Our Approach · Origins · Pacific
The Hawaiian Islands · c. 1000 CE to the present
Hawaiʻi
In Hawaiʻi a person, a family, and the land make one balance, and healing sets it right.
Lomilomi is the Hawaiian healing practice of working the body with hands, forearms, elbows, and feet, transmitted inside ʻohana and opened with pule. Its companions are hāhā, diagnosis by feeling the body with the fingertips, and lāʻau lapaʻau, plant medicine. Practitioners read a person's condition by touch before choosing what to apply. That reading tracks a regulated bodily state. The Unified Model of Tone names that state tone.
forthcoming
Settled
c. 1000 to 1200 CE
Region
The Hawaiian archipelago, eastern Polynesia
Source record
Oral tradition; Nānā I Ke Kumu, 1972
Legal status
Living practice, exempt from medical licensure since 1998
The documentary record
What the record shows
Hawaiian healing survives in ʻōlelo Hawaiʻi, in family lines, and in a legal record that swings between licensing these practices and forbidding them. These are the dated points that carry the argument.
Patrick Kirch's 2011 review of 150 years of scholarship places the initial Polynesian discovery and colonization of the Hawaiian Islands between approximately AD 1000 and 1200. (Kirch, 2011)
The medicine arrives with the canoes. Noni, one of the most significant sources of traditional medicine across the Pacific, is among the plants the voyagers carry with them.
Pukui and Elbert's Hawaiian Dictionary carries kahuna hāhā as a standing entry: an expert who diagnoses, as sickness or pain, by feeling the body. The verb hāhā means to grope or feel with the hands. (Pukui and Elbert, 1986)
Diagnosis by touch is a named occupation inside the language itself. The word is lexicon rather than a later reconstruction.
Kamehameha Schools' Kumukahi curriculum records that a kahuna lāʻau lapaʻau is handpicked young by an experienced practitioner, and that the training can last as long as twenty years. (Kumukahi, Kamehameha Schools)
The record puts the apprenticeship at up to twenty years. What it produces is a hand that can read a body, and that comes from repetition rather than instruction.
The maʻi ʻōkuʻu of 1804 is the first mass-casualty epidemic in the record. Papa Ola Lōkahi's health timeline puts the dead at about 15,000. The Office of Hawaiian Affairs, citing Schmitt, puts the toll at perhaps under 5,000. (Papa Ola Lōkahi, 2016) (OHA, 2020)
The two published estimates differ by a factor of three, and both are in print. What no source disputes is that the epidemic era begins here.
In 1868 the Hawaiʻi Legislature established a Hawaiian Board of Health to examine Native Hawaiians' fitness to practice medicine, traditional medicine included. Fourteen Hawaiians passed its test between 1873 and 1878, and about 300 kāhuna held licenses during Kalākaua's reign. (Donlin, 2010)
A kingdom that had already met Western medicine chose to license its own healers alongside it. The names sit in the Hawaiʻi State Archives.
Luka Kinolau of Kohala, taught hāhā by her grandmother, sat the Territorial Board of Examiners in 1948 and scored zero on the section requiring the Latin names of the plants she used. Her appeal failed. (Donlin, 2010)
The examination tested a vocabulary the tradition never used. Competence and licensure came apart, and the file shows exactly where.
Act 153 of 1965 repealed the 1919 territorial chapter that licensed Hawaiian medicine. Afterward lomilomi could be licensed only under the state massage law, and no other Hawaiian healing practice could be licensed at all. (Donlin, 2010)
For 33 years the only legal route for a Hawaiian healing art ran through a statute written for masseurs. That is why lomilomi is the practice the outside world knows.
Act 162 of 1998 exempted traditional Hawaiian healing from the state medical practice law. On October 31 of that year, seven kūpuna meeting in Kailua-Kona issued the Kāhuna Statement, which rejected government credentialing and named these questions the kuleana of the Hawaiian community itself. (Donlin, 2010)
The law opened and the practitioners set its limit in the same year. Authority over the practice stays with the people who hold it.
Arrival by canoe
Hawaiian medicine reaches the islands in the voyaging canoes
Kirch's 2011 review sets the initial Polynesian settlement of Hawaiʻi between roughly AD 1000 and 1200. The voyagers cross thousands of miles of open ocean in double-hulled canoes, and they carry their pharmacy with them.
