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THE

AMERICAN MEDICAL INTELLIGENCER.'

Vol. IV.

April 1, 1840.

No. 1.

ART. I.—BITES OF POISONOUS SNAKES, AND REMEDIES.' (From Dr. Poeppy's "Reise in Chili et Peru und auf dem Amazon strome.")

The flamon, or jegon, which is found in the province of Huaunco, and is called in Maynas, afaunida, and in the Brazils, sacurucu, appears, in some inconsiderable points, to differ from the Brazilian species, and was described by me on the spot. (See Frorieps's "Notizen aus der Natur und Heilkunde," Oct. 1831.) It is seen from two to seven feet long; the body is flat, and towards the tail unproportionably thick, the tail itself appearing very short, and as if it were broken. The heart-shaped head about three inches broad in full grown animals, and its extraordinary thin neck, indicate at the first glance its poisonous nature, although snakes exist, which are very dangerous, and do not possess these external characters. Their hideous appearance does not however prevent the Brazilian Indians from eating both the sacurucu and the jararaca (Trigonocephalus flavescens, Cuiv.); and one sees with astonishment these frightful animals brought out of the woods of Ega and Coaci for the purposes of food. His brown yellow colour and rough black oblique bands, give the flamon a great resemblance to the soil, and to the decayed leaves of the thick forests in whose darkest spots he loves to conceal himself, and thus increases his dangerousness. They vary in colour and size in different districts. Fortunately they are no where very frequent, and the first and only living individual that I encountered, in my daily excursions through the thickest woods about Pampayaco, brought my life into the greatest danger.

The Indians are universally of opinion, that the greater number of snakes sleep through the dry season of the year, and only become visible after the commencement of the rain, but that then their poison is doubly dangerous. The flamon never avoids a foot passenger, but rather awaits whatever approaches, confiding in his fearful weapons, and winding himself together into a spiral, after the manner of the rattlesnake, out of the centre of which the lurking head is projected forth. Without being trod upon, or in any way injured, the malicious creature strikes at the foot of the incautious traveller, or of cows, mules, ounces, &c., and produces a wound, which although it cannot be considered absolutely fatal, yet frequently costs the life of those attacked. The flamon is never seen otherwise than lying indolently, and in all probability he seizes the smaller mammalia and amphibia, in the same way as the rattlesnake and great boa (yacumamau) of Maynas, that is by means of a kind of fascination, which is produced by his unmoved gazing upon them, which apparently deprives them of their senses, and prevents voluntary flight. The Indians of Maynas even believe that hunters themselves may be thus fascinated, unless some one near by passes a rod

'London Lancet, Dec, 28, 1839, p. 497.

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between the individual and the serpent, and thus interrupts the attracting stream which they suppose to exist between the two. In the United States attempts have been recently made, to vindicate the fact of the existence of this fascination of small animals. I have myself observed something of the same kind. I saw a great lurking snake, after more than a quarter of an hour, secure a frog which had been rendered powerless and incapable of flight during that time, and at last in a kind of despair attempted to make a spring in the direction of the snake, which cost him his life.

The treatment of the bites of snakes by the natives is very various in different parts of the country. They brought me water in which the root of a large cypress had been squeezed, and amongst the Peruvians great confidence is placed in an abominable mixture (excrementa humana aqua soluta pro potu largiter hauriendo, nec non pro vulneris cataplasmate adhibentur.) The excision and cauterization of the wound immediately employed is undoubtedly the safest plan.

