Every summer outdoor America leaves the heat and dust and turmoil of the city for the peace and quiet of the wild. Doubtless many persons penetrate, in their outing, regions where venomous serpents abound. These will carry as a part of their equipment remedies intended for the relief of wounds inflicted by these. Many of these remedies will be absolutely valueless for the purpose intended, and many more will fail from lack of intelligent application. A brief discussion of serpents and the approved methods of treating their wounds may prove of interest at this time.

Permit me to state at the outset that such information as may be contained in this chapter is not the result of conjecture and guesswork, but is derived from over twenty-five years study of reptilian zoÖlogy, many years investigation in the laboratory, during which time an extended series of experiments were carried out, and twelve years' actual practice, in which all of the methods that have suggested from time to time have been thoroughly tested.

There are, roughly speaking, something like twenty-eight varieties of venomous reptiles in the United States. These figures include the one lizard that is known to be poisonous and the several scorpions. Of this number the rattlesnakes comprise at least eighteen. In fact, so important are they that all others may be included in a discussion of the crotalidÆ; more particularly so as all serpent venoms act chemically in the same manner.

Man is unreasoningly afraid of snakes. It is rare, indeed, that a person concerns himself with the classification of the serpent that chances to cross his path. He immediately possesses himself of a stout club and proceeds to maul the unoffending reptile into the earth without troubling his mind to find out if the snake is harmless or otherwise. This is wrong, for when one comes to know them serpents are quite interesting. It is wrong, too, for with a little study the ordinary man can familiarize himself with the characteristic markings of the venomous serpents and differentiate them from those that are non-venomous.

All the deadly snakes, with the exception of the little harlequin snake of the extreme South, are similarly marked and all belong to the class of "pit" vipers, characterized by a depression or "pit" back of the nostril. The head is triangular, with massive muscular development of the jaw; the neck slender in proportion to the size of the head and body. The body itself is quite thick, the skin rough. The pupil of the eye is elliptical instead of being round as in the non-venomous snakes.

The harmless varieties, on the other hand, are long and slender, the skin smooth and shining, the head oval or round. If in doubt after the above, the investigator can pin his subject to the ground with a forked stick placed just back of the head and examine the teeth. If he finds, hanging from the upper jaw, or inclined forward from it, two fangs, long and sharp as needles, he can be pretty safe in assuming that his subject is poisonous. The non-venomous snakes have a dentition very much the same as some of the smaller rodents, the mice for instance.

The habitat frequently furnishes a key to the character of the snake. The venomous varieties choose by preference the rocky uplands, either open or sparsely wooded. The harmless snakes live almost exclusively in low swampy lands or along water courses. Venomous snakes are purely terrestrial. One was never known to ascend a tree. In fact it is impossible for one to do so.

While rattlesnakes are dangerous, their bite is not nearly so fatal as is popularly supposed. This fact has at least two important reasons, viz., season and the habits of life of the snake. In the extreme South and in midsummer the venom attains its highest state of virulence. Then the person fairly struck by a large rattler is in extreme danger, provided the second factor in the equation does not intrude, that is, the habits of life.

All venomous snakes, and more especially rattlesnakes, are sluggish. They do not move rapidly or over great distances. Their lethal power is given them as a means of procuring food and when once the snake strikes he expends practically all the ammunition in his arsenal. It requires hours and perhaps days to renew the supply, during which time the serpent is defenseless. Should the human victim happen along at such time and be bitten it is quite probable that he would not receive a fatal dose of the poison.

The manner in which the rattlesnake inflicts his wound is worthy of some study. In the first place, it may be assumed as axiomatic that the snake cannot strike farther than his own length and seldom even that. Stories of rattlesnakes lifting themselves from the ground bodily and hurling themselves through the air are purely imaginative. Nor can the snake strike unless coiled. It does not follow that he must be in complete coil, but he must have at least a few kinks in his spine before he can deliver a blow; then he can only strike the length of the kinks.

If permitted he will assume full coil before striking and when undisturbed he lies in that position. The maneuver of assuming full coil takes longer than is generally thought. Writers who assert that the snake can throw himself into full coil instantly are far from the truth. In fact it takes, on an average, something like five seconds for him to get his length in position to deliver his most powerful blow. My experiments have developed another interesting fact, that the snake cannot strike an object held directly over his head. It must be held at an angle.

How deep will the needle-sharp fangs penetrate. That depends, too, upon conditions. A large snake, striking from full coil, will naturally drive his fangs much deeper than another smaller, striking from a less advantageous position. Upon the bare flesh the snake will sink his fangs to their full extent. His blow, however, is often delivered with a raking motion and the wound inflicted resembles the scratch of a briar.

