“The patient’s condition being so alarming, not to say desperate, we thought it almost useless to have recourse to Calmette’s method, more especially since at least seven hours had already elapsed since the child was bitten. Nevertheless we gave a hypodermic injection of 20 c.c. of Calmette’s serum. At the same time the wound was crucially incised, and bathed with a 1 in 1,000 solution of permanganate of potash, after which a damp dressing was applied to the whole of the swollen limb. The patient was put to bed, and kept warm. He was given an injection of 50 centigrammes of caffeine, and 300 grammes of artificial serum. In the evening the temperature was 36·8° C.
“May 27.—General condition more satisfactory; pulse still weak, but less irregular. Persistence of dyspnœa, explained by a series of small râles at the bases of both lungs. This morning the little patient passed his urine, about 200 grammes. He is more lively, and replies better to any questions addressed to him.
“May 28.—The improvement continues; the dyspnœa has almost entirely disappeared; only a few râles are still heard at the extreme base. The pulse is stronger and remains regular. The secretion of urine gradually reappears. The temperature of the extremities has become normal.
“On May 29 and following days the œdema continued to diminish, and had totally disappeared eight or ten days later.
“Recovery was complete by about June 15. The child was discharged on June 23, 1904.
“It seemed to us worth while to report this case, in order to emphasise the conclusion that forces itself upon us, namely that in all cases of bites from poisonous snakes an injection of Calmette’s serum should be given, without considering the efficacy of this therapeutic agent as being rendered doubtful by the length of time that may have elapsed since the bite was inflicted.
“In the present case, as we have seen, there was extensive intoxication, which had seriously affected the functions of the various organs, since we found cardiac arhythmia and pulmonary œdema, and that the patient was threatened with collapse, algidity, hypothermia, and anuria. Impregnation by the virus having continued for seven hours, we might have felt ourselves justified, on the one hand in merely employing the proper means for the relief of the general condition, on the other hand in treating the local condition, without having recourse to the serotherapeutic method, that seems to us in this case, in so far as it is permissible to make such a statement, to have been the determining factor in the recovery.”
XXVI.—Case recorded by Dr. Lapeyre, of Fontainebleau (from L’Abeille de Fontainebleau of June 27, 1902).
“M. X., who arrived at Fontainebleau on Sunday morning with a friend, keeps grass snakes at home, in Paris; he finds his hobby as good a means as any other to remind him of the forest and its charms. Human nature includes all kinds of tastes, so that this particular one need not be further discussed.
“The journey, therefore, had a twofold object: firstly to spend a whole day in sunshine and in the open air, and secondly to catch grass snakes to add to the collection.