Vipera

Including the following species and varieties :

Vipera Berus, Daudin (Pelias Berms. Merrera ; V. trilamina, Millet; Coluber Berus, Linn.) ; including three varieties, Cinerea, tartarca, rubiginosa.

Common names. Petite vipere or vipere pelias; the common viper of the North, or Germany; the adder of England.

Vipera Aspis, Merrel (including the quondam species V. Chersea, Delalande; V. Blaniensis, Leroy; V. Redii; V. Delalandei; V. Plaster and V. ocellata). This is the Vipera Berus of Delalande 7ion aliorum; V. communis. Millet.

Common names, Vipere commune, or Aspic; the common viper of the South, or Italy, etc.

Aidhorities. 1, Dr. Merschner, Lond. Med. and Phys. Journ., 1826, p. 198, a boy jet. thirteen years, was bitten on third right finger; 2, Revue j\Ied., Oct., 1826 (Lancet, vol. xi, p. 284), a gardener was bitten on the hand ; 3, M. Piorry, Lancet, 1826, p. 560, a man jet. forty-six years, was bitten on the hand; 4, Arch. Gen., from Rust’s Mag. (Bost. Med. Intel!., vol. v, 1827, p. 262), a shepherd was bitten on the tongue ; 5, Dr. Mariauini, Repert. di Med. Torino, 1828 (Lancet, 1828-9 (1), p. 580), a woman, jet. twenty years, was bitten on the right ankle ; 6, M. Beaumont, Compte des Travail Med. du Dep. de la Moselle (Lancet, 1830-1 (1), p. 384), a boy was bitten on the finger; 7, Dr. Kaiser, Heidelberg Clin. Annals, 1832 (Frank’s Mag. 3, 145), a boy was bitten; 8, Heyfelder, Sanitiits, Ueber das Furst. Hohenzollern, 1833 (S. J. 8, 123), a man was bitten on the leg; 9, Dr. Franclii, Antologia Med., Agosto, 1834 (S. J. 9, 57), a boy was bitten on the foot; 10, Dr. Paulet, Bull, de Therap., 1835 (S. J. 9), a woman was bitten on the toe, during hot weather ; 11, Dr. Chas. P., Bibliotheque Horn, de Geneva, vol. v, 1835, a boy was bitten ; 12, Dr. Butazzi, Feliatre di Napoli (Med.-Chir. Rev., vol. xxvi, 1836, p. 509), a man, jet. forty-four years, was bitten between the forefinger and thumb of right hand ; 13, Gels, Med. Zeit. Preuss., 1836 (S. J. 15), a girl was bitten ; 14, Schumaker, ibid.; 15, Dr. Koch, ibid., effects of bite on the little toe; 16, Dr. Lebrun, Zeit. fur Geburstande, 1837 (A. H. Z. 15, 110), effects of the bite; 17, Casper’s Woch. and Arch, de Med., Dec. 1839 (Lancet, 1839-40 (2), p. Ill), a man was bitten on the tongue ; 18, John Moodie, M.D., Med. Phys. Journ., vol. xi, p. 481, Catharine Bishop, jet. seventy years, was bitten twice on the back of the hand; 19, Gluckselig, Hist. Med. Jahrbuch, vol. xxiii (A. H. Z. 19, 335); 20, same, another case ; 21, Bull, de Therap., vol. vii (A. H. Z. 7, 259), a man was bitten ; 22, Harvey K. Owen, Lond. Med. Gaz., vol. xxvi, 1840, p. 337, John Burr, jet. twenty years, was bitten on the hand ; 23, Francis Adams, Lond. and Edinb. Month. Jour., vol. i, 1841, p. 796, a woman, aet. thirty-five years, was bitten by an adder on her leg; 24, Herbert Mayo, Magendie’s Journ. of Exper. Phys. (Loud. Med. Gaz., volxxix, 1841-2 (1), 487), a man, jet. twenty-six years, was bitten on his inner ankle; 25, same, a robust woman, laboring under ague, was bitten on the ankle ; 26, Wm. Stockbridge, Bost. Med. and Surg. Journ., vol. xxix, 1843, p. 42, a lady jet. twenty-two years, was bitten by an adder; 27, Pemberton, Lancet, 1849 (2), p. 638, a man, set. fifty-one years. was bitten on the thumb by an adder ; 28, Dr. Weber, S. J. 23, 218, a man was bitten on the tongue ; 29, George Lambert, Lancet, 1851 (2), p. 437, a man, £et. twenty-three years, was bitten on the right ring finger by an adder ; 30, Dr. Nick, Wiirt. Corr. Blat., 1851 (S. J. 71, 307), a pharmaceutist was bitten on the right index finger; 31, Pemberton, Lancet,1851 (2),p.l57, a man, set. thirty-one years, was bitten on the cheek by an adder; 32, Ipawitz, (Est. Med. Jahrbuch, 1857 (S. J. 17, 29), a woman was bitten on the foot; 33, Dr. Jarjavay, Gaz. des Hop. (Journ. de Chim. Med., 1857, p. 604), a person was bitten on the hand by a V. aspis; 34, Philip Weston, Lancet, 1859 (1), p. 522, the author was bitten on the right forefinger by a viper; 35, Huss, Allg. Wien. Med. Zeit., 1861 (A. H. Z., M. B., 4, 50), a person, £Bt. fifty-two years, was bitten on the foot; 36, M. Soubeiran, Sydenham Yearbook, 1863, p. 437, a gentleman was bitten ; 37, M. Demeuret, Gaz. Hebd. de Med. et Chir., Nov. 6, 1863 (Ranking’s Abstract, vol. xxxviii, 1863, p. 195), a woman was bitten on the forearm. May 25,1824; 38, Dr. Wenzel, Wien. Med. Woch., 1866 (S. J. 133,192), symptoms from bite on himself, and from other observations; 39, Hering’s Monograph “ Schlangengift,” 1837, Vipera torva ; 40, same, Vipera red (41 to 54, Vipera aspis, from Dr. Viand Grand-Marais, Gaz. des Hop., 1868, No. 62, and 1869, and Etudes med. sur les serpents de la Vendee et de la Loire- Inferieure, first and second edition); 4l, Thomas of Nates, a man was bitten in the left foot ; 42, Merel, Broussau ; 43, Dr. Bourdin, a woman, set. sixty-one years, was bitten in the foot; 44, same, case of a child ; 45, Drs. Clochard and Bitter, a child, set. six years, was bitten on the right hand; 46, Dr. Duchaine, a child, set. six years, was bitten on the foot; 47, Dronet, a man, set. sixty years, was bitten on the left hand ; 48, Dr. Clochard, a man, set. nineteen years, was bitten on the left leg; 49, M. Pestle, a woman, set. fifty-four years, was bitten on the right hand ; 50, Riviere, case of a woman; 51, Lihoreau, a woman was bitten on the hand; 52, Viand Grand- Marais, a boy was bitten on the hand; 53, same, another case ; 54, same, general remarks; 55, Dr. J. B. Ferrier, Deux Cas de Morsure de Serpent Venimeux, Paris, 1874, a child, set. ten years, was bitten on the hand.

