Chanterelle Dreams and Amanita Nightmares

I confess, that nothing frightens me more
than the appearance of mushrooms on the table,
especially in a small provincial town.

Mycologists, medical doctors, and poison control specialists who track mushroom poisoning cases have a pretty clear idea of what they consider a poisonous mushroom. A mushroom is considered toxic if it produces a predictable set of negative reactions in a significant percentage of the people who eat it.

It sounds straightforward, right? And for some species, it is. The death cap, Amanita phalloides, is responsible for at least 80 percent of mushrooming deaths in Europe and is increasingly problematic in the United States.¹ The related destroying angels, A. bisporigera and A. virosa (see #12 in the color insert), are less potent but equally dangerous. No one questions the universal toxicity of these amatoxin-containing mushrooms.

For most mushrooms, though, it isn’t that simple. First of all, how do you define a predictable set of negative reactions? Second, how many sick people does it take to reach the level of significant? Some common and favored edible mushrooms cause problems for a small percentage of the people who eat them. A 2006 compilation of mushroom poisonings includes reported reactions to morels, chanterelles, and honey mushrooms.² Reactions to these popular mushrooms are generally fairly mild and occur only in a very small percentage of the many thousands of Americans who eat them, so they’re not considered toxic by most mushroom experts, although as you can see in this book, responsible mycologists will note the existence of the small risk. Though estimates vary, there are up to 400 toxic mushrooms worldwide,³ based on all reports of people’s negative reaction to eating fungi, including reports on many mushrooms that most people eat without problems. A person can have or develop a bad reaction to a mushroom that the next 99 people enjoy without problems. These “idiosyncratic” reactions happen, but are difficult to use as an assessment of toxicity generalized to all people. The list of mushrooms with proven, consistent toxicity is much smaller, and many good mushroom field guide authors differentiate between a mushroom that has caused problems with a few people and those that sicken most people who eat them. The list of toxic mushrooms commonly found in any region—such as the following sidebar on common toxic mushrooms of the Northeast—will be even smaller. Many of the toxic mushrooms found in the Northeast, or related species, also are found in other regions of the United States.

In the classes I teach and the mushroom walks I lead, a few people regularly question my judgment regarding some mushrooms I refer to as poisonous. Their query is generally along the lines of “I’ve eaten that mushroom many times over the years without problems. It’s not poisonous,” they say. It’s difficult to argue in the face of such persuasive first-person advocacy; however, mushroom chemistry is complex and people’s food tolerances and vulnerabilities are equally complex with a number of variables coming into play. A mushroom earns the label of toxic over time, when a number of people report a bad reaction associated with eating it. Alternately, a mushroom may be labeled as poisonous if only a small number of people have died or suffered life-threatening illness due to eating it. The number of complaints needed to trigger the labeling has never been defined and there is a lot of folk wisdom involved, since the labeling of edibility and toxicity develops over generations and around the world.

For other species, including some with extensive histories of culinary use, the method of preparation can mitigate the toxicity. The false morel, Gyromitra esculenta, (see #13 in the color insert) contains highly toxic and carcinogenic hydrazines and is responsible for serious illness and deaths in Europe, and some cases of severe poisoning in the United States. Yet this mushroom and closely related species are eaten and highly prized by thousands in Europe and western North America. (See Chapter 9 for the full story.)

A couple of mushroom species are good edibles and people frequently eat them, but they can cause illness if the diner drinks alcohol during or after the meal. Coprinus atramentarius, known in England as tippler’s bane and in the United States as the alcohol inky, causes a reaction similar to Antabuse (the trade name of disulfiram), which is used to treat chronic alcoholics by helping them avoid the temptation to drink. The effects of drinking alcohol with tippler’s bane include flushes, sweating, nausea, vomiting, racing heart, and general feelings of malaise, as with Antabuse. Symptoms generally abate within eight hours but can return if alcohol is again imbibed for up to seventy-two hours after a meal of these mushrooms. Interactions with alcohol also have been noted with morels, chicken mushroom, and a few others on very rare occasions. Although alcohol inkys are often categorized as toxic, it could be just as easily argued that the alcohol inky is edible and the alcohol is toxic.

