and muscular exhaustion make their appearance, the emotional excitement becomes increased, and, at an early period, the feeling is one of despair. The face is pallid, and covered with drops of perspiration; pupils dilated; pulse quickened; there is loss of appetite, nausea or vomiting. General muscular paralysis eventually supervenes; there is lethargy and drowsiness, ending in unconsciousness, accompanied or followed by involuntary evacuations, which are sometimes tinged with blood. The breathing becomes slow, laboured and shallow; pupils widely dilated. The body becomes bathed in cold, clammy perspiration; the pulse remains full, quick and compressible. The respiration is gradually stopped, and death is ushered in by convulsions, or convulsive twitchings of the muscles of the extremities and face. The pulse bcats a few minutes (from three to four) after all breathing has ceased.
In some cases, where a person has been bitten by an exhausted snake, or by one whose aggregate supply of poison is small, as is the case in the tiger snake of Australia, or by a vigorous cobra, from which, owing to some cause or other, only a minute quantity of poison has been injected; or where a person has been greatly protected against the absorption of the poison by the early application of the ligature, the above symptoms may be present only in a modified degree. Recovery from the general symptoms may take place. The consequences in the part infected may cause much trouble, but these are to be dealt with by the surgeon on general principles.
TREATMENT.
1. A. By non-professional persons.—Whenever a person has been bitten by a poisonous reptile, issue orders at once for the attendance of a medical practitioner.
2. Pending his arrival, if the bite has been inflicted in the upper or lower extremities, promptly arrest absorption of the poison by immediately applying a strong cord very tightly round the limb, about a couple of inches above the bitten part, and two or more cords, from four or six inches apart, twisted as tightly as possible, higher up the limb. Thus, if a finger be bitten at the tip, the first ligature may be applied to the base of the digit, the second to the wrist, and the third to the middle of the forearm; in like manner, if the end of a toe be bitten, the first cord should be secured round the base of the toc; the second round the instep, and the
