146 PHYTOTOXINS AND ZOOTOXINS 



Viper Poisoning. — "After the bite of a viper the local changes are mo>t pro- 

 nounced; there are violent pains in the bleeding wound, hemorrhagic discolora- 

 tion of its surroundings, bloody exudations on all the mucous membranes, and 

 hemoglobinuria. Usually somewhat later than in cobra poisoning constitutional 

 symptoms develop; viz., great prostration with nausea and vomiting, blood pres- 

 sure falls continuously, and respiration grows slow and stertorous. After a tem- 

 porar}'- increase in reflexes, paresis supervenes, with paraplegia of the lower 

 extremities, extending in an upward direction and ending in a complete paralysis. 

 It therefore resembles an acute ascending spinal paralysis. If the patient re- 

 covers from the paralysi-s, a septic fever may develop; not rarely there remain 

 suppurating gangrenous wounds, which heal poorl}^" 



It will be noticed that there is lacking the usual period of incuba- 

 tion that follows injection of bacterial toxins, and if it happens that 

 the venom has been injected directly into one of the veins, death may 

 occur within a few minutes. When recovery occurs, the disappear- 

 ance of symptoms is remarkably abrupt, within a few hours a des- 

 perately sick person becoming almost entirely free from all evidences 

 of the intoxication. 



Pathological Anatomy. — Postmortem examination shows changes varying with 

 the nature of the poisonous snake that has caused death. In the case of a cobra 

 bite, according to Martin, the areolar tissue about the wound is infiltrated with 

 pinkish fluid; the blood is often fluid; the veins of the pia are congested, and 

 the ventricles often contain turbid fluid; the kidneys may show much congestion. 

 When death occurs in a few minutes, enormous general intravascular clotting is 

 found, which seems to be the cause of death. After death from a viper bite the 

 site of the wound is the seat of intense edema and extrava-ation of blood; if in 

 the muscles, these are much softened and disorganized. Hemorrhages are found 

 in all organs and in the intestinal tract. If death occurs after several days it 

 is generally because of sepsis, and shows the usual changes of this condition; in 

 addition, as a rule, to marked gangrenous, ulcerative, and sloughing processes at 

 the site of the bite. 



Histologically there are found, in addition to innumerable hemorrhages in nearly 

 all the organs, many vessels plugged with thrombi composed of more or less 

 hemolyzed, agglutinated erythrocytes. The changes produced in the nervous 

 tissue by the Australian tiger snake are described by Kilvington,'* who found marked 

 chromatolysis, the Xissl bodies breaking into dust-like particles, and eventually 

 all stainable substance disappearing from tlie cytoplasm; the nucleus retains its 

 central 7)osition, but often loses its outline and may disappear. The cells around 

 the central canal of the cord are most affected. There are no inflammatory 

 changes in the nervous sj'stem, and if death occurs very quickly there may be no 

 microscopic alterations. Hunter'^ found similar changes in the Xissl bodies in 

 both krait and cobra poisoning; in the mcdullated fibers he found the myelin 

 sheath converted into ordinary fat. The venom of sea snakes {Enhydrina vn'aka- 

 dien) has a severe action on the nervous tissues, while Dnboia has none (Lamb 

 and Hunter^"). Nowak" studied experimental animals, and found much fatty 

 change in the livers, even if death occurrcil one-half hour after iH)isoning; also 

 focal necrosis in the liver, acute parenchymatous alterations in the kidney, and 

 pneumonic patches in the lungs. 



Effects on the Blood. — There has been much discussion concerning the part 

 played by the abundant and prominent intravascular clotting in causing death 

 after snake-l)ite. Lamb" states that when venoms are slowly absorbed tiie 

 coagulahility of the blood is decreased and it is found fluid after death, but when 

 a fatal do.se of venom (vi!)er) is rapidly absorbed, clotting is increased and thmni- 

 bosis is the chief cause of death. Martin has demonstrated very lu-tivo fibrin 



" Jour, of Physiol., 1902 (28), 426. 

 " Glasgow Med. Jour., 190.'} (59), 98. 

 ^"Lancet, 1907 (ii), 1017. 

 *' Ann. d. I'Inst. I'asteur, 1898 (12), 3(59. 

 " Indian Medical Gazette, Dec, 1901. 