Common Toxic Mushrooms of the Northeast*

Dangerously toxic:

Amanita virosa and A. bisporigera, destroying angels

Amanita phalloides, death cap

Conocybe filaris, deadly conocybe

Gyromitra esculenta, false morel and related species

Galerina autumnalis, deadly galerina and related species

Lepiota josserandi and L. castanae

Paxillus involutus, poison pax

Pleurocybella porrigens, angel wings

Moderately toxic:

Clitocybe dealbata, the sweating mushroom

Entoloma lividum (sinuatum)

Inocybe spp., especially fastigata and geophylla, fiber caps

Hebeloma crustuliniforme, poison pie

Naematoloma (Hypholoma) fasciculare, sulfur tuft

Omphalotus olearius, jack o’lantern mushroom

Mild to moderate toxicity (generally gastrointestinal):

Agaricus xanthodermus, A. placomyces

Amanita brunescens, A flavoconia, A. flavorubens, A frostiana

Boletus sensibilis and B. subvelutipes, red-pored blue staining boletes

Chlorophyllum molybdites, green-spored Lepiota

Gomphus floccosus, scaly vase chanterelle

Hygrocybe conica, black-staining Hygrocybe

Lactarius chrysorrheus, L. rufus, L. torminosus, milky caps

Lepiota cristata

Pholiota squarrosa (toxic for some)

Ramaria formosa and some related species, coral mushrooms

Russula emetica, R. nigricans, R. densifolia, and other black-staining species

Scleroderma spp., earth ball or pigskin puffball

Tricholoma pardinum and others

Tylopilus eximius, lilac brown bolete

Toxic under certain circumstances:

Clitocybe claviceps, clubfoot Clitocybe (for some, if consumed with alcohol)

Coprinus atramentarius, alcohol ink cap or tippler’s bane

(with alcohol),

Morchella spp., morels (with alcohol, for a small percentage of folks)

Hygrophoropsis aurantiaca, false chanterelle, (edible, but causes problems for some)

Toxic unless completely cooked:

Armillaria mellea complex, honey mushroom

Lepista nuda, blewit

Morchella spp., morels

Laetiporus sulphureus complex, sulphur shelf

Hallucinogenic or inebriating:

Gynnopilus spectabilis, big laughing gym, G. validipes and related species

Psilocybe semilanceata, liberty cap, and other species

Amanita muscaria, fly mushroom, A pantherina, A. crenulata, and others

Panaeolus foenisecii, the lawn mowers mushroom, and other species

Edible, even esteemed by some, but problematic for a very small minority:

Armillaria mellea complex, honey mushroom

Laetiporus sulphureus, sulphur shelf or chicken mushroom

Morchella spp., morel

Suillus luteus and other viscid-capped Suillus

* This table is in no way intended to be a comprehensive listing of toxic mushrooms⁴

There are mushrooms eaten and enjoyed by the overwhelming majority of diners, including the very popular edible honey mushrooms, Armillaria mellea complex, and sulfur shelf, Laetiporus sulphureus. Yet some people, probably less than 5 percent of the population, are unable to tolerate these mushrooms and have a mild to moderate gastrointestinal upset following a dinner with them. Does that make these species poisonous? If you happen to be one in the 5 percent, you might think so, but you would quickly learn to avoid the offending mushroom, as you would with strawberries, peanuts, or shellfish due to allergic reaction. The difference is that since the majority of people have a positive association with and a long history of eating strawberries, we do not paint all strawberries with the broad brush-strokes of suspicion as is often the case with wild mushrooms in the United States.

Finally, there are a few good edible mushrooms that will sicken most people who eat them raw or undercooked. These species contain a heat-labile toxin removed or neutralized by cooking. The popular edibles morels, honey mushrooms, and blewits are included in this group. When properly cooked, they cause no problems. The similarity is to foods like meat that are unsafe when eaten raw or undercooked.

