Poisonous Bites and Stings
by Herbert M. Shelton
DP ND DC DNT DNSc DNPh DNLitt PhD DOrthop
THE HYGIENIC SYSTEM
In this section we deal with the results not alone of the poisons introduced into the body by poisonous insects: scorpions, lizzards, spiders, snakes, etc., but of those introduced by physicians and others, to "cure" the effects of the bites and stings and of the effects of fear born of ignorance and superstition. The varieties of poisonous insects, spiders, snakes, etc., are few and most of these are comparatively harmless and, though momentarily painful, may be ignored.
The stings of bees, wasps, scorpions, ants, etc., are simply painful for a short time, produce a little local inflammation, sometimes slight lymphatic enlargement, and are soon over. They are not dangerous and require no treatment.
Gila Monster: Popular superstition to the contrary notwithstanding, the horned toad, which is really a lizzard, is not poisonous. The Gila Monster of our Western deserts seems to be the only poisonous lizzard on the earth. Its bite is popularly supposed to be sure death. However, experiments conducted in one of our Western universities showed that its venom is of sufficient virulence and amount to kill a rat but not a dog or a man. Deaths attributed to this cause are due to fear or to the heroic attempts to save life. Fear is man's worse enemy in all poisonous bites.
Spiders: Paul Ginswold Howes, in Nature Magazine, March, 1926, under the suggestive title, "Our Friends the Spiders," says:
"The spiders are nearly all harmless or nearly so. They do everything in their power to avoid contact with man in any aggressive manner. They come about our homes for the flies and other insects that are also attracted there, and it is in this manner that they are continually working for our benefit.
Even the dread tarantula of South America is among the spiders that are beneficial and I have seen them in camps remaining hidden during the day and venturing forth by night to prey upon the gigantic roaches that infest the houses. They grow to an enormous size, but people in these countries do not often kill them because of their predatory habits and peaceful nature. In British Guiana I have lived in a shack containing a dozen or more tarantulas which never disturbed me as long as I treated them in a like manner.
"The bite of the tarantula, as far as its deadly quality is concerned, is greatly overestimated. In some few cases where the person has been weak, or in a run-down and non-resistant condition, it is possible that death may have occurred from it. In the cases that I have suffered personally, it resulted in nothing more than a swollen member, accompanied by some fever which passed off rapidly, leaving no ill effects."
Professor Combstock, of Cornell University, an authority on spiders, says the tarantula is definitely not poisonous. Deaths from tarantula bites are, therefore, deaths from fear and from treatment.
The black widow spider (known also as red-rump, hour-glass, shoe-button, etc.) which lives on insects and other spiders and only the female of which bites, has been given undeserved rank as a killer. Although she is our most poisonous spider, she is no menace to man for she attends strictly to her own business of devouring insects. She is belligerent only during the period of incubation and will, not invade a residence unless attracted by an abundance of insects. Her bite, though painful and not to be courted by carelessness, is not dangerous. Though her sting is more potent than that of the scorpion or centipede, it does not kill.
Equipped with two venom-producing glands, each smaller than the head of an ordinary pin, she produces less than one-fourth as much venom at a time as the rattler injects at one strike. Compared to the fangs of the rattler, hers are very inadequate. They are only about one-thirty-second of an inch long and, as they operate on a plane horizontal with the body, she cannot sink them to their depth. Drop for drop, her venom is as deadly as rattle snake venom, but the worst she can do is inject about one-thirty-second as much venom to about one-sixteenth the depth attained by the rattler.
Experiments with direct bites of the black-widow spider showed that guinea pigs are killed by her venom in from one hour and forty-five minutes to four hours. The first symptoms developed about half a minute after the bite. Her bite has little effect on rats, causing only nervousness and general irritability, or lassitude for about twenty-four hours. Only by crushing the two sacs from the head of a spider into an open wound, thus making sure that all the poison is introduced into the blood stream, can it be caused to kill a rat. It requires five hours for the venom thus introduced to kill a rat, while one bitten by a rattler will die in five minutes.
Hospital records of people bitten by the black-widow show that they suffer from various discomforts and pain, but there are no spasms of agony and no deaths. Indeed, there is no record of an adult death resulting directly and entirely from the bite of the spider. Few cases have really been proven to be spider bites many are tick bites or poisonous insect bites. It is thought that such a spider bite might prove fatal to an infant or even to an adult in poor health but according to all available records, healthy adults quickly recover.
