ON THE 
TREATMENT 
OF 
RATTLESNAKE BITES, 
WITH 
EXPERIMENTAL CRITICISMS 
UPON THE 
VARIOUS REMEDIES NOW IN USE. 
BY 
S. WEIR MITCHELL, M.D. 
LECTURER ON PHYSIOLOGY*, PHYSICIAN TO ST. JOSEPH'S HOSPITAL, PHILADELPHIA; FELLOW OF THE COLLEGE OF 
PHYSICIANS OF PHILADELPHIA; MEMBER OF THE ACADEMY OF NATURAL SCIENCES OF PHIL- 
ADELPHIA; CORRESPONDING MEMBER OF THE BOSTON NATURAL HISTORY 
SOCIETY*, HONORARY CORRESPONDING MEMBER OF THE 
BRITISH MEDICAL ASSOCIATION, ETC. 
[Extracted from the North American Medieo-Chirurgical Review for March, 1861.] 
PHILADELPHIA : 
J. B. LIPPINCOTT & CO. 
1861. ON THE 
TREATMENT 
OF 
RATTLESNAKE BITES. 
The subject of the poisons made use of by certain animals has been 
in all times of the utmost interest to the popular mind. That it has 
failed to attract an equal or proportional amount of scientific investigation, 
can only be accounted for by supposing that the popular aversion to ser- 
pents, as well as the real danger which more or less surrounds the pursuit, 
have combined to deter toxicologists from engaging in such researches. 
The admirable effort in this direction made by the Abbe Fontana, who 
has left us the record of 3000 experiments on viper poisoning, may also 
have done something to prevent further study of this serpent, since his 
opinions have been reverentially received as final, and the multitude of 
his experiments has caused them to be looked upon as exhaustive of the 
subject. 
In other than European countries, and whore the more virulent poison- 
ous snakes abound, observers have been wanting, or they have lacked those 
means of pursuing the study which only a great city affords. It has thus 
happened that, through want of material where observers were plenty, or 
lack of these where material was abundant, the knowledge of serpent 
venoms has advanced but little since the days of Fontana. 
Before the time of that great toxicologist, viper venom had been studied 
by Charas, 1G69, Redi, 1672 and 1675, and Mead, 1673. A multitude of 
others had also touched the subject, but, on the whole, they added nothing 
important to the information which came down from the Greek and Roman 
fathers of medicine; or, when they added anything, it took the shape of 
fanciful conjecture, and served only to make more difficult the task of un- 
raveling the united web and woof of popular and scientific beliefs as to 
venomous serpents. 
Without carefully reviewing this mass of strange opinions and super- 
stitious conceptions, it is not possible to appreciate the service done by Fon- 4 
On the Treatment of Rattlesnake Bites. 
tana in clearing the ground for modern research and in setting at rest a 
host of minor absurdities. Most of the definite and novel views which he 
put forth as the direct results of his experiments have been more or less 
unsettled by various partial inquiries of more modern date : but, on the 
other hand, some of the most valuable facts which he discovered have 
never been questioned; and, as a whole, his essay, or series of essays, 
is still a monument of industry, ingeniously directed, and of experimental 
sagacity of the highest order. 
From 1767, the date of his essays, no contributions of any moment 
were made to the toxicology of venoms until the publication of Russel 
on the Poisonous Serpents of India, in 1787. 
In 1793 and 1799 appeared in this country Dr. Barton's Essays, which 
were rather records of his own thoughts and of popular and other opin- 
ions than of original research. In 1817, Mangili settled the question of 
the innocency of venom taken by the mouth; and in 1843, Prince Lucian 
Bonaparte analyzed the venom of the viper, and determined its albuminous 
nature. At various periods also appeared numerous papers by East In- 
dian surgeons and European physicians on the therapeutics of snake bites; 
but, with trifling exceptions, no further experimental papers were produced 
until Drs. Brainard and Green recorded their researches in 1853. Dr. 
Brainard's separate Essay, 1854, contained interesting observations as to 
the phenomena of venom poisoning, but the main object of both the 
papers alluded to was the examination of the value of iodine used locally 
as an antidote. The tendency to regard the subject chiefly from a thera- 
peutical point of view has indeed prevailed throughout nearly all of the 
researches, made either in this country, in India, or in Europe, so that 
if we omit the essays of Bonaparte, Mangili, Russell, and Davy, the 
work of Fontana still remains without a companion-no one since his 
time having examined any one serpent poison as to its chemistry, toxi- 
cology, and mode of formation. Yet, as every physician must concede, 
the treatment of snake bites can never be rationally understood until we 
retrace our steps and study anew and more profoundly the venom malady 
and its cause, in place of playing at perilous hap-hazard with its difficult 
therapeutics. 
When I first engaged in the study of the venom of the rattlesnake, it 
was with the intention of ascertaining what value Bibron's antidote pos- 
sessed. To effect this single end I procured four or five snakes from the 
Pennsylvania Alleghanies and proceeded to subject animals to their fangs, 
and afterward to give the supposed antidote. 
After destroying many animals and attaining only negative results, I 
began to perceive that I was working in the dark, and that it was alto- 
gether impossible to obtain useful results without possessing definite knowl- On the Treatment of Rattlesnake Bites. 
5 
edge as to the nature of the venom, the mode of its formation and ejec- 
tion, and the whole natural history of the disease to which it gave rise. 
The information which I desired was yet to be created. It existed in 
none of the books, and even so much of it as had been acquired by Fon- 
tana with regard to the viper, might not be true of the rattlesnake. 
With a clear sense of these deficiencies in the present state of knowl- 
edge as to venom poisoning, I laid aside my experiments on remedies, 
only to resume them after the labors of two summers had removed from 
my path the impediments which have hitherto rendered the study of anti- 
dotes practically useless. The result of these researches is recorded at 
length in a paper recently published by the Smithsonian Institution, and to 
which I desire to refer the reader for full details of my experiments and 
for the conclusions to which they led me.* The principal difficulty which 
I encountered at the outset was the want of snakes; owing, however, to 
the ready and constant aid which I received from the Smithsonian In- 
stitution, I was enabled to secure a regular supply from the Virginia Alle- 
ghanies, and with these and such other chance supplies as I could purchase, 
or as were procured for me through the kindness of my friends, I was 
enabled to pursue my purpose with only such embarrassments as of neces- 
sity belong to the subject. 
The practical difficulties which lay in the way of one studying the 
treatment of snake bites were among the most easily resolved of the 
many questions which multiplied in number and increased in perplexity as 
I advanced on this interesting path of study. In fact, I cannot but per- 
ceive that I have reopened a field of research which promises most valuable 
and strange results to the toxicologist, nor can I fail to comprehend that 
the whole subject of venom poisoning is to be reconstructed, and that on 
no branch of science are we so utterly ignorant as on this one. M. Ber- 
nard alone, of all the recent writers, seems to be aware of our lack of 
knowledge in this direction, and strongly urges a re-examination of the 
principal animal poisons, such as the venom of toadsf and serpents. 
At the close of the Smithsonian Essay, just referred to, I have given a 
brief statement of my views as to antidotes, and as to the great difficulties 
* Researches upon the Venom of the Rattlesnake: with an Investigation of the 
Anatomy and Physiology of the Organs concerned, by S. Weir Mitchell, M.D., Lec- 
turer on Physiology in the Philadelphia Medical Association. Jan. 1861. Washing- 
ton: Smithsonian Institution. New York: D Appleton & Co. Accepted for pub- 
lication, July 1, I860. 
j- Medical Times and Gazette, September 29th, 1860, p. 296. M. Bernard makes 
some interesting remarks on the venom of the toad. M. Gratiolet had already ex- 
amined this subject and arrived at somewhat similar conclusions, to which, however, 
M. Bernard does not allude. See Gratiolet. Comptes Rendus, vol. xxxiv. p. 731, 
1851. 6 
On the Treatment of Rattlesnake Bites. 
attendant upon their thorough study, and I have appended a short dis- 
cussion of the relative value of the various remedial means now in repute 
for the treatment of snake bites, as well as my own opinion on the rational 
method of treating these injuries. 
The object of this present essay is to consider all the best-known anti- 
dotes by the light of the practical criticism of experiment, and, finally, to 
point out what means of treatment appear to me best calculated to relieve 
the sufferers from these dreaded accidents. 
The course of study thus laid down will involve an examination of the 
following points, which I shall consider at such length as my space per- 
mits :- 
1. Fallacies in regard to the use of antidotes of all kinds, arising from 
want of exact knowledge as to the secretion of venom, and the mode in 
which the serpent uses its fangs and ejects the poison. 
2. Fallacies as to antidotes, arising from want of information on the 
natural history of the disease caused by the venom. 
3. General considerations as to antidotes, and as to the mode of con- 
ducting researches in this direction so as to avoid errors. 
4. Description of the phenomena of rattlesnake bites, analysis of 
symptoms, etc. 
5. Local treatment. Experimental examination of the local medica- 
tion most in repute. 
6. General or constitutional treatment. Experimental examination of 
the principal constitutional remedies. 
7. Sketch of the author's views as to treatment, local and general. 
1. Fallacies in regard to the use of antidotes of all kinds, arising 
from leant of exact knowledge as to the secretion of venom, and the 
mode in which the serpent uses its fangs and ejects the poison. When 
an antidote lias been given, or any treatment used after a snake has bitten 
a man or a lower animal, it is usually taken for granted that the danger 
of any two bites is much the same if the subjects of the bites are alike in 
age or vigor. Now, even when the serpents are themselves of equal bulk 
and have at disposal drop for drop the same amount of venom, it may 
chance that the danger of the two bites is utterly unequal, and thus that 
in one an antidote might fail, and in the other appear to succeed. This 
arises from one of the following reasons:- 
The snake fails to elevate its fangs sufficiently when striking, and the 
fang points touching the skin are driven backward toward their usual 
position of repose without penetrating the part aimed at. When this 
accident occurs, no wound is inflicted unless the teeth of the lower jaw be- 
become entangled in the skin of the bitten part, in which case the small On the Treatment of Rattlesnake Bites. 
7 
wounds thus made may be easily mistaken for fang marks. When experi- 
menting with Bibron's antidote, in July, 1859, a large dog was secured 
and placed within reach of a snake which struck it fiercely and became 
fastened for a short time, so that I was able to perceive that the fangs 
were doubled backward, their anterior convexities resting against the 
skin to which the serpent was attached by the curved teeth of its lower 
jaw. The wounds made by these teeth were of course harmless, and the 
dog experienced no further inconvenience. This cause of failure in the 
bite must be difficult of detection, under ordinary circumstances, the 
snake being free, since it would be dangerous to approach closely, and 
since the snake is usually entangled for but a brief period. When, how- 
ever, the serpents are held by the middle, in a leathern loop at the end of 
a staff, and thus allowed to bite, they not unfrequently fail to elevate the 
fangs sufficiently, and, as in experiments on antidotes, it is often necessary 
to secure the serpents in the manner described, the possibility of this 
occurrence should not be overlooked. 
When the rattlesnake bites, whether it be at perfect freedom or not, 
both fangs do not always pierce the skin of the animal stricken. I have 
sometimes suspected that the serpent does not always elevate both 
fangs. This, however, is a point which does not readily admit of direct 
observation in snakes at liberty, and I can only add, that of seven dogs 
bitten by serpents at freedom, four had two fang marks, and three had 
but one. Now as the fang, duct, and gland of one side are quite dis- 
tinct from those of the other, if only one fang be used, the dose of poison 
administered will be but one-half of that which would be injected were 
both fangs employed. 
Apart from the possibility of the snake using only one fang at will, 
there are other facts in this connection which may enable us to explain 
the frequent occurrence of single fang marks. When, for example, the 
snake strikes obliquely at the flank of an animal, one fang sometimes 
remains out of reach of the part penetrated by the other, and this is the 
more apt to occur, because, in elevating the fang teeth, at the moment of 
attack, their extremities are made to diverge widely.* For a like reason, 
when the serpent strikes a small limb or member, it sometimes chances 
that the fangs either straddle the part completely, or that one fang enter- 
ing it, the other passes it to one side without in any way injuring its 
tissues. / 
Besides these cases of single fang marks, many instances occur in which, 
* The object of this seems to be to protect the lower jaw from injury in case the 
fangs miss their aim and are driven downward, in which case they would pierce the 
lower lip of the snake were it not that their divergence throws their points outside 
of it. 8 
On the Treatment of Rattlesnake Bites. 
although both fangs penetrate the opposing tissues, only one is in reality 
active, or, both entering the flesh, for reasons to be presently detailed a 
part, or perhaps in some cases the whole of the venom fails to be injected, 
and the danger of the wound is materially lessened. 
When the fangs in biting are fixed in the flesh, the lower jaw of the 
serpent is pressed upward against the part bitten, and at the same instant 
the temporal muscles, and especially the anterior temporal, compress the 
venom gland, and urge its accumulated venom along the duct and through 
the tooth. In most cases where both fangs have been used, the actions 
which bury the fangs more deeply, and inject the poison, are consentane- 
ous on both sides; but sometimes a perceptible interval appears between 
the contraction of the right and left sets of muscles, so that a sudden 
motion of the bitten animal occasionally liberates one fang before its 
charge of venom has been duly delivered. 
