REVIEW — TEOPICAL MEDICINE, ETC. 185 



He deals with the action of antivenene, which he believes should be used intravenously, Snake Bite 

 and then passes on to speak of the local treatment with permanganate of potash. He —continued 

 points out that it can only be used with advantage locally, being supplemented in the case of 

 colubrine poisoning by antivenene used intravenously when it is available ; in the case 

 of viperine poisons, by adrenal extract repeatedly injected subcutaneously. The latter is 

 valuable owing to the additional action of viperine venom on the blood, which it renders 

 incoagulable, causing haemorrhages from the bowel and into the tissues. 



The local method is more fully described in another paper, ^ as is the special instrument 

 and receptacle designed by Brunton and now so well known. A free opening should be made 

 on the site of the bite and the crystals of permanganate rubbed into it after the limb has 

 been tightly bandaged higher up. A few drops of saliva may be added to assist solution. 



Much information will be found in various papers by Lamb.'- The most recent standard 

 work on the subject is Calmette's " Les Venins," etc., but exception is taken to his views 

 as regards specificity in an interesting critique,^ which also refers to an article in Allbutt's 

 " System of Medicine," Vol. II. Part II., as upholding the conclusion that both in vivo and 

 ill vitro the venoms are highly but not strictly specific. 



A note may be made of the Brazilian method-** of von Bassewitz, which consists in 

 removing the gall bladder of the venomous snake, triturating it in physiological salt solution, 

 filtering and injecting the filtrate under the skin of the back or flank. The results are said 

 to be excellent, but the method should only be used in cases where freshly-prepared serum 

 is not available. Abscesses are apt to occur at the site of injection. 



Spider Bite. Information is required regarding this condition in the Sudan. Pink'' 

 has an interesting note upon it with reference to India. He says : — 



The effect of a certain spider lick or bite is to be seen frequently in children in Bengal, when the face is 

 generally the part aifected, owing to this part of the body coming frequently into contact with spider webs. The 

 result is often an eruption on the lips or chin, resembling Herjjes, which, if untreated, goes on to resemble Impetigo 

 contagiosa, if you compare these eruptions with it. 



Treatment. The most effectual treatment of a spider's lick or bite is as follows :— 



Take a basin of cold water and let the patient hold his or her head over it. Now get a few lumps of mustard 

 oil cake (which is to be had in almost every oilman's shop, since the cake is obtained after expressed mustard oil is 

 mauufactured, and is used largely to fatten cattle), burn these in a charcoal tire till of a black colour. Drop the 

 burning lumps into the basin of water, and allow the smoke and fumes which rise to come into contact with the 

 part of the patient's skin which is affected, twice a day, for two or three days. The result is a perfect cure. 



Spirochaetes and Spirochaetosis (including Eelapsing Fever). These subjects have 

 recently attained such great dimensions that it will not be possible to do anything like 

 justice to them. A comparatively brief review must suffice. 



Under the special paper on " Spirochaetosis of Sudanese Fowls " (Third Eeport), various 

 points omitted here will be found discussed. 



Leishman" gives Liihe's classification of spirochsetse in three groups, as follow : — 



A. True Spieoch.«t.e 



1. Spirochceia pUcntilis. The typo species. A water organism which may reach a length of 200 f , and in 

 which Schaudinn has demonstrated the presence of an undulating membrane and the absence of flagella. 



2. Spirochaita halhianii. Pound in the intestine of the oyster, and recently re-investigated by Perrin, who 

 figures and describes remarkable details of the structure, and definitely classes it as a trypanosome. 



3. Spirochceta dentium. A very minute spiroohfeta found in the mouth and dental tartar of man. 



4. Spirochocta buccalis. A larger organism, found in the same situation as Spirochmta dentium. 



• Brunton, Sir L., Fayrer, Sir J., and Rogers, L. (September, 1904), " A Jlethod of Preventing Death from 

 Snake Bite, capable of Common and Easy Application." Indian Medical Gazette, Vol. XXXIX. 



'' Lamb, G., " Scientific Memoirs by OSicers of the Medical and Sanitary Departments of the Government of 

 India." Nos. 1, 3, 10 and 17. 



' Indian Medical Gazette, September, 1907, Vol. XLII. 



* Annotation in British Medical Journal, 24th December, 1904, Vol. II. 



" Fink, Q. H. (December 1st, 1906), " Peculiar Eruptions of the Skin in India, due to Vegetable and Insect 

 Life and their Treatment." Journal of I'ropical Medicine and Hygiene, Vol. XIX. 



" Leishman, W. B. (September, 1906), " Pathogenic Spirochsetse." Journal of Preventive Medicine, Vol. XIV. 



• Article not consulted in the original. 



