Chemical destruction of the poison is a possibility, but it is seldom that the required agent is at hand. The best of these are a 5-per-cent. solution of manganate of potassium and strong am monia. Either of these may be injected into the wound with an hypodermic syringe.
Subcutaneous injection of a solution of permanganate of potassium both around and into the bite recommended in the treatment of snake-bites. In very poisonous varieties a 5-per-cent. solution may be necessary. In adder-bites Dr. Sallden, a ,Swedish physician, has found a 1-per-cent. solution sufficient. The in jection must be given as soon as possible. Ligation of the bitten limb will retard the absorption of the virus, but not over twenty-five minutes. Lacerda (Indian Lancet, .Tu]y 1, '97).
One or several ligatures should he placed above the wound, followed perhaps by deep scarifications; then injection of antivenene, if at hand. If the latter can not be had, injections should be made of a solution of hypoehlorite of lime, 1 to GO. at several points near the bite and elsewhere. Stimulation, if necessary, by either strychnine or atropine or alcohol; hypodermoclysis of physiological saline solutions; lavage of the stomach: arti ficial respiration for hours; and, not least of all, eontinnous encouragement of the victim. for a deep mental prostration goes together with the physical depression of the nervous centres. Gustav Langmann (\ied. Record. Sept. 13, BOO).
Nitrate of potassium neutralizes venom of snakes and venomous insects. After sucking the part bitten thoroughly (the poison is not nearly so dangerous in the mouth or stomach as in the wound) and applying a bandage tightly between the wound and the heart, 1 tablespoonful of pulverized saltpeter, dissolved in a glass of water, is given. To a child under ten years, 1 teaspoonful is enough. If the first dose is vomited, the dose is renewed.
Either whisky, aromatic spirit of am monia, ammonia, or sulphuric ether, strychnine, etc., given hypodermically, should be used as stimulant. F. How ard (St. Louis Med. Era, Oet., 1900).
Cardiac stimulants, digitalis and alco hol, by the mouth are important ad juvants, but their stimulating effects are not obtained with large doses, as is well known. A tablespoonful of whisky or brandy and 10 drops of tincture of dig italis in a half-glassful of hot water is an excellent means to sustain the heart's action, the pulse being the guide.
It has long been known that the bile of venomous serpents was a powerful antidote to the venom. It is now, how ever, the rule, according to Fraser, that the bile of any particular species is most efficient against its own venom; thus, the bile of the crotalus and several other species is more efficient against cobra venom than that of the cobra itself. If, instead of venom, the toxins of infec tious disease be employed, it is found that the bile is a more or less efficient antitoxin. This quality is shared, how
ever, by the bile of rabbits, and to a less degree by that of many other animals. As toxins and venom are excreted by the intestinal tract, the bile is most favor ably situated for acting upon them, and remedies, therefore, stimulating hepatic secretion should increase the resistance of the animal. Moreover, toxins intro duced into or generated in the intes tinal tract are those neutralized. It is probable that the particular constituent is, in part, antitoxin or antivenom that has been eliminated from the blood into the bile. Calmette, on the other hand, considers that the active principle in the venom of all snakes and other poisonous reptiles, lizards, scorpions, etc., is a serum common to all, which would munize, therefore, against all these alike.
The an tivenomous serum personally discovered and prepared. It antagonizes the action of all venomous poisons, and the reason certain others have not se cured results equally as good is that they have not taken into full account the difference in weight between the ani mals experimented upon, and have there fore not used the serum in doses propor tionate to the weights and resisting power of the animals employed. In spite of adverse criticism it is main tained that the serum of an animal hypervaccinated against a very active venom can, when injected in a sufficient quantity, prevent the death of an animal inoculated with fatal doses of venom of other serpents. Calmette (Brit. Med. Jour., May 14, 'OS).
Report of several cases of snake-bite treated with antivenene, with recovery. In the ease of a boy, aged 12 years, for instance, bitten in the finger in the early morning by a krait, most acute symp toms supervened, including protrusion of the eyeballs, ptosis of both eyelids, and cedema of the glottis. The patient soon sank into a state of lethargy and col lapse, and his condition was apparently hopeless. Twelve cubic centimetres of Calmette's antivenene were injected hypodermically, also grain of strych nine. Enemata of brandy and beef-tea were administered, and artificial respira tion was kept up for half an hour. From this period onward recovery was rapid and uninterrupted. The cedema, paral ysis, and blindness disappeared in forty eight hours, but diplopia of the left eye persisted for several days. Editorial (In dian Med. Record, Jan. 10, 1900).
Experiments on dogs in order to test the efficacy of antivenene against the bite of the black Indian cobra. Though the antivenene was injected immediately after the bite, in no case was there the least benefit noted. As soon as the cobra poison began to act, the symptoms followed in the same regnlar sequence till death, controls and injected dogs dying alike within an hour. Carr-White (Indian Med. (#az., Nov., 1902). •