Journal Mobile

MR Lee
Journal Issue: 
Volume 38: Issue 4: 2008




The  story  of  ipecacuanha,  derived  from  the  plant Cephaelis,  is  a fascinating one. It was discovered in Brazil in the 1600s and then transported to Paris  in  the  latter  part  of  the  same  century.  It  was  used  there  by  the  physician Helvetius  on  various  members  of  the  French  royal  court  to  treat  the  flux (dysentery) with some success. Later, in the eighteenth century, it was taken up by the physician and privateer Thomas Dover and became, with opium, a fundamental constituent of his celebrated powder, which was used widely to treat fevers and agues for the next 200 years. Progress was then delayed until the early 1800s when the  School  of  Chemistry  at  Paris  established  that  the  dried  root  of  ipecac contained two powerful alkaloids, emetine and cephaeline, that consistently caused vomiting  and  diarrhoea.  The  discovery  of  the  pathogenic  amoeba, Entamoeba histolytica, in the latter part of the nineteenth century, allowed a distinction to be made between the two main forms of dysentery (amoebic and bacillary). Emetine was  shown  to  be  active  against  the  amoebic  form  of  dysentery  but  ineffective against that caused by bacteria. Ipecacuanha, its root and the pure alkaloid emetine have now been abandoned on the grounds of toxicity. They have been replaced by safer, more effective compounds. Nevertheless, they deserve an honoured place in the  history  of  medicine,  especially  in  the  search  for  an  effective  treatment for amoebic dysentery.