Poisonings
[ Many more cases might have been given if the effects of other poisonous mushrooms had been recorded. As none of these, however have been proved, as as A. muscarius fairly represents their toxical influence, it has been thought better to confine ourselves to the effects of this species, in using which we are on safe ground.- EDS]
1. A girl, aged 8, ate one bug-agaric in evening, and six more next day at 3 p.m. About 5, in moving across room, cried out that she felt giddy, and instantly fell down senseless and motionless. When carried to bed she uttered a wild cry, and her eyes looked fixed. Emetics were given without effect. At 6:15 she was stretched out in bed comatose, countenance somewhat swollen and of ghastly leaden aspect; pulse greatly intermittent and tremulous, and scarcely to be felt; eyes pulled up towards angles of orbits and fixed immovably; occasional startings of limbs, and severe convulsive motions of head and upper part of trunk. There was complete unconsciousness. The whole body was unusually cold; heart’s action greatly laboured. Cold water was now dashed on the chest. Making a sudden start, which raised her head from the pillow, she opened her eyes, and for a few seconds stared wildly around. She quickly relapsed into her former lethargic state; the convulsions became more violent, longer in their duration, and recurring at shorter intervals; and the coldness and rigidity were extreme. Stimulants were used, and cold affusion repeated; latter was followed by a violent movement of upper part of body and a wild king of scream, and pulse became for a little more regular and fuller. A turpentine enema brought away a foetid copious motion. Stimulants were continued, and pulse became regular, but weak and quick (above 130). After 3 hours, she was put into a warm bath for 10 m., and pulse became fuller and less quick (80). Mustard was applied to stomach and soles. Soon a general perspiration broke out, and warmth of surface increased; extremities were even more convulsed, and muscles of calf became permanently contracted, and felt rigid and hard; but upper part of body was much less affected than at first. Pulse got quicker again, seldom continuing steady for 1/2 hour, but breathing was natural, save for an occasional emission of a strange sound. The mustard was removed after 2 hours; some colour appeared in face, and she seemed much better; startings of limbs occurring less frequently. At midnight skin was moist, body more warm, pulse 125 to 130; in 20 m. she was in a sound sleep, breathing easily, face a little flushed, and convulsion affecting her at longer intervals. No change, save copious sweat, till 5:20 a.m., when she first opened eyes and turned them in orbits, seeming to look around her without any consciousness of perception. She then fell back again and slept till 6:45, when, suddenly starting up, she threw down the bedclothes, calling out at same time to take them off from her, and seemed quite sensible. She then vomited some of the mushrooms; asked for drink, and complained much of soreness of head and neck, so that she could not swallow. Afterwards she vomited more, and had ineffectual retching. In m. her pulse was 120, weak, but regular. Now and then during day she had involuntary motions of legs. Thirst considerable; pulse in afternoon 110. During n. slept as usual, but with frequent startings. Pulse variable for some days longer. (J. ADAM, Lond. Medorrhinum and Phys. Journ., xxxii, 364.)
2. Dr. JOH. HEINR. BECK relates:- A schoolmaster, aged 73, drank, at 9:15 p.m., by mistake for pure milk, half a pint of milk in which was a decoction of 1/2 a plant of agar. musc. Perceiving his mistake he drank a quantity of warm milk, whereafter he vomited 8-9 times, and had five of diarrhoeic stools. He seemed to be half stupefied, but complained of nothing but acidity, which was relieved after vomiting. He remained in this state till 4 a.m., when he became worse, and died at 5 a.m.
P. M. Skin of body yellow. Blood-vessels of scalp full of blood. All the blood-vessels of the dura mater full of dark red blood. Arachnoid red. Blood-vessels in cerebral sulci full of blood. Cortical substance of brain reddened; medullary substance studded with red points. Each of the cerebral cavities contained about a teaspoonful of bloody serum; the vascular plexuses were bright red; the vessels of base of brain distended with blood; the tentorium cerebelli very vascular; the cerebellum very soft; in the arbor vitae an effusion of blood the size of a small bean. All the fauces, oesophagus, and trachea highly inflamed. Pleura and pericardium highly inflamed (stark entzundet). Lungs greatly distended (aufgetrieben), marbled blue, hepatized and filled with black blood. Cavities of heart filled with black fluid blood. The arch of the aorta outside and inside highly inflamed, studded with atheromatous deposits. The omentum, pancreas, peritoneum and outside of stomach and jejunum uncommonly highly inflamed, all blood-vessels filled with black fluid blood. The inside of bladder very highly inflamed. [ All these high inflammations must be exaggerations; probably he meant congestion or redness.- EDS.] (Henke’s Zeitsch. fur die Staatsarzneikunde, xxi, 307.)