Mind p. 138

Delirium and raving,^h

Delirium with vomiting

Somewhat delirious in the interval of fifty minutes between the bite and death

Appeared wandering, as if drunk, and answered questions in a mumbling incoherent manner (in two hours)

During the night sick with delirium and vomiting, followed by profuse perspiration

Extremely melancholy, delirium alternating with sopor (after two hours)

Irrational talking, with sleeplessness and pains

Screaming, followed by convulsions

Great agitation and anxiety

Great depression

Very great uneasiness of mind

Premonition of death

Anguish

Anxiety and vomiting

Great anxiety

Indescribable anxiety preceding death

Intellectual torpor

Intellect confused (after two hours)

State of great intellectual torpor

Loss of mental functions, with drawn features

Stupor

Stupefaction, with cutting pain in the abdomen

Loss of consciousness and a paralytic condition

Loss of consciousness with swelling

Loss of consciousness and sinking down

Head p. 138

Confusion in the head

Vertigo

Frequent vertigo

Vertigo, headache with nausea

Vertigo, headache and vomiting

Vertigo frequently recurring, with nausea and vomiting, so that he fell into a faint

Staggering with vertigo and falling forward

Giddiness increased to loss of vision

Stupefaction of the head (after half an hour)

Dulness of the head

Head felt heavy (after ten hours)

Violent headache

Persistent headache for several days

Raging pains in the head, jaws, and abdomen, with general spasms

Tear-, ing and sticking pain in the head on every change in the weather, chronic effect of the bite

Eyes p. 139

Eyes glistening with the headache

Eyes pressed out, with swelling of the face

In a short time the eyes became red, inflamed, and very watery

Eyes sunken

The eyes immediately became dark yellow

Lids. Paralysis of the lids (second day)

Lids dropped over the eyes

LcfIJ. Eyeballs immovable

Lupil. Pupils dilated (after two hours)

Right pupil contracted, the left dilated (second day)

Vision. Vision became indistinct (after two hours)

Vision of the right eye lost, of the left dim (second day)

Obscuration of vision, though he hears everything distinctly

Loss of vision

Loss of vision for several minutes during the excessive violence of the attack, though voices were still recognized

Nose p. 139

Blood from the nose with vertigo, with anxiety

Face p. 139

Staring look

Face expressed terror

Great anxiety expressed in countenance (after six hours)

Countenance, naturally pale, has now an appearance of anxiety about it

Countenance pallid, extremely anxious, covered with drops of perspiration (after half an hour)

Face pale

Pale face with chilliness

Extreme paleness of the face

Face pale and hippocratic, with cold sweat on the forehead (after two hours)

Face pale yellow

The face soon became yellowish, and assumed an expression of anxiety

Face livid, with an subicteric color

Excessive swelling of the face

Swelling, especially of the lips and eyelids

Face swollen and anxious

Enormous tumefaction of the face (after two hours)

Face swollen, and nearly double its usual size ; the neck also participated in the swelling

Excessive swelling of the face in a few minutes, so that he could not open his eyes, neither like erysipelas nor oedematous, not very painful, but very tense and blackish, with closure of the throat for eight days

After ten years there was still oedematous puffiness of the face at the place of the bite

Entire face presented a swollen appearance, and the parts immediately adjacent to the bite were discolored, of a livid hue (after two hours); diffuse cellular inflammation extended from the wound to the neck and sternum, and to the opposite side of the face (second day)

Features considerably altered; the cheeks puffed ; the lips and tongue enormously swollen, but not painful, covered with saliva, and very pale (after one hour and a half). The swelling of the tongue rapidly increased, so that it at last almost filled the cavity of the mouth, and caused great difficulty of breathing

Face convulsed (second day)

Lips blue

Lips and tongue livid, swollen and protruding

Acid burning sensation in the lips, mouth, and throat

Raging pains in the jaws

The lower jaw has no longer any power

Mouth p. 139

Gums. The gums often have the scorbutic line

Tongue. Tongue dry, swollen

Tongue swollen, brownish black, protruding from the mouth

Tongue swollen, can be protruded but slowly, and in a small degree, and is evidently directed to the side affected ; voice hesitating and thick, and somewhat resembling a man suffering from intoxication (after half an hour)

His tongue began to swell, so that he could not articulate

The tongue immediately swelled so much that when he reached the nearest village he was unable to speak ; the swelling increased rapidly, so that his tongue hung partly out of his mouth, and two hours afterwards he died

A few minutes after the bite the tongue began to swell, and on the next morning he was found sitting up in bed, anxious, gasping for air, face pale, with an expression of the greatest anxiety, terrible swelling of the submaxillary and parotid glands, the tongue was immovable, blue, enormously swollen, protruding from the teeth, filling the whole cavity of the mouth, constant dribbling of saliva

The tongue at once became enormously swollen, and during the night the man could hardly breathe. The next day the tongue was scarified, but the swelling soon returned again, and he fell to the gound in a state of asphyxia. The respiration and pulse were now completely suspended ; the face became purple, and the neck swelled to such a degree, that its circumference exceeded that of the head,'k

Enormous swelling of the tongue (though bitten in the foot)

In fatal cases the tongue became fuliginous, and the breath fetid

Protrusion of the tongue, paleness

Tongue black, dry

Black tongue

Tongue white in the middle, moist on the edges, with thirst

Tongue coated with a white fur (second day)

Tongue generally white, slightly tremulous

Tongue yellow, tip red

Thickly-coated tongue, with headache and bad appetite

Tongue discolored

Dry tongue (after two hours)

General Mouth and throat so parched and swollen that to swallow any liquid was impossible

Swelling of the mouth after sucking the wound

Saliva. White saliva flows from the mouth, with deathly faintness

Speech. Speech difficult, with swollen tongue and closed jaws

Replies with difficulty, in a deep voice

Stammering a few unintelligible words, with weakness and sleepiness

[HO.] Speech thick and inarticulate

Speech inarticulate (third day)

Loss of speech on account of weakness

Throat p. 140

Closure of the throat, so that for eight days she could only swallow water and milk ; afterwards biting in the fauces, the swelling of which became blackish

Pain in throat, with some difficulty in deglutition, and on examination a copious secretion of viscid mucus was seen to be adherent to the pharynx (after two hours)

Violent pain in throat

Deglutition was greatly impeded

Great difficulty in attempting deglutition

Salivary glands tumefied

Swelling like a goitre on the throat, remaining a chronic result

Stomach p. 140

Appetite and Thirst. Complains of hunger and thirst just before death,*®

Complete loss of appetite

Thirst

Great thirst (after ten hours) **, etc.

