164 
closest resemblance between aa of certain European 
species and other American specie 
Clinical aspects 
The clinical features of poisoning by Amanita muscaria are 
quite as characteristic as those in Amanita phalloides intoxication 
and should enable physicians to distinguish clearly between the 
two conditions. andi nately: piace s fungi are usually 
gathered by the igno ta number of different 
varieties and areata the symptoms in the patients point 
to the combined action of different toxic principles. In general, 
however, there is no difficulty in recognizing the character of the 
intoxication. In Amanita muscaria poisoning there is usually a 
very short interval between the ingestion of the fungi and the 
first signs of trouble. ‘This prodromal stage varies from one or 
two to five or six hours depending upon the amount of the fungi 
eaten. Careful observation of this feature will frequently be of 
the greatest value in deciding upon the kind of intoxication which 
the cases present. In the severe cases the patients show an 
excessive salivation and perspiration, a flow of tears, nausea, 
retching, vomiting and diarrhoea with watery evacuations. 
pulse may rarely be erase buti it is usually slow and irregular. 
There is no feve he respirations are accelerated and the 
patients ae. the nae being filled with mucus. Mental 
symptoms are also present, particularly giddiness with confusion 
of ideas and rarely hallucinations. All these sympto 
vary in their intensity, at some times the meee nna pre- 
dominating and at other times the mental. In light cases, 
where small quantities of the poisonous fungi are consumed, onl 
severe cases, the vomiting and diarrhoea may be so pronounced 
as to rid the alimentary canal of the offending material and the 
nervous symptoms then become the predominant ones. With 
large quantities of poison also the patients may show the nervous 
manifestations from the start, delirium, violent convulsions, and 
