Indian snake poisons, their nature and effects

Front matter

SWaNanan WONN

NNN

ALBERT R. MANN LIBRARY

Preface

Tue following is an attempt to present in a concise form the chief features of snake-poisoning as seen in India. The object that has been kept in view has been to define, as closely as possible, the conditions on ‘ which the mortality from snake-bite depends, both as regards the physiological nature of the poisoning process, and the relations between the reptiles and their victims, so as to indicate the way in which we should best proceed with the hope of diminishing the fearful mortality that exists.

The observations were made by the author in India under the auspices of the Government. It was during the experiments made for the purpose of finding out the exact cause of the fatal results—one of the first steps that must be taken whenever a method of treatment is sought—that the great and numerous differences in®the effects of the various poisons became manifest.

Although every effort has been made to test the vi PREFACE.

various remedies that have been proposed for snake-bite—and they have been very many—it has not been thought necessary to give the unsatisfactory results of the various trials. The effect of potassium permanganate in destroying the activity of cobra-poison when mixed with it before injection was ascertained by the author some four years ago, but frequent experiment has convinced him that as a practical method of treating the constitutional effects of the poison it is of no avail. The recommendations for treatment given have been tested practically, and the circumstances under which the misfortune happens have been constantly borne in mind. Cases of poisoning by snakes do not usually occur in crowded cities with hospitals always open, with every appliance to receive the sufferer, but in the fields where the peasant steps on the lurking reptile, or more frequently still in the remote village where the wife is bitten in a dark corner of her hut by the snake which superstition has compelled her household to protect. Directions for treatment, to be of use, must be adapted to these contingencies.

The snakes mentioned have been referred to, as a rule, by their scientific names. Had vernacular terms been employed it would not have been possible to select any that would have been intelligible except in very limited areas. Thus the Bungarus ceruleus is the Krait of Bengal, but the Gedi Paragidé of the Cotomandel coast. The Hchis carinata is the Afaé of Delhi,

PREFACE. Vii the Kupper of Scinde, and the Foorsa of Bombay. The word cobra has been used as it is of general acceptance, though quite unknown in any native dialect; we are indebted for it to our Portuguese predecessors. It is to be regretted that its scientific equivalent is Naja instead of Naga, as representing more accurately the Sanscrit Néag, a serpent, in which it had its origin.

Although the gravity of a case of snake-poisoning ‘can hardly be over-estimated, yet it must be considered full of promise that recovery may follow even the severe hemorrhages of viperine poisuning. No wound inflicted by a venomous snake can be despised, yet even when symptoms have developed no case should be considered necessarily fatal. Itis hoped that the suggestions made may be of practical use to those who have to deal with this awful scourge, and that the facts here demonstrated may form a starting point for some more successful departure.

Index

PAGE

117-135.

186-163

LIST OF ILLUSTRATIONS.

I—Tracings of Respiratory Movements of a Fowl under gradual Cobra-poisoning

II.—Respiratory Tracings from a Fowl that died very rapidly from a large dose of Cobra-poison. The Tracings are nearly continuous

III.—Tracings of Respiratory Movements of a ae with Cobra-poisoning

IV.—Tracings of Respiratory sifoidemants of a Cat under the influence of Cobra-poison

V.—Continuous Tracings of Respiratory Movements of a Dog from the moment of Intravenous Injection of Cobra-poison till Death

VI.—Tracings of Respiratory Movements in Fowl under the influence of Daboia-poison .

VII.—Tracings of Respiratory Movements in a Fowl under the influence of Daboia-poison that had been heated to 100° C. : :

VIII.—Tracings of Respiratory Movements of a Dog under Cobra-poisoning .

IX.—Tracings of Respiratory Movements of a Fowl under the influence of the Poison of the

Bungarus fasciatus . . .

Head of the Daboia Russellii, and of the Nie Tripudians (Cobra) é *

Structures found in the Poison of tine aa Tripudians (Cobra) i

Structures found in the Poison of fie Daboia Russellii : . . ‘ 3 ‘ - to face p. 33

INDIAN SNAKE POISONS, THEIR NATURE AND EFFECTS.

Chapter. I

THE PHYSIOLOGICAL EFFECTS OF THE POISON OF THE COBRA (NAJA TRIPUDIANS).

