POISONOUS SNAKES OF NORTH AMERICA. 475 



the stoinacli. Two sets of experiments were made upon dogs. In the 

 one set the stomach was washed out carefully, the result being that the 

 animals so treated showed a distinctly less degree of iioisouiug than the 

 control animals. In the other set, the contents of the stomach with 

 proper precautions were inoculated into other dogs, the result being 

 symptoms of poisoning identical with those of the control animals. 

 INIoreover, the presence of the unaltered venom was demonstrated by 

 chemical tests. 



The conclusion seems justified that a washing out of the patient's 

 stomach ought to be part of the treatment of a case of snake bite. 



This entire question seems a promising field for future investigation, 

 which we earnestly recommend to physiologists having the opportunity 

 and wishing to advance our knowledge of snake poison and its treat- 

 ment. 



TREATMENT. 



It is not for the present writer to recommend any one special treat- 

 ment of cases of snake-bite poisoning; but he is willing to state what 

 would seem to be a rational treattaeut, in view of our jiresent knowl- 

 edge of the subject. He will, however, confine himself to such cases as 

 may arise from poisoning by snakes occurring in this country only. 



Evidently the first thing to ascertain is whether the case is really that 

 of a bite by a poisonous snake, ieaving here out of consideration the 

 opistlwglyphs, the bite of which probably is too rare and too insignificant 

 to need special mention. If consisting of one or of two isolated punc- 

 tures, the wound is almost certain to be caused by a poisonous bite, and 

 the distance between the two punctures will usually give a clew to the 

 size of the snake and consequently to the presumable degree of the 

 poisoning. If the snake or its head are secured, the identification may 

 be comparatively easy, as all our poisonous snakes, with the exception 

 of the JiJlaps, or harlequin snake, of the Southern and Southwestern 

 States, are readily recognized by the pit between the eye and the 

 nostril, as before stated (p. 365, fig. 9). The characters of the Elaps 

 have also been given in this work (p. 356, figs. 5, 7, 8), and no difficulty 

 should be found in making a correct identification. As will be plain 

 from what has been said above concerning the difterence in the action 

 of the crotalid and the elapid snakes, this distinction may be of some 

 importance in selecting the correct treatment. 



In very severe acute cases, in which the venom has been injected 

 directly into the circulation, no matter by what kind of snake, the 

 chances for recovery are very slight indeed. The only chance in 

 such cases seems to be to stimulate the nervous centers as speedily 

 as possible, the best known means to this end being injection of large 

 doses of strychnine, if necessary, intravenously, until tetanic effects are 

 obtained and the patient roused from the coma which has probably 

 seized him. This result obtained, other systematic or local remedies, as 

 the case may require, can then be applied. 



