NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
157
IV.—PROYESrCE OF SIND.*
Táluka.
Karáchi
Dádú
Sehwan
Manjhand
Dsh or "Village.
1,—KARA'CHI OOLLECTOBATE,
Mtichi Meani
Mahal Division
Liari Quarter
...
...
Hu.nch.ore Lines
Saddar Bázár
Soldier Bázár
Mochi-jo-Grote
Malir
Total ...
Purano Dehro
Fulji
Muthri
ShahMorio
Haji Khan ...
Johi...
Total ..
Seh.wan
Bag Tusif ...
Karampur ...
Mahi Ootto
Bhutra
Talti
Ahmeda
Dero Dim ...
Lashari
Bilawalpur...
Jhandani
Bakhtawarpur
Rohri
Trehni
Sháh. Hassan
Bhan
Shek
Wahur
Kalubhori ...
Total ..
Mánjhand ...
Abad
Lakha
...
...
...
..
Nurpur
Kubi
Kachi
...
...
Total ...
Number of
Lépera.
7
16
1
17
3
1
5
4
2
1
57
2
2
1
1
3
1
2
1
13
3
9
3
1
3
2
1
6
3
1
2
2
3
3
3
7
1
1
4
7
1
1
4
1
6
• 78
12
2
1
1
1
1
1
1
20
KIND OF LEPROSY.
White.
7
16
1
13
3
1
5
4
2
1
1
53
2
2
1
1
3
1
1
1
12
3
9
3
1
3
2
1
6 3 1
2
2
3
3
3
7
1
1
4
6
1
1
4
1
6
77
12
2
1
1
1
1
1
1
20
Black.
...
4
• • •
• • •
...
4
1
1
...
...
...
...
...
...
...
...
1
...
1
...
...
REMARKS.
* The returns for Sind include cases of both white and black leprosy,_but the two forms of disease are clearly distinguished.
B 1084—40
158
Táluka.
Kotri (including Ko-
histan).
Tatta
Sákro
Ghorábári
Mirpur Batoro
Sujáwal
Sháhbandar ...
Hyderabad City
Táluka Hyderabad ..
Deh or Village.
V.-PROVINCE OF SINB-contd.
'..—KAEA'CHI COLLECTOKATE— contd.
Kotri
Mole
Total ...
Tatta
Ageemani ...
Khakhar Halla
...
Hallat
Total ...
Mirpur
K-ajmalk
Total ...
HamirLakho
Kotri Ghorábári ...
Lark
...
...
...
..
Total ...
Pad
Attalshah ...
Dhand Khad
Babri
Anara
Total ...
Pinilado Samo
...
...
...
Belo Gahki
Wicholo ...
Achh
Badho Talpur
Total ..
Mutni
Grand Total ..
2.—HYDERABAD COLLEOTOKATB,
Hyderabad
Alahdad Chand
Tando Tyeb
Tando Muhammad
Tando Agho
Ismail Shah Dado
Shoro Rahu
Laung Chand
Patoro
Shahdad Panwar ...
Chhuto Panwar ...
Muhammad Pario ...
Total including Hyderabad City..
Number of
Lepers.
5
11
2
18
10
1
1
1
1
14
3
1
4
1
1
1
3
1
1
1 2
1
1
7
1
2
1
1
1
1
1
8
1
223
35
1
1
1
1
1
1
1
1
2
1
1
47
KIND OF LEPROSY.
White.
5
11
2
18
10
1
1
1
1
14
3
1
4
1
1
1
3
1
1
1
2
1
1
7
1
2
1
1
1
1
1
8
1
217
35
1
1
1
1
1
1
1
1
2
1
1
47
Black.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
«
...
6
...
...
...
REMAKKS,
159
Táluka.
Guni
Badin
Tando Bago ...
Dero Molibat
Kandiáro
Nausbabro
Moro ...
Deh or Village.
IV.-PHOVINOE OF SIND-contá.
2.—HYDERABAD COLLECTOBATE—contd.
Miani Sang
Gbot Aclia...
...
Saidpur
Mabi Kbaskeli
Nurkban Hajano ...
...
...