THE inquiry that naturally presents itsclf first in considering the subject of snake-poiscning is:—How does snake-poison kill? and what are the changes it effvcts in the animal system ? And as a consequence of this :— Is there only one poison common to all snakes, or are there several? Upon the answers to these questions depend both the certain recognition of snake-poisoning when it comes under observation, and the indications that must serve as guides to us in the treatment of it. To answer these questions, it will be necessary to examine, with great care, the symptums produced by various poisonous snakes, in order to detect any differences in their effects, paying special attention to those conditions on which the fatal results are dependent, aad any prominent signs that will enable us, with certainty, to say if, in a given case, we have really to deal with theresults of snake-bite, or not.

As the cobra (Naja Tripudians) is at the same time the commonest and the most deadly of all Indian poisonous snakes, it will be best first to consider the symptoms produced by it, and the ways in which its poison may be fatal. To do this it will be necessary to detail a sufficient number of experiments to bring into prominence all the characteristic symptoms of cobra poisoning, and from them to deduce the direct causes of death. We shall then have a standard by which we shall be able to contrast the effects of the poisons of the other species of venomous snakes.

To begin with the symptoms as they occur in human beings; the following is an account, by Dr. Hilson, of a case that came under his own observation :—

“On a night in June, at about half-past 12 o'clock, Dabee, a Hindu punkah coolie, was bitten on the shoulder by a cobra, whilst sleeping. On inspecting the wound, there were found over the prominence of the right deltoid muscle, and about three quarters of an inch apart, two large drops of a clear serous-like fluid tinged with blood, which had apparently oozed from two small punctures, so minute that they could not be perceived by the naked eye. A burning pain was complained of in the neighbourhood of the bite, which rapidly increased in intensity, and extended so as to affect a circular portion of the integument of the size of an ordinary saucer; and, judging from the description given of it, it was very similar in character to that produced by the sting of a scorpion.

“At 12.45 a.m., or about a quarter of an hour after gbeing bitten, he complained of a’ pain in his shoulder ‘shooting towards his throat and chest, and said he was beginning to feel intoxicated ; but there was nothing in his appearance at this time to indicate that he was in any way under the influence of the poison. On the contrary, he was quite calm and collected, and answered all questions intelligently, at the same time that he was fully alive to the danger of his condition. The pupils were not dilated, and they contracted when exposed to the light of a candle; his pulse was normal, and there was no embarrassment of the respiration. About five minutes after, he began to lose control over the muscles of his legs, and staggered when left unsupported. At about o’clock, the paralysis of the legs having increased, the lower jaw began to fall, and frothy and viscid saliva to ooze from the mouth. He also spoke indistinctly, like a man under the influence of liquor. At 1.105a.M. he began to moan, and shake his head frequently from side to side. The pulse was now somewhat accelerated, but was beating regularly. ‘The

1 * respirations were also increased in frequency. He was unable to answer questions, but appeared to be quite conscious. His arms did not seem to be paralysed. At 1.15 aM., twenty-five minims of liquor ammonie were rapidly injected under the skin of the fore-arm ; but aw this produced no results, the basilic vein was laid bare, and twenty-five minims injected into it. :

“The operation caused no amelioration in the symptoms, and the condition was evidently becoming critical. He continued to moan and shake his head from side to side, as if trying to get rid of viscid mucus in his throat. The respirations were laboured, but not stertorous. The external jugular vein of the left side was next exposed, and twenty-five minims of the liquor ammonie injected into it; but without producing any good effect. The breathing gradually became slower, and finally ceased at 144 am., while the heart continued to beat for about one minute longer. No convulsions preceded death, which took place in one hour and five minutes after the infliction of the bite.”

From the description given of the snake, there can be no doubt that it was a cobra, and it is clear that the remedy administered had no more effect’ on the symptoms than it had on the result. It is a good description by a careful observer, and may be taken as a typical example of cobra-poisouing in the human subject.

Qn the lower animals, from which ulone we can learn the detuils of the poisoning process, and the exact causes on which the fatal results depend, the effects of cobra-poisoning are well seen in the following cases.

Experiment I.

e A medium-sized pariah dog had 0°6 cubic centimétre (about 10 minims) of fresh cobra-poison injected subcutaneously. 5.21 p.m. Injection. , 5.23 P.M. Lame in the leg in which the injection was made. 5.29 p.m. Lies down, but does not seem affected. 5.35 P.M. Somewhat sleepy. 5.45 P.M. Got up of its own accord; salivation ; retching. 5.47 P.M. Staggers about, and hangs down its head. 5.48 pM. Cannot stand. 5.49 p.m. Sleepy; respirations 40 per minute. 5.52 P.M. Pulse 72. 5.55 P.M. Convulsions. 5.56 to 5.59 P.M. Convulsions. 6.5 P.M. Respirations quite ceased ; heart beats 84 per minute; pupils commencing to dilate. 6.74 p.m. Heart stopped. Dead.