In the Alleghanies of Pennsylvania I know a hunter, who had twice in his life been delivered by this means; having after the bite of a rattlesnake, with true Indian hardihood cut out the fleshy part in the form of a hole, and filling it several times with gunpowder, suffered it to be fired. Around Cuchero much is thought of the external and internal use of tuberosa (Margueritas, Polianthes tuberosa. L.), which, perhaps on this account is generally planted. The most active means, however, is the guaco, a twining plant, which is very abundant in Maynas, and is grown on the skirts of little plantations, taking the place of the twining lianus of such places, and agrees accurately with mikania guaco. It is easily known by the large indigo-blue spots that mark the under surface of its rough leaves. This spotted character is presented by many similarly employed plants, as the blue-black spotted stalks of calladium helleborifolium; and in the heartshaped leaves, with a dark blood-red under surface, of an aristolochia, Maynas. Whether the knowledge of the curative powers of the guaco was first brought from Quito to Heralagia by the missionaries, or whether the Indians have known this plant of old, is uncertain; the last meritorious intendente militar of Maynas, Requena, sought to extend it generally. The employment is very simple, the wound is somewhat extended, and the fresh-pressed juice is dropped into it, the surrounding parts are repeatedly covered with the pressed leaves, and the juice is also taken by the mouth. The tincture made with common brandy is also much celebrated and recommended to travellers as a secure and easily carried means of cure. In Guayaquil little cakes are formed out of the fresh-bruised plants, which when dried in the sun retain their activity for a long time. The effect of the guaco is not in all cases alike quick and decided, but observations on bitten persons, both in Maranon and Ega, prove that after twenty-four hours' use the swelling had ceased, the pain vanished, and, with the exception of little ulcers, the cure had been effected. In Yuimaguas, and especially around Muniches, every year several persons are bitten by snakes, but the guaco had acted so efficiently, that, in the memory of men only two children were known to have died from such wounds. Only against one kind of snake is this remedy said to be useless, the unuca machacaya, which is of a lively green colour, and about three feet long.

The guaco, of Colombia, judging from some leaves that were brought by merchants to Nasso, coming down from Moyobamba, is entirely the same as that of Yuimaguas, Pebas, and Ega. Both as a remedy and a prophylactic, it has made a great noise in Colombia, and a long essay of Dr. Man. Maria Zuigano (Gazeta de Bogota, 1829) gives some valuable information, which, on the supposition that they may not be generally known, I have given an abstract of, leaving out those facts which Virey (Bulletin de Pharm: VI. p. 244) has made known and derived from the same source:"The guaco is known and treasured in all Colombia as an infallible remedy, and the experiments of Drs. J. C. Mutis and D. N. Mutis, in Mariquita, and

Dr. P. F. Vargas, give favourable results. In the snake-infested Choco, especially around Buenaventura, its employment is very old. In the forests of Magdalena and Caqueza it has been lately introduced by the zeal of the priests. According to the report of Father Nieto, 220 natives were bitten in Fomeque, within eleven years, but, with the exception of eight persons, they were all cured through the treatment of the guaco, lemon-juice, and salts. In the parish of Ubaque more than 200 persons were bitten in fourteen years, and, with the exception of a girl, in whose case no remedy was applied, they were all cured by the use of the guaco. D. Andres Perez, rector of Caqueza, had preserved many of his parishioners by means of the guaco, which he had employed externally and internally, in combination with the cupping glasses and ammonia and oil. He tells an anecdote, which sounds rather fabulous, of the effects of the guaco upon the snake itself. One of the poisonous kind having had some of the juice administered to it, fell into a state of stupefaction, and afterwards, in spite of several bites, it was no longer in a condition to kill even a little dog, as its poison had lost its activity. The inoculation with the use of the guaco has long been used in Colombia as a preservative. D. Josemaria Esteves, Bishop of St. Marto, subjected all Indians to this operation, the consequence of which was, that they lost all fear of snakes." In this account there is undoubtedly some exaggeration, but that the plant possesses considerable powers is to me certain, from the numerous opportunities I have had of observing its effects on bitten Indians. A new medicine, under the name of guaco-root, was brought a few years since from Vera Cruz to Hamburgh, (see Pfaff Mittheil. and Gaz. d. Med. Chirurg. u. Pharm., 1833, p. 352); but it possessed no properties in common with the mikania guaco, and the root of the plant is not used by the Indians.

Besides the guaco, there is a little plant with yellow blossoms (herpestes colubrina,) which is said to be still more active. The truth of this assertion I have had no opportunities of confirming. At Lamas the dorstenia tubicina, R. Pav., which is very common there, is used. In Ega they employ aristolochia cynanchifolia, Mart., and the fallen leaves of some unknown herbaceous plants, probably of a lesbaina or some of the rubiaceæ.