Still more curious, however, is it, that we may have both fangs 
deeply buried in the flesh of an animal, and yet not a drop of venom 
injected. The explanation of this source of fallacy in the use of reme- 
dial means is to be found in the following facts. Redi, in his researches 
on viper venom, published in 1G75, states that the poison passes down 
alongside of the fang, and between it and the mucous cloak which covers 
it when at rest, and which is now known as the vagina dentis. Fontana 
disproved this statement, showing that the venom passes out through the 
canal of the fang. If, as I presume is the case, the arrangement of which 
I shall presently speak belongs to the viper as well as the rattlesnake, 
both were right and both were wrong. Professor Christopher Johnston, 
of Baltimore, and Professor Jeffries Wyman have both of them recently 
described the venom duct of the rattlesnake as ending in a papilla, which 
projects into the basal aperture at the base of the fang. Upon close in- 
spection it can be seen that no tissues connect these two parts together in 
any direct manner, the end of the duct being held in close contact with 
the fang by the gum, which envelops the tooth, and through which the 
extremity of the duct passes. When the fang is couched, at rest, in its 
mucous sheath, the apposition of the fang and duct is still kept up, but is 
less perfect than when the fang is erect, since then the mucous cloak is 
thrown off the anterior convexity of the fang, and gathering in firm folds 
at the base of the tooth, firmly presses the papillary end of the duct into 
the lower orifice of the fang. 
Such being the case, it can be seen that if the fang is not fully erected, 
or if, from any cause, the end of the duct is separated from the fang open- 
ing, a part or the whole of the venom may escape between the fang and its 
mucous cloak, and fall innocuous on the skin of the bitten animal. In a 
modified form this result often happens, and a part at least of the poison On the Treatment of Rattlesnake Bites. 
9 
is cast on the skin, the larger portion traversing the duct, and probably 
the excess alone being wasted. In direct experiments on animals I have 
often noted the escape of venom alongside of the fang, and in general, 
the more the serpent's motions are interfered with during the experiment, 
the more likely is it that the whole or a part of the poison will be lost in 
the way I have mentioned. It thus happens that the most vigorous ser- 
pent may become innocent at the very moment of the bite, and that not 
even the most watchful attention will enable the observer to say that 
the remedy given was the cause of a bite proving mild in its effects. As 
I have here urged, this, like other sources of fallacy, is most apt to appear 
when the serpent is held, and when thus we endeavor to cause the bite to 
occur in a particular part of the body of an animal. 
2. Fallacies as to the value of antidotes, arising from want of inform- 
ation in regard to the natural history of the disease caused by the venom 
of serpents. There exists an idea, not confined to the popular mind, 
that the bite of the rattlesnake is an extremely fatal accident. Although 
we have no full statistics which are available to settle the matter, I 
have gathered enough information from various sources to enable me to 
assert with great confidence that it is far less fatal than has been supposed. 
When making this statement, I do not mean to be understood as saying 
that the rattlesnake is not a dangerous animal, but only that neither man 
nor dog need be regarded as condemned to death when wounded by it, 
whether remedial means are afterward employed or not. A large rattle- 
snake long restrained from biting will use his weapons no doubt with 
deadly effect, and hence, when showmen have been bitten, they have rarely 
escaped. On the other hand, the greater number of such accidents, aris- 
ing from serpents at freedom, will be apt to prove serious in their results, 
but not very often fatal. Of fifty-seven cases of rattlesnake bites which 
are given in full or merely mentioned in the journals, only five died ; 
and even if we make every allowance for the character of the reports, this 
evidence still remains sufficiently strong ; nor have I found that it lost 
force in the presence of such facts as ray experiments on animals have 
brought before me. A close analysis of the table of cases in my Smith- 
sonian essay, (p. 100.1 with reference to the treatment and the result, 
brings us to the conclusion either that all treatment (oil, alcohol, iodine, 
ammonia, etc.) is successful, or else that the greater part of the cases 
must have survived under any form of medication. It can be shown, 
moreover, that most of the plans of treatment employed are utterly 
useless. 
Here, then, is a malady from which at least seven-eighths of the patients 
recover. The mere fact of their surviving can assuredly be no test of the 
value of a plan of treatment. Yet, that this or that case did not die has 10 
On the Treatment of Rattlesnake Bites. 
been thus construed, and this cardinal error exists in almost all of the 
earlier examinations of antidotes, and in some of the later ones. 
Authors who have reported successful cases of the treatment of snake 
bites by various means, have been further misled by a want of knowledge 
as to the duration of cases not treated at all, and as to the character of 
the recovery. A general survey of a number of cases, and a careful 
study of animals bitten and not treated, can alone supply this lack 
of information as to the average natural history of cases undisturbed 
by any therapeutic resorts. As the result of such study, we learn that 
a few cases of rattlesnake bite die, that a few linger long ere recovery 
is complete, and that the larger proportion get well, and that with a de- 
gree of suddenness which is sufficiently surprising, considered with refer- 
ence to the serious character of the symptoms, and well calculated to 
deceive the credulous therapeutist. 
In many cases this abrupt departure of all serious symptoms is most 
remarkable ; a man is bitten, thought to be dying, treated this or that 
way, and on horseback or at work within forty-eight hours from the time 
of the bite. In dogs bitten, alike result obtains, and the recovery after 
the most urgent symptoms is usually rapid and complete. 
Now nothing is more gratifying to the physician than the sudden effect 
of his remedies; and the speedy and favorable change of a case from an 
appearance of extreme danger to one of relief and convalescence, naturally 
leads him to attribute that result to his medication, which really was nat- 
ural to the malady. A fuller acquaintance with the disease must anni- 
hilate this source of error for any but the most incautious minds. 
3. It will now be fitting to consider the third section of our subject, 
and to comprehend clearly how we may avoid the sources of fallacy above 
pointed out, and how the study of antidotes to serpent poison should be 
conducted. 
And first, what is an antidote ? The popular mind usually conceives of 
it as a remedy having power to neutralize directly in the system a given 
poison, destroying its potency by acting upon it chemically or otherwise, 
in some more mysterious way. It is possible that agents of this kind may 
exist, but thus far we are ignorant of any possessing such a relation to 
the venom of the rattlesnake. The pretensions of remedies supposed to 
be so gifted may be easily settled by mingling them writh the venom, and 
afterward injecting the mixture into the tissues of an animal. 
The more rational conception of an antidote, is of an agent which 
merely counteracts the effects of the poison, and which may have no chemi- 
cal influence on the poison itself. Such an antidote may enjoy no power 
to affect the toxic activity of venom when mixed with it, and yet may 
prove to be an active constitutional preservative against its effects. Just On the Treatment of Rattlesnake Bites. 
11 
this position seems to be held by one of the supposed antidotes most in 
repute. 
So far as I am aware, no great difficulty is likely to arise in the study 
of antidotes, owing to their nature as such, for, although some of those 
most in esteem, such as Bibron's antidote (bromine) and the Tanjore 
pill, (arsenic,) are poisonous in a high degree, it is easy to learn how 
much may be given with impunity. Hence, although in one or two in- 
stances observers have actually and plainly destroyed animals with the very 
agents which were designed to relieve them, it is not probable that errors 
of this kind will be perpetuated, or even occur so often as to bring into 
disrepute any really useful remedy. The mode in which the study of anti- 
dotes and local remedies should be conducted, so as to avoid all the falla- 
cies to which I have alluded above, will now claim our attention. 
Opportunities of studying the use of remedies, local and general, in 
connection with cases of venom poisoning in man, are of course more 
or less rare, and it is scarcely possible to eliminate or allow for the varied 
fallacies which surround with difficulty this method of studying the sub- 
ject. Owiug to this, and to the comparative ease with which the means 
of study may be created in animals, it is preferable to employ these, and 
to use only such treatment in human cases as may appear to promise 
enough of success to justify its usage. 
The larger the animal employed the better will it be for the purpos e, since 
the symptoms are more easily studied in large animals, and since they are 
less likely to be injured by active antidotes. Almost all toxicologists who 
have investigated this subject, have been content to submit animals, as 
dogs, etc., to be bitten by the serpents themselves. We have seen, however, 
that when this course is followed, a number of fallacies interfere to pre- 
vent the observer from drawing satisfactory conclusions, and although 
great care and thorough acquaintance with the anatomy and habits of the 
serpent may enable us to overcome this difficulty in part, some portion 
of the obstacles in question are in the nature of things unavoidable. In 
my own researches 1 have sought to escape from these embarrassments: 
first, by a careful study of the natural history of venom poisoning in 
dogs and other animals; second, by injecting into the animal experi- 
mented upon known quantities of venom previously removed from the 
ducts of active serpents. The venom to be thus employed is secured in 
the following manner: A serpent is seized by the middle, with a leathern 
loop at the end of a staff; then the neck is caught and held down on a 
table with a notched stick, while a tube an inch and a half in diameter, 
and holding a sponge soaked in chloroform, is slipped over the snake's 
head, and by a dexterous motion carried downward so as to include one- 
third of the length of the serpent, the notched stick being at the same time 12 
On the Treatment of Rattlesnake Bites. 
removed. About twenty minutes are required to stupefy the snake. It 
is then seized by the neck, and the edge of a saucer slipped under the 
upper jaw, so as to elevate the fangs. This is done by an assistant 
while the operator with his right thumb and forefinger strips forward the 
glands and ducts on both sides. The yellow venom runs out through 
the fang and alongside of this weapon. A known amount of this fluid 
may then be injected into the tissues of an animal, the instrument em- 
ployed being a minute trocar and syringe. It may be objected to this 
method of using the venom, that it is supposed by many persons that 
the poison is less fatal when used artificially than when injected by the 
snake. Of this, however, there is no adequate proof, and I have seen 
nothing to induce me to believe that it is at all correct. On the other hand, 
the advantages arising from the artificial use of the venom are manifold 
and obvious, and it is only essential to know what amount of venom is 
certain to destroy a dog if no remedial agent intervenes. If, in addi- 
tion to this, the observer is thoroughly cognizant of the ordinary phe- 
nomena of the venom disease, he will possess all the reasonable means of 
insuring accuracy which are now attainable. Antidotes may then be 
used internally, in one of two ways to be hereafter illustrated, or mingled 
with the venom, and injected where this mode of study is to be desired. 
Before stating my experiments upon the plans of treatment now or 
recently in repute, it will be proper to give the reader certain necessary 
information as to the nature of venom poisoning, the forms it affects, 
and the symptoms which characterize its varieties. These details must 
of necessity be brief, and the reader who wishes more complete informa- 
tion is referred to the author's previous paper. 
The venom of the rattlesnake is a yellow, albuminous fluid, of an acid 
reaction, of a sp. gr. of 1044, and coagulable at a temperature of 140° to 
160°. Its toxic activity is unaffected, or but slightly affected by boiling, 
and not at all by freezing. Acids and alkalies, alcohol, etc. do not destroy 
its virulence, and when dried it retains its dreaded power for an unlimited 
period of time. Closer qualitative analysis discovers in it at least two 
albuminous substances: one coagulable by boiling, either when alone or 
diluted with water, and also by alcohol; the other, also albuminoid, co- 
agulable by alcohol only, and constituting the active element of venom. 
This latter agent I have described as crotaline. 
Effects of venom on man and animals.-When an animal receives 
in any way a dose of venom, one of two things happens. If the animal 
is small, or at all events if relatively to the size of the animal the 
amount of venom injected is large, the animal dies very suddenly, acutely 
poisoned. If, on the other hand, the dose of venom is relatively small, 
the animal suffers to some extent with the symptoms of acute poisoning, On the Treatment of Rattlesnake Bites. 
13 
and then passes into what I shall term the stage of chronic or secondary 
poisoning, which may endure for an indefinite period, and end in death 
or recovery. Acute poisoning in man is rare,* and is more and more 
common the smaller the bulk of the animal bitten, until we arrive at cold- 
blooded creatures, in whom this sudden ending is the exception, and great 
prolongation of the malady (i.e. secondary or chronic poisoning) the 
rule. In dogs I have rarely seen the very rapid death I speak of; but 
it is not uncommon where the serpents are large and active and their 
venom abundant. 
Let it be clearly understood then, that when man or animal is poisoned 
by venom, a set of symptoms occur which wind up with death, or, being 
prolonged, pass into others of a somewhat different nature, constitut- 
ing the chronic cases, or those which survive long enough to exhibit the 
signs which characterize the secondary poisoning. 
When, for example, a pigeon is bitten, or receives in any way three 
or four drops of venom, it walks a few steps, crouches, gasps for breath, 
rolls over, and is dead in a few minutes, convulsed or not in the moment 
of agony. So sudden and speedy is this ending in some cases, that the 
pigeon may die within a minute. The only additional symptoms which 
we can perceive are the rapidly quickened and enfeebled motions of the 
heart, and sometimes vomiting and evacuations from the cloaca. In larger 
animals the same symptoms take place, but the vomiting is more common 
and the expression of general debility more perceptible. 
Men who have been bitten describe their symptoms as much the same 
in kind, but, as before stated, they rarely end in death in this stage at 
least; the power of resistance acquired by increased bulk being, I pre- 
sume, the chief protective agency. In some cases the more formidable 
signs of prostration do not declare themselves before some minutes or 
even half an hour has passed. In one case a man engaged in splitting 
wood was bitten; he picked up a stick and pursued the snake a few feet, 
when suddenly he became sick at the stomach, complained of deadly 
nausea and general weakness, reeled a few steps farther, and fell on the 
ground In another instance, the sufferer walked briskly for twenty 
minutes before the symptoms of debility became very well marked. 