Noni, Morinda citrifolia, is among the plants Pacific voyaging societies moved across the ocean. Scot Nelson's species profile for Pacific island agroforestry calls it one of the most significant sources of traditional medicines among Pacific island societies. The plants that became Hawaiian medicine crossed the ocean before the islands were settled.
Healing in old Hawaiʻi belongs to religion. Nanea Armstrong-Wassel, writing in the Office of Hawaiian Affairs journal Ka Wai Ola, names Kū and Hina among the deities of medicine. Hiʻiaka is a goddess of healing, and Lonopūhā presides over chronic disease. Aliʻi convalesce in hale lama, houses built of lama wood and raised between sunrise and sunset. Old Hawaiʻi keeps its record in chant and genealogy rather than script, and the knowledge moves hand to hand and voice to voice.
Kahuna training
A healer is chosen young and trained for twenty years
A Hawaiian medical kahuna is handpicked young by an experienced practitioner and trained for as long as twenty years. Kāhuna are masters of a discipline, and the medical kāhuna are the specialists inside it.
Amanda Lokelani Donlin, writing in the Asian-Pacific Law and Policy Journal in 2010, records that medical kāhuna were chosen on genealogy, succession within the kāhuna lineage, the purity of the healer, and the healer's piety. The gathering of medicine carries its own discipline. Practitioners say a pule before they gather, which sets heart and mind in the right place before a leaf is touched.
Much of what a kahuna knows is huna, private, and is not shared with the general public. Donlin says so directly at the front of her own study and writes in general terms because of it. That boundary is part of the practice rather than a gap in the sources.
Hāhā
Hawaiian diagnosis begins at the fingertips
Hāhā means to grope or to feel with the hands. Pukui and Elbert's Hawaiian Dictionary gives kahuna hāhā its own gloss: an expert who diagnoses, as sickness or pain, by feeling the body. The word names both an act and a profession.
The Kumukahi curriculum traces the art to Lonopūhā, who is called a kahuna hāhā because he could diagnose illness by feeling the patient's body with his fingertips. The examination begins with contact. Warmth, texture, resistance, and pulse are read before any treatment is chosen, and the hands doing the reading have been trained for decades.
Hāhā survives into living memory as a taught skill. Luka Kinolau, born around 1887 in Kohala, learned hāhā from her grandmother, a kauka lapaʻau. Sixty years later a territorial board judged her competence by asking for Latin. The order is fixed. Read the state of the body first, then decide what to apply to it.
Lomilomi is a connection between heart, hand and soul with the source of all life.
Aunty Margaret Machado · recorded by Nancy S. Kahalewai, Ke Ola Magazine, 2021Lomilomi
How traditional lomilomi differs from resort lomi lomi
Lomi is the verb. Pukui and Elbert give it as to rub, press, squeeze, crush, mash fine, knead, massage, rub out. Lomilomi reduplicates it, and the practice carries a full clinical vocabulary rather than a single stroke.
Nancy S. Kahalewai is a licensed massage therapist writing in Ke Ola Magazine on Hawaiʻi Island. Her 2021 account describes work administered with the hands, forearms, elbows, and feet, with the recipient seated or lying on the floor or a table. The repertoire runs to compressions, stretches, kneading, percussions, squeezing, and soothing strokes, and treatments are carried further with plants, herbs, salt, heat, saltwater, smooth ʻiliʻili stones, and lomi sticks. Treatments begin and end with pule. Children in the Kumukahi account learn by walking on the backs of adults, and grow into practitioners. Aunty Margaret Machado of South Kona carried the lineage into the modern era with a nursing background and a state massage license, and her students teach today.
The tradition descends inside ʻohana, and the elder chooses who receives it. Prayer opens and closes the work, and the state of the practitioner is treated as part of the medicine. A resort borrows the strokes and the word. One historical accident explains why the word traveled: after 1965, lomilomi was the only Hawaiian healing art that could be licensed at all, and the license was a massage license.
Lāʻau lapaʻau
The pharmacy is grown from garden, forest, and shore
Lāʻau lapaʻau treats with plants, and noni is its best-known remedy. Scot Nelson's species profile lists the traditional Pacific uses. Fruit poultices treat boils and carbuncles. A gargled mash of the ripe fruit treats sore throat. Leaf or fruit poultices go on sprains, deep bruising, and rheumatism, and whole fresh fruits are taken against intestinal worms.
