V.—Case reported by Dr. Brau (Saigon).
“Nhuong, an Annamese agriculturist, on passing through a piece of waste ground beside the barracks, at about 5.30 a.m. on Sunday, September 11, felt himself suddenly bitten behind the right knee. He caught a glimpse of a large blackish snake, with all the characteristics of a cobra, including the raised head and dilated hood, gliding hurriedly away, but was unable to overtake it.
“The seat of the bite merely showed two small blackish punctures. The part soon became painfully swollen, and the patient began to feel giddy. Other natives came to his help; he was lifted into a Malabar cart and brought to the Military Hospital, whence he was sent to my house, where he arrived about a quarter past six.
“I entered the vehicle, and immediately drove with the patient to the Pasteur Institute. The only treatment that he had received was a ligature round the middle of the right thigh. The lower leg was enormously swollen, and the swelling was not stopped by the slight barrier formed by the ligature, but had already extended to the base of the limb.
“The patient lay stretched out between the two seats of the vehicle, with head thrown back and eye-balls turned up and ghastly. His skin and extremities were cold, and his pulse was scarcely perceptible. In order not to lose time, he was not even taken up to the first floor of the Institute, but was carried to an inoculating table. He was then made to swallow black coffee and rum, and was given an injection of as much as six doses of antivenomous serum, which had just been received from the Pasteur Institute at Lille.
“Under the stimulus of this injection, somewhat drastic I admit, an absolute resurrection took place in the sick man. The pulse became strong and bounding, bodily heat returned, and, although the swelling did not at once diminish, its progressive extension seemed to be sharply arrested, while the pain was also greatly lessened. The patient was able to sit up without assistance, and relate the incidents of his misadventure.
“In a few minutes time I thought it possible to have him taken to the Choquan Hospital, the Director of which Institution, First-class Surgeon-Major Angier, has been good enough to furnish me with a note of the subsequent history of this case.
“’The Annamese Nhuong, who entered the Choquan Hospital on September 11, suffering from snake-bite, was discharged on September 20.
“’On admission, heat and puffiness were observed in the calf and thigh. Slight dyspnœa, severe fever, tendency to coma. September 12, temperature 38°, 39·2° C. September 13, temperature 37·3°, 37·6° C. September 17, temperature 36·8°, 37° C.
“’On discharge, slight œdema and puffiness in the region of the bite. General condition good.’”