a shaman. I say that because I look at the world through the lens of "cross-cultural tribalism".

In other words, we had 1 to 2 million years of tribal evolution before agriculture appeared and changed this planet forever. What do all tribes have in common? The answer to this question digs deep into the fabric of our humanity, and explains many things that we are experiencing on this planet right now.

Allen: Can you give me a couple of examples.

David: There are hundreds. We are really smart monkeys. There are rights of passage, of all sorts. Birth rites, adolescence rites, marriage rites, death rites. Particularly important is initiation rites for young males, but also for young females. When males aren't properly initiated they do it themselves, via street gangs.

There is the same structural vertical pecking order in a corporate board room as in a biker gang.

The structures of human societies replicate tribal structure. In a tribe there are the alphas, betas, and omegas. The top and bottom. After agriculture, when we branched out from tribes of 100 or less to cities of 1,000,000 or more, we intuitively kept the structure the same. Only now, individuals have become classes of people. You see the same structure in a wolf pack, elephant herd, a school yard, and at the United Nations. I have a lot of theories as to why certain structures and behaviors evolved, but this is probably not the place to get into that type of speculation.

Allen: Any others?

David: What do shamans do? They journey to the other world and bring back information. They use plants as medicine. They perform laying on of hands. They practice divination. They interface between humans and heaven, and humans and the earth. Information is passed.

As I said before: The physician is a shaman, whether she likes it or not. The stethoscope is a rattle, the diagnosis is divination. When we diagnose we are gathering information from the realm of the Gods.

Science is not shamanism, but our relationship to practitioners of medical science is that of a tribal member to a shaman. This is not "ooga booga" New Age weirdness. This is about why we expect our physicians to be emotionally invested in our lives, but we don't expect the same from our auto mechanics or plumbers.

Allen: Why the difference between Chinese herbal medicine and Western herbal medicine?

David: Because they come from different paradigms. Each has a unique world view. Much of Western herbalism as we know it is a direct result of the Eclectic tradition, a semi-wholistic, semi-scientific system of medicine in North America that pre-dates the A.M.A. At one time there were many colleges of Eclectic medicine in the United States. Because of this, Western herbalism relies almost entirely on the diagnostic system of allopathic/Eclectic medicine. Chinese medicine has it's own system of diagnostics. As a general rule, Western medicine diagnoses and treats diseases. Chinese medicine diagnoses and treats people.

This, however, may be changing in the near future. Both Michael Moore and Mathew Wood are creating systems of Western diagnostics which are "wholistic", and there may be others doing the same thing. Both these practitioners are brilliant in their own right. I think that there is a very strong need for an herbal system which is not as culturally bound as is Chinese medicine... one better suited for life in this nuclear accelerator which we call Western "civilization".

Allen: It's interesting to watch animals. Sometimes when a dog has eaten something that is not right it will eat grass to make itself throw up.

David: Animals use plants all the time. Chinese legends exist of snakes eating herbs when they are ill. Chimps and gorillas will only eat certain plants when they are ill. Baboons and elephants will flock to fermenting fruit and get VERY drunk.

Instinct and intelligence are mutually exclusive. One is preprogrammed, predetermined behavior. The other is learned behavior. Our intelligence comes at the expense of our instincts. That's the price we pay for being so damned smart. Language and culture have taken the place of instinct for human beings. That is one of the reasons we have medicine and culture. We can't pass on our lessons through our DNA. We use culture for that. Doin' that ol' natural selection thang just takes too damned long....

Allen: Do you think that it was innate nature of early people to know what to use, and we lost it?

David: We lost it when we became intelligent... especially when we learned to speak. We traded instinct for intelligence. We lost our instincts, so the only way to transmit information across generations was through language.

Language eventually evolved into culture. This was around two million years ago. 50,000 years ago people probably had no more instincts than we did, but they had a culture which respected traditional information as being essential to survival.

Allen: How did the ancients know what herbs to use for what disease, or illness?

David: Trial and error! (Laughs) It must have been a hell of a learning curve!

Actually when we use plants for food and medicine long enough we begin to see patterns. Today we categorize these patterns as plant families. Our Kupuna (elders) used plants daily and saw patterns as to how these plants affected our bodies. Herbalists know exactly what I'm talking about. Each plant and flower has a specific pattern. You can see it. They have a "look" to them. That "look" more than likely indicates that a plant is in a certain family. Each family has predictable pharmacological actions on the human body. "If you mess with the Malvaceaes, you'll probably moisten your tissues. If you mess with Myrtaceaes, you'll pucker up and become constipated. If you mess with Euphorbiaceaes, you should bring a book with you. And if you mess with Solanaceaes... well, lets just say you'd better have your life insurance paid up!" This was a completely unconscious process. You use these plants long enough and you intuit what the plant will do. You *know* it... and you are right!

Hawaiian Kupuna are well known for being able to use plants as medicine that they have never seen before. I think that this "knowing" is a part in that process. One of my Hawaiian teachers cured himself of emphysema with a plant that he'd never seen before. He just "knew".

Allen: What technique do you use to gather herbs?