Nelson also records that most of these applications have not been tested scientifically. That describes the modern literature. The healers built the list by watching results across generations.
Around noni stands a full materia medica. Kumukahi records kukui oil rubbed into the skin to keep it from drying. ʻŌlena, turmeric, reduces swelling and eases aching joints. Paʻakai, salt, is combined with the red clay ʻalaea and other lāʻau as part of treatment. Nothing is gathered casually, because the pule said over the plant is part of the prescription.
Hoʻoponopono
An unresolved relationship is treated as a health problem
Hoʻoponopono means to put to rights. Pukui and Elbert define the practice as family conferences that set relationships right through prayer, discussion, confession, repentance, and mutual restitution and forgiveness. Mary Kawena Pukui documented the Kaʻū family style with E. W. Haertig and Catherine Lee in Nānā I Ke Kumu, published by the Queen Liliʻuokalani Children's Center in 1972.
Manulani Aluli Meyer, a Native Hawaiian scholar who has practiced the process for more than thirty years, sets out its vocabulary. Hihia is the tangling of emotions that hinders forgiveness. Hala is the fault at the center of it. Hoʻomauhala is the grudge held past its moment. Kala is the release that unties the whole knot. Kukulu kumuhana is the pooling of mana toward a stated purpose, and it is also the moment the problem is named aloud.
Five agreements precede the work: shared commitment, ʻoia iʻo or the essence of truth, aloha for one another, confidentiality, and an agreed haku to hold the process. An entanglement between people is a condition that shows up in bodies, and untying it is treatment rather than counsel.
Lōkahi
Health is harmony across god, land, and people
Lōkahi is unity, agreement, accord, harmony. Native Hawaiian health researchers draw it as a triangle. Mapuana Antonio and colleagues published the figure in the Hawaiʻi Journal of Health and Social Welfare in 2023. Nā akua sit at the apex, kānaka and ʻāina at the base, and health is pono relationships across all three.
Illness follows from falling out of lōkahi, and Donlin records that a kahuna's first step in treating a sick person is to pray and restore it. Papa Ola Lōkahi builds its current ahupuaʻa model on the same logic, treating the stretch of land from mountain to sea as one interconnected unit and healing as collective work across kānaka, ʻohana, and kaiāulu.
The Unified Model of Tone reads lōkahi as a claim about regulation. A body sits inside relationships that load it, and its condition is a balance that can be pushed out and brought back. Hawaiian practice states that balance in terms of akua, ʻāina, and kānaka. This model states it as tone, a regulated property of the nervous system that can be measured directly. The observation belongs to Hawaiʻi. The measurement is what the model adds.
Collapse
Epidemics and law strip the healers of standing
Venereal disease arrives with Cook's crew in 1778. The maʻi ʻōkuʻu follows in 1804. Waves of influenza, measles, whooping cough, and smallpox run through the nineteenth century, and the smallpox epidemic of 1853 to 1854 alone takes an estimated 7,000 lives.
The population figures depend on where the count starts. Estimates of the Hawaiian population at contact range from about 100,000 to more than a million. The countable series is the one Papa Ola Lōkahi begins after contact: 150,000 in 1820, 40,000 in 1893, and 28,800 in 1900.
The legal record moves in the same direction. In 1819, six months after Kamehameha I dies, the kapu system is overthrown, heiau are destroyed, and kāhuna officially lose their standing. New England missionaries land in 1820 with the first Western physician. Armstrong-Wassel records that formal laws begin restricting Native Hawaiian healing practices as early as the 1830s, and that by the late 1840s newspapers are printing the word mea hoʻopunipuni, liars, for kāhuna. After the 1893 overthrow the Republic repeals the Kingdom's laws on kāhuna, and the practice returns to secrecy.
The return
The practice outlasts the laws written against it
Hōkūleʻa sails from Hawaiʻi to Tahiti in 1976, guided without instruments by the Satawalese wayfinder Mau Piailug, and the Polynesian Voyaging Society records more than 17,000 people waiting at Papeʻete Harbor. Kahalewai marks that voyage as the point where lomilomi, ʻōlelo Hawaiʻi, and the healing arts could be carried openly again.
