502 THE SNAKES OF SOUTH AFRICA. 
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THE SALINE SOLUTION. AN EMERGENCY MEASURE. 
In severe cases of poisoning by the venoms of the Adders 
and the Boomslang, extensive hemorrhage occurs. This means 
that blood oozes out through the dilated walls of the capillary 
blood vessels into various parts of the body—mostly into the 
muscular tissue and under the skin. Now, it must be remembered 
that when the blood thus escapes from the blood vessels it cannot 
get back again, and very soon dies. 
To keep the heart beating vigorously, it is essential that it 
should be supplied with a sufficiency of fluid to give it something 
substantial to grip, otherwise it will slow down and eventually 
stop. In proportion, too, as the heart becomes less energetic, 
so do the various organs of the body decline in activity and 
power to generate an anti-toxin, and also to cope with the venom 
and the dead blood and cast them out of the body. 
In these cases death is likely to occur from lack of sufficient 
fluid in the blood vessels. It is advisable in these instances to 
inject into the left median vein of the patient, a solution of 
eommon salt and sterilized (boiled) water. This solution is 
known as “‘ Normal Saline” or “ Physiological Salt Solution,” 
viz. 78 grammes of common salt (Sodium Chloride) dissolved in 
20 ounces of sterilized water. From one to two points of this 
solution may be injected. 
The left median vein is the Jargest vein in the left forearm, 
and the right median vein is a similar one in the right forearm. 
If extensive hemorrhage has not taken place, or if the snake 
which inflicted the bite was one whose venom is a neurotoxin 
or nerve poison, then the right median vein of the patient should 
be opened and the blood allowed to flow out freely. At the same 
time the left median vein should be opened and a pint or two of 
the saline solution injected. By this means a great deal of the 
venom is got rid of and its place taken by the salt solution, which 
keeps the heart beating vigorously until the body is able to 
manufacture a fresh supply of blood to replace that which has 
been drained out. Many valuable lives have, in this way, been 
saved in cases of ordinary hemorrhage, from a severed artery 
for instance. The principal immediate danger of the loss of 
