344 



eesheer in Ned. Ind. Ill, 143), who states that it is not only valua- 

 ble in dysentery but also in chronic diarrhoea and sprue. 



The Malays of the Peninsula chew the roots with betelnut in 

 cases of cough, and boil the roots and drink the decoction for 

 rheumatism and fever. The Javanese say that in Java the leaves 

 are cut up and smoked with opium for, apparently, no other reason 

 than that they taste like opium. 



" This drug, which is little known in Europe though for ages 

 used by Chinese doctors and praised as an anti-dysenteric, was 

 first noted by Dybowskye E. Heckel and Fr. Schlagdenhauf- 

 FEN, have subsequently identified the drug botanically and sub- 

 jected it to exact chemical analysis. The latter detected, in addi- 

 tion to a considerable proportion of fatty qils, the presence of the 

 following active constituents, viz. : — quassin, saponin and another 

 bitter substance distinct from quassin. BERTRAND and PHISALIX 

 have arrived at the conclusion that the efficacy of the Kosam drug 

 is due to cosamin, a glucoside peculiar to it and soluble in water and 

 dilute alcohol. According to PHISALIX this glucoside induces in 

 mammals at first a retardation of the respiratory movements subse- 

 quently vomiting and diarrhoea. Death is attended by paralytic 

 symptoms and coma. The post-mortem examination disclosed a dif- 

 fuse inflamation of the digestive canal and the kidney, also hyperleu- 

 cocytosis accompanied by partial destruction ot the leucocytes. The 

 minimum lethal dose of cosamin introduced intravenously amounts 

 to 25 grm. (grs. 4) per kilo (lb. gV). In the case of subcutaneous 

 injection this dose is twice as large. Administered in small doses, 

 cosamin is an emeto-cathartic and cholagogue and appears to have 

 a detrimental effect upon the nematodes and taenias of dogs, at 

 the same time, it exercises a mildly microbicidal action. A cha- 

 racteristic feature of the preparation consists, however, in its pre- 

 viously mentioned elective action upon the kidneys, and the 

 mucous membranes of the mouth and intestine. MOUGEOT has 

 administered the drug in 879 cases of tropical dysentery and 

 secured a complete cure in 7 99 cases within 3-6 days, in 57 cases 

 recovery resulted after a lapse of 14 days, whilst 15 excessively 

 enfeebled and apparently stationary pitients had to be sent home. . 

 Only 8 cases could be recorded as complete failures. Similarly, 

 Cocnacq found that in fresh cases of acute, as well as chronic non- 

 inveterate cases of dysentery the drug plays the part of a specific. 

 Chronic dysentery of several years standing was not modified by 

 it. Particular importance attaches to the haemostyptic properties 

 of Kosam, and its cholagogic action is worthy of note. The 

 properties of Kcsam have a general resemblance to those of the 

 infusion of Ipecacuanha, its action sets in, however, much more 

 energetically and promptly. The ordinary dose of the drug amounts 

 to 12 seeds on the first day, 10 on the second, 8 on the third day 

 of the treatment. Owing to the fact that the seeds if not divested 

 of their fatty constituents induce vomiting it is advisable to extract 

 the latter before using the seeds. Taking the average proportion 

 of the fatty constituents to be 50 % the dose appropriate for the 

 fresh seeds deprived of their fat is reduced accordingly to one half 