Almost all mushroom field and cooking guides instruct the mushroom hunter to fully cook wild mushrooms before eating. In addition to those mushrooms with heat-neutralized toxins, this is necessary due to the structural make-up of mushroom cells. The combination of chitin and the long-chain complex polysaccharides that comprise the majority of the mushroom cell walls make them largely indigestible unless they are cooked. The heat of cooking starts to break down the complex cell structure and enables us to take advantage of the nutritious proteins, carbohydrates, and vitamins in the mushrooms. Even when mushrooms are fully cooked, our digestive tracts are unable to break down much of the mushroom cell wall components. Most of the glucan polysaccharides and chitin are passed through the gut as fiber, which is a necessary dietary component and helpful in lowering cholesterol, not to mention its assistance in maintaining regularity. (I love that word.) Some of these same polysaccharide glucans stimulate the functioning of the human immune system and are being used around the world as immune stimulants and as an aspect of cancer therapies.

Because they are basically indigestible, uncooked mushrooms are treated as unfriendly tenants in the gut, and overindulgence may trigger nausea and vomiting. It is generally accepted in the mushroom poisoning field that mild cases of gastrointestinal distress are often due to an individual’s difficulty digesting the meal rather than any toxin in the mushroom. This is especially true if the mushrooms were not thoroughly cooked, but also can happen with good old-fashioned gluttony. If you come across a huge basket of honey mushrooms, remember that you don’t need to eat them all in one meal.

A few years ago, a former neighbor of mine expressed her interest in trying wild mushrooms. I gave her a portion of a large fruiting body of hen of the woods, Grifola frondosa, and explained how I normally prepare it. Over the course of the day, as she passed the mushroom lying on her kitchen counter, she began breaking off small pieces of the firm, gray, spoon-shaped caps and eating them raw. She later reported liking the crispness of the texture and the mild flavor. Several hours later, she started to feel quite nauseous and became violently ill for a short time. After emptying her stomach, she fairly quickly recovered and, after talking to me and realizing her mistake, she cooked some of the mushroom the following day and ate it without problems.

As with an increasing number of people and foods, a few mycophagists develop allergic reactions to certain mushrooms, ranging from mild rashes to gastrointestinal disturbance or worse. A few people also develop an allergic sensitivity to mushroom spores. The risk posed by high concentrations of mushroom spores became known only following the increased cultivation of shiitake and oyster mushrooms in controlled indoor fruiting rooms during the 1980s. People employed to harvest the mushrooms are exposed repeatedly to high concentrations of spores when harvesting the mature fruiting bodies. Health officials began to note a rise in cases of this hypersensitivity pneumonitis in Japan and China where up to 10 percent of oyster mushroom workers develop symptoms.⁵ This has also been reported among workers in the U.S. oyster mushroom cultivation houses.

My Inevitable Personal Story of Mushroom Poisoning

Sometimes a pattern of “idiosyncratic reactions” gives us enough cause for concern to re-label an edible mushroom as suspect or toxic. One example of this hit close to home with me, very close.

In August 1986, an abundance of rainy, foggy, overcast days made the tourists on the coast of Maine depressed and the mushroomers ecstatic. During those days, I embarked on regular mushroom hunting excursions and, one day, came upon several fine specimens of a bolete that was new to me. They were distinctive, large mushrooms with a purple-brown cap and a deep chocolate pore surface in place of gills. The inner flesh was pale lavender-brown throughout and firm. The mushrooms were fruiting singly in a mixed hardwood forest. I brought some prime specimens home in my basket and set out determining their identity. A spore print generously deposited showed pinkish-buff brown spores and confirmed that I was looking at a species in the genus Tylopilus. A review of several mushroom field guides including Gary Lincoff’s Audubon Field Guide to North American Mushrooms and David Arora’s Mushrooms Demystified left me little doubt that I had a basket of Tylopilus eximius, the lilac brown bolete. Both books reported the species as edible and Audubon indicated that the few look-alike species were not toxic. So being young (thirty-one) and adventurous, not to mention hungry, I cooked up the mushrooms by sautéing them in olive oil with garlic and salt and pepper, finishing them with a bit of cream and eating them over fettuccini with Romano cheese. Quite yummy!

Two hours later, while I was at work, I began to feel the rumbles and flip-flops of impending trouble. I immediately guessed it was the mushrooms not agreeing with me, and assumed that I would get sick, get rid of the offending contents, and then get over it. Several torturous and embarrassing hours later, I ended up in a local emergency room when my co-workers became so alarmed they called an ambulance. There I spent an extremely uncomfortable night on Compazine and IV fluids before being released in the morning.

