THE POISONOUS SNAKES OF INDIA. 143 



We have seen there are two distinct tj-pes of toxasnAas produced 

 by this snake. Being a colubrine species paralysis of the respira- 

 tory centre is to be feared, and early death will be attributable, to this 

 action, to undo which nothing short of a specific antivenene* 

 will avail. As there is no suitable antivenene prepared the case 

 should be treated on general principles in the hope that the respira- 

 tory centre will escape complete paralysis. The toxic elements in 

 cobra, and cwruleus venom that stimulate the heart are absent in 

 this venom so that syncope is likely to occur (see treatment of 

 syncope, p. 146). In the chronic form of poisoning we can do 

 nothing, but maintain the patient's strength, keep him warm, and 

 remove depressing influences of every kind. Treat wounds as 

 under Daboia (p. 143.) 



Treatment of Daboia Poisoning. 



The polyvalent antivenene prepared at Kasauli is a specific against 

 this toxtemia, and if administered as already indicated under the 

 treatment of cobra poisoning all cases should recover from the acute 

 stage. In this toxaBmia, however, there is great nervous depression, 

 which, with the weakening eff'ects of haemorrhages, if not controlled 

 produce a great tendency to syncope. This syncope should receive 

 every attention or death may occur from this cause in spite of a 

 sufiicient dose of an active antivenene. Pituitrin, adrenalin, and 

 calcium are to be relied upon to control the haemorrhages visible 

 and invisible (See pages 138 and 139). Extensive excision and the- 

 application of permanganate may reduce a lethal to a sublethal dose' 

 and should be practised. 



In the subacute or chronic condition it seems dubious whether 

 the symptoms are directly attributable to the venom, and it is quite 

 likely that they may be simply the result of infective germs. At 

 any rate it is imperative that the local wounds should receive the 

 most careful attention. After incision and permanganate the' 

 wounds should be aseptically dressed. It would be even ^viser to 

 concede the gi-eat probability of infective germs being present, and 

 treat the wounds antiseptically, and when sloughing of the parts 

 has actually occurred this is all the more imperative. The best 

 treatment probably one can adopt is to inject peroxide of hydrogen 



* Lamb tested the efficacy of antivenene as no-sv prepared against this poisoning 

 and found it useless. 



