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General Actions, Toxicity and Clinical Effects in Amebiasis of Kosam, an Oriental Amebicide

1. The amebicidal effects on cultures of Endameba histolytica in vitro of Kosam, an old oriental remedy for amebiasis, were found to compare favorably with such known amebicidal drugs as emetine, chiniofon and carbarsone. However, a number of other agents, not commonly regarded as amebicides, also produced as good, if not better, amebicidal effects in vitro. In fact, a considerable number of chemically and pharmacologically unrelated agents produced amebicidal effects in vitro, but most of these would be without clinical therapeutic value, or could not be used for other reasons.

2. Large oral and gastric doses of ground Kosam seeds, beyond therapeutic dosage, produced no important or significant general effects; a soluble fraction produced no effects on blood pressure when injected intravenously in cats, and no fatalities in rodents. However, in cats and dogs, gastric irritation was definite as indicated by symptoms of nausea and emesis. There were no demonstrable pathological changes in important viscera and other tissues which could be attributed to Kosam directly or indirectly.

3. Clinical trials in 7 patients with amebiasis confirmed the occurrence of gastric irritation, when Kosam seeds were given by mouth. Therapeutically, Kosam showed occasional striking symptomatic benefits in amebiasis stubborn to other amebicides and other treatments, but the benefits were fleeting or temporary, since relapses were common, at least with the doses used. Accordingly, Liu's optimistic report is not entirely confirmed.

Received January 3, 1941.