Kambô is the popular name for traditional medicine extracted from a species of Amazonian frog.
A traditional remedy in the Amazon, kambô is the common name in South America used to refer the skin secretions from the Phyllomedusa bicolor, a tree frog that inhabits certain parts of the Amazon rainforest. The secretions are characteristic of the Phillomedusa family and have been traditionally used as a medicine by indigenous tribes, such as the Katukina, Yawanawa, Cashinahua and Matses. Traditionally, the purpose of this practice – which is commonly named after the frog, kambô or sapo (the word for toad in Spanish) – is to induce a deep cleansing of the body and the soul, to cure panama (which could be translated as “bad luck in hunting”), to give strength, and to cure other diseases.
Interest in the healing potential of traditional Amazonian plants and animals, such as kambô, ayahuasca, or the secretions of the Incilius alvarius toad, among others, is increasing in modern urban civilizations, possibly due to a growing dissatisfaction with western medicine that runs parallel to an equally growing interest in alternative medicines and Amazonian shamanism. In this context, it is important to raise awareness about the history and nature of these substances, as well as about the potential risks that might accompany inappropriate use. These aspects are important to consider when hoping to understand their healing potential and when seeking to “do no harm” to both the originating cultures and individuals who engage in these practices.
Kambo traditional use in practice
Once captured, the frog is carefully tied up in an X shape. The frog will then expel a skin secretion as a defense mechanism from predators. This secretion, stimulated by the stress of manipulating the animal, is collected in a bamboo stick and left to dry for storage. For traditional cultures, this is a medicine that operates on the physiology of the organism or the body, and also in the realm that is beyond material, i.e. the soul. Kambô is regarded as an entity or a spirit that is responsible for the healing process. The frog is treated with respect and never harmed because, according to Amazonian beliefs, harming it would anger the animal spirit and thus fail to produce healing. After the extraction, the frog is released back into the forest.
The application of the extracted venom is done by inflicting a superficial wound on the skin of the individual to be treated with a burned stick (traditionally known as titica vine) and placing the re-hydrated secretion over the burn, which appears like a dot the size of a green pea on the skin. It is generally applied on the arms or chest in men or, and for women, on the legs. The effect of the substance depends on the number of dots. A common minimum dose is around one to three dots, but the number can vary greatly depending on the user’s needs.
By applying the kambô onto a fresh wound, it can be absorbed subcutaneously and enter the circulatory system. Within few minutes, an acute physiological response manifests, generally characterized by an increase in heart rate, sweating, dizziness, and sometimes nausea and vomiting. The acute effect is attributed to the presence of peptides (amino acid chains like proteins, but shorter in length) that last for several minutes before fading. After the effects are gone, the traditional medicine kambô is said to leave the individual with a feeling of increased strength, sensorial awareness, and mental clarity. The peptides present in kambô do not produce any psychoactive effects.
Composition of kambô, a traditional remedy
The secretions of Phyllomedusa bicolor contain a high number of bioactive peptides that are responsible for the physiological effects. Some studies have undertaken several methods of extraction to determine the chemical makeup of kambô and to test the effects of each peptide that is present in large amounts.[1]
In order of abundance:
- Phyllocaerulein is present in the highest concentration and seems to be responsible for kambô’s principal effects. It has a strong effect on the gastrointestinal smooth muscle, stimulating its motility, bile flow, pancreatic and gastric secretions, and mediates analgesic effects in the central nervous system.
- Phillokinin has hypotensive effects on the cardiovascular system.
- Phyllomedusin has also strong hypotensive effects, stimulates gut motility (contributing to purging), and lacrimal and salivary secretions.
- Sauvagine causes a fall in blood pressure due to a vasodilatation of mesenteric vascular area and provokes intense tachycardia. In the central nervous system, it seems to activate the pituitary-adrenal axis, causing an increase in the levels of corticosterone, catecholamines (such adrenaline) and glucose in plasma.
- Opioid peptides, ala-deltorphin and lys7-dermorphin, have strong affinity for opioid receptors that surpass those of morphine. This is one of the reasons why the venom’s effects have been attributed to this substance. However, the concentrations present in kambo are so small that they seem to have no significant biological activity in humans.
