Chinese Medical Journal

SSN Se eet

USE OF PUMPKIN SEED WITH ARECA NUT IN TAPEWORM INFECTIONS 31

Pumpkin seeds when used alone (Tables 1 and 2, series a), do not seem to give much effect. Krayer(12) stated that pumpkin seeds must be used in large doses of 200-400 gm for children and 400-700 gm for adults. He treated 5 patients with the extract of pumpkin seeds in this dosage, but in none of them were complete worms evacuated, although fecal examination later proved all the cases were cured. He likewise treated 6 dogs infected with D. caninum, T. pisiformis and T. hydatigena and in 5 of them tapeworms were evacuated. In the cases treated by us we did not use such large doses. Among 9 cases of T. saginata and 2 cases of T. soliwm infection in which 120 gm of pumpkin seed kernels were used only 1 was cured. However, from the results of our in vitro experiments it seems doubtful that any appreciable better result may be obtained by increasing the dosage.

The active principle of pumpkin seeds, as shown by Krayer, is located in the oil-free portion. It is water-soluble and thermostable.* Clinical trials and experiments have shown that the oil portion is of no value.

Crude areca nut decoction contains a large amount of tannin, which at first has an irritative effect on the tapeworm, but which is soon overcome by the paralytic action of the drug. Pumpkin seeds have no such irritative action on the worm. Under the influence of the paralytic action of the two drugs the whole worm becomes flaccid, and through the peristaltic movement of the small intestine, it is rolled up in a mass and is passed out in the feces. In most of our cases the whole worm was evacuated en masse, but in 22 cases the scolex and the very anterior portion of the worm measuring 0.5-3 inches were missing. However, all these 22 cases except 1 were later proved cured. The detachment of the scolex and the thin and delicate anterior part of the worm probably took place not in the small intestine but in the’ large intestine, or most likely in the rectum due to contraction of the anus, as has already been pointed out by Feng(3). The scolex remaining in the rectum or in the large intestine has practically no chance to survive, as these parts of the intestine are too far down, and it is hardly impossible for the scolex to crawl against the current to reach its normal habitat, the small intestine.

The dosage of areca nut employed by most people is 4 liang or 125 gm. We had one patient who had even used half a catty (250 gm) in one single dose without success. Unlimited increase of the dosage will not necessarily be followed by a cure. Although pumpkin seeds are nontoxic, some

* As stated before, in our investigation we used ready roasted pumpkin seeds. The roasting of pumpkin seeds requires a temperature of 140-170 C for about half an hour, a temperature which evidently does not destroy the active principle.