lymph for several hours. The real danger lies in making an insufficient 
number of incisions rather than too many. Should there be any doubt as 
to the number made, one shculd doubiec reine amount rather than be content: 
with the minimum. 
It is most highly advised to keep the bowels of the patient open 
and free, using an irrigation of salt and soda solution if necessary. 
Ri Special Directions for: the Physician 
It the victim has not received an injection of antivenin, it is 
important to inject the contents of one s¥ringe as soon as possible, 
At the same time, rclease the tourniquet, if one has been applied. 
Repeat the injections every one or two hours unless and until 
symptoms are markedly diminished. To hasten the absorption of the 
serum, intramuscular injections are advised, and, in severe cases and 
those seen late, intravenous injection is recommended. In small 
children when intravenous injection is difficult, the antivenin may be. 
given intraperitoneally, n shocked cases physiological salt solution 
injected intravenously end blood transfusion are supplementary measures 
of life-saving value. For weak pulse and threatened heart failure, give 
caffeine or strychnine. 
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If incisions have been made at of the bite, the wounds 
should be irrigated wath al or 2 t ution (not normal 
saline). The application of strong tion may be continued over these 
incisions, if the symptoms and condition of the paticnt indicate the 
necessity of pushing the treatment. Othorwise, apply a hot application 
of a 1:10,000 part solution of mercury bichloride or @ strong magnesium 
Sulphate solution. 
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xtra Precautions 
It sometimes happens thet after the first shock and reaction have 
passed, the petiont will show marked improvement. Some fatalities from 
snake Bae are plainly caused by an undue sense of security following 
the observation that most patients do weil for the first 15 hours; Even 
though the generel symptoms may be mild, it is important to kcep the 
patient under close observation for at least 24 hours, and activo tr 
ment should be continued as long as the swelling is progressing. Repea 
the aiden ons of antivenin every 1 or 2 hours if the swelling is increas— 
ing. The danger is always in under-treatment rether than in over—treatment. 

In treatment of snake—bite in children it is important to double the 
initial adult dosage, The reason for this is that a mathematical rela- 
tion exists between the weight of the body and the amount of venom that 
it can normally neutralize and dispose of without serious injury, al-— 
though the amount injected by the sneéke is approximately the same. The 
smaller and lighter the body of the victim, the less venom it can with— 
stand, and the greater the excess of venom over the normal body resist— 
ance. Therefore, if the victim is a young child, there is much more 
venom requiring neutralizetion by the serum. 
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