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' '^»»- J

MUSHROOM POISONING

BEAUMONT SMALL.

OTTAWA.

kbprinted prom

Twentieth Century Practice of Medicine

Vol. XX.

NEW YORK

WH,I,IAM WOOD AND COMPANY

POBLISHBRS

IMO.

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I

MUSHROOM POISONING.

BY

BEAUMONT SMALL,

OTTAWA.

■

MUSHROOM POISONING.

The subject of mushroom poisoning is of much importance to the
practising physician, who may at any moment be called upon to care
for such a case. In Europe, where fungi are articles of every -day
diet, accidents are conntantly occurring from the mistaken use of
poisonous species. In America this form of food is nob utilized to
the same extent, and cases of poisoning are not so frequent ; but very
severe illnesses and deaths do occur from this cause, and an autumn
rarely passes without some such case being referred to in our medical
publications. In some instances it is duo to the gathering of poison-
ous forms with the common mushroom. At other times it arises
from the desire to gather species that are not so well known ; and oc-
ci-sionally we find that the attractive appearance of the poisonous
forms has tempted a child to gather and eat. In works upon this
subject very many cases are reported, and the large percentage of
deaths is noticeable. Ziemssen quotes the cases of a mother and
daughter, both fatal ; of a mother and child, both fatal ; of five officers,
all of whom died; of a family of seven, with three deaths. Blyth re-
fers to the statistics of fifty-three cases of poisoning by Amanita phal-
loides, of which forty ended in death. *

The earlier reports of cases are generally very imperfect and brief,
and many of the more recent ones have the same deficiency . Others,
however, are very carefully and minutely reported and are valuable
contributions to the subject.

Illustrative Cases.

The following are a few illustrative cases :

Two adult males ate, at 8 :30 a.m., at breakfast, a quantity of mush-
rooms supposed to be Amanita ca'sai-ea, but in reality A. muscaria.

The first man ate about two dozen. At 8:45 he complained of
feeling unwell, and at nine was found on his bed in a state of collapse.
He complained of a sense of impending death, and there rapidly su-
pervened blindness, trismus, difficulty in swallowing, unconscious-
ness, and convulsions. Death took place in the evening of the second
day. The treatment consisted in the administration of emetics, and
apomorphine and atropine hypodermically.

r)42

SMALL— MUSHROOM POISONINO.

The second man ate about one dozen. After breiikfast lie rode to
liiH office. At 9:80 he be^au to coinphiin of diplopia and drowHiuesH.
At ten o'clock he was found wittiuj^ in his chair, half stupid, with re-
traction of the head. He rapidly became uncouHciouH and remained
so for five hours, excepting ui)on two occasions, when he regained
consciousness for a brief i)eriod. Cold sweats were a prominent
symptom. There was no rise in temperature, no pain, nor any nau-
sea. The treatment consisted in the hypodermi<i administration of
apomorphine, which was of no effect. Strychnine and atropine were
then given; of the latter, gr. ^'i. every two hours, about gr. /,» being
given in the twenty-four hours. Castor oil and sweet oil were also
given. The man recovered. '

A boy, aged 12 years, ate, at 11:30 a.m., about one-third of the
pileus of an Amanita phalhides. No ill effects were felt until 1
A.M., when he awoke complaining Of thirst,' which was followed by
vomiting and purging. These symptoms continued all night, and
less severely during the day. Castor oil and citrate of magnesia weye
given. The following morning he awakened with severe abdominal
pain, and when seen by the ])hysician he was feverish and suffering
from palpitation, purging, vomiting, and extreme exhaustion. A
mixture of chloroform, morphine, and cardamoms was given; also
whiskey. The symptoms eased during the day, but the prostration
continued. He slept the following night, but about 7 a.m. was seized
with convulsions and died in half an hour, on the fourth day after
eating the fungus. The post-raortem examination was made thirty-
six hours after death Rigidity was well marked, the face was cy-
anotic, and dark-brown fluid was issuing from the mouth and nos-
trils. Upon opening the abdomen, marks of recent peritonitis were
seen as bands of lymph gluing the small intestines together. The
stomach contained a small amount of dark fluid, the mucous mem-
brane was inflamed, and the walls were softened. The whole of the
small intestine was inflamed and there were numerous spots of gan-
grene. The liver was ansemic, the heart was empty, and the lungs
were healthy."