Troublesome thirst and craving for cold drinks (after half an hour)

Thirst with the heat

Thirst, with moist tongue

Febrile thirst, with shivering

Desire for water during the coma

Heartburn. Cardialgia

Nausea and Von tin(f. Nausea,*®, etc.

Sickness at stomach and vomiting (within less than half an hour)

Nausea and slight attempt to vomit, which appear to aggravate the suffering (after half an hour)

Nausea is caused by sucking the yellow poison from the wound, which had a flat taste

Nausea, with shuddering

Violent nausea, with oppressed respiration

Nausea, spasmodic vomiting (after two hours)

Violent nausea, with vomiting

Nausea and vomiting *®.

Nausea and bilious vomiting

Immediately inclined to vomit, with attacks of faintness

Violent retching

Frequent efforts of vomiting (second day)

Spasmodic retching and bilious vomiting affording transient relief

Vomiting *, etc.

Frequent vomiting *®, etc.

Immediate vomiting

Vomiting, with violent thirst

Vomiting, with colic

Vomiting, with colic and thirst

Vomiting, purging, and urinating

Vomiting, with diarrhoea

Vomiting and diarrhoea, lasting a long time

Vomiting, with distension

Vomiting, with faintness

Vomiting, with shivering and violent thirst

Vomiting, with coldness of the body

Vomiting, with erysipelas

Vomiting, with great weakness; somewhat better after repeated vomiting (second day)

Violent vomiting and diarrhoea constantly, renewed with great violence

Vomiting after drinking milk

Vomiting affords relief

Drink can be borne by the stomach only after seven days, food only after fourteen days

Bilious vomiting

Vomited, first alimentary matter, then bile, the last repeatedly

Vomiting of mucous and bilious matter

Vomiting of a bitter yellow fluid (after twenty minutes)

Constant vomiting of bilious matter (in two hours)

Vomited a large quantity of bile

Incessant vomiting of a viscid greenish fluid, in color and taste like inspissated bile, followed by severe attack of bilious diarrhoea, ^_ After a few minutes she became faint and vomited a large quantity of black blood, followed by bloody stools; these bloody evacuations upward and downward were repeated at short intervals

Vomiting of blood

Vomiting of blood, followed by prostration and death

Vomiting of green liquid

Incessant vomiting of green substances

Stomach. Digestion slow

Pain in epigastrium and stomach (after one hour and a half)

Pain in the pit of the stomach and in the bowels was excruciating

A sensation of uneasiness about the epigastrium

Extreme degree of pain at epigastrium, the least pressure causing great suffering (after half an hour)

Sudden attack of severe pain at scrobiculus, with considerable thirst

Pain in the epigastrium or umbilical region is almost always present, accompanied by anxiety and vomiting, and, in many cases, excessive thirst, though the patient cannot tolerate much liquid; substances vomited bloody and mucous ; stool diarrhoeic and bloody

Terrible pain in the epigastrium

Abdomen p. 141

Hypochondria very tense

Externe soreness of hypochondria

Intense pain about umbilicus, greatly augmented by pressure (in two hours)

Swelling of the abdomen, raging pains and spasms, even to faintness; after drinking milk vomiting of a large mass of round worms; since that time the patient has been completely free from the worm troubles which he had before

Sudden flatulent distension of the abdomen, with colic, violent pain in the back and vomiting

Abdomen tense, pressure causes distension of the facial muscles

Rumbling in the bowels

Pains in the abdomen and back

Pain in the abdomen alternating with pain in the limbs, after the bite

Pain in the abdomen, with violent thirst and vomiting

Colic

Colic, with profuse diarrhoea (third day)

Colic, with headache instantly, which completely stupefies ; with vomiting and violent swelling and blueness of the foot

Violent griping in the abdomen

Cutting colic

Violent pain in belly

Violent pains in the abdomen, immediately

Violent pains in the intestines and in the shoulders

Raging pain in the abdomen, afterwards also in the jaws and head, exceedingly like destruction

Rectum and Anus p. 141

Pain and tenesmus in the rectum

Urging to pass stool and urine

Stool p. 141

Diarrhoea

Much purged (after twenty minutes)

Diarrhoea and vomiting

Diarrhoea with colic

Diarrhoea; bowels have acted five times since last night, 9 a.m. (second day)

Bilious purging

Bowels acted frequently and involuntarily, and both blood and mucus were mingled with the motions (after two hours)

Involuntary stools

Copious stools (after two hours)

Numerous stools, with urging, shivering, and thirst

Evacuation of the bowels soon after the bite

Evacuation of the bowels very offensive, black (after two hours)

Bloody stools

Discharge of much blood from the bowels, just before death

Discharge from the bowels of black coagulated blood

Stool ou the second day consisting of masses of dark, horribly offensive blood, apparently from the scarification of the tongue

Stools very fetid

JJviiKivy Orf/ails

Sticking pains in the kidneys

Desire to micturate, but could not (after twenty minutes)

Involuntary micturition

Increased secretion of urine

Frequent emission of watery urine

Copious secretion of clear urine, with constipation and headache

Profuse emission of urine, with pains in the back and abdomen, vomiting and purging

Incontinence of urine and faeces at times

The urine is usually completely suppressed

Strangury

Respiratory Organs p. 142

Anxious respiration, as in croup, with threatening asphyxia

Respiration very anxious

Anxious, oppressed respiration (after two hours)

Respiration was short and oppressed (after ten hours) ’®.

Difficult respiration,’® ‘®, etc.

