ar in
appearance to those of snake-poison, that sometimes it is by no means
easy to decide which of the two is in operation, and that only those
cases are of real value to the observer from which this element of fear
is completely excluded.

A.--Action on the Anterior Cornua of the Spinal Cord.

The anterior cornua are almost invariably the first of the motor-centres
attacked by the snake-poison, the affection (commencing with paresis and
in serious cases generally culminating in paralysis) beginning in the
lumbar ganglia and taking an upward course. The lower extremities feel
unnaturally heavy and a paretic condition of the muscles supervenes
_simultaneously on both sides_. The walk becomes unsteady and
staggering, very similar to that of persons under the influence of large
doses of alcohol. By a powerful effort of the will, however, persons in
this condition are often able to walk and even run for some distance,
especially if by prompt ligature the absorption of the poison has been
checked. As the affection proceeds, though still able to move the legs
in a sitting posture, they are unable to rise again. Ere long even
sitting up becomes impossible and they collapse helplessly. At this
stage sensation is still intact, and reflex action, by pricking the
skin, &c., still takes place. The upper extremities generally retain the
power of voluntary motion, even after the muscles of the neck have
become paretic and the head is held up with difficulty or sinks to one
side.

With birds, according to Feoktistow, the reverse is the case. The wings
are usually first attacked, or paresis comes on in wings and legs at the
same time.

B.--Action on the Medulla Oblongata.

a.--The Vaso-Motor Centre.

Whilst the voluntary muscles are thus brought under the influence of the
poison, symptoms denoting the invasion of the oblongata are rapidly
developing. The first of these is the deadly pallor and ashy hue of the
cold skin, evidently due to the blood receding from the surface, a
condition not unlike that obtaining in extreme anaemia. As persons in
this state complain of an agonising feeling about the heart and of
deadly faintness, a paretic condition of the heart suggests itself as
the most obvious cause, more especially when taken in conjunction with
the small, frequent, and compressible pulse. But though the heart muscle
is no doubt participating in the general paresis, the condition of the
surface of the body is in reality