OF THE VENOM OF THE RATTLESNAKE, 1()3 



111 estimating these early local evidences of poisoning in man, as well as the local 

 signs which follow, it is well to remember that in almost every instance the ligature 

 was applied at once, and very tightly. In animals bitten and not subjected to the 

 ligature the swelling occurs, it is true, but forms much more slowly than is usual 

 in the cases of men. 



The primary local symptoms thus described increase progressively, so that within 

 a period which varies extremely, the swelling and discoloration extend up the 

 bitten limb, accompanied on their march by pain of the most excruciating character. 

 At this time, and after the first few minutes, the increase in the local symptoms is 

 probably due to the influence of the septic poisoning upon the tissues near the 

 wound, to the irritation thus resulting, and to the direct and indirect effect of the 

 venom upon the local circulation. Thus the extremity becomes larger and more and 

 more discolored until the skin offers every tint of an old bruise. Vesications appear 

 on the surface, the pain lessens, the local temperature early diminished, falls still 

 lower, and unless the poison has ceased to act, or a potent remedy has interfered, 

 gangrene ensues, and the system, already weakened by the effect of the poison upon 

 its own tissues, dies in the effort to separate the mortified and corrupted part. 



If, on the other hand, the poison is not present in a dose so large as to insure 

 these fatal effects, or is properly antagonized by medical agents, the swelling declines, 

 and the iMin disappears, tvith a celerity toJiich every practitioner or reporter has 

 assumed to he evidence of his own sJdll, or of the utility of his therapeutic means, hut 

 which, as ice shall have reason to see, is in reality, an essential and most strildng 

 feature of the Crotalus malady, and is either attributable to none of the remedies 

 employed, or to every one of the scores of them which popular credulity has placed 

 like blunt weapons in the too yielding hand of the physician. 



It is rather remarkable, that only one reporter. Dr. Woodhouse, has alluded to 

 the occurrence of swelling in the lymphatic glands of the part bitten. His case 

 was in other respects somewhat peculiar, inasmuch as the lymphatic trunks also 

 appear to have been inflamed, which is not a common symptom of Crotalus bite. 

 The venom usually seems to enter the system through the bloodvessels alone, and 

 to sap the life of the parts with which it comes in contact, without of necessity 

 involving the lymph vessels or their glands. 



Local Results. — It is not very easy to form a correct estimate of the local conse- 

 quences in the cases which finally recover. This difficulty will be explained upon 

 glancing over the column of local treatment in the table, when it will be observed 

 that ligatures, the cautery, excision and incision, alone or combined, were resorted 

 to with a freedom dictated by therapeutic despair or the fears of the sufferer and 

 his friends. 



It is hence impossible to learn positively how much was due to remedies, how 

 much to disease. It seems, however, to be certain that in many cases slight or 

 extensive local suppurations follow the cure, that in others local gangrene and 

 sphacelus of flesh and bone occur, while in the graver cases, the economy is too 

 seriously deranged to enjoy the power of spontaneously amputating the mass of a 

 limb. The well-known case reported by Sir E. Home [See Table of Crotalus Poison- 

 ing ill Man, Case 12), approached most nearly to the condition last described. In 



