120 THE POISONOUS SNAKES OF INDIA. 



MoNTicoLA Toxaemia. 



Illustrative Case. 



Reported by me (hidian Medical Gazette, November 1907.) 



Bite from snake 1 foot 9 inches long. Poisoning. Recovery. 



On the 23rd of August at Shillong (Khasi Hills, Assam, 4,900 

 feet) I arrived home at 6 p.m. to find my snakeman awaiting me 

 with the report that he had been bitten in the finger whilst trying 

 to effect the capture of a viper. He produced the snake which 

 proved to be a pit viper (Lachesis monticola) common in these hills. 



The injury had been sustained about 4 p.m. 



I accompanied him to the Civil Hospital walking. On examina- 

 tion I found the wound had been inflicted on the dorsal aspect of 

 the second phalanx of his right middle finger. The wound had 

 been cautei'ised in a very superficial and perfunctory sort of manner 

 with nitrate of silver, and a single string ligature applied above the 

 wrist by a native practitioner. The patient complained of much pain 

 which he said was increasing in the hand, and I have little doubt 

 was due mainly to the ligature. The whole limb was much swollen, 

 .and the swelling extended slightly to the subcutaneous tissues 

 beneath the axilla. The hand was most swollen, partly doubtless 

 ^ue to the ligature for it was cold. 



I removed the ligature, made four parallel incisions to the bone, 

 jnibbed in crystals of permanganate of potash, and dressed the part. 



The patient walked to my house, a mile distant, where I told him 

 to sleep in case of developments. He passed a fair night, and said 

 he slept all right, and he seemed fairly easy in the morning, but his 

 swelling had increased. I sent him home and told him to keep 

 quiet. 



At 12-25 inclement weather having brought me home unexpect- 

 edly I found him sitting on my doorstep, his clothes saturated with 

 blood, and his finger bleeding copiously. He had been there 

 fifteen minutes. He must have lost at least a pint and a half of 

 blood where he sat. The bleeding he said came on suddenly whilst 

 lie was asleep. I controlled the bleeding as best I could with 



