eptic poison seen in pre-antiseptic
times. There is often the same prodromal chill, the high elevation of
temperature, the profound effect on the circulation, and the rapid
cellular involvement. The tissue disturbance following snake poisoning
differs from ordinary cellulitis, however, in the following
particulars: The color is _bronze_, not red; the involved area is
_boggy_, not brawny; and the extension of the process is _exceedingly
rapid_.

The treatment applicable to one condition seems to be equally
successful when applied to the other. In cellulitis, free incisions,
antiseptic lotions, and active stimulation are the three means upon
which the surgeon mainly depends, and in combating the local and
general symptoms excited by snake bite poisoning, the same treatment
has given me the successful results detailed above. Whether or not
permanganate of potassium is more active than other antiseptics in
snake bite poisoning I am not prepared to state, but the high
authority of S. Weir Mitchell, together with my own experience, does
not incline me to substitute any other drug at present.

I would formulate the treatment for poison of the rattlesnake as
follows:

1. Free incisions to the bottom of the wound and immediate
cauterization; or, if this is not practicable, sucking of the wound.

2. The immediate application of an intermittent tourniquet, that is,
one which is relaxed for a moment at a time, so that the poison may
gain admission into the circulation in small doses.

3. The free administration of alcohol or carbonate of ammonium.

This might be termed the _urgency treatment_ of snake bite poisoning.
The _curative treatment_ requires--

4. Free incisions into all portions of the inflamed tissues, and the
thorough kneading into these incisions of a fifteen per cent. solution
of permanganate of potassium.

5. Multiple injections of the same solution into all the inflamed
regions, but particularly into the region of the wound.

6. The complete surrounding of all the involved tissues, by
permanganate of potassium injections placed from half an inch to an
inch apart, the needle being driven into the healthy tissue just
beyond the line of demarkation, and its point being carried to the
deepest part of the border of the indurated area.

7. The permanganate of potassium solution should be used freely in
fifteen per cent. solution. I have used one and a half drachms of the
pure drug diluted, and would not hesit