the venomous reptiles of the united states, with the ... · the venomous reptiles of the united...

THE VENOMOUS REPTILES OF THE UNITED STATES,

WITH THE

TREATMENT OF WOUNDS INFLICTED BY THEM.

BY

PAUL B. BARRINGER, M.D.,UNIVERSITY OP VIRGINIA.

READ BEFORETEE SOUTHERN SURGICAL AND GYNECOLOGICAL ASSOCIATION,

NOVEMBER 12, 1891.

THE VENOMOUS REPTILES OF THE UNITEDSTATES, WITH THE TREATMENT OF

WOUNDS INFLICTED BY THEM.

By Paul B. Barringer, M.D.,University of Virginia.

The more perfect the conception of a mechanism whichinflicts an injury, and the more perfect the comprehension ofthe physiological and pathological changes which ensue as theresult of such an injury, the more perfectly will the knowingsurgeon be enabled to treat it. From my belief in the abovestatement, I have decided to lay before a body of surgeons apaper which possibly has equal claim upon the attention ofnaturalists.

American snakes are divided by herpetologists into threegreat families—the Colubrince, the Elapidce, and the Crotalidce.The Colubrine snakes will not number, under a strict classi-fication, more than some sixty-five or seventy species, and theyinclude about nine-tenths of all American snakes. Moreover,this large family is composed entirely of harmless snakes—-that is, of snakes without fangs or poison sacs, and whose biteis no more injurious than the scratch of a briar. As this classincludes some, however, which are popularly supposed to bevery deadly, I will allude to them though they fall withoutthe limits of this paper. Ido this from the fact that I haverecently learned from reliable sources of a death from anoverdose of whiskey, administered for the bite of a harm-less snake. The Heterodon family, the so-called “ SpreadingAdders,” are, by the great mass of the people, believed to benext in venomous power to the rattlesnake itself. They

VENOMOUS REPTILES OF THE UNITED STATES.2

are perfectly harmless, and their evil name comes entirelyfrom the fact that in coloring, form, and even in action, theymimic the venomous types. The spotted spreading adder(if. platyrhinus ), often called the “ Blow Snake,” from themanner in which it distends its body with air and emits itthrough the throat with a rushing sound, is found both Northand South in the Eastern United States, and is greatly feared,though perfectly harmless. The “Black Adder” (ii. Niger)is limited to the South, and is the special horror of the un-informed. The smaller form {H. simus) is killed as a “ youngrattlesnake.”

The Tropidonotus family furnishes two members that arepopularly considered very deadly. The “Water Snake”(T. sipedon) furnishes the foundation of many blood-curdlingstories North, while the reputation of his Southern brother{T. fasciatus) imparts a flavor to “snake medicine” nototherwise obtained. These are both confounded with thetrue water moccasin, and suffer by the confusion. As itbecomes a matter of some moment in the South, where allthree are found, to distinguish them from the truly venomousmoccasin, I will give the method further on. Though boldand blustering, and striking viciously when approached, thesehave no fangs or venom. I might mention others which, incertain localities, are feared without cause, but the misrepre-sentation of the above is universal.

Turning to the next family—the Elapidce—we find familyand genus represented by a single species, of many varieties.This snake (Maps fulvius) is, however, of especial interest tous, as it is a venomous serpent, though presenting the generalcharacter of a harmless one. This small and beautiful ser-pent is the sole American representative of the dreaded Cobrafamily of India and Africa. First described by Audubon(and drawn by him in one of his ornithological plates) as theHarlequin snake, Holbrook, in 1842, pointed out the fact thatit had venom fangs. Under the names of Harlequin snake,Bead snake, and Coral snake, this beautiful little reptile hasoften been described, but seldom in its true light. Shy in its

PAUL B. BARRINGER. 3

habits, and hence not often seen, it is not considered commonanywhere, and yet it extends from Virginia to Texas. Gentleof disposition, and never aggressive, it often will not bitewhen handled, and seems too small and beautiful to beharmful. Dr. S. Weir Mitchell, of Philadelphia, in a mostinteresting and complete article on the “ Poison of Serpents,”in the Century Magazine of August, 1889, says of this snakethat it is “too small with us to be dangerous to man.” It isto prevent you from falling into a similar error that I reportthe following case ;