Difficult breathing, with sticking pains in the heart

Great difficulty of respiration

Dyspnoea

Suffocative sensation, with retching

Suffocation

He tore his shirt because suffocation threatened, preceded by vomiting

After being carried to the hospital the patient suddenly ceased to breathe, the heart stopped, the face became livid, etc., whereupon tracheotomy was immediately performed; blood drawn from the arm flowed scantily, was dark mixed with bright streaks

Chest p. 142

Swelling of the chest, with difficulty of breathing

Soon after the bite on the face the chest became excessively swollen, without difficulty of breathing, and the abdomen swollen as far down as the navel

The veins in the chest and abdomen became thick and hard like quills

QEdema of the lungs precedes death

Double pneumonia

Oppression of the chest, with anxiety

Oppression of the chest, with great praecordial anxiety

Oppression of the chest, with violent efforts to breathe and to swallow

Violent pains in the chest

The patient complained of flying pains in the chest (after ten hours)

Burning on the chest and abdomen, and longing for cold applications, though the skin was very cold to touch

Pressure over the four or five ribs of the right side causes pain (after half an hour)

Violent pain in the thorax and left side (third day)

Heart and Pulse p. 142

Prcecorclia. Precordial anxiety

Great precordial anxiety

Indescribable sensation of anxiety in the precordial region

Dragging pain in the heart, so that he tears all his clothes, becomes faint and sinks down with weakness, with violent distress in the abdomen, violent vomiting ten times, deathly paleness, icy coldness of the body, blueness and blackness of the bitten finger

Great anxiety of the heart, with soreness of the foot that had been bitten, and paralysis of the right arm, at the same time, for four years

Pain at the heart and faintness

Short sticking in the heart

Sticking pains at the heart, with great weakness, difficulty of breathing, and cold sweat

Heart’s Aethon. Pulsation of heart feeble; no pulsation was felt in the radial or carotid arteries, whilst that in the crural was very strong

Action of heart feeble (after two hours)

Heart’s impulse remarkably feeble

Want of pulsation in the radial and carotid arteries (after two hours)

Beat of the heart slow

False. Rapid pulse, with unquenchable thirst

Pulse rapid and feverish

Pulse small and rapid

Pulse small and rapid, after the coma

Pulse small, rapid, with chilliness and cold sweat/®.

Pulse thready, rapid (after two hours)

Pulse small, rapid, scarcely perceptible

Pulse rapid, small, and hard ; heart’s action tremulous, with oppression of the prsecordium

Pulse low, quick, and interrupted (second day),'l

Pulse in the healthy arm was quick, strong, and full; on the contrary, that of the wounded arm was small and low (after ten hours)

Pulse small, nearly 100 (after half an hour),®l

Pulse 96, soft

Pulse intermittent and small

Pulse extremely slow, full, and hard, with stiffness, coldness, and sweat (after half an hour)

Pulse slow and weak

Pulse irregular, small, rapid, contracted

Pulse irregular, very weak, with vomiting and diarrhoea

Pulse intermittent, irregular, small, rapid, and contracted, with fever

Pulse small, rapid, contracted, irregular (after half an hour)

Pulse irregular

Pulse thready and intermittent (third day)

Pulse small ®®.

Pulse weak, with sopor

Pulse weak and irregular

Pulse extremely weak, with violent pains

Pulse weak and unusually slow

Febrile pulse (second day)

Pulse febrile, slow

Pulse thready and intermittent, followed by syncope, profound prostration, and death

Pulse intermittent and very weak (after one hour and a half)

Pulse small, contracted,®®-’®.

Pulse scarcely perceptible, followed by death, after twelve hours

Pulse scarcely perceptible

Back p. 143

Pains in the back and abdomen

Pains in the loins

Upper Extremities p. 143

Limbs swollen, painful

Swelling of the whole limb

Swelling of the whole extremity, which was covered with bluishred spots

The whole extremity was very much swollen and hard, with inflammation of the superficial veins; the boy complained of total loss of sensation in the extremity

The limb became swollen, like a phlegmonous erysipelas, with an ecchymosis around the bite

Pain, with oedema of the limb, the volume of which had become double its natural size (after two hours)

Limb swollen, red, covered with yellow spots

The limb becomes swollen, blue and black

Dark-red swelling of the bitten limb

On the third day the whole extremity was swollen as far as the abdomen, with feverish coldness of the limb

The whole limb speedily became enlarged, blue and black, even the abdomen was distended

Erysipelatous inflammation of the whole limb

Swelling of the limb, with black spots; the swelling extended to the abdomen, was followed by syncope and death

Great oedema of the extremity

Dark color and great swelling of the affected limb

The limb became excessively tumefied, covered with livid spots

The extremity became excessively swollen and ecchymosed; at the place of the bite there were several ulcers, which exuded a sanious liquid

The extremity became enormous in size, and covered with phlyctenules (second day)

Excessive swelling of the limb ; the swelling became doughy, the temperature elevated, the cutaneous veins looked like red stripes; every attempt to move the limb caused violent pains

Gangrenous spots on the limbs

The bitten limb had a yellowish-green color, with livid spots

Paralysis of the bitten limb for several years, even involving half of the body

Different limbs and even the whole half of the body paralyzed for the remainder of life

• Loss of power to move the muscles and tendons

Limbs in a state of relaxation (after one hour and a half)

Trembling of the limbs, painful

The limb was benumbed

Cramps, especially in the flexor muscles

Excessive pain in the whole extremity

Pains in the limbs, alternately with pains in the abdomen, chronic results

Violent pain in the bitten limb, and stitches in the tips of the fingers

Pain in the extremity aggravated by touch/I

Peculiar crawling in the soles of the feet (after half an hour); afterwards also in the palms

For twelve years she had a recurrence of painful symptoms in the bitten limb, at the time of year corresponding with the time she received the wound

Superior Extremities p. 144

Paralysis of the upper limbs after a bite on the foot

Paralysis of the right arm, recurring for years after a bite on the foot

Idema extending to the shoulder

The arm, shoulder, chest, and back of the side bitten becomes greatly swollen and inflamed

Arm swollen, reddish blue

The whole extent of the right arm was enormously swollen, and its surface was of a livid red color (second day),’l

On the third day the arm was slightly swollen, red, covered with spots, soft, and without pain

The arm was greatly swollen and discolored ; it retained for many years a sickly color, until death, which took place suddenly in the night (in an old woman)

The bitten finger became bluish black, the wound was surrounded by enormous blisters, the hand and arm were greatly swollen, of a grayish-yellow color; scarification over the wound caused oozing of very black blood

The bitten part soon became hot, swelled, and the finger contracted; the contraction and swelling soon affected the arm, J;he latter extending above the elbow ; the whole of the right arm was much swelled, especially about the joints (after ten hours)

On the second day the arm was swollen and puffy, as if he had dropsy

Finger white, but little swollen ; the back of the hand very much swollen; red lines reaching to the elbow; forearm not much swollen or discolored, but rather tender (after six hours) ; arm much swollen and ecchymosed, the discoloration extending to the axilla; the glands in that region also much swollen and inflamed, morning (second day); inflammation subsiding; ecchymosis extending down the side to the crest of the ilium, evening (second day); ecchymosis deepening in color (third day); color decreasing and becoming browner (eighth day); forearm and elbow very hard, and the patient complained of stiffness and pain in attempting to bend the elbow (tenth day)

Part swollen, with tingling pain and sense of coolness (after one hour and a half) ; in a short time afterward the swelling increased enormously. It seemed to be of the nature of oedema, and its appearance indicated that gangrene would speedily supervene. The temperature of the part was lower than it usually is all over the arm, up to the axilla, to which part, in fact, the swelling had extended

