SNAKES OF CEYLON. 543 



Abdomen : No peritonitis or petechial haemorrhages ; the 

 coils of intestine were distended with gas, and the omentum 

 was anaemic. The bladder was strongly contracted, and the 

 urine not blood stained. 



Liver : Normal, anaemic. 



Kidneys : Normal, anaemic — the capsule stripped easily. 



Spleen : Normal, small. 



An enormous retro-peritoneal haemorrhage distended the 

 left side of the abdominal cavity, extending from the 

 diaphragm to the brim of the pelvis, but not crossing the 

 middle line. The blood forming the haemorrhage was dark, 

 and had formed a curiously tough stringy clot, which was not 

 easily broken up. It was impossible to discover what vessel 

 was the source of bleeding ; the arterial system generally was 

 not atheromatous, and the vessels of the kidney did not show 

 any gross degenerative changes. I satisfied myself that the 

 haemorrhage had no connection with the spleen or kidney 

 (inquiries as to whether he had fallen or sustained any injury 

 subsequent to the snake-bite produced no evidence of trauma). 



I examined the snake which bit this man, and identified it 

 as an Echis carinata, 12 inches long ; this has subsequently 

 been kindly confirmed for me by the Bombay Natural History 

 Society. 



(n) Interval before Death : The interval before death 

 necessarily depends upon the dose. Where a death is due to 

 syncope arising from the depression of the heart, or a sudden 

 profuse haemorrhage, this may occur in 24 hours or even less. 

 Where the case lingers on, and death is due to exhaustion from 

 recurrent haemorrhages, the fatal hour may be postponed for a 

 week or even two. 



(o) Treatment : No antivenene is available for this form of 

 ophitoxaemia. It has been prepared on a small scale, and its 

 efficacy proved by Stevenson. In the absence of an antidote, 

 treatment must be symptomatic. Recourse must be had to 

 Bayliss' fluid intravenously, Ca CI2 intramuscularly, and the 

 other measures advised to combat syncope and haemorrhage 

 as advocated under the treatment of Russell's viper. 



