This article is a condensed version of a previous review by the primary author in a 1992 issue of the Journal of Ethnopharmacology.(1) The co-authors have added new material.
Since first significant contact with Europeans in the 18th century, the Oceanic plant, Piper methysticum Forst. (Fam. Piperaceae), and the beverage prepared from it, both called kava, have become familiar to much of the outside world through written and visual media. The ceremonial preparation and consumption of the beverage are probably its most conspicuous and spectacular features. Kava continues to occupy a central place in everyday life in the islands concerned, although its role has been somewhat diminished by time and outside influences.
Despite the large body of literature on kava -- about 850 entries are listed in a recent bibliography by Singh(2) -- there has been no comprehensive review on the subject. Earlier contributions by Keller and Klohs(3) and Shulgin(4) were selective in treatment and dealt primarily with chemical and pharmacological aspects. The monograph by Steinmetz(5) remains a standard reference but some of the information in it has become dated. There are three excellent additions to the recent kava literature, by Lebot and Cabalion,(6) Brunton,(7) and Lebot et al.,(8) which are significant contributions to the subject. A recent popular publication has been written by Kilham.(9))
This review provides an updated and a multidisciplinary overview of kava. It was prepared on the basis of the author's personal experience -- he is a native of Fiji and lived in that country for about 30 years -- as well as the relevant literature listed in the Singh(2) bibliography and some more recent publications.
Oceania is the term for the island communities of the Pacific Ocean encompassed by Polynesia, Melanesia, and Micronesia (see map on page 41). According to some authorities, Oceania is one of the few culture areas (another being most of North America) not to have had alcoholic beverages by the time of the first significant contact with Europeans in the 18th century. However, since the beginning of recorded history for this geographic region, most of the islands did possess the drink kava. Like alcohol, it had acquired important symbolic meanings; associated with it were a large number of rules and procedures for its preparation, distribution among participants, and consumption.
The importance of kava in Oceania should perhaps be considered in the context that every culture has had its own intoxicants, narcotics, or stimulants, or both, and, in spite of their great diversity, they have had the same kind of social status and significance.(10) The kava custom so widespread throughout Oceania might be considered the one item in their material culture that linked together most of the peoples of Oceania. Besides being the social beverage for chiefs and noblemen, it was also used to welcome distinguished visitors at formal gatherings,(11) at initiation and completion of work,(12,13) in preparing for a journey or an ocean voyage, installation in office,(14) validation of titles, ratification of agreements, celebration of important births, marriages, and deaths,(13) as a libation to the gods,(15) to cure illnesses and to remove curses,(16) as a prelude to tribal wars -- in fact, in almost all phases of life in the islands,(17)
The Swedish botanist Daniel Scholander and Sydney Parkinson, the artist charged with the task of making drawings of newly discovered plants, both of whom accompanied Captain James Cook on his first voyage in the Endeavour (1768-1771), probably were the first Europeans who saw and recorded the kava plant. However, the credit for the first detailed description of the plant is usually given to Johann Georg Forster.(18) Forster named the kava plant "Piper methysticum" or "intoxicating pepper," methysticum being the Latin transcription of the Greek methustikos, and derived from methu, which, according to Steinmetz(5) means "intoxicating drink." Since these early accounts, a large body of both scientific and ethnographic accounts on kava has accumulated. Reference to this literature may be found in three extensive bibliographies.(2,19,20) Additional references are included in Lebot and Cabalion,(6) Brunton,(7) and Lebot et al.(8)
Although kava drinking was important on ceremonial occasions, it was not confined to such gatherings. Old men often had a cup first thing in the morning and senior members of the family had a cup before (but not after) a meal.(12) A visitor often took a root of kava as a present for the person being called upon,(21) and this custom persists today.