Immediately felt a sensation of burning and smarting, and soon after the thumb became deadly white, and the lividity the forearm came and went; during the evening the stiffness, which had been present slightly, began to increase; the arm became swollen, and lividity became permanent. These conditions became aggravated during the night, and in the morning presented the following appearance : the part looks sloughy and inflamed, and swelling extends from this point throughout the entire limb, terminating at the shoulder. Lividity commences on the posterior aspect of the thumb, prevails on the inner side of the dorsum of the hand, where it becomes a bluish tint, and gradually assumes the appearance of ecchymosis as it approaches the forearm. Here, and upon the upper arm, the ecchymosis is general, of a bright-red color in places, in others blue and black, and everywhere tinctured with livid spots. The discoloration upon the posterior aspect of the forearm and arm is gradually shaded of a less intense hue. The discoloration and tumefaction terminate at the axilla. Pain on pressing the thumb. A general feeling of soreness extends over the extremity, not aggravated, however, by pressure

The bitten thumb became black, the hand swollen and spotted. On the second day the arm was covered with spots, above the elbow sores filled with liquid

Feeling as if the poison extended from the bitten thumb to the shoulder and then to the abdomen

Pains in the shoulder

Immediately intense pain in the wounded part, in a short time extending along the forearm to the middle of the elbow, and thence to axilla ; he described this pain as being of a burning character, and almost directly followed by great swelling of the hand and wrist; as the pain extended, its severity in the wounded part itself somewhat diminished. Simultaneously with its reaching the axilla, a pain or feeling of constriction was experienced about the head, throat, and right side of tongue, accompanied also with a sense of heat about these parts

The pain in the swollen arm was very distressing

Intolerable pain extending from the arm to the chest

FoveclVDl, Yellow color of the forearm

Subsultus tendinum

Hand. Swelling of the hand

Even the hand not bitten became swollen

Swelling of the bitten hand, with stitches, on motion

Swelling of the hand with pain, as if it would burst, painful to touch, oederaatous, not pitting on pressure

Even after the third day the hand was greatly swollen and stiff

Sticking pains in the bitten hand, which swells and becomes very large

Tint/ers. Burning and swelling for several days of perfectly sound fingers (from only rubbing a stick with which the head of a snake had been bruised)

Edematous swelling of the finger bitten, and of the whole forearm

The bitten finger became bluish black

Swelling of the bitten finger and hand, with stupefaction

Swelling of the bitten finger and nausea

Violent tearing pains extending from the bitten fingers to the wrists, elbows, shoulders, and chest, with uneasiness, vomiting, and sleeplessness

Violent sticking pain in the bitten thumb, piercing its tip, then spreading over the whole arm, followed by a sensation of a flame of fire flickering and burning through the arm

Sudden violent pains in the fingers, after the bite

Violent sticking pains in the bitten finger (fourth day)

Stitches in the tips of the fingers of the bitten arm

Inferior Extremities p. 145

Conv\i\&\ve movement of the lower extremities

Shuffling gait caused by paralysis, chronic result

Paralysis of the leg and a feeling as if dead

Weakness of the lower extremities

Severe cramps in lower extremities

Great swelling of the leg, as far as the abdomen, which was bluish brown with blackish spots about the bite

The whole leg becomes enormously swollen as far as the abdomen, and of a quite black color

The bitten limb became excessively swollen as far as the abdomen, blue and yellow

Pain in the bitten leg like the sting of a wasp, or as after a drop of Sulphuric acid on a sore spot

Immediately he felt as if something moved upwards along his thigh

Knee. Knees stiff for a year after

The knee remained stiff for a longtime, flexion was difficult and painful, when walking

The boy complained of tension about the knee and ankle-joints (after one week)

On every change in the weather, sticking and tearing in the knee and head, after fifty years

Leg. Moderate degree of tumefaction in the leg, from the toes to near the knee, but without pain or discoloration, except a small circle of redness around the wound. The wound was filled with a drop of lymph, which was no sooner wiped off than it was succeeded by another (after four hours)

The limb swelled rapidly up to the knee, and soon to the abdomen, became double its normal size, the swelling was pale green, red, and yellow

The bitten spot became dark blue, the limb swollen as far as the knee, immovable, insensible to hard pressure or cutting

The bitten leg swollen and yellow

Leg swollen, as cold as ice, and as insensible as a piece of wood

Leg swollen, as if puffed up by air, with great pain

After two or three hours, pain in the wound, and towards morning the foot was inflamed and swollen as far as the knee ; there was some swelling even after three months, followed for several years by paralysis of the foot, so that he was unable to ride horseback

Foot, The bitten foot was swollen up as far as the knee, hard and bluish red, and remained swollen for several years

Paralysis of the foot which had been bitten several years before, preventing riding horseback

The foot seemed shortened, so that he limped when walking, chronic result of the bite

Paralysis of the foot, afterwards ulcers, chronic result

Paralysis of the foot, with shuffling gait

Paralysis of the whole bitten foot, after several years

Swelling of the bitten foot and chronic suppuration, after forty years

The swollen foot became indurated, bluish red, and remained so for several years

On the fifth day, the foot became gangrenous, and the swelling extended to the knee

Foot swollen within half an hour, with much pain, as if it had been blown up with air, and two bluish-yellow stripes, as broad and as large as the thumb, gradually extended along the leg to the thigh and to the abdomen

The bitten foot and leg swollen, almost black, together with the whole abdomen

The foot becomes blue and swollen

Aching in the bitten foot returned yearly

Sticking and tearing in the bitten foot on every change of weather for years

Dragging of the foot, chronic result

Burning in the whole of the bitten foot

The whole toe became blue and swollen, also the back of the foot after a short time

Generalities p. 146

Persons become prematurely old ; the development of children is arrested

Modification of the functions of the blood becomes apparent, the fibrin is altered, the globules are less able to perform their proper functions, with tendency to haemoptysis, especially epistaxis; the blood coagulates imperfectly

Symptoms of chronic cachexia after the bite

Every year subsequent to the bite, at the first hot weather, he was seized with a painful oedema of the limb, colic and efforts to vomit; digestion became disturbed; he was tormented with somnolence, the gums became fungoid, and his skin had an icteric tint; he was chilly, with great physical and intellectual weariness

The symptoms subsequent to the bite have a periodic character, with tendency of the cachectic symptoms to return. In a large number of cases there is for many years a return of the troubles on a certain day every year, the swelling, pain in the bitten limb, prostration, loss of appetite, nausea, and jaundiced hue of the skin. One girl in Nates had for years at the period of the bite an eruption of livid spots on the bitten limb. A young man had for years, at the anniversary of the bite, general malaise, swelling of the limb, and development of spots

In many cases, after about eighteen months to two years, there is a marked tendency to apoplexy; the death is due to cerebral congestion or haemorrhage

Each subsequent year, at the anniversary of the bite, he suffered from troubles of digestion and debility, and after four years died of apoplexy,*®.]