The E Ola Mau needs study of 1985 put Native Hawaiian health in front of Congress, and its recommendations included bringing traditional healing back into Native Hawaiian health care. Congress passed the Native Hawaiian Health Care Act in 1988 and established Papa Ola Lōkahi. The Act defined a traditional Native Hawaiian healer in statute, on learning acquired by direct association with Native Hawaiian elders.
Act 162 of 1998 exempted the healing arts from state medical licensure. The kūpuna who met that October declined the certification the law offered them and named the question the community's own. Act 304 followed in 2001, and Act 153 of 2005 handed the criteria to independent Kūpuna Councils. Lomilomi, lāʻau lapaʻau, hāhā, and hoʻoponopono are practiced in Hawaiʻi today by people who learned them from people.
The convergence
What Hawaiʻi documented, and what it is called now
Hawaiian practitioners have no instruments and no anatomy of the nerve. They work from the hands, from what a family says aloud, and from what changes after treatment. Their system is built around a balance that can be pushed out and brought back. Traditions with no contact with one another arrived at the same short list of observations, which is evidence that the state itself is real and detectable by an unaided observer. The Unified Model of Tone names that state tone and measures it.
- Hāhā reads the body with the fingertips before anything is applied, and lomilomi then doses compressions, stretches, percussion, ʻiliʻili stones, heat, lomi sticks, and saltwater to what the reading found.Input quality, where the character of an input decides the response.
- Lōkahi places a person's health inside reciprocal relationships with akua, ʻāina, and other people, and the ahupuaʻa model treats mountain, valley, and sea as one unit that moves together.Coupling, the linkage that makes separate parts behave as one system.
- Hihia names the tangle that builds when people are careless with one another, hoʻomauhala names the grudge held past its moment, and kala names the release that unties both at once.Load, the accumulated demand a system carries until something gives.
- Illness is described as falling out of lōkahi, and the healer's first move is to pray and restore it, which makes health a balance returned to rather than a symptom removed.Set point, the value a system defends and returns to.
Common questions
Frequently asked
What is lomilomi?
Lomilomi is the traditional Hawaiian healing practice of working the body with the hands, forearms, elbows, and feet. Nancy S. Kahalewai describes a repertoire of compressions, stretches, kneading, percussions, squeezing, and soothing strokes, carried further with plants, herbs, salt, heat, saltwater, smooth ʻiliʻili stones, and lomi sticks. Treatments begin and end with pule, prayer. The word comes from lomi, which Pukui and Elbert define as to rub, press, squeeze, knead, or massage.
How is traditional lomilomi different from a spa lomi lomi massage?
Traditional lomilomi descends inside ʻohana. The elder chooses who learns it, prayer and protocol are part of the work, and the practitioner's own state is understood to matter. A spa treatment borrows the strokes and the name. One legal accident explains the confusion: Act 153 of 1965 repealed Hawaiʻi's licensing of Hawaiian medicine, after which lomilomi could be licensed only under the state massage law. The commercial version grew inside that opening.
What is hāhā, the Hawaiian diagnosis by touch?
Hāhā means to grope or to feel with the hands. Pukui and Elbert's Hawaiian Dictionary gives kahuna hāhā its own gloss: an expert who diagnoses, as sickness or pain, by feeling the body. Kamehameha Schools' Kumukahi curriculum traces the art to Lonopūhā, who diagnosed illness by feeling the patient's body with his fingertips. Warmth, texture, resistance, and pulse are read by hand before any treatment is chosen, by a practitioner trained across decades.
What is hoʻoponopono?
Hoʻoponopono means to put to rights. Pukui and Elbert define it as family conferences that set relationships right through prayer, discussion, confession, repentance, and mutual restitution and forgiveness. Mary Kawena Pukui documented the Kaʻū family style in Nānā I Ke Kumu in 1972. Its vocabulary names the problem precisely: hihia is the tangling of emotions, hala is the fault at its center, and kala is the release that unties both. Much of the practice remains within families.
What do mana and lōkahi mean?
Pukui and Elbert define mana as supernatural or divine power, authority, and the quality of being divinely powerful. In hoʻoponopono, kukulu kumuhana is the deliberate pooling of a family's mana toward one stated purpose. Lōkahi is unity, agreement, accord, and harmony. Native Hawaiian health researchers draw it as a triangle joining nā akua, the spiritual, with kānaka, the people, and ʻāina, the land. Balanced relationships across the three produce pono outcomes.
