ute
poisoning in man and other animals. By means of two recurved fangs
attached to the upper jaw, and connected by a duct with poison-secreting
glands, they introduce into their prey a thick, transparent, yellowish
fluid, of acid reaction, probably of the nature of an albumose, and
known as the _venom_.

The _clinical features_ resulting from the injection of the venom vary
directly in intensity with the amount of the poison introduced, and the
rapidity with which it reaches the circulating blood, being most marked
when it immediately enters a large vein. The poison is innocuous when
taken into the stomach.

_Locally_ the snake inflicts a double wound, passing vertically into the
subcutaneous tissue; the edges of the punctures are ecchymosed, and the
adjacent vessels the seat of thrombosis. Immediately there is intense
pain, and considerable swelling with congestion, which tends to spread
towards the trunk. Extensive gangrene may ensue. There is no special
involvement of the lymphatics.

The _general symptoms_ may come on at once if the snake is a
particularly venomous one, or not for some hours if less virulent. In
the majority of viper or adder bites the constitutional disturbance is
slight and transient, if it appears at all. Snake-bites in children are
particularly dangerous.

The patient's condition is one of profound shock with faintness,
giddiness, dimness of sight, and a feeling of great terror. The pupils
dilate, the skin becomes moist with a clammy sweat, and nausea with
vomiting, sometimes of blood, ensues. High fever, cramps, loss of
sensation, haematuria, and melaena are among the other symptoms that may
be present. The pulse becomes feeble and rapid, the respiratory nerve
centres are profoundly depressed, and delirium followed by coma usually
precedes the fatal issue, which may take place in from five to
forty-eight hours. If the patient survives for two days the prognosis is
favourable.

_Treatment._--A broad ligature should be tied tightly round the limb
above the seat of infection, to prevent the poison passing into the
general circulation, and bleeding from the wound should be encouraged.
The application of an elastic bandage from above downward to empty the
blood out of the infected portion of the limb has been recommended. The
whole of the bite should at once be excised, and crystals of
permanganate of potash rubbed into the wound until it is black, or
peroxide of hydrogen applied with the obj