THE VENOMOUS REPTILES OF THE UNITED STATES, 
WITH THE 
TREATMENT OF WOUNDS INFLICTED BY THEM. 
BY 
PAUL B. BARRINGER, M.D., 
UNIVERSITY OP VIRGINIA. 
READ BEFORE 
TEE SOUTHERN SURGICAL AND GYNECOLOGICAL ASSOCIATION, 
NOVEMBER 12, 1891. THE VENOMOUS REPTILES OF THE UNITED 
STATES, WITH THE TREATMENT OF 
WOUNDS INFLICTED BY THEM. 
By Paul B. Barringer, M.D., 
University of Virginia. 
The more perfect the conception of a mechanism which 
inflicts an injury, and the more perfect the comprehension of 
the physiological and pathological changes which ensue as the 
result of such an injury, the more perfectly will the knowing 
surgeon be enabled to treat it. From my belief in the above 
statement, I have decided to lay before a body of surgeons a 
paper which possibly has equal claim upon the attention of 
naturalists. 
American snakes are divided by herpetologists into three 
great families—the Colubrince, the Elapidce, and the Crotalidce. 
The Colubrine snakes will not number, under a strict classi- 
fication, more than some sixty-five or seventy species, and they 
include about nine-tenths of all American snakes. Moreover, 
this large family is composed entirely of harmless snakes— 
that is, of snakes without fangs or poison sacs, and whose bite 
is no more injurious than the scratch of a briar. As this class 
includes some, however, which are popularly supposed to be 
very deadly, I will allude to them though they fall without 
the limits of this paper. Ido this from the fact that I have 
recently learned from reliable sources of a death from an 
overdose of whiskey, administered for the bite of a harm- 
less snake. The Heterodon family, the so-called “ Spreading 
Adders,” are, by the great mass of the people, believed to be 
next in venomous power to the rattlesnake itself. They 2 
VENOMOUS REPTILES OF THE UNITED STATES. 
are perfectly harmless, and their evil name comes entirely 
from the fact that in coloring, form, and even in action, they 
mimic the venomous types. The spotted spreading adder 
(if. platyrhinus), often called the “ Blow Snake,” from the 
manner in which it distends its body with air and emits it 
through the throat with a rushing sound, is found both North 
and South in the Eastern United States, and is greatly feared, 
though perfectly harmless. The “ Black Adder ” (ii. Niger) 
is limited to the South, and is the special horror of the un- 
informed. The smaller form {H. simus) is killed as a “ young 
rattlesnake.” 
The Tropidonotus family furnishes two members that are 
popularly considered very deadly. The “Water Snake” 
(T. sipedon) furnishes the foundation of many blood-curdling 
stories North, while the reputation of his Southern brother 
{T. fasciatus) imparts a flavor to “snake medicine” not 
otherwise obtained. These are both confounded with the 
true water moccasin, and suffer by the confusion. As it 
becomes a matter of some moment in the South, where all 
three are found, to distinguish them from the truly venomous 
moccasin, I will give the method further on. Though bold 
and blustering, and striking viciously when approached, these 
have no fangs or venom. I might mention others which, in 
certain localities, are feared without cause, but the misrepre- 
sentation of the above is universal. 
Turning to the next family—the Elapidce—we find family 
and genus represented by a single species, of many varieties. 
This snake (Maps fulvius) is, however, of especial interest to 
us, as it is a venomous serpent, though presenting the general 
character of a harmless one. This small and beautiful ser- 
pent is the sole American representative of the dreaded Cobra 
family of India and Africa. First described by Audubon 
(and drawn by him in one of his ornithological plates) as the 
Harlequin snake, Holbrook, in 1842, pointed out the fact that 
it had venom fangs. Under the names of Harlequin snake, 
Bead snake, and Coral snake, this beautiful little reptile has 
often been described, but seldom in its true light. Shy in its PAUL B. BARRINGER. 
