Treatise on Poisons by Sir Robert Christison

OF POISONING BY VENOMOUS SNAKES. Another entire group of poisons allied to the acrid vegetables in their action, but infinitely more energetic, comprehends the poisons of the venomous serpents. If we were to trust the impressions the vulgar entertain of the effects of the bite of serpents, the poisons now mentioned would be considered true septics or putrefiants; for they were once universally believed, and are still thought by many, to cause putrefaction of the living body. This property has been assigned them probably on no other grounds, except that they are apt to bring on diffuse subcutaneous inflammation, which frequently runs on to gangrene. But there are some serpents, especially among those of hot climates, which appear also to act remotely on the centre of the nervous system, and to occasion death through means of that action. The present group of poisons is of little consequence to the British medical jurist, as an opportunity of witnessing their effects in this country is seldom to be found. The viper is the only poisonous snake known in Britain, where its poison is hardly ever so active as to occasion death.[1531] This serpent, like all the other poisonous species, is provided with a peculiar apparatus by which the poison is secreted, preserved, and introduced into the body of the animal it attacks. The apparatus consists of a gland behind each eye, of a membranous sac at the lateral and anterior part of the upper jaw, and of a hollow curved tooth surrounded and supported by the sac. The cavity of the tooth communicates with that of the sac, and terminates near the tip, in a small aperture, by which the poison is expelled into the wound made by the tooth. The symptoms caused by the bite of the viper are lancinating pain, which begins between three minutes and forty minutes after the bite, and rapidly stretches up the limbs,—swelling, at first firm and pale, afterwards red, livid and hard,—tendency to fainting, bilious vomiting, sometimes convulsions, more rarely jaundice,—quick, small, irregular pulse,—difficult breathing, cold perspiration, dimness of vision, and injury of the mental faculties. Death may ensue. A case is related in Rust’s Magazin of a child twelve years old, who died two days after being bitten in the foot;[1532] another instance is briefly noticed in the French Bulletins of Medicine, of a person forty years old, dying also in two days;[1533] Dr. Wagner of Schlieben mentions his having met with two instances where persons bit on the toes died before assistance could be procured;[1534] and notice has been taken in Hufeland’s Journal of a girl, eleven years old, having been killed in three hours at Schlawe in Prussia.[1535] In the last case burning in the foot, which was the part bitten, then severe pain in the belly, inextinguishable thirst, and vomiting, preceded a fit of laborious breathing, which ushered in death. The most remarkable instance, however, of death from the bite of the European viper is one lately described by Dr. Braun, as having been occasioned in the Dutchy of Gotha by the Coluber Chersea [Kreuzotter of the Germans]. A man, who represented himself to be a snake-charmer, insisted on showing his skill before Dr. Lenz, a naturalist of Schnepfenthal; and putting the head of a viper belonging to this gentleman’s collection into his mouth, he pretended to be about to devour it. Suddenly he threw the snake from him, and it was found that he had been bitten near the root of the tongue. In a few minutes he became so faint that he could not stand, the tongue swelled a little, the eyes became dim, saliva issued from the mouth, rattling respiration succeeded, and he died within fifty minutes after being bitten.[1536] A French writer observes that the common viper of France is not very deadly; but that the bite of the red viper may occasion death in a few hours.[1537] The activity of the poison of the viper depends on a variety of circumstances. When kept long confined, the animal loses its energy; and after it has bitten repeatedly in rapid succession, its bite ceases for some time to be poisonous, as the supply of poison is exhausted. It appears also to be most active in hot and dry climates. Those cases are always the most severe in which the symptoms begin soonest; and the danger increases with the number of bites. An important observation made by Dr. Wagner is that danger need not be dreaded except when the bite is inflicted on small organs such as the fingers or toes, because larger parts cannot be fully included between the animal’s jaws, and fairly pierced by its fangs, but can only be scratched. The properties of the fluid contained in the reservoir do not cease with the animal’s life; nay they continue even when the fluid is dried and preserved for a length of time. It may be swallowed in considerable quantity without causing any injury whatever. In the course of some experiments lately made in Italy, a pupil of Professor Mangili swallowed at once the whole poison of four vipers without suffering any inconvenience; and that of six vipers was given to a blackbird, that of ten to a pigeon, and that of sixteen to a raven, with no other effect beyond slight and transient stupor.[1538] For the most recent account of the far more terrible effects of the cobra di capello and rattlesnake, the reader may refer to the authorities below.[1539] It was stated above that the poison of the viper retains its activity when dried. I have had an opportunity of observing this in regard to the poison of the cobra di capello, which is said to be preserved in India by simply squeezing out the contents of the poison-bag, and drying the liquid in a silver dish exposed to the sun. The specimen in my possession, for which I am indebted to Mr. Wardrop of London, has the appearance of small fragments of gum-arabic. It had been kept for fifteen years when I tried its effects on a strong rabbit. A grain and a half dissolved in ten drops of water, having been introduced between the skin and muscles of the back, the animal in eight minutes became very feeble and averse to stir, so that it remained still even when placed in irksome postures; occasional slight twitches of the limbs supervened; at length it became extremely torpid, and breathed slowly by means of the abdominal muscles and diaphragm alone; and in twenty-seven minutes it died exhausted, without any precursory insensibility. The heart contracted readily, when irritated nine minutes after death; so that the poison seemed to operate by causing muscular paralysis, and consequently arresting the respiration. There might also be arranged in an appendix to the present group of poisons those _insects_ whose sting is poisonous. The European insects known to have a poisonous sting, are chiefly the scorpion, tarantula, bee and wasp; of which the last two only are natives of Britain. The poison of these insects occasions diffuse cellular inflammation, which always ends in resolution. It is said, however,[1540] and it may be readily believed, that death has been sometimes caused in consequence of a whole hive attacking an intruder and covering his body with their stings. In an old French journal is shortly noticed the case of a peasant who died soon after being stung over the eye by a single bee.[1541] A more probable story has been told in the Gazette de Santé of a gardener who died of inflammation of the throat, in consequence of being stung there by a wasp while he was eating an apple, in which it had been concealed.[1542] But the same accident has often occurred without any material danger. The treatment of poisoning by venomous serpents need not be detailed here. The subject is introduced merely to mention that the treatment of poisoned wounds by the application of cupping-glasses has been lately resorted to with success for curing the bite of the viper. A patient of M. Piorry, two hours after being bitten, had all the constitutional symptoms strongly developed, such as slow, very feeble pulse, nausea, vomiting, and swelling of the face. When a cupping-glass was applied for half an hour, the general symptoms ceased and did not return. Next day diffuse inflammation began; but it was checked by leeches.[1543] An equally successful case is related in the Calcutta Transactions by Mr. Clarke.[1544]