POISONED WOUNDS, 145 
elastic cord is preferable to all others ; if one is not at hand, a tourniquet 
may be improvised with a piece of cord or a twisted handkerchief 
which is tied and twisted with a piece of stick, a key or the handle of a 
pocket knife.. This ligature in place, attention should be directed 
towards the wound. It should be carefully washed with cold water; 
often it may be enlarged advantageously ; its edges should be compressed 
to expel the venom which may be infiltrated in the tissues and which 
may be removed with another washing; if the fang of the adder has 
remained in the wound, it must be extracted. Hemorrhage is beneficial ; 
the blood washes the wound and removes a certain quantity of the 
venom. Suction of the wound might be made without bad results ; the 
venom has no toxic action on mucous membranes, This, however, is 
seldom used for animals. ‘The local treatment is completed by 
cauterization with a strong caustic (chromic, sulphuric, or nitric acid, 
chloride of zinc) or with the red hot iron. Light caustics (ammonia, 
nitrate of silver) are useless. 
If the borders of the wound are already inflamed, the same method 
should be pursued ; but it is good, besides, to make scarifications on 
the tumefied zone and to introduce into them antiseptic mixtures. 
The injections of carbolic acid, 3 p. c. (Waadt), 5 p.c. (Billroth), of 
solutions of permanganate of potassium 1 p. c, or of chromic acid 
(Kaufmann) may prevent local troubles or diminish them should they 
already exist. The numerous specifics recommended here and in 
foreign countries have not given what they promised; it is better to 
hold on to those which possess known properties. For general treatment, 
one should have recourse to diffuse stimulants (wine, alcohol, ether, 
acetate of ammonia). In South America, drinking of alcohol to 
drunkenness is considered, for men, an excellent means to prevent 
death. Hypodermic injections of strychnine (Muller) have also given 
satisfactory results; the ligature or tourniquet should not remain 
more than six or eight hours, if one would avoid gangrenous complica- 
tions. 
Venomous wounds of some arachnida (scorpions, tarantula) are 
treated in the same way. 
For bites of adders or snakes, as for injections, prophylaxis has been 
studied. At first it was observed that the organism seems to accustom 
itself to the action of the toxic: repeated injections of small doses 
seemed to allow it to resist better large doses; nevertheless, these still 
had sufficient power to kill. (Kaufmann, Calmette, Phisalix and 
Bertrand) ; later, from this it was found possible to confer on animals 
immunity from the venom of snakes. The serum of animals thus 
rendered proof against poison is antitoxic. : 
Stings made by dees, wasps, or hornets are accompanied | with great 
pains and a large diffuse swelling, at times quite extensive ; but in 
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