252 AMERICAN SPIDERS 



dizziness, tremors, loss of muscle tone, and shock are all systemic 

 symptoms frequently noted. There may be speech disturbances and 

 general motor paralyses of various kinds. When the respiratory 

 centers are strongly affected, there follow difficulty of breathing, 

 cyanosis, and prostration. 



Many different remedies have been used in the treatment of 

 black-widow poisoning. Most of them have not at all changed the 

 course of the symptoms, and some have undoubtedly made the con- 

 dition more serious. Alcohol is now known to have a most harmful 

 effect, and its use at any time during the course of the disease is a 

 serious mistake. It is imperative that the patient be in the hands of 

 a competent physician, and as quickly as possible following the bite. 

 Ordinarily, complete rest in bed for two or more days is a necessity. 

 The intense pain is alleviated by morphine sulphate, and rest is 

 assured by the use of sodium amytal. The intravenous injection of 

 magnesium sulphate to overcome hypertension and the spasticity 

 of the muscles was a favorite remedy a few years ago. Now it has 

 largely been replaced by an intravenous injection of 10 cc. of 10 

 per cent calcium chloride, or gluconate. This seems to be by far 

 the best method of arresting the symptoms, and is so successful that 

 recourse to the serums currently available is not often necessary. 

 During World War II the use of calcium gluconate for Latrodectus 

 poisoning became standard practice. 



Whereas the illness following black widow poisoning is fre- 

 quently grave, a fata] outcome is rare. In the average case the effects 

 subside within a few hours, and virtual recovery is realized within 

 a couple of days. Very young children and older people are more 

 likely to be seriously affected than those in more robust condition. 

 In 1794 Luigi Totti described the death of a five-year-old child in 

 less than twenty-four hours following the bite of the malmignatte. 

 In older people death is often due to complication rather than to 

 the venom itself. The tiny wound may allow entrance to germs 

 causing tetanus, erysipelas, or other dangerous diseases. The addi- 

 tional strain on the circulatory system occasioned by the venom 

 may cause cerebral hemorrhage. These secondary causes of death, 

 however, do not minimize the importance of the spider venom in 

 initiating the condition leading to the fatal consequence. 



Approximately 1 300 cases of black widow bite were reported in 

 the United States from 1726 to 1943. Every state was represented 

 on the list, but nearly half the total, 578, were from California. 

 Virginia led the eastern states with 173 cases; Florida had 126. 



