Ford and Clark: Properties of Poisonous Fungi 179 
neutralized by atropin. This poison Harmsen calls the “ pilz- 
toxin.” Its presence in Amanita muscaria has never been con- 
firmed but some of the evidence, clinical and otherwise, indicates 
that muscarin may not be at all times the sole poison in Amanita 
muscaria. 
It should be noted in this connection that the term muscarin is 
not the name of a specific chemical substance, but of a group of at 
least five substances with the same formula C 5 H 13 N0 2 and that 
the effects of these various compounds upon the animal organism 
are quite different from each other.* A complete discussion of 
the various muscarins, their properties and manner of preparation 
may be found in the works of Zellner 33 and Kobert. 32 
Treatment 
The outlook in poisoning by Amanita muscaria is more hopeful 
that when Amanita phalloides has been ingested, because of the 
lack of chronic and degenerative lesions produced by the latter 
species. Amanita 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, atro- 
pin is a perfect physiological antidote for muscarin. Whenever, 
therefore, the patients show evidence of muscarin poisoning such 
as lacrymation, salivation, contraction of the pupils, delirium, hal- 
lucinations, 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 employed 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 
* The bases cholin and neurin are closely related to muscarin and have 
both been reported in mushrooms. Neurin is very poisonous. According to 
Harnack (Arch. exp. Path. u. Pharmacol., 4, pp. 82 and 168 (1875)) the ama- 
nitin of Letellier and Speneuxi? is cholin. Clark and Kantor*t> found cholin 
in Amanita muscaria and other fungi. Hofmann (Dissertation, Zurich, 1906) 
discovered neurin in A. muscaria, but it is not certain whether it exists as 
such in the fungus or whether it is produced by processes of decomposition. 
The deadly prussic acid has been found in Marasmius oreades and Clitocybe 
injundibulif ormis by Offner (Bull. Soc. Mycol. de France, 27, 242, 1912). 
