B. lanceolatus, Wagler-Dumeril; synonyms , Coluber glaucus, Linn. Vipera cærulescens, Laurent; Coluber megara, Shaw; Cophias lanceolatus, Merrem; Craspedocephalus lanceolatus, Gray (Trigonocephale jaune, Cuvier; Vipera jaune; ).

An Ophidian of the family Crotalidæ, found in the Island of Martinique.

Authority.

Dr. Ch. Ozanam, L'Art. Méd., 19, 116 (A collection of cases (15) and general observations on the effect of the bite, quoted from Dr. Rufz, "Enquête sur le serpent de la Martinique.")

MIND

Consecutive and long-lasting hypochondria.
Ideas confused.
Coma, becoming deeper until death ensues.

HEAD

Vertigo.
Frequent dizziness.
Hemicrania.

EYE

Amaurosis (sometimes immediately after the bite).
Persistent amaurosis.
Amaurosis, without perceptible dilatation of the pupil.
Hemeralopic amaurosis; can scarcely see her way, especially after sunrise. [10.]
Pupil a little dilated.

FACE

Altered countenance.
Hippocratic countenance.
Injection, more or less dark and bluish, of the entire cutaneous surface of the face; a hue like that of cholera in the algid stage, or that in the last stage of yellow fever.

MOUTH

Trismus (after eighteen days).
Inability to articulate, without any affection of the tongue (after seven to fifteen hours).

STOMACH

Gastric mucous membrane dotted red.
Thirst.
Nausea and vomiting.
Vomiting. [20.]
Vomiting, followed by a nervous trembling.
Painful sensation extending to the epigastrium.
Intolerable epigastric malaise.

ABDOMEN

Small intestines of a livid redness exteriorly.
Small intestines dotted red.
Mucous membrane of the small intestines, especially the jejunum, inflamed in different parts.
Small intestines of a deep blue color, confined entirely to the muscular layer.
Severe pains in the abdomen, which extend to the epigastrium and become intolerable (after a few hours).
The entire abdomen is sensitive to pressure.

STOOL AND URINE

Colliquative diarrhœa. [30.]
Hæmaturia.

RESPIRATORY APPARATUS AND CHEST

Trachea and bronchi blue.
All the symptoms of pulmonary congestion , oppressed breathing, and bloody expectoration, more or less profuse (after three to six days).
Præcordial pains.

HEART AND PULSE

Soft, flabby heart.
Black spots on the pericardium and under the endocardium.
Pulse and respiration become slow.
Frequent and compressed pulse.

EXTREMITIES IN GENERAL

Speedy swelling of the bitten limb.
The swelling, at first pale and confined to the parts around the bite, becomes livid and involves the entire limb, both below and above the bite. [40.]
The swelling of the part bitten gradually extends to a great distance from its original seat; the limb becomes triple its ordinary size, and is soft and flabby, appearing as if distended with gas.
Enormous bloody infiltration, like that which results from a violent bruise (of the bitten limb).
The extremities become cold.
Almost entire inability to move the right arm or right leg.
Paralysis of one arm, or of one leg, only.
Severe pain in the bitten limb.

UPPER EXTREMITIES

Arm swollen from hand to shoulder.
Very considerable tumefaction of the whole limb, from the fingers to the shoulder and adjacent portion of the chest, soft, like emphysema, very sensitive, with blue spots.
After being bitten in the little finger of one hand paralysis began in the finger-tips of the other hand, and extended over the whole of that side.
Cellular tissue, and also the muscles of the forearm (where the bite was inflicted) engorged with black blood. [50.]
The bones of the forearm and hand are laid bare.
Consecutive necrosis.
Numbness in the right arm (after a bite on the right hand).
Anchylosis and deformity of the hand, which became united into one immovable bone, with the wrist and fingers packed together.

LOWER EXTREMITIES

Legs infiltrated with bloody serum.
Very extensive suppuration of the leg.
Destruction of the skin of the whole leg.
Left thigh enormously swollen, and of a bluish color, with here and there blotches of a deeper hue, 6.
Softening of the cellular tissue in the hollow of the ham, and at the posterior portion of the thigh, including one half of the limb.
Gangrene of the skin over the whole anterior portion of the right leg from the foot to the knee. [60.]
Gangrene of the muscles of the leg.
Inferior extremity of the tibia laid bare (after fifteen days).
Tibio-tarsal articulation laid open.
Paralysis of the leg.
Gangrenous ulcer on the great toe.
Intolerable pain in the right great toe (the patient having been bitten on the left thumb).

GENERALITIES

Œdematous swellings, like elephantiasis.
Infiltration of bloody serum, equally diffused throughout the substance of the cellular tissue, but better marked in the vicinity of the bites.
Very extensive suppuration.
Suppuration and sero-sanguinolent infiltration of all the tissues. [70.]
Within two or three days suppuration sets in, the skin comes off, and, if the proper incisions are not made, the part becomes gangrened; portions of cellular tissue are detached, with a reddish sanious discharge; the tendons and bones are laid bare; the joints are exposed; sphacelus invades the parts, especially the fingers; the whole limb is dissected alive; colliquation succeeds, and if the patient does not succumb to the consequences of purulent absorption, or of gangrene, amputation becomes necessary.
Remarkable fluidity, dissolved condition, of the blood.
The blood is black, or rusty-looking; very fluid.
Hemorrhages of various kinds, and especially from wounds.
Very fluid black blood flows in jets at the least movement.
Capillary hemorrhage after amputation; blood discharged continuously, not by jets; very fluid and very pale.
Muscles laid bare.
The blackened muscular tissue is dissected off bit by bit.
Caries of the bones.
Emaciation. [80.]
Tetanus (after amputation).
Nervous trembling.
Opisthotonos (after fourteen days).
Convulsions and death (after two days).
Paralysis (generally incurable).
Hemiplegia of the right side (after five and seven hours).
Inexpressible lassitude.
Weakness.
Repeated fainting fits.
Frequent syncope. [90.]
Indefinable malaise; general uneasiness.
Intolerable pains in the swelling.

SKIN

Bluish skin (of the leg).
Yellow skin, as in yellow fever.
Skin as if affected by a most extensive and severe bruise.
Bloody subcutaneous and intermuscular infiltration.
Blackish, serous infiltration in the intermuscular tissue.
Many phlyctenæ are formed under the epidermis (of the bitten limb).
Phlyctenæ in the hollow of the ham.
Obstinate ulcers. [100.]
Abscess, more or less considerable.
Fistulous openings.
Wounds heal with difficulty.

SLEEP AND DREAMS

Drowsiness.
Very remarkable sleep or coma, which may end in death.

FEVER

Chilliness.
Slight shivering, followed by very profuse cold sweat.
Sometimes very great external heat.
General heat.
High fever. [110.]
Body covered with a cold and viscid sweat.
Profuse cold sweats at the beginning and end of the disease.

Bothrops Lanceolatus