API DM 



111 



With regard to the last, Morgenroth and Carpi have shown that 

 a lecithide is formed which is 200 to 500 times more hsemolytic 

 than the venom alone. There is, therefore, a similarity between 

 this poison and cobra-venom. 



The only marked features recorded in human post-mortems are 

 hyperaemia of the meninges and bloody exudation into the ventricles 

 of the brain. 



Immunity. — ^There appears to be no doubt that bee-keepers 

 often attain a considerable amount of immunity against the 

 venom. 



Thus, Langer says: Out of 164 bee-keepers, 11 were immune 

 from the first; while of the 153 at first sensitive, 126 became more 

 or less immune, and 27 did not. Of the 126 more or less immune 

 persons, 14 said that they Were not affected even when several 

 stings were inflicted quickly one after the other. 



Bee immunity, however, is only passing, and does not last, and 

 the keepers say that the first sting in the early part of the year may 

 produce a strong effect. 



Calmette has immunized a mouse, so that it could resist doses of 

 the venom which would surely have been mortal otherwise. 



The Effects of the Venom.— Usually the symptoms are merely 

 local, and limited to pain in the part, redness, and swelling of the 

 skin, and disappear in a few hours. Suppuration is rare, and blood- 

 poisoning very rare, only taking place occasionally if the sting is 

 on the eyes, ears, lips, or in feeble old people. 



Slight fever may result in sensitive people, and sometimes general 

 constitutional symptoms, such as nausea, faintness, great weakness, 

 vomiting, precordial distress, difficulty in breathing, coldness of 

 the extremities, with an eruption on the skin like measles, or with 

 wheals. These symptoms may pass on to delirium, unconscious- 

 ness, and more rarely death. 



Vespa orientalis causes semi-unconsciousness, the face becoming 

 pale and cyanosed, the skin of the extremities cold with a clammy 

 sweat; respiration becomes shallow and sighing; the pulse quick 

 (130 to 140), irregular, and barely perceptible. On recovery from 

 this state of shock, the patient complains of a sensation of tightness 

 in the throat, and oedema may develop in the neck and face, as 

 well as slight fever (100° to 102° F.), all symptoms disappearing in 

 twenty-four hours. 



The ordinary bee may at times cause severe symptoms, of which 

 the following is an example: a lady was stung in the forehead, 

 and in four minutes swelling of the eyelids and lips began, which 

 rapidly spread to the arms, and was associated with acute abdominal 

 pain. The hands became rigid in the position of main en griffc, 

 and pain and stiffness was felt in the throat, together v/ith difficulty 

 in speaking. There was also vomiting and a sense of chilliness, 

 followed by exhaustion. Recovery was rapid. 



Diagnosis,— There is usually no difficulty in this, the history 

 being clear.- 



