THE TEXAS MEDICAL NEWS. A JOURNAL OF MEDICINE, SURGERY AND HYGIENE. Devoted to the interests of the Medical Profession of Texas and the Published monthly at Austin, by THE TEXAS MEDICAL NEWS PUBLISHING The Management do not hold themselves responsible for the views of their corre For Texas Medical News. Adrenalin Chlorid in the Treatment of Rattle- snake Bite.* BY AUG. D. FERGUSON, M. D., DALLAS, TEXAS. The author spent eleven months in Southwest Texas, in the It was during this stage of development that most cases of rattle- *Read before the Dallas County Medical Society. 194822 snake bites occurred, and it was almost an everyday occurrence. It is in this sub-tropical section of the State, where cacti and catclaws are thickest, and occasionally a tree of black ebony, we find the most vicious species of Pit Viper, which are characterized by being short and thick in proportion to length, with clubbed tails, and their surface appears rough, commonly known among the natives as the diamond-back rattler. The "pit" consists of a depression over the lip between the eye and the nostril. The head is triangular, lanceolate, with massive muscular development of the jaw. The pupil is eliptical instead of round. There are two hollow fangs in the superior maxilla which, in the quiescent stage are retracted until they lie horizontally along the upper jaw with their points looking backward. The fangs in the upper jaw are hollow like a hypodermic needle and communicate with the venom sack, which, when brought into action, is compressed by muscular fibers and forces the venom through the hollow of the fangs. There are two similar fangs in the lower maxilla which have no hollow. The rattlesnake is more dangerous during the hot season or period of reproduction, which, in this Southern latitude, is the early spring. But venomous snakes, with few exceptions, are sluggish, and the poison they possess is given them as a means of securing prey; this poison, consequently, is a powerful paralyzant, and the creature bitten can not get far away from his would-be devourer. Once a creature is bitten, the major portion of the poison contained in the sacks at the base of the fangs is used up, and it requires hours to reproduce it in any quantity. The second use of the fangs, consequently, does not develop the virulence that attains to the first, and the third is still less venomous and perhaps not at all so, the fluid exuded by the fangs being merely a secretion analagous to that developed in the salivary glands of man. The symptoms of all snake bites are similar, regardless of species, but they vary in intensity according to the quantity of venom injected, its location and the species of serpent. At first there is experienced but slight pain, which gradually increases until it becomes severe, when the influence of the poison on the nerve centers now appears, and respiration being labored, cardiac action weak and irregular, nausea and vomiting, faintness and cold, clammy perspiration simultaneously appearing, the patient, unless prompt measures are instituted for combating the toxemia, succumbs in a few hours from cardiac paralysis, the respirations continuing some time after cardiac failure. The patient, if he passes safely through the strain of the first thirty-six or forty-eight hours, manifests the destructive influence of the venom upon the protoplasm of the blood corpuscles and tissues, by more or less violent mental symptoms or exhaustion and coma. In many cases, however, where the patient is otherwise strong, he slowly recovers. Individuals weakened by disease, overwork, or insufficient food, which is generally the case with the poor Mexicans, are those in which the prognosis is unfavorable. The poison acts most readily upon warm-blooded animals, especially if injected into a vein, when death is often practically instantaneous, and the season of the year, more toxic, the hotter and the condition and the health of the snake, more so in the hungry. Rattlesnakes, like all snakes of the viperoid family, are born into the world. The mother will give birth, from the middle of July to the middle of August, to from six to twelve baby rattlers, about fourteen inches long, and no thicker than a lead pencil. The baby is self-reliant from birth and is provided with poison and fangs and is capable of self-existence without any assistance from its mother. Dangerous little fellows they are, marked like the adult snakes and provided with a single button at the end of the tailthe first link in the series of rattles to be developed ring by ring with each shedding of the skin. All snakes are carnivorous, and, as a rule, take living prey only, a few feed habitually or occasionally on eggs. Many swallow their victims live, others first kill it by smothering it between the coils of their body. Not all cases of snake-bite are fatal, for the reason that the snake, having previously bitten something else, his venom-bags being empty. The ignorant Mexicans treat snake-bite by incising the wound and applying a poultice of nopal, which is the prickly pear or cactus. When nopal is not to be had, they use Spanish daggerpoints for puncturing the wound many times, which is very painful and a poor substitute for incisions. It is needless to say that their treatment is ineffectual, except in cases where the reptile has previously emptied his poison-bags. If there is a full charge of venom, the patient is dazed and blinded and will not try to escape or kill the reptile. Treatment consists of adrenalin chlorid, hypodermically, in sufficient doses and often enough to strengthen and sustain the heart until the poison is eliminated. Opium in some form for the pain, -the better way would be to administer morphin hypodermically |