A workman was bitten on the hand by a small snake whileplaying with it. He killed the snake, and thought little ofit. For a while no pain or general effect followed. In lessthan half an hour, however, pain in the arm and some evi-dence of loss of muscular power came on, and, in spite of theaid of a physician called in, at the end of eighteen hours hedied. An examination of the snake showed it to be “ small,and its body was encircled by bright-colored ’bands. An ex-amination of its mouth showed two fangs in the upper jaw.”Mr. Charles E. Coe reports this in the Scientific American ofJune 27,1891, and refers to Dr. Mitchell’s error. He also refersto other, cases that seem to have come under his knowledgewhere a fatal result followed the bite of this snake.

In various parts of the South, from Virginia to Texas, youwill hear tales of a beautifully colored snake whose bite isdeadly. These tales are too uniform in their coloring to beignored. But having no accurate description to go upon, andknowing that most of these gorgeously colored snakes are notpoisonous, mistakes are liable to occur. I will, therefore, giveyou a description that will, I think, enable you at all times torecognize it. It is small, from sixteen to twenty inches long.The neck is full, making the head seem small and hardly sep-arated from the body. The general body-ground is a blue-black, marked as follows: Behind the head, and extendingforward under the throat, is a yellow band. Behind this, onthe body, are a dozen or more wide brick-red bands, extend-ing to the belly, and each red band is bordered by a narrow

4 VENOMOUS REPTILES OF THE UNITED STATES.

band of yellow before and behind. The tail is barred withyellow, and tipped with the same. The ventral plates behindthe anus are all divided, the only poisonous snake in Americain which this is true. The geographical range of this snakeis from Southern Virginia around the South Atlantic Statesto the Gulf; up the Mississippi Valley to Missouri, and thenceto Texas. Common nowhere, it is most abundant in Florida,and there seems to attain a greater size than elsewhere. Spe-cific names have been given to several of its varieties, but itis doubtful if they will hold.

The remaining family—the Crotalidce—includes all theother venomous snakes in the United States. Not only isthis the larger number, but they are snakes that are limitedto this hemisphere. While the Crotaliue snakes may be classedwith the Vipers of the Old World, they present some char-acters so peculiar and constant as to entitle them to a specialdivision. One of these is a deep pit between the eye and nos-tril, and below, -a line joining these, and hence they receivethe name of “pit vipers.” This family includes our rattle-snake tribe, with its various subdivisions, and also the cop-perheads and water moccasin.

The rattlesnakes are divided into two genera by structuralpeculiarities that any observer would notice, and as it is adistinction of some practical bearing, I will ask your atten-tion. The rattlesnakes that inhabited the open prairies of theNorthwest, and to which the Indians applied the name “Mas-sasauga ” (Sisturus catenatus), and the “ Ground rattlesnake ”

of the South (,Sisturus miliaris ) have the top of the head asfar back as the eyes covered with large scales. The Diamondrattlesnake of the South (Crotalus adamanteus), and his moreNorthern brother, the Common rattlesnake (C. horridus), havethe head covered with small scales almost up to the nose, theeyes only being covered each by a large plate. For reasonsthat are not altogether understood, the latter genus is themore to be feared as a poisoner. The ground rattlesnakes ofthe South do not attain a size sufficient to make them greatlyfeared, but their Western relatives often reach five feet in

PAUL B. BARRINGER.