Daboo Wasan
...
...
...
Wasi Mabiksbab
Katiar
Abbayo Samo
Kalul Kbaskeli
Murad Jatoi
Tarai
Gulam Notkani
Total ...
.. Talbar
Jiatb
Begapur
Bokbi
Total ...
Gbot Kbabar Lagari
Total ...
.. Gbot Nur Mubammad Wisrio
Gbot Barani Lagari
...
Kinaro Guni
Kumb Baloo
Jeewan Bburgri
Total ..
.. Moria
...
...
...
,.
Mobbat-dero
...
Bakbri
Kamal-dero...
Cbibbir Babhan
Godlin
Mabrabpur ...
Total ..
... Dabbro
Madalim
Larik
Bbirea
...
...
Mitbani
Dalepata
Mangatb
Kala Tagar...
Bband Mari
Bborti
Nurpur
Nausbabro ...
Machur
Total .
... Sauri
Sadbuja
Dalcband ...
Number of
Lepers,
1
1
1
2
1
1
1
3
2
1
1
1
1
1
1
19
6
1
1
1
9
2
2
1
1
1
1
1
1
6
2
2
1
1
1
1
2
10
4
1
1
1
2
3
1
1
2
1
1
5
1
1
25
1
5
1
KIND OF LEPROSY.
White.
1
1
1
2
1
1
1
3
2
1
1
1
1
1
1
19
1
1
1
1
4
2
2
1
1
1
1
1
1
6
2
2
1
1
1
1
2
10
4
1
1
1
2
3
1
1
2
1
1
5
1
1
25
1
5
1
Black.
...
...
5
5
...
...
...
...
...
*
...
...
...
...
...
KEMARKS.
160
Táluka.
Moro—continued.
Sákrand
Hala ...
Shahdádpur
Shíkárpur
Deh or Village.
IV.PROVINCE
OF SIND—contd.
2.—HYDERABAD COLLECTORATE—contd.
Korai
Balal
Moro
Daro
Khalso
Mori
...
•••
Glralamali ...
Inayatullah...
Baharo Hothiapoto
Daulatpur ...
Toohal Hothiapoto.-.
Mirpur
Mosan Rahu
Total ...
. Jalalani
Mahrabpur ...
Zaktihar Khan
Bliand
That
Total ...
. Muhammad Hay at Mogul...
Sekhat
Changu
Matasi
Shahpur
Muhammad Araf Khatian
Datu Larher
Matu Sand
Tajpur
Datan Chand
Total ...
Gandan
Jhol
Muhammad Khan Rind "...
Bacho
Shahdádpur
...
...
Khairo Kalai
Total ,.
Grand Total ..
3.—SHIKA'BPUR—COLLECTORATE.
.. Shikárpur
Garhi Dukha
Khanpur
...
Dea ...
Shahal
MeharAli
Jagan
ISTune
Kukra
Garhi Tegho
Machi
Mureed Sathar
Total .
Number of
Lépera.
1
1
5
1
3
1
1
2
1
1
3
1
1
1
30
1
1
1
1
1
5
1
3
2
6
1
1
1
2
2
1
20
1
1
2
1
1
1
7
180
36
1
3
2
1
1
1
5
1
1
1
1
1
55
KIND OF LEPROSY,
White.
1
1
5
1
3
1
1
2
1
1
3
1
1
1
30
1
1
1
1
1
5
1
3
2
6
1
1
1
...
...
1
16
1
1
2
1
1
1
7
171
36
1
3
2
1
1
1
5
1
1
1
1
1
55
Black.
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
> • •
...
2
2
...
4
...
...
...
...
9
...
...
REMARKS.
161
Táluka.
Sukkur
Nausbahro
Bohri
Saidpur
Ghotki
Mirpur
Ubauro
Deh or Village.
IV.—PROVINCE OF SIND—contd.
3.—SHIKA'RPUR COLLECTOBATE—contd.-
Blaator
Chak
Tanda Alislier
...
...
Samano
Mahboob
Ubdoo
Nápár
Hothi
New Sukkur
Old Sukkur
Total ...