Mrs. N , aged 55 years, ate a third of a raw mushroom, prob-
ably A. phalloides, about 10 a.m. No symptoms appeared until 7
P.M., after supper, when abdominal cramps commenced and steadily
increased in severity. Vomiting began at 8 p.m., with marked pros-
tration. The patient was found in a condition of collai)se, with a tem-
perature of 100.5° F. ; pulse small, rapid, weak; respirations shal-
low; slight tympanites and abdominal tenderness; the pupils were
contracted; there were cold perspirations, pallor, and an anxious,
drawn expression, with mild delirium, intense retching, and profuse
»vatery stools. Treatment: morphine sulphate gr. i, atropine nitrate
gr. jf,y, strychnine nitrnte gr. j\; and hourly, fluid extract of bella-
donna gtt. i., fluid extract of nux vomica gtt. ss., bismuth subnitrate
gr. ij. ; after every emesis, sodium bicarbonate 3 ss. in half a glass
of water; whiskey ad libitum, and hot applications. From 12 p.m.
the symptoms gradually subsided. The treatment was continued for
two days.^

Five persons, aged 13, 22, 29, 40, and 45 years, ate of what was

ILLU8T11ATIVE CIAHKH.

643

'\

rode to

■wiueBH.

vith re-

muiued

stained

)iiiiuent

ny nau-

atiuu of

ne wero

»„ beint; 1

ere also '

i of the

uutil 1
jwed by
j;lit, and
3Hia weye
jdomiual
HufferinK
jtion. A
veu; also
•ostration
m» seized
day after
le tliirty-
e was cy-

and nos-
,niti8 were
lier. T\ie
niis mem-
ole of the

s of f?an-

the liings

om, prob-
d until 7
. steadily
ied pros-
irith a tern-
ions shal-
iipils were
I anxious,
id profuse
ine nitrate
it of beMa-
subnitrate

ilf a glass
|m 12 P.M.

itinued for

what was

probnV)ly Amninta vcrnn, ])rppared as u Htew, at nine o'clock in the
evening, five hours "fter the fungi had biien gutliered. No discom-
fort was exi)erienceil until towards morning, when all were attacked
with pain in the stomucli, nausea, and a sickening sensation at the
epigastrium. Twelve hours after the nmshrooms had been eaten all
the symptoms had increased in severity, and in addition there were
retching and vomiting. In thirty hours theri^ was intense gastro-
enteric irritation with relaxed bowels and distressing tenesmus. As
these symptocin subsided they were followed by prostration, cokl-
ness of the suvface, and a tendency to coma. In two of the jiatients
who had eiden more than the others the symptoms advanced to
coma and coma vigil, with tlie features shrunken, skin dusky, and
pulse scarcely percei)tible. One, aged thirteen years, died in fifty -six
hours; another, aged twenty-two yejirs, in sixty -three hours. The
treatment consisted in the administration of bismuth and creosote,
morphine, stimulants, heat to the surface, and atrojune. The atro-
l)ine was not begun until twenty -four hours had elapsed ; it was given
in repeated small doses until each patient had had res])ectively ^V»
A, uV, a\), and i;',, of a grain. Temporary improvement was noticed
after each dose of the antidote.^

Father, mother, and child, aged 5 years, ate twelve, eight, and
five mushrooms respectively, sup[)OHed to be Ainanitn imiararin, Ama-
nita phalloidcs, and Amanita verna. They were gathered during the
morning and eaten at dinner. Nausea and headache were comi)lained
of during the afternoon. At six o'clock more were eaten. The same
symptoms were noted, but in greater intensity. At midnight purg-
ing and vomiting became severe, but there was not much pain, ex-
cepting cramps in the legs. The vomiting at first consisted of food ;
then it became choleraic, as also did the stools, and finally of a pink
or purplish color. In twenty-four hours the patients became jaun-
diced and had a peculiar glazed ai)])earauce about the eyes. Muscu-
lar twitchings took i)lace, esj^ecially in the face, arms, and hands.
During the next twelve hours the depression became severe, the heart
was irregular, the respirations were jerky, and the pui)ils were di-
lated. The urine became saffron-colored, and before death it was
purplish. The perspiration and breath smelled of mushrooms. In
forty-eight hours the mother and child died within half an hour of
one another. The child had convulsions for about four hours, up to
two hours before death. The mother was restless and unconscious
about five hours before death. The father recovered in about twelve
hours after the symptoms had commenced. Treatment consisted of
morphine gr. |, atropine sulphate gr. j^^, repeated in two hours;
whiskey, ammonia, and nitroglycerin.**

A nan, aged 52 years, ate of an omelet prepared from mush-
rooms, among which were Amanitn phalloidea and Boletus luridus.
Four hours after eating he was found covered with a cold, clammy
perspirfvtion ; the breathing was stertorous and of the Cheyne-Stokes
type; the pulse was almost imperceptible — 28 per minute. The pu-
pils were dilated. Atropine was given; also ether, coffee, and rum;
and heat was applied to the surface. The symptoms continued to
grow worse until one litre of decinormal saline solution was injected.

