A bright coloured fungus, the fly agaric.
The clearest idea of the general effects of agaricus is obtained by a study of the poisonings recorded in the cyclopaedia of Drug Pathogenesy. A short selection must serve to illustrate this.
(1) Three half starved soldiers ate agaricus roasted (without bread). This was soon followed by gay delirium, talking nonsense, rapidly changing the subject. Convulsions came on with jerking of the muscles of the face and extremities, the jaws were firmly clenched and they wanted to talk but could hardly articulate, the eyes rolled and were sometimes quite turned up. In one case the lower limbs were strongly “retracted” and the arms so agitated that his pulse could not be felt. The tip of nose and the lips were bluish and there was cold sweat on face, neck and chest. Breathing was oppressed and noisy, the breath had a sour sickly odour (? the fungi). Suddenly the spasm relaxed, but for several hours convulsions and stupor alternated. Quick recovery ensued after a night’s rest.
(2) In some cases agonizing epigastric pain was experienced, with vomiting and diarrhoea; or a jaundiced tint of the whole body came on and lasted some days.
(3) In one case, where the dose was smaller, lack of emotional control was conspicuous. A temperate accomplished man at lunch “felt drunk,” every thing and person appeared ludicrous; he laughed immoderately (in law court) and joked immoderately with the attendants and ridiculed in an absurd way his superior officer.
(4) Another official had similar symptoms to a less degree and when recovering, though still under the influence of the fungi, he took a drive in the evening, heightened sensibility was shown. He “never before or since saw the light and shades cast by the setting sun so brilliant, and every object looking so perfectly beautiful.”
The Kamschatkans used to take agaricus must as a stimulant. Giddiness, cheerful flushed face, mental emotion, involuntary words and actions and sometimes loss of consciousness occurred. Exaggerated and ludicrous movements may occur, a person under its influence wishing to step over a straw takes a stride or jump sufficient to clear the trunk of a tree, a talkative person cannot keep silence or secrets, and one fond of music is perpetually singing.
Violent maniacal delirium with roaring, and clonic and tonic convulsions with dyspnoea and oedema of the lungs may be present, leading to death.
Post mortem.-Congestion of brain and membranes was found, also of trachea, oesophagus, pleura, pericardium, omentum, pancreas, stomach and jejunum. The blood-vessels and cavities of the heart were filled with black fluid blood. The liver may be enlarged (Cy. Drug. Path. I.c).
Smaller doses induce marked salivation, perspiration and lachrymation. The pulse is usually quickened at first, then slow and irregular. Respiration is quick and difficult from a feeling of constriction; rales due to mucus in the bronchi may be audible. The solid and fluid elements of secretions are increased.
The mechanism of the various symptoms induced by agaricus and its alkaloid is as follows: They act on the myoneural or glandulo-neural junctions (or “receptive tissue”) of an area very similar to that affected by atropine, but where the effect of atropine is inhibitory that of muscarine is excitant. The glands of the various mucous membranes and the sweat and lachrymal glands are stimulated-but not the kidneys, liver and breast. Unstriped muscle is stimulated in the walls of the bowel and in the small blood-vessels, inducing anaemia of parts; this together with the effect on the intestinal glands causes loose and fluid motions and cramp or severe colic.
Spasm of the bladder, ureters, and pregnant uterus may be produced, and contraction of the pupil and ciliary muscle, causing a temporary myopia.
On the heart muscarine causes lessened frequency and prolonged diastole in the lower animals, but in man quickened pulse and heightened blood-pressure occur with accompanying palpitation. For these phenomena increased secretion of the suprarenals may be responsible.
-Agaricus has been extensively proved both in the tincture and in dilution. The results are not very illuminating. Some points have been brought out which may be of value therapeutically.
In general the convulsive movements are confirmed, with finer twitching and trembling in various parts, and in proportion to the severity of the muscular superaction the body feels bruised’ pains along the spine are prominent and reflex action is readily induced by slight stimuli; “a host of neuralgic pains everywhere,” shooting, stitching, burning are experienced by many provers. Pains are relieved by the warmth of bed, and those of the limbs often disappear on motion and return when at rest. Walking in the open air tends to increase some of the spinal pains (chiefly dorsal), and also to increase the chilliness.
A diagonal distribution of symptoms has been noted, the left arm and right leg being affected in sequence or simultaneously. The variety and changeableness of site, however, lessen the value of this. Mind.- In his delirium the prover may attempt to get up when unable-paralleled in patients by attempts to get out to bed or to escape from their quarters. Confusion and aversion to mental work are sequels.
Head.-The head and neck share in the shooting pains, and a feeling of icy coldness is notable.
Eyes and Ears._The lids, eyeballs and ears may twitch, and vision be temporarily dim from disturbed accommodation. A variety of noises in the head is heard.
Face and lips are pale and bluish, and the lips twitch.