. Garhi Yásin
Kundo Wahan
Fakir
Alikhan ...
...
Wásul
Bhámbo-dero
Total ...
Bohri
Phalu
Pirjo Gote...
...
...
Nurpur
Palk
Total ...
Pano Akil
Bacho Dharejo
. Total ...
Ghania
...
Kalwar Sacheno
Adalpur
Sabho Shikar
Sahta
...
...
Daim Shahjo Gote
Taba
Ghotki
FathoMálhno
Fazal Bhaie
Unur Draho Nando
Gadi Abro ...
Chákár Abro
Total ..
.. Nasir
Mirpur
Chand Tnmrani ...
Gonko
Total ..
Ubauro
Total
Number of
Lepera,
1
1
1
2
1
1
1
1
1
2
8
5
25
4
1
1
1
2
1
10
8
1
3
1
2
1
1
17
1
1
1
3
2
1
1
2
1
1
1
2
1
3
1
2
1
1
1
1
22
1
4
1
1
7
1
1
KIND OF LEPROSY.
White.
1
1
1
2
1
1
1
1
1
2
8
5
25
4
1
1
1
2
1
10
8
1
3
1
2
1
1
17
1
1
1
3
1
1
1
2
1
1
1
2
1
3
1
2
1
1
1
1
21
1
4
1
1
7
1
1
Black.
...
...
...
...
...
...
• ••
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
• • •
• • •
...
...
1
...
...
...
...
...
...
...
...
...
...
...
1
• • •
...
...
KEMAKKS.
B 1084—41
162
Táluka.
Lárkhána
Bato-dero
Labdarya
Kambar
Nasirabad
Deh or Village.
IV.—PROVINCE OF SIND—contd.
3. SHIKA'KPUK COLLECTOBATE—contd.
. Mitho Doro
Shebeg Jamali
Piaro Mohano
Nawa Gote...
...
...
...
Dedur
Ghulam Mahomed ...
Pana Khichi
Ghulam Mahomed Isean ...
Vikia Sanghi
Dhoon
Sbah Yaro ...
Bangalow Mehboob
Phoolpotra...
...
...
Mahota
...
...
...
...
Dadai
Total ...
Panjoo Abro
Khaira Dero
Osman Unar
Total ...
Sher Simdilo
Gaodo
Faridabad ...
Abad Poorano
Chato Wahan
Gerelo
Unar Bhayo
Merabpur ...
Chena
Khokhur
Total ...
Kharira
Mena
...
...
...
...
Hauti
Behram Muthyon...
Sadik Junejo
Maoghud ...
Jiand
Bukhir Mahesur ...
Joya
Lookman ...
...
...
Arzi Bhooto
...
Savaharo Bhati
Total ..
Anho
...
Ali Baher ...
Tharari Hajra
Phekratto ...
...
...
Kathia Bazaar
Taro-dero ...
Total .
Number of
Lepers.
3
1
1
1
1
1
1
1
1
1
1
1
1
1
2
4
22
1
1
1
4
2
4
13
1
1
2
2
2
2
1
2
1
1
1
16
1
1
1
1
4
1
1
2
2
1
1
1
1
18
1
2
1
1
1
1
7
KIND OF LEPROSY.
White.
S
1
1
1
1
1
1
1
...
1
1
1
1
2
4
21
1
1
1
4
2
4
13
1
1
2
2
2
2
1
1
1
1
1
15
1
1
1
1
4
1
1
2
2
1
1
1
1
18
1
2
1
1
1
1
7
Black.
...
...
...
...
• ••
...
...
• •*
1
...
...
...
...
...
...
1
...
...
. ••
• . .
1
...
1
...
...
...
...
...
...
REMARKS.
163
Táluka.
Kakar
...
Tigar
Mehar
Umarkot
Cliachra
Khipra
Mitti
Dipla
Jacobabad
Thul
Deh. or Village.
IV.—PROVINCE OF SIND—contd.
3.__SHIKA'BPUR COLLECTORATE—contd.
KkirIo
Kurhat
Mado
Khairpur
Veji
Kasbo
Total ...
MaTibut
Khan Laklier
Obnyo Kandhro ...
