340 VENOMS 



" In the evening I saw my patient again. He was in bed, with a 

 temperature of 37'2° C. ; pulse 60 ; no malaise, no headache, no 

 further vomiting ; he had taken a little soup, and a small quantity 

 of alcoholic infusion of lime-tree flowers. He complained of his 

 leg, which was swollen as high as the knee ; the pain was greater 

 in the calf than at the malleolus. I applied a damp bandage. 

 The patient had a good night, and slept for several hours, but still 

 had pain in the leg. On the following morning, July 24, I found 

 him cheerful, with no fever, and hungry. Around the bite the 

 oedema had become considerable, and had extended to an equal 

 degree as high as the instep ; the calf and thigh were swollen, but 

 to a much less extent. I gave a second injection of 10 c.c. of anti- 

 venomous serum in the cellular tissue of the abdominal wall. The 

 day was good ; indeed, the patient had no fever at any time ; the 

 spots at which the injections were made were but very shghtly 

 sensitive on pressure. In the evening the general condition of the 

 patient was satisfactory ; he complained most of his calf. Thinking 

 that a contraction was possible, due to his having hopped along 

 quickly on one leg after the accident, I ordered him a bath. 



" On July 25, the second day after he was bitten, the only 

 symptom still exhibited by the patient was a somewhat consider- 

 able amount of oedema in the peri-malleolar region and lower third 

 of the leg. This oedema was slowly and gradually absorbed on the 

 following days. 



" Bemarlcs. — (1) At this season of the year viper-bites are both 

 frequent and dangerous in this district of the Loir-et-Cher. A year 

 never passes without several cases occurring, and it has very often 

 happened that deaths have had to be recorded in spite of the most 

 careful treatment. 



" (2) The therapeutic effect of Calmette's serum was rapid and 

 efficacious; the injections did not cause any pain or febrile reaction. 



" (3) The oedema resulting from the bite was a long time in being 

 absorbed ; this, indeed, was the only remarkable symptom after the 

 injection of the serum." 



