Minuteness of detail in relating this case must be excused on account of
the extreme interest and importance attached to it. Being brought about
under such peculiar and almost unique circumstances it presented the
effects of spider-poison in a superlative degree and showed them to be
identical with those of snake-poison. But whilst the latter ushers in
the symptoms with such rapidity that they cover each other and are
difficult of separate analysis, in this case the highly significant
paresis of the lower extremities, evidently of central origin, remained
separate for some time. Taking this symptom for his guide and
interpreting the formidable array of the others, developed during the
night, on the same principle, the writer's diagnosis of the case, as it
presented itself to him, was paralysis of the motor and vaso-motor
nerve-centres. This, he found, and this alone could explain all the
symptoms, and he therefore determined to put its correctness to a
practical test. There was but one remedy to make this test with and this
had to be applied without delay, for the child was rapidly sinking and
had almost ceased to breathe. _One twelfth of a grain_ of strychnine was
therefore injected in the arm, a bold dose for so young a child, but, as
the result showed, exactly the one that was required. The test was
eminently successful. Having to leave the child immediately after the
injection, the writer on returning in half an hour found his little
patient sitting up in bed, perfectly restored, with both poisons so
completely neutralising each other, that not a trace of either could be
detected. Thus the writer's structure was at last completed, and an
insignificant spider furnished the last material required for an
important discovery.
There are a few hypothetical points yet in the explanation of some of
the symptoms of snakebite-poisoning by the writer's theory, but these
imperfections are more those of science than of the theory. The whole
subject of vaso-motor paralysis for instance, and of the pathological
changes that follow it, is more or less a _terra incognita_. Diapedesis
is now supposed to be the result of blood pressure, but it occurs in
snakebite, where blood pressure is at zero. Feoktistow, we have seen,
produced it locally on the mesentery of animals with normal blood
pressure, whilst Banerjee arrested by strychnine-injections profuse
hæmorrhages from all the mucous surfaces, which were no doubt the result
of diapedesis. We know that neither snake-poison nor strychnine affect
the nerve ends but only the nerve cells. There must therefore be nerve
cells at or near the terminations of the nerves regulating the
capillary circulation in the mucous membranes, but microscopical anatomy
has yet to find them, for minute ganglia have only been discovered at
present in sympathetic nerve ends of the abdomen.
Public-domain text, read in full here on John Shaqi.
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