Kámal Kulhoro ...
...
Malona
Sher Mahomed
Thari Mahbut
Total ...
Lade-dero ...
...
Grand Total ...
4.—THAR AND PARKAK.
Busta
...
...
Katliiajo Par
Arbiar
...
...
...
...
Parno
Jhainrisarjo Par ...
Klaipra
Fuladee
...
...
Kander
Sahibjo Tar
Mitti
Islamkot
Total ...
5.—UPPER SIND FRONTIER'
Jacobabad ...
Sorki
Drukhan
Kurrampure
Mahamadpur
Garhi Hnsan
...
...
Mirpur
Number of
Lepers.
1
1
2
3
1
1
1
10
1
1
1
1
1
1
1
7
1
234
1
1
1
1
1
1
1
1
1
5
3
4
2
1
24
4
1
1
1
2
1
1
1
KIND OP LEPROSY.
White.
1
1
2
3
1
1
1
10
1
1
1
1
1
1
1
7
1
231
1
1
1
1
1
1
1
1
5
3
2
1
23
4
1
1
1
2
1
1
1
Black.
,,,
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
3
...
1
...
...
...
...
1
•••
...
REMARK*.
164
Táluka.
Kashmor
Deh or Village.
IV.-PROVINCE OF SINB-contd.
5.—UPPER SIND FKONTIEK—contd.
Jhanghl Mazari ...
Guian Mazarí
...
...
...
Fazil Mazari
...
Gondok Rosh
Gihalpur
Garki Rowra Shah
Khalti
Lhahie Labzai
Haibal
Jahan Khan
Bhauan
Total ...
Total for the Province of Sind ...
Number of
Lepers.
2
1
1
1
2
1
1
2
1
1
1
1
1
28
689
KIND OF LEPBOSY.
White.
2
...
1
1
...
1
...
1
1
1
1
1
22
664
Black,
1
• ••
2
1
2
• • •
• • *
• ••
...
6
25
REMARKS.
J. NUGENT,
Acting Secretary to Government.
BOMBAY: PRINTED AT THE GOVERMENT CENTRAL PRESS.
2
leprosy on the dates when the information embodied in the returns was
collected :—
District.
Northern Division,
Ahmedabad..
...
Kaira
...
...
Panch Mahals
...
Broach
...
Surat
...
...
Thána
Kolába
...
...
Total ...
Central Division,
Násik
...
...
Khándesh ...
Poona
...
...
Ahmednagar
Sholápur ...
Sátára
Total ...
Number of
Persons
affected.
5
273
62
48
161
899
452
1,900
665
2,186
1,244
1,080
367
1,226
6,768
District.
Southern Division,
Kaládgi
Belgaum...
...
Dhárwár ...
...
Kánara ...
...
...
Total ...
Sind,
Karachi ...
...
,.
Hyderabad
...
...
Shikárpur
...
,,
Thar and Párkar
Upper Sind Frontier ..
Total ..
Grand Total ..
Number of
Persons
affected.
169
386
207
28
790
6
9
3
1
6
.
25
9,483
This statement, it will be observed, does not include any statistics for the City
of Bombay, for which no returns were called for, or for the District of Ratnágiri,
where a Leper Asylum founded by the munificence of Mr. Dinsháh Mánekji
Petit already exists. The total number of persons suffering from the loathsome
disease of leprosy in the other Districts in this Presidency amounts to 9,483.
The disease prevails only to a very slight extent in Sind and Kánara, to a greater
extent in Gujarat and the Southern Marátha Country, and is common in the
Deccan and the coast districts of Thána and Kolába. The maximum number is
reached in Khándesh where there are no less than 2,186 lepers. The proportion
of the population affected with leprosy to the total population is also highest in
Khándesh, as will be seen from the following table in which the different Dis-
tricts are arranged in the order of decreasing percentages :-—
District;
Khándesh.
...
...
...
...
Ahmednagar
..
...
...
...
Poona
...
•.•
...
...
Kolába
...
...
...
...
•••
Satara
...
...
...
...
..
Thána
Násik
Sholápur ...
Kaládgi
Panch Mahála
Population.
