sufficient to show that even after some days a favourable result may be looked for, and that with an operation presenting few difficulties.
POISONOUS SNAKES AND CALMETTE'S SERUM: A SUCCESSFUL CASE.
By Asst. Surgeon FEROZDIN MOHROOF,
A WOMAN named Hussan Bibi called at the Civil
Hospital, Lyallpur, at 9 AH., on 18th October
1903. She said she was bitten about an hour ago
by a thick snake about two yards in length. It
was of a yellow colour with black bands on its
back. She mentioned that she was going to
hold a wire post when the snake caught her
round the left forearm and gave her a bite on
the left hand. She felt the sensation of a needle
pricking and that was all. No sooner had the
animal inflicted its wound than it disappeared
again.
On examination, — There were two fang wounds on the left thenar eminence half an inch distance from each other. These punc- tures were oozing blood. On the outer side of the first left metacarpal there were six teeth marks of a snake ; these were oozing blood also ; the place of bite slightly swollen and inflammcd, more on the palmar aspect ; the site of the wound was very painful, the pain was shooting and burning in the left wrist, left forearm and some- what in the arm. Her eyes were congested. She was in pain and expressed desire to be left alone. Pulse was 96 a minute and breathing 42 a minute.
Treatment — As soon as she came in, a light ligature was tied above the left elbow-joint, and an excision of the injected tissue proposed, which she and her friends refused. A full dose of 10 ec. of Cahnette's serum was injected immediately below the ligature, which was removed by the patient after about half an hour. Th«.s injection was made at 9-15 a.m. on 18th October 1903. At 11 A.M. she expressed relief from the shooting pains ; she said she only felt pain at the site oi injection, and none in the limb at all.
At 5 P.M. next day, the woman complained of giddiness, confusion of ideas, dryness of throat, loss of power (slight in limbs) and heaviness of her body. Her pulse was 104 a minute temperature 99*4 ; she was breathing 35 times a minute. Another dose of 10 cc. was injected there and then in the corresponding portion of the limb. These symptoms subsisted gradually, and next morning she had only a temperature of 102, which was reduced by saline purge. The woman was quite well and entreated discharge on the 22nd October 1903.
The additional treatment was washing of the wound with Condy's lotion, and half a drachm of tinct. quininte ammoniata every four hours. Hot soup and hot milk were given as food.
Condusidns. — A careful lens examination re- vealed the two fangs marks in front and six teeth marks at the back of the limb. The snake there- fore was a fanged one and hence poisonous. From the colour and description I am of opinion that it was of variety Bungarus Fasciatus or Sankin. That Caimette's serum is really useful, is shown and proved from the above case.
I have had many opportunities of treating cases of snake-bite, but I think there is no hopeful case without the serum treatment.
SUPPOSED DHATURA POISIONING: A PERSONAL EXPERIENCE.
,
The following is a condensed narrative of Hospital Assistant R. U. Mehta's personal suffer- ings. On the evening of the 30th May, 1902, he dined with some friends. There were five people present, three adult males, a lad aged 13 years, and his hostess. The repast consisted of wheaten chappatieSjdal and rice, vegetables, and a highly- spiced curry. Fifteen minutes after food he felt giddy and thirsty, so he drank some water and lay down. Then he felt burning hot, so he hur- ried off with his friend to his dispensary. He next experienced dryness of the throat and pain in swallowing, and his gait became unstead}'. At this point one of tlie other adults began to be giddy and thirsty^ and to experience the same train of symptoms. The Hospital Assitntant took an emetic containing 30 grains of sulphate of zinc, which acted in thrf^e minutes. In spite of this, the symptoms progressed. The mouth was very dry, thirst^ unquenchable, swallowing paiiiful, speech thick and difficult, some deafness ; eyelids heavy, but no desire for sleep; hallucina- tions of vision, a stone appearing like a bunch of beautiful fiowei*s, delusions of seeing familiar faces. There was great restlessness, which pre- vented him from lying, sittingor standing quietly, yet his gait was staggering when he attempted to walk. Next he experienced irritability of the bladder, causing him to pass a few drops of urine every few minutes. This condition of things continued up to 5 o'clock next morning, when he slept for 9 hours. After that his head felt heavy, he was slightly deaf, and vision remained in- distinct for about 48 hours. All the others who partook of this meal went through the same experience, only their symptoms began later.
The cook, who cooked this meal, absconded with Rs. 750 worth of ornaments and currency notes. It was proved that on the diiy of the (pinner the cook brotrght some dhatura capsules to the house, and said they were for a hair po- made. It is probable that the dhatura seeds were mixed with the capsicum seeds used in the curry. It appears ^that over a year after theQlp event the cook has been arrested in Sholapur. o