length, and yet their bites do not produce so disastrous resultsas the bite of a common rattler or a diamond rattlesnake ofthe same size. In size the common rattlesnake seldom exceedsfour feet, while the diamond rattlesnake of Florida and ofTexas will sometimes nearly double this. Without goingfurther into the different varieties of rattlesnakes—some four-teen or more—we may say that they all have rattles, and, be-yond the fact that the genus Sisturus does not seem, weightfor weight, as poisonous as the genus Crotalus, they arepoisonous in proportion to their size. The American copper-head is, perhaps, the most widespread of any single species ofAmerican venomous serpent; and while the opinion is notwarranted by the facts, I know of no locality in which therattlesnake and the copperhead are found side by side, inwhich the inhabitants do not fear the latter the most. Intruth, the rattlesnake, drop for drop of venom, is the morepoisonous, but his life-habits are such as to make bites fromhim quite rare, while with the copperhead they are common.This arises from the difference in temperament, if I may sospeak, in the two snakes. Observe them in captivity, andyou will at once see this difference. The rattlesnake is slug-gish and slow in movement. It is boldly indifferent to ap-proach, and half the time will not take the trouble to coilwhen approached. At rest it lies with the head drawn downon the coil, and will seldom attempt to strike except from acoil. How different with the copperhead ! Ever on the quivive, he coils when he hears you coming. Whether fresh ortired, he will not put his head down, but keeps it well up, everon the alert. As his classical name signifies (Agkistrodoncontortrix), he is a snake of action. He can strike underconditions where a rattlesnake would be helpless. Some ofthe feats that I have seen this serpent perform in this lineseem incredible. I have seen him strike the sole of the footthrough an opening in the floor not appreciably larger thanthe snake’s head. This summer I knew a child bitten by ahorizontal blow from under a warped plank on a barn floor.It is the vicious nature and extreme agility of this pest rather


than its real poisoning power that makes it so much to befeared. As before stated, it is very widespread. Under thenames of Copperhead, Highland Moccasin, Cotton-mouth andPilot, its different varieties are found throughout the UnitedStates, east of the Rocky Mountains. In the mountainregionsof Southern Virginia, North Carolina, and Tennessee we have avariety (the atrofuscus of Troost) which perhaps, is a differentspecies, but certainly presents no generic difference. In simplecoloring, snakes vary greatly with the locality, conforming asthey do to their environment. Leaving the copperheads, wecome to another branch of the same genus—the Water moc-casin (Agkistrodon piscivorus). South of a line drawn fromNorfolk to about Cairo, Illinois, this reptile abounds. Nothaving the predilection for barns, corn-cribs, and gardens thatits kinsman, the copperhead, seems to possess, but seeking themeadows and swamps near water, it is not so much to befeared, but is of about the same poisoning power. Mitchellputs it as slightly less, but from cases that I have seen, 1think that the average bite of this reptile is about equal inseverity to that of the copperhead. Its short, compact bodymakes it seem much 'smaller than it really is; the averagespecimen will be heavier than the average copperhead. It isthis malicious reptile that has given the widespread fear of watersnakes throughout the Union, but this fear is without founda-tion at the North. This rough, slime-befouled snake is, as itsname implies, a fish eater. From sheer malice it will killfish too large for it to swallow, and this malicious spirit isshown toward other snakes. If a colubrine snake is placedin a case with a rattlesnake, it will be treated with contempt;but if caged with a water moccasin it will be killed.

This is the complete list of all the poisonous snakes of theUnited States. While it is not within the province of thispaper to give any detailed account of the structural character-istics by which each may be told, I will give a key that willenable anyone to tell a poisonous snake when killed. Leav-ing out of consideration the black, red, and yellow Flapsabove described, any American snake with the pit between


the eye and nostril is a venomous snake, and this is abso-lutely certain if, in addition to this, you find one or moreventral plates behind the anus undivided. Of the second-ary characters that distinguish our venomous snakes may bementioned the following: an elliptical pupil placed vertically,a triangular head, narrow neck, and a blunt tail (rattle or norattle). Living young within the gullet, or eggs in advancedstages of incubation in the ovisac, are likewise distinguishingfeatures, as all of our crotaline snakes are oviparous.

