TREATMENT OF POISONOUS SNAKE-BITES 263 
vitality of the tissues. The period in question also usually affords 
sufficient time for taking the patient to a place where help can be 
obtained, and for the preparation of everything necessary for his 
subsequent treatment. 
The wound should then be freely washed with a fresh 2 per cent. 
solution of hypochlorite of lime, or with a 1 in 1,000 solution of 
chloride of gold. In default of hypochlorite of lime or chloride of 
gold, either eau de Javel, diluted with tepid water to a strength 
of 1 in 10, or a 1 per cent. solution of permanganate of potash, may 
be employed. These reagents should be made to penetrate as 
deeply as possible into the tissues, and a few cubic centimetres of 
them should even be injected with a Pravaz syringe into the 
punctures caused by the bite and all round them. 
The wound being then covered with a damp dressing by means 
of compresses saturated with hypochlorite of lime, or at least with 
pure alcohol, the next thing to be done is to prepare to apply the 
serum-therapic treatment in order to arrest the general intoxication, 
if this has already commenced to take effect, or to prevent it from 
setting in. 
For the employment of serum it is necessary to be in possession 
of a sterilisable syringe of the capacity of 10 c.c., similar to those 
used in the treatment of diphtheria. 
If the life of the patient be not immediately in danger, care 
should first be taken to have the syringe boiled, or at least to rinse 
it out with boiling water, making sure that the piston fits tightly, 
and that the syringe itself is in good working order. 
Should a syringe of 10 c.c. not be available, any kind of Pravaz 
syringe, previously washed out with boiling water, may be em- 
ployed, but in this case the use of so small an instrument renders 
it necessary to give several painful injections. 
The entire contents of a bottle of serum (10 c.c. of liquid serum, 
or 1 gramme of dry serum dissolved in 10 c.c. of boiled water) 
should be injected into the subcutaneous areolar tissue of the 
abdomen, on the right or left side. There is no advantage in 