It becomes important to our purpose to decide the cause of these 
symptoms and what organs are affected. All authors agree in speaking 
of the condition as one of debility, and all describe the pale face and 
cold sweats, the hurried breath and quick and feeble pulse. If we 
* Though rare, not impossible; men have died from this cause within twenty 
minutes of the time of the bite, although no such cases are on record in the jour- 
nals, and are only known to me by personal information. 14 
On the Treatment of Rattlesnake Bites. 
examine an animal dying rapidly with these symptoms, we find absolutely 
no lesions-the blood and the tissues are alike healthy in appearance- 
both to the naked and assisted eye. A series of experiments, the relation 
of which would be misplaced here, has shown that the heart does really 
become enfeebled, and that the arterial pressure is singularly diminished; 
and this appears to be a direct effect on the arterial system, since it is 
impossible long to sustain life by artificial respiration; at the same time 
the nerve centres are attacked, and the respiratory movements failing on 
this account, become jerking and labored; the sensory and motor nerves 
seeming still to preserve their functional integrity. Such, in general 
terms, I suppose to be the causation of death in these cases. Far dif- 
ferent are the symptoms which arise for study when the patient survives 
the stage of acute poisoning. The duration of this stage it is indeed 
difficult to define; this only we know, that after a time the debility con- 
tinuing, as shown by vomiting and syncope, the blood becomes affected 
in a marked and singular manner, while the relations of tissue and fluid 
are so altered that passive hemorrhages take place; jaundice occurs, and 
a variety of symptoms declare themselves as this or that organ becomes 
diseased and the seat of congestion and ecchymosis. Meanwhile the 
local symptoms assume an importance which they do not possess in the 
acute stage, and may even become of paramount influence in deciding the 
fate of the patient. 
If then the patient die very early, there are symptoms of weakness 
alone, and there are no perceptible lesions of blood or tissue; supposing 
life to be prolonged, the early symptoms continue, while signs of blood 
poisoning appear in addition, and lesions closely resembling those of 
yellow fever are found post-mortem. If, again, the patient success- 
fully resists the secondary evils here described, he may still perish from 
the results of the local injury, which increases in danger and importance 
as the case progresses. 
To make this matter clear we will now examine more accurately the 
various symptoms and the character of the wound. 
Wound.-The wound is usually described as very painful, but so far as 
my own experience informs me it is not always so in animals, nor do all 
men who are bitten speak of it as painful at first. Indeed, the wound lias 
sometimes been for awhile disregarded, and at all events the hooked form 
of the fang, the forcible injection, and the sudden withdrawal of the 
weapon, account sufficiently for the pain, without supposing it to be spe- 
cific. The succeeding local symptoms are rarely notable when the patient 
dies within half an hour, except that in animals the muscles twitch most 
violently, of which we hear nothing in the human cases. As the case 
advances, the part swells, becomes discolored and increasingly painful, and On the Treatment of Rattlesnake Bites. 
15 
these changes extend up the limb involved, and, reaching the trunk, swell 
and bloat one side, or the whole body. 
This swelling is not inflammatory, but arises from the gradual effusion 
of blood, which has lost power to coagulate, and which therefore extends 
from the broken vessels, at the seat of the wound. The later swelling is 
also due more to oedema than inflammation, although it seems probable 
that in man the tendency to inflammation under venom poisoning is greater 
than in the lower animals. In dogs bitten, the local swelling is some- 
times slight, sometimes enormous, and when cut into is found to depend 
on a collection of blood, either fluid or semi-coagulated. The pain which 
accompanies the swelling is excruciating in many cases, and does not les- 
sen until the part becomes vesicated, loses heat and falls into gangrene. 
In man this process destroys the skin only, or the whole of a limb, but in 
dogs I have seen no such extensive sloughs, and the skin often escapes, 
so that we find only a small opening, and beneath it a cavity containing the 
debris of broken-down tissues, mixed with pus. I suspect that in man the 
swelling would occur less rapidly were it not for the constant use of the 
ligature about or above the wounded part. If the case be a serious one, 
the early constitutional signs of prostration continue; occasional vomiting, 
or at least nausea, is present, frequent syncope occurs, and the pulse con- 
tinues weak and rapid. In general the bowels are constipated, unless the 
case be greatly prolonged, when diarrhoea may take place as a sequel. The 
mind is, in most instances, clear up to the time of death, or at all events it 
is only confused, excited, or subject to sensory delusions, while convulsions 
seem to be of extreme rarity in any period of the malady in man. The 
fall of temperature in the skin is usually described as an early symptom of 
the general weakness, but no accurate thermometric observations have 
been made in human cases. The duration of cases of rattlesnake bite is 
very various, although both in dogs and men the recoveries are often 
rapid and unexpected. 
As it is impossible for me to dwell in full detail upon the symptoms of 
the venom malady, and equally impossible to describe the great variety of 
lesions which may occur, I have thought best to state three typical cases 
of poisoning in animals, and two in men. The following are quoted in 
full from the essay so often referred to:- 
"Experiment.-The dog, a small terrier weighing about fifteen pounds, 
was intended to make one of a set of observations on the value of Bibron's 
antidote. For this purpose he was placed in the snake-box, where in- 
stantly he was struck twice by a large snake, both wounds being double 
fang marks, and both being in the right flank. On removing him I ob- 
served that from one of the wounds blood was running in a thin stream. 
After it had run for some time, I caught a few drops in a watch glass, 16 
On the Treatment of Rattlesnake Bites. 
and found that it coagulated well. Before I thought fit to use the sup- 
posed antidote, I was called away. Returning at the end of an hour I 
found the dog standing with his head pendent, having just vomited glairy 
mucus. His pulse was quick and feeble, his respiration occasionally 
panting. The hemorrhage had ceased. Owing to an accident which at 
this time deprived me of the supply of Bibron's antidote, which I had 
prepared, I was unable to employ the animal in the manner proposed, 
and not desiring to lose the observation altogether, I made use of the 
opportunity in the following way:- 
" One hour and a half after he was bitten I drew a drachm of blood 
from the jugular vein. It clotted perfectly. 
" Four and a half hours after the bite a drachm of blood from the same 
vein coagulated equally well. 
" Twenty hours from the time of the poisoning, the dog was found 
lying on his left side, having passed slimy and bloody stools in abundance. 
At intervals he seemed to suffer much from tenesmus, but was so weak 
that he stood up with difficulty. His gums were bleeding, a symptom I 
had seen before, and his eyes wrere deeply injected. At this time about 
two or three drachms of blood were drawn. It was very dark, and 
formed within five minutes a clot of feeble texture. 
" Twenty-seven hours and a half after the time at which he was bitten, 
the dog was weaker. His hind legs were twitching, and the dysentery 
continued. Three drachms of blood were drawn as usual, but no clot 
formed in this specimen although it was set-aside and carefully watched 
for some time. While I was collecting the fluid for observation the dog 
suddenly discharged per anum at least four ounces of dark, grumous blood. 
At this time I supplied the dog with water, and left him. Fifty-four 
hours after the bite he was seen again, and found to have drunk freely of 
water, and to have passed fewer stools. Up to this date he declined all 
food. 
"From this time he improved rapidly, and took with eagerness whatever 
nutriment was offered. On the fourth day his blood again exhibited a 
clot, although it was very small and of loose texture. I made no further 
examinations of the blood. The dog lost flesh as he gained strength, 
and had profuse suppuration from an abscess in the bitten flank. At the 
close of two weeks he was active and well, except that the wound was still 
open. 
"The case last related is doubly valuable, as pointing out even in a 
single instance the time at which the blood became altered, and also as 
showing, once more, how profound may be this change, and how perfect 
the recovery. 
"Experiment.-A dog of mongrel bull-terrier breed, weighing thirty- On the Treatment of Rattlesnake Bites. 
17 
one pounds, was lowered into the cage, where he was struck on the outside 
of the right hind leg in the thigh. He drew up the leg when released, and 
whined for a few minutes. The wound, which was a double fang mark, 
bled a drop or two, and the muscles about it twitched considerably at in- 
tervals for an hour, when this symptom was obscured by the swelling. 
His pulse, which was naturally about 145 and irregular, was, at the fifth 
minute, 140 and regular, respiration 35. At the fifteenth minute he lay 
down, much weakened, pulse 160 and feeble, respiration 40. At the 
twentieth minute the bowels moved loosely, with a gray discharge, and 
there seemed to be some tenesmus in the rectum. Twenty-fifth minute, 
pupils so far natural and mobile; he could stand when urged, but lay 
down again at once, and was much weaker. Forty-fifth minute, pulse 160, 
respiration 45 and laborious. Fifty-fifth minute, loss of power in the 
hind legs. Eightieth minute, respiration quick and labored, and so 
irregular as to make it impossible longer to count the heart pulses. The 
eyes were natural, and followed my motions; and he wagged his tail 
when fondled. At this time the observation was temporarily interrupted, 
and, on its resumption at the third hour, the dog was found dead. He 
had no foam about his mouth, and probably died quietly. 
"Post-mortem section.-The whole muscular and areolar tissue of the 
leg and thigh, half way up and down the limb, was dark with infiltrated 
blood. About the wound the swelling was due to a mass of blood par- 
tially coagulated. The extravasated blood extended through the limb, 
and on the inside it passed half way up the sartorius and adductors, and 
along the sheath of the vessels to within two inches of the femoral ring. 
Nearly an inch of the sheath was clear of it, but one-half inch below the 
ring the tissues were shaded with blood, and the same appearance was 
seen around the ring itself. From this point the extravasation extended 
under the peritoneum, into the pelvis, and on to the inner face of the 
ilium. The color of the tissues thus stained was a brilliant scarlet. The 
abdominal viscera were healthy, except that the mucous membrane of the 
lower bowels was somewhat congested. The lungs were sound. The 
heart was relaxed, the right side full, the left nearly empty. The blood 
on the right side was a little darker than that on the left; on both sides 
and everywhere else it was perfectly fluid and free from clots. Placed 
in a phial, it remained fluid until decomposition ensued. Two hours 
after death, some of the blood globules found in the heart were slightly 
indented; those taken from the small vessels of the ear were perfectly 
normal. At the period of examination, the muscular and nervous irrita- 
bility had entirely departed." 
A third observation on a smaller animal, and also drawn from a like 
source, will answer my present purpose. 18 
On the Treatment of Rattlesnake Bites. 
"Experiment.-In this instance the animal, a rabbit, was struck once in 
the back by a large snake already exhausted by frequent use. A few 
minutes after the bite took place, the rabbit was seized with weakness, 
gritting of the teeth, and rapid respiration. It passed urine and feces, 
and remained feeble during some hours. From this period the weakness 
abated somewhat, but the back continued to swell. On the second day 
the local signs were improving, but the animal had passed a very albu- 
minous urine, and a large amount of blood mixed with feces. The symp- 
toms of general weakness now increased, the hind legs began to drag, 
the motions were uncertain, and the bloody purging grew worse. The 
rabbit died on the third day, during my absence. 
"Post-mortem section.-Rigor well developed. The period of death 
being uncertain, the irritability of the tissues was not tested. The wound 
was surrounded by half an ounce or more of dark fluid blood. The ves- 
sels in the neighborhood were full of a similar fluid, but there was no 
vascular redness, like that of acute inflammation. The muscles in the 
track of the bite, which was a double fang mark, were remarkably softened 
and could be torn with the utmost ease. The brain was highly congested, 
and there was a good deal of bloody serum in the cavities of that organ. 
Similar congestion existed in the spinal canal, and at several points the 
white nervous tissue was stained with small patches of blood. The lungs 
were healthy. The pericardium was curiously distended with bloody 
serum. The heart was contracted and contained but little blood, and 
that dark and diffluent. The intestines were spotted at intervals with 
ecchymoses four to five lines in diameter and apparently just beneath the 
serous covering, the cavity of which contained a little bloody serum. 
The intestines from the oesophagus to the rectum were dotted with 
ecchymoses and filled, especially the large gut, with blood and mucus. 
The right kidney was large and absolutely soaked with dark fluid blood. 
The left kidney was more healthy. The bladder and ureters contained a 
good deal of bloody urine. How the rabbit lived so long with such a 
singular complication of serious lesions it is difficult to conceive. In 
most cases of chronic poisoning, some one or two organs may become the 
seat of local extravasations, but for extent and character of lesion this 
case stands alone in my experience." 
The accounts given by our own authors of the cases of human poison- 
ing are extremely meagre and unsatisfactory-the best reports being 
those by Sir E. Home* and M. Pihorel,f both of whom described cases 
which took place in showmen. 
* Engl. Phil. Trans, at large, 1810, p. 75. 
f Journ. de Phys. Exp. et Pathol., vol. viii. p. 97. On the Treatment of Rattlesnake Bites. 
19 
Dr. Horner's* case is perhaps one of the best among our own reports, 
but like the more curious one given by Sigaud,f the patient was not alto- 
gether a healthy subject. I shall quote Dr. Horner's case with the state- 
ment that the local symptoms were better illustrated in the second case 
quoted, that by Dr. R. 
* Am Journ. Med. Sci., vol. viii. 397, 1831. 
f Du Climat et des Maladies de Brasil, p. 394, contains the following account of 
the singular case above mentioned, a case so curious in every point, of view that I 
have been tempted to add a translation of it. 
"According to a popular idea in divers parts of America the bite of the rattle- 
snake cures the leprosy (lepre leontine of Alibert) without injury to the patient. 
Many facts would seem to show that lepers have been bitten without fatal results, 
not only by the coraline viper, by the jararacasu, but even by the rattlesnake. 
Among these fac*s may be cited those which have been collected by Dr. Jacintho 
Pereira Reis, and by the deputy, Estevao Rafael de Carvalho. The first is that of a leper 
of the district of Rio-das-Velhas, in the province of Minas-Geraes, who having been 
bitten by a rattlesnake, was cured of his disease in fifteen days. The second is 
furnished by a negro slave of the province of Maranhao, who recovered from his 
leprosy in a very short time after having been bitten. M. de Lima assures us that 
being one day in the town of Saint Charles, province of Carabobo, in Colombia, he 
observed a man whose face was covered with a single large cicatrix, which at first 
he attributed to a burn, but on inquiry learned that it was the result of a radical 
cure of a case of leprosy, by the bite of the rattlesnake. The same observer tells 
us that an opinion favorable to this means of cure is entertained throughout the 
district of Caracas and Apure, where leprosy is common. These statements which, 
after all, are but hearsay, induced a leper to resort to this fearful mode of relief. 
