Dysentery, remedies ipecac

The antidiarrhoeal drug ipecac, which was introduced into Europe from Brazil in 1658, contains the amoebicidal alkaloids emetine (12) and cephaeline. Emetine remained the major remedy for amoebic dysentery and amoebic hepatitis for many years. Cephaeline is less active and more toxic. ( j-2-Dehydroemetine, which is made by synthesis, is equiactive with (—)-emetine and less toxic, but other chemical modification has not yielded better amoebicides. From investigations of synthetic routes to the benzoquinolizine moiety the tranquilizer tetrabenazine (13a) was discovered. The very similar compound benzquinamide (13b) is also a tranquilizer and antiemetic. 

Ipecac ( Brazil root ) was long employed by the native people of Brazil in the treatment of diarrhea. It was sold as a secret remedy to the French government in 1658, and its use in dysentery rapidly spread throughout Europe and India. Its employment was entirely empirical until 1912 when Vedder demonstrated the in vitro efficacy of emetine against E. histolytica and suggested that ipecac be used in amebic infections. The source of ipecac is the dried root or rhizome of C. ipecacuanha or C. acuminata, plants native to Brazil and Central America, but also cultivated in India, the Straits Settlements, and the Federated Malay States (see Grollman, 1962). 

Brazil root" (Cephaelis ipecacuanha), now known as Ipecac, was used by the natives of Brazil several hundred years ago as a cure for diarrhea. It was sold as a secret remedy to the French in 1658. It was not until 1912 that Vedder demonstrated that its effectiveness was due mainly to one of its components, emetine, that killed Eschericia histolytica, which we now know as one of the major causes of amoebic dysentery. 

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