500 THE SNAKES OF SOUTH AFRICA. 
ale 
INTRAVENOUS VERSUS SUBCUTANEOUS INJECTION OF SERUM. 
It must be borne in mind that serum injected intravenously 
(direct into a vein) is on an average fifty times greater in its 
curative effects than if injected subcutaneously (under the skin). 
This is highly important to remember in the treatment of snake 
venom poisoning, for the reason that if the serum comes in 
contact with the venom while it is yet in the blood, it will render 
it harmless in proportion, of course, to the quantity and quality 
of the anti-venene serum used. In the case of the Cobras, the 
venom, after a time, leaves the blood and enters into combination 
with the nerve cells, notably those composing the nerve centres 
controlling the movements of the lungs. In the viper (adder) 
family of snakes, including the Boomslang, which is a Colubrine 
snake, the venom seriously affects the walls of the capillary blood 
vessels, causing such changes in the cells as to allow the blood 
to flow out into the various tissues. Now, it is obvious that if 
the venom has, previous to the injection of the serum, acted upon 
nerve cells, and the cells of the blood vessel walls, the serum 
cannot repair the damage done. All it is capable of doing is to 
neutralize whatever venom remains in the circulation, and so 
prevent further mischief. Then, if the damage is not beyond 
repair, the inherent curative power of the body will build up new 
cells, absorb and cast out the dead blood, and restore the body 
to its normal condition. A good all-round plan is to have at 
least enough anti-venene serum on hand for two full treatments, 
viz. about fifty cubic centimetres. Then if any one is bitten, 
inject one full dose of say twenty-five cubic centimetres in two 
or three places under the skin, and instantly send for a doctor, 
and then, if he considers the case a grave one requiring more 
serum, he can inject the second dose, or some of it, direct into 
a vein. Of course in those cases where it is impossible to obtain 
the services of a medical man or a veterinary surgeon within 
a reasonable time, the most capable person in the house should 
undertake the injection of the serum into a vein in the manner 
stated previously in this volume, if the symptoms are sufficiently 
serious to justify this operation. 
Residents in snake-infested countries should take a few 
lessons in injecting serum into veins and under the skin. 