I was interested in how I could have made such a painful mistake in identification or judgment, so I continued to seek collections of and information about this very distinctive mushroom. Both Louis Krieger⁶ and Charles McIlvaine⁷ agreed with the edibility call and noted that the specific epithet “eximius” means select. But in talking with other mushroomers, most notably Sam Ristich, the mycological guru of New England, I learned that several other people had ended up in emergency rooms around Maine after eating the same mushroom in 1986. I reported my case to the National Mushroom Poisoning Case Registry managed by NAMA as, I hope, did others involved with similar cases. When Roger Phillips published his popular guide Mushrooms of North America in 1991, he became the first field guide author to add a note of caution to the edibility of T. eximius. Over the intervening years the mushroom poisoning community in New England has become aware of perhaps a dozen or more cases of severe GI distress caused by eating T. eximius. I have heard of no cogent explanation for the toxicity of T. eximius in the Northeast when it has been eaten in other regions of the country for an extended period of time. The populations in the Northeast may have developed additional chemical toxins or we may have a slightly different variety of Tylopilus. In any case, I have not tried it a second time, thereby demonstrating my ability to learn from experience. Vomiting is not on my list of most desired activities.

A number of people assumed that, following my episode of mushroom poisoning, I would stop collecting and eating wild mushrooms. They expressed their surprise in varying fashion, but certainly some deepened their doubts about my judgment (or lack thereof) when I told them about my intention to continue eating wild mushrooms. My response to them was to ask if they have ever suffered food poisoning after eating out. The overwhelming majority replied, yes. I then asked if they continue to eat out. Generally they answered with some indignation, “Well certainly not at the place where I got sick!” Alas, I, also, no longer eat the lilac-brown bolete.

To put my personal saga of mushroom misadventure into context, I have collected and eaten wild mushrooms since the mid-1970s and over the years have tried more than fifty different species. During this period, I have been sickened only this once. Over the same period of time, I have easily enjoyed a thousand great meals of wild mushrooms and shared many of them with family and friends. Nobody has ever complained of more than an overfull feeling.

The risk of being sickened by eating wild mushrooms is real, but the potential for many fine meals of incomparably fabulous fungi is at least as real and much more likely to occur if you follow basic precautions outlined in this book. The task for the mushroom forager is to bring caution, preparation, and excitement into play in roughly equal proportions and to do your homework in order to learn about the potentially toxic mushrooms as you consider edible mushrooms for the table. Start slow, start small, and have fun.

Toxic mushrooms are generally grouped by the type of toxin they contain, and more specifically, the effects of the toxin on the human body. Officially, there are eight groups of toxins, though the incidence of poisoning in several of the groups is quite rare in the United States. The most dangerous and life threatening of the toxins have spurred scientists to understand their structure and mode of action. Thus we know a great deal about the amatoxins (see Chapter 8). We also have learned about the structure and action of gyromitrin from false morels (see Chapter 9). On the other hand, we know relatively little about the structure and specific mode of action for a range of compounds responsible for the most common presenting symptoms of mushroom poisoning, the gastrointestinal irritants.

The most frequently encountered set of symptoms in mushroom poisoning mimic those I experienced after dining on the lilac-brown bolete, Tylopilus eximius. They generally include mild to severe gastrointestinal distress including nausea, vomiting, diarrhea, and perhaps abdominal cramping generally lasting less than twenty-four hours and often accompanied by a general feeling of malaise. If the victim has poor health, the poisoning can further compromise their functioning and the very rare deaths have occurred under these conditions. In a healthy adult, the effects usually pass without lasting damage to any bodily system save to one’s self-confidence regarding mushroom identification.

In general, the more quickly symptoms of mushroom poisoning develop, the less severe the outcome. Muscarine toxicity and the effects of hallucinogenic psilocybin and psilocin generally are seen within thirty minutes and pass within five hours. Most often they leave benignly, though there are occasional severe reactions to muscarine and it has caused a few deaths worldwide. Muscarine is the only mushroom toxin for which there exists an antidote. Victims recover rapidly when given an IV with atropine.⁸ Muscarine is a toxin that causes profuse salivation, tearing of the eyes, sweating, and increased urination, among other symptoms.

