mussels develops regularly, is either a mere truism, for everything under the sun develops regularly, or the sapient writer has some vague notion of an analogy existing between the above poisons and that of snakes. He is quite welcome to it, but takes a most unwarrantable liberty in saddling me with an idea, which I have never even hint6d at in any of my writings; (4) that snake poison may
Corrrapirdcitce. SNAKE-BITES. To the
Editor,
"
Indian Medical Gazette."
Sir.?Your leading article entitled snake-bites in the
October issue of your valuable paper contain some statements quoted from the Therapeutic Gazette for August 1894, which are falsely attributed to me by the latter journal. Will you kindly permit me to lodge the strongest possible protest against the crude and ill digested notions expressed therein as coming from me. So far from ever writing to the Therapeutic Gazette.1 do not even know in what part of the civilised world it is published, and to the best of my recollection have only seen one or two issues of it. It would appear that the bad habit of the ancient Hebrews, which caused fchem to write under other people's names with a view of procuring credence and acceptance for their writings, is not quite extinct, yet however desirable it is in the interests of honest journalism that it should be. As to dosage, more espcially for India, it is untrue that I recommended only 16 and afterwards 8 minims of Liquor Strychnine P. B. to be injected. These doses may suffice in mild cases, provided they are continued at short intervals, till the first symptoms of the physiological But in any bad case, action of the drug are produced. more especially of cobra-bite, they would, like drops of water on a hot stone, produce no appreciable effect dillydallying with them, whenever there is reason to suppose, that a large quantity of venom has been imparted, would take away the last chance of life from the victim and only bring the treatment into discredit. It was for this reason that I recommended doses of ^ to and even to ^ grain in bad cases, when requested by the Secretary of Colonies to send whatever recommendations State for the I might deem advisable direct to the Indian GovernHer Majesty had graciously acceded to the ment, after memorial for a fair trial 'of the treatment prayer of my in India. That, with comparatively small doses of the nntidctes in some of the cases, there has been but four failures is a matter of congratulation to all parties As rpgards the failures, it may safely be concerned. assumed that occurring as they did before the drug had developed its own action small and insufficient doses were the cause of them. Quoting further from the Therapeutic Gazette your article concludes by enumerating four points, which. I am alleged to believe, are proven: (1) that strychnine acts regularly and promptly. This I do not merely believe, but know as an absolute fact; (2) that its action stops entirely This is quite unintelligible to me. It after a time may probably refer to the fact which we have ascertained here that when injected long after the bite (from 24 to 48 hours or m^re) the originally functional derangement of the nerve cells has apparently brought on organic changes, which the antidote cannot cope with successfully. Still even in such cases its action does nt stop entirely, for though unable to remove the paralyses of the nerve centres speciallv effected, is acts on others in the usual manner, and if pushed to extremes brings on tetanic convulsions ; (3) that snake poison, like the poison of fungi, of fishes and ^
remain latent in the system for a considerable time is evidently a misconception arising from the fact observe 1 both here and in India, that after having been counteracted by strychnine for a time it may suddenly re-assert itself, if left behind partially as it sometime is. after the strychnine has been eliminated through the kidneys. Under any other circumstances its action is prompt and decisive, and the fear expressed by the writer, of the antidote overpowering the victim, if applied before the state which requires and neutralises its action has been developed, shows him to be anything but well informed both as to snake poison and antidote. Any healthy person may have strychnine injected with impunity, until muscular twitchings are produced, which is all that is required of it as an antidote to snake poison, the only difference being that much larsrer doses are required to produce the twitchings in a person suffering from snake poison than in a perfectly healthy one. In either case the muscular affection is harmless, and no person has ever succumbed to it, even when convulsions, always slight and passing off quickly, developed from it.
Trusting you will give me the opportunity of disavowing publicly statements. I should be thoroughly ashamed of having made and thanking you for your impartial advocacy of an extensive trial of the strychnine-treatment. Jackandandah Noveviber
YHth,
;
1894
I )
A.
MUELLER, M.D.
Corrrapirdcitce. SNAKE-BITES. To the
Editor,
"
Indian Medical Gazette."
Sir.?Your leading article entitled snake-bites in the
October issue of your valuable paper contain some statements quoted from the Therapeutic Gazette for August 1894, which are falsely attributed to me by the latter journal. Will you kindly permit me to lodge the strongest possible protest against the crude and ill digested notions expressed therein as coming from me. So far from ever writing to the Therapeutic Gazette.1 do not even know in what part of the civilised world it is published, and to the best of my recollection have only seen one or two issues of it. It would appear that the bad habit of the ancient Hebrews, which caused fchem to write under other people's names with a view of procuring credence and acceptance for their writings, is not quite extinct, yet however desirable it is in the interests of honest journalism that it should be. As to dosage, more espcially for India, it is untrue that I recommended only 16 and afterwards 8 minims of Liquor Strychnine P. B. to be injected. These doses may suffice in mild cases, provided they are continued at short intervals, till the first symptoms of the physiological But in any bad case, action of the drug are produced. more especially of cobra-bite, they would, like drops of water on a hot stone, produce no appreciable effect dillydallying with them, whenever there is reason to suppose, that a large quantity of venom has been imparted, would take away the last chance of life from the victim and only bring the treatment into discredit. It was for this reason that I recommended doses of ^ to and even to ^ grain in bad cases, when requested by the Secretary of Colonies to send whatever recommendations State for the I might deem advisable direct to the Indian GovernHer Majesty had graciously acceded to the ment, after memorial for a fair trial 'of the treatment prayer of my in India. That, with comparatively small doses of the nntidctes in some of the cases, there has been but four failures is a matter of congratulation to all parties As rpgards the failures, it may safely be concerned. assumed that occurring as they did before the drug had developed its own action small and insufficient doses were the cause of them. Quoting further from the Therapeutic Gazette your article concludes by enumerating four points, which. I am alleged to believe, are proven: (1) that strychnine acts regularly and promptly. This I do not merely believe, but know as an absolute fact; (2) that its action stops entirely This is quite unintelligible to me. It after a time may probably refer to the fact which we have ascertained here that when injected long after the bite (from 24 to 48 hours or m^re) the originally functional derangement of the nerve cells has apparently brought on organic changes, which the antidote cannot cope with successfully. Still even in such cases its action does nt stop entirely, for though unable to remove the paralyses of the nerve centres speciallv effected, is acts on others in the usual manner, and if pushed to extremes brings on tetanic convulsions ; (3) that snake poison, like the poison of fungi, of fishes and ^
remain latent in the system for a considerable time is evidently a misconception arising from the fact observe 1 both here and in India, that after having been counteracted by strychnine for a time it may suddenly re-assert itself, if left behind partially as it sometime is. after the strychnine has been eliminated through the kidneys. Under any other circumstances its action is prompt and decisive, and the fear expressed by the writer, of the antidote overpowering the victim, if applied before the state which requires and neutralises its action has been developed, shows him to be anything but well informed both as to snake poison and antidote. Any healthy person may have strychnine injected with impunity, until muscular twitchings are produced, which is all that is required of it as an antidote to snake poison, the only difference being that much larsrer doses are required to produce the twitchings in a person suffering from snake poison than in a perfectly healthy one. In either case the muscular affection is harmless, and no person has ever succumbed to it, even when convulsions, always slight and passing off quickly, developed from it.
Trusting you will give me the opportunity of disavowing publicly statements. I should be thoroughly ashamed of having made and thanking you for your impartial advocacy of an extensive trial of the strychnine-treatment. Jackandandah Noveviber
YHth,
;
1894
I )
A.
MUELLER, M.D.