Certain articles of dress are less permeable than others. Rubber, even thin rubber, is wellnigh impenetrable. Soft, closely woven cloth is also resistent. In experiments I have placed blotting paper behind two thicknesses of heavy flannel and only in rare instances have I found the virus staining the paper. This fact will serve to inform the reader that the ordinary protection of the lower limbs will be adequate to shield the wearer in a rattlesnake country.

The chances of being bitten, even in a country abounding in snakes, are really quite insignificant. The rattler is the most inoffensive gentleman of my serpentine acquaintance. He is perfectly willing, if you will permit him, to lie all day basking in the sun upon some convenient rock and never molest the passer in the least. If he has sufficient warning he will slip quietly out of your path and give you the right of way. He only strikes when in his reptilian mind he deems himself insulted or in danger.

An extended discussion of the chemistry of serpent venoms would be manifestly out of place at this time. We owe practically all our knowledge upon the subject to the painstaking efforts of two men, S. Weir Mitchell and Prof. Reichert. These gentlemen gave to the world almost simultaneously the result of their labors. The lethal principle of all serpent venoms consists of two elements, a venom peptone and a venom globulin.

These elements are albuminoid in character, and it is interesting to note that they act no differently from the pure albuminoses of digestion. One element has the power to destroy the fibrin ferment in the blood, the other acts as a paralyzant upon motor and sensory nerve trunks.

Time has no effect apparently upon the poisonous quality of these venoms. After twenty years' preservation in glycerine Dr. Mitchell found the virus as active as ever, and it is known that arrows steeped in rattlesnake venom retain their power for many years. Heat in varying degrees, or a sudden violent application of it, will destroy the poisonous property, as will also absolute alcohol.

The action of the virus on the animal economy is interesting and worthy of study. When taken into the circulation the symptoms are quite characteristic and not easily mistaken, even by the man of no scientific training. This is well, as the wound itself is insignificant and might be overlooked. In fact, I have known many persons to be bitten and not know it until the symptoms apprised them of the fact.

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 hurried. In a short time, as the virus penetrates deeper into the systemic circulation, the heat 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 especially upon the limb bitten. If the amount of the 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.

The reader will appreciate that in the above has been pictured an extreme case. Nothing like nearly all cases bitten present even half the symptoms described. Statistics reveal that only something like 12 per cent. of all persons bitten by the New World venomous serpents die from their wounds.Before passing to a consideration of the means for combating a poison let us pause for a time and glance at the probabilities of being struck even in a country where venomous serpents abound. The "rim rock" of the Columbia River in Washington and Oregon is an ideal place for rattlesnakes and they abound there in profusion.

Children run barefoot all summer among the basaltic rocks, and but few of them are bitten. Haymakers fork them up with the haycocks, harvesters find them beneath the bundles of bound grain, still it is rare to hear of an accident. Among the "brakes" of the Clearwater in Idaho the great "timber" rattler dwells. The Indians never molest him, yet during my nine years' sojourn among them only seven cases appeared, and two of these were very young children.

Still, people are bitten, and the location of the wound has much to do with the chances of recovery. About 60 per cent. of all persons wounded are struck on the lower limbs, thirty-five on the hand or arm, and five on the trunk and face. Of these, wounds on the lower limbs are the least dangerous and those on the trunk or face, being near large nerve and arterial vessels, most so. The more remote from the general circulation, the less danger from the wound.

The treatment of a rattlesnake wound resolves itself into the application of a few very simple rules. In the first place a person wounded by a snake usually does the very thing he should not do—that is, goes tearing off at top speed for the nearest human habitation, thereby increasing the circulation and disseminating the virus through the system more rapidly. The man should sit calmly down and bind his handkerchief around the limb (if it is a limb), break off a stout twig and insert beneath the handkerchief, producing a rude tourniquet, and twist until the circulation is effectually shut off.

With a sharp knife make an X incision over the wound, taking care to penetrate deeper than the fangs have done. If he has good teeth and no canker in his mouth, he may now suck vigorously upon the wound. It does no good to suck the original wound. It is quite difficult to get any virus back through an opening not greater in caliber than a fine needle.

If all this is done without delay, the chances are that the patient will suffer no great inconvenience from his experience. If he chances to have handy a stick of silver nitrate he can cauterize the wound thoroughly. Failing that, a brand from the fire will serve. After a time he may release his tourniquet somewhat and permit a portion of the retained blood to enter the circulation; the system is capable of taking care of a great deal of poison if it is allowed to flow into the blood gradually.

