SYMPTOMS OF VENOM POISONING IN MAN 109 



may occur from the rectum and other orifices of the body. Albuminuria or 

 haemorrhage from the kidneys is a constant symptom. Rapid emaciation 

 soon appears and in the prolonged cases a profound anaemia and lethargy 

 set in. There is an absence of paralysis or any symptom which might point 

 to any direct action of the poison on the central nervous system. Death may 

 be delayed for several days; this, however, depends more on the local condi- 

 tions. Recovery in these cases is not at all uncommon. 



ECHIS CARINATA POISONING IN MAN. 



Although the venom of this snake is very active, on account of its small size 

 less mortality results. The symptoms following its bite are similar to daboia 

 poisoning. Local swelling and haemorrhages are severe. An authentic case 

 was recently reported in St. George Hospital, Bombay, of which Martin and 

 Lamb give a full account. A man was bitten on the temple by an Echis 

 carinata, which was in captivity in the Museum of the Bombay Natural 

 History Society. He came under observation a quarter of an hour after 

 the bite and was then very frightened, as was natural under the circum- 

 stances. The whole of the temple, on which two small punctures could 

 be seen, was swollen and ecchymosed, the swelling extending to the side 

 of the face and including the upper and lower eyelids. There was severe 

 pain over the wounds. The blood which exuded from incisions made over 

 the wounds was very liquid and remained unclotted. Vomiting soon began 

 and continued till death. The pulse was very small, feeble, irregular, 

 rapid, and at times could hardly be felt at the wrist. Extreme restlessness 

 and complete insomnia were marked symptoms. The extremities were 

 cold and clammy. The patient remained conscious for many hours; but 

 a short time before death, which took place 25 hours after the bite, he 

 became unconscious and delirious. There were no haemorrhages from any 

 of the orifices. 



VIPERA BERUS POISONING IN MAN. 



The symptoms following the bite of the European viper are similar to 

 those of a small dose of crotalus venom. Local pain follows the bite imme- 

 diately and the limb soon swells and becomes discolored. Within i to 3 

 hours entire prostration, accompanied by vomiting and often by diarrhoea, 

 sets in. Cold, clammy sweat is usual. The pulse becomes extremely feeble, 

 and slight dyspnoea and restlessness may be seen. In severe cases, which 

 occur mostly in children, the pulse may become imperceptible and the limbs 

 cold; the patient may pass into coma. In from 12 to 24 hours these severe 

 constitutional symptoms usually pass off; but in the meanwhile the swelling 

 and discoloration spread enormously. The limb becomes phlegmonous and 

 occasionally suppurates. Within a few days recovery usually occurs suddenly, 

 but death may occur from severe depression or from the secondary effect of 

 the suppuration. 