I

644

SMALL— MUHHROOM POIHONINO.

Iiiiproveineiit followed iiiim(>(li>it(>l,v ; thiH trcMitinout w»h continued,
and in on(> hour tho pulHo wuh (iO \}or minute, the rtmpimtiou iM^oinio
sti'oU|,{er, and the putient nillied from the Htate of collupHe. No diur-
rh(L'a or vomiting whh present Jit uu.v time."

The PoisonouB Principles in Mushrooms.

The poisonous i)r()perties of fungi and the active principles that
produce the poisonous eff(M*ts have received much attention fronj
many careful observers. For manv years a principle common to all
8[)ecies was Hought for, and various cluunists described several poisons
under as many titles. Thus we have had miiHcnriHC, hitlhoHuu', attitni-
Ifin, (ujdvicin, iKjaryih'nx', and many others. At present all are re-
solved into two poisons, vinHcaruic and />/Kilfiit, the former char-
acteristic of Amanita muscaria, being an alkahnd ; the latter charac-
teristic of Amanita phalloiden and an entirely dift'erent ])oisou.

In addition to the action oi poisonous species, very many instances
of poisonous effects have followed the use of species which are known
to be free from any [)<)isouous pro2)erties. Most of these were un-
doubtedly due to gastrointestinal irritation, more or less severe, in
some cases leading to peritonitis. All, however, cannot be traced to
this condition, and in sf)me cases the poisoning has been popularly
explained by the fact that the edible form was gathered from a manure
heap or from some other deconii)osing organic matter, which produced
a poisonous action. Another exi)lauation is that the mushroom may
have been kept too long, and that decomposition and putrefactive
changes had begun which rendered it poisonous in character. In
the light of modern bacterial science, this idea of a toxic jninciple
being generated by the decomposing mushroom is of much import-
ance. We know that many cadaveric jioisons are produced in this
way, and we also know that the mushroom has been termed a " vege-
table beefsteak" on account of the very large percentage of nitrogen-
ous matter in its composition. The flesh of the mushroom, in addi-
tion to a large j)ercentage of water, about eighty per cent., is made up
of a proteid or nitrogenous substance called fmigin, which contains
from 3.2 to 7.2 jier cent, of nitrogen. It is to this fungin that the
mushroom owes its highly nutritive properties.

Muscarine, CjH,,,NO„ the most carefully studied and best known
of the poisonous jmnciples, is an alkaloid, first described by Schmiede-
berg and Koppe,' whose investigations form the foundation for our
present knowledge of this subject. Their work ^as been confirmed
by others (I. L. Prevost") and reaffirmed by Schniiedeberg."

It is a colorless, syrupy fluid, tasteless and without odor. It is
very soluble in water and alcohol, but insoluble in ether; very slightly

I

THE POISONOUS PRINCIPLES IN MUfiUnoOMH.

645

atinued,

Iwcjiine

No diar-

pleH that
Lou fi<>»u
lon to all

il po'lHOUrt

lie, nnnni-
ill aro ro-
mer char-
er I'lmrac-

iaou.

y iuHtanceH
uro kuown
le ^vel•e un-
\ Hever(>, in
le traced to
1 popularly
m a mauure
3h produced
broom may
putrefactive
iracter. lu
:ic principle
Qch import-
uced in this
led a " vege-
of nitrogen-
om, in addi-
, is made up
lich contains
igin that the

best known
)ySchmiede-
ition for our
3n confirmed

erg."
odor. It 18
very slightly

soluble in chloroform. It is alkaline in reaction and combines with
acids to form salts. The suli)hate and nitrate are prepared for com-
merce. They are very hygroscopic and solub'o in water and alcohol.

The quantity of musotiriue present in the fungus has not l)een de-
termined. It has l)een estimated variously from one-fifth to one per
cent, of the dried fungus. The i)ercentage varies greatly according
to the season of the year, the locality in which it grows, and many
such conditions.