ETYMOLOGY OF THE TERM KAVA
The term kava and the variant kawa are used for both the plant and the beverage made from it. However, some other names or variants are also encountered. In Hawaii, Tahiti, the Marquesas, and some other Polynesian areas, the initial k of the word is often dropped and it may become ava or awa. The Maoris, on migration to New Zealand, did not find the kava plant in their new environment, so they applied the names kava and kawakawa to a related plant (Piper excelsum) much used in religious ceremonies. However, this plant was not made into a beverage.(22)
The term kava or its equivalent may be used in Polynesia to designate various properties of food and drink. In Hawaii, it means "bitter," "sour," "sharp," or "pungent." In the Marquesas it signifies "bitter," "sour," or "sharp." In Tahiti, the range is broad, including "bitter," "sour," "acid," "acrid," "salty," "sharp," and "pungent".(23)
A commonly held view is that kava was introduced into Melanesia from Polynesia. In some parts of Melanesia, it is probable that the use of kava has been so introduced, and that recent Polynesian influence has greatly modified an earlier method of using this substance.(22) Thus, in various members of the Vanuatu group (formerly New Hebrides), the name is the same as in Polynesia.(22) In the Banks Islands it is called gea, and in the Torres Islands gi, both of which are perhaps related to the Polynesian word.(22) Another view holds that kava may have originated in either northern Vanuatu or Papua New Guinea.(6)
In Fiji, there is a wholly different term, yaqona. In Fijian orthography, the letter q stands for the sound ng and hence yaqona is pronounced yangona. Lester reports that the word qona is used on the northwest coast of the main Fijian island of Viti Levu to denote both "beverage" and "bitter."(25) He suggests that it was to this part of Fiji that kava was first introduced and that local people supplied the name yaqona now used throughout the Fijian archipelago.
GEOGRAPHIC DISTRIBUTION OF KAVA USAGE
Although identified mainly with Western Polynesia, kava has been found and historically used in nearly all the Pacific islands, except for New Zealand, New Caledonia, and most of the Solomon Islands, although it is now being used in some of these areas. A survey of the available literature establishes the presence of kava in nearly all the island groups of Oceania. The map on page 41 shows the location of most of the islands in the Pacific Ocean on which kava has been found or used.
The Hawaiians placed great importance on kava drinking as late as the end of the last century.(26) Titcomb states that the kava custom was highly esteemed in Hawaii because it was a sacred drink of great significance in many phases of Hawaiian life.(27) Outside of water and coconut milk, no other drink was known. Its effect was to relax the mind and body, and it was used by farmers and fishermen alike for this purpose. Medical kahunas (or learned men) had many uses for it. It was customary for chiefs to drink it before meals, commoners also if it was obtainable. At one time, commoners were subject to penalty of death if caught drinking kava. Kava drinking was essential on occasions of hospitality and feasting, and was the drink of pleasure of the chiefs. However, the sale and use of kava rapidly decreased from the beginning of this century.(153) Titcomb notes that in 1903 "no Hawaiian went home from the Saturday market without an `awa' root tied to his saddle."(27) In 1930 awa w as still to be purchased in the market. Missionaries discouraged drinking of kava and were responsible for discontinuation of its use by Hawaiians. By 1948 the practice had completely disappeared, although the plant continues to grow in the wild.
The resurgence of kava drinking on the Vanuatu island of Tanna in the early 1940s may be related to the ritual of the John Frum cargo cult, that arose partly as a repudiation of the teachings of the Christian missionaries.(28) Kava in Vanuatu is drunk socially and ceremonially, and the plant is recognized as a remedy for a number of physical ailments. Previously kava was not use in ceremonies.
Historically, the most important centers of kava usage were Fiji, Samoa, and Tonga. In these countries it was consumed not merely as a beverage but as the focus of an elaborate system of social ceremonials and rituals, and also had certain important magicoreligious aspects. In the last few decades kava has begun to resume some of its earlier importance. This may be closely linked to the gaining of political independence and the subsequent reassertion of ethnic values and customs which were somewhat suppressed or discouraged during the colonial era.
Kava was drunk in the Solomons on the islands of Vanikoro and Utupua,(21) but it was unknown in the Santa Cruz islands.(20,29) Men drank kava at burial ceremonies but not on other occasions. The only island in the Solomons group reported to have contemporary knowledge of kava and its uses is Choiseul, where some islanders claim it is used medicinally.(31)
During the last century, kava was grown on all the islands of the Cooks group, but the infusion, prepared from the root of the plant, did not have the same ceremonial significance as it had in Western Polynesia.(32) However, it is now impossible to locate the plant on these islands, and all practices related to it have completely disappeared.
Scarcity is the reason sometimes given for the fact that in Tahiti kava drinking was only indulged in by the chiefs.(33,34) Although the kava root was scarce and little used in Tahiti, in the other Society Islands (or French Polynesia) there were great plantations of it.(18) This suggests that it was probably a lack of desire rather than of supply which limited kava drinking by the natives of Tahiti, as they could presumably have obtained supplies from the other nearby islands if they wished.