Leaving the snakes, we come to an American lizard that,in spite of some protests to the contrary, takes its place amongthe venomous reptiles of the Uuited States. I allude to theGila Monster of Arizona and New Mexico. This hideousreptile, in its tough armor of orange and black, has been thesubject of no little controversy among medical writers. Withthe Apache Indians, Mitchell, and Reichert on one side, andYarrow and others on the other, the war still goes on. Butone fact remains, that men have died from the effects of thebite of this lacertilian. lam able to add other cases to thosepreviously reported. Dr. Charles C. Barrows, of New York,late of the United States Army, in reply to a letter of inquiryon this subject, writes me as follows :

“ I have known of two deaths from this cause (Gila mon-ster). In each ease the man bitten was drunk, and the cir-cumstances surrounding the cases were almost identical. Inone case a crowd had tormented and worried the monsteruntil lie was in a violent rage. A man picked the animal up,and was bitten deeply in the forearm. He had all the symp-toms of cardiac depression, and although he was freely pliedwith stimulants, within a few hours he was dead.

k ‘ The other case occurred near Tombstone, and except thatthe man was bitten on the thumb, was similar in detail andending.”

Similar deaths have been ascribed by the non-venomousside of the controversy to “a mixture of disease, Gila mon-ster, and bad whiskey,” but the facts of case remain.

Let us now turn from the reptiles themselves, and take up


the Mechanism by which they administer the venom to thesubject of their wrath.

The little Flaps, the first considered, has in common withall the Cobra family, to which it belongs, on either side of theupper jaw a single permanently erect and immovable fang.This is pierced by a venom-duct, opening near the point, andcommunicating with a comparatively large venom-gland be-hind the eye, and running down into the neck. The set ofthe teeth is such that if they catch, they will hang—i. e., theywill pull upon the tissues, and drag in more deeply. As inother snakes, the forcible closing of the mouth upon the partbitten compresses the so-called venom-sac, and forces out thefluid.

In the Crotalidce, by far the greater number of our venom-ous snakes, we have an entirely different and more complicatedmechanism. In these, as in all the Vipers, with one excep-tion, we have the fangs large and movable, lying folded backwhen at rest, and capable of being erected and brought for-ward when striking. This act is performed by the rotationof the superior maxillary bone, in which they are firmly fixed,on a process of the lachrymal. This is partly a muscularand partly a bony lever movement. The fangs are relativelylarge, and not regularly curved, but consist of two segmentsof an arc of given radius, joined at an obtuse angle. For thisreason, the tooth is seldom or never sent to the hilt, so tospeak, but seems best suited for tearing or ploughing thetissues. The tooth of a serpent is formed of a flattened plate,folded to form a tube, and the opening at its end, where notjoined, is the exit of the venom-duct. In the snakes underconsideration, the opening, contrary to the general belief, is inthe convex side of the tooth. If we accept the fact that it isa cutting hook, and not a stabbing tool, the opening is placedjust right. The tissues are uninjured on the concave sidewhere the tooth hangs, but are more or less torn on the con-vex side. About the same mechanism is used to propel thevenom from the sac as in the preceding. One of the tem-porals, and the spheno-pterygoid muscle, so-called, make


pressure upon the sac, and squeeze out its contents the in-stant the fang is engaged. In some snakes, the copperheadespecially, even if the fang fails to- engage, the venom issqueezed out and thrown quite a distance. The venom-glandin the Crotalidce is placed below and behind the eye. It is ofthe compound sacculated type, and from each of its manylobules the ducts run downward and forward to join a largeduct somewhat expanded—the so-called venom-sac. Wherethis duct or sac joins the tooth at its ampulla-like base, theduct is very small, and it is claimed by some to have a sphinc-ter, which I have never been able to distinguish. The truemethod of closure here lies in the fact that while the tooth isfolded back, this constricted portion is drawn tight over thebase of the tooth, and when the fang is erected, it is relaxed.The mechanism is the same in all the rattlesnakes, copper-heads, and moccasins.