According to Dr. Jacintho Rodrigues Pereira Reis, another leper had already made 
this experiment in this capital, (Rio de Janeiro.) This person had the courage to 
allow himself to be bitten at one time by the coraline viper, and at another by the 
jararaca preguicosa. Each time he was left for dead, but notwithstanding, gradually 
revived without aid. After this he still had the pain to observe that his original 
malady continued its fearful progress. 
"Case.-Marianno Jose Machado, born at Rio Pardo, province of Rio-Grande 
do Sud, aged fifty, had been for six years afflicted with tubercular lepra. During 
four years he had resided at the leper hospital, at Rio de Janeiro. On the third of 
September, he came out, resolute to put to the test the bite of the rattlesnake, de- 
spite the prudent and wise counsels of divers physicians, who saw in the means he 
desired to employ a more than dubious chance of success, and who also were aware 
that the patient had not exhausted all the more available and proper remedies. The 
patient finally resorted to the house of M. Santas, a surgeon, Rue de Vallongo, No. 
61, who possessed a rattlesnake." After describing the appearance and character 
of the leprosy, and mentioning those who were present, M. Sigaud continues as 
follows:- 
" Marianno Jose Machado, before proceeding, declared that he acted on his own 
responsibility, and then having signed a paper to this effect, put his hand into the 
| North Amer. Med. and Surg. Journ., xi. 227, 1831. 20 
On the Treatment of Rattlesnake Bites. 
"Adam Lake, aged about forty, a robust, muscular man, acting in a 
laborious capacity, and who, from his own account, was in the habit of 
cage and twice seized the serpent. The reptile at first fled, and finally licked his 
hand, but, feeling itself pinched with force, turned and bit him at the metacar- 
pal articulation of the little finger and ring finger. The bite took place at 10 minutes 
of 12, September 4th. The patient did not feel the bite, and only knew of it by the re- 
marks of those around him. His hand was a little swollen, but painless, and bled 
somewhat, the pulse and respiration remaining normal. Five minutes later, be ex- 
perienced a slight, sensation of cold in the hand, with a little pain in the palm, 
which, in a few minutes, increased considerably. 17th minute, pain in the wrist. 
20th minute, hand swelling. 30th m., pulse stronger and fuller, mind tranquil. 
55th in., sensation of swelling in sides and back of neck; size of hand increasing; 
pain extends to two-thirds of the forearm. 59th m., general numbness. 1 hour and 
20 minutes, general tremor; hyperaesthesia. 1 h. 36 m., mind troubled, pulse more 
frequent; difficulty in moving the lips; tendency to sleep: choking sensation; in- 
tense pain in the hand and whole arm; hand swelling. 1 h. 45 tn., pain in tongue 
and pharynx, extending to the stomach; increased pain and swelling in the bitten 
hand; feet cold. 2 h. 5 m., difficulty of speech, and a little later, difficulty of swal- 
lowing; anxiety; copious sweating on the chest. 3 h., weakness; nose bleeding; 
inquietude; pulse 96. 3 h. 4 m , general sweat, and a little after, involuntary 
groans; pulse 100; great pain in the arm; face injected; continual epistaxis. 3 h. 
35 m., the patient swallows wine and water readily, and changes his shirt; a red 
color is seen throughout the body, and a little blood leaks out of one of the pus- 
tules under the arm; the color deepens, especially in the bitten limb; atrocious 
pains are felt incessantly in the arms; the throat seems to be narrowed, and the 
breathing becomes difficult. At 4 h. 30 m., pulse 104; salivation; great heat of 
body. 5 h. 30 m., pulse 104; torpor; urine abundant; saliva thick; muscular 
weakness; groans from excessive pain; respiration tranquil; pulse full; increased 
swelling of the bitten hand. 7 h., somnolence; awaking, complains of great pain 
in the chest, and of a sense of constriction in the throat; free and full urinations; 
deglutition more difficult; saliva abundant; continued epistaxis; entire inability 
to swallow. 8 h., inquietude; copious urination. 9 h. 15 m., profound sleep. 
10 h., patient took three teaspoonfuls of infusion of guaco; refusing sugar and 
water which were also offered; the epistaxis now ceased; pulse 108, regular; the 
leprous tubercles on the face and arms are a little depressed, and have an erysipe- 
latous look. 10 h. 20 m., made two ounces of clear urine; better; sleep for a few 
moments; pain in the chest lessened, and pain is now felt in the legs and feet, 
which with the bitten hand are still cold; pulse 108, regular; thirst; the patient 
drinks water; sitting up with facility. At 11 h., takes four spoonfuls of strong 
infusion of guaco. 11 h. 45 m., urinated a colored urine; continues to drink with- 
out trouble; pulse 119; arm and hand much inflamed, with excessive pain. 12 h., 
sleep; excitement; urination. 12 h. 30 m., sleep; anxious face; cries of pain; the 
patient demands the last offices of his church, and refuses remedies. Rather later, 
emission of urine; great heat in the limbs; the patient takes two doses of the 
remedy at successive half hours; symptoms as before. 14 h., sits up twice, to 
drink water; the difficulty of swallowing augmenting. 14 h. 13 tn., takes the 
remedy; sleeps; pulse 110. 15 h. 30 m., micturates; sleeps. 15 h. 45 m., takes a 
dose of the remedy; involuntary movements of the right hand and left leg. 16 h. On the Treatment of Rattlesnake Bites. 
21 
drinking from half a pint to a pint of alcoholic liquors daily; on 
Friday, July 1, 1831, was in a crowd collected at Fisher's tavern, in Ken- 
sington, to witness a popular exhibition of rattlesnakes, confined in a 
cage. Lake being somewhat intoxicated, opened the door of the cage, 
and allowed one of the animals to creep out and ascend his bare arm ; as 
it was going up, he caught the animal somewhat abruptly by the neck, 
it immediately struck at him, and inflicted two small wounds. In the 
evening, he felt some itching about the bend of his arm, and he rubbed it 
accordingly, without thinking of the snake. The itching increasing, he 
was induced to examine the part, and there he found a little red spot. 
The recollection of the rattlesnake then occurred to him, and he began 
to bathe the part in salt water. This not relieving him, he called upon 
Dr. Elkinton, at which time the whole extremity was swollen to nearly 
double its size, and was very painful. Dr. Elkinton applied a dry cup 
over the part which had originally itched, and was bitten ; it was near 
the cephalic vein at the bend of the arm; scarified cupping was also done 
in three or four places in the same region, and some ounces of blood were 
extracted by a repetition of the cups; the forearm was also rubbed with 
the terebinthinate tincture of cantharides, which produced vesication. In 
the course of the evening, some doses of spirit of hartshorn were admin- 
istered, and also some tablespoonfuls of the expressed juice of plantain, 
(alisma plantago,} and hoarhound, (marubiuni vulgare.) 
" The next morning (July 2, 1831,) the patient was brought to the alms- 
house, about half-past eight o'clock, lie had vomited in the conveyance. 
He was sensible, and stated that the scarifications had bled much during 
the night; they were then bleeding freely. The arm, from the shoulder 
and front of the thorax to the fingers, was swollen to twice its natural 
size, and was very painful when moved. His pulse was almost imper- 
ceptible and thread-like, his extremities cold, he was disposed to cramp in 
the legs, and his debility very great. His respiration was natural and 
easy. His eyes were muddy and heavy ; his face was somewhat bloated. 
45 m., takes a spoonful of the remedy; repose; pulse 100; two emissions of urine 
during 17th and 18th hours; respiration being easy. 21 h. 45 m., great prostra- 
tion; convulsive movements of jaw and lower extremities; bloody urine. 22 h., 
pulse quickened and absent at long intervals; increase of convulsive movements; 
diminution of swelling of extremities and of the dark color of the skin; degluti- 
tion very difficult; breathing labored; blisters were applied to the thighs, and the 
infusion of guaco given. 22 h. 50., convulsive; motionless; an injection of brandy 
given. 22 h. 55 m , convulsions stopped. 23 h., same condition; an ounce of oil of 
lezard given by the mouth ; was taken with great difficulty. Death, at 23 h. 30 in. 
The corpse became livid, and swelled considerably in a few hours, being mottled 
with violet-colored spots. The odor was such, next day, as to forbid an examination 
post-mortem." 22 
On the Treatment of Rattlesnake Bites. 
Feeling the desire to go to stool, he was assisted from his bed for that 
purpose, but was seized, while on his way, with a general spasm, without 
foaming at the mouth; being laid down on the floor of the ward, it went 
off in a few minutes, and he there had an involuntary evacuation from 
the bowels, of a dark bilious color. This occurred before I saw him. He 
received from the resident physician five grains of ammonia and an ounce 
and a half ol. olivarum. 
"Sinapisms were also applied to his ankles and breast; he was directed 
to take liquor volat ammoni{e, 5j; sp. vin. dilut. every two hours, and 
intermediately use ol. olivarum, 5 j; of the former prescription, he took 
two doses before he died, and one of the oil. Another application of 
cups over the old scarified parts was made, and the hemorrhage from 
them diminished. The extremity was then enveloped in cloths, dipped 
into ice water. 
"The symptoms continued stationary till 11| a.m., he then complained 
of violent pain in the course of the colon, and, on taking his last dose of 
medicine, he said he felt sleepy, closed his eyes, and in a few minutes 
died without agony or convulsion. 
"Dr. Harlan's case.-On Monday, the 13th of September, 1830, Daniel 
Steel, a showman of living animals, in this city, was severely bitten by a large 
male rattlesnake, immediately below and on the metacarpal joint of the index 
finger of the left hand ; the accident occurred about four o'clock p.m., on a 
warm day, while he incautiously seized the reptile by the neck, not so close 
to the head but that the animal was able to turn upon him. Immediately 
after the bite, the blood flowed freely from both the fang punctures; the 
parts in the immediate vicinity of the punctures became tumid and livid, 
notwithstanding the efforts of the patient at suction with his mouth- 
which faintness obliged him soon to relinquish. On my arrival, about 
half an hour after the accident, I found him extremely pale and faint, and 
was informed that he had fainted several times, the whole of the back 
of the hand was puffy and tumid, with infused non-coagulated blood, 
which appeared to have infiltrated from the vessels and forced its way 
through the cellular tissue; a ligature had been previously applied on the 
wrist; another was now placed on the arm, the forearm having already 
commenced swelling. 
" The situation of the wound rendered the use of cups inapplicable, and 
the flow of blood was so rapid as to make their application inexpedient. 
The punctures were separated some distance from each other, which ren- 
dered it requisite to excise two large portions of integument; the exci- 
sions extending down to the tendinous fascia; the blood, which flowed 
freely after the operation, did not appear disposed to coagulate ; cold 
water was now poured on the wounds in a continued stream, from the On the Treatment of Rattlesnake Bites. 
23 
mouth of a pitcher, held at a considerable elevation, and the swollen parts 
in the vicinity of the wounds were forcibly pressed, in order to expel the 
effused blood. The patient again became very faint, and was laid in a 
recumbent posture. The wounds were next washed with spirit of harts- 
horn, several doses of which were administered internally; but being 
now informed that the patient had drunk freely of sweet oil, the hartshorn 
was omitted, until the stomach should be evacuated by drinking warm 
water. A poultice of bread and water was next applied, to encourage 
the bleeding, and the patient was put to bed. At ten o'clock p.m., I was 
sent for in haste ; the patient was thought, by attendants, to be dying. 
The bleeding of the wounds had been extensive, the tumefaction had ex- 
tended up to the arm, the inner and inferior portions of which were dis- 
colored by effused blood ; the patient vomited incessantly; he complained 
of insatiable thirst, and drank cold water every few minutes ; he had 
pain and stricture at the pit of the stomach, great restlessness and anx- 
iety, cold skin, with the exception of the wounded arm, which was very 
painful; add to which, there existed delirium, singultus, difficulty of 
breathing, and pulse at the wrist scarcely perceptible. The poultice, 
bandages, and all ligatures were immediately removed ; the back of the 
hand was blacker and more swollen, and the skin of the forearm was hot 
and tense. Asa substitute for the poultice, and in order to suppress the 
bleeding, which appeared to endanger the life of the patient by the de- 
bility it occasioned, large flat pieces of fresh meat, were bound on the 
wounds, hand, and forearm. Before this operation was completed, the 
patient exclaimed, 'That feels comfortable.' The indications arising 
from the present symptoms, were : 1. To allay irritation and thirst. 2. 
To arrest the vomiting. 3. To procure sleep, if possible. 4. To excite 
the sanguineous system to resist the depressing power of the poison, which 
had so emphatically manifested itself on the system in general. 
