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During the cold months, when the reptiles are torpid, few deaths occur ; but in the autumn, when the young are produced, and especially after heavy rain, when they are driven from their retreats, deaths are most numerous. The number of male sufferers to that of females is just in proportion to their employment as outdoor labourers. The amount of mortality was much greater in low districts covered by grass and jungle, especially when the snakes were driven by inundation from their underground hiding-places to the spots where cattle and herdsmen congregate, the number of deaths rising and falling with the waters of the inundation. Careful police inquiries confirm the reported cases,
To remedy the evil, the Commissioner suggests that proper directions and remedies should be issued to the local authorities; that a reward should be offered for the destruction of venomous snakes; that a prize of 500 rupees should be adjudged to the best treatise in English on the poisonous snakes, on the mode of action of the poison, together with a code of practical instruction on the treatment to be pursued ; and one of 250 rupees for the best translation of the code of instruction into Sindee or Persian. These suggestions have been accepted by the Government, with the addition recommended by the Medical Board, that the prize treatise should contain an account of the symptoms exhibited during life by the poisoned, with a description of the postmortem appearances..
Dr. Innlach's paper includes reports from the deputy collectors of several districts, together with extracts from his own report addressed to the superintending surgeon, Sind, on the snake season of 1854. The following are the principal points of interest :
a. With regard to the varieties of poisonous snakes in Sind, correct information appears to be wanting. Mr. Young, deputy-collector at Sehwan, states, on the authority of a jogee or snake charmer, that the number of species is smaller than is generally supposed, and that, as is commonly affirmed by naturalists, the snakes with long tapering tails are all harmless. The kardar of Sehwan describes forty-three species, most of them poisonous. The deputy collector of Jerruck, on information communicated by the kardars, enumerates eleven species of poisonous snakes, giving a short description of each. Dr. Imlach has met with only four :-the black cobra, the kuppur (scytab byzonata), the loondee (blind snake), and the ghorel.
The cobra averages from two feet six to over three feet in length, the adult is jet black, the younger specimen of a leaden blue colour. All exhibit the white spectacle mark on the inner side of the hood. The bite of the cobra is very poisonous, and the venom is not exhausted by two insertions of its fangs. Dr. Imlach relates the case of a jogee who nearly lost his life by the bite of one of these reptiles, which had previously fairly bitten a dog twice. On introducing a dog to a cobra they each appear to act on the defensive, the snake does not bite until irritated, and the dog only seizes it as a last act of self-defence, catching it by the head, as if by instinct, shaking it as a terrier does a rat, and chewing it until he has rendered the cobra powerless. The cobra cannot withstand the poison of the kuppur. In its society the cobra appears as it were fascinated; on being bitten it shows no signs of pain, but in a few minutes its head and crest sink down, and it dies in less than half an hour.
The kuppur, which Dr. Imlach takes to be the scytab byzonata, and to differ only in colour from the West Indian snake of that name, is the most deadly reptile in Sind. The greatest number of deaths are produced by the bite of this species. Its average length is 15 inches, and it measures from 2 to 21 inches round the thickest part of the body. The head is covered with small scales of a flat, irregular, hexagonal shape; the neck is small in comparison with the head and body; the tail fines off abruptly, barely exceeds an inch and a half in length, and is very small in circumference. The expression of the kuppur is most ferocious, the eye brilliant, and however long he may remain unmolested, his crest will be found erect, and his head fixed in the direction of the person watching him, ready for the defensive. The forehead of the kuppur exhibits a cross in white and brown, the ground mark of the body is of a dull muddy grey, and the sides of the body are marked with black and white double crescents, the concavity of each being towards the abdomen. A fowl bitten by this snake dies in three-quarters of a minute, exhibiting symptoms similar to those observed in man, the mucous membrane is powerfully acted on, the head droops, the legs give way, and it rolls on its side in the last agony.
The blind or double-hooded snake is considered to be harmless. The poison is not so dangerous.-Report of Deputy Collector of Jerruck.)