Muscarine was formerly considered to be characteristic of the fly
agaric and similar fungi, but in the progress of chemical and bacterial
science it has been obtained from other and very diffeiv.::t sources. It
has been separated as a ptomain from decomi)osing fish and also
from horseflesh undergoing the same change (Vaughu.. ). It is also
prepared synthetically from choliu by the oxidizing acti(m of nitric
acid. Cholin, ueurin, and other ptomains to which it is allied are all
of cadaveric origin, and nearly all are powerful poisons. The phys-
iological action of muscarine bears a resemblance to that of pilocar-
pine, and also of calabar bean. It is primarily an excitant to the nerve
centres, the period of excitement rapidly passing into one of depres-
sion. Upon the brain it is an intoxicant, causing dizziness, vertigo,
confusion of ideas, delirium, disturbed vision, ataxia, and other like
symptoms, which may end in convulsions, coma, paralysis, and
death. Its depressing action is specially directed to the cardiac and
respiratory centres, and its fatal effects are due to paralysis of these
organs. The heart remains in a dilated state after death. The vaso-
motor centres are also depressed, causing a lo>Vering of the blood
pressure. It increases the secretion of the sudoriparous, lacry-
mal, salivary, and all other glands, probably witli the excei)tion of
the kidney. The muscular system is also irritated and weakened,
giving rise to muscular fatigue and cramps of the extremities and of
the intestines. The pupils are contracted.

The action of atropine upon Ihe heart is directly antagonistic to
muscarine, and furnishes us with the physiological and most valuable
antidote. Atropine paralyzes the inhibitory nerves of the heart and
[increases the rapidity of its action. The effect of muscarine is to
produce a slowing and weakening of its action. The opposing effect
lis frequently demonstrated upon the exposed heart, which, when fail-
ling from the presence of muscarine, is at once aroused into action
[by a drop of atropine solution, or, if the atropine has been first ap-
[plied, the toxic effect of muscarine is prevented.

No cases of poisoning by pure muscarine have been reported.
[All our knowledge is derived from experimental work upon animals
land man. It has been found that 8 to 12 mgm. (gr. | to \) will
Vol. XX.— 35

T^

546

SMALL— MUSHllOOM I'OISOKING.

cause the death of a cat in about eighteen miuutes, and 3 to 4 mgm.
(gr. 5^ to -^g) will have the same result in a few hours. Five milli-
grama (gr. /j) taken by an adult man causes in a few minutes pro-
fuse salivation and lacrymation, increased freiiuency of pulse, nausea,
giddiness, confusion, determination of blood to the head, and perspira-
tion. There is no vomiting or diarrhoea. Fatal doses in cats cause
salivation, contraction of pupils, vomiting and purging, rapid breath-
ing, and dysjmoea; as death approaches the respirations grow slower,
iue i)upils become dilated, and convulsions usher in death.

The poisonous lu'inciple ol Amanita phalloidcs has been frequently
investigated, and the poison obtained has been variously named.
Biilhosin, amanitui, phalloidln, and several others have been described,
but no satisfactory result was reached until Kobert ' ' i)ublished the
results of his researches and named the poison phallin. Phallin is
an entirely diflferent poison from muscarine. It is a toxalbumin, a
member of that group to which belongs the specific poison of cheese,
meat, rattlesnake i)oison, as well as the toxic agent of diphtheria and
other bacterial poisons.

Tlie action of phallin is directed to the blood corpuscles, causin, ;
their destructiijn and setting free the hajmoglobin. It produces such
changes in the ])lasma that the serum escai)es from the vessels into
the various tissues and cavities, and a condition resembling i}vA pro-
duced by cholera is the result. Its action is slow, and the symi)tom8
of poisoning do not appear for an interval of from three or four to
twelve or fourteen hours. They begin as severe abdominal ])aiu,
prostration, vomiting, free watery evacuations, and symptoms of col-
lai)se. Irritation to the nervous system is shown by muscular cramps,
tetanic in character, and convulsions. Consciousness usually remains
unaffected. The i)ulse becomes weak and flabby. The kidneys
secrete much less urine, and there are signs of albuminuria and
luemo^Iobinuria.

