A handsome girl of 17 is bitten in a bathroom on the back of the second right toe at dusk on a Sunday evening by a half-grown tiger snake, subsequently caught and killed in the room. She does not suspect snakebite, and no ligature is applied until the poison has been absorbed and overpowers her. Instead of sinking into coma, she becomes unconscious for a short time only. Her brain then clears itself, and all symptoms seem to disappear so completely that when a medical man of undoubted ability and skill sees her a few hours after the bite, she declares herself quite well again, and does not appear to require any treatment, least of all that by strychnine injections. She passes a good night, but on Monday morning symptoms denoting paresis of the respiratory and glosso-pharyngeal centres make their appearance, almost identical with those described by Indian writers as following cobra-bite. She has difficulty in breathing and swallowing, but one injection of 1/10th of a grain removes it completely and speedily, and once more all danger is thought to be past. On Monday evening, however, dyspnœa and dysphagia appear again in an aggravated form. The urine also becomes scanty and loaded with albuminates. Strychnine now is again resorted to, but it fails to act as before, and from hour to hour the young lady's condition becomes more critical. When the writer reached her on Tuesday afternoon, 42 hours after the bite, paralysis of the centres named was imminent, and her case appeared a hopeless one, unless a vigorous use of strychnine yet turned the scales in her favour. One-tenth grain doses were therefore injected every half-hour, and continued until the physiological action of the drug showed itself. This took place, but failed to have the least effect on the affected centres; and complete paralysis ensued 45 hours after the infliction of the fatal bite.
The first lesson the Australian practitioner should learn from this sad case is that of extreme care and caution in dealing with any case of snakebite, no matter how slight it may appear at first sight. It is not for the first time we have been taught this lesson, though it has rarely, if ever, been conveyed in so singular a manner. Recent utterances about the innocuousness of Australian snake-poison find a fitting answer in this melancholy occurrence.
The second lesson it conveys is a new one, even to the writer. From the fact of one strychnine injection removing all poison-symptoms early on Monday, but the free use of the antidote failing entirely to have this effect on Monday night and on Tuesday, we are warranted to draw the conclusion that the antidote can only be relied on within the first 24 hours after the bite; and that, after this period, the snake-poison produces organic changes in the affected nerve-cells, preventing their depressed functional activity from being restored by the antidote. Further observations, of course, are required to confirm these conclusions. Their correctness, however, appears to be borne out by the fact observed by the writer, that the larger domestic animals, who sometimes linger on for days after being bitten by a snake, usually recover under the strychnine treatment if it is applied immediately or soon after a bite, but die when found and treated in an advanced stage of the malady.
That the grave kidney complication, checking the elimination of the poison from the system, militated against recovery in this case, and greatly influenced the singular course of the poisoning process, cannot be doubted.
CONCLUSION.
In the little work submitted herewith to the medical profession and the general public, for both of whom it is intended, the author may justly claim to have solved the difficult and long-standing problem of snake-poison. We have at last a correct theory of its action, and, what is of more importance to the public, we have an effective antidote. These facts, being as fully established in these pages as any scientific facts can be, the most exacting and even captious criticism will not upset, nor can further research add anything very material to the writer's deductions and their final result.
In order to show how an obscure Australian country practitioner succeeded in a discovery, for which all his predecessors in this field of research had laboured in vain, it will be necessary in conclusion to give a short history of the discovery as by slow degrees it has originated and matured in the writer's mind, who during the last 35 years with respect to this subject had followed the advice which Schiller gives in his grand poem, "Die Glocke:"—