"A mustard plaster was directed to be applied to the pit of the stomach ; 
sixty drops of laudanum to be administered every half hour, until the vomit- 
ing should be arrested; after which the following bolus, to be taken every 
two hours until sleep should be induced : B pulv. opii, six grains; pulv. 
gum. camph., eighteen grains ; pulv. carb, ammonia, thirty grains. M. ft. 
in three boluses. Sig. as directed. Of these pills he took three before the 
effects desired were manifested. On the morning of the second day, his 
pulse was raised ; the extreme thirst and irritability of the stomach were 
allayed, and reaction of the system in several respects was manifested; 
but the tumefaction of the arm had extended to the shoulder, with broad 
black streaks up to the axilla; stricture at the breast and great local 
pain were now the chief complaints. The application of raw meat was 
renewed, as it afforded comfort to the patient, and appeared to reduce 24 
On the Treatment of Rattlesnake Bites. 
the swelling of the hand, and by pressure, had nearly suppressed the 
hemorrhage. In order to allay the pain and tension of the whole arm, 
he was directed to expose it naked to the fumes of burnt wool, in a con- 
venient apparatus, which wras attended by such marked alleviation of 
symptoms, that the patient himself was desirous to have the operation 
frequently repeated, and continued for two or three days; the swelling 
always diminishing after each application; it caused the arm to perspire 
profusely, and covered it with blackish soot impregnated with ammonia, 
resulting from the decomposition of the wool. During the intervals, the 
arm was rubbed with volatile liniment. The raw meat having become 
offensive from its disposition to ferment and putrefy, was omitted, and 
flaxseed poultices substituted ; the anodyne boluses were continued in 
half doses through the day, and the quantity increased at night to pro- 
duce sleep. The system again became depressed and appeared to strug- 
gle with the effects of the poison ; as the patient had been somewhat 
addicted to intemperance, he was allowed milk-punch to support his 
strength. On the third day, a greater degree of reaction was obvious; 
the bowels were evacuated by castor-oil; the dose of the anodyne was 
diminished, and by carefully nursing the arm, in less than a week suppu- 
ration supervened, and the patient was able to leave his bed." 
It is much to be regretted that physicians in this country should have 
paid so little attention to the venom malady as only to report cases in 
which they supposed themselves to have been successful. Hence is it 
that no good history of the disease can be made out from their state- 
ments, and hence it is that post-mortem examinations of the lesions are 
almost unknown-there being only three on record, of which two took 
place in Europe. The reader need not be surprised then at the small 
amount of accurate knowledge of symptoms placed at the author's dis- 
posal : fortunately the ability to create the disease in animals enables us 
in some measure to fill up this gap. 
The information now in possession of the reader will enable him, I 
trust, to follow the remarks upon the use of remedies. A number of 
these, whether local or constitutional, may be readily dismissed, either 
because their value or want of value is plain, or else because former ob- 
servers have settled their therapeutic position in some conclusive manner. 
In treating of this matter, I have been obliged to deny notice to a 
host of herbs which enjoy repute in small sections of our country, and 
which, in turn, have once possessed and lost a wider reputation. The 
reader who calls to mind what has here been said as to the many fallacies 
which surround the observer, will not fail to perceive in the accounts of 
these remedies given by authors the reason of their apparent success 
and ultimate loss of favor. On the Treatment of Rattlesnake Bites. 
25 
Local Therapeutics.-Following the classification adopted in my 
essay, we may divide the various local means of treatment into four 
classes:- 
1. Agents which remove the poison and the poisoned part, as excision 
and amputation. 
2. Means which partially remove the venom, or more or less detain it 
in the injured part, as scarification, ligature, suction, and caustics. 
3. Agents, which being applied to the wounded part, or injected into 
it, are supposed to destroy the venom, or render it in some way innocuous, 
as injections of iodine. 
4. Local usage by inunction or otherwise, of various substances, such 
as alcohol, indigo, ammonia, olive oil, simple warm or cold poultices, 
water dressings, etc. 
Excision, or amputation of a small part or member, has been occa- 
sionally resorted to, the former by Dr. Harlan, the latter in a successful 
case which took place in France soon after M. Pihorel's case. Dr. Har- 
lan's patient was extremely ill, but recovered. 
Class 1st. The experiments of Fontana on viper poisoning have shown 
conclusively that immediate excision or amputation of the part bitten will 
save the life of an animal which must otherwise have died, and however 
swiftly the poison may pass into the circulation, it does certainly seem clear 
that in a severe case the removal by these decisive means of even a part of 
the venom might favorably determine the balanced chances. The question 
of resort to these ultimate surgical means in cases of poisoning in man, is 
one involving many considerations. Thus, where it is known or probable 
that the serpent was a large one, and where both fangs entered, and 
where the early symptoms were grave, free excision, or even amputation- 
of a finger, for instance-would be justifiable. While on the other hand, 
where the reverse of these circumstances is met with, or information as to 
the size of the snake, etc. is lacking, it would be well to remember how 
few fatal cases occur, and to accept for the patient the chances of a less 
heroic local treatment. It should also be recollected that the value of 
ablation lessens as we recede from the time of the original injury, unless 
the circulation has been arrested by ligature or cups immediately after the 
infliction of the wound. The means just discussed depend for their use 
on certain very simple considerations, and require at our hands no experi- 
mental questioning. 
In class 2d we have, first, scarification or incision, which, like ablation, 
is of some use if done early, and is justifiable later in the case because 
it is so much more mild a resort. When used at all, the track of the 
fang wounds should be opened by the knife, and the part afterward ex- 
hausted of blood, and as far as may be of venom, by the use of suction, 26 
On the Treatment of Rattlesnake Bites. 
cups, or pressure. Caustics are more doubtful remedies in these cases 
than has been supposed. Potassa, soda, ammonia, and the undiluted min- 
eral acids affect very little the toxic activity of the venom when mixed 
with it for a time, unless heat is also employed in addition. The actual 
cautery is more efficient, as it destroys both venom and tissues, and is 
more likely to be within reach. Like all the other local means, it is less 
useful as time advances. It has been but little used in this country. 
Ligatures, suction, cups.-One of the oldest remedies in snake bites is 
the ligature, the simplest, most ready, and for a time the most effective 
means. Whenever the bite is on an extremity, a cord or handkerchief 
should be tied tightly about the limb, as near to the wound as possible. 
After a time, the swelling will necessitate its removal, when a second 
ligature should be placed on the part, a little higher up, and this ready 
means of quarantining the poison should in no case be abandoned until 
such necessary local treatment as seems requisite shall have been insti- 
tuted, and the proper constitutional remedies employed. If it is possi- 
ble, as it sometimes is, to use both the cupping-glass and the ligature, 
it will of course be best to do so; but cups alone can be employed in 
certain localities, and in some, as the nose, neither of the means at present 
under review can be made available, and suction by the mouth of a by- 
stander may be the only resort; unless preceded by incision, or unless the 
fang mark is large enough to bleed spontaneously, this latter means is 
not likely to be of much service in removing the venom. 
Intermittent ligature.-Ligation obtains for the patient a reprieve, 
of which the physician may make excellent use. A period arrives, how- 
ever, when the local swelling threatens gangrene, and the band being 
then of necessity loosened, the venom rapidly overwhelms the system. Are 
there no means of securing the advantages of the ligature, without sub- 
jecting the sufferer to all the inconveniences of its employment, as com- 
monly advised ? 
About twenty years ago two physicians of Charleston, South Carolina, 
Drs. Holbrook and Ogier, used the ligature in a way which was then 
novel. They loosened the band for a few minutes at a time, and then 
tightened it again, as the system began to show signs of feebleness. By 
this means, patiently followed out, they succeeded in admitting to the gen- 
eral circulation such small doses of the poison at any one time as to diminish 
materially the ultimate danger of the bite in the animals which they em- 
ployed.* Dr. Alexander, j* (1855,) in a short but very sensible essay ad- 
* These experiments were made, as Dr. Holbrook informs me, by one of his 
pupils, superintended by Dr. Ogier. They have never yet been published. 
f St. Louis Med. and Surg. Journ., vol. xiii. p. 116, 1855. On the Treatment of Rattlesnake Bites. 
27 
vised a like use of the ligature, and urged also that alcoholic stimulants 
should be given before relaxing the ligature, and afterward in such quan- 
tities and at such intervals as may seem desirable. So far as I am aware 
Drs. Ogier and Holbrook first experimented on this use of the ligature, 
and Dr. Alexander first advocated it in print, and reported cases of its 
use in man in combination with the internal administration of stimulants. 
Dr. Alexander relates the following case in illustration of his views. 
The bite was in a child, near the tendo achillis. The limb was corded 
below the knee, and whisky being freely given, profound intoxication 
followed its use. " Regarding this as an indication of safety, I announced 
to the parents, at the end of sixteen hours from the reception of the bite, 
that the child was out of danger, and directed the removal of the cord. 
At this time there was intense swelling and commencing vesication below 
the cord, but not a trace of poison above it. Immediately after the re- 
moval of the cord the swelling advanced up the limb, as it had done pre- 
vious to its arrest by the cord ; the poison reached the trunk, as could be 
perceived by the swollen condition of that side of the body when com- 
pared with the other, and in two hours after the announcement of my 
joyful prognosis the heart ceased to beat. Aly patient was dead." 
Dr. Alexander's further remarks, which fully represent the author's 
views, are as follows: "Thus instructed by this unfortunate case, I never 
afterward administered alcoholic stimulus until I was ready to remove the 
cord, which should not be done for four or six hours, or at least until the 
cups have effected all that they can accomplish. It should then be merely 
loosened, and the whisky or brandy given, so as to keep the pulse natural 
or full. And I would here observe that intoxication should be avoided 
on account of the debility which it induces; a moderate exhilaration is all 
that is necessary. In one or two hours more I loosen the cord still 
further, continuing the use of the spirits, and thus by admitting the poison 
into the circulation gradually, I counteract its influence more successfully 
than if I were to allow the whole amount of poison that the veins were 
capable of absorbing, to assail the heart at once." 
Class 3d, of local remedies, consists of various substances such as alco- 
hol, olive oil, ammonia, indigo, and the numberless herb infusions, poul- 
tices, raw meat dressings, etc., which at different periods have found favor 
in this or other countries. 
If alcohol and ammonia have any value, it is purely as local stimulants. 
The advantages of alcoholic agents used internally, and the supposed 
value of ammonia similarly employed, have led, however, to the idea that 
they would prove specifically useful as local antidotes. As we shall see 
in future, the utility of stimulants taken by the mouth depends less upon 
their meeting the poison and neutralizing it than upon their power to 28 
On the Treatment of Rattlesnake Bites. 
counteract its physiological effects on the heart and nerve centres, and 
perhaps also on the blood. Moreover, the following direct experiments 
prove with sufficient clearness that these agents in no way directly destroy 
the toxic activity of venom. 
Experiment.-Two drops of venom and ten drops of alcohol were 
left in contact for ten minutes, and then injected into the breast of a pigeon. 
It died in 71 minutes. 
Experiment.-Two drops of venom and twelve of alcohol were left 
in contact for half an hour, and then thrown under the skin of a pigeon. 
It died in 62 minutes. 
Experiment.-Three drops of venom and forty of alcohol were min- 
gled, and after twenty minutes injected under the dorsal skin of a rabbit. 
It died in 37 minutes. 
Six similar experiments ended in the same way, all the animals-three 
pigeons and three rabbits-dying within various periods. As test experi- 
ments, I injected small amounts of alcohol into animals of these same 
species, but except more or less stupefaction, observed no serious effect. 
In another series, two or three drops of venom were placed in a drachm 
of alcohol and the alcohol afterward evaporated slowly. The poison 
which remained was then slightly diluted with water, and injected as 
usual; but in each case with the ordinary fatal effect. Under these cir- 
cumstances, it is plain that if, when directly mixed with venom, alcohol 
does not destroy its activity, it is little likely to do so when merely placed 
upon the wound. The experiments with ammonia as a local antidote, 
were made in the same way and with like results. Only one difference 
was perceptible : the local extravasation and swelling were not so well 
marked when alcohol and venom were injected together, as when venom 
alone was thus employed; while in regard to ammonia, I could not per- 
ceive this modification of the local phenomena. Inunction with oil was 
once a favorite remedial means, and was studied by Fontana with refer- 
ence to viper venom, and by him pronounced useless. I have made no ex- 
periments upon its employment, nor do I suppose that any physician is 
likely at present to displace for it more potent and plainly indicated 
remedies. 
The remaining local resorts enumerated above may equally be dismissed 
with the briefest notice. Poultices of various kinds, meat dressings, etc. 
are probably of some value in the later stages of the local treatment, 
where such applications are usually needed to aid in softening and remov- 
ing gangrenous parts. I have not considered them as worthy of serious 
attention under any other point of view; and the same may be said of a 
multitude of herb applications of which Dr. B. S. Barton gives a long 
list, and to which the credulity of sixty years has added considerably. On the Treatment of Rattlesnake Bites. 
29 
Most of these have been used internally and externally at the same time, 
and have enjoyed a reputation which can only be explained by reference 
to the general considerations in regard to constitutional remedies which 
have already been urged upon the attention of the reader. 
Class 4th,inyec/ion of iodine in solution.-In 1853, Dr. David Brainard, 
of Chicago, in conjunction with Dr. Green,* proposed the sub-cuticular 
injection of an iodized solution of iodide of potassium as a local antidote 
in rattlesnake bites. He further desired to extend this treatment so as to 
include poisoning by woorara, which he believed owed its toxic power to 
a serpent venom, an opinion general at that time, but now no longer 
held. 
Dr. Brainard's process is as follows: Ten grains of iodine and thirty 
grains of iodide of potassium are dissolved in an ounce of water. The 
bitten part is first cupped, or a ligature is placed on the limb, until the 
tissues are so swollen with serum as to allow of the injection passing 
readily through the distended areolar spaces. A small trocar and canula 
is then pushed laterally into the bitten part, so as to reach the site of the 
wound, and the injection effected by screwing to the trocar a small syringe 
charged with the iodine, and so filling the part by pressing down the pis- 
ton of the syringe while the cupping-glass remains over the wound and 
exhaustion is kept up with its aid. Apart from the antidotal value of 
this ingenious means, it is clear that the necessary apparatus is rarely at 
hand, and that cups of various curves, to fit the equally various surfaces 
of the body, as advised by Dr. Brainard, are not likely to come into 
general use in localities where the rattlesnake is found. 
