102 PHYSIOLOGY AND TOXICOLOGY 



JScx. — It is needless to state that men are the most frequent subjects of Crotalus 

 bite, owing to the nature of their occupations, wliich necessarily bring them within 

 reach of the reptile. Children and women are sometimes bitten, and, as may be 

 seen from the table, even young children may recover from the effects of the acci- 

 dent. It is not possible or right to infer from this, that young or weakly persons 

 suffer no more than the strong or fully grown, because we do not know how much 

 venom may have been inserted in each case. Thus, a child struck by an exhausted 

 snake would have a far better chance of escape than a vigorous man bitten by a 

 serpent which had been caged for months. This element is, of course, deficient in 

 calculations upon the prognosis of our ordinary maladies, such as typhoid fever and 

 others, since in them the severity of the resultant symptoms alone informs us as to 

 the probable amount of poison received by the system. In the present instance, 

 it is an important, and usually an attainable factor, in estimating the probabilities 

 of any given case, which it never can be in those modes of septic poisoning which 

 we call diseases, and know only through their symptoms. 



The Situation of the Wb^md. — In almost every reported case, the wound has been 

 upon an extremity, A woodman steps over a log which conceals a snake; a child 

 thrusts an arm into the hollow trunk, where a serpent lies; or, an intoxicated man, 

 ignorant and reckless, puts his hand into a snake cage, or handles a snake which is 

 benumbed with cold, and to appearance harmless. Another not uncommon cause 

 of bite, is due to want of caution in dealing with serpents which have been 

 wounded, or even decapitated. One of the best of the reported cases, that of Dr. 

 Woodhouse, was thus produced. 



Local Symptoms. — The pain of the wound made by the snakeis usually the earliest 

 symptom, but it is by no means a constant phenomenon in either men or animals. 

 Thus, while one reporter speaks of the sudden and intense pain, another does not 

 mention it at all, or expressly states that the wound was at first disregarded. In 

 most instances, the bite is certainly painful, and when we consider the hooked form 

 of the fangs, the double wound, the injection of a foreign fluid, and the final forci- 

 ble withdrawal of the teeth, we can feel no surprise that, in most cases, pain is 

 felt, and may wonder that it is not felt in all. Certainly we need not look to the 

 specific nature of the venom, to explain the primary pain here described. 



The succeeding local symptoms are almost inevitably swelling, discoloration, and 

 increasing pain. The reader who has followed this Essay thus far, will have no 

 difiiculty in explaining at least two of these symptoms. The swelling is due, not 

 to inflammation, but to a large or small collection of effused blood about the wound. 



In some loose tissues the amount thus accumulated may be very great, but in 

 other cases the anatomical peculiarities of the part wounded may limit the early 

 extravasation of blood, by confining it under a fascia, of which I have seen repeated 

 examples in animals. The discoloration is to be explained in the same manner. 



Hemorrhage from the wound may limit, for a time, the last two symptoms. It 

 is, however, a rare occurrence, and depends upon the size of the external opening 

 of the wound inllicted by the fang, and x^erhaps, also, upon the character of the 

 vessels accidentally encountered by the fang. In one of the dogs whose medical 

 history is recorded in this Essay, the hemorrhage from the fang wounds amounted 

 to several ounces. 



