166 
Treatment 
The outlook in poisoning by Amanita muscaria is more hope- 
ful than when Amanita phalloides has been ingested, because of 
the lack of chronic and degenerative lesions produced by the 
latter species. Amaniia muscaria causes an acute intoxication 
which comes on soon after the ingestion of the fungus, develops 
rapidly, and is amenable to treatment. As we have indicated 
above, atropin is a perfect ee antidote for muscarin. 
Whenever, therefore, the patients show evidence of muscarin 
poisoning such as lacrymationa, salivation, contraction of the 
pupils, delirium, ae and coma, atropin should be 
administered at once and in large doses. At the same time the 
stomach and bowels should be emptied of the ingested material 
by the free use of emetics and purgatives. Even though the 
vomiting and diarrhoea are pronounced, drugs should be em- 
ployed to increase this action since it is essential that all the fungi 
be removed and the absorption of poison be prevented. In 
refractory cases with bad heart action, respiratory distress and 
coma, atropin should be administered intravenously. In suc 
cases atropin, indeed, offers the only hope of saving the patient’s 
life 
PROPHYLAXIS 
Mushrooms are usually eaten for their flavor which makes them 
an agreeable relish and food-accessory rather than a staple 
article of diet. There is no general cook-book test to distinguish 
the dangerous fungi from the edible ones. The habits and 
appearance of the poisonous species must be studied until one 
may recognize them with the same ease and certainty as any of 
the common plants of our gardens. Neglect of this precaution 
in gathering mushrooms for the table will sooner or later cause a 
typical attack of poisoning, and in such cases it should be re- 
membered that the mortality is often as high as in any of the 
most fatal diseases. The rapidly increasing number of deaths in 
this country from sparse pone show ws that some effort 
must be made to di about the danger- 
ous species in order to prevent unnecessary suffering and death. 
