294 VENOMOUS SNAKES AND THE PHENOMENA OF THEIR VENOMS 
SPECIFIC TREATMENT. 
The most rational treatment of snake poisoning is by specific anti- 
venins. That the action of antivenin is highly specific has been related 
under the chapters concerning antivenin. The therapeutic value of anti- 
venin is also discussed at length, and we may duly hope that in the near future 
specific antivenins of higher potency for the most deadly venoms will be 
produced and placed in the hands of practitioners in the countries where 
accidents and death from venomous serpents are frequent. 
Up to the present time a polyvalent antivenin is not sufficiently strong 
to be of much practical use, and it would be necessary to employ various 
monovalent specific antivenins for the cases indicated. There are, at the 
least, several available antivenins for practical purposes, as follows: Cobra 
antivenin, Daboia antivenin (issued from the Pasteur Institute, India), No- 
techis antivenin (Tidswell, Australia), Lachesis antivenin (Brazil,) Crotalus 
antivenin and Moccasin antivenin (Rockefeller Institute, New York). A 
seventh is another Lachesis antivenin (Trimeresurus antivenin) and may be 
gotten from the Institute for Infectious Diseases, Tokio. 
Besides these monovalent antivenins there is a polyvalent antivenin pre- 
pared by Calmette at the Pasteur Institute, Lille, although its action is more 
pronounced against cobra venom than the other venoms. 
As Martin and Lamb rightly pointed out, the antitoxic powers of all these 
antivenins are still feeble and are far from being satisfactory for practical 
purposes. But, asI have stated elsewhere, the amounts of venom introduced 
into the body by the bite are extremely variable, and death may occur in 
certain instances as the result of a small excess over the quantity which by 
itself is insufficient to be fatal. Here antivenins are of immense service in 
averting death by neutralizing that excess. The excess may again be very 
variable, but there must be a range of doses by which the antivenins, however 
feeble they may be, can prevent the venom from reaching the vital organs of 
the organism. Remembering that the antivenins are the only agents that 
can neutralize the venom after the absorption of the latter into the general 
system, we are amply justified in injecting as large a dose of antivenin as 
practicable in every case of snake bite and, indeed, no practitioner would be 
justified in hesitating to use this specific agent freely simply because of the 
comparatively low antitoxic value which our present preparations of anti- 
venins possess. 
To my mind there can be no room for the slightest doubt as to the great 
service that antivenin has rendered towards saving the unfortunate victims 
of snake poisoning from certain death. In many instances the cases of 
recovery might have been due to the shortage of amount of venom introduced, 
but equally as many cases must have been due to the removal of the excess 
of the venom by the use of antivenin. The cases of death in spite of the 
injection of antivenin are the instances where the excess of the venom has 
been more than the employed dose of antivenin could neutralize. 