On Wallis Island the position of the kava ceremony was as highly esteemed as anywhere else in the Pacific.(35) All official decisions concerning the community's administration, such as promotions, official takings of possessions, and proclaiming of laws and codes of conduct were made at such ceremonies. The kava root was often used in reconciling with enemies or in preserving the goodwill of kings and chiefs. Indeed, guilty persons often owed their pardons and sometimes even their lives to it. In the neighboring island of Futuna kava was used to express friendship and to allay fear. Mangeret notes that once, on the arrival of a French ship, the native people, fearing vengeance for the murder of a missionary a few months earlier, presented the captain with an enormous kava root.(35)
Tikopia is perhaps the most famous of the Polynesian outliers (i.e., islands which lie in Melanesia but whose people are Polynesian in origin), mainly because of the extensive work done there by the renowned anthropologist Sir Raymond Firth. In Tikopia the use of kava differs radically from its use in other areas of the Western Pacific. Firth contends that "historically there is little doubt that the kava rites of Tikopia belonged to the same general series as those of Tonga, Samoa and Fiji and may well have been imported from that area."(15) In Tikopia kava was and still is very rarely drunk. Most of the liquid is poured away in libations, and the remainder usually emptied out on the ground before the bowl is wiped clean. The Australian Aborigines had no contact with kava until the early 1980s when they learned about it from missionaries who came to their communities from Fiji, Tonga, and other kava-growing societies of the South Pacific.(36) At about the same time Aboriginal leaders visiting Fiji and Polynesia were impressed with the kava ceremony and advocated kava use in their own communities as an alcohol substitute.(37) Soon thereafter kava was introduced from Fiji to Aboriginal communities in Northern Australia and rapidly became a substance of abuse,(36,38) probably because of a lack of ceremonial or traditional restraints controlling its use. Estimates for individual consumption have ranged as high as 50 times the amount habitually consumed in the Pacific Islands. Some reports contend that kava abuse has become a serious social and health problem in regions of Northern Australia(39,40(+)) but these reports have been largely discredited.(153) BOTANIC ORIGINS OF KAVA The origins of kava usage in Oceania are not known. Kava drinking itself is much older than any written history of this part of the world, and oral traditions do not seem to have brought forward relevant reliable accounts. It should be noted that at first contact none of the island communities had an alphabet, and therefore a written language of their own. Some of the hypotheses concerning the botanic origins of kava are worth considering. According to Newell, the origin of the kava plant appears to have been in the New Guinea-Indonesia area or further north.(17) He discusses three possible ways in which the plant could have spread to Tonga and the eastern Pacific, namely: (a) by the islands being attached to a main land mass on which kava evolved and developed; (b) by drifting or being otherwise transported from island to island; and (c) by being transported by people in canoes. The first of these proposals may be discounted, as most of the islands of Oceania are of comparatively recent geological origin and consist of coral limestones or volcanic cones. The possibility that the plant or its root drifted to the various islands on which it is now found seems equally remote because of the great distances and the large number of islands involved. Thus, without completely dismissing the first two possibilities, Newell concludes that the kava root or plant was brought by early Polynesian explorers in much the same way as they brought other plants in their canoes. The second hypothesis places the origins of the kava custom on the Asian subcontinent. In his works on the cultural origins of Polynesians, Handy proposes an alternative to the theory that the different cultures of the Polynesian area are the products of evolution within Polynesia itself, that is, of a single culture which the original Polynesians brought with them. He compares various cultural traits of Polynesians with those found in Southern China and connects the drinking of kava in Polynesia with the ancient Chinese tea ceremony.(41) Williamson, on the other hand, thinks that the Polynesians might have originated slightly further west, in the southern parts of India.(42) In a detailed and carefully documented treatise, he argues that the kava ceremony might equally well be compared with the ceremonials, rituals, and beliefs connected with the drinking of soma in the ancient Vedic religion, a ceremony to which it bears considerable resemblance. He discusses many points of similarity between the kava ceremonial and the Vedic ritual. Another theory, proposed by Rivers, holds that the kava custom was related to, or developed out of, an earlier established practice of betel nut chewing.