3 
habits, and hence not often seen, it is not considered common 
anywhere, and yet it extends from Virginia to Texas. Gentle 
of disposition, and never aggressive, it often will not bite 
when handled, and seems too small and beautiful to be 
harmful. Dr. S. Weir Mitchell, of Philadelphia, in a most 
interesting and complete article on the “ Poison of Serpents,” 
in the Century Magazine of August, 1889, says of this snake 
that it is “too small with us to be dangerous to man.” It is 
to prevent you from falling into a similar error that I report 
the following case ; 
A workman was bitten on the hand by a small snake while 
playing with it. He killed the snake, and thought little of 
it. For a while no pain or general effect followed. In less 
than half an hour, however, pain in the arm and some evi- 
dence of loss of muscular power came on, and, in spite of the 
aid of a physician called in, at the end of eighteen hours he 
died. An examination of the snake showed it to be “ small, 
and its body was encircled by bright-colored ’bands. An ex- 
amination of its mouth showed two fangs in the upper jaw.” 
Mr. Charles E. Coe reports this in the Scientific American of 
June 27,1891, and refers to Dr. Mitchell’s error. He also refers 
to other, cases that seem to have come under his knowledge 
where a fatal result followed the bite of this snake. 
In various parts of the South, from Virginia to Texas, you 
will hear tales of a beautifully colored snake whose bite is 
deadly. These tales are too uniform in their coloring to be 
ignored. But having no accurate description to go upon, and 
knowing that most of these gorgeously colored snakes are not 
poisonous, mistakes are liable to occur. I will, therefore, give 
you a description that will, I think, enable you at all times to 
recognize it. It is small, from sixteen to twenty inches long. 
The neck is full, making the head seem small and hardly sep- 
arated from the body. The general body-ground is a blue- 
black, marked as follows: Behind the head, and extending 
forward under the throat, is a yellow band. Behind this, on 
the body, are a dozen or more wide brick-red bands, extend- 
ing to the belly, and each red band is bordered by a narrow 4 
VENOMOUS REPTILES OF THE UNITED STATES. 
band of yellow before and behind. The tail is barred with 
yellow, and tipped with the same. The ventral plates behind 
the anus are all divided, the only poisonous snake in America 
in which this is true. The geographical range of this snake 
is from Southern Virginia around the South Atlantic States 
to the Gulf; up the Mississippi Valley to Missouri, and thence 
to Texas. Common nowhere, it is most abundant in Florida, 
and there seems to attain a greater size than elsewhere. Spe- 
cific names have been given to several of its varieties, but it 
is doubtful if they will hold. 
The remaining family—the Crotalidce—includes all the 
other venomous snakes in the United States. Not only is 
this the larger number, but they are snakes that are limited 
to this hemisphere. While the Crotaliue snakes may be classed 
with the Vipers of the Old World, they present some char- 
acters so peculiar and constant as to entitle them to a special 
division. One of these is a deep pit between the eye and nos- 
tril, and below,-a line joining these, and hence they receive 
the name of “pit vipers.” This family includes our rattle- 
snake tribe, with its various subdivisions, and also the cop- 
perheads and water moccasin. 
The rattlesnakes are divided into two genera by structural 
peculiarities that any observer would notice, and as it is a 
distinction of some practical bearing, I will ask your atten- 
tion. The rattlesnakes that inhabited the open prairies of the 
Northwest, and to which the Indians applied the name “Mas- 
sasauga ” (Sisturus catenatus), and the “ Ground rattlesnake ” 
of the South (,Sisturus miliaris) have the top of the head as 
far back as the eyes covered with large scales. The Diamond 
rattlesnake of the South (Crotalus adamanteus), and his more 
Northern brother, the Common rattlesnake (C. horridus), have 
the head covered with small scales almost up to the nose, the 
eyes only being covered each by a large plate. For reasons 
that are not altogether understood, the latter genus is the 
more to be feared as a poisoner. The ground rattlesnakes of 
the South do not attain a size sufficient to make them greatly 
feared, but their Western relatives often reach five feet in PAUL B. BARRINGER. 
length, and yet their bites do not produce so disastrous results 
as the bite of a common rattler or a diamond rattlesnake of 
the same size. In size the common rattlesnake seldom exceeds 
four feet, while the diamond rattlesnake of Florida and of 
Texas will sometimes nearly double this. Without going 
further into the different varieties of rattlesnakes—some four- 
teen or more—we may say that they all have rattles, and, be- 
yond the fact that the genus Sisturus does not seem, weight 
for weight, as poisonous as the genus Crotalus, they are 
poisonous in proportion to their size. The American copper- 
head is, perhaps, the most widespread of any single species of 
American venomous serpent; and while the opinion is not 
warranted by the facts, I know of no locality in which the 
rattlesnake and the copperhead are found side by side, in 
which the inhabitants do not fear the latter the most. In 
truth, the rattlesnake, drop for drop of venom, is the more 
poisonous, but his life-habits are such as to make bites from 
him quite rare, while with the copperhead they are common. 