The toxins responsible for more severe and lasting damage generally have a delayed onset of initial symptoms ranging from six hours to several days. I will not review all of the known classes of mushroom toxins in depth here. It seems more valuable to focus on the general paths to making unfortunate mistakes as a method to underscore how to avoid them. For an excellent and thorough treatment of mushroom poisoning, including clinical treatment recommendations, acquire a copy of Denis Benjamin’s very readable book Mushrooms: Poisons and Panaceas.

An arrogant fool from Muscongus *
Claimed he knew all there was about fungus
I need no advice,
I eat what looks nice.
So now he’s no longer among us.
DIMITRI STANCIOFF

The range of decisions and actions resulting in a victim being evaluated by medical personnel to treat the effects of mushroom poisoning can result from a number of complex personal decisions and behaviors, including misinterpretation of mushroom descriptions, innocence based on naïveté or ignorance, faulty logic, belief in myths regarding mushrooms, and pure unadorned recklessness. To this list, I might add bad luck: the rare combination of the right mushroom, prepared in the right way, but eaten by a person who cannot tolerate the species, such as the honey mushroom. The good news is that most bad experiences can be avoided by following a few basic guidelines set forth in this section.

There are a few common mushroom poisoning scenarios that bear closer examination since the repeated and somewhat predictable mistakes of others can teach the rest of us what not to do. Though the specific examples given below come from my own experiences as a mushroomer and an identification consultant for Poison Control, they also represent common themes mentioned by other consultants and in the literature of mushroom toxicology

The Grazer
The regional Poison Control Center gets a call from a panicked parent, grandparent, or caregiver of a two-year-old child found clutching a mangled mushroom in the yard or, even scarier, with a portion of the mushroom in his or her mouth. It is rarely clear whether the child actually swallowed any portion of a mushroom. Upon questioning by the anxious caregiver, the child becomes equally scared and anxious and gives conflicting information. The child shows no signs of poisoning, but after consulting with a regional Poison Control Center, or often on their own accord, the caregiver decides to take the child to a local hospital for observation, evaluation, and possible treatment. At this point, the poison control staff frequently contacts a consulting mycologist to aid in the identification of the offending mushroom(s). The family is urged to bring examples of the mushroom with them to the hospital for identification.

This example is an amalgamation of many “grazer” calls I have addressed as a volunteer consulting mycologist to the Northern New England Poison Control Center. The most extreme case involved at least nine children who had collected and sampled mushrooms in the woods as part of a group dare. After being tipped off by the most anxious child, terrified parents scoured the woods and brought all the mushrooms they could find to the hospital for examination. When I got the call from the hospital, the medical staff in possession of the mushroom samples initially hoped that I would be able to identify them over the phone. One MD who claimed to know mushrooms said he believed that one of the mushrooms was an amanita, but it was soon evident that the staff had minimal familiarity with mushroom morphology and lacked the vocabulary to describe what they were holding. They also lacked the technology to take and transmit accurate digital images of the mushrooms to me. It quickly became clear that my presence in the same room with the mushrooms was vital if I was to make sense of the diverse collection.

By the time I arrived, frantic parents and caregivers had brought the children and more than a dozen different types of mushrooms to the hospital. Several children had been evaluated by emergency department staff and admitted for observation and more were on their way in to the emergency department. At that point, no child was showing symptoms of distress beyond anxiety that was likely caused by seeing their parents so fearful. Several hours later I knew that there were no deadly amanitas or other seriously toxic mushrooms involved and, of the rest, even if the kids had eaten any of them, the worst-case scenario would be moderate to severe gastrointestinal symptoms. In the end, none of the children involved developed symptoms, though several suffered through the process of ingesting activated charcoal and having gastric lavage performed on them. All, I am certain, were convinced to never eat a wild mushroom again.

In another case tailor-made for the coast of Maine, I received a call directly from an offshore island medical provider after a grandparent found her toddler grandchild in possession of a large yellowish mushroom with whitish patches on the cap and a ring around the stem. From the phone description of free gills and the base of the stem described as swollen, it appeared that we had a likely case of Amanita ingestion, but it was difficult to ascertain which species. It was late June, a time when few Amanita species fruit in Maine and not a time when I normally see any Amanita muscaria var. formosa, a known toxic species (see Chapter 12).

