SHAKES AND SHAKEBITE

Evening Star, Issue 20993, 6 January 1932, Page 10

SHAKES AND SHAKEBITE

• +- THE LIGATURE SURVIVES

[By Donald Macdonald, m the Melbourne 1 Argus.’]

In observation upon snakes and snake-bite, especially the value of the ligature in treatment, the most commonly used of all methods, comment is being constantly modified by new conclusions drawn from skilled research. In these we naturally look for ah exactness and completeness which no general observer can possibly possess, even when he declines to bo influenced by the romantic gossip handed on.by bushmen of one generation to another. As snake-bite accounts, for an average or only fifteen deaths a year m the Commonwealth, it is not a menace of much consequence. Circumstances and surroundings have given it a false importance, yet they have made it an appealing problem to a people who worry little about risking life, yet who will do heroic things to save it. So snake-bite has a perennial appeal for us—a sort of mesmerism or fascination of horror which its lethal power does not warrant That fascination may continue long after research has given the snake as a potential killer the last knockout blow. Personally, I now know that I might have had many more fishing days better worth remembering could I, as reason dictated, have shut out the subconscious thought of tiger snakes and employed both eyes in the sporting purpose of looking for trout. Any conclusions upon the percentage of deaths from snake-bite based upon the only data available —the Tidswell and Ferguson series of investigations—are certain to be misleading as applied to Victoria. The very active and aggressive black snake literally springs into prominence as responsible for half the total number of bites—l2s out of 250. There is but one death recorded for those 125 black snake bites, and even in that case the identity of the snake was So doubtful that it should properly be eliminated. So by the most conclusive evidence we can have upon the subject the black snake, venomous by structure, equipment, appearance, and habit, is innocuous to human beings, and all conclusions based upon treatment or results in such , cases, in the use either of an antidote or of a ligature, are useless. This particularly concerns Victoria, which has few black snakes confined to a lightly settled area. In place of the black snake we have a blackish one in the copperhead, which does not come into the TidsweU-Fergu-son records at all, and which is without doubt highly venomous, though most of the deaths caused by it are inerror attributed to Pseudecbis porphyriaous instead of Denisonia superha. In one notable case the victim was a snake charmer with a reliable antidote, who made the fatal mistake of assuming that because he had become immune by repetition from tiger snakebite he was protected against . the venom of a copperhead also. Briefly, the percentage of deaths from snakebite is certain to be higher in Victoria than in either New South Wales or Queensland, where the total cases of snakebite exceed ours. THE SCIENTISTS’ THEORY. With faith in the methods and conclusions of scientific research, as conducted in Melbourne for some time past, I accept its recommendations as the most reliable of all methods for the treatment of snake-bite. The scientists assure us that the prompt and proper use of the ligature is more important in Victoria than elsewhere. Snake venoms vary greatly in character. In some, 1 understand, is an element called thrombose, whicn has an effect of clotting the blood, and against these venoms a ligature may delay the action of the poison long enough to enable a chemical change to occur, and so give the ligature m itself some curative value. This thrombose is, I understand, a constituent of the venom of tho tiger snake, but not of that of the copperhead. These are the two most dangerous snakes in the State of Victoria. Yet against both of these the ligature is highly desirable, but more vital, be-

cause more beneficial, in the case of the tiger snake. . If we accept, as . I am convinced we must, the conclusion that a serum specially prepared from venom is the only proved antidote for snakebite, there is a second reason why the immediate use of a ligature becomes important, even where it does not actually remove or minimise the potency of venom which has entered the circular, tion. The progress of snakebite symptoms is often slow, and antivenene is used with confidence ds a cure hours after a person has been bitten and is still in danger. So where the serum is obtainable sooner or later —as it will he a few years hence—anything which delays tbe progress of the venom, such as a ligature, can and must have an important secondary value which is fully realised at present in the more thoroughly organised methods for the treatment of snakebite employed in the United l States. There aircraft are often used either to take serum to the sufferer or the sufferer to the serum, whichever may be more convenient. There is reason to conclude, though, that the ligature is often wrongly aped. Generally the locality of the is the leg or arm, usually below the elbow or the knee. There was an

impulse which, wanting more knowledge at first seemed to be rational, to use the ligature to intercept venom as far away from tbe heart as possible. We are now assured that in no circumstances should the ligature be applied to the shin or lower leg between knoo and ankle, or to the forearm between wrist and elbow, which at one time were accepted as the natural and most convenient positions for it. The proper place for the ligature is • above the knee or the elbow although in the case of a finger bite a second and smaller ligature may be used l at the base of the finger. The best form of ligature is a strong elastic band, but as this is rarely obtainable in an emergency the readiest substitute is a loop of stout cord with a long pencil or pen handle to be used as a twitchstick—tho most convenient way of increasing or lessening tension as required. There are more detailed recommendations, I .understand, about the intermittent use of a ligature, but I have not seen them. THE USEFUL INCISION.

Prompt excision—which means cutting out the piece of flesh containing the venom immediately after the bite—is an instant cure, but no layman is likely to undertake it, and .if the person bitten has both the will and the nerve for this rather heroic plan he is seldom able to use it. An incision at the site of the bite when using a ligature is at least useful as showing, if the blood continues to run from it, that the ligature is not achieving its purpose. With so many curves which did not cure hut which, one may suggest, often helped to kill by establishing a false sense of security, loss of life from snakebite in a country such ns Australia, with the dubious distinction of possessing two of the most deadly snakes on earth, is amazingly light. Our indiscretions seem to have, served us not too badly, yet snakebite will continue to bo a spoil sport out of doors and a popular, if not a real, menace. In the treatment of snakebite extremes meet. To permit them to do so one uses a ligature to shut off or slow down the progress of the venom, and, at the same time, all tho speed the local traffic regulations permit in getting to the nearest doctor.