THE POISONOUS SNAKES OF INDIA. 107 



adopted was that described by Dr. J. W. Watson Stephens, and in 

 his hands proved very sucessful in Siam. The vomiting ceased 

 after the first dose of whisky had been administered. I was not 

 certain as to whether the vomiting and cold sweats were due to the- 

 snake poison or to the emetic administered by the constable, but it 

 was evident later that these were effects of the former. The poison,, 

 therefore, had undoubtedly entered the general circulation before I 

 first saw the patient. At dawn the patient was not so restless, but 

 complained of great thirst and hunger. The bowels had acted once- 

 and were relaxed, the skin was warm, the tongue dry, the expres- 

 sion anxious, and the eyelids had now a vevy heavy appearance^ 

 and he was unable to open them wide. 



The elevators of the lids exhibited paretic symptoms. The- 

 pupils were contracted, fixed, and equal. Pulse was quick, 115 per 

 minute, and moderately full. Finding that the ligatures were- 

 ' rather lax, I proceeded to remove them, following the procedure- 

 recommended by Prentiss Wilson in the " Arch, of Internal Medi- 

 cine," June, 1908, by intermittingly relaxing the ligature nearest 

 to the heart, letting it become looser and looser until it was entirely 

 removed, and the other ligatures removed in the same manner, at 

 the same time watching the effect on the patient. At midday 

 vomiting commenced again, but was not persistent. The tissues all 

 round the wound were slightly tumefied and inflamed. Bleeding 

 took place every now and again, especialty if the patient exerted 

 himself. A noteworthy feature of the blood was that it was thick,, 

 dark in colour, and did not coagulate. Restlessness was more 

 marked. Weakness, depression, and exhaustion and pain in the 

 small of the back were complained of, but there were no cramps, no 

 paralysis of the limbs, and no convulsions. The skin again began 

 to break out in cold, clammy sweat. The abdomen was distended 

 and tympanitic, the upper part exhibiting a board-like hardness.- 

 Bructations were frequent, but did not appear to relieve the patient.. 

 He complained of suffocating pains, as if both sides of his chest were- 

 being compressed. There was great oppression. Respiration was 

 hurried and laboured, and the pulse was becoming weak and more- 

 rapid — 125 per miniite. Sight was rather dimmed, but recognition 

 of objects and persons was possible. Sinapisms were applied to the- 



