THE TREATMENT OF SNAKE BITE 445 



(5) Noguchis pura Ancistroden piscivorus serum. 



(6) Brazil's pura Crotalus horridus serum. 



(7) Kitajima's pura Lachesis Hallow serum. 



(8) Polyvalent sera, not very efficacious. 



Sera can be so made as to remain unimpaired for two years in 

 all climates. They can be given prophylactically and curatively 

 in the latter instance as soon as the species of snake is known 

 or suspected. They all degenerate rapidly if not kept in a dark 

 cool place. They must be used in large doses, Calmette recom- 

 mends 10 c.c. subcutaneously and Martin, Lamb, 100 c.c. 

 intravenously. There is a wide difiference of opinion on the 

 dosage question. 



(3) To aid the Excretion of the Venom. 



The kidney is said to excrete most of the venom that leaves the 

 body. The urine of a poisoned dog is said to have killed an injected 

 pigeon in twenty-four hours. 



The salivary and mammary glands also play some small part in 

 its excretion. The condition is usually so acute and the toxin so 

 destructive that there is but little opportunity for stimulating the 

 excretorv organs. 



Salines can be given and sweating encouraged. 



(4) To iVIaintain the Strength of the Patient. 



Strychnine can be given when there is but little neurotoxin in the 

 venom. 



Caffeine and adrenalin injections are indicated. 



Salines intravenously, per rectum and subcutaneously. 



Ammonia and ether are good. 



Apply a binder to the abdomen and bandages to the legs. 



Warmth is necessary. 



Energetic movements are exhausting. 



Alcohol as a rule reduces the activity of the antivenene. 



(5) Symptomatic Treatment. 



Give calcium lactate in large doses for viper venom. 

 Bromides, chloral hydrate and chloroform may be useful for rest- 

 lessness, spasms and convulsions. 

 Morphia for the pain. 

 Artificial respiration when such is failing. 



(6) To Prevent Secondary Infection. 



Treat on antiseptic lines with much care and patience, especially in 

 viper cases. 



Acton and Knowles in working on this subject tell us : — 

 That ligature is efficacious. 



