246 TROPICAL MEDICINE AND HYGIENE 



Next, to consider antivenoms as remedial agents : 

 There is a consensus of expert opinion that each is specific, 

 that is to say, is fully potent only against its corre- 

 sponding venom, and is more or less impotent against 

 other venoms, just as a specific bacterial antitoxin is 

 active only against its corresponding microbe. From 

 this point of view, which is well supported by experiment 

 both in vitro and and in vivOj it follows that the employment 

 of antivenom is conditioned in one of two directions. 

 Either (i) we must capture and identify in every case 

 the snake that inflicted the bite, and must have at hand 

 the corresponding antivenom ; or (2) without stopping to 

 consider the snake, we must have at our disposal a synthetic 

 (multivalent) antivenom a serum that has been rendered 

 immune to all the common species of Thanatophidia of 

 the country served. Neither of these conditions is at 

 present fulfilled : the first is obviously a condition of 

 unattainable perfection is outside ihe possibilities of ex- 

 perience and practice ; there is good hope that the second 

 may be fulfilled, indeed, something is now being done 

 towards its fulfilment in some countries. 



Coming now to the possible use of antivenines at the 

 present moment : if the specific antivenom for the snake 

 that has inflicted the bite is at hand, it should be in- 

 jected as soon as possible. If the specific antivenom is 

 not available, then in dealing with a case of bite by any 

 Viperid, or by an Australian Elapine, nothing is to be 

 hoped from an injection of cobra aritivenine ; but if it 

 be a case of bite by any of the other alien Elapines, 

 then there can at least be no objection to the use of 

 cobra antivenine. The procedure may not be entirely 

 rational a priori, but, in the present state of our know- 

 ledge, it is at least a legitimate experiment, based on a 

 hope of " increasing the natural resistance " of the 

 patient, and of retarding the action of the alien venom. 

 Leonard Rogers's experiments, though they helped to 

 establish the view that Calmette's cobra-antivenom is 

 fully potent only against cobra- venom, make it clear that 



