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Peden NR, Pringle SD. 
“Hallucinogenic Fungi”. 
The Lancet. 1982 Feb 13.
SIR, Dr Young and colleagues (Jan. 23, p. 213) describe an 'epidemic," of abuse of hallucinogenic fungi in Glasgow. A similar epidemic occurred is Dundee between Sept. 13 and Octob 17, 1981. : 44 patients (mean age 18 years), chiefly schoolchildren and unemployed youths, were seen in the admissions and emergency department of Ninewells Hospital after ingestion of liberty caps (Psilocybe semilanceata). Large numbers of young people were eating these mushrooms and those presenting did so because of a dysphoric reaction to the experience, and 4 patients thought they were about to die. The 44 patients seen were assessed according to a proforma prepared in the light of our previous experience with this conditiom. All but 4 patients had dilated pupils. Other evidence of sympathetic stimulation was less frequent, a heart rate above 100/min being noted in 10 patients, diastolic blood pressure of 100 mm Hg or more in 17 patients, and hyperreflexin in 16 patients. Flushing ofthe upper trunk, neck, and face was noted in 8 patients; 23 patients were nauseated or had vomited, while 9 complained of upper abdominal pain, and in 2 cases this was severe enough to be the cause of presentation. Distortions of perception were very common and were usually visual although only 4 patients were frankly hallucinating. Paraesthesiae affecting the limbs and face occurred in 16 patients and 2 were ataxic. . Patients presented to the department an average of 3.8 h (range 1-8 h) after ingesting the mushrooms, and after a short period of observation 20 were sufficiently well to be discharged from the accident department in the care of a responsible adult. 18 patients were admitted to hospital and all had fully recovered within 12 h. In most patients - therefore the effects of the hallucinogen are short lived. We have found that gastric intubation can be difficult in these young patients who are often already distressed and not frequently aggressive. Furthermore the mushrooms may block
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