(22) In fact, Rivers has suggested the presence of two quite distinct cultural traditions in Oceania: the betel nut culture and the kava culture. Betel nut chewing involves three separate ingredients -- crushed nut of the areca palm (Areca catechu L. Palmae), leaves of Piper betle L. Piperaceae, and slaked lime -- while kava requires only one ingredient. Rivers believes that partly because of this, kava drinking succeeded betel nut chewing as migrants were unable to acquire all the necessary components for the earlier habit. Rivers also thinks that kava drinking arose in part as a result of the needs encountered by the immigrants under alien conditions who found the kava root more satisfying than the betel nut. This latter suggestion is queried by Williamson on two counts.(42) First, both the betel nut and the kava plant grow in the same areas of New Guinea and Samoa, and yet, in New Guinea, kava is of little importance, whereas in Samoa betel nut chewing is virtually unknown. Second, the fact that kava is less potent than the betel nut may invalidate Rivers's reason for the immigrants' preference for kava over the betel nut. Churchill also proposes the presence of two cultures based on the distribution of kava and betel in Oceania.(43) He suggests that these two cultures belonged to two immigrant peoples whom he calls the kava people and the betel people. The kava people settled in Southern Melanesia, Fiji, and Polynesia while the betel people did not extend in their southeasterly movement beyond the Solomon and Santa Cruz islands. However, elements of the culture of the betel people may have carried directly or indirectly to Southern Melanesia, Fiji, and Polynesia, in a minimal way, and any that does exist is probably of recent origin.(7) LEGENDS OF THE ORIGIN OF KAVA Kava enters into many myths and legends, many relating to the origin of the plant and the beverage. Different versions have been recorded from all parts of Oceania, e.g., Hawaii,(427,44) Samoa,(21,42,45) Marquesas and Rotuma,(46) Tonga,(47) Futuna,(25) Vanuatua,(22,) Fiji (25) and Tikopia(15) to name a few. In Fiji, three legends regarding kava and its origins are remembered.(25) The first refers to a root which was found growing on the grave of a Tongan leper. The second legend, which comes from the eastern Fijian islands of Lau, implies that kava was introduced into Tonga from Lau -- or vice versa -- because of the close proximity between the islands. The third, and probably the most important, comes from the northeast coast of Viti Levu, not far from a traditional settlement. One group of settlers, led by Degei, journeyed inland and settled near Nakauvadra. The legend is that two of the settlers killed a rooster which had awakened Degei by its crowing every morning. This action angered Degei and they fled from his wrath, taking with them samples of all of the material culture of the community with the sole exception of kava, which they left behind for Degei's use. This legend might also explain why kava was originally used only at religious rites, with its consumption limited to the chief (who was considered the mortal representative of the ancestor god) and his priests. According to a Samoan tale from Manu'a, an island studied by Margaret Mead,(13+) Tangaloa came down from heaven with two assistants who went fishing for him. In those days there were no hooks, lines, or nets, so they had to fish with their hands. They caught a fish and brought it to Tangaloa, but he wished to have kava to drink with it. As there was none on earth, he sent them back to heaven to bring down a root of it. They, however, pulled up the whole plant and brought it down with them, and as Tangaloa scattered the superfluous parts all over the earth, they grew up luxuriantly. He wanted some water in which to infuse the kava and this was supplied by a downpour of rain. The two attendants also brought down from heaven the necessary bowl (tanoa), strainer (tau'anga), and cup (ipu) for preparing and drinking the kava. That is how, according to the tale, this drink of the gods was introduced to earth.(42) In the Marquesas, the original kava was the child of their great god Atea, the provider of good seasons and rain, and patron deity of farmers. In Rotuma, in the Fiji group, the original kava was believed to have floated to the island from Samoa.(46) And on Pentecost(**) in Vanuatu, the story is told that a man once saw a rat nibbling a root of kava, and watched it fall down and presently come back to life again. He saw this happen several times and then tried the root himself.(22) In his monograph, Tongan Myths and Tales, Gifford describes four variants of a Tongan legend, one of which is outlined below.(47) The great chief Loau, who lived in Ha'amea, on the island of Tongatapu, one day sailed to the small island of Euaiki to visit his faithful servant Feva'anga. Feva'anga wished to honor his chief with a great feast but it was during the time of a great famine. In desperation he and his wife killed and cooked their only daughter to be served to the chief. However, Loau recognized the human flesh in the food when it was served. He instructed Feva'anga to plant the food in the ground and to bring him the plant when it matured. On receiving the mature plant, Loau instructed that a drink be prepared from it and consumed with due ceremony. EFFECTS OF KAVA DRINKING There is some disagreement as to the taste of the kava drink. In 1903, Emerson wrote: "While tramping in the woods I have often moistened my tongue with a piece of awa chipped from some root, and experienced relief from thirst by its pleasant, cooling, aromatic, numbing effect in the mucous membrane of the tongue."