IMMUNITY REACTIONS OF THE FUNGI 131 



toxins of diphtheria and tetanus bacilli and scarlet fever streptococci, 

 it augments the toxicity of Amanita and botulinus. 



Ford proposed a classification of mycetismus (mushroom poison- 

 ing) which recognized five types and listed some of the species of 

 mushrooms associated with each type. In reporting four cases of 

 mushroom poisoning caused by A. phalloides, Vander Veer and 

 Farley, for practical purposes, simplified Ford's classification and 

 recognized a rapid type of poisoning caused by A. muscaria and a 

 delayed type caused by A. 'phalloides ^^ In the rapid type symptoms 

 appear within a few minutes or at most within 3 hours and include 

 "salivation and lacrimation; pupils contracted and not reacting to 

 light or accommodation; nausea and vomiting; abdominal pains with 

 profuse watery evacuations; pulse at times slow and often irregular; 

 dizziness and confusion with convulsions and coma in severe cases; 

 fatal cases, death within a few hours." *^ The prognosis is good even 

 in severe cases if atropine is administered. 



In the delayed type symptoms appear 6 to 15 hours after ingestion 

 and include sudden onset "with severe abdominal pains; nausea, 

 vomiting, and usually diarrhea; vomitus and stools often showing 

 blood and mucus; extreme thirst; anuria at times; usually jaundice 

 in from two to three days; cyanosis and coldness of extremities; in- 

 creasing prostration with coma and death usually from the fifth to 

 eighth day." *^ The mortality rate is 50 to 70 per cent, often 100 

 per cent in a given group. If the mushroom meal has contained other 

 poisonous species in addition to A. phalloides the prognosis may be 

 better because the early action of other toxins aids in early evacua- 

 tion. Emetics, gastric lavage, and thorough purging are important 

 even though several hours have elapsed since ingestion. Rest in bed 

 is essential until there is definite recovery. Apparent improvement 

 may be followed by fatal relapse if patients are allowed to resume 

 activity too soon. A high carbohydrate liquid diet is recommended, 

 with forced fluids, intravenous dextrose solution, and physiological 

 salt solution subcutaneously. An antitoxin serum has been used in 

 France and Germany. 



Immunity Reactions of the Fungi. The available information 

 about immunity reactions in the fungi is somewhat contradictory. 

 It would appear that in general fungi give rise to antibodies only in 

 small amounts and that the antibodies so formed are not highly 

 specific, reacting in some cases with widely divergent types. The 

 difficulty may be due in part to the relatively thick wall of the 

 fungus cell which allows only a slow diffusion of the intracellular 

 proteins into the tissues, This is indicated by the results of Balls ^ 



