poisoning. If this is less than five hours the patient has probably eaten of the irritant mushrooms of which I have been speaking. If from eight to twelve hours have elapsed before the person feels ill he has probably eaten of some deadly member of the genus amanita and his case is a serious one. Of this second class of poisonous fungi we probably have three species, the amanita phalloides, amanita verna and amanita muscaria.

These fungi contain active poisonous principles, muscarine or amanitine, depending on the species from which they are derived.

The symptoms of poisoning by this deadly group are: Sometimes nausea, vomiting, purging and distress in the epigastrium (these are sometimes wanting); ashy or leaden paleness, cold extremities, feeble and rapid pulse, contracted pupils. The sight becomes dimmed, the intelligence blunted, stupor comes on and death

supervenes.

TREATMENT.

If the case is seen early enough give an emetic and a cathartic. Usually, however, the poison has entered the circulation before the patient is seen. There is one, and only one known antidote for amanita poisoning. That is sulphate of atropine administered hypodermically. I should give one-sixtieth of a grain at first and then half that amount every hour until the characteristic effects of the drug showed themselves or there was some other reason for its discontinuance. An occasional hypodermic injection of one-sixtieth of a grain of sulphate of strychnine would help to support the oppressed heart. Other indications should, of course, be met as they arise.

Mushrooms afford food for swarms of insects and their larvae. Some species are especially infested by them. I could find hardly a specimen of any of the edible russulae last summer that was not full of burrows and their

squirming inhabitants. Most of these larvae gain entrance at the base of the stem and work their way up. Even before they reach the cap the mushroom is made unfit for use, for their presence in the stem imparts an unpleasant flavor and perhaps an unwholesome quality to the whole fungus.

In closing I would make a few suggestions to mushroom eaters. In collecting in the field cut off the stem to avoid getting the dirty base against the other specimens, and to see whether larvae have tunnelled up from the ground. All wormy specimens should be discarded.

Keep the edible fungi separate from the unknown or suspected specimens, or disastrous results may follow from the contamination of the good by the constantly falling shower of spores from the poisonous. I have known an instance where a whole family was made ill in this way.

In preparing mushrooms for cooking the stems of most species should be discarded, as they are too tough and fibrous. As a general thing mushrooms should be peeled and the pore-surface of the boleti should be removed, as it forms a mucilaginous mass in cooking which is distasteful to most persons.

Cook all mushrooms as soon as possible after gathering, as they decay rapidly. If more than enough are gathered for one meal it is best to cook them all and warm over the residue, if desired, for the next meal.

Cook as simply as possible so as to preserve the flavor. A good way is to put them in a covered dish with a little butter and salt and set them in the oven for twenty or thirty minutes.

It is well to have different species cooked by themselves, so as to enjoy the special flavor of each.

Do not gorge on mushrooms any more than you would on meat. Remember their nitrogenous nature. Eat only species of whose nature you are sure. Avoid all sus

picious kinds, and in the words of the story-book you will live happily ever after.

LIST OF MUSHROOMS EATEN 1896-7.

Agaricus Compestris.

A., Procerus.

A.. Ulmarius.

Marasmius Oreades.

Russula Virescens.

R. Lepida.

R. Heterophilla.

Coprinus Comatus.

C. Atramentarius.

C. Micaceus.

Lactarius Deliciosus.

Boletus Edulis.

B. Scaber.

Strobilomyces Strobilaceus.

Fistulina Hepatica.

Polyporous Sulphureus.

Hyduum Repandum.

Clavaria Flava.

Lycoperdon Cyathiforme.

Amanita Caesaria.

THE RELATION OF MUSCULAR CO-ORDINATION

TO TRAUMA.

E. H. ARNOLD, M.D.,

NEW HAVEN.

It is a matter of daily observation that children are subject to slight forms of trauma, as cuts and bruises, much more frequently than adults. Especially is this true in regard to traumata of the upper extremities, and here again the hands in particular bear witness to this fact. The hands of the average active boy are hardly ever free from the marks of some slight injury. The lack of muscular control is without doubt responsible for this state of affairs. The painful impressions connected with these injuries are one of the means by which we finally acquire muscular control, thereby giving accuracy to our motions. They are teachers of coördination, so to speak. If, therefore, slight injuries of the above character are an unavoidable and necessary phenomenon of childhood, nothing need nor should be done to prevent them. If, however, this lack of coördination does not disappear within a reasonable time, or if it gives rise to the graver forms of injury, then it is time to think of a remedy for the condition.

Proof must first be had that lack of coördination is a cause of graver injuries. Let us have an understanding of what is meant by coördination. Coördination is defined as the combination of muscles in consistent and harmonious action. Consistent with the necessities of the case which calls for muscular action, it must, in range of movement, celerity of movement, duration of posture and degree of force of muscular contraction, be suited to the circumstances of the case. Harmonious means

that only the muscles or groups of muscles concerned in the performance of the movement should actively contract, that those limiting or controlling the degree and celerity should be in what may be termed passive contraction, and that muscles not in any way needed for the execution of the movement stay relaxed. If any of these factors are faulty, then the product will be a faulty one, an action inexact and unsteady. Depending upon the surrounding circumstances we may then expect an injury to take place by the more or less violent contact of our body with things surrounding. While We are absolute masters over surrounding circumstances and therefore cannot hope, even if coördination were developed to an ideal condition, to entirely abolish injury by such contact, we can certainly by improving coördination diminish the number of accidents of this kind and modify somewhat the character and extent of the same.

never

If this

were all that could be accomplished by developing the power of coordination, motor training as a prophylactic against injury is deserving of a great deal of attention.

The importance of coördination would be greatly increased if it could be proved that the incoördinate use of muscles is apt to harm tissues without bringing them into contact with things exterior. Proof to that effect is not wanting. I need only refer you to that well-known fact that fractures of the clavicle in most cases result not from direct violence to that bone but must be attributed to muscular contraction. That other fractures come about in the same way can be inferred from this, but we are not without positive proof. Let me relate a case of that nature. A boy of ten years, of some fame among his classmates for clumsiness, in the attempt to stop a tennis ball with his right hand tore off the internal condyle of his right arm. There was no contact with the ground, but simply with the ball, which was not thrown with much force.