. Observations on recent cases of mushroom poisoning in the District of Columbia. 23 Mr. Chesnut has prepared the following account of the effect of phallin and its treatment: The fundamental injury is not due, as in the case of muscarine, to a paralysis of the nerves controlling the action of the heart, but to a direct effect on the blood corpuscles. These are quickly dissolved by phallin, the blood serum escaping from the blood vessels into the alimentary canal, and the whole system being rapidly drained of its vitality. No bad taste warns the victim, nor do the preliminary symptoms begin un
. Observations on recent cases of mushroom poisoning in the District of Columbia. 23 Mr. Chesnut has prepared the following account of the effect of phallin and its treatment: The fundamental injury is not due, as in the case of muscarine, to a paralysis of the nerves controlling the action of the heart, but to a direct effect on the blood corpuscles. These are quickly dissolved by phallin, the blood serum escaping from the blood vessels into the alimentary canal, and the whole system being rapidly drained of its vitality. No bad taste warns the victim, nor do the preliminary symptoms begin until nine to foirrteen hours after the poisonous mushrooms are eaten. There is then considerable abdominal pain and there may be cramps in the legs and other nervous phenomena, such as convulsions, and even lockjaw or other kinds of tetanic spasms. The pulse is weak; the abdominal pain is rapidly followed by nausea, vomiting, and extreme diarrhea, the intestinal discharges assuming the " r i c e - water" condition char- acteristic of cholera. The latter symptoms are persistently maintained, generally without loss of consciousness, until death ensues, which hap- pens in from two to four days. There is no known antidote by which the effects of phallin can be counteracted. The un- digested material, if not already vomited, should, however, be removed from the stomach and intestines by methods similar to those given for cases of poisoning by Amanita muscaria. After that the remain- der of the poison, if the amount of phallin al- ready taken up by the system is not too large, may wear itself out on the blood and the patient may recover. It is suggested that this wearing-out process may be assisted by transfusing into the veins blood freshly taken from some warm-blooded animal. The depletion of the blood serum might be remedied by similar transfusions of salt and warm water. Common table salt dissolved in water is a solvent of phallin, but, while it might be applied in remov
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