Bloody fluid is sometimes vomited or comes from the nose. It may also occur in the discharge from the bowel.
Retching and purging occurred more frequently as early symptoms than in animals poisoned by A. muscaria.
Coma appeared early and continued until death. The administration of atropine soon after giving the poison when cardiac inhibition was present, caused a slight temporary rise of blood pressure but did not affect the dilated condition of the blood vessels. The pressure continued low notwithstanding the atropine. Although the experiments with this fungus were not as numerous as with the A. muscaria because of difficulty in obtaining it, yet it seems clear that atropine is of very little value as an antidote. Death very rarely resulted from the cardiac inhibition occurring early but usually came on late after that condition had disappeared. The lethal dose was no larger when atropine was given than when no antidote was used.
Amanita verna is very much more toxic than A. muscaria, the average of four experiments in which the former was given without an antidote being .034 gram. (dried) per kilo of body weight, while .103 gram. (dried) per kilo, was the average for the latter fungus.
POISONING BY AMANITA PHALLOIDES.
The symptoms described in man are very similar to those caused by the A. verna, except that the convulsions are less constant and cyanosis is not mentioned. In some cases vomiting and purging are prominent symptoms. There is dizziness and fainting, extreme ashy pallor, cold skin covered with sweat, subnormal temperature, muscular twitchings and occasional convulsions and somnolence which deepens into coma and lasts until death, which usually occurs two or three days after eating the poison. Sometimes the gastro-intestinal symptoms are less severe or may be absent, though they are usually present; in that case the nervous symptoms are more prominent, particularly the convulsions and circulatory disturbance.
In experiments upon animals the convulsions were not observed so constantly as with the A. verna. Out of twenty-five dogs poisoned by the Amanita phalloides, convulsions only occurred twice, while twelve frogs injected with different preparations (dried toadstool and glycerine and alcoholic extracts of the fresh) failed to show a convulsive seizure in a single instance. It seems to be difficult for mycologists to draw a sharp line between the A. verna and the A. phalloides and say to which of these two certain fungi belong. This may explain why convulsions are recorded more frequently in persons poisoned by this toadstool than in animals poisoned by it. Frogs are very susceptible to poisons acting upon the spinal cord, and all of those poisoned by lethal doses of A. verna had convulsions, while none of those poisoned by the A. phalloides had any. It would therefore appear from this striking difference in the physiological actions that the two are separate and distinct.
The circulatory and gastro-intestinal symptoms were quite similar to those caused by the A. verna.
A. phalloides is less toxic than the A. verna, but more so than the A. muscaria, the average lethal dose of the dried fungus (eight experiments) for dogs, where no antidote was used, being .117 gram. per kilo.
The antidotal value of atropine is very slight, if indeed it has any action other than removing the temporary cardiac inhibition. The animals very seldom died from this, but mostly from the late effects after the inhibition had disappeared. In four experiments on dogs in which atropine was given either at the same time as the poison or before it, the average lethal dose was .198 gram. of the dried fungus per kilo. Two dogs were killed by .1 gram. per kilo without atropine; another was given the same amount and was given atropine hypodermatically a number of times and recovered, though very ill for two days.