THEIB NATURE AND EFFECTS. 143 



the appearance of areolar tissue, both in health and 

 under the influence of the presence of snake-poison, as 

 mistakes may easily be made from ignorance of the 

 appearances presented. 



The next step is to remove the whole of the deposited 

 poison. Many proposals have been made from time to 

 time on this subject. Suction, burning, igniting gun- 

 powder on the spot, excision, &c. &c., have been recom- 

 mended. But, practically, all methods must yield to 

 the careful dissection out with a knife of all the parts 

 likely to contain the poison. It is not of the least use 

 pinching up the skin and excising it, as the skin never 

 contains the poison at aU, and the areolar tissue holding 

 the poison would retract before the knife and be left 

 behind. The following is the only efficient way : — An 

 incision at least an inch and a half long should be 

 made through the site of the bite; the skin should then 

 be excised on each side for three-quarters of an inch. 

 This will freely expose the parts below. The skin should 

 be reflected back in every direction by the scalpel, and 

 with a forceps the whole of the areolar tissue under- 

 neath should be thoroughly and completely dissected 

 out, going freely up the limb in the direction of the 

 returning blood-current. On the ball of the thumb, 

 not only the areolar tissue, but the deep fascia and some 

 of the muscle beneath should be removed, as the fang 

 is capable of sinking in especially deeply here. On the 

 fingers and toes all the tissues should be cut away at 



