Immunisation against serpents' venom and the treatment of snake-bite with antivenene / an address delivered by Professor Fraser on Friday, March 20, 1896.

Date:
1896
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Licence: Public Domain Mark

Credit: Immunisation against serpents' venom and the treatment of snake-bite with antivenene / an address delivered by Professor Fraser on Friday, March 20, 1896. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    As to the probability, in a fatal snake-bite, of the quantity of venom received by the victim being only about, and not much in excess of, the minimum-lethal dose, it would appear that, in many cases, even so large a dose is not introduced; for general experience indicates that the majority of persons who are bitten actually recover, whatever treatment is adopted. Sir Joseph Fayrer also shows, in his classical ‘ Thanatophidia,’ that in 64 per cent, of fatal cases of snake-bite in India, the victims survived the infliction of the bite for periods of from three to twenty-four hours ; and this duration of life implies that the dose of venom received could not have been much greater than the minimum-lethal. It must be admitted, however, that even for the minimum-lethal dose of venom, the quantity of antivenene required to prevent death in man is probably inconveniently large, especially if, in the treat- ment, reliance is placed solely upon the administration of antivenene, to the exclusion of all or several of the auxiliary measures to which I have referred. It is desirable, also, that the antivenene treatment should be a practical one, not only for doses of venom which do not much exceed the minimum-lethal, but also for the considerably larger doses that are occasionally introduced in snake-bite. To attain this object, further work is required in order that there may be obtained an antivenene even more powerful than that whose antidotal capabilities I have described. I am not sanguine that this will be accomplished by carrying to a higher degree the process of artificial protection in animals. A comparison of the antivenene of rabbits which had last received thirty times the minimum-lethal dose of cobra venom with that of other rabbits which had last received fifty times that dose, has shown that tlie latter has but little antidotal advantage over the former, and has suggested that, in the process of artificial protection, the satura- tion point of the blood for antivenene is reached before the possible maximum non-fatal dose of venom has been administered. I would anticipate with more hope the results of endeavours to separate the true antivenomous principles from the inert constituents of the blood-serum with which they are mixed; and although the required chemical manipulations are attended with many difficulties, some success has already been obtained in effecting this separation. In the foregoing remarks, it has, however, been shown that even with the antivenene whose properties have been described, human life may be saved in a considerable, if not in a large, proportion of the cases of snake-bite which would otherwise terminate in dea^. The attainment of this result is a satisfactory one; for the mortality from snake-bite is large, and is not restricted to the 20,000 deaths which annually occur in India, but includes additional thousands in all the tropical and sub-tropical regions of the world.