Seed of Abrus precatorius of the Natural Order Legu-wiinosce.

Description

The name jequirety is a local designation, used by the rude peoples of Brazil to indicate its action in some forms of eye-diseases. The seeds—the part employed for topical purpose—are of a bright-scarlet color, very hard, ovoid in shape, and have a hilum surrounded by a black border.

There are differences of opinion as to the source of the pathogenic local action possessed by jequirety. It contains a bitter principle— abrin—a large proportion of vegetable albumin, and a ferment. An infusion, prepared at a proper temperature (below 60° C), in a few hours is found to contain a vast number of microbes in active development, the albumin of the seeds being a soil peculiarly fitted for their sustenance and growth.

The infusion is the preparation used. The formula proposed by De Wecker is the following:

Thirty-two grains of jequirety are well pulverized and thoroughly triturated with two ounces of cold water. The mixture is allowed to macerate for twenty-four hours. Two ounces of warm water is then added, and the infusion filtered immediately on cooling. With this the part to be acted on is washed three times a day.

De Wecker also proposes a solution somewhat stronger than the foregoing: One hundred and fifty grains of the seeds (decorticated) are macerated for twenty-four hours in two ounces of cold water, and filtered. This, or the infusion given above, is applied to the eyelids for fifteen to thirty minutes, and a little is allowed to penetrate through the lids to the conjunctiva. The applications are kept up for three days, as a rule. This period is the "incubation period" of Sattler. As respects the pathogenic activity of the solutions, they differ somewhat according to their strength, but more according to their age. Deneffe, of Brussels, and Sattler (De Wecker's assistant), have described minutely, and, as our observations go, accurately, the process of inflammation resulting.

The application of the infusion to the eyes is free from pain, and it is not until the incubation period (three hours) has passed that the characteristic inflammation begins. Slowly at first, but then more rapidly, an acute, suppurative, and membranous inflammation develops, the lids are tumefied, glued together, and the conjunctiva coated with a yellowish-white croupous membrane, which reaches its maximum in twenty-four hours, continues at that point for the same period, and then slowly subsides, the last trace disappearing in four to six days. During the greatest height of the inflammation there is fever, sometimes as high as 104° Fahr.

The infective activity of a solution of jequirety is the greater the longer it is macerated—within suitable limits—and hence, by this expedient, solutions can be prepared to be adapted to all the varying conditions of disease. The strength most used is from 0·5 to 1 per cent.

A final decision has not been reached as to the constituent setting up the peculiar inflammation. Sattler, who discovered the ferment action and the formation of microbes, referred the inflammation to the pullulation of these organisms. Klein has proved, as he supposes, that the microbes do not have this pathogenic power. In turn, abrin has been, and has not been, considered the agent. Recent observations by Kobert indicate that abrin is the active agent in setting up the characteristic destructive inflammation. Abrin is so powerful an irritant, that if brought in contact with the mucous membrane or any wounded surface it causes violent reaction, and must therefore be handled with care.

Actions and Uses

To apply a suggestive term to the action, jequirety sets up a substitutive inflammation to take the place of the existing morbid process. To what end? It is only the papillary granulations of the eye that are cured by jequirety. True granulations—trachoma—remain unchanged after the jequirety inflammation has passed. According to Deneffe, it is absolutely useless in the treatment of pannus. There are, however, ophthalmologists of high character who find jequirety very useful in these cases, and who explain failures by asserting that sufficient time was not given, and that per. severing applications, extending over many months, are necessary in obstinate cases (Soloveitchik, Smirnoff, Tangeman, and others).

Jequirety has been successfully used in the treatment of fungous granulation of the external auditory canal. Chronic metritis of a severe type has been successfully treated, and skin-diseases, of hypertrophic character, resisting all other agencies, have been cured by painstaking applications. Lupus and epithelioma, especially the latter, old ulcers with thickened margins and sluggish in character, are quickly changed in condition, and, if curable at all, are disposed for healing.

The author must couple some cautions with these recommendations of jequirety. The subcutaneous injection of the microbe-laden infusion causes such general destructive changes in cold-blooded animals, and so much local mischief in mammals, that it should be practiced in man with great caution, if at all.

Authorities referred to:

BordÉ, Dr. L. Bul. Gén. de Thérap. for 1884. Cornil et Berlioz, MM. Journal de Thérapeutique, 1883, p. 814. Deneffe, Dr. Ibid., p. 521, et seq.

Sattler, Dr., and De Wecker, Dr. Semaine Mvdicale in Annuaire de Thérap. for 1884.

Soloveitchik and Smirnoff, Drs. London Medical Record of March 15, 1886.