3a. Three half-starved soldiers in the retreat from Moscow in 1812 made a meal of agar. musc., which they roasted on the coals, with a little butter and salt, and ate without bread. One ate four, the two others three each. They then lay down to sleep. At 10 p.m., the first soldier commenced to speak nonsense, passing from one subject to another in a gay delirium with great loquacity. Some time afterwards he had violent convulsions. Seen soon after he was found with convulsive movements of muscles of face and extremities, the jaws were firmly clenched, he could not be got to take anything; he always wanted to talk, but could hardly articulate. His eyes rolled in their orbits, and were sometimes quite turned up. The agitation was extreme, the lower limbs strongly retracted, and the arms so agitated that his pulse could not be felt. Cold sweat on face, neck, and chest. Tip of nose and lips bluish. Some froth at the commissure of lips; respiration oppressed and noisy; breath had a sickly and sour odour. In an instant he became more calm, and the jaws were loosened. An emetic was given. He threw up much phlegm, which smelt sour, together with fragments of the fungus. He then got vinegar and water to drink. He passed the rest of the day alternately convulsed and in stupor. The beginning of the n. was restless, but he grew quiet, and in the m. was as usual.
3b. The second was attacked by convulsions soon after the first with great anxiety and pain at epigastrium, which was relieved spontaneously by vomiting. He then developed much strength with gay delirium; he sang and talked, but gave no replies to questions. He imagined himself an officer commanding at drill, and various manoeuvres which he thought he was conducting. The convulsions ceased for a short time, but soon recommenced; irregular and hurried movements of the upper extremities; restlessness of hands, which he pressed together as though he was rolling a soft body between his hands in order to make it round. Speaking with volubility and animation to his father and mother, as though he were beside them, giving no replies to questions, he sang and lamented alternately, embracing his comrades and kissing their hands. All this took place in the midst of a general spasm resembling trembling rather than convulsions. Half an hour later he fell into a faint, which did not last long, but left him in a deep stupor. Extreme alteration of physiognomy, general prostration, with cold clammy sweat all over the body. The scene ended in a soporous state, from which he gradually roused and recovered, but remembered nothing of what had happened since eating the fungi.
3c. The third was seized with some pains which he referred to the stomach, with great oppression, then convulsive movement that lasted but a short time, but was violent, and was succeeded by a yellow tinge of the whole body, a kind of jaundice, most apparent on the face, neck and chest. Soon he vomited spontaneously a great quantity of fetid matter, and had some stools which relieved him greatly. When seen he was very feeble, pulse scarcely perceptible. The rest of the day was found in a state of stupor and spasmodic agitation, but he slept well at n., and next day was well. The yellow colour disappeared in a few days (VADROT, Obs. sur I’empoisonnement par les Champignons, 1814.)
4a. Five soldiers, after eating plentifully of the fungus, were attacked by the usual symptoms. About 5 or 6 hours after their meal they perceived the first symptoms. After anxiety, oppression, general malaise, and some convulsive movements, two of them had spontaneous vomiting, which was kept up by means of hot water. The violent symptoms went off, and there remained general prostration, stupor mingled with spasms, and later some faecal evacuations. This state lasted 7.8 hours, when they rallied, and the next day were quite well. 4b. The three others had more serious symptoms; one especially, of feeble constitution and only just recovering from an internal disease, had extreme prostration and delirium greatly resembling that of ataxic fever. Tartar emetic was administered, but the alarming symptoms persisted for a long time. The abdomen was tympanitic, he had very foetid evacuations from the bowels, the pulse was extremely feeble, and fainting fits frequent, a soporous and spasmodic condition lasted nearly 2 days and the convulsions were protracted; he could not go back to his military duties for a fortnight.
Hughes was a great writer and a scholar. He actively cooperated with Dr. T.F. Allen to compile his 'Encyclopedia' and rendered immeasurable aid to Dr. Dudgeon in translating Hahnemann's 'Materia Medica Pura' into English. In 1889 he was appointed an Editor of the 'British Homoeopathic Journal' and continued in that capacity until his demise. In 1876, Dr. Hughes was appointed as the Permanent Secretary of the Organization of the International Congress of Homoeopathy Physicians in Philadelphia. He also presided over the International Congress in London.