THE POISONOUS SNAKES OP INDIA. 71 



The symptoms — vomiting, collapse with weak pulse, and incap- 

 ability to swallow (not a genuine paralysis) — are all to be attributed 

 to an attack of syncope, in the main due to fright, but probably 

 aggravated by the pain occasioned by the surgical wounds, and the, 

 burning of the permanganate. 



Had the snake not been killed, this casualty like so many others 

 wotild probably have been reported as " another case of snake- 

 poisoning cured by antivenene or permanganate of potash." 



Now it appears to me that quite a large number of cases are 

 reported each year as snake poisoning which have never shown a 

 symptom of toxtemia, but which are comparable to the cases quoted 

 above, the gravity of the symptoms being wrongly interpreted as 

 due to the action of snake venom. 



I think the conditions to be met with in the two states, i.e., 

 fright and colubrine poisoning require emphasizing, especially as 

 they are in almost every detail strikingly different, and as a result 

 call for completely different methods of treatment. 



To begin with fright operating through the nervous system 

 mainly affects the heart. The symptoms may vary from a transient 

 pallor and giddiness, to syncope of so profound a nature that unless 

 combative measures are speedily employed the condition may pass 

 insensibly on to death. 



Now if we take the cobra as the type of a colubrine snake the 

 toxaemia produced by its bite exerts its main force upon the 

 nervous system, and principally operates upon the respiratory 

 centre, the heart remaining unaffected. The constitutional effects 

 seen in the two cases are as follows : — 



Fright. Cobra-poisoning. 



(1) Onset of weakness often sudden. (1) Onset of weakness very gradual. 



(2) Involuntary prostration ; often (2) Recumbency voluntary after 



the patient falls in a faint and some time owing to gradual loss 



is brought in this state to hos- of power of legs. The patient 



pital. often walks to hospital by him- 



self or with help. 



(3) Complete or semi-unconsciousness. (3) Consciousness not impaired. 



(4) Syncope — (4) Heart not afifected — 



{a) Pallid face, (a) Face natural at first, livid 



later on. 