The presence of this second poison ex] plains the symptoms of
many cases of poisoning that were obscuie when muscarine was con-
sidered the sole poisonous principle of mushrooms. At present A.
mnscdvia and A. panihevoidt'H have been studied as the source of
muscarine only, and A. pludloidcs alone has furnished pliallin, but it is
not i)robable that either poison is limited to these particular 8i)ecies.
There is much more reason to believe that each jioison is widely dis-
tributed. MuHcarine is certainly the chief poison of A. muacana,
bat many of the symptoms that follow poisoning by this fungus can
be explained only by the i)roKeuce of phallin.

I

CI

SYMPTOMS.

547

4mgm.
e milU-
ies pro-
nausea,
lerspira-
,t9 cause
1 breath-
jv slower,

requently
y uauieil.
lescribed,
iaiied the
Phallin is
Llbumin, a
of cheese,
theria and

B9, causin,;
(luces such
vessels into
ig tV.^'t pro-
s symptoms
e or four to
niual pain,
;oms of col-
ilar cramps,
(lly remains
|he kidneys
pinuria and

^■mptoms of
tue was con-
present A.
\q source of
jlUn, butitis
Liar species,
widely dis-
miisecwia,
fungus can

Pathological Anatomy.

The post-mortem ai)pearances are not very definite. By some it
is stated that rigor mortis is absent. Others have found it to exist,
but to disappear early. There are evidences of gastrointestinal irri-
tation, and portions of the fungus may be present. The various
organs are congested, especially the kidneys. The abdominal and
])leural cavity may contain lluid colored by the transuded hfomoglo-
bin. The heart is dilated. In a series of autopsies, when death
probably resulted from phallin poisoning, there were numerous small
ecchymoses on the pleural surfaces, and also in the lungs, heart, kid-
neys, liver, and other organs. The blood, also, '"as found to be of a
dark cherry-red color and fluid. The veins were full. Fatty degen-
eration of the liver has been found in some cases.

Symptoms.

The symptoms that follow tlie use of poisonous fungi coincide
with tlie results of tlie experimental work with these poisons. In the
majority of cases the symi)toms are distinctly those of one or the
other poison, sometimes complicated by the irritation of undigested
portions of the fungus. In poisoning by muscarine the diagnostic
iwints are the early onset of symptoms, the signs of intoxication, and
the functional weakness of the heart and lungs. In i)oisoning by
phallin the symptoms are delayed; there is an absence of cerebral
disturbance, .and severe gastroenteric irritation, becoming choleraic
in character, is the prominent symptom.

In nmscarine i)oisoning the alkaloid is very stable and is excreted
with the urine, which retains the intoxicating properties. This, it is
eported, the inhabitants of certain districts of Siberia take advantage
f in order to prolong their intoxication. The fly agaric is a com-
on fuugns in northern Asia, and furnishes the natives with a sub-
titute for the alcohol, o])ium, and the narcotics of other countries.

The duration and termination of cases of mushroom poisoning
ary greatly according to the quantity of poisonous material taken into
10 system. Tliey are also influenced by the health and strength of
10 patient. Cases due to muscarine run a more rai)id course than
lose due to phallin. The symptoms begin ahnost at once, and death
ay take place in five or six hours ; more frecpieutly a fatal termina-
on does not take i)lace until the seccmd or third day. Convalescence
always slow, more ])articul}iily in severe cases. Wlien pliallin is
10 poison, the course is slower. Death may take place on the

548

SMALL— MUSHROOM POISONING.

ijii

second day, but four or five days is the more common period. In
some instances the ;)atient has lingered seven days. Of five officers
poisoned by eating, A. bulbosa, symptoms did not begin until eleven
hours had elapsed ; two died on the second day, two on the third,
and one on the fifth day. In another case a child died on the second
day, the mother on the fifth day. In still another instance, one vic-
tim died .j'ter forty-eight hours, one at the end of sixty hours, and
the third on the seventh day.

>i

I I

Treatment.

The treatment consists of measures to allay the gastrointestinal
irritation and overcome the depression, and also the employment of
special antidotes to counteract the poison. , The stomach should be
emptied as rapidly as possible for the purpose of removing all jjor-
tious of the fungi that may remain undigested. Castor oil and ene-
mata should be used with the same object in view; milk, barley
water, and other demulcent drinks, bismuth, magnesia, and antacids
are to be given for the double i^urpose of soothing the irritated mu-
cous membrane and of retarding the absorption of the poison. Mus-
carine becomes very soluble in the acid fluids, and for this reason
acids should not be given. Alcohol and ammonia may be required to
stimulate the heart and respiration and lessen the general depression.