The chronic local effects consist of permanent alteration of the tissues; in some cases the oedema persists for a very long time; in others there is tendency to ulcers or blisters

Ecchymoses appeared in the endocardium and pericardium; the lungs were hypermraic, the mucous membrane covered with ecchymoses, the tissue oedematous; the mucous membrane of the intestines was ecchymosed ; the blood did not coagulate

General chilliness; nausea; vomiting; somnolence; great dyspnoea; black spots on the limb and even over the abdomen ; temperature depressed, as in cholera

Falling to the ground in a ftiint, vomiting several times, lying as if completely paralyzed and unconscious, with involuntary stools and urine, followed by death after half an hour, without swelling or spasms

Intoxication, with sleep, exhaustion, loss of vision, with difficulty of breathing, retching and vomiting, spasms, violent pain in the umbilical region, tension of the abdomen, pulse small and rapid, voice almost lost, wanted to be allowed to sleep, even were it death to him

Violent headache, with inclination to sigh, which the pain prevented ; restlessness even to despair ; eyes glistening; face slightly yellow, cheeks red ; violent thirst, with moist tongue, which is white in the middle, red on the edges; pulse weak and small; constantly inclined to faint; pains in the loins; warm dry skin; constipation; copious discharge of clear urine (from Orfila)

After ten minutes he became thirsty and very much exhausted, which symptoms continued to increase, so that it was with difficulty that he could reach the house. After half an hour violent vomiting and diarrhoea set in, at first consisting of bilious and sour liquid, afterwards only of substances smelling like broth, with most unquenchable thirst. The pulse was scarcely perceptible, the skin pale and covered with clammy sweat; the lips, tongue, and the affected arm oedematous, as far as the elbow, the latter colorless and insensible. In the evening the pulse became stronger, the sweat less. Delirium at times. The swelling of the lip and tongue diminished, but that of the arm extended to the shoulder. On the next day the vomiting and diarrhoea had ceased, the delirium was better, pulse full and strong not rapid, skin hot and dry; lips and tongue normal; glands of the axilla swollen and sensitive; the swelling had extended up the arm and along the spine as far as the right hip. On the third day the delirium had ceased entirely, though the fever was still violent, the swelling continued, and in the lower portion was of a bluish-red color. On the fourth day the redness had extended up the back of the arm, along the back, and on the hip, places upon which he lay in bed were bluish black, though severe pressure caused no pain, indeed the skin over the whole surface of the swollen parts was insensible. The fever and swelling gradually diminished, sensitiveness returned, and on the thirteenth day the patient was able to be about, with only the hand somewhat swollen, and only the index finger insensible

Violent pain immediately after the bite, sinking down in a faint, loss of all power; at the same time sensation of heat and shivering shooting like lightning through the body for half an hour, when he was first able to call for help. This was followed by vomiting of bile several times, afterwards with great relief. Thirst, cold clammy sweats, features drawn, eyes protruding, look staring, color dark yellow; pulse very slow, hard and full. Jaws spasmodically closed ; talking and swallowing very difficult. Swelling at first of the bitten foot. After emetics vomiting of bile followed by relief, and diarrhoea, warm perspiration and sleep instead of cold perspiration ; recovery after fifteen days

After a bite on the tongue, the face speedily becomes red, the eyes look like one raving, after three minutes reeling and falling forward ; face as usual; speaks of going home, stumbles against an object, so rising and falling, or standing still, reeling and falling again ; but then also speaking distinctly; after a quarter of an hour he remained lying down, face red, eyes dim, complaining of heaviness of the head; jerking of the tongue, which protruded between the teeth, and which was pale and not swollen, began to have a rattling, and died in fifty minutes after the bite (from Dr. Benz)

After a bite on the right ring finger sudden violent pain, some blood flowed from the finger, which began to swell, then she became quite sick, had cold shivering with violent thirst, and frequent vomiting and several evacuations of the bowels, at the same time she was more cold than warm to touch. After nine hours and a half the limb was swollen to the middle of the upper arm, the whole limb painful to touch, pale, very oedematous, only slightly pitting on pressure; associated with paleness of the face and shivering; pulse very slow and weak, with general exhaustion

Inflammation and enlargement of the lymphatics extending from the bite

Black blood flows from a wound near the bite; the cellular tissue is green and blue

Swelling and induration about the wound persisted for a long time

Swelling began on the next morning, extending from the toe to the neck, involving the whole right side of the body, not in tbe least the left side

General swelling, with cold sweat and twitchings, followed by death

The hand, arm, and even the whole right side of the trunk, began to swell under the violent pain, so that the patient repeatedly fainted away

The swelling frequently involves the lymphatics and extends to the body

Swelling and inflammation of the margins of the bite and neighboring parts

Swelling of the bloodvessels, with general weakness

General cedema

Enormous cedema, nausea, vomiting, syncope, and death, from a bite in the foot

General cedema, with profound coma, followed by death

Painful tumefaction, followed by vomiting

Great tumefaction of the bitten parts

General oedema over the whole body (second day); even to the eyelids (third day)

General oedema, followed by profound coma and death

The whole extremity became tumefied and covered with livid spots; this tumefaction extended to the thorax, and was followed by nausea, vomiting, somnolence, difficult respiration, and death

Tumefaction of the part bitten is a constant symptom, accompanied by oedema, redness, and heat; the parts become hard, tender, and swollen to twice or three times their normal size ; the tumefaction lasts from four to eight days, sometimes persists a long time; the pain accompanying the inflammation consists of tension, which is rarely acute

Swelling of the extremity, with livid spots in the skin, followed by general chilliness, dyspnoea, nausea, and vomiting, and death on the seventh day