Before passing to the practical examination of this remedy, it is proper 
to state that Dr. Brainard describes it as a direct antidote enjoying the 
power to neutralize the venom. He adds:- 
"Aly experiments were commenced with the venom of the rattlesnake, 
and made principally on pigeons, dogs, and cats. Birds die from it sooner 
than quadrupeds, and are therefore much more difficult to save by treat- 
ment. The way of using the serpent is, to have it confined in a groove, 
with only the head projecting. Denude the breast of the pigeon of its 
feathers, and when the fangs are raised in anger, press it against them. 
I prefer this method to that of extracting the venom and inoculating it, 
for two reasons:- 
"First. The poison, when extracted, is uncertain in its operation, being 
often composed in part of-saliva, and sometimes wholly of that fluid. 
* Comptes Rendus de 1'Academie des Sciences, 1853, p. 811. Brainard and Green. 
See also an 8vo. pamphlet, Chicago, 1854, by Dr. Brainard; and Smithsonian 
Reports, 1854. 30 
On the Treatment of Rattlesnake Bites. 
Fontana constantly found that the wounds made by inoculating the venom 
were less dangerous than the bite of the viper. 
" Second. The bite is the wound we are called upon to treat, and is 
placed in circumstances less favorable than a wound by inoculation." 
One-half of the pigeons bitten and thus treated, died. The serpent 
employed was the crotalophorus tergeminus* or prairie rattlesnake. 
The method of using the serpent, described by Dr. Brainard, is open 
to objections already stated. The presumed mixture of the venom with 
saliva could scarcely occur, as the duct of the venom gland serves for 
it alone, and under no circumstances is it mixed with saliva unless 
the two fluids accidentally meet in the serpent's mouth. It is cer- 
tainly true that Fontana found inoculation less effectual than the bite, 
but it is to be remembered that he in nowise imitated the mechanism 
of the bite when inoculating,! so that it is hardly fair to compare the 
results of the two processes. A fine trocar and syringe enables us to 
simulate the fang, and yet to use known quantities of venom. With these 
few remarks, we will pass at once to the experimental mode of criticism. 
It was clear that if animals bitten could be saved by subsequent injection 
of venom, and if iodine possessed the power of neutralizing the venom, a 
mixture of iodine with the venom ought to render it altogether innocuous 
when injected. At the same time we should thus escape from the numer- 
ous fallacies which embarrass all the other modes of study in which the 
antidote is used after the injury has been inflicted. 
Experiment.-About six drops of venom were divided into equal 
parts One-half was injected into the breast of a pigeon, which fell in 6 
minutes, and in 80 died convulsed. The remaining half was mixed with 
30 drops of the iodine antidote, and after 3 minutes the whole was thrown 
into the breast of a pigeon. At the close of 90 minutes the pigeon was 
crouching and very feeble; 27 hours later it appeared well. The local 
swelling was solid and not large, nor did it afterward slough or sup- 
purate. 
Experiment.-About 15 drops of venom were divided into three por- 
tions. Five drops injected into the breast of a pigeon killed it in 6 j 
minutes. 
Experiment.-Five drops of venom were mixed with 10 drops of the 
iodine solution, and, after 1 minute, injected into the breast of a pigeon. 
Death took place in 32 minutes with convulsions 
Experiment.-Five drops of the same venom were mingled with 1 
* Or, more properly, Crotalus tergeminus. 
| Ills inoculations were made on the surface of wounds, or by pushing the 
venom into incisions previously made. On the Treatment of Rattlesnake Bites. 
31 
drachm of iodine solution, and, after 3 minutes, the mixture was injected 
as usual into the breast of a pigeon. At the 12th minute general convul- 
sions took place; and death followed at the 17th minute. 
Experiment.-About 12 drops of venom from one snake were sepa- 
rated into two parts. About one-half was treated with 1 drachm of 
iodine solution. At the end of 6 minutes the mixture was injected into 
a pigeon's breast. At the 4th minute the pigeon fell-death occurring at 
the close of 85 minutes. 
Experiment.-Three and a half drops of venom and 35 drops of 
iodine solution having remained in contact 23 minutes, were injected into 
the thigh of a pigeon. At the 5th minute it fell, and died without con- 
vulsions at the 20th minute. 
Experiment.-Three and a half drops of venom were mixed with one 
drachm of iodine solution, and after 43 minutes the whole was injected 
into the thigh and breast of a pigeon. In 20 minutes it fell, and died in 
73 minutes, not convulsed. 
A series of five experiments of like nature was made on pigeons, using for 
each case 3 drops of venom and 25 of iodine solution. No. 1 died in 24 m. ; 
No. 2 and No. 3, in 18 m. ; No. 4, in 95 m.; and No. 5, in 127 m. In 
a comparative series where no iodine was used with the venom, No. 1 
died in 7 m.; No. 2, in 16 m.; No. 3, in 23 m.; No. 4, in 49 m.; and No. 
5, in 71 m. 
A comparison of these results and a reference to the above stated ex- 
periments, suffice to show that while iodine seemed to retard the consti- 
tutional action of the venom, it did not annul that action. I am there- 
fore unable to confirm Professor Brainard's views. If it be urged that I 
did not use cups in addition to the antidote, I would reply that my desire 
was to test the value of this antidote apart from any interfering aid, such 
as cups, whose utility we already comprehend. If, moreover, the cups 
were used by Dr. Brainard only to detain the venom in the part, and so 
secure to the antidote the chance of meeting it, this is needless where the 
venom and iodine are mixed before using them. 
There remains for examination another fact of great value, first ob- 
served by Dr. Brainard. In all the cases in which Dr. Brainard in- 
jected iodine into the site of the fang wound, he found a remarkable 
absence of the usual local phenomena, such as swelling, ecchymosis, 
hemorrhage, etc., and he explained this deficiency by supposing that the 
venom was altered specifically by the antidote, and had thus lost its power 
to produce either its local or general effects. So far as the absence of 
the usual local signs is concerned, I can fully corroborate this statement. 
If venom alone be injected in one case, and venom and iodine in another, 
the difference between the two wounds will be such as to impress the most 32 
On the Treatment of Rattlesnake Bites. 
casual observer-the one being black, swollen, and dripping with blood; 
the other showing slight change of color from the iodine, but not 
otherwise altered. 
The question now arises, is the altered character of the wound due to 
the influence of iodine on the venom, or to its effects on the tissues ? To 
settle this point, I added the iodine solution as usual to portions of venom, 
and then exposed them to a gentle heat for two or three hours, hoping 
to drive off the iodine. In this I was but partially successful; only a part 
was thus lost, and, at all events, the iodide of potassium still remained. 
Thus prepared, the venom was injected. The local signs which followed 
were much more marked than before, and led me to suppose that if I 
could entirely dissipate the iodine, I should restore to the wound its 
original character. It would have been possible to separate the venom 
and the antidote by following the process of M. Reynoso,* whose ad- 
mirable experimental criticism upon iodine as an antidote to woorara is 
a model of such research. This means, however, involved exposure of 
the venom to other chemical agents, and the end in view was attainable 
by simpler means. 
After observing the local influence of iodine, I was led to employ sim- 
ple astringent agents in the hope of finding that they possessed equally 
with this substance the power of modifying the local action of venom. 
A series of experiments was therefore instituted, using tannic acid in 
place of iodine. On mixing this agent with venom and injecting the 
mixture, I found that the local effects of the wound were equally well 
counteracted, and that, so far as lessening the danger of the wound was 
concerned, tannic acid answered as well as iodine. Pursuing the matter 
still further, I treated the venom with tannic acid in excess, and then 
added ammonia until the previous precipitate was redissolved. The whole 
mixture was next injected, and the animals were found to die as usual 
with signs of local and constitutional poisoning. It was also observed 
that although these agents affected the local phenomena, the usual signs 
of blood poisoning took place when the animals lived long enough to 
allow of this occurring. From these data, I drew the general inference 
that both iodine and tannic acid delay the action of the venom, by affect- 
ing the tissues rather than the venom. 
Notwithstanding this conclusion, there remains the unmistakable fact 
that these agents so modify the local phenomena as to lessen the ultimate 
danger, and that, moreover, unlike caustics, their use does not involve 
any loss of tissue, so that they are conservative of the part, and in so 
far valuable and available where circumstances admit of their employ- 
* Comptes Rendus, xxxix. 67, and xl. 118, 825, 1153. Ox the Treatment of Rattlesnake Bites. 
33 
ment. In a practical point of view, it is of little moment whether they 
effect this desirable result by action on the venom or the tissues. 
In Dr. Brainard's experiments, pigeons were employed, and, in fol- 
lowing him, I have naturally used them also. Death took place, how- 
ever, so invariably when I used full doses of venom, that I could obtain 
but one chance of observing whether the wound continued to preserve a 
normal appearance, or whether in spite of this, the secondary local re- 
sults, such as gangrene, etc., would occur. To satisfy myself as to this, 
I made the following experiments:- 
Experiment.-A rabbit received in his flank one-half drop of venom, 
mixed with 18 of iodine solution. He became feeble in 10 minutes, but 
rallied, and finally recovered ; at the 30th hour he was killed with woorara, 
and the wound examined. The tissues about the wound were a little 
gray, and shrunken, but not otherwise changed, and there was no effusion 
of the black blood, such as usually gives peculiarity to the wounds made 
by the venom alone. 
Experiment.-Three drops of venom and sixty of iodine solution were 
injected into the lower part of the thigh of a dog, weighing twenty-nine 
pounds. The animal was ill for several hours, with feeble pulse, labored 
respiration and vomiting; next day he was well, but without appetite. 
He was killed by pithing, and the wound examined. The muscles were a 
little altered in color, by the iodine; but except in one locality-about 
two inches from the trocar wound-there was no ecchymosed appear- 
ance, and even in this spot it was trivial. 
It usually happens in dogs bitten, that, on recovering, the locality of 
the wound forms an abscess, filled with bloody pus, and the debris of 
neighboring tissues, but not involving any considerable loss of skin. In 
two additional cases of dogs wounded with a mixture of venom and iodine 
solution, the dogs recovered, and the local appearances being watched 
with care, it was found that in one case only a little serous oozing took 
place, and in the other no secondary results could be observed. On the 
whole, therefore, the evidence is strongly in favor of the ability of iodine 
to diminish the local evils caused by venom, and, in so far, to lessen the 
general danger. If, too, a mixture of iodine and venom gives this as a 
result, it may be perfectly possible to modify a previous wound by the 
subsequent infiltration of neighboring tissues with iodine or tannic acid, 
and for this nothing can be more effectual than the mechanical means pro- 
posed by Dr. Brainard. 
Constitutional remedies.-When defining the various fallacies which 
are to be avoided in studying the comparative value of remedies addressed 
to the cure of rattlesnake bites, I took occasion to define what was meant 
by an antidote, and so to correct the popular error, which limits its use to 34 
On the Treatment of Rattlesnake Bites. 
such substances as really neutralize the poison, whereas the derivation 
and actual meaning of the word more truly express the position of most 
remedies which possess any claim to the title, they being rather counter- 
active agents than anything more direct. Thus aconite enfeebles the 
heart, alcohol stimulates it, and is thus a physiological antidote to its 
effects. 
A number of substances have at one or another period enjoyed the 
celebrity of being direct antidotes to venom, and even alcohol, which is 
certainly of use in these cases, has commonly been regarded as owing its 
value to some mysterious ability to neutralize the poison. 
The remedies still in vogue as internal antidotes are ammonia, olive 
oil, cedron, guaco, arsenic, Bibron's antidote, (bromine,) and alcoholic 
stimulants. In studying these substances it will be proper to determine 
first, whether they directly neutralize, or rather alter the venom itself; and 
secondly, what power they possess when given internally. The first end 
may be attained by mixing the venom with an excess of the antidote, and 
injecting the mixture : if the venom acts us usual, the supposed antidote 
must be presumed to have no immediate influence on the venom. 
The second method of study by the internal exhibition of the remedy 
will inform us as to whether it has the ability to counteract the effects of 
the venom. It may be pursued in two ways, by giving the antidote first, 
or by giving the antidote after the venom has been employed. Finally, 
it is absolutely necessary to give the venom in known amount by artifi- 
cial subcuticular injection, rather than to trust to the uncertain plan of 
subjecting the animal used to the bite of a serpent. 
Ammonia.-The volatile alkali, proposed by Jussieu in 1141, was 
closely studied by Fontana, who came to the conclusion that it was alto- 
gether valueless as a remedy in viper bite, whether used on the wound or 
internally, or in both ways at once. His experiments are open to criti- 
cism from the fact that he does not state how much ammonia he gave, or 
what effects it produced. On the whole, however, he makes out a strong 
case as against its antidotal value; but not even his high authority has 
prevented its frequent use, since his time, in India, Europe, and America. 
In our own country especially it has been regarded with much favor, and 
has received the support of numerous cases of rattlesnake bite ending 
happily under its use.* To know that a thousand cases of coryza 
got well after taking cubebs, gives us no strong conception of its sav- 
ing power when once we learn that coryza does not kill; and in like 
* Drake, West. Jour. Med. Phy. Sei., vol. i. p. 60; Miller, A. G., Boston Med. and 
Surg. Jour., vol. viii. p. 246, 1833; Moore, J., Am. Jour. Med. Sci., vol. i. p. 344, 
1827. On the Treatment of Rattlesnake Bites. 
35 
manner when it becomes known that rattlesnake bites are really less 
fatal than they were once thought to be, we come to regard reports of 
their successful treatment, and limited mortality under this or that treat- 
ment, with some reasonable caution and reserve. To this fallacy, how- 
ever, I have already alluded; it is well illustrated in most of the reports 
favorable to the use of ammonia. I have already shown, p. 294, that 
ammonia does not modify or affect at all the toxic activity of venom; 
when mingled with it and injected, the animals die as usual. If it has 
any value, it must be as a counter active agent, and this, at first sight, 
seems not unlikely, when we recollect the symptoms of weakness which 
belong to cases of venom poisoning, and when we consider that ammonia 
is a stimulant. 