The ghorel is exceedingly venomous ; it has the bead covered with large plates. The specimens procured were under two feet in length, exhibiting white and black linear marks along the body on a greyish yellow ground.
B. Snakes principally frequent swampy districts, low-lying lands covered with grass, the banks of old canals, and rocky ground in the vicinity of flooded land.
y. From the beginning of May to the latter end of October may be considered the snake season; during this time the snakes wander about, and the greater number of accidents occur.
8. The parts bitten are usually the hands or lower extremities; no species of snake in Sind appears to possess the power of leaping to any height.
€. The report furnishes but little new information with regard to the symptoms produced by this class of animal poisons. It would appear that the phenomena following the bite of the different varieties of snake differ more in degree than in kind. At first there is great heat of body and headache; this is succeeded in two or three hours by drowsiness, which merges into complete insensibility. In all cases the patient is insensible before death. Swelling supervenes in from balf-an-hour to three hours from the accident. The part bitten becomes black, or bleeds; the latter is considered by the natives a favourable sign. In some cases blood issues from the mouth, ears, and pores of the skin. Purging is considered favourable. The whole body in many cases changes in colour, becoming of a reddish, blackish, or yellowish hue.
Ś. With regard to the average of fatal cases, as compared with recoveries, out of 48 cases reported in the Jerruck Deputy Collectorate, 20 were fatal. This proportion, however, is probably much too high, owing to neglect in making returns of those cases which terminated favourably." Of 306 cases collected by Dr. Imlach, 63 were fatal, or 20:58 per cent.; 262 of these cases were males, and of these 53 died, or a per-centage of 20-21. Of the 44 females bitten, 10 died, or 22:72 per cent.
. Remedies and their Effects.—Most of the native remedies are either perfectly inert, or have a purgative or stimulant effect. As specimens of the first class, we may note charms, the application of blood-stone to the wound, wrapping the person in fresh goat-skin, the application of the skin of the tail of a white cock to the bite, &c. Of the purgatives, the fruit of the peloo tree in large quantities of ghee appears to be the favourite. Black pepper, onions, and tooree-seed are also given internally, and assafætida is administered in the form of snuff. The actual cautery is occasionally applied; sometimes also the patient is treated by a kind of water-cure, being wrapped in wet clothes. Of European remedies, ammonia is the one on which chief reliance seems placed, and very favourable results from its use may be extracted from Dr. Imlach's tables, for of 45 cases treated with ammonia, only 4 proved fatal. - Transactions of the Medical and Physical Society of Bombay for the years 1855 and 1856, pp. 80-131.
Poisoning by Creasote.—Mr. Batho, surgeon to the 26th Regiment Native Infantry, records a case of poisoning from an over-dose of creasote. A stout young man swallowed half an ounce of the drug. The symptoms presented were complete insensibility, small and rapid pulse, quick and laboured respiration, attended with puffing of the cheeks and violent working of the alæ nasi, foaming from the mouth (exhaling a strong odour of creasote), a warm skin, flushing of the face, slight injection of the conjunctiva. There was neither vomiting, purging, nor convulsions. On the following day there was sympathetic fever, with pungent heat of the mouth, fauces, and csophagus; no tenderness at the epigastrium, but little thirst, a foul tongue; and the mucous membrane of the mouth and fauces presented patches of erythematous redness. On the 3rd day there was a sense of burning in the chest, and difficulty of deglutition. These symptoms gradually subsided, and he was discharged on the fifth day. The principal points in the treatment were the repeated injection and withdrawal by the stomach-pump of albumen in large quantity, until the odour of creasote was no longer perceptible, and the combating of the inflammatory symptoms by leeching the throat, general bleeding, and the administration of demulcents, castor oil in the form of enema, and a turpentine epithem to the thorax. — Transactions of the Medical and Physical Society of Bombay, for the years 1855–56. Appendix, p. 19.
