Kambo, also known as sapo (from ) or vacina-do-sapo, is substance derived from the natural secretions of an amphibian belonging to the Phyllomedusa family. Commonly the dried skin secretions of the giant leaf frog, known as the kambô in Portuguese, a species of frog, are used for ritualistic purposes with a strong religious and spiritual components. Less commonly it is used as a transdermal medicine, however, evidence for its effectiveness is limited.
Kambo is usually used in a group setting, called a kambo circle or kambo ceremony. Some of the effects on humans include tachycardia, hypotension, nausea, as well as vomiting and sometimes bowel movements owing to smooth-muscle contractions. A literature review of acute adverse events identified 11 reported cases involving severe adverse effects, including psychosis, SIADH, kidney injury, liver injury, dermatomyositis, esophageal rupture and seizures, with some cases resulting in death. Such severe outcomes are limited to a small number of published cases and some evidence suggests that pre-existing medical conditions may exacerbate these outcomes: a 2025 systematic review of deaths associated with kambo found that only a few fatal cases had been described and noted that reported severe outcomes may be exacerbated by pre-existing risk factors.
Kambo, which originated as a folk medicine practice among some indigenous peoples in the Amazon basin, is also administered as a complementary medicine and alternative medicine treatment in the West, often as a pseudoscientific cleanse or detox. The ceremony involves burning an arm or leg and applying the kambo secretion directly to the burn. Promoters claim that kambo helps with several illnesses or injuries. There is no scientific evidence that it is an effective treatment and causal evidence is limited.
Excessive water consumption during or after kambo administration has been associated with SIADH and severe electrolyte imbalances. Controlling water intake is therefore an important safety measure. Naloxone is under study as a possible antidote; hospital treatment also includes medicines to protect organs from damage and restore electrolyte function.
Terminology
Kampo pae, a name used by the Noke Kuin (formerly Katukina) Dow kiet, a word used by the Matses Sapo, kampô, kampu, vacina de sapo, or vacina da floresta, in Brazilian Portuguese
"Kambô" is a common name of Phyllomedusa bicolor, an Amazonian tree frog, also known as the blue-and-yellow frog, bicolored tree-frog, giant monkey frog, giant leaf frog, or waxy-monkey tree frog. "Sapo" means "toad" in Spanish and Portuguese. The frog is an anuran amphibian that inhabits the Amazon and Orinoco basins in South America.
History
Natives who practice kambo are Panoan-speaking indigenous groups in the southeast Amazon rainforest, such as the Matsés, Marubo, Amahuaca, Kashinawa, Katukina, Yawanawá, and Kaxinawá. There are ethnographic studies on the use of kambo in traditional Noke Kuin medicine in the region of the state of Acre, in the Brazilian Amazon.
Since the mid-20th century, kambo has also been practiced in urban regions of Brazil. In 2004, Brazil banned the sale and marketing of kambo. Import is illegal in Chile. Outside of South America, it first became known as an alternative therapy in the late 2010s.
In 2021, the Therapeutic Goods Administration (TGA) of Australia banned the use of kambo in Australia and classified it as a schedule-10 poison. It is listed in the category for "substances of such danger to health as to warrant prohibition of sale, supply and use".
Indigenous use In contemporary discourse, the original ritualistic context in which kambo is consumed in indigenous communities has generally been ignored or looked down upon in favour of a more biomedical or western approach to health. Further inspection of indigenous usage allows for a more holistic understanding of its cultural importance and avoids the overt commercialisation of its spiritual qualities.
To collect the secretions from the frog's body, first, the frog has to be caught. A practitioner will tie the frog to four sticks placed in the ground with its limbs stretched. This causes the frog to become stressed enough to activate its defense mechanism and secrete a substance containing peptides from its skin. After these secretions are obtained, the frog is released back into the wild. The secretions are then left to dry. Small burns are created on the skin, and a small dose of the frog secretions is applied to the open wounds. In native practice, the secretions are removed from the wounds after 15 to 20 minutes, ending the acute symptoms.
The healing ritual typically begins with the consumption of caiçuma, a traditional, lightly fermented beverage prepared exclusively by women in the associated community. After the consumption of caiçuma, a person believed to have "good luck", usually a proficient hunter, is elected to make burns with a stick on the recipient before the secretions are applied. Kambo is viewed as a "medicine of the heart" and has both physical and, importantly, spiritual effects in the eyes of indigenous communities. This ritual thus operates not through the supernatural, but through a system of shared social reality. In this reality, the shaman and patient trust in the therapeutic powers of the shamanic ritual and the community as a whole has faith in its efficacy. In other contexts, kambô is reportedly used in ritualistic practice to improve hunting outcomes rather than as a healing method. In these circumstances, kambo is self-administered by an individual, without a shaman, who is expected to experience sickness and hallucinations over a short period of time, before becoming a more adept hunter.
