LORQUINIA 
29 
The majority of the would-be cures have proved ineffectual because 
the originators were ignorant of the toxicological properties of the 
peculiar venom for which an antidote was sought. 
The venom of the Rattlesnake, "Crotalus," is the only one which 
will be considered, as the other venoms have chemical differences 
which cannot be considered, but the method of treatment is identical. 
When the snake strikes, the venom is injected subcutaneously by the 
fangs, which are slightly curved and resemble a very sharp hypo- 
dermic needle with the opening on the side, just above the point. 
The active principle, crotalin, is alkaloidal. The alkaloid contains 
three constituents, a peptone which is neurotoxic and causes paralysis 
of the efferent or motary nerve centers. The climax of this action is 
paralysis of the respiratory organs, and the patient dies from inability 
to breathe. The external symptoms will be shortness of breath and 
soon cyanosis or a blue discoloration of the skin. The second con- 
stituent is a globulin having a hemolytic action. This destroys the 
power of coagulation in the blood and extravasation, or a hemorrhage 
in which the blood escapes from the vessels into the rest of the body, 
sets in. The third constituent is a fibrin ferment causing gangrene, 
and resulting in death from mortification of the affected parts. This 
may not appear until later. 
In treating snakebite, "Preparedness" is the keystone of success. 
The operator should have a good knowledge of anatomy, with special 
reference to the circulation, the more complete the better. Keep cool 
and don't let the patient get excited. More cases die of hysteria 
than poison. Let whiskey alone. More cases have been lost than 
cured by the use of alcohol, which depresses the whole system. Anti- 
venin is undoubtedly the ideal treatment, but at present the antivenins 
of Calmette, Flexner, Noguchi and Brazil are all monovalent and a 
different one must be carried for each species of snake. Antivenins 
are also not sold on the open market and must be obtained from the 
maker. The H. K. Mnlford Co. expect to put a polyvalent antivenin 
on the market soon. In the antivenin treatment, one or more in- 
jections are given as required, and as the solution is shipped in sterile 
glass hypodermics containing the required dose, treatment is simple. 
In the absence of antivenin, use potassium permanganate, which 
will oxidize the poison to harmless compounds if used soon enough. 
Tie any kind of a ligature loosely between the wound and heart, put 
a stick .through the ligature and twist it to tighten. With a sharp, 
sterile blade cut across the wound both ways and allow it to bleed 
moderately. Inject two or three hypodermics of potassium perman- 
ganate solution in and around the wound. If the patient shows 
marked depression of circulation, use strychnine in the hypodermic. 
If the pain due to ligature cutting off the circulation is marked, par- 
tially loosen it for a few minutes, as keeping it tight too long may 
