902 16. CROTALIDM 



1 . To prevent as much poison as possible from reaching 

 the circulating blood. This resolves itself into: 



a. Attempts to remove venom from the bitten part by 

 sucking or cupping. 



b. Attempts to destroy venom in the fang punctures 

 and in the tissues about them by the injection of chemicals. 

 This involves the use of a hypodermic syringe. The chemi- 

 cals ordinarily used are one per cent solutions in water of 



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either (potassmm permanganatejor chromic acid. 



c. The stopping of the flow of blood into and from 

 the bitten part by means of a tourniquet or tight bandage. 

 This, of course, cannot be done if the bite is on the head or 

 body. The danger of gangrene resulting from the prolonged 

 application of the tourniquet probably has been much over- 

 estimated. Dr. William S. Halsted informs me that in his 

 surgical service at Johns Hopkins Hospital the blood-flow 

 in a limb has been shut off for six hours without gangrene. 



2. To permit that portion of the venom which cannot 

 be removed from the wound, or locally destroyed, to enter 

 the circulating blood in small amounts and at safe intervals. 

 This must be done by loosening the tourniquet from time to 

 time for a few seconds only, regulating the periods of flow 

 and the intervals between them according to the severity and 

 duration of the symptoms which follow. Unless handled 

 in this manner the tourniquet is a source of danger, for its 

 sudden removal would permit the blood to carry the poison 

 into the general circulation in an overwhelming dose. I have 

 seen a frog, into whose leg venom had been injected beyond 

 a tourniquet, remain well for 24 hours and then die within 

 a few minutes after the protecting band was removed. 



3. To stimulate and support the vital processes of the 

 body as from time to time may be indicated by the symp- 

 toms. 



