172 
APPENDIX. 
Post-mortem, Examination at 6 a.m., or five hours after death —- I 
Rigor mortis well marked. Countenance placid. Nothing abnormal i 
could be noticed externally except a slight tumefaction of the bitten 
shoulder. The apertures formed by the fangs of the snake could not 
be seen with the naked eye, but on removing the skin extensive 
ecchymosis of the cellular tissue was disclosed around the bitten part. 
The blood was everywhere fluid and of a peculiar claret like colour. 
The large thoracic and abdominal veins were gorged, and all the 
cavities of the heart were distended with fluid blood. Roth lungs 
were much congested, and on making a section blood flowed freely 
from them. The liver, spleen, and kidneys were of a deeper colour 
than usual, but otherwise were healthy. The membranes of the brain 
were much congested, but only a small quantity of serum was found 
either external to that organ or in its ventricles. The brain substance 
was nowhere softened or diseased, but a section displayed numerous 
puncta cruenta. The post-mortem appearances in short were identical 
with those seen in the lower animals after Cobra bite, except that the 
blood did not coagulate on exposure to the air. On examining this 
fluid with the microscope magnifying 500 diameters, I was unable to 
observe any of the peculiar cell formations which are said by Professor 
Halford to be discernible in it after death from snake-bite. The 
white cells were not increased in numbers while the red corpuscles 
were to a great extent broken up and had coalesced so as to form 
bright-red amorphous masses. Many of them, however, had undergone 
no change. 
Case II.—On the 11th September last, at 4 p.m., one of my grass 
cutters named Futwah, a healthy young man about twenty-two years 
of age, whilst taking his pipe out of a hole in the stable wall, was 
bitten by a snake on the end of the middle finger. I saw him about 
ten minutes after the occurrence, when I found a ligature had been 
put round the finger, from the end of which blood was oozing freely. 
The epidermis being rough and horny, no distinct punctures could be 
seen. Pain was complained of in the finger, but there was no swelling 
beyond what was due to the ligature. The statement of the man 
regarding the appearance of the animal that had bitten him was at 
first rather puzzling, for he assured me most positively that he had 
seen it, and recognised it to be a Biscobra, a species of lizard, the bite 
of which is universally believed by natives to be more deadly than that 
of the Cobra itself; but the fallacy of this supposition need scarcely 
be pointed out, because it is well known that none of the Saurian 
reptiles possess poisonous properties. On questioning him further, 
and after examining the hole in the stable wall, it became evident that 
he could not possibly have seen more than a very small part of the 
animal, and judging from the absence of pain in the arm and the 
quantity of blood flowing from the wound, I concluded he had been 
bitten by some non-venomous species of snake, probably a Dliamin. 
As there was some doubt, however, on this point, the ligature was 
tightened and an escharotic applied, after which I left him. One 
hour afterwards, or about a quarter past five o’clock, I saw him again, 
when he said he was feeling intoxicated, and his appearance did not 
belie his statement. His eyelids drooped, but he could raise them on 
making an effort to do so ; he was unsteady on his legs, though he 
could still walk in a staggering sort of way ; he could speak with 
difficulty, and complained of a choking sensation in his throat, and of 
a pain shooting up the bitten arm and extending all over the body, 
as he expressed it. The pupils were slightly dilated, and contracted 
on the application of light; the pulse beat steadily and without inter¬ 
ruption, and its rate and force showed no deviation from the normal 
standard. There was perfect consciousness, and the patient, being 
aware of his dangerous condition, begged that one of his relatives, 
living a short distance off, might be sent for. The paralytic symptoms 
gradually increased until he could not walk; the choking feeling in 
the throat became intensified until it prevented him speaking or 
swallowing, but the pulse remained good, and he breathed freely, 
although somewhat quicker than usual. At 6 o’clock, while he was 
in this condition, 1 laid bare the basilic vein of the left arm, and 
injected into it twenty-five minims of the liquor ammonite of the 
strength of the British Pharmacopoeia. The operation seemed to rouse 
him a little, and increased the force and frequency of the heart’s action, 
but no beneficial change in the general symptoms could be observed. 
Dr. Ruttledge, of II.M. 5th Regiment, now saw him, and at his 
suggestion the actual cautery was applied to the back of the neck. 
