SNAKE -VENOMS. 481 



vascular clotting, especially in the pulmonary arteries, is 

 the cause of the symptoms and rapid death in the acute 

 cases of viper poisoning. 



From, a study of Cunningham's paper, it will be seen 

 that he based his opinion solely on the interpretation of 

 symptoms, and his examinations were quite inadequate. 

 It is evident, then, that Cunningham did not observe, or 

 put no value on, the clotting which has such an important 

 bearing on the question. 



Regarding the cases of viper poisoning in which a fatal 

 issue is delayed, or in which even after grave symptoms 

 have developed, recovery takes place, we may divide the 

 symptoms into local and general. 



At the site, a few hours after the bite, a more or less 

 extensive subcutaneous haemorrhage has developed. 

 Around this there is a considerable exudation of serous 

 fluid. In other cases the patient may die rapidly from 

 spreading gangrene. The patient is dull, depressed, 

 refuses food, and the skin is cold. No - convulsions or 

 paralyses occar. The coagulability of ithe blood is 

 markedly diminished, and may remain so for some time ; 

 in cases of death it may absolutely refuse to clot.' 



The diminution in coagulability of the blood is no doubt 

 the chief factor in the causation of the symptoms in chronic 

 cases of daboia poisoning, especially of the haemorrhages 

 and serous infiltrations, and if this deficiency be at all 

 prolonged, the more likely will the case have a fatal issue. 

 This aspect of the action is in marked contrast to the 

 increased coagulability due to the rapid absorption of 

 large quantities, and resulting in rapid death from 

 asphyxia, due to clots in the pulmonary vessels. 



The manner in which this diminution of blood 

 coagulability is brought about is a problem whirl) has not 

 vet been solved. 