As special antidotes, tfinuin, charcoal, and permanganate of potas-
sium have been recommended. The first two are ot value in render-
ing insoluble the poisons, and the latter for the i)urpose of decom-
posing the alkaloid; their value, however, is as yet uncertain.

When the poisoning ii> due to muscarine, the only antidote to de-
pend upon is atropine, which should be immediately administered in
all cases of suspected i)oisoniug from this source. Experiments have
proved conclusively that wlien the inhibitory nerves of the heart are
dejjressed by atropine the effects of muscarine are almost entirely
counteracted, and when the heart and respiration are failing from the
poison, the atropine helps to restore their tone and force. In the
cases in which it has been employed, even when death has finally
taken place, its favorable effects have been specially mentioned. It
should be administered hypodermically, in gr. y), „ to -^^ doses, re-
peated hourly, according to the symptoms and its effect.

When A. phalloldes has been taken and phallin is the poisonous
princii)le, there is no drug that can be employed with the same
feeling of hopefulness, as there is no known antidote to this i)oison.
As soon as the poisoning is suspected the same general treatment
is iudicHted for the purpose of removing any portion of the fungus

^

CLASSIFICATION OF MUSHROOMS.

649

iod. In
B officers
;il eleven
he third,
16 second
, one vic-
ours, and

I

)intestinal
oymeut of
should be
ng all por-
l and ene-
ilk, barley
id antacids
•itated mu-
ion. Miis-
;his reason
required to
depression .
te of potas-
in render-
of decom-
ain.

Ldote to de-
inistered in
iraents have
10 heart are
ost entirely
Qg from the
>e. In the
has finally
tioned. It
u doses, re-

a poisonous

^1 the same

^his poison.

il treatment

the fungus

and preventing further absorption. Stimulants should be freely ad-
ministered. Nitrite of amyl and nitroglycerin may i)rove of service
to maintain the cutaneous circulation. When the severe symi)tom8
supervene and collapse is threatening, intravenous injections of deci-
normal saline solution or its subcutaneous use will prove of great ser-
vice, and upon this procedure will depend the greatest hope of suc-
cess. Transfusion of blood has also been recommended.

Classiflc!xtion cf Mushrooms.

The higher forms of fungi which grow so j^rofusely throughout
the whole world are classified into tliree groups, according to their
mode of producing spores. These are —

Hymenomyceiea', in which the spores are external to the lining
membrane, which membrane is o;i the under surface of the pileus or
cap and folded as gills. This comprises all such as are commonly
called mushrooms or toadstools.

Biscomycetece, in Avhich the spores are also formed external to the
membrane, but in depressions, or lacunsB, on the upper and outer
surface, as in the ordinary morel.

Gastromyceteaiy in which the spores are contained in a cavity
formed by the membrane, as in the well-known puff-balls.

Of the many thousand species that are included in these three
classes, only a few are known to contain an active poison, and nearly
all these are closely allied and form a single genus of the hymenomy-
cetesB. The most important of the many generi of hymenomycetese
are Agaricus and Amanita. The former contains the ordinary edible
mushrooms, the latter the poisonous forms.

These genera are variously arranged by different botanists, and
this want of uniformity has led to much confusion of names. For-
merly all were included in the single genus Agaricus, and we will
find the poisonous forms referred to as Agaricus muscaria, etc. It
is nov. more general to regard the Amanita as a sub-genus, or as a
separate genns, with its distinctive name.

Distinction between Edible and Poisonous Mushrooms.

The structural and botanical differences between the amanitas and
agarics are very slight, and their resemblance is the cause of the
many accidents that occur. Between the common mushroom and the
fly agaric the difference is very marked, and one should never be mis-
taken for the other, but there are many other edible mushrooms that
bear a close resemblance. The danger is also increased by the fact

.r

650

SMALL— MUSHROOM POISONING.

I'*

H

u

Is

that certain species of the amanita), as A. ca'sarea, are edible; and
unless the collector is a skilled mycologist a mistake may easily
occur. Man}' suggestions have been offered to facilitate the recog-
nition of the poisonous and edible species, but none is sufficiently
trustworthy to be depended ui on without some knowledge of the
distinctive characters of each. The most important sign is the pres-
ence of the I' ^Iva which is formed on the poisonous species, but is
absent from the others. When young, the growing fungus is envel-
oped in a membrane, which is ruptured as the plant expands, its
traces remaining as a cup-shaped ring, or sheath, around the base
of the stem, and as excrescences on the upper surface of the cap.
This volva is often below the surface of the soil and is easily over-
looked. In gathering the fungus, the stem is generally broken off,
and the characteristic base with the volva is left behind. The
color of the gills is also suggestive, those of the edible forms being
pinkish, while those of the poisonous species, with few exceptions,
are white. A disagreeable, noxious odor and sharp, acrid taste also
indicate a dangerous species.

