The experience of 18 years voluntary work in collaboration with the health authorities in a Centre for Toxological Studies is reported. The Centre was called upon to diagnose 282 cases of mushroom poisoning (including 262 hospital patients) in the Commune of Trieste. The identification of the fungi ingested was in all cases based on microscopic identification of the spores isolated from the stomach contents or the faeces using a rapid, original technique. The value of other diagnostic methods in use or under experimentation is discussed. Out of the 282 patients studied, 45 (16%) presented spores of highly toxic responsible for phalloid syndrome; 40 (14%) presented spores of moderately toxic fungi causing atropine, muscarine, antabuse-type, haemolytic and acre-resinoid syndromes. All other spores were from non-toxic species. The original incidence of requests for diagnosis, presumably covering all cases occurring in Trieste, was 16 +/- 11 cases with ingestion of highly toxic fungi accounting for 3 +/- 4 cases and ingestion of moderately toxic species 2 +/- 3 cases. The tendency is towards an increase in such cases.
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