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 
u. ( ed 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 oils, the presence of the 
following active constituents, vis. : — 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- 
tuse inflamation of the digestive canal and the kidney, also hyperleu- 
cocytosis accompanied by pariial destruction of the leucocytes. The 
minimum lethal dose of cosamin introduced intravenously amounts 
to 0 25 grm. (grs. 4) per kilo (lb. -^E). 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 Kosam 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 fattv 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 
