Toadstool Poisoning and its Treatment 



the inhibition had disappeared. In four experiments on dogs in which 

 atropine was given either at the same time as the poison or before it, 

 the average lethal dose was .198 gram, of the dried fungus per kilo. 

 Two dogs were killed by .1 gram, per kilo without atropine; another 

 was given the same amount and was given atropine hypodermatically a 

 number of times and recovered, though very ill for two days. 



Transfusion of physiological salt solution (.6 per cent, table salt) 

 was practiced in three dogs. Although death occurred in all of these 

 and the lethal dose was not unusually high, the pressure was restored 

 for a time at least. It should be employed in treating poisoning in man, 

 and not be depended upon as the only procedure, but used in conjunc- 

 tion with other remedies. This will be referred to again in describing 

 treatment. 



It will be seen from the above that poisoning by the A. verna and 

 A. phalloides present symptoms in the lower animals which are quite 

 different from those caused by the A. muscaria, and that in either case 

 poisoning is far more serious than by the latter fungus. This is not only 

 because they are so much more toxic, but also because there is no de- 

 cidedly antagonistic action by atropine, and hence its value as an anti- 

 dote is much less. 



In treating a case of poisoning by either A. verna or A. phalloides the 

 only thing that can be done is to meet the indications in the individual 

 case. If the heart is beating slowly, atropine should be given in liberal 

 doses. This will not overcome the chief disturbance of the circulation, 

 viz., the tremendous dilation of the blood vessels. Strychnia will do 

 this to a certain extent, but its use may be contra-indicated by twitch- 

 ings or convulsions from the toadstools. If it can be used it is exceed- 

 ingly valuable, as it stimulates not only the vaso-motor center** but the 

 respiration and heart as well. Caffein or strong coffee may also be used 

 to this end if the stomach will retain it. Suprarenal extract should 

 also be given hypodermatically, as it will restore the blood pressure more 

 nearly to normal than any other drug, according to our experiments. 

 It has the advantage of not increasing the excitability of the spinal cord 

 as strychnia does, and hence would not be contra-indicated by nervous 

 symptoms. 



Perhaps the most rational treatment to meet the most serious condi- 

 tion of the poisoning by these toadstools is the transfusion of normal 

 saline solution (.6-. 7 per cent, solution of table salt) into the subcu- 



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