Murphy’s Law peered over the horizon. It was a Friday night and the ferry had already made its last run from island to mainland. Since the child in question was asymptomatic, the situation did not meet the island’s criteria for an emergency ferry run, so there was no way to get the mushroom to the mycologist. The solution came in the shape of a friendly lobsterman who traversed the ten miles of open sea with the mushroom carefully wrapped in wet paper towels and then caught a taxi and delivered the mushroom right to my door as evening ran into night. The mushroom proved to be Amanita flavorubescens, which is, at worst, mildly toxic, and the child remained symptom free under the vigilant eye of family and the island medical staff.

Of the thousands of calls to poison control centers each year regarding mushrooms, about 80 percent involve young children in the grazing stage of life. Before age five, and especially from six months to three years, kids explore the world and objects in their world by putting them in their mouths. When the object is a pretty little mushroom found growing at the edge of Nana’s yard, it becomes every parent’s nightmare. The overwhelming majority of young children evaluated for possible mushroom ingestion never develop symptoms of poisoning, but it is nevertheless prudent to identify the mushroom in question to ensure that the child is adequately treated. Due to their small body mass and developmental stage, young children can be seriously affected by a small amount of mushroom toxin. Some mushrooms that are benign to adults can have a dangerous impact on young children. The compounds psilocybin and psilocin, for example, which are found in several small species of Psilocybin, Panaeolus, and related genera, usually leave the average adult fully recovered from hallucinations and an altered mental state within six hours; in young children, however, the same toxins can spike elevated fever, trigger convulsions, and even lead to death in rare cases.⁹

As every parent or caregiver of a toddler knows, it is almost impossible to control what they put in their mouths. It is equally impossible to mushroom-proof the average backyard or park. As always, I recommend vigilance and either removing mushrooms from where toddlers might encounter them or removing toddlers from where they might encounter mushrooms. Rest assured that it is extremely rare for a toddler to be seriously sickened by poisonous mushrooms in the United States. If you suspect your toddler has eaten a mushroom, seek a phone consult with your hospital emergency department or poison control center.

The Case of Mistaken Identity
It was almost 1:00 AM, well past my normal witching hour, when the phone rang and jarred me from my sleep. The physician covering our local hospital emergency department was calling about a middle-aged man who was suffering from severe gastrointestinal distress. The man told a story of collecting a bunch of chanterelles, cooking them for dinner, and eating a fair-sized portion. His girlfriend, unsure of the mushrooms, his skills at identification, or both, declined the meal (much to her subsequent relief). Several hours after the meal, he began to feel sick and soon found himself in a painful gastrointestinal drama in which the bathroom played a starring role. He reported eating chanterelles in the past, supplied and cooked by a friend, and said that for a long time he’d been wanting to find his own. When he came upon the dense cluster of orange-yellow mushrooms on the ground at the base of an oak tree, he thought he’d stumbled on a bonanza of delectable fungi. The color and vase-shape, combined with the gills running down their stems, met his memory of chanterelles. (#7) Back home with his collection, he looked at the description of chanterelles in a popular field guide and made the mushrooms in his hand fit the description in the book.

Unfortunately, for his health and sense of mushrooming competence, the mushrooms that he actually picked and ate that late summer evening were jack o’lantern mushrooms, Omphalotus illudens (see #8 in the color insert). The jack o’lantern grows in dense clusters around the base of hardwood trees, predominately oaks, and as a bioluminescent mushroom (see Chapter 16), glows in the dark with an otherworldly greenish light that emanates from its gills and can be seen in a very dark room. It is a beautiful and fascinating tree parasite, but it is toxic. Jack o’lantern mushrooms cause moderate to severe cramps, vomiting, dizziness, and an overall feeling of weakness and fatigue that can last for many hours or unusually, even days. Onset of the symptoms is generally within two to three hours of the meal. The individual in this case spent the night in the hospital for control of nausea and support of hydration and was released late the following morning.

