xxvi Annual Address. [February, 1916. 



different alkaloids of cinchona bark, as the excellent investiga- 

 tions of Major MacGilchrist in Calcutta during the last two 

 years have shown. 



The next example I will take is that of ipecacuanha and 

 its active alkaloid emetine, which also have an interesting and 

 instructive history. Ipecacuanha appears to have been first 

 carried to Europe from Brazil by Piso in 1648 and was brought 

 into public notice by Helvetius, who used it successfully as a 

 secret remedy in 1686, and, after he had cured the dauphin 

 with it, the secret was bought from him by the French Govern- 

 ment and made public. In those days it was used in large 

 and effective doses of twenty to forty grains, but subsequently 

 the usual dose was reduced to one to three grains. The drug 

 has been much used in India during the last century, while the 

 method of giving large doses was revived by Docker in Mauri- 

 tius in 1858, although I find that Edmund Parkes as early as 

 1846 advocated equally large doses in the Madras Presidency. 

 Docker received the practical reward of an increased pension, 

 albeit a small one, from the Government for his rediscovery of 

 the value of large doses of the drug in dysentery. Since his 

 time it has retained its reputation in India, although up to the 

 end of the nineteenth century there was much difference of 

 opinion regarding the class of cases it benefited, as it was not 

 then known that there are two totally different forms of dysen- 

 tery, and that it is only useful in that which has now been 

 shown to be due to a pathogenic amoeba. The amoebic form 

 of dysentery was discovered by Koch and Kartulis in Egypt as 

 far back as 1883 and in 1890 in America by Sir William Osier. 

 In 1887 Kartulis also recognized the same organism in the pus 

 of a liver abscess, while McConnel, the very able physician and 

 pathologist of the Calcutta Medical College Hospital, was the 

 first to confirm this observation in India, although curiously 

 enough he does not appear to have recognized the occurrence of 

 amoebic dysentery in India. When 



in 1900 there was still great confusion and difference of 



opinion regarding the relationship, if any, between dysentery 

 and liver abscess, and it was one of the first subjects which 

 attracted my attention. I very soon discovered the presence 

 of amoebic desentery as a very common disease in India, 

 and after two years' work established the fact that tropical 

 liver abscess is always secondary to amoebic dysentery, and 

 never follows the bacillary form of bowel disease. Next I 

 showed that ipecacuanha has a specific action in the amoebic 

 disease only, which at once explained the widely divergent 

 views of physicians in different countries regarding the value of 

 this drug as it is only effective in places where°the amoebic 

 form is prevalent. It was only a step further to recognize that 

 ipecacuanha was also a specific in amoebic hepatitis which 

 always precedes abscess formation, as had indeed been held bv 