It is scarcely requisite to give in detail the experiments upon the in- 
ternal use of ammonia. Upon giving it to dogs which had been bitten, 
or to others into whose tissues I had injected venom, I failed to observe 
any marked stimulating effect, so completely was the remedy over- 
mastered by the malady. In one case I believe that I actually destroyed 
a dog with the means which was meant to save him. On the whole, 
then, from my own results and those of Fontana and others, I am inclined 
to believe that the volatile alkali possesses no power over these injuries 
which does not belong in a far higher degree to other stimuli, which are 
usually more accessible.* 
Olive oil has been used internally, both for viper bites and for those of 
the rattlesnake, and no remedy has been more favorably considered. The 
verdict of Fontana and the dictates of common sense are however against 
it, and it is quite impossible to perceive how in any way it could be of 
value. 
Cedron.-The nut of the simaba cedron, and gwico, the root of nvika- 
nia guaco, are two remedies which have been greatly praised, especially 
in South America. Cedronf is stated by M. Dumont (Aug. Dumerilf 
rep.) to be so perfect an antidote to viper venom that if freely given to an 
animal beforehand it becomes insusceptible to the effects of viper venom, 
and may then be bitten again and again with entire impunity. If this be 
correct, no better evidence of the value of this antidote can be offered, 
* There is still another objection to ammonia, arising from the fact that it pos- 
sesses the power <sf rendering the blood incoagulable, as Dr. Richardson, of London, 
has shown; and although the loss of coagulability arising from this agent and that 
which conies from venom poisoning are probably different, it should still have some 
weight in deciding our choice between ammonia and alcohol. 
f Cedron is chemically a simple bitter, not unlike quassia. 
J Notes Historique sur la Menagerie des Reptiles du Museum. Mem. du Musdum, 
vol. vii. p. 273. 36 
On the Treatment of Rattlesnake Bites. 
and the only possible defect in the evidence might arise from the fact that 
the vipers were directly used, in place of known amounts of their venom. 
We shall see hereafter, that like powers have been ascribed to another 
antidote, which was found to fail under this test, applied with fitting pre- 
caution in my own laboratory. Late in the fall of 1860 I became pos- 
sessed of a sufficient amount of cedron to test the above statements of M. 
Dumont, but unfortunately my snakes were torpid, and long captivity had 
so diminished their capacity to secrete venom that I was obliged to delay 
my examination of cedron until I should be more fortunately situated. 
Guaco, vaunted by Vargas* and Chabertf as a prophylactic against 
snake bites, or rather their effects, must be a marvelous remedy if all said 
of it be true. I have no personal experience of its use. 
Arsenic, unlike many of the supposed specifics against snake bites, 
certainly does not belong to the class of expectant remedies. It has been 
principally used in the East Indies, as the well-known Tanjore pill. This 
medicine is composed of arsenious acid, three East Indian roots, of which 
two are purgative, and one an active acro-narcotic, mixed with pepper, 
and the juice of the wild cotton plant. Each pill contains three-fourths 
of a grain of the arsenic. Two are given at once, and one at the close of 
an hour; no trifling dose of so potent a medicament. Russell, p. 65, 
examined this agent, and pronounced against its use; nor lias it retained 
the celebrity which it once enjoyed. I have made no personal examina- 
tion of its merits, nor indeed could I have procured the pill in question, 
which really contains other and active ingredients besides the arsenic. 
Bibrori's antidote has a very singular history, to which I have else- 
where called attention. It is thus described by my friend Prof. Ham- 
mond. £ 
"Some four years since, Prince Paul of Wurtemburg, the celebrated 
naturalist, communicated to my friend, Mr. de Vesey, (Xantus,) the re- 
sults of some experiments performed before the French Academy of 
Sciences by Professor Bibron, relative to an antidote to the venom of the 
rattlesnake. According to Prince Paul, Prof. Bibron allowed a rattle- 
snake to bite him in the lips, cheeks, etc., and by taking the antidote dis- 
covered by him, prevented all alarming symptoms, and, in fact, suffered 
no inconvenience therefrom. The antidote in question, as stated by 
Prince Paul, is prepared according to the following recipe: R.-Potasii 
iodid. grs. iv; hydrarg. chlorid. corrosid. grs. ij; bromini, 5V- M. Ten 
drops of this mixture diluted with a tablespoonful or two of wine or brandy 
* Semanario de agricultura yartes dirigido a los purrocas, vol. iv. p. 397, 
Madrid, 1798. 
f Du Huaco et de ses vertus medicinales in, 8vo., 1853. 
| Am. Journ. Med. Sci., No. Ixix. p. 94, 1858. On the Treatment of Rattlesnake Bites. 
37 
constitute a dose, to be repeated if necessary. Prince Paul forwarded 
some of this medicine to Mr. De Vesey, who used it successfully in two 
cases of men bitten by rattlesnakes." 
Prof. Hammond then proceeds to state two cases and certain experi- 
ments on animals. The first case was satisfactory as evidence, the second, 
which was reported by Dr. Coolidge, was less so, as Brainard's local treat- 
ment was also made use of. 
The experiments were as follows: A young wolf was bitten by a very 
large rattlesnake. In thirty minutes, the symptoms being severe, six 
drops of the antidote were given. Relief occurred almost immediately, 
and recovery followed. Next day the same snake was allowed to bite 
the same wolf thrice. Before the antidote could be used, the animal fell 
and was apparently dead; the remedy poured into the throat remained 
there, but seemed to revive the animal for a lime, when finally, at the 
twenty-seventh minute, death took place. The third case failed alto- 
gether, owing to the dog being unable to swallow when the antidote was 
given. In the last experiment, the snake having been used the day 
before, bit a dog in the jaw ; his symptoms were not extreme, and he 
recovered perfectly after taking the antidote. Two of these cases, there- 
fore, got well, and two died. Mr. De Vesey* (Xantus) reports a severe 
case of bite in a boy in whom the use of the antidote was followed by 
rapid amendment and permanent relief. Several experiments on dogs 
are also related, but the account given is wanting in details. He also 
states that dogs which had taken several doses of the antidote "were for 
some time incapable of being infected by the venom of the rattlesnake.'1'1 
Dr. Heeryf relates a case which was treated within five minutes, and 
promptly relieved. The information as to the bite was scarcely so full 
as might have been desired. Dr. Sabal£ gave the antidote freely to six 
dogs, of whom two recovered. 
The defects in the experiments above quoted must be plain to any one 
who has carefully followed my exposition of the fallacies which attend 
upon the direct use of the serpents in place of the injection of known 
quantities of their venom. Moreover, the reader will remember also 
that the suddenness of recovery is really a part of the natural phenomena 
of this mode of poisoning. 
NIy own experiments with Bibron's antidote have been such, on the 
whole, as to lead me to regard it with considerable doubt. While ex- 
pressing this opinion, I ought also to say that those who first used it in 
* Am. Journ. of the Med. Sci., No. Ixx. p. 375, 1858. 
j- Am. Journ. Med. Sci., No. Ixxvi. p. 574, 1859. 
| Savannah Journ. of Med., September, 1858. 38 
On the Tbeatment of Rattlesnake Bites. 
this country were skilled observers, whose views are entitled to so much 
respect, that I shall still consider the question as somewhat unsettled 
until other observers have followed in my own track of research, employ- 
ing the same caution which I have endeavored to preserve. 
Before I became well acquainted with the peculiarities of the rattle- 
snake and its venom, I made the first series of observations which I 
shall now relate. Eight dogs were subjected to the fangs of rattlesnakes, 
which had been from three to five weeks in captivity, but had bitten 
nothing for a week. In all of the cases, the symptoms were serious; but 
of the eight oidy three died. A second set of dogs, eight in number, 
and resembling as nearly as possible the first set in weight and other cir- 
cumstances, was selected for comparative study. After each of them was 
bitten, he was watched, and on the first appearance of grave symptoms, 
the bromine antidote was used in the manner about to be described : 
When no severe symptoms declared themselves within a reasonable 
period, a second snake was permitted to bite the animal; and again, 
upon the symptoms declaring themselves fully, the antidote was given as 
usual, although in somewhat smaller doses than those which I after- 
ward employed. Of the eight dogs three recovered. So small a pro- 
portion, as compared with the recoveries of dogs bitten, but not treated, 
lends very little aid toward the solution of the question. I have selected, 
for full statement, three of the eight cases in which bromine was used:- 
Experiment.-Black cur, weight 34 pounds, was bitten by both fangs 
2j inches above and to the right of the anus; pulse, before the bite, a 
little irregular (a natural condition in the dog) and about 137 ; he yelled 
when bitten, and being set at liberty moved about uneasily. At the 15th 
minute, pulse 155, and weak ; dog lying down, disinclined to move; mus- 
cles about tail twitching; he received 3 drops of the antidote in 10 of 
alcohol, and 4 ounces of water; the dose was given without the stomach 
tube and seemed to annoy him. 35th minute, swelling large and grow- 
ing; pulse 120, feeble; respiration tremulous; when thoroughly aroused, 
he can walk, but seems inclined to lie down. 80th minute, pulse 130; 
swelling larger; took 4 drops of the antidote with water only ; the pulse 
124 to 130 ; no longer irregular, but feeble respiration as before. 119th 
minute, nausea an I partial vomiting; appears stupefied; sensation still 
good. The presence of water seemed to excite in him the utmost dread ; 
on its approach he rose and staggered backward, and fell as before ; at 
the close of the third hour he took 5 drops of the antidote, and was then 
left until next day, when he was to all appearance well, and ate and drank 
greedily. The wound sloughed but little externally, although a large 
abscess formed beneath the skin. He gradually recovered from this, and 
experienced no secondary evils. On the Treatment of Rattlesnake Bites. 
39 
Experiment.-A mongrel terrier, weight pounds, about 19 
months old, was bitten under the jaw by one fang, and on the knee by 
two fangs. At the second minute he fell; with feeble pulse and much 
local quivering; took four drops of the antidote. At the 25th minute, 
micturated and passed solid stools; took six drops of antidote, shortly 
after which the quivering became general; the pulse more rapid and 
feeble; the breathing labored, and vomiting took place at the 60th 
minute. There was no odor of bromine in the matter ejected, and in 
general the speed with which this substance disappeared from the stomach 
was remarkable. Death took place at the 63d minute, without con- 
vulsions. 
Experiment.-A large black terrier, weight 24 pounds, was bitten 
on the foreleg by one fang, and again by one fang on the inside of the 
hind leg, nine minutes later ; the last wound bled about two ounces, and 
swelled but little ; he sunk down almost immediately, making efforts to 
vomit. At the 18th minute, took four drops of the antidote, and again, 
three drops at the 32d minute; the respiration now became laborious 
and jerking, and the dog was unable to stand at all; five drops were now 
given, when he got up on his feet, coughed a little, and again lay down. 
At the 70th minute, another dose of four drops was given. At the 76th 
minute, the heart-beat imperceptible ; respiration only occasional; invol- 
untary evacuations; general fremitus; death. 
In the remainder of my experiments I used known quantities of venom, 
which I injected; and the doses of venom employed were large and the 
dogs themselves of greater size. These observations were nine in num- 
ber, and in all of them the amount of venom given was such as my 
experience taught must in all likelihood have been fatal were no anti- 
dote resorted to. In each of four cases the prophylactic power of the 
antidote was tested, and in the remainder this medicine was given after 
the venom had been injected. 
Experiment.-Prophylactic power of bromine antidote. A brown 
bitch, weight 27 pounds, received through a stomach tube seven drops of 
the antidote in water; and in twenty minutes eight drops. Three 
minutes later, ten drops of rattlesnake venom was injected into the left 
fore shoulder; five minutes later, the local quivering was marked and the 
animal vomited some mucus and water, having neither smell nor color of 
bromine; pulse feeble and rapid. At the 74th minute, the animal was 
cold, and received five drops of the antidote ; immediately after which she 
regurgitated a small amount of fluid into her mouth, but swallowed it 
again. The taste of the bromine seemed to annoy her, and she coughed 
considerably, and with much effort stood up and walked a few steps ; this 
appearance of amendment was fallacious ; she fell again, and so remained, 40 
On the Treatment of Rattlesnake Bites. 
until at the end of three hours and twenty minutes death occurred with- 
out convulsions. 
Experiment.-A white cur dog, weight 24 pounds, took eight drops 
of the antidote at nine in the morning, and received no food up to a quar- 
ter to five p.m., when five drops of antidote were given in five ounces of 
water. Seventeen minutes later, ten drops were given as before; this 
dose appeared to annoy the dog, and in a few minutes he vomited ; the 
matters expelled, water and mucus, smelled of bromine. At the 24th 
minute, five drops more were given, and again a slight attack of vomit- 
ing followed; but I did not think that he lost thus all of the bromine. 
At the 27th minute, I gave three drops of antidote, which were retained ; 
and at once I injected ten drops of venom on the outside of the left fore 
shoulder. At 31st minute, made water freely. At 33d minute, very weak ; 
stands with head drooping; quivering about wound conspicuous. 35th 
minute, urinated and defecated; lies down groaning. At 41st minute, 
gave three drops of antidote, when he rose up, moaned, and fell again ; 
extremities cold; pulse feeble; respiration laborious and quivering. 42d 
minute, pupils dilating. 8Gth minute, general muscular quivering ; wound 
much swollen ; convulsive motions of head and jaw. Death at the close 
of an hour and forty-five minutes. 
