590 OPIIIDIA CHAP. 



temperature and repeated syncope, and laboured respiration. 

 Death may occur in this stage. The local haemorrhagic ex- 

 travasation frequently suppurates, or becomes gangrenous, and 

 from this the patient may die even weeks afterwards. Eecovery 

 is sudden, and within a few hours the patient becomes bright 

 and intelligent. 



" Symptoms of bite from the European Viper. Local burning 

 pain ; the bitten limb soon swells and is discoloured. Great 

 prostration, vomiting, and cold, clammy perspiration follow 

 within one to three hours. The pulse is very feeble, with slight 

 difficulty in breathing, and restlessness. In severe cases the 

 pulse may become imperceptible, the extremities may become 

 cold, and the patient may pass into coma. In from twelve to 

 twenty-four hours these severe constitutional symptoms usually 

 pass off, but in the meantime the swelling and discoloration 

 have spread enormously. Within a few days recovery usually 

 occurs somewhat suddenly, but death may occur from the severe 

 depression, or from the secondary effects of suppuration. 



" Symptoms of bite from the Daboia or Vipera russklli. 

 These resemble the effects of Eattle-snake poison, but sanious 

 discharges from the rectum, etc., are an additional and prominent 

 feature. The recovering patient suffers from haemorrhagic 

 extravasations in various organs, besides from the lungs, nose, 

 mouth, and bowels. Kidney haemorrhage and albuminuria is a 

 constant symptom. The pupil is always dilated and insensitive 

 to light. 



" Symptoms of bite of Australian Elapine snakes. Pain and 

 local swelling. The first constitutional symptoms appear in 

 fifteen minutes to two hours. First faintness, and an irresistible 

 desire to sleep. Then alarming prostration and vomiting. The 

 pulse is extremely feeble and thread-like, and uncountable. The 

 limbs are cold, and the skin is blanched. Respiration becomes 

 shallow with the increasing coma. Sensation is blunted. The 

 pupil is widely dilated, and insensible to light. There is some- 

 times passing of blood. If the patient survives the coma, 

 recovery is complete and as a rule rapid, without secondary 

 symptoms. The Australian venom and that of all viperine 

 snakes, perhaps also that of the Cobra, if introduced rapidly into 

 the circulation, occasions extensive intravascular clotting. If 

 the venom is slowly absorbed, the blood loses its coagulability, 