The points of difference between the common edible mushroom and
the two poisonous forms are very concisely described by Dr. W. G.
Far low of Harvard University, as follows:

" (1) The common mushroom has a pileus which is not covered
with wart-like scales; gills which are brownish-purple when mature;
a nearly cylindrical stalk, which is not hollow with a ring near the
middle, and without a bulbous base sheathed by a membrane or by
scales.

"(2) The fly a«?aric has a pileus marked with prominent warts;
gills always white; a stalk, with a large ring around the upper part,
and hollow or cottony inside, but solid at the base, where it is bul-
bous and scaly.

" (3) The death cup has a pileus without distinct warts, gills
which are always white, and a hollow stalk, with a large ring, and a
prominent bulb at the base, whose upi)er margin is membranous or
bag-like.

" (4) Other points of difference are the different places in which
these species grow, and also the colors, which, although they vary in
each case, are brilliant yellow or red in the fly agaric, white varying
to pale olive in the deadly agaric, and white usually tinged with a
little brown in the mushroom.

"(5) In the mushroom the pileus averages from three to four
inches ixi breadth, and the stalk is generally shorter than the breadth
of the pileus and comparatively stout. Ihe pileus remains convex
for a long time, and does not become quite flat-topped until old.

^

POISONOUS MUSHROOMS.

551

lible; and
lay easily
the recog-
iufficieutly
Ige of the
1 the prea-
iea, but is
IB is envel-
:pau(ls, its
i the base
)f the cap.
sasily over-
broken off,
liud. The
Drms being
exceptions,
I taste also

shroom and
r Dr. W. G.

not covered

leu mature;

!g near the

)rane or by

uent warts;
upper part,
e it is bul-

warts, gills

ring, and a

ibranous or

!es in which

ihey vary in

Hiite varying

[nged with a

Iree to four

the breadth

lains convex

[l until old.

The substance is firm and solid. In the fly agaric the pileus, at first
oval and convex, soon becomes flat and attains a breadlh of six to
eight inches and sometimes more. The stalk has a length ecpial to or
slightly exceeding the breadth of the pileus, and is comparatively
slenderer than in the common mushroom. The pileus of the deadly
agaric is thinner than that of the mushroom, and, from being rather
bell-shaped when young, becomes gradually flat-tor)i.3d with the cen-
tre a little raised. In breadth it is intermediate. The stalk usually
is longer than the breadth of the i)ileus, and the habit is slenderer
than the other two species."

The special characteristics of the amanitas are as follows : " Pileus
(or cap) at first campanulate, "then plane ; fleshy towards the centre,
attenuated at the margin ; gills ventricose, narrow behind, free, nu-
merous, at length denticulate, the imperfect ones few, of a deter-
minate form according to the kind, and, with one exception (A.
ctesareus), white. Stalk generally enlarged at the base, frequently
bulbous, solid, or stuffed with a cotton-like substance, which is at
length absorbed ; ring descending, imperfect, fugaceous ; flesh white,
unchanging" (Badham).

Poisonous Mushrooms.

The following species, growing in this country, comprise all that
are known constantly to possess uctive toxic proi)erties. There are
othfs that are probably poisonous, but as yet they have not been
properly authenticated, nor have any deaths been* attributed to their
use. Many of them often produce distressing symptoms, but they
are uncertain and may often be eaten with perfect safety.

Amanita muscaeia Grev. Agaricus muscaria L. Fly agaric.
This is a large showy fungus, very common in some localities, grow-
ing in oak and pine woods from June to late in the autumn. The
pileus is of an orange or yellow color, sometimes becoming brilliant
red, in others it varies almost to a white ; it is covered with warty ex-
crescences, generally whitish. The under or spore-i)roducing surface
is white. The pla'^.t is very free from insects and flies and does not
blacken when broken. In early growth the pileus is convex, but be-
comes flat and sometimes concave. The stem is bulbous, white, and
I and springs from a volva. It is rough and covered with warty growths
on shaving-like shreds. It should be readily distinguished from
[ the edible species by its color and appearance, the color of its gills,
! and its place of growth, as it is never found in meadows, nor does
I the mushroom grow in woods. The flj? agaric is of sturdy growth,
ranging from four to sixteen inches in height. Mistakes are more

652

SMALL — MUSHROOM POISONINO.

