390 VENOMS 
finger and hand were swollen. A few minutes later we gave 
a second injection of serum. Until evening (the accident took 
place at 11 a.m.) the patient suffered from nausea, but sweating 
set in, and at 7 o’clock the temperature had risen to 36°7° C. The 
feeling of depression was much less. On the following day the 
symptoms had disappeared, and forty-eight hours afterwards the 
patient returned to duty.” 
K.—Bitis arietans (Puff Adder). 
XXXII.—Case reported by Dr. P. M. Travers, Chilubula 
Mission, North-eastern Rhodesia. 
‘On Thursday, September 6, 1906, information was brought to 
me that a child, aged 7 or 8, in inserting his hand into a mole’s 
hole had been bitten by a lifwafwa ( Death-Death,’ v.e., Puff 
Adder). I set off in all haste on my bicycle. An accident obliged 
me to leave the road when half-way, and, to complete the series 
of mishaps, I went to a village with a similar name, a good 
half-hour distant from that where the patient lived. The result 
was that by the time I arrived I should say that about two hours 
had elapsed since the child had been bitten. The snake had been 
killed, and was, indeed, a puff adder. It had bitten the child in the 
middle finger of the right hand, and half the arm was greatly 
swollen, and as hard as stone. As quickly as possible I gave 
an injection of 10 c.c. of antivenomous serum, and then vainly 
endeavoured to make the wound bleed. In a very short time the 
serum was absorbed. On the following morning the child was still 
ill, with wild eyes resembling those of an epileptic. He yawned 
continually, and did not seem altogether conscious ; the inflamma- 
tion, however, had greatly diminished. <A few days later recovery 
was complete, but a large abscess formed on the forearm, and the 
hand became necrosed. I was obliged to amputate all the pha- 
langes. The natives said the child was going to die during the 
night. In my opinion the serum saved the child’s life, and recovery 
would have been more rapid had I not been so late in arriving.” 