1,237,231
751,228
900,621
381,649
1,062,350
908,548
781,206
582,487
864,014
804,800
614,198
638,493
255,479
882,907
Number of Persona
affected with
Leprosy,
2,186
1,080
1,244
452
1,226
899
665
367
386
273
161
169
62
207
Percentage.
•177
•144
•138-
•118
•115
•098
"085
•063
•044
•033
•0262
•0261
•024
•023
5
4. His Excellency the Governor in Council fully recognizes the desirabilit
of establishing Leper Asylums in this Presidency, especially in the City of
Bombay itself, for the segregation and care of the numerous sufferers. But it
is evident that provision cannotbe made for all the lepers in the Presidency
except at a very great cost—so great that however much His Excellency the
Governor in Council may wish to alleviate the sufferings of lepers, he cannot
undertake to meet the whole of the expenditure with due regard to other claims
on the public revenues. The alleviation of the common sufferings of humanity is
however a work in which the State and the public may alike participate : indeed
what the State cannot, with its limited means and the large calls upon its
resources for the effective maintenance of the administration, undertake to do in
this direction may well be performed by benevolent persons possessing largemeans.
With this view His Excellency the Governor in Council is pleased to direct that
the leper returns now before Government for the Northern, Central and Southern
Divisions of this Presidency and the Province of Sind should be published
with this Resolution in the Bombay Government Gazette, in the hope that they
will attract the attention of wealthy philanthropists both in this Presidency and
elsewhere. In the words of Dr. Carter leper asylums would rank amongst
the fittest of charities, and if sufficiently large donations for their foundation and
maintenance are offered or subscribed by the benevolent, His Excellency the
Governor in Council will have great pleasure in granting such further aid from
the public revenues as the finances will admit.
J. NUGENT,
Acting Secretary to Government.
To
The Commissioner, N. D.,
The Commissioner, C. D.,
The Commissioner, S. D.,
The Commissioner in Sind,
All Collectors including the Collectors and Deputy
Commissioners in Sind,
The Surgeon General with the Government of Bombay,
The Sanitary Commissioner,
Surgeon-Major H. Y. Carter, M.D.
The Accountant General,
The Financial Department of the Secretariat.
With copies
• of the leper
returns.
I P | Q B . 1 0
m . 9 1 . b .
SCIENTIFIC MEMOIRS
BY
MEDICAL OFFICERS OF THE ARMY OF INDIA.
EDITED BY
SURGEON MAJOR -GENERAL J. CLEGHORN, M.D.,
SURGEON-GENERAL WITH THE GOVERNMENT OF INDIA.
PART IX
.
1895.
1.—The Physiological action of Snake-venom.— Brigade-Surgeon-Lieutenant-
Colonel D. D. Cunningham, C.I.E., F.R.S. (Page 1.)
2.—On Milula, a new genus of Liliaceæ from the Eastern Himalaya.—
Surgeon-Captain D. Prain, Indian Medical Service. (Page 55.)
3.—An experimental investigation of the effects of hæmostatic and other
drugs on the intravascular coagulability of the blood.— Surgeon-Lieuite-
•
n a n t L e o n a r d R o g e r s , M . B . , B . S . , L a n d . , F . R . C . S . , E n g
. (
P a g e 5 9 .
)
4.—Is Mycetoma primarily owing to he action of the fungal elements
ordinarily associated with its products ?—Brigade-Surgeon-Lieutenant-
Colonel D. D. Cunningham, C.I.E., F.R.S. (Page 67. )
CALCUTTA :
OFFICE OF THE SUPERINTENDENT OF GOVERNMENT PRINTING, INDIA.
1895.
Price Three Rupees.
SCIENTIFIC MEMOIRS
BY
MEDICAL OFFICERS OF THE ARMY OF INDIA.
EDITED BY
SURGEON MAJOR-GENERAL J. CLEG HORN, M.D.,
S U R G E O N - G E N E R A L W I T H T H E
GOVERNMENT OF INDIA.
PART IX.
1895
.
