520 SNAKES OF CEYLON. 



condition of the tissues as revealed by incision, will furnish 

 confirmatory testimony of the entrance of snake poison, which, 

 in the opinion of my namesake, A. J. Wall, is absolutely 

 characteristic. He says the areolar tissue becomes purple in 

 colour and infiltrated with coagulated purple blood-like fluid. 

 This fades gradually to a pinkish colour, and this again to 

 normal conditions as the site of the poisoned wounds are 

 receded from. These changes are extremely rapidly produced, 

 having been seen by this authority within 30 seconds of the 

 entrance of the poison. 



To the surgeon this sign is invaluable. Its presence pro- 

 claims the envenomed nature of the wound, and dictates a 

 course of action completely different from that necessary in 

 its absence. 



(5) Discolouration : A greenish or bluish tinge is fre- 

 quently observed in the skin in the immediate neighbourhood 

 of the punctures within a few minutes of the bite when venom 

 has been introduced. Sometimes, indeed, the skin is purplish 

 from severe subcutaneous bleeding. 



(6) Sloughing : The tissue cells in the vicinity of the 

 wounds frequently die as a result of the powerful action of the 

 poison. The result is the formation of a slough varying in 

 extent to the dose of the poison injected. This dead matter 

 under normal constitutional conditions offers an ideal pabulum 

 for putrefactive germs to flourish. But in snake poisoning, 

 among other things, it has been shown by Ewing, that the 

 natural germicidal properties of blood are rendered inert, so 

 that with the entry of germs there is a grave danger of another 

 form of blood poisoning to be set up, and death may be the 

 result of an intoxication from such germs. When the slough 

 separates, a deep ulcer is left which takes some time to heal. 



(7) Illustrative Case :* A case of daboia poisoning, by W. R. 

 Taylor, M.R.C.S. (Eng.), L.R.C.P. (Lond.). 



* Appeared in the '• Indian Medical Gazette'' for September, 1919, 

 337. 