Turning to the venom apparatus of the Gila Monster, wefind a mechanism differing greatly from either of the’above.The venom fangs, if the lizard’s twelve or more lower teethmay be so called, are sharp and nearly straight. A recentwriter on this subject describes the venom-sacs as located atthe base of each tooth, and intimates that the grooves foundin the teeth carry their venom into the depths of the wound.This does not agree with my own dissections in the least. Inall animals (five) dissected by me, I find the following:

There are eight, or, at most, nine curved teeth in each sideof the lower jaw, ossified to its upper surface, lacertiliau-fash-ion, and not implanted in its substance. These teeth presenta groove from base to apex as the result simply of their beingmade of a flat plate folded on itself, shell-fashion. The only“ venom-gland ” that I could ever find is an enormously de-veloped salivary gland of the serous type, lying external to thebody of the inferior maxilla, and extending from the sym-physis backward and downward. I should call this gland asub-mental gland. Just external to the line of the inferiorteeth is a very marked and deep fold of mucous membrane,a peculiar and pronounced trough-like cavity, and into the

VENOMOUS REPTILES OF THE UNITED STATES.10

bottom of this, between each of the teeth, the ducts from thegland before mentioned open by large distinct openings. Whilethe teeth are much similar, this condition does not obtain inthe upper jaw. This animal cannot bite, therefore, unlessthe object seized can be gotten within the mouth. When itdoes seize, it holds on, shaking the object held as if to sinkits fangs deeper and work the saliva-like fluid into the wound.You can readily see how this trough-like cavity, as it is pressedupon by the mucous membrane of the gumbeing pressed down,will readily discharge its contents into the openings made bythe teeth. The owner of this queer device is sluggish andpeaceful, and only when he is tormented and worried can hebe made to bite.

Let us now consider the Venom of these pests. While toL. Bonaparte and others great credit is due for pioneer workin this field, it is to Drs. Weir Mitchell and his colleague inlabor, Dr. Reichert, that we owe a debt of gratitude for whatis really known on this subject. Through them we learnconcerning serpent venom that it is a complex proteid com-pound, having two distinct factors, which differ one from theother markedly.

The first of these is venom peptone. It is, as its name im-plies, a highly diffusible, modified albumin that is very rapidin its penetration of the tissues when injected subcutaneously,or even when swallowed. Its physiological action is as fol-lows : Injected into the tissues, as a crystalloidal body, itpasses with ease into the blood and lymph currents. Its firsteffect is to depress the heart’s action, and in large enoughdose will stop it at once in diastole. This effect is usuallyslight however, from American serpents, but not invariably.It produces but little of the marked local effect seen when theother type of venom proteid is injected. After quite a periodsome swelling is seen, but at no time is it marked. In themeantime it is beginning to show its selective properties uponthe nervous system, and an acute ascending paralysis of thecord results. 1 Death by asphyxia ensues when the respiratory

1 Marine-Hospital Reports, 1890.


ceutre is reached. Foektistow shows that the cardiac depres-sion is due, not to the influence on the heart muscle, but todisturbance of function in the ganglia of cardiac control, bothextrinsic and intrinsic. The same writershows that strychniaconvulsions are checked at once by snake venom, but I regretto say that this was not demonstrated of venom peptone alone,though it was, from what we know of the other constituent,doubtlessly the agent. As regards its influence on the blood,Kinyouu shows that Cobra venom, which is nearly all venompeptone, has no decided influence in modifying the coagula-bility of the blood.

The other potent factor of serpent venom is venomglobulin. This class of proteids—the globulins—as youknow, are all soluble in dilute saline solutions while pre-cipitated by saturated saline solutions. In accordance withthe theory of Schmidt, this globulin class includes two outof the three (fibrin) factors concerned in the coagulation ofblood. Looking, then, at the ease with which these globulinstake upon themselves a change of form, and the close rela-tionship that venom globulin bears chemically to the usualclot constituents of blood, we cannot be surprised if we learnthat the first marked action of venom globulin is the pro-duction of a change in the coagulating power of the blood.While it has not the power of passing through animalmembranes that venom peptone has, and hence may beswallowed with impunity, it seems to have the powerof dissolving animal membranes, so quickly does the bloodrush out of its vessels. This causes a swelling; of the softparts so quickly that I have known a boy’s foot to be mark-edly swollen by the time he ran two hundred yards. Whilethis pronounced local effect is taking place, the same series ofchanges are taking place throughout the body, and if thequantity of venom injected be great enough and life be pro-longed, we have bloody extravasations on every mucous andserous surface in the body. But venom globulin is a nervepoison as well as a local one. Pari passu with the changesaforesaid, we have a gradual but not so pronounced paralysis