Experiment LI.

At 10.46 a.M. a pariah dog was bitten in the thigh by a cobra, 11.14 a.m. Very lame in the bitten limb.

11.27 a.m. Affected by the poison; staggers when it attempts to walk; chewing movement of jaw and lips.

11.28 a.m. Salivation.

11.30 a.m. Pupils somewhat small.

11.31 a.m. Attempting to vomit.

11.35 a.m. Respiration becoming slower.

11.87 a.m. Respirations 16 per minute.

11.38 a.m. Copious salivation.

11.39 a.m. Respirations fallen to 12.

11.40 a.m. Respirations of a jerky character.

11.42 a.m. Tongue hanging out of the mouth.

11.43 to 11.45 a.m. Convulsions.

11.46 a.m. Convulsions lessening.

11.47 a.m. Convulsions stopped.

11:474 a.m. Respiration completely stopped ; pupils dilating.

11.49 a.m. Heart stopped. Dead.

Experiment III.

A pariah dog was watched for about an hour, during which his respirations varied from 40 to 62 a minute. His pulse was 120.

At 11.56 a.m. a very small quantity of fresh cobra virus was injected subcutaneously into the left thigh ; the amount injected was about 0°1 cubic centimétre. The dog lay down after the injection, and seemed to take no notice of what had been done.

12.26 p.m. Respirations 44, occasionally a deep respiration ; dozing.

12.32 p.m. Respirations 28; very regular; asleep.

_ 12.85 p.m. Respirations 24; respiratory movement very slight ; still sleeping.

12.48 p.m. Awoke suddenly with a start, probably aroused by flies; chewing movement of lips and jaws.

12.45 p.m. Attempting unsuccessfully to rise; staggered about on his fore-legs.

12.47 p.m. Respirations 26; hardly perceptible, of a somewhat spasmodic character, and lasting an exceedingly short time; salivation.

12.49 p.m. Pupils about normal.

12.50 p.m. Convulsive twitchings of the whole body.

12.52 p.m. Tongue hanging out; convulsions much stronger.

12.55 p.m. No trace of normal respiratory movement, only convulsions: micturition.

12.56 p.M. Pupils slightly contracted.

32.58 p.m. Convulsions are becoming feebler.

12.59 p.m. No convulsive or respiratory movement whatever ; pulse 120.

1.1 p.m. Pulse 96; pupils dilating. The only sign of life remaining is the beating of the heart. 1.2 p.m. Pupils fully dilated; heart stopped. Dead.

Experiment IV.

A pariah dog was bitten by a vigorous cobra. The skin in the middle of the dog’s back, as near as possible at an equal distance from his fure and hind legs, was taken up, and the cobra injected its poison into it.

8.25 a.m. Infliction of the bite.

8.26 a.m. The dog is evidently in some pain from the bite; he turns round and round in endeavouring to lick the bitten part. .

829 4.mM, Is quieter; pupils normal; no symptom.

8.380 a.m. Able to walk and stand perfectly well.

8.31 aM. Pupils normal, neither contracted nor dilated : they answer well to light.

8.85 aM. Slight spasm of diaphragm.

8.386 a.M. Can walk perfectly.

8.39 am. Walks with uncertain tread, as if weak; all the legs equally affected.

8.40 aM. Staggering, but no difference can be observed between the fore and hind legs.

8.41 a.M. Fell over, his fore-legs first giving way ; pupils about normal—at any rate, no tendency to dilatation. ©

8.42 a.m. Lying on his side unable to rise, or even to stand when placed on his legs; all his legs equally weak ; twitching of respiratory muscles, also to a less extent of certain muscles in his limbs. 8.438 am. Tongue protruded. 8.44 a.M. Pupils contracted; all motion ceased ex- ®cept that of: heart. 8.45 aM. Slight spasm of depressors of larynx. 8.46 aM. Heart alone acting; pupils suddenly dilated widely. » 8.47 a.m. Heart stopped. Dead.

Experiment V.

A large cock had two milligrammes (about ‘08 grain) of dried cobra-poison, dissolved in one cubic centimétre of distilled water, injected into its leg. .

3.13 pM. Injecticn.

8.20 p.m. Respirations 80 per minute.

8.84 p.m. Prefers to sit, but can stand and walk.

