THE ADDER. 129 



Only when absolutely cornered does the adder turn 

 to attack — for example, when in a box or something 

 of that sort. The part most likely to be the seat 

 of the bite is therefore the hand or the foot : especi- 

 ally does the adder appear to aim just above the 

 ankle, if nearly trodden upon. On examination the 

 skin shows the two points of puncture made by the 

 two fangs, looking like two severe pin-pricks. In 

 doubtful cases the presence or absence of these marks 

 must decide the diagnosis. The symptoms, which 

 come on very rapidly, are, pain at the seat of the 

 wound, sickness, and a feeling of extreme prostration, 

 terminating in actual fainting and loss of conscious- 

 ness. In fatal cases death occurs soon from heart 

 failure. If, however, the dose injected was not so 

 large, or the venom of the particular adder less potent, 

 the patient recovers consciousness (or may not actu- 

 ally faint), and a set of secondary symptoms set in. 

 The day after the bite the vessels of the arm or leg, 

 as the case may be, become painful, and the lym- 

 phatics stand out as dark lines. The limb becomes 

 swollen, and the swelling may extend to the body. 

 The patient, in fact, exhibits all the signs of severe 

 local blood-poisoning, in addition to great weakness 

 of the heart. In some cases the limb shows consider- 

 able discoloration, more or less of a green colour. 

 The symptoms then gradually subside, but the patient 

 is some weeks before feeling quite the same as before 

 the accident. 



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