On 4 Nov 2004 16:53:10 GMT, (Nick Maclaren) wrote:


| There has been a serum available since (at least) just post-war.
| L'institut Pasteur used to have a light plane always ready to go to
| anywhere - which included UK. (Mushrooms & Toadstools, Collins NN
| series, Dr. John Ramsbottom)
|
| Whether in these days of scheduled flights this is still the case, I
| don't know, but as long as a diagnosis is made within reasonable time,
| it's no longer all doom and gloom.
|
| The trouble is the diagnosis - after all evidence has been passed or
| puked, and the usual sufferers can only say "It looked like a mushroom
| to me."

I believe that the problem is that the serum will help only if
administered early, and that the symptoms emerge late and few UK
doctors would recognise the symptoms. By the time that the
diagnosis is made, it has already caused serious and irreversible
organ failure.

| Fortunately, A. phalloides is uncommon.

Not as much as all that. When I lived in Wiltshire, I found it
fairly often. For comparison, I have ONCE seen a giant puffball.
I agree that it is probably only locally fairly common.


Regards,
Nick Maclaren.

As this was originally about lawn mushrooms and what follows is
undiluted science I offer an apolgy for being a little off topic and
indigestible but I think the ungarnished science is a salutary
reminder. There is no magic serum or curative treatment just some that
tip the odds more in your favour. The following is the current
published medical data and basically the treatment for Amanita
poisoning is that which any big hopsital with a renal unit ,
transfusion unit and ITU would offer. The last resort is a liver
transplant. with lifelong immunosupression to follow.

These are taken direct from something called Medline which is a
listing of all published medical research each year. It is available
to the public as PubMed.


Plasmapheresis in the treatment of Amanita phalloides poisoning: II. A
review and recommendations. [Review] [48 refs] Therapeutic Apheresis.
4(4):308-12, 2000 Aug.

"Amanita phalloides poisoning is the most common cause of lethal
mushroom poisoning (lethality 20% in adults, 50% in children).
However, there is no standard treatment strategy and no antidote
against the ensuing hepatic failure. This review of 14 investigations
published over the last 20 years shows that the introduction of
detoxification techniques, in particular the use of plasmapheresis, in
combination with supportive therapy to prevent the absorption of
aminitine toxins into blood, produced a substantial reduction in
mortality. The main complications in using these techniques include
infections and coagulation disorders. Because of the latency period in
the development of symptoms, treatment should begin on the first
suspicion that an intoxication is present. The best therapeutic
results can be expected when the detoxification techniques are applied
in combination with conservative therapies within the first 36--48 h.
Using this approach, mortality rates in some recent studies have been
below 10%. [References: 48]"

Plasmapheresis = a technique used for removing substances from blood
plasma in a living person. It uses a machine available in most big
transfusion centres

American Journal of Gastroenterology. 96(11):3195-8, 2001 Nov.
Mushroom poisoning from the genus Amanita is a medical emergency, with
Amanita phalloides being the most common species. The typical symptoms
of nausea, vomiting, abdominal pain, and diarrhea are nonspecific and
can be mistaken for gastroenteritis. If not adequately treated,
hepatic and renal failure may ensue within several days of ingestion.
In this case series, patients poisoned with Amanita virosa are
described with a spectrum of clinical presentations and outcomes
ranging from complete recovery to fulminant hepatic failure. Although
there are no controlled clinical trials, a few anecdotal studies
provide the basis for regimens recommended to treat Amanita poisoning.
Use of i.v. penicillin G is supported by most reports. Silibinin,
although preferred over penicillin, is not easily available in the
United States. In those with acute liver failure, liver
transplantation can be life saving. [References: 12]


Journal of Toxicology - Clinical Toxicology. 40(6):715-57, 2002.
BACKGROUND: Amatoxin poisoning is a medical emergency characterized by
a long incubation time lag, gastrointestinal and hepatotoxic phases,
coma, and death. This mushroom intoxication is ascribed to 35
amatoxin-containing species belonging to three genera: Amanita,
Galerina, and Lepiota. The major amatoxins, the alpha-, beta-, and
gamma-amanitins, are bicyclic octapeptide derivatives that damage the
liver and kidney via irreversible binding to RNA polymerase II.
METHODS: The mycology and clinical syndrome of amatoxin poisoning are
reviewed. Clinical data from 2108 hospitalized amatoxin poisoning
exposures as reported in the medical literature from North America and
Europe over the last 20 years were compiled. Preliminary medical care,
supportive measures, specific treatments used singly or in
combination, and liver transplantation were characterized. Specific
treatments consisted of detoxication procedures (e.g., toxin removal
from bile and urine, and extracorporeal purification) and
administration of drugs. Chemotherapy included benzylpenicillin or
other beta-lactam antibiotics, silymarin complex, thioctic acid,
antioxidant drugs, hormones and steroids administered singly, or more
usually, in combination. Supportive measures alone and 10 specific
treatment regimens were analyzed relative to mortality. RESULTS:
Benzylpenicillin (Penicillin G) alone and in association was the
mostfrequently utilized chemotherapy but showed little efficacy. No
benefit was found for the use of thioctic acid or steroids. Chi-square
statistical comparison of survivors and dead vs. treated individuals
supported silybin, administered either as mono-chemotherapy or in drug
combination and N-acetylcysteine as mono-chemotherapy as the most
effective therapeutic modes. Future clinical research should focus on
confirming the efficacy of silybin, N-acetylcysteine, and detoxication
procedures. [References: 420]

Silybin = experimental drug which ( roughly speaking )
increases the activity of the livers detoxification mechanisms

I would echo those who have said go an learn properly best of all from
an expert. A friend of my parents was looking at a mushroom
suspicious that it was Death Cap. Another walker looked and said it
was related but was good eating. He knew his stuff it was good
eating. Mushroom picking is a pleasure but not essential to life,
getting it wrong is potentialy fatal.