The seriousness of the bite depends largely upon its location. The symptoms described in recorded severe cases are acute pains, localized and general, profuse perspiration, tautness of the abdominal muscles to a board-like hardness, restlessness, nausea, constipation, urine-retention, labored breathing and an increase in blood pressure. Generally there was a fine rash covering the entire body after the first or second day, with complete recovery four or five days later.
Contrasting the above symptoms with those produced in the rat, we are led to believe that the severity of the above symptoms is due to something other than the spider venom. The poisoning is complicated by much toxemia, or by treatment, or by fear, or by all three. In black-widow spider bites, as in all other poisonous bites, fear and drugs are our greatest enemies. To know the facts about her bite should dispel all fear and prevent resort to drugs.
Care of the Patient: If bitten, it is best to lie down and keep quiet. No food should be taken as long as there are acute symptoms. The same emergency treatment used in snake-bite that is, lance the flesh at the point of the bite, so that the blood flows freely, or apply suction will be useful. There need be no fear of using the mouth for suction.
Snakes: The danger of being bitten by a snake is not great, even where these are plentiful. Most snakes are quite harmless. There are really only a few poisonous snakes. In America the rattle snake, of which we have fifteen varieties, the copper head, the water moccasin and the little harlequin snake of our Southern States are our only poisonous snakes. Of these the rattle snake and copper head are most dangerous.
The copper head is the most widely distributed of the venomous snakes in the Eastern United States. It is smaller than its cousin, the rattle snake, but is more active, has an irrascible temper and approaches its victims silently.
The coral snake, represented in the Southern States by the harlequin is of a rich red color with black and yellow transverse bands. The, harlequin is a beautiful snake, about two feet or more long, of a retiring habit and not a serious menace to man. The coral snake belongs to the same family as the cobra, but owing to the position of the poison fangs and to the size of the mouth, is usually unable to injure man. Their venom is not thought to be very strong. Perhaps the more venomous of these snakes are those of the West Indies, and tropical South America.
The water moccasin is not as poisonous as is popularly supposed.
The cobra, of which several varieties exist in India, Africa and the East Indies, is reputed to be the most venomous of all the snakes. Death has been known to follow within a few minutes after its bite, while under ordinary circumstances in a few hours. No doubt fear has much to do with the most speedy of these deaths.
The bite of the rattle snake is popularly supposed to be sure death and the publicity given the anti-venom serum a few years ago was of a character to lead the uninitiated to believe that every reported recovery was due to the serum. The popular notion that a rattle snake bite is invariably fatal was inferentially upheld in favor of the serum.
Statistics show that only about two to seven per cent of snake bites prove fatal and there is every reason for believing that many of these deaths are due to a mode of treatment that is as deadly as the snake bite. For instance the old standby, alcohol, is given to snake bite victims in large doses. The depressing effects of alcohol are exactly the same as the depressant effects of snake venom. When a bitten person recovers after drinking a large quantity of whisky, he recovers in spite of the "remedy" not with its aid. But the addition of the whisky must have resulted in the death of many who might otherwise have recovered.
The venom of all poisonous snakes is the same, but it is more virulent in some than in other snakes. Snake venom poisoning is protein poisoning. The lethal principle of all snake venoms consists of two elements, a venom peptone and venom globulin. One of these elements has the power to destroy the fibrin ferment in the blood, the other paralyzes the motor and sensory nerve trunks. Time does not destroy its lethal character. Preserved in glycerine, its virus is as active as ever after twenty years. Arrows steeped in rattle snake venom retain their powers for many years.
Like all poisons, snake venom kills only if the victim receives a dose large enough to produce death. If he receives less than a deadly dose, he may be made very sick, but will not die unless killed by the madcap endeavors to save life, and by fear. Snake venom in small doses must be aided by fear and malpractice to produce death.
A doctor with a fear-complex frightens and maltreats many patients to death.
How much venom the victim will receive will depend upon a variety of circumstances which may be grouped under season and the habits of life of the snake, and the manner and circumstances of the bite.
Iii the extreme South and in midsummer the venom attains its highest degree of virulence.
When once a snake strikes, as in killing a rat or other animal for food, he expends practically all of his venom. A rattle snake may not accumulate a full supply of venom for a fortnight after expending it. During this period of depleted venom the snake is relatively harmless. One bitten during such a period would receive little or no venom.