The symptoms, after a wound by a snake, are in the highest degree alarming. In my own case the pain commenced in the inguinal glands in less than ten minutes after the bite, and with such violence and so rapid swelling that the free use of the entire limb was lost. After a quarter of an hour, nausea, pain in the head, dimness of the eyes, and a partial palsy of the tongue came on; and at the same time an indescribable burning sensation, apparently more in the course of the bones than between the muscles, occurred in the wounded foot. In less than half an hour the fever had reached a great height, the operation' was over, and the repeated fits of faiuting were followed by stupefaction, which probably gave to the external observer the appearance of actual death. During this state, which lasted about eight hours, some blood flowed from the nose, which is considered by the Indians a fatal sign. On awaking, the rending pain was very severe, but changed in its character; the leg, even up to the hip, was swollen to a frightful size, perfectly immovable, cold, and on the surface destitute of feeling, but sensible, even to pain, of the slightest shaking; the breast and upper arm of the same side were likewise swollen. A copious perspiration, with fever and headach, had commenced, consciousness was perfect, and a crisis was evident. Fomentations of polianthes and mucilaginous drinks were used, and the wound was dressed by an Indian, with a warm poultice,

'This operation, which is described in the text, consisted in the excision, or, rather, from the want of better instruments, in the tearing away by a pack-needle, a portion of the skin and muscle in the region of the wound, and the subsequent application of a piece of red-hot gold, the superstition of the Peruvians not allowing them to apply silver or iron.-TRANSLATOR.

made from the leaves of tobacco and the solanum incanum, R. Pav., a beautiful tree, which in the neighbourhood grew very abundantly; but it was two weeks before the swelling would permit even the leaving of the bed. The wound healed very slowly, and only at last closed by the constant use, for many weeks, of the very astringent bark of the macronemum corymbosum, R. Pav. The fever left after the establishment of suppuration, and the peculiar pain of the poisoning disappeared at the same time. No other consequence was felt besides a kind of nervous sensibility, disagreeable enough, which produced a shuddering and trembling at the slightest noise. during an excursion, and induced great horror at even the sight of a dead snake.

Whether ammonia is useful against the bites of American snakes I do not know; little confidence is placed in it in the interior of America. Arsenic and corrosive sublimate are both celebrated in Peru and Colombia. But prevention is better than cure, and by an adequate clothing for the feet, and other little foresights, preservation from the ordinary possibilities of wounding may be insured, as poisonous snakes in hot regions are nothing near so frequent as is generally supposed.

For the American Medical Intelligencer.

ART. II.-COLD DOUCHE IN ENCEPHALITIS.

BY ABNER HESTER, M. D., NEW ORLEANS.

[This is an additional instance to the many we already possess of the ulility of the cold douche, as a revellent, in' encephalitis and cerebral excitement. Dr. Hester ascribes the disease to what he considers improper treatment on the part of the physician, who preceded him in attendance. We regret to see this. Charity and correct professional etiquette should induce us to be very cautious in making these charges, especially as in all such cases good reasons could, we doubt not, be assigned for the course animadverted upon.-ED.]

Dr. R. Dunglison, M. D.

New Orleans, La., February 28, 1840.

Dear Sir.-I send you the following case, and should you find it worthy a place in your valuable Journal, you will please insert it, and oblige, very respectfully yours.

ABNER HESTER, M. D.

On the night of the 14th of August, 1838, I was requested to visit, at 12 o'clock, W. R., æt. 25, who was said to be dangerously ill. I ascertained that he had been under the treatment of a physician for several days, and I accordingly desired the attending physician to meet me in consultation on the case. This he declined, asserting nothing could be done for the patient-that he must inevitably perish, since medicines could not arrest the progress of his disease. Being earnestly solicited by the friends of the sick man, I consented to see him. Some days previously, after fatigue, and exposure to a hot sun, he was suddenly seized with an affection of the chest, attended with cough, and some pain, on taking a full inspiration. In his person he was tall; muscles well developed; chest rather contracted and sunken; cranium small, and indicating a feeble intellect. As his physician was opposed to blood-letting, he gave him pectorals, and anodynes, into which opium entered largely. Previously, however, to this, the patient had been seriously devoting his time to the study of some new religious doctrine.

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