September 1,
OjS" MALARIAL SITES AND FEVERS, &C.-BY JOHN MEREDITH.
1871.]
175
should act, to be of any service, in averting the entry of the poison into the circulation. The following are the notes made by the native doctor who saw him at the hospital:? When the patient came at i to 2 o'clock I found him quite Surgeon of Rawulinsensible, with a feeble pulse, and imperfect sighing respirafatal case of
FATAL CASE OF SNAKE BITE. By J. Fayeee, M.D., C.S.I.
"
I AM indebted to Dr. Aitcheson, Civil pindee, for the following particulars of a bite.
snake
tion ; he was cold, and his skin was moist. There were in the extremities, and both pupils were dilated. spasms A young man, European, aged 24, of robust and muscular " and minutes the
severe
In a few respiration having ceased, pulse having indulged rather freely in drink, returned he died. with his alone he took some servant, home, where, being He was quite insensible when admitted and did not speak. food and wine to drink. At about 11-30 p.m. on a bright A dose of liquor ammonise was administered, incisions were out for the purpose of went he to an moon-light night, going made in the swelling at the back of the right carpus, and a out-house in the compound ; on the path he saw a snake, was tied tightly round the arm." tape which he tried to seize; in making the attempt, it bit him in Dr. Aitcheson having been kind enough to send me the the hand. He called out to his servants that he had been snake, in spirits, I identify it, although much crushed about bitten; he then chased and caught the snake, which again bit the head and neck, as a dark-coloured variety of the Naja him twice on the hand ; he then threw it on the ground, and di capello), three feet seven inches in length, killed it by crushing its head with his heel. The servants tried Tripudians (cobra not full grown ; the head and neck so much injured and him to at once to the but to persuade he refused go hospital, shrunk in the spirit that it is not possible to say whether it to do so, and fully an hour was thus lost; he had meanhad the spectacle mark on the head, or not. while tied a handkerchief tightly round his arm, and said
frame,
after
his
to
that
"
was
sufficient.
In
about
an
hour
after
the
bite
he
suddenly complained of great pain in the head, told them to take him to the hospital, and began to become insensible. His servants carried him to the detachment hospital of the 23rd I., where there were no medicines; and thence to the hospital of the 25th N. I., where the native doctor, who administered some ammonia, states that he was almost dead on arrival, that his pupils were dilated, and that he died as two o'clock struck. On
carefully examining
his hands Dr. Aitcheson found
a
the dorsal aspect of the right hand between the metacarpal bones of the thumb and index finger; on the palmar aspect, distinct marks of two fangs, a quarter of an inch from the web between the thumb and index finger. The two wound
on
punctures here could not possibly be doubted. There was also a puncture at the base of the proximal phalanx of the middle finger, close to the web between the middle and ring finger. The right hand and arm up to the neck were swollen, As to the period as might be seen by comparing the two sides. of time that elapsed between the bite and death, Dr. Aitcheson ascertained by cross-examination of those who saw the patient, that it was, as stated, between 11-30 p.m. and 2 a.m., i. e. within 2| hours. He was a person who led
an irregular life; but there was stronger, healthier or better built young man in the station. Dr. Aitcheson remarks that there can be no doubt
not
a
that the
rapid
effect of the
due to the several all most evident. it shows how quickly the This is a very will prove fatal in man, if thoroughly poison of the cobra inoculated. From the unfortunate circumstances under which the accident occurred, no opportunity of any immediate treat-
bites by
an
poison they were interesting case, for
was
irritated snake ;
was affected, and the poison was thus enabled to enter the circulation and work its deadly effect without hindrance. The presence of alcohol in the sufferer's system does not appear to have had any antidotal action, for the full effects of the manifested, death occuring in 150 minutes. were
ment
rapidly poison It is possible that it might have occurred sooner had he not been excited by alcohol, but even as it was, death was fearfully rapid. Alcohol has been, and is recommended as both a prophylactic and an antidote in snake poisoning.' I fear that its utility is limited to its stimulant action, while it may, no doubt, be of gome service in bites that are not of so complete and deadly a character as they were in this instance. There is no reason to suppose that the handkerchief, he himself tied round his arm, could haye acted as a ligature
OjS" MALARIAL SITES AND FEVERS, &C.-BY JOHN MEREDITH.