If, however, the virus has been permitted to enter the circulation at once the case is one calling for radical measures. In this connection it is well to state that alcoholics defeat the end required. The time-honored belief in the efficacy of whiskey in the treatment of rattlesnake bites is pernicious in the extreme. Alcohol, like serpent venom, has two effects, the later or depressant effect being exactly the same as the depressant effect of the venom itself. Therefore the man who recovers from a rattlesnake wound after drinking a large quantity of whiskey does so in spite of his remedy, not with its aid.

The one sovereign remedy in these cases is strychnia, and no man should penetrate a snake country without having this valuable adjunct with him. The administration of strychnia is not so difficult but that any man of ordinary intelligence can inform himself about it in a short time. It is a powerful alkaloid, of course, and must be applied with intelligence to accomplish the end desired. How much to administer will depend upon the person and the character of the wound.

It must be taken into consideration that the system already poisoned by the venom will tolerate a larger quantity than one in a normal condition. The average dose of strychnia hypodermically applied is 1/30 of a grain. This may be increased to say 1/15 grain without any serious danger. A person suffering from rattlesnake venom will bear without danger perhaps 1/2 grain or even more.

It will be understood that this amount is not to be thrown into the blood all at one dose, but spread out over an interval of thirty minutes. Strychnia has its most important field in the treatment of these cases after the depressant effect of the venom has taken place. The rule then should be to administer until the heart approximates the normal. The patient can take too much, then again he can take too little.

Chemical antidotes directed against the venom of serpents are extremely problematical. It is questionable if there is at present any chemical that will exert more than an antiseptic effect upon the virus. Permanganate of potassium may possess the property of setting up a chemical reaction, but if so it is so prone to deteriorate when in solution and requires so much time to place in solution that it is nearly valueless.

Ammonia applied to certain of the less dangerous venoms is efficacious. Applied to crotalus poison it is of no use. In fact, when the matter is reduced to its lowest terms, the whole process of combating the effect of serpent venoms is comprised in what has been stated above. Restrict the circulation, destroy the virus by heat either chemically or by fire, and keep up the vital forces. Very few Indian tribes have any suggestion of a remedy for rattlesnake poison. The Moquis probably have, though if so no white man has ever been able to extract the secret from them. It is known that during the Moqui Snake Dance many Indians are bitten and none of them die. It might be inferred then that they do possess an effective antidote.

In conclusion permit me to suggest an equipment for the treatment of rattlesnake wounds and briefly outline its uses. Procure a rubber ribbon about four feet long, technically known as an Esmarch tourniquet—this ribbon can be rolled into a compact form and is very elastic—; a sharp surgeon's knife known as a bistoury which should be securely wrapped in absorbent cotton; a blue bottle, or one about which several thicknesses of blue paper have been wrapped, containing a stick of silver nitrate; another bottle containing one hundred tablets of strychnia sulphate gr. 1/30; an all-metal hypodermic syringe for administering the same.

All these should be placed in an oiled silk bag and kept in a convenient pocket. The bag should be changed when the clothing is changed just the same as the watch or compass.

Now for their use: Let us suppose that you have encountered a rattler and are not too scared to know what you are doing. You quietly sit down, expose the limb, locate the wound, get out your Esmarch and beginning at one end wrap it securely about the limb above the wound, gradually increasing the tension until the rubber sinks into the skin.

This done, take your knife and make a deep X over the wound, using the cotton in which the knife was wrapped to sponge away the blood. Encourage free bleeding. If you are near a stream bathe the wound freely, either squeezing or sucking it. You need not fear to swallow the poison. It will do no harm in the stomach. After the wound has bled freely, take the stick of silver nitrate and burn it out quite to the bottom. All of this will hurt, of course, but it is necessary.

The administration of the strychnia will follow next in order only if the depressant symptoms of the venom indicate its need. Should the patient feel the approach of the dizziness that is the beginning of the stage of paralysis, he should then think about his strychnia. Dissolve one of the tablets in warm water and fill the barrel of the syringe; screw on the needle, first removing the fine wire that runs through it. Plunge the needle into the fleshy part of the arm at an angle of about ten degrees from the horizontal and push home the plunger. Repeat this every fifteen minutes until the heart Has returned to the normal.

These directions closely followed will save every case of rattlesnake bite, and in many instances the patient will not require the strychnia at all. The wound made by the knife will require the same general treatment as any other simple wound.

THE CAMPER'S MEDICINE CHEST