Whilst then it must be laid down as a principle that the antidote should
be administered freely and without regard to the quantity that may be
required to develop symptoms of its own physiological action, the doses
in which it is injected and the intervals between them must be left to
the practitioner's judgment, as they depend in every case on the
quantity of snake-poison absorbed, the time elapsed since its inception
and the corresponding greater or lesser urgency of the symptoms. If the
latter denote a large dose to have been imparted and it has been in the
system for hours, delay is dangerous and nothing less than 16 minims of
liq. strychnine P.B., in very urgent cases even 20 to 25 minims should
be injected to any person over 15 years of age. Even children may
require these large doses, as they are determined by the quantity of the
poison they have to counteract and are kept in check by it. The action
of the antidote is so prompt and decisive that not more than 15 to 20
minutes need to elapse, after the first injection, before further
measures can be decided on. If the poisoning symptoms show no abatement
by that time, a second injection of the same strength should be made
promptly, and unless after it a decided improvement is perceptible, a
third one after the same interval. As the action of strychnine when
applied as antidote is not cumulative, no fear needs to be entertained
of violent effects suddenly breaking out after these large doses
repeated at short intervals. They are, so to say, swallowed up by the
snake-poison and remain latent except in counteracting the latter. This
has now been proven abundantly by scores of qualified observers in all
parts of Australia, and still more by Banerjee in India. No hesitation,
therefore, should be felt by medical men in other snake-infested
countries to adopt the Australian treatment. It is seldom that more than
half a grain of strychnine administered in 16m. doses of liq. strychniæ
is required here to effectually counteract the venom and place its
intended victim out of danger. Ligature and excision of the bitten skin
have usually been practised and much of the poison eliminated before the
antidote is applied. Our snakes, however, as already pointed out, with
their shorter and merely grooved fangs, do not perforate the cellular
tissue to such depth nor instil as large a quantity of poison as the
cobras, kraits and vipers of India or the rattlesnake of America, all
having perforated and much longer fangs and much more productive poison
glands. Even if after the bite of a vigorous cobra, for instance, a
ligature has been applied and the bitten part deeply excised, a
comparatively large quantity of poison will probably be absorbed
requiring much larger quantities of the antidote, perhaps grains of it,
to effect a cure.
Public-domain text, read in full here on John Shaqi.
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