Toadstool Poisoning and its Treatment 



There can be no doubt, therefore, of the antidotal value of atropine for 

 poisoning by Amanita muscaria. 



It should be borne in mind, however, that it is not an infallible anti- 

 dote even when given early, and that it does not prevent death from the 

 late effects in severe cases, although given in large doses. In some ex- 

 periments atropine was administered at the same time the poison was 

 given and in others before it. 



The important practical lesson is that too much reliance should not 

 be placed upon atropine. It will be shown later that it has little value 

 as an antidote to A. verna and A. phalloides. Probably these fungi 1 

 contain less muscarine than A. muscaria. Although there is no drug 

 so antagonistic in its physiological action to the poison of the A. mus- 

 caria as atropine, the use of other remedies should not be neglected. 

 The symptoms have to be treated as they arise. Strychnia, alcohol in 

 moderate amounts and suprarenal extract could all be used to ad- 

 vantage in restoring the circulation, especially late in the poisoning. 

 Atropine merely removes the inhibition of the heart which occurs as an 

 early symptom. 



External heat should be applied if the body temperature is sub- 

 normal. The treatment of gastro-intestinal symptoms will depend upon 

 the conditions of each individual case. The injection of a large amount 

 of warm physiological salt solution (.6-. 7 per cent, sodium chloride) 

 into the subcutaneous tissues should also be tried in severe cases seen 

 late in the poisoning. 



POISONING BY AMANITA VERNA OR A. BULBOSUS VERNA BULL. 



The symptoms appear from six to fifteen hours after the ingestion of 

 the poison and may be largely choleraic in nature, i. e., vomiting and 

 purging, the discharges from the bowel being watery with small flakes 

 suspended and sometimes containing blood. 



The disturbance of the circulation is somewhat similar to that caused 

 by A. muscaria, viz., slow, strong pulse early, but rapid and weak later. 

 Dizziness and faintness may be early symptoms. Sometimes the skin 

 is pale and covered with cold, clammy sweat; at others there is great 

 cyanosis. The body temperature is subnormal, unless nervous symp- 

 toms are very severe. Very prominent among the symptoms are tetanic 

 convulsions, which may appear comparatively early and persist until 

 the end. 



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