Active Ingredients. - It still remains doubtful whether the crystalline, acidly reacting substance, koussine, is the only active element in kousso; or whether a peculiar resin, a volatile oil, and two species of tannin, which it contains, are also poisonous to intestinal worms. So far as I know, the only positive evidence is in favor of koussine, C26H44O5, which occurs in very minute white crystals that have a bitter and irritant taste. It is very insoluble in water, easily soluble in alcohol; concentrated sulphuric acid dissolves it yellow, and, if water be added to this solution, white flocky masses are separated. The alcoholic solution gives a brown precipitate with perchloride of iron, and a grayish yellow one with acetate of lead.

Physiological Action. - Kousso produces no observable effect on the human body, excepting occasional sickness from the nauseousness of its taste. But it is a perfect and direct poison to intestinal worms, especially tape-worms. And as regards the active ingredients, it may be mentioned that koussine has been successfully employed by various physicians, in a dose of about 20 grains, against tape-worm; this sometimes causes vomiting and diarrhœa, and it has been round needful to give it in three or four divided portions, with some aromatic substance added.

Therapeutic Action. - As a vermicide, against both varieties of tape-worm, and to a less extent against round worms, kousso has received the support of very large and varied experience. So long ago as 1850 the Lancet gave details of its successful employment by several London physicians: and in Switzerland, where tapeworm (especially Bothriocephalus latus) is very common, from the habit of eating certain meats raw, the value of kousso has been well established. It has also been freely used both in France and Germany, though in the latter country it is not much employed at present. Its nauseous flavor is certainly an objection, but the same defect belongs to the Filix-mas, the value of which no one of any experience could now permit to be disputed on that ground.

Preparations And Dose. - For administration to an adult, about one oz. of the powdered flowers should be mixed with lukewarm water, and allowed to infuse for a quarter of an hour. A little lemon-juice is then swallowed by the patient, and subsequently the infusion, flowers included, is added to some tea without either milk or sugar, a short interval being allowed after the lemon-juice. Should the worm not come away in three or four hours, a castor-oil or saline purge should be administered, kousso being in itself scarcely at all purgative. The dose of koussine has been already mentioned (20 gr.); its taste may be covered by peppermint.