The manner in which the snake inflicts the wound helps to determine the amount of venom he will inject. A snake cannot strike further than his own length and seldom that. A snake cannot strike unless coiled and then only the length of the coil. He must have at least a few kinks is his spine and then can strike only the length of the kinks. Nor can a snake strike at objects held directly over its head.
A snake striking from full coil will drive his fangs deeper than if he strikes from half coil. A direct blow will deliver more venom than a glancing blow. The snake's blow is often delivered with a raking motion and the resulting wound resembles a briar scratch. Little venom is administered in this way. A large snake will be able to deliver a heavier blow, thus driving his fangs deeper, than a small snake.
The fangs of the rattle snake are one-fourth to three-fourths of an inch in length permitting him to contact the blood stream. He may inject as much as six drops of venom. The average is two to four drops. Three drops of venom injected half an inch into the flesh may easily prove fatal.
Upon the bare flesh the snake will drive his needle-like fangs deeper than through clothes. The clothes will absorb part of the venom. Certain articles of clothing are less permeable than others. Rubber, even thin rubber, is nearly impermeable. Soft, closely woven cloth is resistant. In experiments, blotting paper placed behind two thicknesses of heavy flannel showed no venom (on the paper) after a strike. As about seventy-five per cent, of all snake bites occur on the lower part of the leg or foot, ordinary shoes and pants offer adequate protection.
The location of the bite has much to do with the danger. Wounds on the lower limbs are, least dangerous, on the hand and arm more dangerous, and on the face and trunk most dangerous. The more remote from the general circulation and from the large nerves and arterial vessels, the less danger.
Contrary to popular opinion, snake venom is slowly absorbed from the tissues. Its slow absorption seems to be due to its highly irritant character. As late as seventeen hours, and in some instances, as late as twenty-four hours, after the injection of venom, the poison could be recovered from the tissues around the wound by suction. This represents slow delivery. The body is but slowly poisoned by it and an ordinarily healthy body can dispose of considerable poison if it, is not delivered in overwhelming quantities.
Before discussing the care of the bitten person let us briefly glance at the futility of the old forms of medical care. We will then see that medical superstition is a much more virulent juice than the venom of the rattle snake.
Dr. Afraino de Amaral, director of the snake serum institute at Butanan, in South America, injected cobra venom into six dogs and then gave alcohol to three of these. The dogs that got the alcohol died sooner than the other three. He says that alcohol is not only not a remedy for snake bite, but that, "on the contrary, alcoholic liquors are harmful to persons bitten by venomous snakes."
Col. M. L. Crimmins and Dr. Dudley Jackson made an exhaustive series of experiments in the Robert B. Green hospital in San Antonio, using dogs for their cruel and needless experiments useless because they only confirmed what was already known.
After first determining what constitutes a minimum lethal dose of venom, they injected dogs with venom and then tried out the various reputed cures of snake bite. Potassium permanganate proved worthless as a remedy. Weak solutions of this drug would not antidote the venom in a test-tube while neither a strong solution nor the pure crystals will antidote the venom after its introduction into the body. In a controlled experiment, two dogs that were given choral hydrate died quicker than two that received no treatment. Strychnine, given as a "heart stimulant," proved valueless. Ammonia applied locally had no value. Magnesium sulphate and glycerine packs were tried and found wanting. Soaking the wound in kerosene did no good, nor did burning powder from a shotgun shell on the wound help in any way. A paste of egg white and alum had no more effect than a ceremony by a shaman.
Finally, they tried the anti-venom serum and it proved to have no more value than the kerosene. Dogs treated with the serum all died and presented, at subsequent autopsies, all the usual findings in death from rattle snake poisoning.
About the only "remedy" they did not try is that of faith and prayer offered by certain religious sects. While faith and prayer are admittedly better than fear and frenzy, it must still be admitted that these appear to save only where less than a fatal dose of venom is received. The belief in cure removes fear; this is the only virtue any cure possesses.
Let us return briefly to the serum. "It will not entirely neutralize venom when the two are mixed in a bottle in the same ratio on which the government permit was issued and are left together twenty hours before injection," says W. A. Bevan, Snake Lore Editor of Outdoor Life. He says "the anti-serum manufacturers were shown in their own laboratories that their serum was not a cure-all. In those experiments 100 per cent of the cases treated by surgery alone recovered, though every case had from two to five times a lethal dose of poison; 66 per cent of the cases treated with serum only, died, and it was shown that three of the commercial doses would not prevent death when the equivalent of less than three drops of venom had been given."
