Bonduc

Cyclical fevers with chills and sweats where quinine is unavailable, poorly tolerated, or produces cinchonism

Lingering low-grade fever after a febrile illness with marked weakness and loss of appetite

Overview. Caesalpinia bonducella is a spiny, scrambling leguminous shrub found throughout the tropics of Asia and Africa, well known in India for the hard, gray, marble-like seeds that give it the name fever nut or nicker nut. The roasted and powdered seed kernel was used by eclectic and Ayurvedic physicians alike as a bitter antiperiodic tonic, and it enjoyed a period of interest in the early twentieth century as a proposed substitute for quinine in the treatment of intermittent fevers. It holds a long-standing place in Indian household and folk medicine as a general tonic and anthelmintic.

Clinical Notes. The traditional preparation is important: the raw kernel is bitter and can be strongly purgative and emetic, so it was always roasted before powdering, which mellows the drug and renders it far better tolerated for internal use.

A new substitute for quinine is brought forward by Keshav Lal J. Dholakia, Delhi, India, in Practical Medicine. He recommends the powdered kernels from roasted bonduc nuts. These are derived from a legume-bearing climbing plant, Caesalpinia bonducella , found almost throughout India. The drug is antiperiodic, febrifuge, tonic and anthelmintic. It is given in doses of from ten to fifteen grains every four hours. It is described as closely resembling quinine in action, as harmless to pregnant women, as not being contraindicated during fever, and as well borne by patients with quinine idiosyncrasy. As an anthelmintic the action is weak. The drug is comparatively harmless in large doses.