'.-V 
SECTION III. 
ON THE TREATMENT OF SNAKE-BITE. 
Snake-poison produces fatal or deleterious effects, either by 
completely paralysing the nerve centres, and thus causing rapid 
dissolution, or by partially paralysing them, and poisoning the 
blood, thereby inducing pathological conditions of a secondary 
nature, which may, according to circumstances, cause the 
slightest or the most dangerous symptoms. 
The effect produced depends on two sets of conditions: first, 
the species of the snake; its actual state at the time, the 
quantity and quality of its poison, and the circumstances under 
which it inflicts the bite; second, the species, size, and vigour 
of the living creature, and the circumstances under which it is 
bitten. 
Snake-poison is essentially a neurotic, and when it takes full 
effect, it kills by annihilating, in some unknown way, the 
source of nerve force. 
It is also an irritant, for, if applied to a mucous membrane, 
or to the conjunctiva, it causes violent inflammation, absorption 
at the same time takes place, and symptoms of poisoning are 
produced. 
It is also, to a certain extent, a septic, for if the bitten 
creature survive, the wound and the parts about it are apt to 
slough and to induce septicaemia. The poison acts by absorp¬ 
tion, that is, by entering the circulation, and so reaching the 
nerve centres, it produces, according to the quantity or intensity 
of the venom, either death, or severe local and constitutional 
symptoms. If it find entry by a large vein, such as the femoral 
or jugular, life may be destroyed in a few seconds. 
The blood itself is affected by the poison. I have not been 
able to detect any corpuscular changes, such as those described 
by Professor Halford, nor have I any exact information on the 
chemical changes it undergoes or may have undergone; but 
that it is altered there can he no doubt; and in poisoning of 
the lowei animals, at all events by the Viperidce , its coagula¬ 
bility after death is generally destroyed, whilst after death by 
poisoning by the colubrine snakes the blood generally coagu¬ 
lates. 
As the blood is the channel through which the poison acts, 
it is obvious that the first object should be to arrest, destroy, or 
prevent its entry into the circulation, or, if it have already 
entered, to neutralize or counteract its action, or to procure its 
elimination by the agency of the natural depurating organs and 
their secretions, and to treat local, consecutive, and constitu¬ 
tional symptoms by such remedial measures as may be required 
by the patient’s condition. Absorption takes place with extreme 
rapidity; so fast, indeed, that it was formerly supposed in the 
case of some of the more active poisons, that they acted by 
transmission of a shock through the nervous system; and so 
far as we know at present, it is not improbable that such in 
some instances may be the case. But rapid as the effect of 
snake-bite sometimes is, there is no reason to believe that gene¬ 
rally it operates on the nerve centres through any other channel 
than that of the vascular system. 
The experiments of Blake, Hering, and later of Claude 
Bernard, show that absorption takes place with such rapidity 
as to explain the most rapid deaths from such cause. Blake 
{vide Guy’s “ Forensic Medicine,” 3rd edition, p. 388) found 
that a poison passed from the jugular vein to the lungs of a 
dog in from four to six seconds, from the jugular vein to the 
coronary arteries of the heart in seven seconds; a poison 
injected into the jugular vein was distributed throughout the 
circulation in nine seconds. Claude Bernard found that a » 
saturated solution of sulphuretted hydrogen introduced into 
the jugular vein of a dog began to he eliminated from the lungs 
in three seconds, and when injected into the femoral vein of the 
same dog in six seconds. 
I have neither seen nor heard of any case of snake-poisoning, 
in man or the lower animals, so rapid—though in some I 
have observed the first symptoms in a few seconds—as to 
justify the conclusion that poisoning had occurred otherwise 
than through the medium of the circulation. 
Such being the rapidity of the absorption and action of the 
poison, it is obvious that if the means, whatever they may be, 
of destroying or arresting its entry, be not applied immediately, 
but little benefit can be expected from them. If more than a 
few seconds have elapsed, we can only hope by these measures 
to prevent the entry of so much of the poison as may be diffused 
in the areolar tissue surrounding the bitten spot. 
As the chief hope of safety lies in preventing the entry of 
any poison at all into the circulation, the earlier appropriate 
measures are resorted to the better is their chance of success. 
These I will now describe. 
The Ligature.—This, if applied immediately at a little dis¬ 
tance above the bitten part, may not only arrest the entry of 
the poison into the circulation, but may also prevent its diffu¬ 
sion m the areolar tissue m a centric direction. The efficacy 
of this method of treatment has long been recognised by the 
natives of India, who apply it, not just above the bite 
only, but at several places on the limb at intervals of some 
inches, lliere is reason to believe that if this be done without 
delay, the course of the poison may sometimes be stayed and 
life saved. Not long ago I saw a professional snake-charmer 
in the employ of the King of Oude, who said that he had been 
bitten in the finger by a fresh Cobra. A ligature was imme¬ 
diately tied in three or four places above the bite, and though 
he suffered constitutionally to some extent, he had escaped 
with life. His finger, however, was shrunk and anchylosed, 
owing to excessive burning, the result of fire which was applied 
in the form of live-coal, until the tendon shrivelled and was 
destroyed. 
The danger and difficulty lie m not applying the ligature 
quickly enough. The confusion and alarm caused by the bite, 
the brief time that must elapse before the simplest ligature can 
he improvised, are certain to cause dangerous delay; and with 
every second of time lost the danger increases. There is also 
the probability that the ligature may not be sufficiently tight¬ 
ened; no mercy therefore can be shown: it must be tightened 
to the utmost, or it will not effect its purpose, and the poison 
will enter and do its fatal work. A piece of the dress twisted, 
a bit of string, a strap, anything that can be made to enclose 
the limb or part, should be immediately applied, and should be 
strained to the uttermost by twisting with a piece of stick; nor 
should the tension cease until the circulation is entirely arrested, 
and the part is livid with the retained blood. 
The experiments I have made on the lower animals show not 
only how rapidly the poison enters, if the circulation be not 
immediately arrested, but also how difficult it is so thoroughly 
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