This arises from the difference in temperament, if I may so 
speak, in the two snakes. Observe them in captivity, and 
you will at once see this difference. The rattlesnake is slug- 
gish and slow in movement. It is boldly indifferent to ap- 
proach, and half the time will not take the trouble to coil 
when approached. At rest it lies with the head drawn down 
on the coil, and will seldom attempt to strike except from a 
coil. How different with the copperhead ! Ever on the qui 
vive, he coils when he hears you coming. Whether fresh or 
tired, he will not put his head down, but keeps it well up, ever 
on the alert. As his classical name signifies (Agkistrodon 
contortrix), he is a snake of action. He can strike under 
conditions where a rattlesnake would be helpless. Some of 
the feats that I have seen this serpent perform in this line 
seem incredible. I have seen him strike the sole of the foot 
through an opening in the floor not appreciably larger than 
the snake’s head. This summer I knew a child bitten by a 
horizontal blow from under a warped plank on a barn floor. 
It is the vicious nature and extreme agility of this pest rather VENOMOUS REPTILES OF THE UNITED STATES. 
6 
than its real poisoning power that makes it so much to be 
feared. As before stated, it is very widespread. Under the 
names of Copperhead, Highland Moccasin, Cotton-mouth and 
Pilot, its different varieties are found throughout the United 
States, east of the Rocky Mountains. In the mountain regions 
of Southern Virginia, North Carolina, and Tennessee we have a 
variety (the atrofuscus of Troost) which perhaps, is a different 
species, but certainly presents no generic difference. In simple 
coloring, snakes vary greatly with the locality, conforming as 
they do to their environment. Leaving the copperheads, we 
come to another branch of the same genus—the Water moc- 
casin (Agkistrodon piscivorus). South of a line drawn from 
Norfolk to about Cairo, Illinois, this reptile abounds. Not 
having the predilection for barns, corn-cribs, and gardens that 
its kinsman, the copperhead, seems to possess, but seeking the 
meadows and swamps near water, it is not so much to be 
feared, but is of about the same poisoning power. Mitchell 
puts it as slightly less, but from cases that I have seen, 1 
think that the average bite of this reptile is about equal in 
severity to that of the copperhead. Its short, compact body 
makes it seem much 'smaller than it really is; the average 
specimen will be heavier than the average copperhead. It is 
this malicious reptile that has given the widespread fear of water 
snakes throughout the Union, but this fear is without founda- 
tion at the North. This rough, slime-befouled snake is, as its 
name implies, a fish eater. From sheer malice it will kill 
fish too large for it to swallow, and this malicious spirit is 
shown toward other snakes. If a colubrine snake is placed 
in a case with a rattlesnake, it will be treated with contempt; 
but if caged with a water moccasin it will be killed. 
This is the complete list of all the poisonous snakes of the 
United States. While it is not within the province of this 
paper to give any detailed account of the structural character- 
istics by which each may be told, I will give a key that will 
enable anyone to tell a poisonous snake when killed. Leav- 
ing out of consideration the black, red, and yellow Flaps 
above described, any American snake with the pit between PAUL B. BARRINGER. 
7 
the eye and nostril is a venomous snake, and this is abso- 
lutely certain if, in addition to this, you find one or more 
ventral plates behind the anus undivided. Of the second- 
ary characters that distinguish our venomous snakes may be 
mentioned the following: an elliptical pupil placed vertically, 
a triangular head, narrow neck, and a blunt tail (rattle or no 
rattle). Living young within the gullet, or eggs in advanced 
stages of incubation in the ovisac, are likewise distinguishing 
features, as all of our crotaline snakes are oviparous. 