All the vaunted antidotes having proved valueless, recoveries from snake bite must be accounted for on other grounds than on the usual assumption that the treatment saved them. We assume that if the "remedy" does not kill the patient, it cures him. Fortunately only a few of those bitten by venomous snakes receive a fatal dose.
Symptoms: I quote the following description of the symptoms of rattle snake poisoning, which is that of an extreme case, from Backwoods Surgery and Medicine by Chas. S. Moody, M. D. He declares "nothing like nearly all cases bitten present even half the symptoms described." He says: "A stinging, burning pain radiates from the wound and the wound itself becomes inflamed and angry. Swelling comes on, the heart action is immediately accelerated and the respiration is hurried. In a short time, the virus penetrates deeper into the systemic circulation, the heart and respiratory symptoms change, the heart slows down, the respiration decreases, the face becomes dusky and anxious, covered with profuse perspiration, and the mind grows dull. Blindness, due to the effect upon the optic nerve, takes place.
"The patient staggers as he walks, and soon unless relief comes, he will become totally paralyzed. Spots of blood appear just beneath the skin and usually upon the limb bitten. If the amount of virus is sufficient to produce death, all the above symptoms are soon followed by tetanic convulsions and lockjaw. If, however, the dose is not sufficient to produce death, they gradually subside, leaving the patient much debilitated and subject to poisoned blood states that manifest themselves in the form of skin eruptions and ulcers."
Care of the Patient: When bitten, don't go running at top speed to the nearest human habitation. This serves to speed up circulation and disseminate the virus through the system more rapidly. Sit down calmly and carry out the following instructions:
(1) A tourniquet, or ligature, made of a handkerchief, belt, neck tie, or anything that may be handy, a reed or the bark off a tree, if nothing else, should be bound around the leg or arm, just above the bite and made tight enough to obstruct the circulation. This must be loosened for a few minutes every fifteen minutes to prevent the blockage of the circulation from resulting in gangrene.
(2) A knife, or other sharp object should now be used to make a number of incisions, through, around and above the wounds where the fangs of the snake entered. The danger, according to Dr. Jackson, is not in making too many Incisions, but in not making enough. The incisions should be about a quarter of an inch long and a quarter of an inch deep.
(3) Suction, with the mouth or a suction bulb (a breast pump is not powerful enough for this), should now be applied for at least a half hour. The more blood and lymph one extracts in this manner the better. This should be done immediately, although, if done within an hour after being bitten there is little likelihood of more treatment being required.
The old Hydropaths placed one end of a large quill or small tube over the wound and, taking the other end in the mouth, sucked vigorously through the tube to extract the venom. See The Water Cure Journal, Jan. 1851.
If the mouth is used to supply the suction one must be sure there are no abrasions in the mouth, or else, that the abrasions are carefully protected from absorbing the poison.
(4) Where the above treatment has not been administered early, and the inflammation extends up the limb, this should be followed, and incisions made at the head of the advancing inflammation and suction again applied. This may have to be done several times.
If a pocket forms, this is to say, if one area becomes more swollen than the rest of the inflamed part, a "nest" of incisions should be made in and around this area, and suction applied. In cases that are not treated early, it may be necessary to repeat the incisions and suction as often as every four hours.
In the meantime, it is necessary to retain your poise and to avoid panic. Keep cool and inspire the patient with confidence and courage. I do not doubt that fear has accounted for the death of more than one bitten person who should have recovered, except for the addition of fear to the snake poison. Keep cool. Keep your wits about you. Do not resort to any mad-cap endeavors to "sustain the heart" of the patient. Keep him quiet and keep him warm. Give him no food but water. If these few simple measures are employed in every case of snake bite, deaths from this cause will soon be a thing of the past.
Col. Crimmins and Dr. Jackson injected four times the ascertained minimum fatal dose of venom into a dog and applied suction to the poisoned tissues within five minutes after the injection. The dog made a complete recovery. The venom-containing blood drawn from this dog by suction was injected into another dog. This dog developed the characteristic symptoms of snake-bite poisoning and died. This method will probably save every case, regardless of how large the dose, if applied early enough. The "surgery" mentioned by Mr. Bevan in a previous quotation is simply the above old back-woods procedure which the self-elected authorities had always declared valueless because "the venom could not be removed by mechanical means."
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