Traditional practitioners claim that it aids fertility, cleanses the body and soul, increases strength, and brings good luck to hunts, though there is no scientific evidence for these claims. It is used by natives to who attempt to expel "panema" (bad spirit) and to induce abortions. The secretions are also commonly used in people who suffer from laziness, a condition perceived as unfavorable by the Noke Kuin as the person stops participating socially.
Joaquim Luz, a Yamanawa leader, criticized internet sales and kambo's use without the preparation or permission of indigenous peoples, saying that such users are at risk, even of death. Other native groups have also expressed concerns.
Non-indigenous use Outside South America, a kambo ceremony can involve just two people: the practitioner and the participant, or many participants at once, which is known as a kambo circle. Participants are equipped with water, a towel, and a bucket.
During the ceremony, small superficial burns are made, usually on the upper arm or leg, by the practitioner using a smoldering stick or vine, so that the secretion can be applied. The practitioner uses saliva or water to reconstitute the secretions and place it on top of the burnt skin. Short-term effects include nausea, vomiting, diarrhea, facial edema, headache and tachycardia.. The secretions seem to be vasoactive (affecting the circulation), explaining why they are absorbed rapidly.
Intoxication may occur immediately or within hours.
Journalist Hamilton Morris has covered kambo, including trying it and reporting on its effects.
Effects The effects of kambo have been described. It produces relatively subtle psychoactive effects and does not appear to produce psychedelic or hallucinogenic effects. However, the drug is reported to produce a state of self-centered inwardness or internal connectedness. It has also been reported to cause apathy, drowsiness, dizziness, sedation, hallucinations, and euphoria, among others. Kambo also produces strong physical effects, including hypotension, sweating, tachycardia, severe nausea and vomiting, diarrhea, urination, edema, and general physical distress. In addition, it reportedly produces long-lasting and pronounced subacute or afterglow effects, such as clarity of thought, euphoria, feelings of well-being, positive mood and attitudes, increased resilience, positive and altruistic behavioral changes, and increased physical strength and stamina.
Medical claims Non-indigenous users and practitioners of kambo claim it helps with a wide variety of issues and conditions. These claims include treating addiction, depression, and chronic pain, reducing fevers, increasing fertility, boosting energy and physical strength, and improving mental clarity. It is also claimed that kambo removes negative energy. There is currently no scientific evidence to support positive health effect claims.
There is no high-quality medical evidence on the safety and efficacy of the kambo practise: while studies of some of the individual peptides exist, clinical evidence on the safety and efficacy of kambo administration remains limited, . Adverse effects have been reported, including in cases involving experienced practitioners.
Kym Jenkins of the Royal Australian and New Zealand College of Psychiatrists, in a Sydney Morning Herald article, said "people with mental illness are a more vulnerable group anyway for a variety of reasons. If you're feeling very anxious or very depressed, you're automatically more vulnerable, and you could be more susceptible to people advertising or marketing a quick fix. I do have concerns that people can be preyed upon when they are more vulnerable."
The Australian Medical Association (AMA) supports the TGA's ban on the sale, supply, and use of kambo, saying it considers kambo to be a "significant health risk".
Marketing In non-indigenous use, the frog secretion is described and marketed as a "detox" treatment, cleanse, purge, and as a "vaccine" that is "good for everything". Kambo has been marketed both as a "scientific" remedy, emphasizing the biochemistry, and as a "spiritual" remedy, emphasizing its Indigenous origins. Purging (deliberate vomiting) has been a popular treatment since the 1800s. "Detox" has been described by Edzard Ernst, emeritus professor of complementary medicine, as a term for conventional medical treatments for addiction, which has been "hijacked by entrepreneurs, quacks, and charlatans to sell a bogus treatment."
In Brazil, given the growth in the consumption of kambo in urban centers, there has been criticism by indigenous people, academics and communicators regarding the cultural appropriation of indigenous knowledge, the process of extracting the secretion of the Phyllomedusa bicolor frog, the form of transmission of wisdom, and the price charged by the ritual and the mystification of the origin of the frog.
There is also concern about pharmacological patents on the peptides identified in kambo (see biopiracy), the commercialization of the kambo outside its place of origin, and the unknown impact on frog populations, since many more are now removed from their natural habitats.
A 2022 review on the diagnosis and treatment of kambo cases noted the chemical complexity of the secretion and recommended greater surveillance of websites promoting its use and greater control of e-commerce and illicit trafficking involving the secretion.
Environmental impact The effect of the increased use of kambo rituals, and trafficking of the frogs and their secretions, may have an effect on the population of Phyllomedusa bicolor in its natural habitats: the forests of Bolivia, Peru, Brazil, the Guianas, Colombia, and Venezuela. Phyllomedusa bicolor is not considered an endangered species by the IUCN. Besides Phyllomedusa bicolor, other threatened endemic frog species of South America's neotropical regions have been poached and smuggled on the black market.
Parasitology