Leaving the snakes, we come to an American lizard that, 
in spite of some protests to the contrary, takes its place among 
the venomous reptiles of the Uuited States. I allude to the 
Gila Monster of Arizona and New Mexico. This hideous 
reptile, in its tough armor of orange and black, has been the 
subject of no little controversy among medical writers. With 
the Apache Indians, Mitchell, and Reichert on one side, and 
Yarrow and others on the other, the war still goes on. But 
one fact remains, that men have died from the effects of the 
bite of this lacertilian. lam able to add other cases to those 
previously reported. Dr. Charles C. Barrows, of New York, 
late of the United States Army, in reply to a letter of inquiry 
on this subject, writes me as follows : 
“ I have known of two deaths from this cause (Gila mon- 
ster). In each ease the man bitten was drunk, and the cir- 
cumstances surrounding the cases were almost identical. In 
one case a crowd had tormented and worried the monster 
until lie was in a violent rage. A man picked the animal up, 
and was bitten deeply in the forearm. He had all the symp- 
toms of cardiac depression, and although he was freely plied 
with stimulants, within a few hours he was dead. 
k‘ The other case occurred near Tombstone, and except that 
the man was bitten on the thumb, was similar in detail and 
ending.” 
Similar deaths have been ascribed by the non-venomous 
side of the controversy to “ a mixture of disease, Gila mon- 
ster, and bad whiskey,” but the facts of case remain. 
Let us now turn from the reptiles themselves, and take up VENOMOUS REPTILES OF THE UNITED STATES. 
8 
the Mechanism by which they administer the venom to the 
subject of their wrath. 
The little Flaps, the first considered, has in common with 
all the Cobra family, to which it belongs, on either side of the 
upper jaw a single permanently erect and immovable fang. 
This is pierced by a venom-duct, opening near the point, and 
communicating with a comparatively large venom-gland be- 
hind the eye, and running down into the neck. The set of 
the teeth is such that if they catch, they will hang—i. e., they 
will pull upon the tissues, and drag in more deeply. As in 
other snakes, the forcible closing of the mouth upon the part 
bitten compresses the so-called venom-sac, and forces out the 
fluid. 
In the Crotalidce, by far the greater number of our venom- 
ous snakes, we have an entirely different and more complicated 
mechanism. In these, as in all the Vipers, with one excep- 
tion, we have the fangs large and movable, lying folded back 
when at rest, and capable of being erected and brought for- 
ward when striking. This act is performed by the rotation 
of the superior maxillary bone, in which they are firmly fixed, 
on a process of the lachrymal. This is partly a muscular 
and partly a bony lever movement. The fangs are relatively 
large, and not regularly curved, but consist of two segments 
of an arc of given radius, joined at an obtuse angle. For this 
reason, the tooth is seldom or never sent to the hilt, so to 
speak, but seems best suited for tearing or ploughing the 
tissues. The tooth of a serpent is formed of a flattened plate, 
folded to form a tube, and the opening at its end, where not 
joined, is the exit of the venom-duct. In the snakes under 
consideration, the opening, contrary to the general belief, is in 
the convex side of the tooth. If we accept the fact that it is 
a cutting hook, and not a stabbing tool, the opening is placed 
just right. The tissues are uninjured on the concave side 
where the tooth hangs, but are more or less torn on the con- 
vex side. About the same mechanism is used to propel the 
venom from the sac as in the preceding. One of the tem- 
porals, and the spheno-pterygoid muscle, so-called, make PAUL B. BARRINGER. 
9 
pressure upon the sac, and squeeze out its contents the in- 
stant the fang is engaged. In some snakes, the copperhead 
especially, even if the fang fails to- engage, the venom is 
squeezed out and thrown quite a distance. The venom-gland 
in the Crotalidce is placed below and behind the eye. It is of 
the compound sacculated type, and from each of its many 
lobules the ducts run downward and forward to join a large 
duct somewhat expanded—the so-called venom-sac. Where 
this duct or sac joins the tooth at its ampulla-like base, the 
duct is very small, and it is claimed by some to have a sphinc- 
ter, which I have never been able to distinguish. The true 
method of closure here lies in the fact that while the tooth is 
folded back, this constricted portion is drawn tight over the 
base of the tooth, and when the fang is erected, it is relaxed. 
The mechanism is the same in all the rattlesnakes, copper- 
heads, and moccasins. 
Turning to the venom apparatus of the Gila Monster, we 
find a mechanism differing greatly from either of the’above. 
The venom fangs, if the lizard’s twelve or more lower teeth 
may be so called, are sharp and nearly straight. A recent 
writer on this subject describes the venom-sacs as located at 
the base of each tooth, and intimates that the grooves found 
in the teeth carry their venom into the depths of the wound. 