(26) According to Sir Peter Buck -- or to use his given name, Te Rangi Hiroa -- a Polynesian physician from New Zealand who often drank kava, "It is cooling, refreshing, and stimulating without being intoxicating....Used in moderation, it is probably the best drink for a tropical climate."(48) On the other hand, other reports talk of great bitterness and a burning taste in the mouth. For instance, Ellis wrote: "If an opinion of its taste might be formed by a distortion of their countenance after taking it, it must be a most nauseous doser,"(49) while Churchill observed that "Polynesians do not praise kava for its taste, it is the odor which appeals to their sense of pleasure."(23) It is generally agreed that the first effect of drinking kava is a numbing and astringent effect on the tongue and, to a lesser extent, the inner lining of the mouth. Titcomb quotes two Hawaiians, one of whom reported, "there is a peculiar bitterness with a feeling of thickness in the mouth, so that one does not taste the deliciousness of food after chewing or drinking awa," and the other, "If you chew a piece in your mouth, it is sour, and very bitter. The mouth will not taste food that is eaten after."(27) A little while after drinking, kava is found to reduce fatigue, to allay anxiety, and to produce a generally pleasant, cheerful and sociable attitude, although some other quite different physiological effects -- some bordering on intoxication -- have been noted in various parts of Oceania. For instance, consider the following typical accounts from Melanesia and Western Polynesia: It gives a pleasant, warm and cheerful, but lazy feeling, sociable, though not hilarious or loquacious; the reason is not obscured.(50) The head is affected pleasantly; you feel friendly, not beer sentimental; you cannot hate with kava in you. Kava quiets the mind; the world gains no new color or rose tint; it fits in its place and in one easily understandable whole.(51) Thomson, in a highly prejudiced and exaggerated account, describes slightly more severe effects in this passage on "confirmed topers": The body becomes emaciated. The skin becomes dry and covered with scales, especially the palms of the hands, the soles of the feet, and the forearms and shins. Appetite is lost. Sleep is disordered. Eye becomes bloodshot. There are pains in the pit of the stomach. The drinker sinks into unwholesome lethargy.(30) Compare these reports with other accounts from various locations in Eastern Polynesia. Morrison, who visited Tahiti between 1788 and 1791, wrote: (Kava) almost immediately deprives them of the use of their limbs and speech, but does not touch the mental faculty, and they appear in a thoughtful mood and frequently fall backwards before they have finished eating. Some of their attendants then attend to chafe their limbs all over till they fall asleep, and the rest retire and no noise is suffered to be made near them. After a few hours they are as fresh as if nothing had happened, and are ready for another dose.(52) Titcomb quotes a report by a Hawaiian, Kaualilinoe, written in the last century: There is no admiration for the body and face of an awa drinker whose eyes are sticky, and whose skin cracks like the bark of the kukui trees of Lilikoi in unsightliness. If you are drunk with awa, you will find your muscles and cords limp, the head feels weighted and the whole body too.(27) Consider also Torrey's description of kava drinking in the Marquesas: Copious draughts cause a dizziness and a horribly distorted countenance. They lose the use of their limbs, and and fall and roll about on the ground, until the stupefication wears away.(53) All the above observations are based on infusions, not water-alcohol extracts or other dosage forms becoming popular in the West. There are obvious and well-documented differences in the pharmacological effects observed in Eastern Polynesian societies on the one hand, and in a large group of Western Polynesian and Melanesian societies on the other. Some reasons that may be advanced to explain the differential effects are: (a) Different varieties of Piper methysticum were used in different societies. Some indication has already been given of the large number of varieties available and of the differences in the strengths of kava prepared from them. For instance, the Samoan varieties are considered much less potent than those cultivated elsewhere in Polynesia.(54) (b) There could also be differences in soil and climatic variations. Titcomb notes that certain localities in Hawaii were famous for the potent kava. She quotes the native historian Kamakau who stated that: "From of old, there were places made famous by the intoxicating qualities of their awa, for example, Ko' uko'u on Kauai, Hena on Oahu, Lanakila on Maul, and Puna on Hawaii."(27) (c) The plant may be used in different states of freshness or maturity. Furthermore, the green root or stem provides the much stronger drink. Gadjusek found that islanders in Tanna and Tongariki in Vanuatu showed a distinct preference for freshly harvested roots for this reason, as do people in the Sigatoka River valley in Fiji.