Chapter 5

Beside garden A was prepared another plot of the same dimensions, having the same kind of soil and treated in like manner as the first, but the electrical apparatus and wires were wanting. At the close of the experiments only three plants had partially developed, and two of these were nearly destroyed by mildew--one only was free from the disease. The results, therefore, show that the healthiest and largest plants grew in the electric plot.

In the second experiment, which we called B, twenty plants of the same variety of lettuce and of equal size were taken. The treatment given was the same as the plants in plot A received. Five plants only remained unaffected with mildew; seven died from the disease when they were half grown; the rest were quite well developed, but at the last part of the experiment began to be affected. Several heads were large, the largest being over the greatest number of wires and nearest the electrodes. Examination of the roots disclosed the same phenomena as in A.

Near plot B were also set twenty other plants, subjected to like conditions as the first, but without electricity; all but one died from mildew before they were half grown, the solitary plant that survived being only partly developed at the close of the experiment, and even this was badly affected with the disease.

Everything considered, the results were in favor of electricity. Those plants subjected to the greatest electrical influence were hardier, healthier, larger, had a better color, and were much less affected by mildew than the others. Experiments were made with various grasses, but no marked results were obtained.

The question would naturally arise whether there may not be a limit reached where electricity would completely overcome the attack of mildew and stimulate the plant to a healthy and vigorous condition throughout its entire growth. From the fact that the hardiest, healthiest, and largest heads of lettuce grew over the greatest number of currents and nearest the electrodes, it would seem that electricity is one of the agents employed by nature to aid in supplying the plant with nourishment and to stimulate its growth. To what extent plants may be submitted to electrical influence, or what strength of current is best suited to them and what currents prove detrimental to their development, have not been determined as yet, but it is desirable to continue this research until some definite information shall be gained on these points. Probably different varieties of plants differ greatly in their capacity for enduring the action of electric currents without injury--experiment alone must determine this.

It has been proved that the slow discharge of static electricity facilitates the assimilation of nitrogen by plants. Faraday showed that plants grown in metallic cages, around which circulated electric currents, contained 50 per cent. less organic matter than plants grown in the open air. It would seem from the researches of the latter physicist that those plants requiring a large percentage of nitrogen for their development would be remarkably benefited if grown under electric influence.--_Massachusetts Agricultural College, Bulletin No 16._

[A very interesting article on the Influence of Electricity upon Plants, illustrated, is given in SUPPLEMENT 806. It presents the results of the studies of Prof. Lemstrom, of Helsingfors.]

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THE TREATMENT OF RATTLESNAKE BITE BY PERMANGANATE OF POTASSIUM, BASED ON NINE SUCCESSFUL CASES.

By AMOS W. BARBER, M.D.,[1] Cheyenne.

[Footnote 1: Governor of Wyoming.]

Poisoned wounds, inflicted by the fangs of the rattlesnake, are happily more rare each year, since, as the country is becoming more populated, the crotalus is rapidly being exterminated. Yet, considering the recklessness which characterizes the cow boy in his treatment of this reptile, it is astonishing that this class of injury is not more common. Thus it is the invariable custom among the cattlemen to dismount and destroy these snakes whenever they are seen. This is readily accomplished, since a slight blow will break the back. This blow is, however, generally delivered by means of the quirt, a whip not over two and a half feet long, and hence a weapon which brings the one who wields it in unpleasant proximity to the fangs of the reptile. A still more dangerous practice, and one which I have frequently seen, is a method of playing with the rattlesnake for the delectation of the cow boy at the expense of a "tenderfoot." It is well known that unless a snake is coiled, or held by the tail or body, or placed at length in a hole or crevice so narrow that by rendering its length sinuous a certain amount of support is given, it cannot strike. On this theory a mounted cow boy first puts a rattler to flight, then pushes his pony in pursuit, stoops from the saddle, seizes it by the tail, gives a quick upward jerk, and, swinging it so rapidly around his head that it is impossible for it to strike, sets off in pursuit of whoever has exhibited most terror at the sight of the reptile. When within fair distance he hurls the snake at the unfortunate victim, in the full assurance that even should it strike him it cannot bury its fangs in his flesh, since it is impossible for it to coil till it reaches the ground. This is a jest of which I have frequently been the victim, nor have I yet learned to appreciate it with unalloyed mirth.

The belief that rattlesnakes always give warning before striking is not well founded. If come upon suddenly, they often strike first, and if disturbed when in a space so narrow that the coil cannot be formed, they may give no warning of their presence beyond the penetration of the fangs into the hand or foot of an intruder. One such case I saw.