This does not agree with my own dissections in the least. In 
all animals (five) dissected by me, I find the following: 
There are eight, or, at most, nine curved teeth in each side 
of the lower jaw, ossified to its upper surface, lacertiliau-fash- 
ion, and not implanted in its substance. These teeth present 
a groove from base to apex as the result simply of their being 
made of a flat plate folded on itself, shell-fashion. The only 
“ venom-gland ” that I could ever find is an enormously de- 
veloped salivary gland of the serous type, lying external to the 
body of the inferior maxilla, and extending from the sym- 
physis backward and downward. I should call this gland a 
sub-mental gland. Just external to the line of the inferior 
teeth is a very marked and deep fold of mucous membrane, 
a peculiar and pronounced trough-like cavity, and into the 10 
VENOMOUS REPTILES OF THE UNITED STATES. 
bottom of this, between each of the teeth, the ducts from the 
gland before mentioned open by large distinct openings. While 
the teeth are much similar, this condition does not obtain in 
the upper jaw. This animal cannot bite, therefore, unless 
the object seized can be gotten within the mouth. When it 
does seize, it holds on, shaking the object held as if to sink 
its fangs deeper and work the saliva-like fluid into the wound. 
You can readily see how this trough-like cavity, as it is pressed 
upon by the mucous membrane of the gum being pressed down, 
will readily discharge its contents into the openings made by 
the teeth. The owner of this queer device is sluggish and 
peaceful, and only when he is tormented and worried can he 
be made to bite. 
Let us now consider the Venom of these pests. While to 
L. Bonaparte and others great credit is due for pioneer work 
in this field, it is to Drs. Weir Mitchell and his colleague in 
labor, Dr. Reichert, that we owe a debt of gratitude for what 
is really known on this subject. Through them we learn 
concerning serpent venom that it is a complex proteid com- 
pound, having two distinct factors, which differ one from the 
other markedly. 
The first of these is venom peptone. It is, as its name im- 
plies, a highly diffusible, modified albumin that is very rapid 
in its penetration of the tissues when injected subcutaneously, 
or even when swallowed. Its physiological action is as fol- 
lows : Injected into the tissues, as a crystalloidal body, it 
passes with ease into the blood and lymph currents. Its first 
effect is to depress the heart’s action, and in large enough 
dose will stop it at once in diastole. This effect is usually 
slight however, from American serpents, but not invariably. 
It produces but little of the marked local effect seen when the 
other type of venom proteid is injected. After quite a period 
some swelling is seen, but at no time is it marked. In the 
meantime it is beginning to show its selective properties upon 
the nervous system, and an acute ascending paralysis of the 
cord results.1 Death by asphyxia ensues when the respiratory 
1 Marine-Hospital Reports, 1890. PAUL B. BARRINGER. 
11 
ceutre is reached. Foektistow shows that the cardiac depres- 
sion is due, not to the influence on the heart muscle, but to 
disturbance of function in the ganglia of cardiac control, both 
extrinsic and intrinsic. The same writer shows that strychnia 
convulsions are checked at once by snake venom, but I regret 
to say that this was not demonstrated of venom peptone alone, 
though it was, from what we know of the other constituent, 
doubtlessly the agent. As regards its influence on the blood, 
Kinyouu shows that Cobra venom, which is nearly all venom 
peptone, has no decided influence in modifying the coagula- 
bility of the blood. 
The other potent factor of serpent venom is venom 
globulin. This class of proteids—the globulins—as you 
know, are all soluble in dilute saline solutions while pre- 
cipitated by saturated saline solutions. In accordance with 
the theory of Schmidt, this globulin class includes two out 
of the three (fibrin) factors concerned in the coagulation of 
blood. Looking, then, at the ease with which these globulins 
take upon themselves a change of form, and the close rela- 
tionship that venom globulin bears chemically to the usual 
clot constituents of blood, we cannot be surprised if we learn 
that the first marked action of venom globulin is the pro- 
duction of a change in the coagulating power of the blood. 
