l46 THE POISONOUS SNAKES OF INDIA. 



tissues freely and apply permanganate crystals moistened with 

 water, remeiiibering that the larger the amount of surface exposed 

 to the action of the salt the larger will be the amount of poison 

 neu.tralised. Make your incisions therefore a series of parallel 

 slices, and cut in the length of the limb to avoid wounding large 

 blood vessels as far as possible. Let the wounds bleed freely. Put 

 the patient to bed, and keep him warm, and treat any tendency to 

 faintness as laid down on pages 146 to 149. Avoid alcohol. 

 Dress the wounds aseptically. See Daboia, p. 143. These are 

 general rules to be observed by ordinary non-professional people. 



The special treatment for cases where a poisonous snake accom- 

 panies the bitten subject has been already discussed. 



Where it is obvious that a poisonous wound has been inflicted, 

 but the culprit escaped destruction, it is justifiable, I think, to inject 

 antivenene, as the cobra and daboia are such common snakes. In 

 \\-atching the progress of a case if paralytic symptoms begin to 

 appear, the injection of antivenene subcutaneously is all the more 

 justifiable, if not actual!}' imperative. If no paralytic symptoms 

 come on before six hours, there is considerable probability that the 

 culprit was not a colubrine snake. 



Bloody discharges in the absence of paralytic symptoms make it 

 more and more probable as time elapses that the culprit was a 

 viperine snake, and after six hours if measures to prevent bleeding 

 have not been up till then commenced, these should be no longer 

 deferred, see remarks on calcium (p. 138), adrenalin (p. 139), 

 pituitrin (p. 139), and antivenene should be injected on the chance 

 that the snake was a Daboia. 



(3) Syncope and its Treatment. 



Reference has been frequently made in the foregoing pages to 

 the effects of pain, and the emotions upon the heart. Among the 

 latter we may include the shock sustained by a timid individual 

 in merely seeing a snake. A bite from so repulsive an object 

 •will certainly accentuate that shock as will also the sight of blood 

 and the pain from the wounds it may inflict. Later the knowledge 

 that many snakes are venomous, and even deadly leads to a natural 

 anxiety, which may be intensified to actual fear of the possible 

 consequences. 



