XIX.—Case recorded by Mr. H. W. Peal, Indian Museum, Calcutta (Indian Medical Gazette, July, 1903, p. 276).
“On April 1, 1903, at 7.30 p.m., a man was bitten at Dhamra, in Orissa, by a sea-snake which had been caught in a fishing net. He was not brought to me until 2.30 the next day, when he was in a state of collapse, semi-unconscious, and unable to speak, with eyes dull and almost closed. The bite was on the third finger of the left hand, just above the first joint. The finger was swollen, tense, and stiff. I gave the man an injection of 5 c.c. of antivenene ten minutes after he was brought to me. Three or four minutes after the injection the man with some assistance was able to sit up, and said he felt much better. He complained of great pain at the back of the neck and also in the lumbar region. He was able to speak fairly coherently after a little time. His eyes were brighter and he seemed to be aroused from his lethargy.
“I had about one hundred living sea-snakes with me, belonging to the three genera Enhydrina, Hydrus, and Distira. He identified Enhydrina valakadien as being the snake which bit him; so did the men who were with him. The snake was said to be about 3½ to 4 feet long.
“The antivenene did the man so much good, that he himself asked me to give him a second injection. This I gave him at 2.25 p.m. (5 c.c.).
“Date on bottle used, May 8, 1900.
“The pains in the joints had disappeared on the second injection (which was given in opposite flank). At 5 o’clock the man walked away with assistance. He was quite well a couple of hours after the second injection, and when I saw him again on May 8 he was in perfect health.”
G.—European Vipers (Pelias berus and Vipera aspis).
XX.—Case published by Dr. Marchand, of des Montils, Loir-et-Cher (Anjou médical, August, 1897).
“About 11 a.m., on Friday, July 23, Jules Bellier, aged 26, was mowing in a damp spot, when he was bitten in the heel by a large viper (Vipera berus). The bite, which was deep, was situated on the outside of the foot, 1 cm. behind the malleolus and 3 cm. above the plantar margin; at this point there were two punctures in the skin, 1 cm. apart. Directly after the accident the patient left his work, tied his hankerchief tightly round the lower third of his leg, made the wound bleed, and came to me with all speed, hopping on one foot for about a kilometre. When I saw him scarcely twenty minutes had elapsed since the accident; his general appearance was altered, and his pulse rapid. The patient had vomited twice; he complained of pains in the head, and of general weakness, and ’was afraid,’ he said, ‘of fainting.’ The foot and leg were painful under pressure; a slight tumefaction was visible in the peri-malleolar region, around the bites, which bled a little. Forthwith, after washing the wound freely with a solution of permanganate of potash, I injected 10 c.c. of Calmette’s serum into the antero-external region of the middle part of the thigh; then I enveloped the leg in a damp antiseptic dressing as high as the knee. The patient breathed more freely and plucked up his spirits. After lying down for quarter of an hour he went home on foot (he lives a hundred yards from my house).
“In the evening I saw my patient again. He was in bed, with a temperature of 37·2° C.; pulse 60; no malaise, no headache, no further vomiting; he had taken a little soup, and a small quantity of alcoholic infusion of lime-tree flowers. He complained of his leg, which was swollen as high as the knee; the pain was greater in the calf than at the malleolus. I applied a damp bandage. The patient had a good night, and slept for several hours, but still had pain in the leg. On the following morning, July 24, I found him cheerful, with no fever, and hungry. Around the bite the œdema had become considerable, and had extended to an equal degree as high as the instep; the calf and thigh were swollen, but to a much less extent. I gave a second injection of 10 c.c. of antivenomous serum in the cellular tissue of the abdominal wall. The day was good; indeed, the patient had no fever at any time; the spots at which the injections were made were but very slightly sensitive on pressure. In the evening the general condition of the patient was satisfactory; he complained most of his calf. Thinking that a contraction was possible, due to his having hopped along quickly on one leg after the accident, I ordered him a bath.