*llte POISONOUS SNAKES OF INDIA. 14.0 



Attention mnst always be directed to any attendant syncope 

 (see treatment of syncope, page 146), which is always likely to be 

 met with in viperine toxfemia. Treat wounds as under Daboia 

 (p. 143.) 



No antivenene has been prepared against these venoms, and that 

 prepared from cobra veiiom has been shoM-n by Lamb to be 

 inoperative against at least one of these vipers, viz. Laohesis 

 graminms. 



(6) Treatment to be adopted by Non-professional People. 



To recapitulate, in being confronted with a case of supposed 

 snake-bite, the first thing to decide is whether it is a case of snake- 

 poisoning. In this decision be guided entirely by the local con- 

 ditions, the pain, the swelling, and discharge of bloody serum from 

 the wounds (p. 103). Usually the pain is so instantaneous, severe, 

 stinging and persistent in character that this alone Avill proclaim 

 the injection of venom. If moderate and transient, its existence 

 may be dismissed in the absence of swelling and bleedicg. The 

 aching pain of a ligature will mask the usual characters of pain due 

 to poison. Swelling in a poisoned wound conies on in a few seconds, 

 or minutes, and increases progressively for hours. If a ligature has 

 bsen applied this symptom may be masked, the whole limits below 

 the ligature becoming tumefied. Absence of swelling is sufficient 

 justification to believe poison has not gained entry. If the punc- 

 tures are not sealed up in a few minutes, but continue to discharge 

 blood or bloody serum there can be- no doubt as to the injection of 

 venom. Any one of these signs points to poisoning. 



Next if a diagnosis of snake-bite is made, and snake-poisoning 

 negatived, keep the patient under close observation, seek to al\aj any 

 apprehension he may feel, and reassure him as to his fate with 

 every confidence. Take special note of his surface temperature at 

 frequent intervals, so that any impending faintness may be dis- 

 covered early, and the measures laid down on pages 146 to 149 

 resorted to. It should liowevei' be born in mind that if antivenene 

 is used it should only be injected subcutaneously by the layman 

 and not intravenously. Above all give no alcohol. 



If one's decision is one of snake-poisoning, -whether dubious or 

 certain, do not waste time with ligatures, but incise the poisoned 



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