- Peptides from the dermaseptin family have been detected in reduced amounts. These are said to inhibit the growth of a broad spectrum of microorganisms (protozoa, fungi, bacteria and viruses) without harming differentiated mammalian cells, thus being responsible for a potential antibiotic activity.[2]
Physiological effects of kambô
The principle effects of kambô use seem to correspond to the peptides present in larger amounts, which affect the vascular system, glandular secretions, gastrointestinal activity and regulation of the hypothalamic-pituitary-adrenal axis, this last being that which is responsible for physiological functions, such as stress response, immune regulation, and energetic metabolism. It causes no hallucinatory or psychoactive effects whatsoever.
Many other peptides are present in lesser quantities, though their roles in producing effects are uncertain. In humans, it is unlikely that their presence has significant effects due to their very reduced amounts. However, this possibility cannot be excluded. One possibility is that some of these peptides may act together to cause a slight increase of vasodilatation and permeability in the blood-brain barrier, facilitating the compounds access into the circulatory system and the central nervous system, but this is still unclear.
The presence of the variety of peptides in kambô whose purpose is yet not understood may make the substance attractive to pharmaceutical companies interested in developing new drugs. This topic elicits an important debate around the legitimacy of the substance and that of the economic benefits associated with its use (or the use of its components).
The Matses indigenous peoples from southwestern Amazon have traditionally used kambô application as additional support for hunting practices. They self-apply 20 to 30 mg of kambô twice daily. As previously mentioned, some of the peptides present in kambô are responsible for activation of the pituitary-adrenal axis of the central nervous system. Thereby, continuous application could result in an increased state of alertness, resistance to hunger and thirst, and have certain analgesic effects. This would provide an extra sense of strength, awareness, and stamina (and maybe “good luck” too, as claimed by the Matses), to enhance endurance in the jungle for days, or at least for as long as the hunting lasts.
People who use in modern contexts claim that the use of kambô boosts the immune system, and “works” for allergies, headaches, neuralgic and muscular pain, and other conditions, as well as reducing psychological imbalance (such as negativity, sadness, or depression). Kambô is also said to cleanse the body and contribute to healing of the spirit or the soul. Scientific research on these effects is, at present, non-existent.
Frog poison or human medicine?
Widespread enthusiasm with regards to the benefits of traditional kambô among practitioners and users is also important to consider, yet, there is currently no clinical research on kambô. Thus, the actual benefits have yet to be established. Medical doctors who have seen cases involving its use maintain a cautious attitude. It is difficult to predict how a person with neurologic or heart problems or other conditions could be affected by its application. Some reports have been published on kambô’s toxicity, for example, a hepatitis case related to the use of the frog venom.[3] There is also a recent forensic report (2017) of a sudden death which happened 30 minutes after applying kambô.[4] In this report they indicate that this person was a “chronic user” of kambô, and that an acute reaction accumulated through continued use could have been the cause of his death. Two deaths related to the use of kambô were reported in Chile and Brazil in 2008 and 2009 respectively.[5] However, there was no forensic examination, no further information is available, and a definitive cause of death was never reported.
As noted, death from kambô use is rare, only one forensic case has been reported so far, and given the incidence of use in the general population, this represents a rather low number. However, it shouldn’t be overlooked nor the potential risks denied, since no proofs of effectiveness have been presented, although this could be due to the little amount of research on the subject.
It is also important to mention that accidents are often due to lack of information and/or due to bad practices. There is a report on a recent intoxication (November 2017) of an administration combining kambô and ayahuasca for the treatment of depression.[6] The person presented visual hallucinations, agitation, tremors in the limbs, oral paresthesia, seizures, nausea, vomiting and sweating. Some symptoms subsided after the administration of diazepam, but not the agitation or seizures. Ultimately, the patient recovered without any sequels. This case illustrates that it is necessary to be cautious when combining different substances and more so in the case of patients who in turn may be taking psychiatric medication such as might have been the case with this individual.
Promoting such substances as healing tools without warning about the risks, or preparation prior to their use, can be very dangerous. This gap in information needs to be gradually filled in by those who wish to have experiences with these substances, by the ones who offer them, as well as by health professionals, so as to be able to respond to any unintended outcomes in an appropriate manner.
Given the current medical uncertainty and the spread of kambô’s use, it seems that it is in the public’s interest to promote a stronger scientific investigation into the issue.
Socioeconomic context
The increasing popularity of kambô, the traditional remedy, has started a debate on who is the rightful owner of the knowledge surrounding its use. Its origins are generally linked to the indigenous people of South West Amazon and one of the main concerns and topics for debate concerning kambô is that of ‘biopiracy’ – the notion that resources located in a territory or practices originating among indigenous people are being stolen [5]. The increasing availability and interest in kambô as an alternative medicine practice is attracting the attention of those who want to explore its therapeutic potential, as well as by those interested in profiting from it, as it can be regarded in some cultures as an “emerging market.” This issue adds fuel to the fire regarding the topic of ownership and the consequential right to benefit.