As these stories show, the case of mistaken identity isn’t always as straightforward as dissonance between a mushroom in hand and the description in a field guide. Especially for new mushroomers, there can be a strong temptation toward magical thinking. The desire to find a great edible can overwhelm rational judgment. If the collector has a strong preconceived notion of what the mushroom’s identity is or, more importantly, what he wants the mushroom to be, his mind will be less open to objectively evaluating the specimen in hand. In the chanterelle case, the victim saw all of the relevant characteristics he wanted to see and ignored or downplayed the features that didn’t fit. Eating wild mushrooms demands that the collector remain objective in seeing and evaluating identification features and not ignore or devalue characteristics that don’t fit. Never eat a mushroom unless you are 100 percent certain of the identification. “When in doubt, throw it out!”

The situation above is a typical example of mistaken identity and there are several ways to avoid repeating it. First, know the characteristics of the most dangerous and most common toxic species in your area and avoid eating mushrooms with close toxic look-alikes. The classic example is the genus Amanita, the group of mushrooms responsible for the majority of serious poisonings and deaths in temperate climates. All members of this genus have a set of common features—free gills that give off white spores, a swollen stem base with remnants of a universal veil, and the presence of an annulus, or ring, around the mid-stem—that are apparent even to the untrained eye. It is the responsibility of anyone who wants to eat wild mushrooms to be familiar with the amanitas and their shared identification features. When these features are found together, it should place a mushroomer on high alert. The genus Amanita has some very edible and desired mushrooms in addition to the toxic species, but I strongly discourage novice collectors from eating from this group. In addition to amanitas, the genera Lepiota and Macrolepiota share many characteristics with amanitas, including the presence of some severely toxic species (as well as some great edibles). It is another genus to be avoided by all but the most experienced mushroomers.

Most good mushroom field guides include cautions about toxic look-alikes in their descriptions of edible mushrooms. Some guides, such as the Audubon Field Guide to North American Mushrooms, are particularly good at this. Again, my mantra about eating mushrooms that have toxic look-alikes or are known to cause problems for some diners is, “Why bother?” Why bother taking a chance when there are so many great, easily identifiable edibles growing in our forests, fields, gardens, and lawns? Start out with a couple of the common “Foolproof Four” and add to them as you become more competent at identification.

The Mycological Immigrant: Strangers (Eating Mushrooms) in a
Strange Land
The mushroom poisoning literature is filled with stories of recent immigrants who collect and eat mushrooms found in their new homeland and who base their identification on knowledge and collection history from another region of the world. The most tragic cases in the United States have often involved Asian immigrants collecting and eating deadly toxic death caps, Amanita phalloides, believing they are edible paddy straw mushrooms, Volvariella speciosa. The result has been several deaths and serious illnesses that required life-saving emergency liver transplants (see Chapter 8).

Situations that result in less severe outcomes are far more common. A few years ago I handled a mushroom identification call from our regional Poison Control Center that involved two Central European sisters and one sister’s American husband. The sisters, who had recently moved to the United States from Germany, had a long history of collecting and eating mushrooms as a normal part of their diet. It was late summer, there had been a prolonged period of rain, and the boletes were fruiting.

The sisters collected and cooked a meal of boletes and all three partook, though the sisters ate fewer mushrooms than the man did. After the meal, the man suffered from nausea and vomiting for about five hours before going to the hospital and, while there, reported that his wife and her sister also felt ill but had not developed his severe symptoms. Based on descriptions and photographs, it was determined that the mushrooms eaten were the lilac-brown bolete, Tylopilus eximius. The man was kept overnight, treated with IV fluids and something to control his nausea, and released the following day.

According to the patient and the emergency department doctor, the man’s wife said she collected and ate a similar species in her native country. However, the lilac-brown bolete, which has been responsible for a number of cases of illness in New England and eastern Canada, does not occur in Central Europe. Many Europeans grow up learning that almost all boletes are edible with the exception of some of the red-pored, blue-staining species. Clearly, and unfortunately, the toxic nature of T. eximius in Maine was new to this recent immigrant.

Moving into a new area—especially if it involves a radical change in climate—challenges the mushroomer to learn new species and the ecological associations related to their growth. If the climates are similar, they will likely be home to many of the same major species. Many of the more common and popular edible mushrooms hunted for food in Europe, such as the golden chanterelle and the king bolete, are also common or have similar, related edible counterparts in the United States.

Like all strangers in a strange land, the immigrant mushroomer, whether moving from Michigan to Florida or Vietnam to Northern California, needs to learn the local mushrooms before eating them. The best option is to find an experienced guide in the new location. Others might get by with the purchase and use of a mushroom field guide covering the new region. As with many aspects of life, the danger is in assuming that nothing is different.

