212 JOURNAL, BOMB A Y NATURAL HISTORY SOCIETY, Vol. XIX. 



liagin, acting on the blood, and that poisons only differ from one another in 

 the relative amounts of these substances which they contain. He further 

 holds that colubrine venoms in general contain neurotoxine and viperine 

 venoms haemorrhagin : also that a serum prepared with the venom of one 

 colubrine serpent is antitoxic for the poisons of all other colubrine snakes and 

 that a serum prepared with the poison of any viperine snake neutralises the 

 venoms of all other snakes of this group. We cannot too strongly repudiate 

 this view. The recent work which has been done in Australia, in America and 

 in India is quite against it and the general consensus of opinion of all other 

 workers but Calmette is that both ' en viro ' and ' in vitro ' anti-venomous 

 serums are highly buc not strictly specific. For this reason we hold that 

 Dr. Calmette is wrong in recommending a serum prepared with cobra venom 

 alone as useful in the case of bites from other colubrme snakes. It would 

 appear on the other hand that the specific anti-sernm alone would be of use 

 in a case of snake venom intoxication. The same principles hold good in the 

 case of the venoms of viperine snakes and their anti-serums. 



Chapter XV is devoted to the practical treatment of snake bite. For local 

 treatment the author recommends the injection into the situation of the punc- 

 tures of a solution of hypochlorites. No mention is made of the Lauder 

 Brunton lancet or of dissection as recommended by the elder Wall, Local 

 treatment, no matter of what kind, is limited to destroying whatever portion of 

 unabsorbed poison may be brought in contact with it. Once absorbed the only 

 remedy is antitoxin. The technique of serum injection is fully described with 

 illustrations and 10 to 3U cubic centimetres of serum according to the severity of 

 the symptoms is the dose recommended. This recommendation is made on the 

 basis that 1 c.c. of serum is able to neutralise 1 milligramme of cobra poison, that 

 the minimum lethal dose for an ordinary man is about 14 milligrammes and that 

 a cobra will inject an average amount of about 20 milligrammes. With the first 

 two of these suppositions we can agree as the experimental evidence is in har- 

 mony with them. But as we have already pointed out an Indian Cobra may 

 inject a much larger amount than the equivalent of 20 milligrammes of dried 

 venom. We have ourselves recovered as much as 300-400 milligrammes of 

 dried poison from the fluid ejected into a watch glass at one bite of a fresh 

 adult cobra. Moreover, in practice the antitoxin is not mixed with the 

 venom before injection but at variable times subsequently and both Fraser 

 and Martin have shown that this makes a very great difference, for these 

 reasons we hold that the doses recommended by Dr. Calmette require multiply- 

 ing by ten to reach reasonable security and even this quantity would be inade- 

 ([uate in some cases. Further we would recommend that the serum should 

 in all cases be injected intravenously and not under the skin. We could 

 thus bring the antitoxin in contact with the venom as soon as possible. 

 There are no doubt many cases of snake bite in which for many reasons the 

 snake does not inject its full complement of poison and for such treatment 

 with the smaller quantities injected subcutaneously would suffice. As about 