1871.]
175
should act, to be of any service, in averting the entry of the poison into the circulation. The following are the notes made by the native doctor who saw him at the hospital:? When the patient came at i to 2 o'clock I found him quite Surgeon of Rawulinsensible, with a feeble pulse, and imperfect sighing respirafatal case of
FATAL CASE OF SNAKE BITE. By J. Fayeee, M.D., C.S.I.
"
I AM indebted to Dr. Aitcheson, Civil pindee, for the following particulars of a bite.
snake
tion ; he was cold, and his skin was moist. There were in the extremities, and both pupils were dilated. spasms A young man, European, aged 24, of robust and muscular " and minutes the
severe
In a few respiration having ceased, pulse having indulged rather freely in drink, returned he died. with his alone he took some servant, home, where, being He was quite insensible when admitted and did not speak. food and wine to drink. At about 11-30 p.m. on a bright A dose of liquor ammonise was administered, incisions were out for the purpose of went he to an moon-light night, going made in the swelling at the back of the right carpus, and a out-house in the compound ; on the path he saw a snake, was tied tightly round the arm." tape which he tried to seize; in making the attempt, it bit him in Dr. Aitcheson having been kind enough to send me the the hand. He called out to his servants that he had been snake, in spirits, I identify it, although much crushed about bitten; he then chased and caught the snake, which again bit the head and neck, as a dark-coloured variety of the Naja him twice on the hand ; he then threw it on the ground, and di capello), three feet seven inches in length, killed it by crushing its head with his heel. The servants tried Tripudians (cobra not full grown ; the head and neck so much injured and him to at once to the but to persuade he refused go hospital, shrunk in the spirit that it is not possible to say whether it to do so, and fully an hour was thus lost; he had meanhad the spectacle mark on the head, or not. while tied a handkerchief tightly round his arm, and said
frame,
after
his
to
that
"
was
sufficient.
In
about
an
hour
after
the
bite
he
suddenly complained of great pain in the head, told them to take him to the hospital, and began to become insensible. His servants carried him to the detachment hospital of the 23rd I., where there were no medicines; and thence to the hospital of the 25th N. I., where the native doctor, who administered some ammonia, states that he was almost dead on arrival, that his pupils were dilated, and that he died as two o'clock struck. On
carefully examining
his hands Dr. Aitcheson found
a
the dorsal aspect of the right hand between the metacarpal bones of the thumb and index finger; on the palmar aspect, distinct marks of two fangs, a quarter of an inch from the web between the thumb and index finger. The two wound
on
punctures here could not possibly be doubted. There was also a puncture at the base of the proximal phalanx of the middle finger, close to the web between the middle and ring finger. The right hand and arm up to the neck were swollen, As to the period as might be seen by comparing the two sides. of time that elapsed between the bite and death, Dr. Aitcheson ascertained by cross-examination of those who saw the patient, that it was, as stated, between 11-30 p.m. and 2 a.m., i. e. within 2| hours. He was a person who led
an irregular life; but there was stronger, healthier or better built young man in the station. Dr. Aitcheson remarks that there can be no doubt
not
a
that the
rapid
effect of the
due to the several all most evident. it shows how quickly the This is a very will prove fatal in man, if thoroughly poison of the cobra inoculated. From the unfortunate circumstances under which the accident occurred, no opportunity of any immediate treat-
bites by
an
poison they were interesting case, for
was
irritated snake ;
was affected, and the poison was thus enabled to enter the circulation and work its deadly effect without hindrance. The presence of alcohol in the sufferer's system does not appear to have had any antidotal action, for the full effects of the manifested, death occuring in 150 minutes. were
ment
rapidly poison It is possible that it might have occurred sooner had he not been excited by alcohol, but even as it was, death was fearfully rapid. Alcohol has been, and is recommended as both a prophylactic and an antidote in snake poisoning.' I fear that its utility is limited to its stimulant action, while it may, no doubt, be of gome service in bites that are not of so complete and deadly a character as they were in this instance. There is no reason to suppose that the handkerchief, he himself tied round his arm, could haye acted as a ligature
