THOMAS G. Asirrox, Philadelphia.
MALE FERN.—Male fern (aspidium, U. S. P.) is the rhizome of Dryopleris mas and of Dryopleris marg-inalis (nat. order Filices), ferns which are found in almost all parts of the globe, especially so the former; the latter is in digenous to North America. The rhi zome, which deteriorates on keeping, has a sweetish-bitter, astringent taste, and a slight odor. It contains an active principle, filicic acid; a fixed oil, a vola tile oil, resin, tannin, etc. The ethereal extract deposits a yellowish-white, granu lar, crystalline substance (filicic acid), upon which the medicinal activity de pends. The oleoresin is a thick, dark brown fluid, of a bitter and nauseous taste; on standing, it deposits its active constituent, and must, therefore, be thoroughly mixed before being dis pensed.
Preparations and Doses. — Aspidium (powdered crude drug), 1/, to 1 72 drachms.
Oleoresina aspidii, V, to 1 drachm.
Physiological Action. — The physio logical effects of male fern are usually attributed to an amorphous acid, filicic acid; but the oleoresin is thought to contain all the virtues of the drug. Filicic acid first causes excitement of the nervous system, then paralysis of the latter, of the muscular system, and of the heart in the frog. This is mainly due to its depressing effects upon the spinal centres. Tn man its effects are probably similar, judging from the symp toms, following the injection of an over dose, mainly marked gastro-intestinal irritation, weakness, vertigo, tremors, cramps, amaurosis, stupor, and coma. Male fern is a vermifuge, i.e., it expels the tape-worm, the entozoon against which it is generally employed. Poisoning by Male Fern.—Toxic doses of the ethereal extract, or oleoresin, cause irritation of the gastro7intestinal tract, vomiting, purging, and great pain in the abdomen. If absorbed, it acts on the central nervous system and causes cramps in the extremities, giddiness, amaurosts, paralysis, collapse, coma, and death.
Albuminuria and glycosuria are occasion ally produced by overdoses of male fern. Poulssen, Katamaya, and Okamoto have found that castor-oil and other fixed oils increase the rapidity of absorption of the active principle. They should not, fore, be used with, or after, filix mas.
Six drachms have proved fatal in one adult, 12 drachms in another, and 2 drachms in a child 5 1/2 years old.
• Study of the influence of male fern upon the blood and tissues of rabbits. There Ivas a preliminary examination of each animal for several days, in order to determine the normal number of red cells, the proportion of hmmoglobin, and the weight of the body. The drug was ad ministered through a sound passed into the cesophagus. As soon as the animal died the autopsy was performed, and frag ments of the liver, spleen, bone-marrow, kidneys, and occasionally of the heart and central nervous system were hard ened and subsequently sectioned. Of the eight animals experimented on, some were poisoned acutely with large doses, and others gradually with frequent small doses. In the acute eases the animals frequently died, and examination of their bodies failed to reveal any change that accounted for death. In the more chronic
cases, considerable change in the consti tution of the blood was not infrequently observed. This usually consisted in a diminution in the number of red cells and in the proportion of hmmoglobin, although the animals had lost a consider able portion of liquid, and consequently the blood was thickened. Morphological changes were not present. The glandular organs, the lungs, the heart, and the nerv , ous system were apparently normal. The liver, the spleen, the bone-marrow, and occasionally the kidneys often contained a considerable excess of iron-pigment. The author is convinced that the liver is the organ in which the red cells are de stroyed, and that the pigment deposited in it is subsequently conveyed by the cir culation to the other organs. In his own observations, the granules of hremosiderin appeared in the liver invariably one or two days earlier than in the spleen. The accumulation of the pigment in the liver does not appear to indicate that the liver cells are incapable of getting rid of it, particularly on account of its extensive metastasis. Icterus did not occur in any case, and there was no reason to believe that, aside from the increased activity of the liver-cells caused by their participa tion in the destruction of the erythro cytes, there was any injurious influence exerted upon the organ. Georgiewsky (Phila. Med. Jour., iii, p. S3, '93).
The poisonous symptoms liable to be produced by the liquid extract of male _fern are due, as its anthelmintie action is also, to its active principle: filicic acid. To avoid these effects, the dose should be kept about 30 grains at most, and no castor-oil or other oil should be given about the same time, owing to Elide acid being soluble in it. The usual method of emptying the bowel and withholding food tends to favor absorption of the drug, and consequently its poisonous effects. No preliminary treatment, except, per haps, a mild saline, is necessary, followed by coffee. One hundred cases treated in this manner proved successful. Gra witz (Miinchener med. Woch., Sept. 19, '99).
Treatment of Poisoning by Male Fern. —The poison should be removed by evacuants, avoiding the use of castor or other oils. Stimulants by mouth and by hypodermic injection are useful to com bat depression and collapse.
Therapeutics. — TAPE-WORM. — -Male fern is used almost exclusively as a remedy atrainst tape-worm. It is seldom .? • r ; t. .rude form, or ' ' 't: ft rill Of HD.' oleoresin, t.tro,t (non-otheial). The - . nonseous taste, isn it can be given r but is 110t fIS -.!. t. A milk diet having tad to for a day or two, a s en. followed by the rn. and that in turn is I.v another purgative. The • rt ziltn in divided doses, an hour .1.:rt. acts bett(r in some cases.
/1'11 k.- Lanara has used male fern 1.11 api lication eczema:— 1: Extract of male fern, alcoholic, drachms.
AlLohol. 1 2 ounce.
Extract of myrrh.
Extract of opium, of each, 1 drachm.-31.