12 VENDMOUS REPTILES OF THE UNITED STATES.

of the nerve centres of the cord from below upward, and ifthe amount be great enough, ultimately death from asphyxia.The temporary heart disturbance found in poisoning fromvenom peptone is found here also, and about in the same de-gree. But the most pronounced change in the circulation isnoted in the immense and rapid fall in blood-pressure. Foek-tistow found this to be due, not so much to the extravasationsbefore mentioned, as to a vasomotor paralysis of the splanch-nic area, and a resulting drainage of the general blood of thebody into this area. Injections of defibrinated blood intothe bitten animal raises the pressure only while it lasts, evenwhen injected in great amount.

Applying this knowledge to our American snakes, we findthe following :

The venom of the Harlequin snake (Elaps fulvius) hasnever been subjected to examination, as far as I can learn,and we must therefore judge by analogy. As the Elaps be-longs to the Cobra family, Cobra venom may safely be takento represent it. This venom, nearly all peptone, and only1.75 per cent, globulin, would give us little local action andpronounced paralytic result. I have looked up the carefulestimates of amounts likely to prove fatal, and find that forfresh Cobra venom, 0.00008 of a gramme per kilo is a fataldose (Vincent Richards), while of dried Cobra venom about0.002 of gramme per kilo was necessary (Kiuyoun). Forfresh venom this is about yfqT °f a grain P er pound ofweight. With these figures, the Elaps seems quite a largesnake.

Turning next to our Rattlesnakes, we find a very differentstory. The venom of the Diamond rattlesnake, probably ourworst, contains 24.6 per cent, venom-globulin (Mitchell), andbut little venom peptorae. Hence, we would have pronouncedlocal effect and a much more uncertain and slow paralytic re-sult. As to the amount of venom that a rattlesnake containsfor a given size, so much depends upon the time which haselapsed since he last struck that any series of observations,to be of any value, must extend over quite a time, and be


made upon a large number of animals. lam at work uponsuch a table now, but for so short a time, that any result givenwould be little short of guesswork. I do not think, how-ever, that it will be found ultimately to be far from onegramme of venom per kilo of snake. From a number ofmeasurements, I find that a snake will have to be nearly fourfeet long to weigh a kilo. Such a snake would, therefore, giveabout 15 minims of venom as his average. Taking Fon-tana’s estimate of -g1 of a grain per pound of weight as thefatal dose, we find that 3 minims absorbed would producedeath in a one-hundred-and-eighty-pound man. It should bestated, however, that in estimating this amount per snake, wetook in every case all that could be obtained, urging the mostpersistent biting on his part, at the cup. FTo snake of fourfeet in length can deliver anything like 15 minims in a woundat one blow.’Turning from the rattlesnakes to the other Crotalines, we

find that the copperhead gives of venom globulin about 8 percent, aud the water moccasin a little less, while their venompeptone is little.

