Treatment of black widow bites
Since the venom of the black widow, among other properties, appears to affect the nervous system, its effect is almost instantaneous, and most first-aid measures are of little value.
Stahnke has found that the iced-water treatment (as described in detail in the [scorpion section] of this booklet) is beneficial. The points of puncture should be treated with iodine, the patient kept as quiet as possible, and an ice pack applied or the part submerged in iced-water, and a physician summoned immediately.
Baerg[4] recommends hot baths—as hot as the patient can endure. These should be used only in cases of advanced poisoning, never immediately after the bite is received.
Internal use of alcohol is dangerous, and a person bitten when intoxicated would have much less chance of recovery.
Professional treatment consists mostly in the use of opiates, hydrotherapy, and similar measures to alleviate the acute pain. Of more than 75 different remedies used, three seem to be outstanding as palliatives: spinal puncture, intravenous injections of Epsom salts, and intramuscular administration of convalescent serum when given within 8 hours. Dr. Charles Barton, of Los Angeles, recommends intramuscular or intravenous injection of calcium gluconate, 10 cc. in a 10 per cent solution. The patient should be encouraged to drink as much water as he will. He usually leaves the hospital on the fourth day. Recent experiments with an injection of neostigmine followed by one of atropine have had encouraging results, and the use of ACTH in several cases has had spectacular results, according to Readers’ Digest (Nov. 1951, p. 45).