Mouth and Throat.-Salivation or later dryness, stitches from throat to right ear; constriction felt in throat and larynx.
Digestive Sphere.-Besides the nausea, &c., already described, excessive appetite in the evenings, rumblings, distension, inodorous flatus, and piles with burning in the anus are on record. Urinary Sphere.-Irritable bladder and slight dysuria are mentioned, and also incontinence of urine. Sexual Sphere.- Stimulation of sexual appetite without erections is produced. In women pruritus pudendi and bearing-down in the back and abdomen occur.
Respiratory Sphere.- Paroxysms of cough, sneezing and noisy breathing may be added to the previous records.
Circulatory Sphere.-The irregular action of the heart is relieved by coffee.
Skin.-Among the conspicuous effects brought out by provings are itching, redness and burning of the skin, especially in hands, feet, nose and ears. A creeping feeling in and beneath the skin in noteworthy. The itching induced and curable by agaricus may have the twofold characteristic that it is replaced by icy coldness after scratching the part, and that the itching reappears in another part- “scratching causes change of site.”
Drowsiness after eating, chilliness on motion and sensitiveness to draughts, and profuse inodorous perspirations, general or on chest only, complete the picture.
Any of the above conditions (if not due to fungus poisoning) may be treated with success by agaricus. The skin symptoms just mentioned suggest chilblains and the drug has been found very useful to prevent recurrence. Frequent doses of a low dilution should be given internally and, after batching with hot water, the parts affected should be frequently painted with the strong tincture.
The major nervous symptoms-twitchings, spasmodic movements in limbs and trunk-have led to the use of agaricus in chorea in most of its forms, and it is certainly one of the most hopeful drugs for this affection. The occurrence of “neuralgic” pains, especially if like cold needles and relieved by the warmth of bed or fire, strengthens the indications for the drug. Slighter degrees of loss of muscular control, such as letting things fall when at work, may require agaricus. The patient is aggravated by warmth might call for apis. Enuresis also may be present in these cases.
The delirium of agaricus has many features resembling belladonna poisoning, but it is even more like that of alcohol. The drug should certainly be used in early and mild cases of delirium tremens.
Many of the nerve pains, especially those made worse by cold, and the local sensitiveness to touch, indicate agaricus in the vague complex of symptoms known as spinal irritation or neurasthenia, and it may be used with confidence in such cases where the similarity between drug and disease-symptoms is close.
The marked sudorific action of the drug has not been applied therapeutically as much as would be expected.
Clinically, the use of agaricus has been justified in several spheres-nervous subjects faint or twitch from excitement or alarm; children late in developing mentally and physically are benefited by it (late talking, see nat. Muriaticum; late walking, see calcarea); those who are slow to grasp a subject and quick in forgetting it. Adults suffering from over-study, excessive mental exertion, sexual indulgence to excess, or nervous hyperaesthetic women, may require it. It has many of the symptoms, both mental and nervous, of general paralysis of the insane, and should be useful in that disease.
Nystagmus (e.g., miners) when not a part of a serious organic nervous lesion may be benefited by this drug, and twitching of the eyelids, muscae volitantes, distortion of colour or shape in connection with headaches should cause it to be carefully studied.
Agaricus is one of the remedies for morning diarrhea with straining before, during and after stool; although the headache is relieved by the evacuation, straining in the rectum continues. The call is somewhat urgent and there is abdominal distension, loud rumbling and foetid flatus. The urine will be high coloured and scanty if much diarrhoea or perspiration has taken place; there may be difficulty in voiding it or it may dribble away.
The exercise of the genital function has an exhausting effect-it may cause fainting in sensitive women and exhaustion in men.
All symptoms in agaricus cases may be worse after intercourse, without any excessive indulgence. Prostatic aching maybe induced. In women the usual symptoms of the case are aggravated at the period; bearing-down and backache are noticeable, but they are of a nerve type than due to displacements, inflammatory lesions of the pelvis or rheumatism.
This drug will repay an extended study of the Materia Medica.
(1) Delirium as described; delirium tremens.
(2) Chorea: involuntary jerking movements or loss of muscular control. Spinal Irritation.
(3) Retarded development of children-mental and physical- late walking and talking ; alternations of stupidity and clumsiness with brilliancy.
(4) Skin: redness, burning and itching or icy coldness. Profuse perspiration, sensations of creeping and crawling Chilblains.
(5) Alcoholics-after drinking or for headaches.
(6) Most suitable subjects are thin, restless, highly-strung people, light complexioned and atonic.
(7) Elderly people with feeble circulation.
(1) AGGRAVATION: Morning, cold air; (nerve pains, vertigo), after eating; after sexual intercourse; during menses; after mental exertion; before storms.
(2) AMELIORATION: Walking (Backache): warmth of bed (nerve pains): mental powers heightened in the evening.