While waiting for our arrival a ligature had been applied to the injured arm, and near the bite there had been made two deep incisions, from which some dark blood escaped. At the same time the patient received hypodermically a first injection of 10 c.c. of Dr. Calmette’s antivenomous serum, and two injections of ether and caffeine. As the result of this treatment we found a marked increase in pulse-rate. After a subcutaneous injection of 500 grammes of artificial serum, there appeared to be a further distinct improvement until about 8.45 (four hours after the bite). From this moment, however, the patient gradually sank. A second dose of antivenomous serum was injected beneath the skin,[171] and, since the respiratory movements gradually became slower, artificial respiration by Sylvester’s method was resorted to, while the tongue was rhythmically drawn forward. From time to time these proceedings were interrupted for a few moments, in order to observe the condition of the respiration; at the base of the thorax and in the flanks abrupt, jerky, tetaniform undulations were observable, but there was no free respiratory movement. The abdominal aorta, the pulsations of which were visible behind the navel, raising the anterior wall of the abdomen, was somewhat misleading, simulating the rhythmical oscillations of the abdominal respiratory type. The heart, however, continued to beat regularly, without any appreciable weakness. The radial pulse persisted, although weak and slow: rate 48. The patient was kept alive by repeated injections of ether and artificial serum (1¼ litres in three doses). About 8.30 there appeared to be a slight improvement; the patient was warmer, and showed some degree of sensation in the region of the bite. On pinching the vasculo-nervous bundle in the left axilla reflex movements were produced in the fingers, which closed convulsively. The pulse, which had momentarily disappeared in the radial artery, could again be felt, weak but regular. At the same time, when the epigastric region was examined, a few faint respiratory movements were just perceptible. A third injection of antivenomous serum was given and artificial respiration was continued. This factitious amelioration, however, was not maintained, and after a few scarcely visible movements of the thorax the end soon came. The eyes were fixed and insensible, the pupils slightly dilated; no sweats, no urine passed. The body slowly grew cold; the pulse disappeared from the femoral and carotid arteries, and diminished in the aorta. The contractions of the heart were once or twice irregular, and its beats became weaker and gradually The reflexes had disappeared. There were still a few slight muscular contractions near the base of the chest, and the patient quietly passed away at 11.5 p.m., as the result of the progressive arrest of the heart’s action, respiration itself having virtually disappeared two hours before the heart had ceased to beat.