DOCUMENTS 351 
L.—Lachesis ferox (known as the Grage, in French Guiana). 
XXXIII.—Case reported by Dr. Lhomme. 
“In May, 1898, A., aged 48, a European convict undergoing 
sentence, was admitted to the Penitentiary Infirmary, of Roches de 
Kouvous (French Guiana), suffering from a poisonous bite. 
“The man had been bitten while engaged in felling timber, at 
the place called Passouva. The locality is one that is infested with 
snakes, especially at the end of the wet season. Two venomous 
species in particular are found there in considerable numbers, the 
rattle-snake and another called the Grage by the blacks, which 
appears to be a Lachesis. 
“The patient arrived at the Infirmary in the evening, about 
twelve hours after the accident. We endeavoured to obtain precise 
details, but, owing to special circumstances, A., who was alone, 
had been unable to see what animal had bitten him. The clinical 
signs, however, pointed to a venomous snake ; inflammatory pheno- 
mena and pain set in soon after the wound was inflicted, and in 
a very short time became acute. 
“ Clinical Signs.—On examining the patient we found that the 
whole of the right arm was swollen. The skin, which was of a 
dark red colour, was acutely inflamed. The slightest touch or 
the least movement caused the patient to cry out. The hand 
showed traces of the bite, in the shape of two small red marks, 
each surrounded by a bluish areola. The general condition was 
good. The thermometer, however, indicated a slight rise of tem- 
perature, and the pulse seemed a little soft. The urine on being 
examined on the day after the accident contained a small quantity 
of albumin. Organs normal. General health before the accident 
excellent. Nothing worth mentioning in the previous history. 
“ Progress.—The conditions that we have just described dis- 
appeared very quickly, once the treatment was applied. The pain 
soon ceased, the temperature fell, and the patient was able to 
get a few hours sleep. By the following day the inflammatory 
phenomena had noticeably diminished. The cedema of the forearm 