It seems to be well established that a snake will not voluntarily crawl over a hair rope, and in certain parts of the country it is common for campers-out to surround their beds with such a rope, since the reptiles seek warmth, and are frequently found under or in the blankets of those sleeping on the ground.

After an exceptionally large experience with wounds inflicted by the fangs of the rattlesnake, and an experience which, I am glad to say, has been most successful in its outcome, I think it my duty to add, from a practical standpoint, my testimony as to the efficacy of permanganate of potassium in the treatment of this class of cases. This drug was first introduced by Lacerda, of Brazil, and, if more generally used, would, I believe, render comparatively innocuous a class of injury which now usually terminates in death.

I make this statement as to the fatality of crotalus poison advisedly. I know the belief is very common that the poison of a rattlesnake is readily combated by full doses of whisky. This is fallacious. I have taken the pains to investigate a number of instances of cure resulting from the employment of free stimulation. In each case the fangs did not penetrate deeply into the tissues, but either scratched over the surface or tore through, making a wound of entrance and exit, so that the poison, or at least the major part of it, was not injected into the tissues of the person struck. The effect is very much the same as when an inexperienced practitioner picks up a fold of skin for the purpose of making a hypodermic injection, and plunges his needle entirely through, forcing the medicament wide of his patient.

Nearly all, if not all, of the cases treated by stimulation alone have, according to my experience, perished if they have received a full dose of virus from a vigorous snake. One of these cases lived for upward of a month. He then perished of what might be considered a chronic pyæmia, the symptoms being those of blood poisoning, accompanied by multiple abscesses. Another case, not occurring in my own practice, died at the end of four days apparently of cardiac failure. Active delirium persisted all through this case. Two other cases treated by stimulants also died with symptoms of more or less acute blood poisoning.

The feeling is almost universal among the people of Wyoming that a fair strike from a rattlesnake is certain death, and that the free use of stimulants simply postpones the end. I do not for a moment deny that a strong, lusty man may be struck fairly by a rattlesnake and if the wound is at once opened and cauterized, and the heart judiciously supported, he may yet recover; still the fact remains that the great majority of these cases perish at a longer or shorter interval following the infliction of the wound. Hence any treatment that will save even the majority of such cases is a distinct gain, and one which has saved every one of nine cases to which it has been applied needs no further commendation.

The first case of rattlesnake wound to which I was called occurred in 1885. A cow boy was bitten on the foot, the fang penetrating through the boot. He was brought forty miles to Fort Fetterman, where I was then stationed. I saw him about twenty-four hours after he was struck. There was an enormous swelling, extending up to the knee. The whole limb was bronzed in appearance. There was no special discoloration about the wound; in fact, the swelling disguised this to such an extent that it was impossible to determine exactly where the fangs had entered. The pulse was scarcely perceptible at the wrist; the heart was beating with excessive rapidity. The patient was suffering great pain. His mind was clear, but he was oppressed with a dreadful anxiety. Up to the time I saw him he had received absolutely no treatment, excepting the application of a cactus poultice to the leg, since there was no whisky at the ranch where he was wounded. I at once made free incisions, five or six in number, from one to two inches in depth, and about three inches in length. These cuts gave him very little pain, nor was there much bleeding, though there was an enormous amount of serous oozing. Into these wounds was poured a fifteen per cent. solution of permanganate of potassium, and fully half an hour was devoted to kneading this drug into the tissues. In addition I made many hypodermic injections into all portions of the swollen tissue, but particularly about the wound. Since there was no very distinct line of demarkation between the swollen and healthy tissue, I did not, as in other cases, endeavor to prevent the extension of the cellular involvement by a complete circle of hypodermic injections. I employed, in all, about forty grains of the permanganate. In addition to the local treatment I pushed stimulation, employing carbonate of ammonium and whisky. By means of diuretics and laxatives the kidneys and bowels were encouraged to eliminate as much of the poison as possible.

The patient went on to uninterrupted recovery. The wound healed with very little sloughing. The patient returned to his work in about a month. The cure of this case was regarded by the cow boys as most exceptional, since, in their experience, similar cases, even though very freely stimulated, had not recovered.

