472 REPORT OF NATIONAL MUSEUM, 1893. 



the most insidious and dangerous one, more especially in its effects on the vaso- 

 motor centers. The latter are wrought very insidiously and where they predom- 

 inate rec^uire the most energetic use of the antidote; for whilst the timid practi- 

 tioner, after injecting as much strychnine as he deems safe, stands idly by waiting 

 for its effects, the snake virus, not checked by a siititlcient quantity of it, continues 

 its baneful work, drawing the blood mass into the paralyzed abdominal veins, aud 

 finally, by arrested heart action, bringing on sudden collapse. In such cases even 

 some tetanic convulsions are of little danger and may actually be necessary to o\er- 

 come the paralysis of the splanchnicus and with it that of the other vaso-motor 

 centers. 



Whilst then it must be laid down as a principle that the antidote should be 

 administered freely and without regard to the quantity that may be required to 

 develop symptoms of its own physiological action, the doses in which it is injected 

 and the intervals between them must be left to the practitioner's judgment, as they 

 depend in every case on the (quantity of snake poison a1)8orbed, the time elapsed 

 since its inception and the corresponding greater or lesser urgency of the symptoms. 

 If the latter denote a large dose to have been imparted and it has been m the system 

 for hours, delay is dangerous and nothing less than 16 minims of liq. strychuiie P. B., 

 in A-ery urgent cases even 20 to 25 minims, should be injected to any person over 15 

 years of age. Even children may re<]uire these large doses, as they are determined 

 by the quantity of the poison they have to counteract and are kept in check by it. 

 The action of the antidote is so prompt and decisive that not more than fifteen to 

 twenty minutes need to elapse after the first injection before further measures can 

 be decided on. If the poisoning symptoms show no abatement by that time, a second 

 injection of the same strength should be made promptly, and unless after it a 

 decided improvement is preceptible, a third one after the same interval. As the 

 action of strychnine when applied as antidote is not cumulative, no fear need to be 

 entertained of violent efi'ects breaking out after these doses repeated at short 

 intervals. * * * 



If under the influence of these large doses the symptoms abate, or if the latter are 

 comparatively mild from the first, smaller doses of strychnine should be injected, say 

 from one-fifteenth to one-tenth of a grain, but under all circumstances the rule that 

 distinct strychnia symptoms must be produced before the injections are discontinued 

 should never be departed from. This rule is a perfectly safe one for its observance 

 entails no danger, a few muscular spasms or even slight tetanic convulsions being 

 easily subdued and harmless as compared with that most insidious condition exem- 

 plified in case No. 1, cited below, the first-one treated with strychnine by the writer, 

 Avho, having no experience in the treatment, did not administer quite enough 

 strychnine. The patient, after apparently recovering from a moribund condition 

 and being able to walk and even to mount a hoi'se, remained partly under the 

 infinences of the poison and succumbed to it during sleep, when, according to subse- 

 quent experience, one more injection would have saved him. 



The tendency to relapses is always great when much snake poison has been 

 absorbed. Apparently yielding to the antidote for a time, the insidious venom, after 

 a shorter or longer interval during which it appears to have been conquered, all at 

 once reasserts its presence, and has to be met by such fresh injections, regardless of 

 the quantity of strychnine previously administered, but the amount required in 

 most relapses is not a large one. 



In speaking of the applicability of the treatment to bites of snakes 

 with longer fangs antl more powerful venom than those of Australia, 

 he concludes as follows : 



In those cases only where the long fangs of these snakes perforate into a vein 

 and a large quantity of venom injected into the blood stream overpowers the nerve 

 centers so as make death imnunent, if not almost instantaneous, the subcutaneous 



