The patient's condition is one of profound shock with faintness, giddiness, dimness of sight, and a feeling of great terror. The pupils dilate, the skin becomes moist with a clammy sweat, and nausea with vomiting, sometimes of blood, ensues. High fever, cramps, loss of sensation, hæmaturia, and melæna are among the other symptoms that may be present. The pulse becomes feeble and rapid, the respiratory nerve centres are profoundly depressed, and delirium followed by coma usually precedes the fatal issue, which may take place in from five to forty-eight hours. If the patient survives for two days the prognosis is favourable. _Treatment._--A broad ligature should be tied tightly round the limb above the seat of infection, to prevent the poison passing into the general circulation, and bleeding from the wound should be encouraged. The application of an elastic bandage from above downward to empty the blood out of the infected portion of the limb has been recommended. The whole of the bite should at once be excised, and crystals of permanganate of potash rubbed into the wound until it is black, or peroxide of hydrogen applied with the object of destroying the poison by oxidation. The general treatment consists in free stimulation with whisky, brandy, ammonia, digitalis, etc. Hypodermic injections of strychnin in doses sufficiently large to produce a slight degree of poisoning by the drug are particularly useful. The most rational treatment, when it is available, is the use of the _antivenin_ introduced by Fraser and Calmette. CHAPTER VIII TUBERCULOSIS Tubercle bacillus--Methods of infection--Inherited and acquired predisposition--Relationship of tuberculosis to injury--Human and bovine tuberculosis--Action of the bacillus upon the tissues--Tuberculous granulation tissue--Natural cure--Recrudescence of the disease--THE TUBERCULOUS ABSCESS--Contents and wall of the abscess--Tuberculous sinuses. Tuberculosis occurs more frequently in some situations than in others; it is common, for example, in lymph glands, in bones and joints, in the peritoneum, the intestine, the kidney, prostate and testis, and in the skin and subcutaneous cellular tissue; it is seldom met with in the breast or in muscles, and it rarely affects the ovary, the pancreas, the parotid, or the thyreoid. _Tubercle bacilli_ vary widely in their virulence, and they are more tenacious of life than the common pyogenic bacteria. In a dry state, for example, they can retain their vitality for months; and they can also survive immersion in water for prolonged periods. They resist the action of the products of putrefaction for a considerable time, and are not destroyed by digestive processes in the stomach and intestine. They may be killed in a few minutes by boiling, or by exposure to steam under pressure, or by immersion for less than a minute in 1 in 20 carbolic lotion.