Swelling of the arm and hand began after half an hour, was followed by nausea and vomiting; after an hour and a half the swelling had extended to the shoulder, the arm was hot; the swelling gradually extended to the body over the chest; the upper extremity was of a livid color, covered with black and dark-red spots of ecchymoses ; the arm was of enormous size, about that of the thigh, the skin tense, but not painful to pressure, the livid red color disappearing on pressure, but the color of the spots of ecchymoses was not affected thereby, the lymphatic glands of the axilla not much swollen; at the point of the bite blisters of a large phlyctenular form with reddish serum; several of these phlyctseuulie developed on the back of the hand. The patient complained of cephalalgia, great vertigo, had a rapid pulse, and pale tongue. After this the hand began to diminish in size, but the shoulder continued very large, covered with black mottled spots; the whole scapular region of the left side and part of the right of a livid red color, with several spots of ecchymoses ; this red color and these spots extended over the anterior portion of the thorax ; the right breast became oedematous and hard, and presented a spot of ecchymoses that extended into the corresponding axilla ; apparently this trouble in the right breast, where it was isolated from the rest of the trouble, was caused by a blow ; afterwards these ecchymosed spots spread over the lumbar region. On the ninth day the sclerotic was somewhat yellowish. On the tenth there seemed to be an aggravation, the back became more oedematous, and the ecchymoses and infiltration spread over the nates. On the twelfth the ecchymoses had greatly diminished, but the oedema of the upper extremity and shoulder still continued; the hardness was remarkable. On the fourteenth the sclerotic again became yellow ; the urine was perfectly clear and transparent. On the fifteenth the oedema of the upper extremity still persisted, with a yellowish tint. On the seventeenth day there was still hardness of a portion of the arm and back, but all the ecchymoses had disappeared, though the skin over the arm and back was still yellow; the urine was perfectly clear and transparent; the sclerotic still somewhat yellow

The bitter part becomes black, hard, swollen, and covered with spots

After a quarter of an hour the arm began to swell, it became tense and bluish red; together with nausea, violent vomiting, great prostration, and at times inclination to fainting. The bite was found to look like the scratch of a pin, and to extend scarcely through the epidermis, nevertheless the whole hand and arm as far as the elbow was swollen, so that a rather large shirt had to be cut away; there was no pain, either in the wind or in the room, but an unpleasant tense sensation ; the skin dark bluish red, with black and yellow spots, and stripes following the course of the cutaneous veins of the arm. The usual fresh and ruddy color of the face had rapidly changed to a very yellow and earthy color, the mood was anxious and irritable; pulse weak, slow ; there was also a constant sensation of faintness. The yellow color of the face continued five days, and of the arm ten days

Finger became swollen and painful; and sense of numbness and rigidity gradually extended up the hand and arm (in five minutes); towards evening the hand and arm became painfully inflamed and swollen to three or four times their natural size. Spots of purpura hemorrhagica appeared the next day in various parts of the body and limbs. The inflammation, which was of an erysipelatous character, gradually spread from the arm to the shoulder, integuments of the neck, chest, abdomen, and back, on the right side, as low down as the hip. The bright-red hue of the skin began to fade on the fourth day, leaving it of a mottled livid color, with patches of ecchymoses. The oedema of the legs was considerably relieved by finely puncturing with a lancet. At the end of a week I was able to leave my bed, but the hand and arm were quite useless, and did not recover their former powers until six or eight weeks after the accident; the right leg also remained weak for some time, causing me to drag it in walking. After a fortnight, collections of matter formed successively in the finger, hand, forearm, and axilla, requiring evacuation by the lancet

After a bite on the foot, swelling and pain suddenly extended to the abdomen ; for many years afterwards the leg was always diseased, presented at times yellow, at other times blue spots, and was painful. After various remedies these suddenly disappeared and attacked the eyes; after suffering for a long time she became completely blind for two years. Then the eyes improved, but it extended through the whole body, and gave rise to pains internally, in various parts of the abdomen and limbs. At last she became almost numb

The bitten extremity was covered with leaves, the tumefaction disappeared on the fourth day, and the patient seemed convalescent, but on the seventh day he was seized with extreme suffocation, followed bydeath

The pain was at first exceedingly acute; the wound became livid, and the arm was much enlarged, towards evening; the next morning the swelling encompassed her whole breast, and even extended to the bottom of the true ribs; the third day the swelling extended over the lower part of the abdomen, and her body was cousideraMy increased beyond its natural size

After being bitten in the finger and sucking it, there was swelling of the finger and also of the mouth, he was obliged to sit down, it was impossible to go forward; he felt as if he would die, became helpless and weak, leaned against a tree, the hands became black and cold, the mouth and abdomen swollen, constantly said that he should die, followed by bloody vomiting, diarrhoea, and death, in an hour and a half

The foot becomes as blue as if washed with indigo, without swelling, after the vomiting and great weakness; the next night he had violent fever with much delirium, and in the morning decided swelling from the bite as far as the neck, the whole right side of the back was bluish, greenish, and yellowish ; there was no swelling at all on the left side. Therewith the urine was dark yellow, as in jaundice. So weak that every time he rose he fainted

Subsequently a gangrenous slough formed at the place of the bite, involving the soft tissues, including the tendons of the muscles, which after several weeks sloughed off

Gangrenous spots on the foot. After the bite on the foot some drops of blood flowed from the wound which he sucked into his mouth. This was immediately followed by vomiting. The foot swelled and became insensible. The vomiting was incessant, with bleeding from the nose, oppression of the chest, and indescribable anxiety, sunken eyes; distorted face. The foot was greatly swollen as far as the abdomen, grayish yellow, covered with large blisters. After fourteen years the knee still remained stiff and the leg drawn backward

Whole body pale, and from time to time agitated by fits of shivering (after one hour and a half)

Paralysis yearly with pain and insensibility

Stiff, rigid, cannot make the slightest movement

Epilepsy one, two, and five years after the bite

Violent spasms

General spasms, with raging pain in the abdomen and head

Restlessness

Easy fatigue

Weakness

Weakness, so that he was unable to stand upon his feet

Weakness, so that he was no longer able to mov'e

Great weakness and sleepiness

Extreme weakness, unable to move a limb, having barely strength to speak

So weak that he fainted every time he raised the head

Falling down when standing

Extreme debility

Great prostration

Prostration followed by death (fourth day)

General prostration of the vital forces

General torpor (third day)

Faintness,®®®, etc.

Immovable

Sinking down with faintness, immediately-,®®.

