165 
loss of consciousness developing in rapid succession and the 
patients sinking into a coma from which they can be roused with 
difficulty if at all. Rarely, consciousness is retained till the end, 
the patients dying from a paralysis of respiration. Finally, in 
many cases, after the preliminary attack of vomiting and diar- 
rhoea, the patients sink into a deep sleep from which they wake 
several hours later slaaeed prostrated but on the road to 
recovery. In such cases the effect of the poisoning passes off 
rapidly, the patients ae restored to normal health within two 
or three days. There are no late nein or after-effects in 
manita muscaria intoxication, and the prognosis is always good 
if the patients recover from the meee symptoms. Chronic 
lesions such as develop in Amanita phalloides intoxication and 
are to be referred to the degenerative changes in the internal 
organs, do not occur with Amanita muscaria. Rarely, the 
nervous eae of “muscaria’’ intoxication feats muc 
more pronounced than the alimentary and the patients become 
the victims of excitement and hallucinations evidencing many of 
the symptoms of alcoholic intoxication. This variety of poison- 
ing is particularly common in Siberia where decoctions of Amanita 
muscaria are employed to induce orgies of drunkenness in which 
che most disgusting practices are followed, according to Kennan. 
The physiological effect of the Siberian Amanita muscaria has 
never been clearly understood and the symptoms shown by the 
oraks who employ the fungus as an intoxicant are seldom seen 
either in Europe or in America. Possibly the method of pre- 
serving the plants may alter the poisonous principles in them or 
possibly the Siberian plants do not contain the same poisonous 
substances as the European or American varieties. Death, 
however, is by no means an infrequent occurrence among the 
oraks from an overdose of Amanita muscaria and, as we shall 
see later, the active principle of the reas plants, muscirin, 
has also been obtained from the Siberia 
topsie sei individuals dead from ae ingestion of Amaniia 
muscaria have vealed surprisingly little. The pathological 
changes in the ten organs seen with Amanita phalloides are 
lacking, particularly the hepatic lesions. In general, the findings 
point to the action of a profound nerve poison (Ford). 