In their Smithsonian Report of serpent venom, Drs. Mitchelland Reichert state that they found bacteria of various kindsin venom, and that they were harmless. I can readily con-ceive that a diseased snake might have bacteria in its venom-sac, but that they exist in the venom of the average snake Iam convinced is an error. In conjunction with my colleague,Prof. Tuttle, of the University of Virginia, I tested the venomof various snakes, and in no instance did I find bacteria iftaken from a sterilized fang. The procedure was as follows :

The snake was caught with the staff, the mouth drawn open,andthe upper jaw held up by a piece of cloth in the mouth throughwhich the fangs projected. Over the fangs were slipped layerafter layer of antiseptic filter-paper until only the tip was ex-posed, By pressing the side of the head a few drops of venomwere expressed, and this was allowed to run, to clean the ductAfter this, no venom removed through the fang (from a healthysnake) ever gave a single colony, though tested in media of


various kinds. While on the subject of healthy snakes, Imay mention a find that we did make during these examina-tions. In expressing the venom of a big “four-foot” rattle-snake (C. horridus), we noticed a white, flaky material com-ing out from one of the fangs, and upon microscopical exam-ination found in the venom a living colony of nematodeworms. These worms lived in a small vial of mixed venomfrom various suakes until it decomposed—about two weeks. 1

I must, therefore, conclude that the bacteria at various timesreported in venom came from the serpent’s mouth, and thatthese mouth-bacteria are harmless is more than doubtful.If any one will examine any series of reports on bites ofAmerican snakes, he cannot fail to be struck with the factthat about one case in every five is complicated with symp-toms of septicaemia. This is especially true of Yarrow’sseries of cases in theAmerican Journal of the Medical Sciences,April, 1884. That the bacteria of infection do not reside inthe venom I feel assured. That they come from the snake’smouth, and that they are often pyogenetic, I am absolutelycertain from repeated experiments in which the bite of a non-venomous snake (Heterodon) was followed by pus formationtoo frequently to be merely accidental. This should cause us tomodify our treatment of snake-bites —at least, enough to bringthem within the pale of modern surgery. The results ofKin-youu’s experiments with Cobra venom as a germicide arestrongly corroborative of the views here put forth. Not onlyare pyogenetic bacteria not found in venom, but a 1 per cent,solution of Cobra venom produces a decided inhibition to thegrowth of many bacteria, including streptoccocus pyogenesand staphylococcus pyogenes aureus. 1

Leaving the snakes’ venom, and turning to the Gila Mon-ster, we find that we know far less about it. That it is amodified saliva is certain, and that it comes from their sub-

1 The species to which this worm belongs was not determined, and probablyhas never been described. It is possibly a member of the Strongylus family.

2 American Marine-Hospital Reports, 1890.


mental gland I also feel assured. It would seem from thedivergence in the results obtained by Yarrow and Mitchell,both careful observers, that it differs in toxic power underdifferent conditions of body. To those familiar with the im-mense variation in the saliva of other animals when produceduuder varying stimulation of the secretory nerves, it wouldnot seem too much to look for some such change here. Thepeculiar odor of the saliva found in these animals is mostmarked when the animal is enraged. Moreover,I have knownof no case in which a serious result followed its bite, iu whichthe animal was not in a fury of rage.

The diagnosis of a snake-bite is usually easy with Americansnakes, as all except the Elaps produce marked local swellingand extravasations. But if it were an Elaps, the absence oflocal lesion, the decided mental hebetude, almost coma, dilatedpupil, and general paralytic condition might, especially if thesmell of whiskey be upon the breath, mislead with seriousresults.

The wound made by a nou-venomous snake is usually dif-ferent from that made by a poisonous one. In the former, aseries of small punctures iu a double line shows the pointstruck, while in the latter, if there be more than two, theothers are comparatively insignificant.

While in certain countries, as in India, death from snake-bite runs up into the thousands per annum, the returns ofdeath from this cause in the United States amount to almostnothing. And yet every practitioner in the country districtsmeets cases almost yearly. These two facts together give usas favorable the general prognosis in the wounds inflicted byour reptiles. Taking them in detail, I can give no statisticsfor the Elaps, but as it is not a common snake, and of gentledisposition, its bites must be comparatively few. From a

series of thirty-eight rattlesnake bites that I have gotten, Ithink that taking man, woman, and child, the mortality willnot run over 10 per cent. This is meant to cover the regioninhabited by the huge Diamond rattlesnakes, as well as the


less dangerous Sisturus. As regards the copperhead’s bite, Ihave (including Yarrow’s nine cases) sixty-nine cases, with onedeath. This was a boy six years of age, and it took placeafter several days. All in all, Ido not believe the mortalityfrom the copperhead’s bite will run over 1 per cent., takingman, woman, and child bitten. The water moccasin being,from its peculiar habitat, less apt to bite children, will fallbelow this. In fact, I have never been able to learn of anauthentic case of death from the moccasin’s bite.