Is traditional Hawaiian healing recognized in law today?
Yes. Congress passed the Native Hawaiian Health Care Act in 1988, established Papa Ola Lōkahi, and defined a traditional Native Hawaiian healer in statute. Hawaiʻi's Act 162 of 1998 exempted the Hawaiian healing arts from state medical licensure. Act 304 followed in 2001 and Act 153 of 2005 placed the criteria with independent Kūpuna Councils. The kūpuna who issued the Kāhuna Statement in October 1998 held that credentialing is the Hawaiian community's own responsibility.
What does the Unified Model of Tone say about Hawaiian healing?
That Hawaiian practitioners are reading a regulated bodily state by hand and describing what they find accurately. Hāhā reads before anything is applied, and lomilomi doses pressure, rhythm, stone, and heat to what the reading found. Lōkahi holds health inside relationships that load a person. Hihia and kala name accumulation and release. The model does not adopt mana as its mechanism. It holds that the state these practitioners track is the state it now measures as tone.
Keep reading
Where this connects
- Tone is the regulated state a kahuna hāhā reads by hand, defined and measured.
- Input quality is why lomilomi specifies pressure, rhythm, stone, heat, and saltwater rather than force.
- Coupling is the modern account of lōkahi, where a change in one relationship shows up in the body.
- Load is what hihia names when an entanglement is carried long enough to cost the person health.
- Set point explains why falling out of lōkahi and being restored to it are two directions of one quantity.
- Aotearoa holds romiromi, the Māori bodywork practice whose name carries the same Proto-Polynesian root as lomi.
- The wider Pacific carries the same canoe plants and the same conviction that a trained hand can read a body.
- Aboriginal Australia holds its healing knowledge in Country and in oral law, with no written canon standing behind it.
Sources
References
- Kirch, P. V. When Did the Polynesians Settle Hawaiʻi? A Review of 150 Years of Scholarly Inquiry and a Tentative Answer. Hawaiian Archaeology 12(1): 3 to 27, 2011.
- Pukui, M. K. and Elbert, S. H. Hawaiian Dictionary. University of Hawaiʻi Press, 1986. Entries for hāhā, lomi, lomilomi, lōkahi, hoʻoponopono, and mana, via Wehe²wiki².
- Pukui, M. K., Haertig, E. W. and Lee, C. A. Nānā I Ke Kumu (Look to the Source), Volume 1. Queen Liliʻuokalani Children's Center, 1972.
- Meyer, M. A. Hoʻoponopono: Healing through ritualized communication. Indigenous Peacemaking Initiative, Native American Rights Fund.
- Donlin, A. L. When All the Kāhuna Are Gone: Evaluating Hawaiʻi's Traditional Hawaiian Healers' Law. Asian-Pacific Law and Policy Journal 12(1): 211, 2010.
- Papa Ola Lōkahi. Hawaiian Health Timeline and Events. Compiled by Kekuni Blaisdell, 1998; updated 2016.
- Office of Hawaiian Affairs, Research Division. A Brief Overview of Epidemics in Hawaiʻi. Information Sheet, 2020.
- Armstrong-Wassel, N. Hawaiian healthcare traditions endure. Ka Wai Ola, Office of Hawaiian Affairs, March 1, 2018.
- Kahalewai, N. S. Traditional Hawaiian Lomilomi Is Alive and Well. Ke Ola Magazine, November to December 2021.
- Kamehameha Schools. Kumukahi: Lāʻau Lapaʻau and Lomilomi.
- Nelson, S. C. Morinda citrifolia (noni). Species Profiles for Pacific Island Agroforestry. Permanent Agriculture Resources.
- Antonio, M. C. K., Keaulana, S., Keliʻiholokai, L., Ho-Lastimosa, H. I. and Chung-Do, J. J. Indigenous Research Methodologies with Kānaka ʻŌiwi to Address Health Inequities. Hawaiʻi Journal of Health and Social Welfare, 2023.
- Papa Ola Lōkahi. Ahupuaʻa Cultural Healing Model.
- Native Hawaiian Health Care Act of 1988, Public Law 100-579, 102 Stat. 2916, approved October 31, 1988.
- Polynesian Voyaging Society. Hōkūleʻa: History. Account of the 1976 Hawaiʻi to Tahiti voyage.
Last updated 2026-08-10