(55) (d) There are differences in the methods of preparing kava. The "Tonga method" and the "Fiji method" are described under the section on "Chewing and Pounding." A third method is sometimes used with the malicious intention of quickly intoxicating the drinker. For this, hot water is used to extract the kava from dry or green stock and the drink allowed to cool before serving. The effect far exceeds that of the other two methods of preparation. Obviously, the method of preparation would increase the amount of the active constituents extracted from the kava stock and hence the strength of the drink. (e) Effects may vary according to whether or not drinkers combine kava consumption with eating. Imbibers often assume that the combination of feasting with kava ingestion may result in less debilitating effects. In earlier times, Tongans always took food with kava to prevent nausea, and Mead speaks of an invariable association of food with kava in Samoa.(13) Morrison, writing of Tahiti, says that "a gill of this juice is a sufficient dose, but if they eat anything immediately before it, it has no effect,"(52) while Holmes found that in legends describing the origins of the kava ceremony in Samoa, the fono o le 'ava (food for the kava) went hand in hand with the beverage.(56) (f) The accounts of missionaries and explorers exaggerated the deleterious effects of kava drinking. This possibility should be seen in the context of the role of missions in helping shape Oceanic attitudes towards alcohol and kava. O'Brien, for instance, discusses the efforts to ban the drinking of kava and alcohol on Ponape as part of a program by the missions to gain and assert political power. He notes: The attack on kava was much more than the general missionary dislike of alcohol. The missionaries were far less concerned with prohibiting coconut toddy or rum. Kava was singled out for special attention because of the important position it held (in the system of political tribute) in native society.(57) (g) Different psychological attitudes towards kava drinking affected the response to ingestion of the drink. Those who expected or desired intoxicating effects were more likely to experience them, in very much the same way as with marijuana and other hallucinogens. (h) Additives, which might have been mixed with the drink, could have produced some of the more extreme effects. The practice of adding extracts of yaqoyaqona (Piper puberulum) or the daturas (Datura spp.), often with a malicious intent, is still practised in some places in Fiji. SOCIOLOGICAL ASPECTS SOCIAL CEREMONIAL The most significant role of kava continues to be social ceremonial. As Ford states, it is "the only way to welcome an important visitor. Sharing a bowl of kava tends to foster socializing and friendship and it is unthinkable that kava should not be a part of commemorating any important event. The practice is solidly embedded in social and political context."(11) Holmes, writing on the position of kava in modern Samoa, found that "kava drinking is without doubt the most important element of the aiava, the ceremony of greeting for visiting parties (malaga), and therefore carries much of the burden of Samoan hospitality."(56) Present-day ceremonies of welcome in Tonga, Samoa, and Fiji invariably include the kava ceremony. President and Mrs. Lyndon Johnson were offered the kava drink on their visit to Samoa in October, 1966. (See photo on page 37) On that occasion, "Samoans who had turned out from every corner of the island to welcome the Johnsons, applauded delightedly.(87) Queen Elizabeth of Great Britain and members of her family are always offered kava on their visits to Fiji and they always drink the beverage! On other occasions, Pope John Paul II has consumed the beverage as have First Lady Hillary Rodham Clinton, former First Lady Lady Bird Johnson and President Lyndon Johnson. However, kava is not always in the form of a drink when used in welcoming ceremonies. It appears from Friedlander's account that it was the custom in Samoa for each of the parties, both guest and host, to make a present of kava root to the other -- which was accompanied by polite speeches of welcome.(59) La Pérouse reports the appearance, on the arrival of the French in Samoa, of an old man with a branch of kava in his hand, and also the throwing into the sea of several branches of kava by some natives in another part of Samoa, as a sign of peace.(60) Cook says that in Tonga it was brought out in canoes to the English ships as a sign of peace and friendship,(62) and Mariner reports an incident where a chief, visiting the island of Vavau to quell an insurrection, was met by one of the rebellious men who removed his turban, gave the chief a piece of kava root, and kissed his feet as a mark of respect.(16) This practice of exchanging kava is still prevalent and is performed even where no chiefs or dignitaries are involved. Waqavonovono, in her study of Fijian medicinal plants, reports that she first "presented a sevusevu(¥) to the leader of the Y.W.C.A. group who returned the same procedure with another sevusevu of welcome. After several bowls of yaqona, I described to the group the purpose of my visit."