Treatment of Reptile Bites.—ln the first place, thepreventive treatment lies in keeping out of the region inhab-ited by these pests, or, if you must expose yourself, wearinggood protective leggings, etc. The hog is, of all creaturesknown, the greatest practical enemy of the snake. In someswamp and mountain districts of the country, the abundanceof the bears prevents the raising of hogs, and here the snakesabound, the bear being the unintentional protector of thesnake.

Leaving preventive treatment out of consideration, we maydivide the immediate into two heads :

First, the local treatment. Every individual whose occu-pation exposes him to the danger of such wounds, shouldknow that immediate attention to such wounds will save hislife in almost any contingency. With a knife, or even witha thorn, cut or tear open the wound until it bleeds freely.As almost all bites are on the extremities, the patient may beable to suck the wound. If so, do it at once—a sore mouthor decayed tooth makes no difference; the very act of suctionwill prevent the entrance of the poison into a mouth lesion.If the surgeon is at hand, which seldom happens when thebite first occurs, he should open each of the punctures trans-versely to the line of lymph and blood flow, and apply acupping-glass. If $t hand, a solution of permanganate ofpotash (10 per cent.) or a strong solution of liquor potassse,injected into the wound, will destroy the physiological activityof the venom entirely. If he can do two things at the same

PA UL B. BARRINGER. 17

time, let him likewise tie an extemporized tourniquet aroundthe limb at once. The above treatment is entirely independ-ent of the kind of snake, provided only it be poisonous. Nowlet me say one more word in regard to the local treatment. In5 per cent, of all bites that are recovered from, a chronic sep-ticaemia results. This is due to the fact that almost all snake-wounds are more or less infected with pyogenetic bacteria fromthe saliva of the snake. The viscid mucus always in a ser-pent’s mouth to enable it to swallow its prey, is a perfectnidus for the propagation of these .germs. The abundance ofthis mucus gives to our copperhead in many localities the termcotton-mouth, and it is from them especially that we receivethese septic bites. In viewing the local effects of venomglobulin, in which our snakes abound, we saw a conditionproduced most favorable to the spread of pyogenic and sapro-phytic bacteria, and they very readily take hold here. There-fore, all snake-wounds should have applied to them the samesurgical care applied in these days to other wounds. Thischronic septicaemia seems to produce a recurrent neuritis inthe nerves distributed to the part bitten, and often whensimilar telluric conditions again obtain, we are apt to haveherpetic eruptions break out at the seat of the wound.

Turning to the constitutional treatment, we find that alco-hol in moderate quantities (not over a half pint all told) is anagent usually sufficient to maintain the heart’s action andblood-pressure at a safe point. But as the poison begins tomake itself more distinctly felt on the centres, we find thatalcohol, especially if the amount of venom be great, is unableto prevent a dangerous fall in the force of nerve impulsessent out, and we must assist it by strychnia. One-thirtiethto one-twentieth of a grain hypodermatically administered,will increase the nerve-centre tone, and restore the waningpowers. To avoid gangrene of the limb, as the result of ourtourniquet, it will be necessary at intervals to remove it, andat these times more or less venom will enter the system. Byrepeating the alcohol, strychnia, and, in case of a Gila Mon-


ster. bite, digitalis, we may tide over these periods, and save apatient under conditions most adverse. The above include ailremedies of demonstrated power. Bibron’s antidote, the Tan-jore pill, viola sagittata, squirrel’s ear, sweet oil, and manyother remedies, each have their advocates, but I know nothingof them. The means that I have suggested have in verymany cases saved human life, but they should be in thehand of a man who will not lose his head from excitement.

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