ON THE TREATMENT OF SNAKE BITE. 
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have set in, either when the ligature and excision, or caustic or 
cautery have failed, or when they have not been used, I believe 
that the most rational treatment is to support life by artificial 
respiration when that is failing, to endeavour to rouse the 
sinking energies, and arrest the tendency to fatal paralysis of 
the nerve force, by the aid of alcohol or other stimulants, such 
as ammonia or ether, judiciously administered, avoiding any¬ 
thing that can depress, such as over-exertion or fatigue, espe¬ 
cially that produced by the popular practice of making the 
sufferer walk when his force is almost expended, and to en¬ 
courage elimination of the poison by the natural emunctories 
of the body. Brandy or whisky, indeed any form of alcohol, 
may be given freely and frequently, though not in the large 
quantities sometimes recommended. Gfalvanism may also be 
of service along the spine, to the solar plexus or to the 
heart; in certain cases cold douches may be useful. Hot 
bottles and sinapisms may be applied, and every encourage¬ 
ment should be given to the sufferer, for much of the de¬ 
pression depends on mental causes. I have seen a strong 
man who appeared almost at the point of death (from fright) 
recover in a very short time when I told him that the snake 
that had bitten him was innocent, and let it take hold of my 
finger to prove it so. So that, whatever can be done to remove 
this element of depression, should be done by encouragement 
and assurance of safety (when the snake is found to have been 
innocent or weak), and in other cases, by holding out hopes of 
recovery, which not unfrequently takes place, not because anti¬ 
dotes have been given, but because the bite has been imperfect 
or the snake incompetent; and no doubt the recovery may be 
aided and expedited by treatment such as I have described. 
Experiments made by keeping up artificial respiration after 
inoculation with snake-poison, have seemed to warrant farther 
investigation. The practical value of this proceeding, however, 
in the treatment of snake-bite has yet to be determined. In 
the sequel I have put on record the results of the experiments 
with artificial respiration made by Hr. Brunton and myself and 
other observers on animals bitten or inoculated with the venom. 
It will be inferred from what I have said that I put little faith 
in any of the so-called antidotes. My views of the treatment of 
snake-bite are, that if the early endeavours to prevent the entry 
of the poison into the system are unsuccessful, as unfortunately 
is too frequently the case, our reliance must be placed on sup¬ 
porting the strength with alcoholic, ammoniacal, or ethereal 
stimulants, and by treating consecutive mischief of constitu¬ 
tional or local character by such combination of remedial 
measures as the peculiar symptoms may suggest. My belief 
is that if a certain quantity of the poison have entered the 
circulation we can expect but little benefit from treatment of 
any kind; where less has entered, yet enough to cause dan¬ 
gerous present and consecutive symptoms, we may do much to 
support the strength and save life by ordinary rational mea¬ 
sures. But that we possess any drug or substance, solid or 
fluid, that either swallowed or inoculated, can counteract or 
neutralize the poison once absorbed, and acting on the nerve 
centres, I do not believe, and I think the notion that we do is 
a dangerous one, and liable to do harm by inspiring confidence 
in ways and means in which none should be placed. I have 
already explained how snake-bites may occur, and yet the bitten 
person may not be poisoned at all, or so slightly as to leave it 
quite possible that recovery may take place. In such cases, 
recovery is due mainly to the inherent vigour of the individual, 
and in part no doubt to treatment. It is also my belief that 
a large proportion of such cases would recover without any 
treatment at all, though in some the judicious use of remedies 
may turn the balance in the patient’s favour. I neither wish 
to discourage treatment nor to throw cold water on investiga¬ 
tion, but merely to state the facts as I think they exist. 
It is well that the truth should be known, even though it be 
not what we could wish; and it is better that we should study 
preventive measures, and ascertain exactly how much we can do 
in those cases where our aid may be of avail, than that we 
should trust to measures which common sense and science alike 
should make us distrust. 
With reference to the subsequent effects, constitutional or 
local, they should be treated on ordinary surgical principles.* 
The strength should be supported by nutrients and wine, with 
such mineral or vegetable tonics as may seem appropriate. 
Collections of pus should be evacuated; the separation of 
sloughs aided by poultices and antiseptics, and the healing 
wounds dressed as other wounds of a similar form or character 
from other causes would be dressed and tended. 
Should symptoms of a pyaunic or septicsemic nature arise, we 
must treat them as we would do similar conditions arising under 
other circumstances. The result will depend on the extent of 
blood-poisoning and the vigour of the person. 
Although, from what I have said, it will be evident that in 
cases of real bites from the deadly forms of snake, our reliance 
is chiefly on early and preventive measures, and not on the so- 
called antidotes, I hope it will not be inferred that I mean we 
are altogether powerless; far from it! I believe that in a 
number of cases—and I have described them—we may be of 
use, and we can at all events alleviate suffering, give hope and 
confidence where we are justified in doing so, and do all that 
science and common sense suggest as likely to be of service. 
The plan suggested by Hr. Halford, of Melbourne, of injecting 
ammonia into the veins, does certainly seem more rational than 
most suggestions that have been made, and I regret exceed¬ 
ingly that in my own experiments it has proved of no avail. 
The reason may, indeed, be in the greater virulence of the 
Indian Thanatophidia, and this may be the explanation of my 
failure, where Hr. Halford has found success. But, after all, 
the more venomous snake is the most crucial test. I would say 
the same in reference to the similar use of the liquor potassse 
by Hr. Shortt, in Madras. He, I believe, does not attach the 
same amount of importance to it as Hr. Halford does to the 
ammonia. In my researches both have been equally powerless, 
and I confess that I have felt much disappointed that expe¬ 
rience has not confirmed the benefit of what certainly were 
rational suggestions by authorities to whom science is deeply 
indebted for much valuable information, and most earnest 
investigation into an important subject. 
I would summarize the treatment of snake-bite as follows:— 
Apply, at once, a ligature, or ligatures, at intervals of a few 
inches, as tight as you can possibly tie them; and tighten 
the one nearest to the wound, by twisting it with a stick or 
other such agent. Scarify the wound, and let it bleed freely. 
Apply either a hot iron or live-coal, or explode some gunpowder 
on the part; or apply either carbolic or some mineral acid, or 
caustic. Let the patient suck the wound whilst you are getting 
the cautery ready, or if any one else will run the risk, let him 
do it. 
If the bite be on a toe or finger, especially if the snake 
have been recognised as a deadly one, either completely excise, 
or immediately amputate at the next joint. If the bite be on 
another part, where a ligature cannot be applied, or indeed if it 
be on the limbs above the toes or fingers, cut the part out at 
once completely. 
Let the patient be quiet. Ho not fatigue him by exertion. 
When, or even before symptoms of poisoning make their appear¬ 
ance, give eau-de-luce, or liquor ammonim, or carbonate of am¬ 
monia, or even better than these, hot spirits and water. There 
* Since the above was written (first edition) the subject has undergone further 
investigation by myself and Dr. Lauder Brunton, and a Committee has been 
appointed by the Government of India, in Calcutta, to carry out our suggestions 
that artificial respiration should be tried in India, as it has had the effect of 
prolonging life in snake poisoning in our experiments here. The subject will be 
found dealt with in detail in subsequent pages. 
