SYMPTOMS OF VENOM POISONING IN MAN 109 
may occur from the rectum and other orifices of the body. Albuminuria or 
hemorrhage from the kidneys is a constant symptom. Rapid emaciation 
soon appears and in the prolonged cases a profound anemia and lethargy 
set in. There is an absence of paralysis or any symptom which might point 
to any direct action of the poison on the central nervous system. Death may 
be delayed for several days; this, however, depends more on the local condi- 
tions. Recovery in these cases is not at all uncommon. 
ECHIS CARINATA POISONING IN MAN. 
Although the venom of this snake is very active, on account of its small size 
less mortality results. The symptoms following its bite are similar to daboia 
poisoning. Local swelling and hemorrhages are severe. An authentic case 
was recently reported in St. George Hospital, Bombay, of which Martin and 
Lamb give a full account. A man was bitten on the temple by an Echis 
carinata, which was in captivity in the Museum of the Bombay Natural 
History Society. He came under observation a quarter of an hour after 
the bite and was then very frightened, as was natural under the circum- 
stances. The whole of the temple, on which two small punctures could 
be seen, was swollen and ecchymosed, the swelling extending to the side 
of the face and including the upper and lower eyelids. There was severe 
pain over the wounds. The blood which exuded from incisions made over 
the wounds was very liquid and remained unclotted. Vomiting soon began 
and continued till death. The pulse was very small, feeble, irregular, 
rapid, and at times could hardly be felt at the wrist. Extreme restlessness 
and complete insomnia were marked symptoms. The extremities were 
cold and clammy. The patient remained conscious for many hours; but 
a short time before death, which took place 25 hours after the bite, he 
became unconscious and delirious. There were no hemorrhages from any 
of the orifices. 
VIPERA BERUS POISONING IN MAN. 
The symptoms following the bite of the European viper are similar to 
those of a small dose of crotalus venom. Local pain follows the bite imme- 
diately and the limb soon swells and becomes discolored. Within 1 to 3 
hours entire prostration, accompanied by vomiting and often by diarrhcea, 
sets in. Cold, clammy sweat is usual. The pulse becomes extremely feeble, 
and slight dyspnoea and restlessness may be seen. In severe cases, which 
occur mostly in children, the pulse may become imperceptible and the limbs 
cold; the patient may pass into coma. In from 12 to 24 hours these severe 
constitutional symptoms usually pass off; but in the meanwhile the swelling 
and discoloration spread enormously. The limb becomes phlegmonous and 
occasionally suppurates. Within a few days recovery usually occurs suddenly, 
but death may occur from severe depression or from the secondary effect of 
the suppuration. 
