80 THE POISONOUS SNAKES OP INDIA. 



Cobra Toxemia. 



Symptoms of Gohra Poisoning. 



In a subject poisoned by a cobra, which we may take as the type 

 of Colubrine toxaemia, the earliest constitutional symptom is a 

 feeling of iritoxication, but this frequently passes unnoticed in an 

 unobservant subject. Later the patient feels his weakness (para- 

 lysis) insidiously creeping upon him, till, uncertain of maintaining 

 the upright posture, he voluntarily reclines. His paralysis begins in 

 his legs, mounts to the trunk, and finally affects the head which 

 droops. Synchronising with this drooping of the head, a drooping 

 of the eyelids may be noticed, and simultaneously the muscles of 

 the lips, the tongue and throat become gradually paralysed. As a 

 result the lower lip falls away from the teeth, allowing the saliva to 

 dribble from the mouth, speech becomes increasingly difficult, till 

 the subject, unable any longer to control his lingual and labial 

 muscles, attempts by signs to communicate to those around him, 

 often striving with his fingers to remove the viscid saliva that 

 clings to his mouth. Breathing soon becomes embarrassed, later 

 laboured, and finally impossible. Distress is written on the counte- 

 nance, which becomes increasingly livid from defective aeration of 

 the blood. Swallowing similarly becomes difficult, and later 

 impossible, so that fluids taken into the mouth are apt to regur- 

 gitate through the nose. Nausea and vomiting are frequent 

 symptoms. A convulsion often heralds the cessation of respiration, 

 but the heart goes on beating for a minute or two longer. 

 Consciousness is retained till the end. There appears to be no 

 special sequence in the development of these paralyses. Those 

 affecting the muscles of the lips, tongue, voice, throat develop 

 synchronously, and evoke a train of symptoms exactly comparable 

 to the organic nerve disease " bulbar palsy," as first pointed out 

 by that excellent observer A. J. Wall. Such are the effects 

 produced by the paralysing influence of the poison on the cord 

 and brain, which may cause death in from 1^ to 6 hours usually. 

 (Nicholson says after 12, or even 24 hours). 



Symptoms arising from the action of another toxin, viz., 

 hcemorrhagin on the blood may be present, but a discussion of 



