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POISONING BY AMANITA PHALLOIDES 
Botanical en 
The vast majority of ca of mushroom intoxication are 
caused by Amanita palit. the ae or deadly Amanita. 
This species has a characteristic appearance and should be 
usually grows to a height of 5-7 inches and its white spores, its 
ring or annulus and its base or cup (frequently called the poison 
cup) render its identification comparatively simple. The colors 
of the pileus, varying from brownish amber to yellow, are im- 
portant, but are not as a rule regarded as of specific value. In 
Europe the pileus is usually greenish in color, but in America the 
greenish color is rarely seen. Amanita phalloides usually grows 
in the woods but this rule is by no means universal. Occasion- 
ally, plants are to be found out in the open pastures near the 
margin of dense forests or in the grassy spots in the roads leading 
to and from them 
Clinical aspects 
In poisoning by Amanita phalloides the clinical symptoms are 
practically always the same. After a prodromal stage of six to 
teen hours in which no discomfort is felt, the victims are sud- 
denly seized by severe abdominal pain, cramp-like in character, 
and accompanied by vomiting and diarrhoea. Vomitus and 
stools consist of undigested food with much blood and mucus. 
Anuria is usually sea and rarely constipation develops. 
Hemoglobinuria does not occur. Paroxysms of pain and vomit- 
ing alternate with cen of remission, the extreme suffering 
producing the Hippocratic ie described by the French as “la 
face vulteuse.”” The loss of strength is rapid and excessive. 
Jaundice, cyanosis, and aes 7 the skin develop within a 
ae followed by profound coma from which the patient pi 
not rally. There is no fever. Convulsions are absent in the 
ae stages and when present in the late stages are usually a 
terminal event. Ocular symptoms also do not usually occur. 
The course of the disease lasts four to six days in children and 
eight to ten in adults but if large quantities of the fungus are 
