SYMPTOMS OF VENOM POISONING IN MAN 111 



vulsion, results from gradual cessation of respiration. The heart may beat 

 for a few seconds after the cessation of respiration. In unusual cases hsem- 

 orrhagic extravasation from mucous surfaces occurs and the patient coughs 

 or vomits blood or passes it by the rectum or kidneys. Albuminuria has 

 generally been found and may be accompanied by blood or haemoglobin 

 in the urine. If the patient survives the coma, recovery is complete and, as 

 a rule, rapid, and without any secondary symptoms. 



ELAPS FULVIUS POISONING IN MAN. 



Many fatal cases from the bite of the coral snake have been reported and 

 some of the cases will briefly be stated in order to outline the symptoms 

 experienced with human subjects. 



In one case reported by True ^ the bite was inflicted by a medium-sized 

 Elaps fulvius on the left index finger of a man, who, while handHng the snake 

 by grasping it by the neck, was bitten at the moment of releasing the snake. 

 Instead of a quick strike the snake fastened its fangs to the finger and bit 

 hard, closing the lower jaw upon the finger. The closure of the jaws was so 

 firm that it had to be wrenched off, by which operation one of the fangs was 

 broken off in the wound. The first symptom, which appeared immediately 

 after the bite, was a violent pain at the wound. Within one hour the first 

 symptoms of drowsiness and unconsciousness made their appearance, and 

 remained until the morning of the third day. After the period of lethargy and 

 general depression the patient gradually recovered. There was a tendency for 

 the symptoms to reappear periodically. Another patient,^ complained of the 

 pain in the bitten limb ^ about half an hour after the accident, then deep 

 lethargy and collapse set in and ended the case with death in i8 hours. In 

 still other cases death usually ensued about 24 hours after the bite. It seems 

 that the danger of death from the bite passes away if the victim survives 

 three or four days. 



POST-MORTEM EXAMINATION. 



In cases of cobra bite rigor mortis occurs as usual. The subcutaneous 

 tissue of the region of the bite is infiltrated with pinkish fluid and the neigh- 

 boring vessels are congested. The blood is often fluid, and when examined 

 by the microscope directly after death presents no changes. The brain 

 appears to be normal, but the veins of the pia mater are usually gorged with 

 blood and the ventricles often contain turbid fluid. The lungs are usually 

 congested and the lining membrane of the bronchi is intensely injected. 

 Kidneys are excessively congested. 



In cases of death from the bite of the Australian species of snakes the 

 appearances are about the same as those described in the cobra cases. The 

 blood is almost invariably fluid, but may contain a few soft clots. The lungs 



1 Fred. W. True. American Naturalist, XVII, 1883, 26. 



2 Coe. Scientific American, 1891, LXIV, 401. 



3 In most cases pain and a faint reddening of the bitten part are the only local symptoms. Dis-color- 



ation, hagmorrhages and extensive swelling have not been reported. 