While it has not the power of passing through animal 
membranes that venom peptone has, and hence may be 
swallowed with impunity, it seems to have the power 
of dissolving animal membranes, so quickly does the blood 
rush out of its vessels. This causes a swelling; of the soft 
parts so quickly that I have known a boy’s foot to be mark- 
edly swollen by the time he ran two hundred yards. While 
this pronounced local effect is taking place, the same series of 
changes are taking place throughout the body, and if the 
quantity of venom injected be great enough and life be pro- 
longed, we have bloody extravasations on every mucous and 
serous surface in the body. But venom globulin is a nerve 
poison as well as a local one. Pari passu with the changes 
aforesaid, we have a gradual but not so pronounced paralysis 12 
VEND MOUS REPTILES OF THE UNITED STATES. 
of the nerve centres of the cord from below upward, and if 
the amount be great enough, ultimately death from asphyxia. 
The temporary heart disturbance found in poisoning from 
venom peptone is found here also, and about in the same de- 
gree. But the most pronounced change in the circulation is 
noted in the immense and rapid fall in blood-pressure. Foek- 
tistow found this to be due, not so much to the extravasations 
before mentioned, as to a vasomotor paralysis of the splanch- 
nic area, and a resulting drainage of the general blood of the 
body into this area. Injections of defibrinated blood into 
the bitten animal raises the pressure only while it lasts, even 
when injected in great amount. 
Applying this knowledge to our American snakes, we find 
the following : 
The venom of the Harlequin snake (Elaps fulvius) has 
never been subjected to examination, as far as I can learn, 
and we must therefore judge by analogy. As the Elaps be- 
longs to the Cobra family, Cobra venom may safely be taken 
to represent it. This venom, nearly all peptone, and only 
1.75 per cent, globulin, would give us little local action and 
pronounced paralytic result. I have looked up the careful 
estimates of amounts likely to prove fatal, and find that for 
fresh Cobra venom, 0.00008 of a gramme per kilo is a fatal 
dose (Vincent Richards), while of dried Cobra venom about 
0.002 of gramme per kilo was necessary (Kiuyoun). For 
fresh venom this is about yfqT °f a grain Per pound of 
weight. With these figures, the Elaps seems quite a large 
snake. 
Turning next to our Rattlesnakes, we find a very different 
story. The venom of the Diamond rattlesnake, probably our 
worst, contains 24.6 per cent, venom-globulin (Mitchell), and 
but little venom peptorae. Hence, we would have pronounced 
local effect and a much more uncertain and slow paralytic re- 
sult. As to the amount of venom that a rattlesnake contains 
for a given size, so much depends upon the time which has 
elapsed since he last struck that any series of observations, 
to be of any value, must extend over quite a time, and be PAUL B. BARRINGER. 
13 
made upon a large number of animals. lam at work upon 
such a table now, but for so short a time, that any result given 
would be little short of guesswork. I do not think, how- 
ever, that it will be found ultimately to be far from one 
gramme of venom per kilo of snake. From a number of 
measurements, I find that a snake will have to be nearly four 
feet long to weigh a kilo. Such a snake would, therefore, give 
about 15 minims of venom as his average. Taking Fon- 
tana’s estimate of -g1 of a grain per pound of weight as the 
fatal dose, we find that 3 minims absorbed would produce 
death in a one-hundred-and-eighty-pound man. It should be 
stated, however, that in estimating this amount per snake, we 
took in every case all that could be obtained, urging the most 
persistent biting on his part, at the cup. FTo snake of four 
feet in length can deliver anything like 15 minims in a wound 
at one blow. 
’Turning from the rattlesnakes to the other Crotalines, we 
find that the copperhead gives of venom globulin about 8 per 
cent, aud the water moccasin a little less, while their venom 
peptone is little. 
In their Smithsonian Report of serpent venom, Drs. Mitchell 
and Reichert state that they found bacteria of various kinds 
in venom, and that they were harmless. I can readily con- 
ceive that a diseased snake might have bacteria in its venom- 
sac, but that they exist in the venom of the average snake I 
am convinced is an error. In conjunction with my colleague, 
Prof. Tuttle, of the University of Virginia, I tested the venom 
of various snakes, and in no instance did I find bacteria if 
taken from a sterilized fang. The procedure was as follows : 
The snake was caught with the staff, the mouth drawn open, and 
the upper jaw held up by a piece of cloth in the mouth through 
which the fangs projected. Over the fangs were slipped layer 
after layer of antiseptic filter-paper until only the tip was ex- 
posed, By pressing the side of the head a few drops of venom 
were expressed, and this was allowed to run, to clean the duct 
After this, no venom removed through the fang (from a healthy 
snake) ever gave a single colony, though tested in media of  VENOMOUS REPTILES OF THE UNITED STATES. 
