104 PHYSIOLOGY AND TOXICOLOGY 



this instance the poison produced great local swelling. When the system began to 

 recover from the pi-imary depressing effects of the venom, it found the bitten arm 

 for the most part dead. Intense inflammation ensued as the patient rallied, but 

 being unequal to the effort of repair, he died before it was accomplished. 



In connection with the local signs, it is as well to note that no reporter has de- 

 scribed in man the local twitching which is so common in dogs and other animals. 



The comtihUional symptoms of Crotalus poisoning sometimes declare themselves 

 very early, and if we can believe their reporters, almost immediately after the bite. 

 It is more probable, however, that an interval of several minutes elapses, or that 

 the faintness of terror and pain has been mistaken for the constitutional effects of 

 the venom. In a few instances these symptoms do not announce themselves for 

 twenty or thirty minutes, but aside from these exceptional cases, it seems evident 

 that the general manifestations of the influence of the venom on the system appear 

 with a rapidity which is sufficiently surprising, so that the local symptoms are 

 sometimes overshadowed and forgotten for a time, in the singular phenomena which 

 characterize the systemic disturbance. 



The principal constitutional effect of the venom is a general prostration of the 

 most appalling character. Sometimes within a few minutes, sometimes within one 

 or two hours, this condition of profound sedation attains its height. The snake 

 strikes and the faintness comes on while the person injured is endeavoring to kill 

 the reptile. Or, as in another instance, he walks for some time and suddenly finds 

 his limbs giving way beneath him. 



I have looked in vain through the reports for any evidence of a primary stimu- 

 lating power on the part of the poison, but neither in the published cases, or in 

 my own observations, have I met with any early symptoms of excitement which 

 might not with reason be attributed to terror and pain. 



The condition of prostration referred to, is accompanied by a variety of pheno- 

 mena which are in general such as accompany the action of any sudden and violent 

 depressing agency. The patient staggers or falls, cold sweats bathe the surface, 

 nausea and vomiting ensue, the pulse becomes quick, and rapid, and feeble, the 

 expression anxious, and, in a few cases, the mind slightly disturbed. 



A patient dying in this condition would probably exhibit no lesion of fluid or 

 solid, and would be an example of acute or primary poisoning, such as sometimes 

 occurs in the early stage of epidemics of cholera or yellow fever. So great, however, 

 is the power of resistance on the part of man, owing, perhaps, in some degree to his 

 bulk, that very early death seems to be a rare incident of venom poisoning, so 

 rare, indeed, that I have met with no reported example of its occurrence. 



If death does not intervene, the local symptoms soon begin to play a more import- 

 ant role, and the swelling and discoloration extend up the limb, and pass on to the 

 trunk, so that when the arm has been wounded, half of the chest and back have 

 been seen to be discolored, as though severely bruised. 



Meanwhile, the signs of general blood-poisoning develop themselves, and within 

 a few hours, or a day, the face and other parts become swollen and puffy. At the 

 same time, the general weakness remains well marked, as shown by repeated syn- 

 cope, the heart quick, feeble, and fluttering, and the respiration labored. 



