8 TREATMENT OF SNAKE POISONING. 
11. Amputation here is in itself a grave proceeding, and it is for- 
tunate that it is not primarily involved in the consideration of the case. 
Provided the ligatures have been tightened to the utmost, time will be 
allowed in which to make the excision so extensive and deep as to em- 
brace the whole of the infected area; to resemble, in truth, in principle 
at least, and in completeness, the small and comparatively unimportant 
amputation of the fingers or toes. But it will often happen that 
gangrene will have resulted from the ligature, and, as a secondary 
measure, amputation will become needful. A case of this kind occurred 
to me at the Calcutta General Hospital. The patient, a Mohammedan, 
had been bitten in the forearm by a daboia. Ligatures and the cautery 
were applied. Gangrene supervened. He was admitted under my care. 
The soft parts, up to within half an inch of the axilla, were destroyed 
by sloughing and gangrene. Enough skin over the deltoid remained 
for a flap. The arm was taken off at the shoulder-joint, and the patient 
made an excellent recovery. 
12. When an effective bite has been inflicted on any part of the 
trunk, the ligature cannot be employed. But excision and the cautery, 
if done at once, may be the means of saving life. In these cases suffi- 
cient time usually elapses to permit the absorption of a fatal quantity of 
poison before the arrival of the surgeon. It may sometimes happen, 
where only a limited quantity of poison has been injected, that, even 
after the signs of snake poisoning have been fairly developed, the com- 
plete extirpation of the infected parts may succeed in saving life, which 
would otherwise be sacrificed. 
13. It is much to be regretted that the intravenous injection of 
ammonia first introduced by Fontana and the Italians, and energetically 
revived by Professor Halford, of Melbourne, has not been found (by the 
Calcutta Snake Poison Commission) to be of any practical use in dogs 
poisoned by Indian or Australian snakes. Nor does the liquor potassz 
recommended to be injected into the blood by Dr. Short, of Madras, 
apparently do much good. It might do more if injected freely into the 
poisoned part. 
Sir Joseph Fayrer recommends that liquor ammoniz, nitric acid, 
carbolic acid, strong whipcord, and a small sharp knife be kept at all 
police stations for immediate use in cases of snake poisoning. 
