112 THE POISONOUS SNAKES OF INDIA. 



At Hangu, on 13th July, at 7 a. m., dhooly bearer R., age about 

 40, while removing a dhooly from a tent, was bitten by a snake on 

 the outer side of the forearm, 3 inches above the wrist. 



He at once went to the Hospital Assistant and told him what had 

 happened. The Hospital Assistant with commendable promptitude 

 applied a ligature immediately above the site of the tooth marks, 

 from which oozed two minute drops of blood, he then incised across 

 the tooth marks and removed semi-circular flaps of skin to the size 

 of an eight-anna piece, induced free bleeding and rubbed in crystals 

 of permaganate of potash. 



By this time the snake had been killed by some sepoys, and the 

 Hospital Assistant went to see it ; recognising it as a poisonous one 

 he applied a further ligature round the fleshy part of the forearm of 

 the man. 



Since the hospital at Hangu is only a camp one, the patient was 

 removed in a cart to the civil dispensary, and here at 9 a. m., 

 rubber ligatures, above and below the elbow, were substituted for the 

 cloth bandages, and potassium permanganate re-applied. 



No antivenine being available, it was not used. 



The wound in the arm continued to ooze all daj'', but the patient 

 complained of severe pain in the arm, which was attributed to the 

 ligatures ; however, he managed to get some sleep. 



At 5 p. m. there was considerable swelling of the arm, and 

 severe pain complained of : as the general condition of the man 

 remained satisfactory, it was decided to remove the ligatures. 



At 7 p. m., the patient passed a diarrhoeic motion in bed, but 

 got up later to pass water and clean himself. There was no blood 

 in the motion or urine, and active bleeding had ceased from the 

 wound in the arm, the dressing being merely stained. 



At 10 p. m. the patient complained of pain in the abdomen and 

 was given aromatic spirits of ammonia and cinnamon water. 



At mid-night the pain in the abdomen was worse ; patient de- 

 scribed it as a burning sensation. There was no vomiting. 



At 2 a* m. the patient passed a diarrhoeic motion (no blood) 

 going out, with assistance, to the latrine , 20 yai-ds away, for the 



