SUPPLEMENT 671 



of the field of vision followed three days after taking 8*0 grin, extract, 

 filicis maris. Stuelp 1 attributes the amaurosis occurring after taking 

 filix mas to a toxic action on the muscularis of the central retinal 

 artery ; there followed paralysis of the vessel, vascular engorgement, 

 and thereby nutritional defects of the nervous elements followed. 

 In children one has to diminish the dose correspondingly, as with 

 them, still more so than with adults, severe disturbances arise. Huber 2 

 claims that this drug should not be given to children indiscriminately. 

 The view is frequently expressed that a combination of extractum 

 filicis maris with fatty oils in which the active constituents are soluble 

 favours intoxication. Marx 3 also argues from this standpoint and 

 assumes that the ideal preparation, free from objection, would be got 

 if from filix-mas extract a preparation free from fatty oils could be 

 made, and he considers it advisable to limit the use of castor oil as an 

 aperient before and after taking the " cure," and to prescribe instead 

 a saline laxative, such as Epsom salts or Glauber's salts. Sonnen- 

 schein 4 also advises against the simultaneous exhibition of extractum 

 filicis maris with oleum ricini, as is the case with Helfenberg's 

 capsules, and Boas 5 is likewise anxious that ol. ricini should be 

 avoided. Lenhartz 6 appears to consider the warning against the 

 simultaneous combination of the extract with fats or ethereal oils, and 

 especially against the employment of castor oil as an after-treatment, 

 as without justification, and we, too, in the course of our many 

 filix treatments, have never yet witnessed any unfavourable effect from 

 the use of castor oil in the after-treatment. The surest way of 

 obviating the toxic effects of extractum filicis is to give a laxative 

 (ol. ricini) as soon as the extract has left the stomach, say, about half 

 an hour, so that it need not stay longer than necessary in the gut and 

 become absorbed. Perhaps in most cases of poisoning, transgressions 

 against this rule have been the cause of the toxic action. The nausea 

 that sets in the day after taking the drug and the inclination to vomit 

 are best resisted by giving iced coffee, iced tea, iced pills, peppermint 

 tea, cognac, one to two wafer powders of menthol and sacch. lactis 

 aa o'2 grm. (Apolant 7 ) half an hour before the drug is taken. 

 Fischer 8 considers that lying still in the horizontal position is the 

 best remedy. Boas 9 recommends the injection of the drug into the 

 stomachs of patients who tolerate extractum filicis badly, in the form of 

 a thin emulsion (with gi. arab.). In the case of children the extract 



1 Stuelp, Arch. f. Augenhcilk., 1906, li. 



2 Huber, Munch, med. Wochenschr., 1903. 3 Marx, loc. cit. 

 4 Sonnenschein, Munch, med. Wochenschr., 1903. 5 Boas, loc. cit. 



6 Lenhartz, loc. cit. 7 Apolant, Deutsch. med. Wochenschr.^ 1905, xliv. 



H Fischer, loc. cit. 9 Boas, loc. cit. 



