108 VENOMOUS SNAKES AND THE PHENOMENA OF THEIR VENOMS 



peritoneal cavity and the mucous membrane of the intestine showed numerous 

 minute red spots, especially in the jejunum. However, such definite anatomi- 

 cal changes were not described in the other two cases. 



LACHESIS POISONING IN MAN. 



Local symptoms consist of very severe pain at the point of the bite, and red 

 and then purplish discoloration. The tissues around the bite become infil- 

 trated with serous sanguineous fluid. Severe pain, accompanied by cramps, 

 irradiates toward the root of the limb. The patient complains of unquench- 

 able thirst and dryness of the mouth and throat. The mucous surfaces of the 

 eye, mouth, and genitals congest. These symptoms persist even beyond 24 

 hours, and there are often haemorrhages in the mucous membrane of the eye, 

 mouth, stomach, intestine, or bladder, and a more or less violent delirium. 



If the amount of the venom is sufficient to cause death, there are, after some 

 hours, stupor, insensibility, then sleepiness, the respiration getting gradually 

 more and more shallow and finally of a stertorous character. 



The loss of consciousness seems to be complete, even before coma sets in. 

 After complete cessation of the respiration the heart may beat for about 15 

 minutes. In some instances death occurs very rapidly, and even before any 

 local manifestation of venom poisoning becomes apparent. This rapid death 

 is usually a result of the extensive coagulation of the blood brought about 

 by the direct inoculation of the venom into the circulation. 



DABOIA POISONING IN MAN. 



This viper is one of the most deadly snakes, and next to the cobra probably 

 causes more deaths in India than any other snake. If daboia venom enters 

 directly into the blood circulation violent convulsions rapidly set in and soon 

 end in death. These symptoms are due to a more or less general intravas- 

 cular thrombosis. When the poison is introduced into the subcutaneous 

 tissues the symptoms may be divided into local and general. Locally severe 

 pain and rapid swelling occur and soon extend up the limb, if the bite is on 

 an extremity. There is often a blood-stained discharge from the wounds. 

 Ecchymose is soon very apparent all round the point of puncture. 



The general symptoms are evidenced by marked collapse, thready pulse, 

 cold sweats, nausea, vomiting, dilated pupils insensitive to light, and often 

 complete loss of consciousness. The patient may temporarily recover from 

 these general symptoms, only to fall into a deeper state of collapse than before. 

 Death often takes place soon after the infliction of the bite. 



If the general collapse or depression disappears the local symptoms play 

 an important part in the subsequent course of the case. There is a large 

 extravasation of blood with much cedema all round the wounds, and the 

 swelling increases. Extensive local suppuration and sloughing, malignant 

 cedema, and tetanus may supervene and aggravate the symptoms already 

 resulting from the venom. In the meantime, haemorrhages, often severe, 