II. HYGIENE Notes on the Cape of Good Hope, its Climate, &c. &c.—Mr. Martin (Bengal Medical Service) comes to the conclusion that “with reference at any rate to the troops, the Cape of Good Hope is one of the most healthy of the British Colonies; and that, compared with even a European climate, it may be considered as favourable for British soldiers. The average mortality among the troops serving in the colony, during six successive periods, when they were not exposed to the risks and fatalities of active military service, only amounted to something less than 12 per 1000;" the rate of mortality of troops serving in Great Britain being about 15 per 1000. The Caffre war, with its attendant deprivation, exposure, and excitement, has entailed very serious losses, apart from the direct casualties of combat, which however cannot be put to the account of climate. The author observes that the amount of moisture in the atmosphere is never very great, the rain which falls is in amount inconsiderable, so that the fevers of all types are rarely met with ; while the great and sudden transitions from heat to cold, and cold to heat, induce an unusual frequency of rheumatic affections, with their complications and consequences of heart disease. Accordingly, the diseases that predominate at the Cape are disease of the heart, rheumatic affections, and functional disorders of the stomach. Head affections are not cominon. Chest affections are more so; in children, mild forms of bronchitis are not unfrequent; in adults, if pneumonia or any of the more acute affections of the lungs come on, they arise from neglect or extraordinary exposure. Diseases of the bowels are stated not to be common, but bilious cholera, diarrhea, and dysentery prevail in the autumn. After some desultory observations about children's diseases, the author remarks that leprosy is not uncommon, in the form attended by loss of the joints, and intractable ulcerations; and then says, “There is a complaint peculiar to the Cape climate, called Zinkins, which is most painful and prostrating for the time, but not dangerous. It seems to be a severe form of influenza, but I do not think it occurs as an epidemic; it is characterized by painful swellings about the jaws, face, head, and joints, great lassitude, and nervous derangement.” For the children of European origin, the climate seems to act like a hothouse, causing a rapid and precocious development; to Indian invalids, who often resort to the Cape as a sanatorium, it is apt to prove too relaxing; while the sudden changes of heat and cold, dryness and moisture, render it peculiarly trying to those who are endowed with weak lungs. “The cases which seem to have a chance of doing well at the Cape, are those in which the nervous system has become debilitated by residence in a tropical climate, and has induced the various forms of indigestion, disorder of the functions of the liver, bowels, &c." Madras Annals of Medical Science, Oct. 1856.
Quarantine.—The minutes of the proceedings of the Quarantine Convention held at Philadelphia by invitation of the Philadelphia Board of Health, in May, 1857, is an interesting document. The Convention agreed, That the system of quarantine regulation should be revised. That the diseases smallpox, typhus, yellow-fever, and cholera may be introduced into a community by foul vessels and cargo and diseased crews, but that such diseases cannot become epidemic unless there exist in the community circumstances favourable for their development, independent of importation. That all parts of a vessel should be ventilated during a voyage, and that no vessel arriving between the 1st of May and the 1st of November should be admitted into port until her hold is ventilated and her bilge-water removed. That all portions of the cargo of a vessel capable of communicating a disease should be removed and purified. That all persons labouring under a disease should be removed immediately, and comfortably accommodated. That these provisions should be intrusted to a single officer, who should be a qualified medical man, and one competent and firm in the discharge of his duties. That a thorough examination should be made of all emigrants on their arrival, and that if they are not protected against the small-pox, they should be vaccinated. Lastly, the Convention recommends that there should be attached to quarantine establishments stations for meteorological observations and vaccination, and that records of these should be published for the public benefit.
Transmission of the Virus of Grease from the Horse to Man.-Drs. Maunoury and Pichot have published an interesting series of experiments tending to prove the identity of grease and cowpox. This doctrine, which was always maintained by Jenner, has received confirmation from the observations of Loy, Godine, and others.
