not go unchallenged in Europe and the medical profession was slow to come to terms with the new ideas of illness and the new ways of treatment. The concepts were even slower to become accepted in the distant Australian colonies (Cumpston 1978: 1-8). The 'tyranny of distance' (Blainey 1982a) which so often influenced the political, social and commercial history of Australia in the nineteenth century also encumbered the dissemination of medical knowledge. So, at the beginnings of the colonial period and well into the nineteenth century, the understanding of disease aetiology and therapy was still based on the long-held theories of humeral causes (Cumpston 1978: 1-8).
The traditional view held by Galen was that the four humours; blood, phlegm, white bile and black bile, present in the body, coincided with the four elements that comprised the world; air, water, fire, and earth. Each of the humours had qualities of hot/cold and wet/dry. As the theory passed through the centuries it became subtly altered and adorned with new connotations but the core concepts persisted. Illness in a previously healthy person was perceived to be the result of an imbalance between the bodily humours brought about by changing climatic or environmental factors (Howe 1972: 7; Duin & Sutcliffe 1992: 56). Most epidemic diseases were understood in much the same way. But some, for example smallpox, were seen to be rather different and appeared to result from a tangible contagion that was passed through the air from an infected person to others. This was the presumption underlying the development of variolation in the early eighteenth century and later Jenner's idea of inoculation. An infective agent was also suspected by some to be the cause of tuberculosis (Ruddock 1873; Johnston 1993:1064).
The underlying principle behind treating the ill and affecting a cure was to restore the balance of the humours. One of the most common practices up to the late 19th century was to bleed the patient to expel the corruption within. This may actually have
been extremely deleterious to the health of the patient because it reduced the body's own ability to fight the infection by the loss of the very medium, the blood supply, that carries the antibodies to the infected area. Other methods used to restore the bodily balance were medicinal. The drugs used for the treatment of diseases were, however, generally ineffective in combating the infectious agents and in most cases had only limited effect on the symptoms. For example, a range of drugs was prescribed for the treatment of diarrhoea. Acute bacterial diarrhoea was a prevalent complaint of the times, mainly due to the lack of knowledge regarding the cause of putrefaction and the poor hygienic conditions that commonly prevailed. Conversely, drugs purported to relieve constipation were used for almost all the non-specific illnesses e.g. debility, headache, anxiety, rheumatism etc. Along with the practice of blood letting, purgation was considered to be one of the best treatments to rid the infectious matter from the body and restore the balance of the body humours (Duin & Sutcliffe 1992).
In many cases drugs were prescribed to relieve pain symptoms. Before modern analgesics, the most effective were opium and its derivative morphine, often causing problems of dependence and withdrawal symptoms when the drugs were no longer available (Duin & Sutcliffe 1992). Others were given for the relief of respiratory symptoms, e.g. coughs, colds, and the effects of bronchitis, influenza, and tuberculosis (Potterton 1983). Perhaps the most dangerous of the forms of chemotherapy of the time was the use of mercury, particularly in the treatment of syphilis symptoms. Until the introduction of arsenic derivative treatments and the development of penicillin antibiotics in the twentieth century, mercury chemotherapy had been the mainstay of treatment for syphilis for four hundred years. Despite such a long faith by the medical profession in its effectiveness, the drug had little effect on the symptoms of syphilis and was completely ineffective against the causative agent of the disease. But if taken over a long period, as it customarily was by the sufferers of chronic syphilis, it induced severe iatrogenic illnesses,
the cause of which frequently went unrecognised by doctors and often resulted in the victims' demise.
Many of the drugs used in the nineteenth century were patent medicines of little use in reducing the symptoms of infection. A highly popular concoction of the day was 'Holloway's Pills' reputed to cure gout, rheumatism, inveterate ulcers, sore breasts, sore heads, bad legs and so on. 'Doctor Morse's Indian Root Pills' were another invention that claimed to purify the blood and to be a positive and permanent cure for 'biliousness, constipation, indigestion, headaches, kidney troubles, piles, pimples, and female ailments etc' (Cumpston 1978: 3). Even as late as the turn of the twentieth century little effective treatment was available for most of the known infectious diseases and doctors treating the ill were helpless because of their lack of knowledge of the true causes of the diseases (Cumpston 1978: 3).
At the time of colonisation and for many years afterwards, Western anthropologists had little or no knowledge of Aboriginal medical theories. Because of the rapid destruction or transformation of many Aboriginal societies, many of the then existing medical practices and beliefs have been lost for ever. But by drawing upon more recent anthropological studies of contemporary Aboriginal medical beliefs and practices we can gain some insight into how diseases and their cures may have been perceived.
