A Case of Mushroom Poisoning

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As mushroom season approaches, with Black Trumpets burgeoning later this month, I thought this might be a good time to post about treating mushroom poisoning. 

There is a saying,

There are old mushroom foragers and there are bold mushroom foragers, but there are no old bold mushroom foragers. 

I count myself as an old, cautious mushroom forager who has never been poisoned. I forage mushrooms that have no near look-alike that is poisonous. I have never treated someone with mushroom poisoning either, but given the circles I travel in, one never knows when this information may come in handy. 

I'll first write about a teensy, weensy formula called Gan Cao Tang. A teensy weensy formula is a single herb formula and maybe should not even be considered a formula since they are made up of just one herb.  There are a bunch of examples of this in the Shang Han Lun. This is made up of the single ingredient of unprocessed Gan Cao.  It should not be confused with Zhi Gan Cao Tang,  Prepared Licorice Decoction, which contains many herbs.  

There are teeny tiny formulas, too, which consist of two herbs: Shao Yao Gan Cao Tang, Gua Lou Mu Li Tang, or Gan Cao Gan Jiang Tang. And there are tiny three-herb formulas like Gan Mai Da Zao Tang and Dang Gui Sheng Jiang Yang Rou Tang. I am particularly fond of these tiny and teensy formulas because they are often building blocks for or can be integrated into larger formulas, making understanding larger formulas more straightforward. For example, Gua Lou Mu Li San is in Chai Hu Gui Zhi Gan Jiang Tang, and Shao Yao Gan Cao Tang is in many formulas, including Si Ni San and Xiao Jian Zhong Tang. 

Below is the original clause about Gan Cao Tang and a remarkable case. I love this case, in part because of my mycophile tendencies. I spend hours and days every summer and autumn foraging for wild mushrooms on horseback.  

Gan Cao Tang

Gan Cao      2 Liang      6 gm

Original Text:

Shang Han Lun clause 311: In Shaoyin pattern that has lasted 2-3 days.  There is a painful throat.  Gan Cao Tang can be given.  If it does not resolve, give Jie Geng Tang.

Case 1: Poisoning by a Poisonous Mushroom

Dr. Pan Wen-Zhao  潘文昭

Mr. Su was 42 and came to see me on April 2, 1972, in the evening at about 9:00.  He had cooked and eaten about 250 gm of wild mushroom that he had picked on a mountaintop.  Five hours later, he developed abdominal pain with nausea and dizziness.  He was sweating and vomiting, and his whole body felt weak.  Two hours after this came on, he came for a consultation.  I gave him 1500 gm of Gan Cao in a concentrated liquid.

Ten minutes after the first time he took this, he vomited once. Thirty minutes later, he took the herbs for the second time.  In two hours, the abdominal pain and nausea diminished, but he still had no strength in his body and was dizzy.  Four hours later, he had rotten yellowish-brown diarrhea one time.  He then took the remaining liquid, which was 100 milliliters.  Six hours later, all the symptoms were completely gone, and there was a complete cure.  No other method was applied during the whole course of treatment.

Discussion:  Ben Jing says that Gan Cao "resolves toxins."  The Ming Yi Bei Lu says that Gan Cao "resolves 100 toxins of medicinals."  This case illustrates Gan Cao's ability to resolve toxins.  This is genuinely not spoken rashly!

Gan Cao is the sweetest herb in the Chinese medical pharmacy. It can bring in a lot of dampness through the middle. One way I think of Gan Cao's ability to resolve toxins is that it irrigates, dilutes, and flushes the body.  

Which of the mushrooms pictured here is poisonous, and which is edible?