5o6 THE SNAKES OF SOUTH AFRICA. 



serum, he can inject the second dose, or some of it, direct into 

 a vein. Of course in those cases where it is impossible to obtain 

 the services of a medical man or a veterinary surgeon within 

 a reasonable time, the most capable person in the house should 

 undertake the injection of the serum into a vein in the manner 

 stated previously in this volume, if the symptoms are sufficiently 

 serious to justify this operation. 



Residents in snake-infested countries should take a few 

 lessons in injecting serum into veins and under the skin. 



I. 



The Saline Solution. An Emergency Measure. 



in severe cases of poisoning by the venoms of the Adders 

 and the Boomslang, extensive haemorrhage occurs. This means 

 that blood oozes out through the dilated walls of the capillary 

 blood vessels into various parts of the body — mostly into the 

 muscular tissue and under the skin. Now, it must be remembered 

 that when the blood thus escapes from the blood vessels it cannot 

 get back again, and very soon dies. 



To keep the heart beating vigorously, it is essential that it 

 should be supplied with a sufficiency of fluid to give it something 

 substantial to grip, otherwise it will slow down and eventually 

 stop. In proportion, too, as the heart becomes less energetic, 

 so do the various organs of the body decline in activity and 

 power to generate an anti-toxin, and also to cope with the venom 

 and the dead blood and cast them out of the body. 



In these cases death is Hkely to occur from lack of sufficient 

 fluid in the blood vessels. It is advisable in these instances to 

 inject into the left median vein of the patient, a solution of 

 common salt and sterilized (boiled) water. This solution is 

 known as " Normal Saline " or " Physiological Salt Solution," 

 viz. 78 grammes of common salt (Sodium Chloride) dissolved in 

 20 ounces of sterilized water. From one to two pints of this 

 solution may be injected. 



The left median vein is the largest vein in the left forearm, 

 and the right median vein is a similar one in the right forearm. 



If extensive haemorrhage has not taken place, or if the snake 

 which inflicted the bite was one whose venom is a neurotoxin 

 or nerve poison, then the right median vein of the patient should 

 be opened and the blood allowed to flow out freely. At the same 



