Remarks ON POISONING BY FUNGI: AMANITA PHALLOIDES
Authors: C. B. Plowright
Journal: BMJ (1905)

A CERTAIN number of cases of poisoning by fungi occur every autumn in this country, although they are not so numerous with us as abroad.It is not long since that tte tendeney was to regard every fungus other than the common mush- room as poisonous.So far from this being the case, the msjority of them are eatable, in the sense that they can be eaten without making the eater ill, when cooked in an appro- priate manner.The really poisonous species can almost be counted on the fingers.But wemay go even furtherthan this, and say the vast majority of deaths in this country is caused by the consumption of one species, and one species alone.These deaths are caused by mistaking this particular species for the common mushroom which it to a certain extent resembles.This fungus also is the commonest cause of fatal poisoning on the Continent of Europe, where fungi are eaten as food andwhereall sorts and kinds are pressed intothe service of keeping soul and body together, not as we eat mushrooms as luxuries.It so happens that our textbooks lead us to suppose that the poisonous qualities of all fungi are due to the alkaloid muscarin, the antidote for which is atropin.That certain English fungi do contain muscarin is per- fectly true, but these are such as can hardly be mistaken for the common mushroom bythemosteareless.The specieswhich cauEes so many death8 both here and abroad owes its lethal power not to an alkaloid but to a toxalbumin-phallin.This fungus, Amanita phalloides, presents certain very definite botanical characters by which it and its allies can easily be recognized.During the last thirty years I have been able to trace it as the cause of the following four deaths in and near the town of King's Lynn.CASE I.R. H., of King's Lynn, a boy aged 12, ate at 11.30 a.m., on Saturday, September 27th, I879, about a third ot the pileus (top) of a specimen of A. phallhides, uncooked.He had no symptoms until i a.m. the following morning, September 28th (thirteen hours), when he had vomiting, diarrhoea, and great thirst.He was, however, able to eat his breakfast at 8 a.m.Diarrhoea and vomiting occurred again at noon (twenty-four hours).On the following day (September 29tb) his symptoms were ameliorated; at 7 p.m. the late Dr. C. Glasier saw him.The above-mentioned symptoms continued and were accompanied by severe abdominal pain.On September 31st, at 7 a.m., he died, slightly convulsed-that is, on the fifth day (8ij hours).Post-mortem examination showed peritonitis with the lymph; gastric mucous membrane vivid red; walls of the stomach ooftened, so as to be readily perforated by the finger; gan- grenous spots on the mucous membrane of the intestine.CASE 1I.J. C. B., a little boy of 5, residing near King's Lynn, ate an unknown quantity of A. phalloidem between 3 and 4 in the afternoon of August 29th, 1894.He had no symptoms till the middle of the night, ten to twelve hours after eating the fungus, when he had sick- ness and diarrhoea.Dr. P. de C. Potter saw him about i i a.m. on August 30th; he had previously had an emetic of salt and water, which acted freelyt; afterwards a doee of castor oil was given him and milk.The most prominent symptoms besides diarrhoea and vomiting were severe abdominal pain and intense thirst, which continued until 8 p.m. on August 31st, when he became worse and died unconscious on September ist at 7.30 a.m., sixty-eight hours (fourth day) after eating the fungus.