The medicinal part of the plant is the ripe, dried fruit.
Flower and Fruit
The plant's petiolate inflorescences are paniclelike, 16 to 40 cm long, and usually inserted in the stem. Male flowers are occasionally axillary. The two outer petals are smaller and about 1 mm long. The inner petals are imbricate, whitish or yellowish-green, broad-elliptoid, 2 to 3 mm long, and appear in 2 alternating, triple whorls. The synandria are formed from a short-stemmed, globose cluster of about 30 to 35 anthers. The pollen is round and tricolporate. The female flowers have 3 tepals as well as small staminoids. The 3 or 4 carpels are set sideways on a central, erect fruit axis that becomes conically oblong when the fruit ripens. The style is inserted in the side and the stigma is turned back. The drupes are globose to reniform, 9 to 11 mm long, glabrous, and sit on the short, spreading branches of the fruit axis. The fruit is about 1 cm long, blackish, and contains a horseshoe-shaped seed.
Leaves, Stem, and Root
Anamirta cocculus are hardy, woody lianas with ash-gray to straw-yellow striped bark. The leaves are ovate to cordate. The leaf blade is 16 to 28 cm long and 10 to 24 cm wide and coriaceous. The main veins are arranged in palmate fashion at the base with parallel secondary veins. The 6 to 18 cm petiole is thickened at both ends.
The fruit shell is tasteless; the seed is bitter and oily.
The plant grows in India, Sri Lanka and Malaysia.
Fish Berry seeds are the fruit of the false myrtle Anamirta cocculus. They are collected in the wild and sun-dried after harvesting.
Levant Nut, Crow Killer, Fish Killer, Indian Berry, Cocculus Indicus
Actions & Pharmacology
Sesquiterpens: picrotoxin, a mixture of picrotoxinine and its by product picrotin, picrotoxin acid methyl ester
Isoquinoline alkaloids: menispermine, paramenispermine
The effect of the drug is due to the picrotoxin content. Picrotoxin paralyzes presynaptic blocking mechanisms and, like strychnine, has an analeptic effect in low doses. The central ends of the parasympathetic nerves are stimulated, as is the medulla oblongata. Breathing frequency is initially increased and subsequently decreased. The pulse slows due to the stimulation of the vagus and an increase in blood pressure. Central nervous system-stimulated vomiting along with an increase in perspiration and saliva are probably also due to the action of picrotoxin.
Indications & Usage
In the past, the drug was used as an insecticide in powder form for scabies. Its use against skin parasites and lice, while not substantiated, seems plausible. It was also used in cases of barbituric acid poisoning. In more recent times, it has been used in the treatment of peripheral and vestibular nystagmus, and in both long- and short-term therapy for peripherally based dizziness as well as travel sickness.
The seeds have been used externally in India and on the Malaysian archipelago for gout, skin diseases, and parasites. The tender leaves are used as a contracting agent for the womb after birth.
The drug is used for nervous exhaustion, attacks of dizziness, cramps, paralysis, dysmenorrhea, and occipital headaches. Efficacy has not been proved.
Precautions & Adverse Reactions
The drug is very poisonous. Mild poisonings cause headache, dizziness, nausea, coordination disturbances, general depression, and spastic twitching.
With high dosages, the symptoms above are followed by frequent vomiting, sleepiness and tonic-clonic spasms. Death follows, often not until days later, through asphyxiation and heart failure. Two to three Cocculus kernels can be fatal.
Treatment consists of inducing vomiting and/or gastric lavage, purging with sodium sulphate, instillation of activated charcoal and forced diuresis. The spasms should be suppressed with diazepam, but only as much as is absolutely necessary. In case of fever, the patient should be wrapped in ice packs, administered high-caloric infusions and possibly given oxygen respiration. Phenothiazines and analeptics should be avoided.
Mode of Administration
In combination preparations.
Commercial preparations include ampules, drops, and tablets.
Liquid extract is prepared using a 1:1 ratio of the drug and 90% ethanol A mixture of the extract and coconut oil is prepared using a ratio of 1:8; tincture: 1:10 tincture: 70% ethanol; unguetum cocculi: 125 g extract plus 650 g coconut oil plus 50 g beeswax and 250 g paraffin; picrotoxin extraction is made using special procedures; maximum yield 1.5%
One to 5 mg can be taken by healthy patients who do not experience side effects. For peripheral states of dizziness: 1 mg to 5 mg (picrotoxin) by slow intravenous infusion. As a long-term treatment: 1 mg suppositories for 3 weeks.
5 drops, 1 tablet, or 10 globules every 30 to 60 minutes (for acute conditions), or 1 ml twice a week sc or ointment 1 or 2 times daily for chronic conditions.
Because they are poisonous, preparations should be secured in tightly closed containers, protected from light and unauthorized access.