Case 16.—Reported by Dr. St. George Queely, of Maytown, Queensland, lad of 19 years, bitten by black snake, symptoms serious. Four injections of m. xv., xv., xx., and xv., total 65 minims of liq. strych. P.B. injected within less than two hours, muscular spasms appearing after last injection. Patient made rapid recovery, riding home, a distance of 16 miles, within a few hours after treatment.
Case 17.—Reported by Dr. Ray, of Seymour, severe bite of a tiger snake. Within six hours 4/5th of a grain administered subcutaneously, besides a considerable quantity given by the mouth. Patient made a good recovery. "Every injection after the second one," Dr. Ray reports, "having a distinct effect within three or four minutes, and lasting from one to one and a half hours before tendency to coma returned."
Case 18.—Very remarkable. Read by Dr. Forbes, medical officer of hospital, Charters Towers, Queensland, before the North Queensland Medical Society. Boy, 6 years old, was admitted to hospital at 9 p.m. on 27th October, 1890, bitten on foot by a death adder, which was killed and identified. Dr. Forbes reports: When seen by me, two hours after the accident, he was sitting on his mother's knee with his head hanging on one side, but quite conscious, and answering questions rationally, pupils widely dilated with almost no reaction to light, pulse very fast and soft, &c. Thinking his condition might be due to fear I hesitated to use strychnine. So, ordering strong coffee, I hurried to attend an accident case just admitted with severe hæmorrhage, and left the boy in charge of a nurse, with orders to call me at once if she saw any change. I had scarcely been away 15 minutes when the father rushed in saying his boy was dead, and indeed his statement seemed but too true. The child was lying quite limp, face blue, eyes half shut, extremities very cold, no pulse perceptible, no respiration visible. I at once injected m. x. of liq. strychniæ P.B. and made artificial respiration. He soon began to improve, and in about 20 minutes was able to speak. He was watched all night, but suffered no relapse, and was discharged on the next day.
Cases 19 to 21, reported by Dr. Weekes, of Lithgow, N.S.W. Dr. Weekes writes:—"Within the last year I have had three cases under my care, all bitten by black snakes, and all in about the same place, on the outside of the calf of the leg. The patients were all comatose, exhibiting all the usual symptoms of snakebite-poisoning, and in one, my last case, the patient had convulsions. In all of them I made hypodermic injections of m. xv. liq. strych., and the effects were most marked, the patients being completely roused and becoming quite sensible and rational each time," &c.
Case 22.—Mrs. Ryan, of Oberon, N.S.W., bitten on leg by tiger snake, comatose and nearly pulseless after three hours, treated by Dr. Kingsburry, amount of strychnine not stated.
Case 23.—Benjamin Childs, bitten on finger by death adder, treated by Dr. Campbell, of Grafton, N.S.W.
Case 24.—Rather remarkable. Reported by Dr. Lloyd Parry, of Emmaville, N.S.W., in Gazette of March, 1891, and further particulars in private correspondence with writer. A Chinese miner, aged 30 years, was bitten on the back of the foot by a death adder. His mates, deeming medical aid useless, did not send for Dr. Parry until death was imminent, and then only with a view of getting a certificate of death, and avoiding autopsy and inquest. When seen, three hours after infliction of bite, the man was deeply comatose and pulseless, skin icy cold, pupils dilated and insensible to light, lower jaw hanging down and tongue protruding, respiration scarcely perceptible. He was in fact so near death that this event was expected to take place from minute to minute. In order to task the antidote to the utmost, Dr. Parry cut the tight ligature without excising the bitten skin and then injected xv. of liq. st. P.B. To his surprise in a few minutes the man began to groan and very soon afterwards became conscious. Dr. Parry then watched him carefully and in about an hour found coma returning, when another injection was made and roused him for good. There was much swelling and effusion in the leg, but no ill effects followed.
In this case, judging from the comparatively small quantity of the antidote required, only a small amount of poison had been imparted, the bite being on the back of the foot, where the fangs cannot penetrate deeply. Still there can be no doubt that even this small quantity of the justly dreaded death adder poison would have proved fatal, if it had not been counteracted by the antidote.
Case 25, reported from Tasmania by Dr. Holmes, of Launceston, presents different features, showing the very large quantity of the antidote sometimes required. After describing the condition of his patient, a Mrs. Frazer, of St. Leonards, Dr. Holmes writes:—"From her desperate condition I thought it too late for the ammonia treatment and decided on injecting liq. strychniæ. At 12.30 p.m. injected m. xv, at 1.40, m. xv., at 2.10, m. xv., at 2.40, m. xv., and 3.10, m. xv., at 4 p.m., m. x., and at 5, m. x. A few minutes after the last dose I noticed the physiological action of the drug and desisted from injecting. At 8 p.m. she seemed almost well, pupils normal in size and reacting well, was not sleepy and could swallow easily. The patient made a good recovery."
This is the largest quantity of strychnine that has been required in Australia, namely, 126 minims of liq. strych., or 1-1/9th gr. injected in less than five hours, with the most beneficial result. Surely the most cynical scepticism must give in to such facts.