148 THE POISONOUS SNAKES OP INDIA. 



milk, tea, and black coffee are most comforting and beneficial. 

 To obtain the best results small quantities — a table spoonful or 

 two — every ten minutes or quarter of an hour should be given if 

 swallowing is possible. 



(2) Determining Hood to the starved centres. — The position of a 

 fainting person is most important. If the head is kept lower than 

 the body, and the legs flexed at right angles to the trunk, blood by 

 gravity alone will pass into the brain, and, supply the needful stimu- 

 lus to the centres. One may even more or less invert the patient 

 with this object in view. Again if the limbs are tightly bandaged 

 from below upwards, their contained blood small, though it may be, 

 will be expressed, and conserved for the heart to act upon, and 

 drive into the brain. Further a tight broad abdominal binder such 

 as ■we appl}^ after confinement will greatly assist in this direction. 



(3) Direct stimulation to the heart muscle. — The following drugs 

 will act in this direction and are best administered by hypodermic 

 injection. Pituitary extract one cubic centimetre (18 minims ) 

 every four hours intramuscularly, adrenalin chloride in ten minim 

 doses, or digitalin 1/130 of a grain. Half these doses every two 

 hours may prove more satisfactory. 



(4) Restoration of general Mood i>ressnre. — The drugs pituitary 

 extract, adrenalin chloride, and ergot, bj- constricting the blood 

 vessels increase blood pressure and indirectly reinforce the heart. 

 Ergot may be given intramuscularly in the form of ergone, or citrate 

 of ergotine in jJq to Jj grain doses, or as tyramine in ^ grain doses. 

 Saline injections of various sorts also act powerfullj-, though less 

 speedily in restoring the lost blood pressure. The best method for 

 the layman is by the rectum, an enema syringe being introduced 

 into the rectum, and salt solution allowed to gravitate into the bowel. 

 It should not be pumped in. The salt solution should be warm 

 (100 F.), and of the strength of one and a half teaspoonfuls to the 

 pint. One pint is allowed to flow in from a vessel attached to the 

 tube, and the vessel held not higher than one foot above the level of 

 the patient's anus. Other methods of saline infusion open to the 

 phj'sician are subcutaneous injections, intravenous injections, and 

 proctolysis. 