1.—The Physiological action of Snake-venom.— Brigade-Surgeon-Lieutenant
-Colonel D. D. Cunningham, C.I.E., F.R.S. (Page 1.
)
2.—On Milula, a new genus of Liliaceæ from the Eastern Himalaya
—Surgeon-Captain D. Prain, Indian Medical Service. (Page 55.
)
3.—An experimental investigation of the effects of hæmostatic and other
drugs on the intravascular coagulability of the blood.— Surgeon
-Lieutenant Leonard Rogers, M.B., B.S., Lond., F.R.C.S., Eng. (Page 59.
)
4.—Is Mycetoma primarily owing to the action of the fungal elements
ordinarily associated with its products ?— Brigade-Surgeon-Lieutenant
-Colonel D. D. Cunningham, C.I.E., F.R.S. (Page 67.
)
CALCUTTA :
OFFICE OF THE SUPERINTENDENT OF GOVERNMENT PRINTING, INDIA.
1895.
The Physiological action of Snake-venom.
BY
BRIGADE-SURGEON-LIEUTENANT-COLONEL D. D. CUNNINGHAM,
C. I. E., F. R. S.
IN the course of a prolonged series of experiments, which were primarily
undertaken with a view of testing the efficacy of various reputed remedies for
cases of snake-bite, certain phenomena have presented themselves, appearing to
justify some conclusions in regard to the nature and physiological action of the
venom of Colubrine and Viperine snakes, which appear to be of sufficient interest
to merit publication, and it is accordingly proposed to draw attention to them in
the following pages. Certain of the conclusions are by no means new ; but they
are, at the same time, not in accord with currently-accepted opinion, and, there
-fore, appear to be worthy of renewed discussion in the light of newly-recorded
facts, and, in any case, they have not been arrived at hastily, but as the result
of much experimental work.
Any course of experiments on ordinarily reputed remedies for cases of
snake-bite is somewhat heartless work from the monotonously futile results
which it yields when regarded solely in the light of a quest for practical means
of contending with the action of snake-venom ; but it possesses one great advan
-tage in enforcing the constant employment of minimal lethal doses of the latter
and, therefore, in affording opportunities for the accurate study of the precise
sequence of events occurring in the course of the intoxication,which are not present
in cases where relatively large doses enter the system, and where, consequently,
the progress of the symptoms is much more accelerated.
Various factors would appear to have co-operated to give rise to misconcep
-tions in regard to the precise nature and the physiological action of snake-venoms.
The employment of excessive doses has, in many cases, served to obscure
details in the course of the intoxication by hurrying on the symptoms so rapidly
that their sequence could not be accurately followed ; confusion has arisen from
comparing the results of the action of the venom in different cases in which no
precautions had been taken to secure any accurate parallelism in the proportions
of the doses to the weights of the recipient animals ; the use of fresh venom,
and specially its introduction in the natural fashion by means of bites, has,
probably in some instances, led to the effects of the specific toxins being con
-founded with those of pathogenic organisms which may enter the system along
with them ; and, finally, in so far as Viperine venom is concerned, errors have
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Scientific Memoirs by
crept in from a failure to recognise and discriminate the presence and action of
two distinct toxic principles.
As it has been possible to study the action of the venom of the cobra ( Naia
tripudians, Merr.) and of Russell's viper ( Vipera
russellii Strauch ) most closely,
and as these snakes may fairly be taken as the most lethal representatives of the
families of Ophidia to which they belong, the data and conclusions regarding them
naturally form the first subject for discussion, leaving the question of the extent
to which similar conclusions are applicable in respect to the poisons of other
venomous Colubrine and Viperine snakes for subsequent consideration.
1.—The Physiological action of the venom of Naia tripudians.
Almost all the observers—who, like Fayrer and Brunton, the Members of the
Indian Commission, Wall, Aron and Calmette, have specially studied the physio
-logical action of cobra-venom within recent years—seem to assume that it is
necessarily a primary neurotic poison, acting directly upon the nervous, and
specially the central nervous apparatus to give rise to the characteristic symp
-toms of the intoxication, and finally to cause death by asphyxia dependent on a
paralytic suppression of respiratory movements. When, however, we come to
examine the grounds on which this belief is founded, they certainly do not
appear to possess any conclusive value, consisting, as they do, of observations
showing that the blood, although of extremely dark colour when first removed
from the dead bodies of poisoned animals, ordinarily rapidly brightens on expo
-sure to air, and of the fact that nervous phenomena constitute conspicuous
symptoms during the progress of the intoxication. Now no one can deny either
of these data ; but, at the same time, the question remains whether they warrant
the conclusions which have been derived from them.