At about 6.30 the breathing began to be embarrassed by phlegm or 
mucus falling into the rima glottidis, and much relief was obtained 
by putting him on his side so as to allow the fluid to trickle from the 
mouth. He made no attempt to clear his throat, from which I 
surmised he had not the power to do so. Little change in the 
symptoms occurred until 7.15, when he became very restless, and put 
his hands frequently to his throat. The breathing began to be 
laboured but not stertorous-, while the pulse continued regular and of 
a good force. The pupils were slightly dilated, and contracted slowly 
when a candle was brought near them. He was unable to speak, but 
appeared to be quite conscious, and waved his hand in the native 
fashion to indicate his dissent when told the injection of ammonia was 
about to be repeated. He also put his hands to his knees when asked 
to try and raise his legs. The latter seemed completely paralysed, 
while the arms could be moved with considerable freedom; and in this 
respect no difference could be noticed in the two arms. I was unable 
to elicit any signs of pain or of reflex action by pinching or tickling 
the legs, but the sensibility of the upper part of the body and arms 
was retained to a great extent, which was proved by the patient 
wincing when the actual cautery was applied, and also when the skin 
was cut for the purpose of exposing the vein. The sense of hearing 
remained intact almost to the last. Vision did not seem to be impaired, 
but from his losing the power of speech so soon, it was impossible to 
determine this point. The sense of taste was not tested. At 7.30, 
although the state of the circulation did not seem to demand it, twenty- 
five minims more of the liquor ammonise were injected into the basilic 
vein without producing any effect. Shortly after—8 p.m. —saliva 
began to flow profusely from the mouth, the breathing became slow'd’ 
and slower, and at last stopped altogether. Perceiving that he was 
on the point of death, I thrust the nozzle of the syringe through the 
wall of the thorax and injected twenty-five minims of liquor ammonite 
into the right ventricle of the heart, and with the aid of attendants 
kept up artificial respiration until that organ ceased to beat. This 
occurred about two minutes after the respirations had stopped. Death 
took place in four horn’s after the infliction of the bite, and was not pre¬ 
ceded by convulsions or any involuntary action of the bladder or bowels. 
Post-mortem Examination at 7 a.m. on the 12th, or 11 hours after 
death. —Body well nourished. Countenance placid. Rigor mortis 
well marked. Middle finger slightly swollen. No distinct punctures 
could be seen. On removing the skin of the bitten finger, extensive 
serous infiltration was discovered. On opening the chest, the venous 
system was found to be gorged. All the cavities of the heart were 
distended with dark red fluid blood which, when looked at against the 
side of a white porcelain cup, had a peculiar claret like tint. The 
lungs were deeply congested, and on making a section of them blood 
poured from the cut surface as from a fresh wound. The mesenteric 
veins were congested, and the liver and spleen were of a deeper colour 
than usual. There was nothing remarkable about the other abdominal 
organs. There was much congestion of the brain and its membranes, 
but more particularly near the sulci between the convolutions. The 
substance of the cerebrum, cerebellum, optic thalami, and medulla 
oblongata was of normal consistence, and sections displayed numerous 
puncta cruenta. There was some effusion of serum on the surface of 
the brain, and a considerable quantity was found in the ventricles. 
The blood was everywhere fluid, and did not coagulate even when left 
exposed to the air for three days. The contents of the right ventricle, 
into which the liquor ammoniae was injected when the patient was in 
articulo mortis, were of a deep claret colour, and after standing for 
five minutes, threw clown a dark coloured precipitate, leaving the 
supernatant fluid quite clear. I failed to see with the microscope the 
changes described by Professor Halford. The white cells were not in 
abnormal numbers. Many of the red corpuscles had broken up and 
coalesced, while others preserved their usual rounded appearance with 
the characteristic central disc. 
Remarks. —It is unfortunate that in neither of these cases was the 
snake found, but I think there can be little doubt that the Punkah 
Cooly Dahee was bitten by a Cobra, which, judging from the state¬ 
ment of the man and the distance by which the punctures were 
separated, must have been a large one. 
The grass cutter was probably killed by a small Cobra or a Krait 
(Bungarus cceruleus), but it could not be found, although a large part 
of the wall of the stable was pulled down in searching for it. 
Many Cobras and Ivraits were killed or seen in my own compound 
and in those adjoining it, during the hot and rainy seasons of last 
year, while as far as I am aware no other poisonous species is met with 
in Moradabad or its neighbourhood. 
(The Cobra is doubtless the most deadly snake in the North-west 
Provinces and gives rise to more mortality than any other species ; 
but the Krait, while it is scarcely less venomous, is found in much 
greater numbers. Indeed, as far as my observations go, it would 
appear to be much the most common snake either venomous or non- 
venomous met with in these provinces, yet strange to say very few 
natives or Europeans are able to recognise it. 
Natives sometimes apply to it the comprehensive name of “ Kala 
Samp,” which includes both the Cobra and the Krait, and in some 
parts of the country it is called “ Kowreeala” from the presumed 
resemblance of the white transverse bars on its back to Kowries. 
It is much more nimble and active in its habits than the Cobra, and 
finds less, difficulty in escaping when alarmed, to which circumstance 
may be attributed the smaller number of its victims. Snake-charmers 
are very chary of handling it, and drop it quickly whenever it turns its 
head towards them or shows the slightest sign of being angry.) 
The symptoms exhibited by the two men corresponded in a great 
measure—indeed, I may say they were almost identical—with those 
witnessed in the lower animals when under the influence of Cobra 
poison, but it is interesting to note that neither of them lost con¬ 
sciousness until within a few minutes of their death. 