14 
various kinds. While on the subject of healthy snakes, I 
may mention a find that we did make during these examina- 
tions. In expressing the venom of a big “four-foot” rattle- 
snake (C. horridus), we noticed a white, flaky material com- 
ing out from one of the fangs, and upon microscopical exam- 
ination found in the venom a living colony of nematode 
worms. These worms lived in a small vial of mixed venom 
from various suakes until it decomposed—about two weeks.1 
I must, therefore, conclude that the bacteria at various times 
reported in venom came from the serpent’s mouth, and that 
these mouth-bacteria are harmless is more than doubtful. 
If any one will examine any series of reports on bites of 
American snakes, he cannot fail to be struck with the fact 
that about one case in every five is complicated with symp- 
toms of septicaemia. This is especially true of Yarrow’s 
series of cases in the American Journal of the Medical Sciences, 
April, 1884. That the bacteria of infection do not reside in 
the venom I feel assured. That they come from the snake’s 
mouth, and that they are often pyogenetic, I am absolutely 
certain from repeated experiments in which the bite of a non- 
venomous snake (Heterodon) was followed by pus formation 
too frequently to be merely accidental. This should cause us to 
modify our treatment of snake-bites—at least, enough to bring 
them within the pale of modern surgery. The results of Kin- 
youu’s experiments with Cobra venom as a germicide are 
strongly corroborative of the views here put forth. Not only 
are pyogenetic bacteria not found in venom, but a 1 per cent, 
solution of Cobra venom produces a decided inhibition to the 
growth of many bacteria, including streptoccocus pyogenes 
and staphylococcus pyogenes aureus.1 
Leaving the snakes’ venom, and turning to the Gila Mon- 
ster, we find that we know far less about it. That it is a 
modified saliva is certain, and that it comes from their sub- 
1 The species to which this worm belongs was not determined, and probably 
has never been described. It is possibly a member of the Strongylus family. 
2 American Marine-Hospital Reports, 1890. PAUL B. BARRINGER. 
15 
mental gland I also feel assured. It would seem from the 
divergence in the results obtained by Yarrow and Mitchell, 
both careful observers, that it differs in toxic power under 
different conditions of body. To those familiar with the im- 
mense variation in the saliva of other animals when produced 
uuder varying stimulation of the secretory nerves, it would 
not seem too much to look for some such change here. The 
peculiar odor of the saliva found in these animals is most 
marked when the animal is enraged. Moreover, I have known 
of no case in which a serious result followed its bite, iu which 
the animal was not in a fury of rage. 
The diagnosis of a snake-bite is usually easy with American 
snakes, as all except the Elaps produce marked local swelling 
and extravasations. But if it were an Elaps, the absence of 
local lesion, the decided mental hebetude, almost coma, dilated 
pupil, and general paralytic condition might, especially if the 
smell of whiskey be upon the breath, mislead with serious 
results. 
The wound made by a nou-venomous snake is usually dif- 
ferent from that made by a poisonous one. In the former, a 
series of small punctures iu a double line shows the point 
struck, while in the latter, if there be more than two, the 
others are comparatively insignificant. 
While in certain countries, as in India, death from snake- 
bite runs up into the thousands per annum, the returns of 
death from this cause in the United States amount to almost 
nothing. And yet every practitioner in the country districts 
meets cases almost yearly. These two facts together give us 
as favorable the general prognosis in the wounds inflicted by 
our reptiles. Taking them in detail, I can give no statistics 
for the Elaps, but as it is not a common snake, and of gentle 
disposition, its bites must be comparatively few. From a 
series of thirty-eight rattlesnake bites that I have gotten, I 
think that taking man, woman, and child, the mortality will 
not run over 10 per cent. This is meant to cover the region 
inhabited by the huge Diamond rattlesnakes, as well as the 16 
VENOMOUS REPTILES OF THE UNITED STATES. 
less dangerous Sisturus. As regards the copperhead’s bite, I 
have (including Yarrow’s nine cases) sixty-nine cases, with one 
death. This was a boy six years of age, and it took place 
after several days. All in all, Ido not believe the mortality 
from the copperhead’s bite will run over 1 per cent., taking 
man, woman, and child bitten. The water moccasin being, 
from its peculiar habitat, less apt to bite children, will fall 
below this. In fact, I have never been able to learn of an 
authentic case of death from the moccasin’s bite. 
