POISONOUS SNAKES OF NORTH AMERICA. 473 



injections may be found of little use. Here intravenous injections of half a grain 

 and even 1 grain doses would appear to be indicated, and might yet fan the liame 

 of life afresh, even when respiration and pulse at wrist have already ceased. We 

 have seen both these functions extinct in Australia and restored by comparatively 

 small doses of the antidote, and can see no reason why a more energetic use of it 

 should not restore them in India. 



Dr. Mueller uext enumerates in detail 50 cases, only 2 from his own 

 practice, some of them very remarkable and several, as it seems, quite 

 conclusive, but as none of these cases were caused by snakes directly 

 related to our American poisonous serpents, except to the Elajndce, it is 

 not thought necessary to reprint any of them here. The first case 

 reported is the one alluded to above, the first case treated by Dr. 

 Mueller with strychnine. The case ended fatally. 



The death of the unfortunate lad, however, has saved some lives since. It taught 

 the writer the lesson never to trust to the apparent success of the antidote until it 

 shows distinct signs of its own physiological action, and even then to watch his 

 patients carefully for the first twenty-four hours, and let them sleep for short periods 

 onlj- 



The cases from India reported by Dr. Banerjee, also reprinted in the 

 book, have been assailed as unreliable, but since the publication of the 

 book others have been recorded in the Indian Medical Gazette, for 1S93, 

 and reprinted in the Australasian Medical Gazette (see, for instance, 

 two in Vol. XIII, January lo, 1894), which seem to indicate a success for 

 the treatment in India as great as in Australia. 



An entire chapter is devoted to the unsuccessful cases, which are 

 analyzed and explained. The last one Dr. Mueller finds to convey a 

 new lesson even to him, as he draws from it the conclusion that the 

 antidote can only be relied on within the first twenty-four hours after 

 the bite. 



It can not for a moment be supposed that the discovery of the strych- 

 nine treatment will be accepted as the final settlement of the question 

 of a physiological antidote. As a matter of fact, our knowledge of the 

 physiological action of the various venoms is as yet but imperfect, and 

 the physiological properties of many of the drugs which may be called 

 to play a role are not better known. Experiments are still carried on, 

 but as no definite results have as yet been obtained we shall only men- 

 tion them very briefly. 



In 1888, Dr. H. 0. Yarrow published a scries of articles in Foi^est 

 and Stream concerning "Snake bite and its Antidote."* In the intro- 

 duction he gives an interesting historical sketch of the search for anti- 

 dotes, and then submits in detail a series of experiments of his own, 

 among which I wish to call special attention to those with jaborandi, 

 or its alkaloids pilocarpine and jaborine, the use of which was first 



* Forest and Stream, N. Y., xxx; Pt. i. May 10, 1888, p. 307; Pt. ii. May 17, pp. 

 327,328; Pt. iii. May 24, pp. 349,350, and May 31, pp. 369,370; Pt. iv, June 7, pp. 

 386-388; Chapters ii and iii also reprinted in Albany Medical Annals, 1888, ix, pp. 

 204-212. 



