Use of Phyllomedusa bicolour secretion during kambô ritual: observational responses, dosage, and risk of adverse events

Abstract The ‘kambô’ ritual involves application of Phyllomedusa Bicolor poison to superficial burns made on the user’s skin. Existing kambô literature describes case reports of severe harms. The objective of the current study was to better characterize typical observed responses to kambô administration. We performed a retrospective review of a kambô practitioner’s practice. Statistical analysis was descriptive, and characterized the number of kambô points or location of points administered as well as physical responses such as facial swelling, diaphoresis, immediate bowel movement, syncope, and occurrence of emesis. There were 147 unique participants that underwent 241 kambô rituals included. The mean number of points administered was 4.2 ± 2.2, while the median was 3 (range 1–11). Common physical responses included facial swelling (70.5%), diaphoresis (53.3%), bowel movement (45.2%), and syncope (10.4%). Higher number of points administered and receiving kambô at multiple locations appeared to increase facial swelling and diaphoresis. Responses to kambô are likely to be dose-dependent. No severe adverse effects were recorded in the sample, although some responses or components of the kambô ritual may promote risks of harm due to hyponatremia, asphyxiation from emesis, and injury due to syncope.