554 
H. C. YARROW. 
applied and the incision made, and then if circumstances will ad¬ 
mit the following procedure, it is thought, will be the best. Cup¬ 
ping glasses should be applied over the wound, after which a 20 
per cent, solution of permanganate of potassa should be injected 
with a hyperdomic syringe directly into the wounded tissue and 
retained there by means of the finger or compress. The flesh 
should also be kneaded so as to distribute the solution through 
the tissues in the immediate vicinity of the bite. In addition the 
patient should be made to swallow 20 minims fluid extract of jab- 
orandi, or its alkaloid, pilocarpine, may be used hypodermically. 
If the venom appears to be gaining ground another injection of 
the permanganate may be given, followed by more of the jabor- 
andi, or pilocarpine, but the latter drug should be suspended when 
it is found the patient is perspiring freely and when excessive sal¬ 
ivation is produced. Carried too far this remedy would weaken 
instead of strengthening the heart. Whiskey or brandy may also 
be used in limited quantities from time to time. In the absence 
of any of the means suggested in the way of remedies the pri¬ 
mary fact to keep in mind is the importance of the ligature, inci¬ 
sion or scarifying the affected part, and the promotion of a free 
flow of blood. If nothing can be found to use as a cupping 
glass and no one is courageous enough to use the mouth, the old- 
fashioned country remedy of splitting open a live chicken and 
applying it over the wound may be tried, or, as has been tried in 
India with success, the anus of a chicken may be applied over 
the wound, using a number of different fowls for the purpose. 
The writer recommends these methods only because there is un¬ 
doubted evidence of their efficacy. A piece of porous clay might 
be applied, as it would doubtless act in the same manner as did 
the snake stone in our experiments. It is very important to re¬ 
member that the ligature or constricting band cannot be allowed 
to remain very long, as gangrene would inevitably result; it should 
be loosened from time to time so as to admit of a slight circula- 
tion through the affected part, and to permit a small amount of 
the venom only to enter the system, and the effect of this should 
be met by the administration of the remedies already indicated. 
In the case of a rapidly weakening heart, tincture digitalis in 15 