The Adventurer
Adventurers are characterized by a lack of rational concern about the identity of the mushrooms they eat. Another way of looking at it is that they share an affinity for dinner by mushroom Russian roulette. In my experience, they have included a sixty-year-old man who collected and ate the pretty white mushrooms growing near his compost pile and later reported to the doctor covering his case of gastrointestinal distress that the mushrooms looked “beautiful and benign.” He cooked and ate them, making no effort to identify his dinner. Fortunately for him, those pretty white mushrooms were not the pure white destroying angel, and he recovered.

I’ve also seen a man in his mid-twenties who, while walking in the woods with a friend, found an unusually large cluster of robust brown mushrooms fruiting on a stump. He reported to me that he’d eaten raw mushrooms in the woods before without any difficulty and felt he had a good sense of what would be edible. Both he and his friend reportedly ate one or two caps of the mushrooms raw and, while his friend became quite ill within two hours and had violent gut-cleansing symptoms for about twelve hours, the other young man—the one I questioned—did not develop symptoms for about twenty-four hours, but reported ongoing difficulty holding down food for the next ten days with only a slow abatement of the distress. He said that eating the mushroom was an impulsive act; he’d had no intention of collecting mushrooms and has had no training in mushroom identification. He also assured me he did not collect the mushrooms to get high.

Adventurers tend to be people with a sense of invincibility, magical thinking, and a dearth of common sense and judgment. Fortunately for them, less than 10 percent of the species of mushrooms they are likely to find are toxic and only a few of those possess toxins capable of severe damage or death. “God protects fools, drunks, and little children.” Based on the literature of mushroom poisoning and the rarity of lethal events, this also seems to hold true for adventurers.

There is another sort of adventurer—those who seek mushrooms for the experience of hallucinations, visions and mind expansion, or the recreational high. Many adults have made rational, educated decisions regarding use of psychedelic mushrooms. They’ve done their homework to correctly identify the mushrooms they seek, as well as identify the risks involved, and many have had positive experiences, which, for some, have been life altering.¹⁰ Paul Stamets in his 1996 revision of Psilocybin Mushrooms of the World gives a series of suggestions for the responsible and respectful use of hallucinogenic mushrooms.¹¹ Unfortunately, some young people using these mushrooms are seeking the high without the homework. When they are out collecting their own mushrooms, this can mean confusing toxic little brown mushrooms (LBMs) for the psychotropic ones. Some LBMs contain dangerous levels of muscarine. A few, found growing in the same habitat as certain psilocybin mushrooms, contain the deadly amatoxins.

Treatment challenges can arise from people who collect and eat mushrooms but are unsure of their identification skills, or worse still, are not aware of how little they know until too late. The anxiety that sets in once the mushroom has been eaten is often enough to produce symptoms of panic in the anxious neophyte.

It was an early autumn evening in 2006 when I received the call regarding a twenty-something male who had ventured into the woods in search of the big laughing gym, Gymnopilus spectabilis. The laughing mushroom and a couple of related species contain hallucinogenic psilocybin and psilocin, though they are not well known or recognized as psychedelic mushrooms in the Northeast. The young adventurer, who apparently had read about the laughing mushroom online, collected a number of mushrooms and ate some of them before returning home. It was only when doubts about accurate identification began to settle into his consciousness that he, again, looked up the description, became increasingly unsure that he’d eaten the correct mushroom, and began to feel flushed, nauseous, and panicky. He arrived at the hospital emergency department in full panic and, following contact with the regional Poison Control Center, I was contacted to provide identification expertise. The digital images of the mushrooms collected and consumed proved to be a mixture of four different species, none of which were the laughing mushroom. Fortunately, none of the species presumably eaten were dangerously toxic either. The symptoms shown by the “victim” in this case could all be explained by his rising sense of panic over eating mushrooms he did not know compounded by his fear that they might be dangerously toxic.

Mushrooming is a great hobby and a healthy way to get out into nature. Eating mushrooms adds a richness and variety to the diet and focuses your mushroom education. For a careful person, the risk of eating a bad mushroom is very low and easily avoided by following my guidelines.