108 VENOMOUS SNAKES AND THE PHENOMENA OF THEIR VENOMS 
peritoneal cavity and the mucous membrane of the intestine showed numerous 
minute red spots, especially in the jejunum. However, such definite anatomi- 
cal changes were not described in the other two cases. 
LACHESIS POISONING IN MAN. 
Local symptoms consist of very severe pain at the point of the bite, and red 
and then purplish discoloration. The tissues around the bite become infil- 
trated with serous sanguineous fluid. Severe pain, accompanied by cramps, 
irradiates toward the root of the limb. The patient complains of unquench- 
able thirst and dryness of the mouth and throat. The mucous surfaces of the 
eye, mouth, and genitals congest. These symptoms persist even beyond 24 
hours, and there are often hemorrhages in the mucous membrane of the eye, 
mouth, stomach, intestine, or bladder, and a more or less violent delirium. 
If the amount of the venom is sufficient to cause death, there are, after some 
hours, stupor, insensibility, then sleepiness, the respiration getting gradually 
more and more shallow and finally of a stertorous character. 
The loss of consciousness seems to be complete, even before coma sets in. 
After complete cessation of the respiration the heart may beat for about 15 
minutes. In some instances death occurs very rapidly, and even before any 
local manifestation of venom poisoning becomes apparent. This rapid death 
is usually a result of the extensive coagulation of the blood brought about 
by the direct inoculation of the venom into the circulation. 
DABOIA POISONING IN MAN. 
This viper is one of the most deadly snakes, and next to the cobra probably 
causes more deaths in India than any other snake. If daboia venom enters 
directly into the blood circulation violent convulsions rapidly set in and soon 
end in death. These symptoms are due to a more or less general intravas- 
cular thrombosis. When the poison is introduced into the subcutaneous 
tissues the symptoms may be divided into local and general. Locally severe 
pain and rapid swelling occur and soon extend up the limb, if the bite is on 
an extremity. ‘There is often a blood-stained discharge from the wounds. 
Ecchymose is soon very apparent all round the point of puncture. 
The general symptoms are evidenced by marked collapse, thready pulse, 
cold sweats, nausea, vomiting, dilated pupils insensitive to light, and often 
complete loss of consciousness. The patient may temporarily recover from 
these general symptoms, only to fall into a deeper state of collapse than before. 
Death often takes place soon after the infliction of the bite. 
If the general collapse or depression disappears the local symptoms play 
an important part in the subsequent course of the case. There is a large 
extravasation of blood with much cedema all round the wounds, and the 
swelling increases. Extensive local suppuration and sloughing, malignant 
oedema, and tetanus may supervene and aggravate the symptoms already 
resulting from the venom. In the meantime, hemorrhages, often severe, 
