Venoms: Venomous Animals and Antivenomous Serum-therapeuticsCalmette, A. (Albert)
Science
Venoms: Venomous Animals and Antivenomous Serum-therapeutics
Calmette, A. (Albert)
Antitoxins; Poisonous snakes; Toxins; Venom
The entire contents of a bottle of serum (10 c.c. of liquid serum, or
1 gramme of dry serum dissolved in 10 c.c. of boiled water) should be
injected into the subcutaneous areolar tissue of the abdomen, on the
right or left side. There is no advantage in making the injection at
the actual spot bitten; the serum is best and most rapidly absorbed
when injected into the loose tissues of the abdominal wall (fig. 95).
[Illustration: FIG. 95.--TECHNIQUE OF THE INJECTION OF ANTIVENOMOUS
SERUM BENEATH THE SKIN OF THE ABDOMEN.]
If it has been impossible to apply the treatment until several hours
after the bite, and if the latter has been inflicted by a poisonous
snake of large size or belonging to a very dangerous species, such as
the Cobra or Indian Krait, it is preferable to inject into the patient
three whole doses of serum at once.
In cases in which the phenomena of serious intoxication have already
appeared, and when asphyxia threatens, one must not hesitate to inject
10 or even 20 c.c. of serum directly _into a vein_. For such an
injection it is most convenient to choose a superficial vein at the
elbow or wrist, or on the back of the hand.
The introduction of serum into the veins is never dangerous if good
care be taken not to allow either bubbles of air or particles of
precipitated albumin to enter.
It is not advisable to repeat the injections beneath the skin or into
the veins unless the general symptoms appear to become more acute.
In most cases the local pain, excitement, and attacks of cramp and
nausea disappear within a few minutes after the first injection.
Improvement progresses very rapidly, and by the following day the
patient has recovered.
The administration of ammonia, alcohol, morphia, or ether by the mouth
is entirely superfluous. These drugs, as I have already stated, may
even be harmful to the patient and hinder the effects of the serum. All
that should be done is to give copious hot drinks, tea or coffee, and
to cover up the patient warmly in order to induce abundant perspiration.
The bitten member should not be cauterised with red hot iron or with
chemical agents of any kind, since such cauterisations only lead to
injuries which are too often prejudicial to the normal action of the
affected organs.
_Treatment of Poisonous Bites in the Case of Domestic Animals._--It
often happens that dogs, horses, or cattle are bitten and succumb to
the poisoning in a few hours or in two or three days. Such accidents
are especially frequent among sporting dogs, even in Europe, in regions
in which _vipers_ are found.
In most cases, dogs, horses, and cattle are bitten on the nose, and
such bites are immediately followed by a very painful swelling,
which arouses the suspicion of the owners of the animals. It is then
necessary, as soon as possible, to inject subcutaneously in the
right or left flank, or at the base of the neck, one or two doses of
antivenomous serum, according to the gravity of the effects observed.
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