The following is a summary of the facts related by Drs. Maunoury and Pichot, François Barthélemy B a ged twenty-eight, of lymphatic temperament, a farrier, presented himself to Dr. Pichot on the 5th of March, 1856. He had not been vaccinated. On the backs of his hands, which were red and swollen, were several confluent opaline pustules, depressed in their centre, having all the appearance of vaccine pustules of the eighth or ninth day. The inflammation with which the pustules were surrounded had appeared on the second, the pustules themselves preceded the inflammation soine days. This man had not been in contact with any cow, but on the llth of February he had shod & horse suffering from grease. There existed at the time numerous cracks about his hands. The disease from which the horse was suffering was certified by a qualified veterinarian. On the Ilth of April, circular depressed cicatrices occupied the situation of the pustules. Various inoculations were practised with the liquid taken from the pustules presented by B- , with the effect of reproducing the same disease. The most perfect set of experiments were made by N. Maunoury, who transmitted the virus through four sets of cases. The following are the results of his observations :
1. That virus obtained from the hands of the farrier B- , and inocuInted on the arm of an infant, produced a full pustule, having all the characters of a Faccine pustule-form, evolution, termination.
2. That lymph taken from this pustule and inoculated on the arm of three persons, has produced identical pustules, which are truly vaccine.
3. That the transmission of the virus by successive generations, has not diminished the intensity of the force of the poison. One of the set of cases presented large pustules, depressed in the centre, and filled with matter; each pustule served for several inoculations, and the charging of several sets of glasses.
4. That from these facts it is evident that the virus taken from the pustules of the farrier was identical with the vaccine.--Archives Générale de Médecine, April, 1857, pp. 365-398.
III. MISCELLANEA. Death by Hanging.--Dr. E. Leudet publishes a case of asphyxia by hanging, in which death was the result. Examination revealed fracture of the two great cornua of the thyroid cartilage, tearing of the thyro-hyoidean membrane, and incomplete rupture of the epiglottis.
An English sailor was occupied in the rigging of a ship, when a spar broke under his weight, and in falling he was arrested by a rope, which held him suspended by the neck. When he was taken down he had not lost consciousness. He was carried, about an hour after the accident, to the Hôtel Dieu, at Rouen. The face was cyanosed, the conjunctivæ much injected, there was considerable dyspnea, a full, strong, and frequent pulse. The rope had left a large bluish-red furrow round the neck, there was tenderness on pressure over the anterior part of the larynx, the voice was feeble but very distinct, respiratory murmur feeble, expectoration sanguinolent. He died at one o'clock the next morning. On examination thirty-two hours after death, the integuments of the whole body, but principally of the face, were found cyanosed. There was considerable ecchymosis and swelling about the neck, the two sterno-cleido-mastoid muscles were ruptured transversely, the right almost completely, the left through half its thickness. The great vessels and nerves had escaped. In front of the thyroid cartilage was a small cavity bounded by cellular tissue and the ruptured muscles, which communicated with the cavity of the larynx through a rent in the thyro-hyoid membrane. The body of the os hyoides was sound, its right greater cornu loosened. The two great cornua of the thyroid cartilage were fractured near their base, one was almost de tached. There was an oblique crack on the front of the thyroid cartilage, also a transverse fissure on the posterior surface of the fibro-cartilage of the epiglottis.— Archives Générales de Médecine, April, 1857, pp. 479-481.
Fatal Results from the Sling of a Bee.-Dr. N. Nivison records a case in which death was apparently produced by the sting of a bee. A farmer in good health, aged about fifty, was stung by a bee at the side of the neck, on the 8th of August, 1856. He had been used to such accidents, which were always followed by considerable swelling and local inflammation. On this occasion, though severe pain was momentarily felt, no swelling or discoloration followed. He removed the sting with his fingers. Two hours after he began to experience unpleasant sensations, and a degree of nausea, which was followed by free vomiting. Four hours after the accident, when Dr. Nivison saw him, he complained of nausea, was vomiting occasionally, and his breathing was somewhat oppressed, and sighing. There was no trace of local irritation in the part stung. Dr. Nivison supposed that the poison had been speedily absorbed, or had entered directly the circulation. The next day the vomiting had continued, and diarrhæa was added. The countenance was shrunken, wan, and anxious. The pulse had lost much of its force and volume, but was na