Taking them in order we have, in the first place, to consider the question of
the change of colour ordinarily occurring in the blood of poisoned animals on ex
-posure to air. It appears to be assumed that this is conclusive evidence that
no loss of respiratory property can have taken place, and that, therefore, the as
-phyxia, which is the immediate cause of death, is solely dependent on failure of
respiratory movements incident on a directly paralytic action of the venom on
the nervous centres. As a matter of fact, however, the evidence is by no means
conclusive, as it is by no means necessary that the blood should wholly lose its
respiratory capacity in order to the occurrence of fatal asphyxia. This point
has been carefully worked out in connection with poisoning by Carbonic oxide
(CO), and it has been clearly shown that, in order to induce a fatal result, it is
only necessary that a loss of 30 per cent, should occur in the respiratory capacity
of the blood, i.e., that the capacity of absorbing oxygen should be diminished by
30 per cent. But, if this be so, it is clear that blood, which has undergone suf-
Medical Officers of the Army of India.
3
ficient loss in respiratory property to cause death, may still be liable to undergo
very conspicuous changes in colour according to the degree to which it is de
-prived of, or exposed to, the influence of atmospheric oxygen, and, as a matter of
fact, we find such changes occurring in the case of CO-blood. For example,
in the case of a fowl, which had just been poisoned by exposure to an atmos
-phere highly charged with CO, the blood when first removed from the heart was
of a peculiar, brick-red colour, very similar to that which is so frequently present
in the blood in cases of poisoning by Daboia-venom, but, after a brief exposure
to the air, the surface became of an extraordinarily vivid scarlet. The original
colour of the blood in this case must have been dependent on the mixture
of that of CO-hæmoglobin with that of reduced hæmoglobin, whilst that
which it subsequently acquired was the result of a mixture of CO-hæmoglobin
with oxyhæmoglobin. The alteration in colour could not have been con
-nected with any change in the relatively stable CO-hæmoglobin, but must
have been dependent on oxidation of the residual hæmoglobin which had under
-gone general reduction in connection with the antecedent failure and final aboli
-tion of respiratory movements.
Now there can be no question that in cases of CO-poisoning we have to
deal with asphyxia, primarily induced by loss of respiratory property in the
blood, and yet conspicuous changes in the colour of the latter are liable to attend
exposure to atmospheric oxygen. The changes in the blood primarily caused
by the CO imply diminished respiratory property, and this in its turn finally
leads to diminution and cessation of respiratory movements and thus to a cessa
-tion of exposure of the blood to the air, and with this, a secondary factor of
blood-change comes into play, The CO reduces the respiratory property by
replacing unstable oxyhæmoglobin by relatively stable CO-hæmoglobin, and the
ultimate result of this is to occasion diminution and finally cessation of the ex
-posure of the yet unaltered hæmoglobin to the atmospheric air, and therefore to
its reduction.
It is clear, then, that the change in colour which the blood in cases of
death from cobra-venom ordinarily undergoes on exposure to air is no satisfac
-tory and conclusive evidence that the poison has not occasioned alterations in
respiratory capacity in the fluid of sufficient magnitude to give rise to fatal
results. All that the phenomenon does show is that a total loss of respiratory
property has not occurred when death takes place ; but, as we have just seen, it
is quite unnecessary that such a loss should happen in order to induce death.
It will be presently shown that cobra-venom does produce most conspicuous
effects on the respiratory property of blood ; but, in the meantime, assuming that
it may do so, and knowing that a reduction of 30 per cent. in respiratory property
is sufficient to cause death by asphyxia, the colour of the blood after death in
ordinary cases of cobra-poisoning may be taken to be dependent on the presence
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