1 i

t i

•'I '

liable to arise in mistaking the fly agaric for some of the edible ama-
nita, us Amanita coisarea and Amanita rubescans.

Amanita phalloides (Pers.) Fr. Death cup. This species is not
so large nor so brilliant as the A. muscaria. It grows from three to
six or eight inches high, and is found in woods, but often extends
into meadows and fields. It may be gathered in summer and is very
common in the autumn months. The pileus is white or fawn-colored,
sometimes becoming yellow or greenish and smooth, and the invest-
ing membrane, separating from the cap, remains as a deep cup-like
volva, which has given it the name of death cup. The stem is white,
or tinged in the darker forms, and smooth, excepting when the invest-
ing cap is closely adherent, when it has a bulbous appearance. It
also is very free from insects and remains of a clear color. Its odor
and taste, when fresh, are not noticeable, but after it has been gath-
ered they become disagreeable. Its gills and spores Bre white.

This species is likely to be mistaken for the common edible mush-
room, but it bears a much greater resemblance to Lepiota naucina,
another fungus having white gills and spores, but quite free from any
poisonous properties. Another source of danger is that in some im-
mature specimens of A. phalloides the gills are of a faintly pink color.

Amanita verna Bull. The vernal or bulbous amanita is consid-
ered by many to be simply a variety of A. phalloides, and is one of the
most important of the poisonous species on account of its resemblance
to the common edible mushroom. It is smaller than A. phalloides,
more delicately formed, and of a pure whit.e color. It is found in the
early summer mouths and is very common in many localities. In
Europe it appears in the spring, from which it derives its specific
name. Its distinctive character is the manner in which the sheath
adheres to the stem, giving the stem a very bulbous appearance, and
depriving it of its cup-shaped volva.

Amanita pantherinus Deb. is a common species with many va-
rieties, lo is of a yellowish-brown color, over which there are many
markings of a darker hue, which give it a mottled appearance. The
gills and flesh are white. The following instance of poisoning is
quoted by Christison : " A boy, having eaten some of the fungus, be-
came delirious and maniacal and gradually passed into a condition of
trance. Recovery took place."

Boletus luridus Schoeff. This fungus is of a different class from
the agarics and amanitas, as its spores are formed in lacunae on the
under surface of the pileus. In its shape it resembles the agarics.
The upper surface varies from an amber to a brown color; the under
surface and stem are of a bright red or ferruginous brown. The flesh
is yellowish ; when broken and exposed, it changes to a blue. The

BIBLIOGRAPHIOAL REFERENOEB.

658

dible aiua-

)oie8 is not
m three to
»n extend^
and is very
vn-colored,
the invest-
ep cup-like
in is white,
I the invest-
arance. It
:. Its odor
been gath-
nrhite.

dible mush-
ota naucina,
ee from any
in some im-
f pink color,
a is consid-
is one of the
resemblance
phalloides,
'ound in the
alities. In
its specific
the sheath
tarance, and

pileus is from two to six inches broad. The stem is solid, bulbous,
sometimes quite smooth, and more or less mottled. It grows in
woods and thickets.

Bibliographical References.

1. Prentiss: Philadelphia Medical Journal, September 24, 1898.

2. Plowright: The Lancet, 1879, ii., p. 941.

3. Norris: Philadelphia McdicalJournal, October 22, 1898.

4. Bhadle*: Therapeutic Gazette, May, 1893.

5. Berry : Philadelphia Medical .Journal, September 24, 1898.

6. Delobel : La Presse Medicale, September 30, 1899 and British Medical Jour-
; nal, Epitome 52, 1900.

I 7. Schmiedebcig und Koppe: Das Muscarin, das giftige Alkaloid des Fliegen-

I pilzes, Leipsic, 1869.

8. Prevost . Transactions of the International Medical Congress, 1878.

9. Schmiedeberg : Transactions of the International Medical Congress, 1881.

10. Vaughan: Twentieth Century Practice, vol. xiii., p. 16.

11. Kobcrt : Ueber Pilzvergif tung, Dorpat, 1891.

^.

Ih many va-

|re are many

ranee. The

)oi8oning is

fungus, be-

jondition of

U class from

BunsB on the

[the agarics.

the under

The flesh

I blue. The