Aboriginal approaches to health and illness were most probably holistic ones, recognising spiritual, physical, and biological aetiologies and therapies (Reid 1982: 91). For the most part, however, the theories of illness were based on magicoreligious beliefs (Taylor 1977:423; Saggers & Gray 1991:47). Blame for an illness was often attributed to the machinations of rivals or to the will of angry supernatural beings intent on revenge for the alleged misdeed of the patient. Divine anger was seen by some as the cause of the 1828- 30 smallpox epidemic which swept along the river systems of south eastern Australia
(Dawson 1881:60). Others placed the blame on the first European they had seen. The explorer Charles Sturt was present in the land of the Wiradjuri just as smallpox began and was seen as the cause of the epidemic (Mair 1831). The Ngarrindjeri and Meru along the Murray River in South Australia blamed those further upstream for unleashing the epidemic (Chapter Three). Determining the cause was an important part of coping with illness (Saggers & Gray 1991: 41-52). It allowed the victims or their families to vent their anger and frustration and so alleviate their feeling of helplessness which often arose from being unable to control the disease. Finding a cause also transferred the responsibility for the condition to someone or something else (Goodall 1994: 68-72;
Mobbs 1991:303-308).
The practice of healing the sick was often vested in special people. Doctor- sorcerers were able to evoke and control alternative supernatural forces to combat those already causing the illness. Not all of these practitioners, however, used their skills for healing. They in turn could use their power and knowledge to cause illness and death among others. The pointing of a bone by a sorcerer accompanied by a magic ritual, chant, or song was widely used across the continent to invoke an illness, or to cause the death of the unfortunate recipient (Berndt & Berndt 1988: 307-322). Frequently the process of healing involved an act of purification or cleansing, such as sucking the skin to remove the underlying pathogen, blood-letting, rubbing and massaging the skin to purge the illness from the body. Heat was often applied to the body by burying the victim in warm sand and ashes or suspension over a fire. This induced perspiration which was to sweat the illness out. In other methods the illness could be ritually transferred to another object and then cast out.
More profane (and potentially dangerous) methods of treatment were used by the doctor-sorcerers. During the 1830 smallpox outbreak in the Lachlan and Wellington
Valley region of New South Wales a victim had his hair scorched from his head, probably in an attempt to relieve a severe headache which was a common symptom of the disease.
The Kradjee (healer), who had previously observed other cases of smallpox where the pustules had burst, then began to prick the pustules with a sharp-pointed fish bone and squeezed out the fluid contained in them with the flat part of the instrument (Bennett 1834: 154-156). The outcome of this treatment on the patient and the doctor-sorcerer is unknown, but considering the highly contagious nature of the disease, a favourable result for both would not be expected.
Patient's participation in their own or their family's treatment was a socially important aspect of the healing process. This allowed the sick to assert some measure of control over the state of their body and their future well-being. With the breakdown of the social fabric following the incursions of European colonisation, and the loss of faith in the powers of the healing doctor-sorcerers to cure the new illnesses, this was often the only way open to healing. An extreme method was used by one Aboriginal group in South Australia in the late 19th Century who were probably suffering from the maculopapular rash of venereal syphilis. They approached a group of Europeans who were treating a flock of sheep with an arsenic based dip. One of the men was in a poor state and in jest it was suggested by the Europeans that he should be dipped like the sheep.
The scabby black was put in the vat, and after a short time he became so ill that it was feared he would not recover, and lost his hair, toe nails and finger nails; but in time an improvement was observable. His skin peeled off, and he was described as a magpie when moulting. Eventually he quite recovered, his hair grew again, and his skin became as smooth and as glossy as marble.
When this became known among the tribes others having the same complaint presented themselves at Cannowie, and begged to be "jipped like it other feller;" but the experiment was considered too hazardous, and no one cared to risk a trial for murder or manslaughter, if, as was by no means unlikely, a patient should die under the treatment (Adelaide Observer 1904).
While sorcery and supernatural agents probably formed the most important component of medical concepts, a relationship of physical cause, medical consequence, and biological treatment was widely acknowledged. Accidental and deliberate trauma, diet and weather fluctuations were seen as direct causes for certain medical conditions and specific methods were used to reduce their effects on well-being (Scarlett et al. 1984;
Saggers & Gray 1991). Together with this knowledge Aboriginal societies could draw upon an extensive knowledge of medical resources and treatments. Scarlett et al. (1982) have documented medical practices of the Yolngu from northern Australia and have revealed an extensive pharmacopoeia based mainly on plant species but also using animal and mineral preparations. Preparations were used for the treatment of coughs, colds, disorders of the lungs, eyes, teeth, and healing agents for surface and penetrating wounds.
Most of the people were aware of these 'bush medicines', in particular the elderly women who regularly collected the species and prepared the medicines. Many of the treatments were used on specific ailments, others had multiple uses, while others were more generalised treatments.
Australian Aboriginal pharmacopoeia was quite adequate for dealing with wounds, burns, bites, gastro-intestinal ailments and body aches that were likely to occur in the daily life of any group. But there were no traditional remedies for the Old World pathogens such as tuberculosis, influenza, and smallpox that caused high morbidity and mortality after 1788. This is not to say that European medicine could cope any better with these diseases. In reality the European medical system could offer no cure and very little relief from the major infectious diseases.
Smallpox