(62) In the past, ceremonial kava drinking has invariably been the first act of most important community functions. Other important ceremonial uses of kava occur at meetings for divination, pacts of revenge, before the confinement of a woman when prayers are said so that the child may be a son,(14) the naming of a child at one year of age, after seeing the shark god Sekatoa in the water, settling disputes, pigeon snaring,(17) consecrating a boy child, and ceremonial initiation of girls trained in the sacred hula dancing and chanting.(63) In Tikopia, kava serves as a medium for the reaffirmation of the value of sacred symbols. Since it is used as a religious libation and not as a beverage, it is ceremonially poured out, not drunk.(15) In less peaceful times kava was consumed by chiefs and warders prior to battle. For example, the first king of Tonga, Taufa'ahau, incited his troops to battle by a kava ceremony,(14) and Mariner(16) describes how the head chief of a village anointed his war leader by symbolically offering the first cup of honor to him. MEDICINAL In many parts of the Pacific, it was generally thought that kava, taken judiciously, had a beneficial effect on health. The Hawaiians used it for many purposes -- to soothe the nerves, to induce relaxation and sleep, to counteract fatigue,(27) for congestion in the urinary tract, for asthma and rheumatism, and to reduce weight.(63) They considered the leaf good as a poultice for headache or for placing under a patient to make him or her perspire to break a cold or fever. Treatment by kava for excessive fat brought the body back to normal fitness. According to Diehl, "it is a spinal rather than a cerebral depressant; it steadies the pulse, does not raise the temperature, and acts as a diuretic and a stomachic tonic. Its chief medical use is in the cure of chronic cystitis and gleet and, amongst those South Sea Islanders affected with syphilis, its stimulating and diaphoretic action was highly appreciated."(54) Harrisson found that it was formerly used extensively as "a curative i n cases of gonorrhoea.(63) Kava-drinkers very seldom get gonorrhoea. If they do, the kava itself cures it in time, always keeps it under control." According to Titcomb, Hawaiian medical men (kahunas) made extensive use of kava for the cure or alleviation of such ailments as "general debility, especially in children," "weary muscles...a great restorer of strength," for "chills and head colds," "difficulty in passing urine," "sharp blinding headache," and for children having a "disorderly stomach and...thick, white coating on the tongue."(27) Other disorders for which kava was recommended and used included "lung and kindred troubles," "weaknesses arising from certain conditions during virginity," "displacement of the womb," and as "a poultice for boils." Jarret notes that "it was extensively used in Germany previous to the World War, in the manufacture of certain drugs and medicines,"(65) and Emerson mentions kava as an article of export, noting that its "value as a drug is in the preparation of remedies for urinary troubles."(26) In Tanna, where custom ascribes to women a mysterious power which may destroy the potency of ka va, Tannese women drink it medicinally, and give it to their children (a one-teaspoon dose is considered to cure whooping cough); its power then seems unimpaired.(66) MAGICO-RELIGIOUS In addition to its social ceremonial uses, kava has been employed for a number of magico-religious purposes. One of the most important of these was the pouring out of libations of the beverage to the gods, although in some cases the symbolic offering of kava root was substituted. Turner notes that in Samoa the head of a household, at the beginning of the evening meal, would pour a little kava onto the ground or around the edge of the mat as an offering to the gods.(12) In pre-Christian days in Fiji, the first cupful was poured out at the foot of the main kingpost of the bure or tribal hall.(67) At formal kava parties, the first cup was always proclaimed by the priest as being for the gods.(22, 68,69) Often the names of ancestors were also invoked at this time. Mariner also refers to a Tongan custom whereby a small piece of kava root was left before a consecrated house or grave, out of respect either to a god (or gods), or to the departed spirit of a relation or chief.(16) On so me of the outlying Tongan islands a piece of scraped kava was thrown into the sea when invoking the shark god Sekatoa.(42) Reference was made earlier to the presumed absence of kava drinking by Niueans, probably because of its scarcity; whatever material was available was reserved for the inspiration of their priests.(69) In Hawaii, a major function of the kahunas was to establish communication with the gods. These priests were experts of religious practice, with knowledge of what to offer, what prayers to use, and what interpretations to place on portents.(27) Of the offerings made, kava was thought to be the most important to propitiate the favor of the gods. Root, beverage, and leaves were all suitable, while one exceedingly powerful offering was a "complete" kava -- that is, a plant with one root, one stem, and one leaf. Among the orders of priesthood in Hawaii, there were three which were particularly dreaded -- those who prayed victims to death, sorcerers, and those who sent evil spirits on errands of death.(27) Of these, the last named used kava exclusively. In Fiji, kava has also been used both in sorcery and witchcraft.