Sinking down with violent pains, after the bite

Faintness, with a feeling of warmth in the head

Faintness, with loss of sight and hearing, almost imperceptible pulse

Fell into a faint with alternate vomiting and diarrhoea

Attacks of faintness in rapid succession

Felt so faint that he was obliged to lie down

He fainted after walking a few steps, immediately after the bite

Fainting alternately with great anxiety and restlessness

After half an hour the patient could scarcely stand erect and was faint

Fell to the ground in a faint and remained so for an hour, until he was awakened by cold water

Collapse, followed bv death

Loss of acuteness of the special senses

Sensitive to every change of weather

After six years he asserted he still experienced attacks of rather severe pain in the arm bitten, with sensations of lassitude and malaise; these symptoms recurring every year in the month of April, and lasting a month

Violent pain in the part bitten,^h

Violent shooting pains through the whole body, spreading from the point of the bite

Violent pain began at the wound and extended through the whole limb,V

Violent pains after the bite

The pain caused by the bite is not severe, but is followed by a burning sensation, which spreads over the whole limb

The bite was immediately followed by acute pain and by a burning sensation of heat and tumefaction

Violent burning pain in the wound, immediately

Pains like the sting of a bee in the bite; after a time the wound became leaden gray, and swollen ; the swelling began to diminish after two or three days

The bite was felt through the whole body like a streak of lightning, she sank to the ground

The swelling was insensible

When bitten he felt a stitch through the whole body

Skin p. 151

The skin of the hand is dead and comes off like a glove, detached in large plates, the subjacent tissues livid (third day)

The skin is of a yellowish color

The face and trunk had a jaundiced hue, and the extremities exhibited diffused patches of redness (second day)

The skin of the affected limb was of a yellowish livid hue, mottled

Livid color of the skin

Livid spots on the skin

The bitten limb became covered with livid violet spots like ecchymoses

Livid spots appear later than the swelling, are very characteristic, red, bluish, or blackish, varying in tint and intensity, in different individuals and in different limbs; they usually begin within six to twelve hours after the bite, and on disappearing leave a greenish or yellowish spot, which persists for several days; they consist of true ecchymoses of blood, sometimes followed by gangrenous sloughs

Black petechial spots, extending over the whole body, which was cold to touch

Ecchymosed spots in the skin, which, after death, were also found in the membrane of the brain,®®.f

Ecchymosed spots in various parts of the body, just before death

Swelling covered with black and yellow spots

Very bright blue or almost black spots about the wound

Reddish black spots all over, as large as peas, over the whole abdomen, and even on the face

The parts about the wound became very much swollen and very red, and blackish-blue spots appeared on both sides of the thigh and leg, which after twenty-four hours turned yellow, and disappeared after a few days

The skin of the arm was of a deep-red color (after ten hours)

Hands violetcolored, covered with phlyctenules (second day)

A disagreeable herpetic eruption, with extremely distressing itching about the wound, persisted for a long time

Roseola-like eruption on the inner side of the arm and down the side of the body

About the bite, bluish-black spots developed and discharged disorganized blood

Large blisters developed about the bite, which, after an hour, burst and left an ulceration ; on the sixth day there was such great destruction of flesh that the muscles were laid bare; the wound was a line and a half in depth, and apparently was not inflamed ; the muscles had a dark-red color, were quite dry, and looked like smoked meat, insensible to touch ; the sore was offensive

Collections of pus sometimes but rarely appear at the point of the bite

Immediately afterwards the arm became swollen, red, livid, almost purple; and with these local symptoms were extreme anxiety, headache, vomiting, and shiverings. In the course of a few hours a large bulla, with a dull red base, had developed itself over the wound. Afterwards, bullse of the same description made their appearance all over the body, even on the face, the intermediate space being red and swollen. When ruptured, a very large quantity of turbid serum escaped. This eruption continued from 28th May, 1824, to November, 1825. On the 28th May, 1826, the same phenomena reappeared ; the eruption beginning at the seat of the bite, and continuing until November of the same year. And every year, from 1826 to 1863, the history of the patient has been the same, the symptoms beginning in the month of May, with lassitude, anxiety, nausea, headache, etc.; then, after six or eight days of these introductory troubles, the cicatrix becoming red and painful; then tingling and swelling of the arm; then the development of the bullse exactly as in 1824; the only difference being that the eruption disappears in five or six weeks instead of continuing for five or six months as at first. In the interval the patient is apparently quite well, and a white faint cicatrix is the only visible remains of her troubles

Skin generally dry,k

Skin dry and burning

Sleep p. 152

Disposed to yawn

Heavy and drowsy,‘^k

Drowsiness

Sleepy without being able to sleep

Great inclination to sleep, but the patient was unable to sleep, and was constantly obliged to change the position

Tendency to somnolence,“k

Slept for several hours after the vomiting, felt well on waking

Sleep prevented by pains

Very restless during the night (first night)

Sleeplessness for three or four nights,®k

No inclination to sleep till noon of the second day

Loss of sleep

Fever p. 152

Chilliness, Chilliness

Great chilliness

Constant chilliness, with cold sweat

Chilliness, with pale face and thirst

Chilliness, with pain in the chest

Chilliness, followed by fever (second day)

Shivering (after two hours)

Shivering, with flushes of heat

Cold shivering, with nausea, vomiting, and great thirst

Shivering, with febrile symptoms; small, rapid, contracted, at times irregular, intermittent pulse

Coldness of the body

Surface cold and clammy (in two hours)

Coldness and rigidity, with clammy sweat

■ Temperature diminished ; resists cold badly

Diminished warmth of the body, immediately

Rather cold than warm to touch, with desire for stool

Head and upper extremities ice cold

Finger cold (after ten hours)

Heat. Violent fever; towards evening (first day)

Violent fever, with delirium (second night)

The fever persisted for several days, with an irregular type, and necessitated the employment of antiperiodic

The reactionary fever after the poisoning assumed the type of an intermittent

Heat of the whole body

Violent heat, followed by shivering

Burning heat rising from the heel to the tongue

Sensation of burning heat through the whole body, with swelling of the hand that was not bitten, so that he could not close it

Burning heat running up the arm

Heat, thirst, and restlessness, on the next morning with moderate pains

Skin warm and dry, with brain symptoms

Heat rises from the bitten foot into the tongue

Burning heat, extending from the bitten spot on the arm up to the chest

When bitten, heat shoots through the whole body like lightning

For some minutes after a bite in the heel, a kind of numbness in the foot, followed by a sensation of heat, extending from the point on the foot up through the leg to the abdomen, chest, and at last to the throat and tongue; this violent heat affected him severely, and caused burning thirst; soon followed by restlessness, febrile shivering, trembling of the whole body, and complete loss of strength

Skin hot (second day)

Siveat, Profuse perspiration

Perspiration after vomiting

After chamomile tea copious perspiration, except over the bitten limb from the abdomen to the toes

Sweat with the coldness

Profuse cold perspiration with difficult respiration

Cold sweat, with the most violent attacks

Cold perspiration, with sticking at the heart, and faintness

Cold sweat

Whole body covered with clammy sweat

Profuse cold clammy perspiration

Body bedewed with a cold clammy sweat (second day)

Perspiration relieves

No perspiration with the febrile warmth

Conditions p. 153

Aggravation.

(Change of weather), Tearing and sticking pain in bite; tearing and sticking pain in leg; the symptoms.

(Pressure), Pain at umbilicus.

(Touch), Pain in extremity.

Footnotes p. 146

† This person had always enjoyed excellent health, and had never shown any tendency to cerebral troubles.

† Infusion of a bloody serum was found in the ventricles of the brain.