Some time later I was called to see a girl, aged 14, who was struck by a rattlesnake, fifty-six miles from Fort Fetterman. There was some trouble about procuring relays, and I was compelled to ride the same horse all the way out. This took a little short of five hours. This, together with the time consumed in sending me word, caused an interval of about twenty hours between the infliction of the injury and the time I saw the patient. I found the fangs had entered on either side of the distal joint of the middle metacarpal bone. The arm was enormously swollen, almost to the axilla, and exhibited a bronzed discoloration; this was especially marked about the wound and along the course of the lymphatics. The swollen area was _boggy_ to the touch, and exhibited a distinct line of demarkation between the healthy and diseased tissues, excepting along the course of the brachial vessels, where the indurated discolored area extended as a broad band into the axilliary lymphatics, which were distinctly swollen. The patient was delirious, was harrassed by terror, complained bitterly of pain, and had an exceedingly feeble, rapid heart action. There was marked dyspnoea, and all the signs of impending dissolution. I at once made free multiple incisions into all parts of the inflamed tissue, carrying two of my cuts through the wounds made by the fangs of the snake. In the arm these incisions were several inches long and from one to two inches deep. As in the former case, the bleeding was slight, but there was a free exudation of serum. Into these wounds a fifteen per cent. permanganate of potassium solution was poured, and as much as possible was kneaded into the tissues. In addition multiple hypodermic injections were made, these being carried particularly into the bitten region, and circularly around the arm just at the border of the line of demarkation, thus endeavoring to limit by a complete circle of the antiseptic solution the further extension of the inflammatory process. In the region of the brachial vessels I hesitated to make my injections as thoroughly as in the rest of the circumference of the arm, fearing lest the permanganate of potassium might injure important vessels or nerves.

This treatment caused very little pain, but immediately after the constitutional symptoms became distinctly aggravated. I stimulated freely, and at once made preparations to take the patient to the Fort Fetterman hospital. She was transported over the fifty-six miles, I riding the same horse back again, and arriving at Fort Fetterman the same evening.

The after treatment of this case was comparatively simple. She was stimulated freely as long as cardiac weakness was manifested. As in the former case, diuretics and laxatives were employed. The arm was wrapped in cloth soaked in a weak permanganate solution, was placed in a splint, and was loosely bandaged. There was some sloughing, but this was treated on general surgical principles. The patient recovered the entire use of her arm, and was turned out cured in about six weeks.

The third case I saw about fourteen hours after he was struck. The patient was a healthy blacksmith, about 30 years of age. The wound was at about the middle of the forearm, the fangs entering toward the ulnar side. When I saw the patient he exhibited comparatively trifling symptoms. His heart action was rapid, and he was suffering from the typical despondency and terror, but I could not note the profound systemic depression characteristic of the great majority of cases. Surrounding the wound and extending up the forearm for several inches there was a boggy swelling, exhibiting a sharp line of demarkation. It was bronzed in color, and was apparently spreading. I at once applied the intermittent ligature just above the elbow, and injected the permanganate of potassium solution freely all through the involved tissues, particularly in the region of the bite and about the periphery of the swelling, surrounding the latter by a complete ring of injections.

The general treatment of this patient was continued on the same general line as described in the former cases, stimulants being employed moderately. He recovered without any bad symptoms. There was no sloughing; the swelling disappeared without any necrosis of tissue. He is still pursuing his trade in Cheyenne, and suffers from absolutely no disability.

I saw but one case shortly after the wound was inflicted. This patient was a healthy young man, who was struck about the middle of the dorsal surface of the hand, the fangs entering on each side of a metacarpal bone, and the poison lodging apparently in the palm of the hand. The patient, when seen, exhibited the characteristic terror and depression, weak, rapid heart action, and agonizing local pain. I made two small incisions in the region of the wound upon the dorsum of the hand, and injected permanganate of potassium freely. This patient ultimately recovered, but only after sloughing and prolonged suppuration. I believe that had I incised freely and at once from the palmar surface, I would have been spared this unpleasant complication.

I have had in all nine cases, and without a single death. The others are in their general features and in the treatment employed quite similar to those given.

The symptoms resulting from snake bite poison are strikingly like those dependent upon the violent septic 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 hesitate to use four times that quantity were it necessary, since it seems to exert no deleterious effect, either locally or generally.

8. The involved area should be dressed by means of lint saturated with fifteen per cent. permanganate of potassium solution. Stimulants should be given according to the indications--i.e., the condition of the pulse. Laxatives, diuretics, and diaphoretics should be administered to aid in the elimination of the poison. The diet should be as nutritious as the stomach can digest.--_The Therapeutic Gazette_.

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CHINESE COMPETITIVE EXAMINATIONS.