In this situation, it is important to acknowledge its origins and to be aware of the potential for misuse. In the absence of adequate knowledge about safe use, accidents can occur, such as in cases where the venom from the wrong frog was used. Furthermore, an increase in demand could easily lead to the over exploitation of a natural resource and compromise the ecological stability of the Phillomedusa bicolor frog. In the case that there are serious adverse health outcomes or even fatalities, the legal status of the practice (currently there is no legislation regulating the use of kambô) could be compromised. In order to offer stability in the current context, it would be helpful if associations and movements that are promoting its use also commit to promoting conservation and supporting scientific research to explore therapeutic potential.
The emergence of such practices in modern culture offers opportunities and approaches for exploring human health and well-being. In the case of kambô, although its benefits are still uncertain for modern medicine, its traditional use and extension into contemporary interest and practices invite further exploration of its therapeutic potential. And, within this exploration, it is crucial to maintain the ecological and socioeconomic equilibrium of the practices and cultures involved.
Authors
Eduardo Carchedi
Masters Student in Neuroscience, Universidad Autónoma de Barcelona
José Carlos Bouso, PhD
Scientific Director, ICEERS
Notes
1. Erspamer V, Erspamer GF, Severini C, Potenza RL, Barra D, Mignogna G, Bianchi A. 1993. Pharmacological studies of ‘sapo’ from the frog Phyllomedusa bicolor skin: a drug used by the Peruvian Matses Indians in shamanic hunting practices. Toxicon. 31(9):1099-111.
2. Vouldoukis I, Shai Y, Nicolas P, Mor A. 1996. Broad spectrum antibiotic activity of the skin-PYY. FEBS Lett. 380(3):237-40.
3. Pogorzelska J, Łapiński TW. 2017. Toxic hepatitis caused by the excretions of the Phyllomedusa bicolor frog – a case report. Clin Exp Hepatol. 3(1): 33–34.
4. Aquila I, Gratteri S, Sacco MA, Fineschi V, Magi S, Castaldo P, Viscomi G, Amoroso S, Ricci P. 2017. The Biological Effects of Kambo: Is There a Relationship Between its Administration and Sudden Death? J Forensic Sci. Sep 8. doi: 10.1111/1556-4029.13641.
5. Labate BC, de Lima EC. 2014. Medical Drug or Shamanic Power Plant: The Uses of Kambô in Brazil. Ponto Urbe [Online], 15. doi: 10.4000/pontourbe.2384
6. de Morais R, Lanaro R, Barbosa IL, Santos MJ, Cunha KF, Hernandes VV, Tessaro EP, Gomes CS, Eberlin MN, Costa JL. (2017). Ayahuasca and kambo intoxication after alternative natural therapy for depression, confirmed by mass spectrometry. Forensic Toxicology. doi: 10.1007/s11419-017-0394-5.
Additional references
Daly JW, Caceres J, Moni RW, Gusovsky F, Moos M Jr, Seamon KB, Milton K, Myers CW. 1992. Frog secretions and hunting magic in the upper Amazon: identification of a peptide that interacts with an adenosine receptor. Proc Natl Acad Sci USA. 89(22):10960–10963.
den Brave PS, Bruins E, Bronkhorst MWGA. 2014. Phyllomedusa bicolor skin secretion and the Kambô ritual. J Venom Anim Toxins Incl Trop Dis. 20:40.
Erspamer V, Melchiorri P, Falconieri-Erspamer G, Negri L, Corsi R, Severini C, et al. 1989. Deltorphins: a family of naturally occurring peptides with high affinity and selectivity for delta opioid binding sites. Proc Natl Acad Sci USA. 86(13):5188–92.
Lacombe C, Cifuentes-Diaz C, Dunia I, Auber-Thomay M, Nicolas P, Amiche M. 2000. Peptide secretion in the cutaneous glands of South American tree frog Phyllomedusa bicolor: an ultrastructural study. Eur J Cell Biol, 79(9):631–641.
Leban V, Kozelj G, Brvar M. 2016. The syndrome of inappropriate antidiuretic hormone secretion after giant leaf frog (Phyllomedusa bicolor) venom exposure. Toxicon. 120:107-9.
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, Kambô
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