(25) If an individual desired the death of his neighbor, he recruited the services of a sorcerer who prepared kava and poured a libation on the grave site of an ancestor of the intended victim. The ceremony was repeated after the victim was dead. In many parts of Fiji kava is considered to have the gift of healing. If a child is sick, a piece of the kava plant is suspended from the roof of the house in full view of the patient. It is claimed that after two or three days normal health would be fully restored. CLINICAL STUDIES Mathews and coworkers have assessed the effect of kava usage on the physical health status of a group of Australian Aborigines.(40) (Subsequently, this research was discredited as being politically motivated by commercial alcohol interests to pressure a government ban of kava.(153)) The study found a correlation between the extent of kava usage and a number of abnormal medical symptoms in these individuals, including scaly skin rash, increased patellar reflexes, underweight, reduced levels of albumin, plasma protein, urea and bilirubin, decreased platelet and lymphocyte count, shortness of breath and pulmonary hypertension. On the basis of the above observations, these workers recommended urgent social action to improve the health in Aboriginal communities by reducing kava consumption and improving the nutritional status of kava users. Although the effect of chronic drinking of traditionally prepared kava beverages (as distinct from water-alcohol extracts) on the skin has been mentioned in many reports,(27, 30, 44, 71)there have been only two reported attempts, those of Frater and Ruze, to understand the pharmacological basis for it and to search for a cure.(72,73) The lesion in question, called kani in Fijian, requires regular, almost daily, consumption of kava before it appears, and takes from a few months to a year or more to develop. The skin becomes dry and covered with scales, especially the palms of the hand, the soles of the feet, and the forearms, back, and shins. Frater, working with Fijian subjects, came to the tentative conclusion that kani was caused by an interference by kava with the normal uptake and assimilation of some of the B group vitamins. The condition could be reversed, even in the most serious cases, by a reduction in kava consumption and a balanced diet. In her study, Ruze selected 29 male Tongan kava drinkers, all of whom showed the characteristic skin lesions. Fifteen of these individuals were randomized to receive a dose of niacin (or nicotinamide) vitamin, while the remaining 14 received a placebo containing no active ingredient. After three weeks, clinical improvement was observed in five members from each group. These findings led Ruze to conclude that niacin vitamin deficiency was not responsible for the skin condition associated with excessive kava consumption since treatment with the vitamin did not produce an effect significantly different from control. In a 1996 randomized placebo-controlled double-blind study two groups of 29 patients were treated with a standardized special extract made from kava rhizome or placebo. The dose was 100 mg. of dry extract standardized to 70 mg. kava lactones three times daily for four weeks. The study concluded that the kava was clinically effective in reduction of states of anxiety, tension, and excitedness of non-mental origin. No adverse reactions were noted.(154) CONCLUSIONS Kava continues to occupy a central place in South Pacific communities, and its importance there recently has increased with the surge of interest in the ethnic culture and customs of the native people. Kava products are sold in the U.S. in many health food stores, Polynesian grocery stores, by mail order, and now in mass market outlets. Because of its reputed lack of addictive properties, legal availability, and claims by various authors (it induces "deep restful sleep and clear, epic-length dreams,"(74) "enhances psychic powers and visions,"(75) and "relieves insomnia and nervousness")(76) and because it has been recognized by European health authorities as a relatively safe remedy for anxiety,(77) kava is rapidly gaining popularity. Correspondence to: Prof. Y. N. Singh, Ph.D., College of Pharmacy, South Dakota State University, Box 2202-C, Brookings, SD, 57007 Fax: 605/688-6232. (+) For a detailed account of the impact of kava in Australia, see Prescott and McCall (1988). (++) Manu'a is one of the Samoan islands studied by the famous anthropologist Margaret Mead (1930). (*) The island of Pentecost is famous for its "land divers," whereby young men tie one end of jungle vines to their ankles, the other end being secured to the top of a platform 15-25 meters high, and leap to the ground from the top of the platform. The flexibility and the length of the vines are such that the fall almost always is broken just before the divers reach the ground, thus usually preventing any serious injury from occurring to the young men (see Johnson and Johnson, 1955; Muller, 1970). The recently introduced sport of "bungee" jumping from bridges and other high structures using large elastic bands (Time, April 15, 1991) has its origins in this custom of "land divers". (**) Fijian word for exchange of gifts, often as a prelude to a request for a favor.