Experiment.-Mongrel dog, weight 23 pounds ; took ten drops of 
Bibron's antidote, and in thirty minutes five drops more; forty-five minutes 
later, three drops more were given, and at the same time eight drops of 
venom were thrown into the left fore shouldei'; in a few minutes the dog 
became extremely feeble, fell down, made unsuccessful efforts to vomit, and 
had a slight but general convulsive movement; at the close of an hour 
and twenty-five minutes, he wras growing rapidly worse ; when I gave 
five drops of antidote and left him. Sixteen hours after he was found 
dead and in complete rigor mortis. 
Experiment.-The remaining case was differently treated. The dog 
received every night and morning seven drops of the bromine antidote 
during three days, and was then poisoned with seven drops of venom just 
after taking his last evening dose of the antidote. He died during the 
following night, the wound being found enormously swollen with fluid blood. 
Five experiments were made with the same antidote, which I gave to 
dogs after injecting their tissues with venom. All of the dogs were 
large-none less than twenty-six pounds in weight-and all received the 
same dose of venom, about seven drops, and all were treated immediately 
with ten drops of antidote, and afterward with five-drop doses if they 
grew worse. If they mended, they were merely watched. Two of the 
five recovered; one of these being the smallest, the other the largest of 
the dogs. The remaining animals perished; one of them surviving 
thirty-one hours, and another three days. On the Treatment of Rattlesnake Bites. 
41 
The experiments here related, and the general results of the use of 
Bibron's antidote are, on the whole, so discouraging as to render it prob- 
able that it is in reality not more valuable than other agents which have 
once enjoyed an equal reputation. While expressing this opinion, founded 
chiefly on my own inquiries, I cannot help feeling that it is impossible to 
settle the question definitively without a further and larger experience in 
the form of human cases of venom poisoning, which should be studied 
with care by the light which I have endeavored to throw upon the sub- 
ject-reference being had to the number of fang-marks, the size of the 
snake, etc. 
Alcoholic stimulus is not so ancient a remedy in snake bites as most of 
the means already discussed. William Patterson, in 1791, after speaking 
of the effects of snake bites, advises the use of the Tanjore pill, and fail- 
ing in this, Madeira wine, strengthened with brandy, and given in full 
doses.* In 1823 William Mayrantf reported cases of the use of alco- 
holic stimulus in snake bites. Dr. Atchison,J 1853, is the next authority 
advising its use; and finally, Dr. Alexander,§ in a brief essay, already 
alluded to, reports cases in which it was employed, and assigns to it a cor- 
rect position as a physiological antidote, or counter-active agent. The 
three American authors last named mention the use of stimulants in these 
cases as if it were common, and in fact throughout this country the prac- 
tical sagacity of physicians generally, and even of those who were not, 
seems to have perceived how plainly a stimulant was needed to correct 
the depression produced by venom. That the popular theory of the stim- 
ulus as a neutralizing antidote is incorrect, and that the remedy has been 
often abused in practice, admits of little doubt; but the general reliance 
placed upon it must, to some extent, be admitted as evidence in its favor, 
whenever other and more scientific proof of efficacy can be brought for- 
ward. 
Besides the authors named, and a brief additional record by Dr. Bur- 
nett, there are no cases on record in which alcoholic stimulus was princi- 
pally used. In examining the few cases alluded to, we are struck with 
the enormous amounts of stimulus which can be taken by a patient under 
the influence of venom, and indeed the very antagonism between the 
effects of the poison and that of the remedy which we may thence infer 
to exist, is of itself something in favor of the treatment alluded to. 
* Four Voyages into the Hottentot Country, and into Caffraria. 4to. 1791, 
London. 
f Amer. Med. Recorder, vi. p. 619, 1823. 
| Southern Journal of Med. and Phys. Sei., i. p. 47, 1853. 
?, On the Use of Alcohol in Snake Bites; St. Louis Med. and Surg. Journal, xiii. 
116, 1855. 42 
On the Treatment of Rattlesnake Bites. 
Many cases have been related to me, in which the patients took pints of 
brandy or whisky within a few hours ; but I prefer to quote from Burnett* 
the following case, as sufficiently illustrative of my meaning :- 
" Mr. B. was bitten just above the heel, when three-quarters of a mile 
from home. The usual symptoms of acute pain and large swelling imme- 
diately followed. lie soon after complained of being blind and of having 
general pain, with the usual signs of prostration. The patient took one 
quart of brandy within an hour, but, although nauseated, he was not made 
drunk by this nor by a second quart, taken during the two ensuing hours." 
In Dr. Atchison'sf case a delicately-nurtured young lady, aged seven- 
teen years, took within a few hours three pints of whisky, without the 
least intoxication being observable. The physician who recalls the cases 
of low fevers in which he has had occasion to give stimulants, with an eye 
to their effects less than to their amount, will not be surprised that, in the 
face of a deadly sedative, the system should acquire this tolerance of 
alcohol. 
The manifest adaptation of stimulus to meet the indications in cases 
of rattlesnake bites is, then, a strong point in favor of this mode of 
treatment. If, forgetting the local cause, we were called on to observe a 
case of snake bite, and to note the enfeebled circulation, with pallor, nau- 
sea, and general prostration, we would almost by instinct resort to some 
stimulant, nor would our decision be incorrect. The early feebleness of 
the heart, and the depression of the nerve functions, so obvious to the 
eye, is not less notable when we come to measure, by more accurate means, 
the loss of cardiac energy, and the diminution of the intra-arterial pres- 
sure. For the details of the researches establishing these facts I must 
again refer to my former essay, contenting myself with the simple state- 
ment that the general result of my experimental inquiries led me even then 
to suspect that a rational treatment of venom poisoning could scarcely 
dispense with stimulants, at least in the early stages of the malady. 
If, then, I am correct in my views, alcohol is to be looked upon as 
merely a counter-active agent; in a word, as a stimulus to be employed to 
buoy the patient over the prostration caused by venom poisoning. More 
than this it certainly is not, and thpse who have looked upon it as a direct 
chemical antidote, and as available for local treatment, need but to be told, 
to settle the matter, that a mixture of alcohol and venom is not less poi- 
sonous than the unmixed venom. 
In conclusion, I ought perhaps to notice the argument against the use 
of stimulants, founded upon the fact that intoxicated persons have been 
* Proc. Boston Soc. Nat. Hist., vol. iv. p. 315. 
j- Southern Journal of the Med. and Phys. Sei., vol. i. p. 47, 1853. Ox the Treatment of Rattlesnake Bites. 
43 
bitten, and found no immunity in their condition. I have, however, dis- 
cussed this question elsewhere, and I desire to state here only the simple 
fact that, in the cases alluded to, no attempt was made to keep up the 
essential condition of stimulation. Furthermore, profound intoxication, 
where that has pre-existed, is not the condition which is to be desired, nor 
should we seek to do more, in using the alcohol treatment, than merely 
excite and sustain the flagging energies of the system, just as we would 
desire to do were the evil to be remedied an overdose of tartar emetic. 
The following experiments were made in part during 1859 and 1860, 
and were broken in upon in the fall of the latter year, by circumstances 
which interfered with their completion. They are neither so numerous 
nor so varied as I desired to make them, but, in conjunction with what has 
already been urged, they appear to me to strengthen the popular notion 
in regard to the value of alcoholic stimulants in snake bites. The first 
two cases ended fatally, as follows:- 
Experiment.-Dog of mixed breed, chiefly setter; weight 34 pounds. 
The animal standing, his pulse was 80, and but a little irregular. He 
was tied, as usual, to the leg of a table ; pulse 86. The snakes had not 
been used for three weeks, and were very active. A large serpent bit the dog 
in the groin, upon which he howled fearfully, and made desperate efforts to 
escape. In 10 minutes, pulse 120. At 13 minutes he was bitten again 
by a snake, which struck him twice, in right groin and right shoulder, 
before he could be removed ; 17| minutes after first bite, pulse 134, feeble ; 
10th minute, dog howling, very weak, urine dribbling; 23d minute, gave 
1|5 alcohol in 4 ounces of water, when at once he vomited a yellow bil- 
ious matter, and the pulse fell to 120; 26th minute, gave alcohol 15, as 
before, pulse 120, no longer irregular. At this time he lay down sud- 
denly, and at the 28th minute took, with extreme difficulty, another 
drachm of the alcohol; 30th minute, general fremitus, pulse 120, but ex- 
cessively feeble ; 35th minute, took 2 drachms of alcohol, pulse 200, and 
feeble, breathing irregular; 48th minute, the dog was evidently dying, 
when he took 2 drachms of alcohol, and perished, with a slight general 
convulsion, 65 minutes after the first bite. The blood was diffluent, and 
did not coagulate on being kept for 24 hours. The colon contained dark 
fluid blood, and the peritoneum was dotted with ecchymoses. 
Experiment.-In this case, a small cur, weight 10 pounds, was twice 
bitten in the leg by a large and active serpent. At the 5th minute he was 
feeble, pulse 120; before the bite, 116. 6th minute, gave 4 ounces of 
whisky, and repeated it at the 8th minute, when the heart was becoming 
more rapid and stronger. 10th minute, gave 1 ounce of whisky; pulse 
128, and strong. At this time I was forced to leave him, and returning 
in an hour, I found him lying in a puddle of vomited matters; pulse 168, 44 
On the Treatment of Rattlesnake Bites. 
and feeble; I gave about 3* whisky, but the dog ejected it at once, and, 
stretching himself, expired quietly. 
The first of these cases was probably too freely poisoned for any hope 
of recovery. The second exhibited the constitutional effects of the stim- 
ulus, and might possibly have recovered. 
Experiment.-Four efforts were made to test the prophylactic value 
of alcoholic stimulants. To each of four dogs, at different times, I gave 
two drachms of alcohol, in water; one became sleepy at once, the others 
were more or less excited. All were poisoned by the injection of 8 or 
9 drops of venom; the injection being delayed an hour in the case 
of the dog, whom the alcohol stupefied. Under the influence of the 
venom, the exhilaration passed off rapidly, and in two the pulse rose and 
became feeble; while in the remainder it fell in force, but in number 
rested unchanged. The alcohol was now continued in each case, with one- 
drachm doses at intervals dictated by the symptoms. In the case of the 
dog specially alluded to above, the alcohol seemed to possess but little of 
its usual exciting power; his pulse changed less than the others, and in an 
hour and forty minutes he died convulsed, having taken in vain four ounces 
of alcohol. A second dog succumbed in three hours after the third dose ; 
his heart failed to respond as before, and he sunk rapidly, but with his 
senses curiously clear, so that a few minutes before death, he followed 
the motions of a large fly hovering above him. The remaining pair both 
got well, and as the stimulus manifestly affected them, and as the dose of 
venom given was such as was likely to have killed, it seems fair to infer 
that the alcohol really aided them. 
Experiment.-In two remaining cases, I gave whisky. One dog of 
rather small size took it with such freedom that, after being poisoned with 
10 drops of venom, he swallowed within seven hours 18 ounces of this 
stimulus, not only without being injured, but with the most apparent good 
effects on his circulation and strength. The second dog experienced some 
good from the first dose which followed his poisoning, but he vomited 
so incessantly afterward as to baffle my efforts to keep up the use of the 
stimulus. I tried, finally, to excite him anew by ether inhalation, but the 
effort came too late, and he perished. 
I am not disposed to lay too much stress on the above cases, but they 
taught me distinctly enough that stimulation was really of some use in 
venom poisoning, and I suspect that experience will hereafter bear me out 
in this conviction. 
The disease caused by the venom is sometimes so prompt and terrible 
that it is impossible to rouse the system through the stomach, and this is 
doubly difficult when vomiting becomes one of the prominent symptoms 
of the general prostration. Under these circumstances, enemata of brandy On the Treatment of Rattlesnake Bites. 
45 
may be used, and inhalations of hot alcohol or even of ether resorted to, 
in order to re-excite the flagging powers. 
When called to a patient who has been bitten by a rattlesnake, the 
physician should at once ligate the limb with a broad band, as tightly 
as maybe needed to check the circulation, while wherever it is possible cups 
should be also used immediately over the wound. The question of immediate 
excision or ablation of the part will be then determined by considerations 
already before the reader, (local treatment.) Setting these means aside, 
the iodine treatment, as limiting the local disease, may be then resorted 
to; but if, as is usually the case, there is no instrument at hand to make 
possible this treatment, incisions and the actual cautery are the final resort. 
Meanwhile, stimulus in some shape should be given, and when the excite- 
ment thus obtained is sufficient, the finger should be laid on the pulse 
and the band loosened. As the system becomes depressed, the ligature is 
once more to be drawn tighter, and, with continued use of stimulus, the 
economy prepared for another dose of the venom, which is thus to be 
antagonized little by little. Finally, it will be requisite to shift the band 
higher up the limb, to avoid the too great constriction of the damaged 
member. The further management of the case, with regard to stimulus, 
must be left to the physic'an, who will remember that in most cases of 
severe poisoning, he has to deal finally with a blood which has lost a part 
or the whole of its power to coagulate. lie may find in the mineral 
acids, tonics, as quinine, and the continued use of stimulus, the necessary 
means for carrying his patient through the later stages of the malady. 
I indulge the hope that the great interest of this subject may hereafter 
tempt physicians in this country to observe more minutely and record 
more fully such cases of snake bites as occur in their practice, observing 
them not as well-known maladies, but as instances of disease produced 
by animal poison, and of whose course and symptoms we know really but 
little.