Treatment of Reptile Bites.—ln the first place, the 
preventive treatment lies in keeping out of the region inhab- 
ited by these pests, or, if you must expose yourself, wearing 
good protective leggings, etc. The hog is, of all creatures 
known, the greatest practical enemy of the snake. In some 
swamp and mountain districts of the country, the abundance 
of the bears prevents the raising of hogs, and here the snakes 
abound, the bear being the unintentional protector of the 
snake. 
Leaving preventive treatment out of consideration, we may 
divide the immediate into two heads : 
First, the local treatment. Every individual whose occu- 
pation exposes him to the danger of such wounds, should 
know that immediate attention to such wounds will save his 
life in almost any contingency. With a knife, or even with 
a thorn, cut or tear open the wound until it bleeds freely. 
As almost all bites are on the extremities, the patient may be 
able to suck the wound. If so, do it at once—a sore mouth 
or decayed tooth makes no difference; the very act of suction 
will prevent the entrance of the poison into a mouth lesion. 
If the surgeon is at hand, which seldom happens when the 
bite first occurs, he should open each of the punctures trans- 
versely to the line of lymph and blood flow, and apply a 
cupping-glass. If $t hand, a solution of permanganate of 
potash (10 per cent.) or a strong solution of liquor potassse, 
injected into the wound, will destroy the physiological activity 
of the venom entirely. If he can do two things at the same PA UL B. BARRINGER. 
17 
time, let him likewise tie an extemporized tourniquet around 
the limb at once. The above treatment is entirely independ- 
ent of the kind of snake, provided only it be poisonous. Now 
let me say one more word in regard to the local treatment. In 
5 per cent, of all bites that are recovered from, a chronic sep- 
ticaemia results. This is due to the fact that almost all snake- 
wounds are more or less infected with pyogenetic bacteria from 
the saliva of the snake. The viscid mucus always in a ser- 
pent’s mouth to enable it to swallow its prey, is a perfect 
nidus for the propagation of these .germs. The abundance of 
this mucus gives to our copperhead in many localities the term 
cotton-mouth, and it is from them especially that we receive 
these septic bites. In viewing the local effects of venom 
globulin, in which our snakes abound, we saw a condition 
produced most favorable to the spread of pyogenic and sapro- 
phytic bacteria, and they very readily take hold here. There- 
fore, all snake-wounds should have applied to them the same 
surgical care applied in these days to other wounds. This 
chronic septicaemia seems to produce a recurrent neuritis in 
the nerves distributed to the part bitten, and often when 
similar telluric conditions again obtain, we are apt to have 
herpetic eruptions break out at the seat of the wound. 
Turning to the constitutional treatment, we find that alco- 
hol in moderate quantities (not over a half pint all told) is an 
agent usually sufficient to maintain the heart’s action and 
blood-pressure at a safe point. But as the poison begins to 
make itself more distinctly felt on the centres, we find that 
alcohol, especially if the amount of venom be great, is unable 
to prevent a dangerous fall in the force of nerve impulses 
sent out, and we must assist it by strychnia. One-thirtieth 
to one-twentieth of a grain hypodermatically administered, 
will increase the nerve-centre tone, and restore the waning 
powers. To avoid gangrene of the limb, as the result of our 
tourniquet, it will be necessary at intervals to remove it, and 
at these times more or less venom will enter the system. By 
repeating the alcohol, strychnia, and, in case of a Gila Mon- 18 
VENOMOUS REPTILES OF THE UNITED STATES. 
ster. bite, digitalis, we may tide over these periods, and save a 
patient under conditions most adverse. The above include ail 
remedies of demonstrated power. Bibron’s antidote, the Tan- 
jore pill, viola sagittata, squirrel’s ear, sweet oil, and many 
other remedies, each have their advocates, but I know nothing 
of them. The means that I have suggested have in very 
many cases saved human life, but they should be in the 
hand of a man who will not lose his head from excitement.