274 



VENOMOUS ANIMALS 



it to see whether it is poisonous or not, especially to see whether 

 there are fangs, and if non-poisonous, the patient's mind can be 

 relieved at once. 



Prognosis. 



It appears that only a relatively small percentage of persons 

 bitten by snakes (supposed to be poisonous) die. C. J. Martin and 

 Lamb place it about 30 per cent., but much depends upon the 

 quantity of venom injected and the rapidity with which symptoms 

 develop. The recoveries from full doses of echis-venom in un- 

 treated cases is about 40 per cent., and of cobra- venom only 3 to 

 4 per cent. Personally, we believe that in most cases if treatment 

 has been prompt, and the symptoms appear slowly, the outlook is 

 by no means hopeless. 



Treatment. 



Snake-poisoning consists in the hypodermic or intravascular 

 injection of a series of poisonous principles which act chiefly upon 

 the nervous system and the blood. 



The virulence of the poisoning depends upon the ratio of the 

 quantity of the poison injected to the size of the animal. The 

 same quantity of poison will therefore have a more serious effect 

 upon a child than upon an adult. The less the quantity of poison 

 which gets into the general circulation, the less the symptoms; 

 hence the first indication for treatment is to prevent the passage 

 of the poison, as far as possible, into the circulation. 



The second indication for treatment is to neutralize the poison 

 which has got into the system, and the third indication is to treat 

 special symptoms as they appear. 



I. Prevent the Poison getting into the General Circulation. — In 

 order to prevent the poison getting into the general circulation, 

 three points must be attended to 



(1) Stoppage of the flow of blood and lymph from the. 



affected area. 



(2) Free opening of the poisoned area. 



(3) The neutralization of the poison locally. 



(i) Stoppage of the Flow of Blood and Lymph from the Affected 

 Area. — person is usually bitten in the arm or leg, and in such a 

 case the old treatment advised by Celsus should be carried out by 

 applying a tight ligature round the affected limb on the proximal 

 side of the wound, so as to compress the blood and lymphatic vessels. 

 In order to do this successfully, the ligature must be applied to the 

 arm or the thigh' — i.e., where there is one bone — and not the fore- 

 arm or leg. 



Such a ligature cannot be left in position indefinitely, otherwise 

 gangrene will result; and after some attempts at neutralization of 

 the poison have been made, it must be loosened for a couple of 

 seconds and reapplied, and this must be repeated. It must be kept 

 on for at least twenty or thirty minutes. 



