A  m.  Jour.  Pharm.  ) 
Sept.  1,  1872.  J 
On  Koussin  for  Tapeworm, 
395 
The  best  process  for  obtaining  this  principle  is  that  of  Pavesi,  and 
is  analogous  to  the  one  by  which  santonin  is  obtained ;  kousso  is  re- 
peatedly treated  with  alcohol,  to  which  hydrate  of  lime  has  been  added, 
the  residue  is  boiled  with  water,  the  different  liquids  mixed,  filtered 
and  distilled,  and  the  residue  treated  with  acetic  acid,  which  separates 
koussin  as  a  white  flocculent  precipitate,  soon  becoming  denser  and 
resin-like,  and  on  drying  easily  turning  yellowish,  or,  at  a  higher 
temperature,  brown.  The  yield  of  kousso,  free  from  stalks,  is  three 
per  cent.  Carefully  prepared  and  dried,  koussin  has,  in  larger  quan- 
tities, a  peculiar  odor  of  Russian  leather ;  it  has  a  persistent  bitter 
and  acrid  taste,  a  yellowish  or  yellowish-white  color,  and  under  the 
microscope  an  indistinct  crystalline  appearance.  It  is  very  sparingly 
soluble  in  water,  but  readily  in  alcohol,  ether  and  alkalies  ;  its  em- 
pirical formula  is  C26H2205. 
Koussin  has  been  used  therapeutically  for  the  last  thirteen  years, 
and  the  author  cites  a  number  of  cases  from  Munich,  Dresden,  Vienna, 
Paris,  Stuttgart  and  other  places,  in  which  koussin  proved  effectual 
in  the  hands  of  various  physicians.  A  factitious  koussin  is  met  with 
in  Germany,  which  is  either  the  black  resin  spoken  of  above,  or  has 
been  prepared  analogous  to  resin  of  jalap  ;  it  is  a  black  powder,  al- 
most tasteless,  and  of  a  disagreeable  odor. 
The  author  arrives  at  the  following  conclusions  : 
1.  Koussin  is  the  only  active  principle  of  kousso,  and  deserves  the 
preference  before  the  latter. 
2.  It  is  preferable  to  other  taenifuges,  because  2  scruples  =  2*5 
grm.  are  sufficient  for  dislodging  the  tapeworm,  and  the  remedy, 
divided  according  to  age  and  constitution  into  two  or  four  powders, 
is  conveniently  taken  between  wafers,  and  usually  agrees  well  with 
the  patient,  producing,  in  exceptional  cases,  merely  transient  nausea 
or  vomiting. 
3.  In  the  doses  mentioned,  koussin  leaves  no  ill  effects  of  any  du- 
ration ;  on  the  contrary,  most  patients  enjoy  good  health  and  appe- 
tite after  the  tapeworm  has  been  expelled. 
4.  Koussin  needs  no  preparatory  treatment  in  diet  or  with  other 
remedies ;  but  in  obstinate  cases  it  may  be  advisable  to  aid  its  action 
by  giving  some  Epsom  salt  or  other  convenient  purgative. 
5.  If,  after  the  use  of  koussin,  the  tapeworm  should  not  be  entirely 
expelled  and  its  small  head  not  be  found,  it  is  well  to  ascertain  whether 
it  has  not  been  killed  and  the  head  is  not  subsequently  discharged. 