3.38 P.M. Head drooping, as if the neck were too weak to support it, but from time to time the head is raised with a jerk.

3.39 P.M. Beak rests on ground.

8.41 P.M. Respirations 25; can barely stand.

3.48 P.M. Respiratory movement very slight.

8.50 p.m. Cannot stand.

3.54 p.m. Cannot keep the eyes open.

8.55 P.M. Respirations 19; pupils somewhat contracted.

4.3p.mM. Respirations 16 ; of a somewhat exaggerated character.

4.5 p.M. Comb has become ofa dusky purple colour; slight convulsive movements of body.

4.13 p.m. Slight convulsions.

4.15 P.M. Pupils contracted ; answer to light.

4.20 to 4.22 p.m. Convulsions continuing, but gradually becoming less violent.

4.25 p.M. Pupils widely dilated. Dead.

Experiment VI.

A medium-sized frog (Rana tigrina) had a solution of five centigrammes ("77 grain) of dried cobra-poison, in one cubic centimétre_of distilled water, injected into its dorsal sac.

lpm. No change.

1.23 p.m. Struggling violently to escape.

1.40 p.M. Becoming paralysed.

From these cases it may be gathered that the symptoms of cobra-poisoning are as follow :—

The first manifestation of cobra-poison having pan injected beneath the skin is a sensation of pain in the bitten part. It seems to vary much in degree, but is

THEIR NATURE AND EFFEC'S, j1 usually described, as in the case given, as being of a stinging and burning character. The site of the wound may also become swollen, red, and painful on pressure. The evidence of the pain occurring in dogs is very’ eclear: the animal often turns round and licks the bitten spot; and if it is the leg that is wounded, it either limps on that leg, or, what is more usual, it draws it up, so as to raise it. and relieve it completely of the _weight of the body. This action has been termed paralysis of the bitten leg, due to the local contact of the poison with the muscles. Now, though it can be proved that the local effect of cobra-poison on muscle is to weaken it, yet after the bite of a cobra a very small extent of muscle indeed comes in contact with the poison, very often none at all; and if the limb were really paralysed, it would hang uselessly down, dragging upon the ground, instead of being drawn up.

An interval now occurs before the accession of any fresh symptom, but its length varies greatly in different cases. In that of the man quoted it was fifteen minutes; but this is probably considerably under the average time. In another case, related by the same careful observer, an hour and a quarter elapsed in this way; and an intelligent eye-witness, who described a case with great accuracy as to details, stated four hours was passed before any change was noticed. Taking into consideration all the evidence on the subject, it appears probable that in the majority of cases of cobra-bite in

i)

the human subject, an interval of an hour occurs before any constitutional symptoms are developed. Under certain exceptional circumstances the symptoms of poisoning may begin almost at once. In the case of dogs bitten by cobras this interval varies very greatly—e perhaps fifteen minutes may be taken as its average length, or perhaps a little less.

The retardation of the constitutional symptoms probably means that before cobra-poison can produce any, effect, it must be present in the blood in certain proportion, and, of course, in slow absorption, either due to the small quantity of the poison injected, or to its being injected into an unfavourable situation, some time must elapse before this proportion can be attained. In these cases the symptoms are delayed, as is also the fatal result; whereas, should the poison enter the circulation rapidly, as by injection into a vein, the symptoms and fatal. result follow immediately. At the same time it is clear that for a short time a fatal quantity of poison may be present in the circulation without producing a symptom; for the bitten part may be sometimes amputated before the occurrence of any sign of poisoning, yet, nevertheless, the animal may die. |

In man the first constitutional symptom that cobra-poison produces seems to be a feeling of intoxication, although there appears to be no outward evidence of it. That this symptom is not more frequently described in the history of cases can be easily accounted for by the fact that it would require a certain amount of intelligence on the victim’s part to mention it; and in animals, of course, it is impossible to get proof of a purely subjective condition.

The special symptoms of cobra-poison now rapidly manifest themselves. It man it is very commonly observed that the patient cannot any longer keep his eyes open, and about this time it is found that he is losing power in his legs. When he walks he staggers, and, if left unsupported, falls. The arms seem to retain their strength much longer. In the case of dogs, the animal at this stage can scarcely stand without falling frequently, but there does not seem to be that difference between the anterior and posterior extremities that is ‘ observed in the legs and arms of a man. Usually, a dog loses strength equally on his fore and hind legs, and rolls from side to side helplessly.

The order in which the symptoms now occur varies in different individuals. In some, loss of the power of speech and of raising the lower jaw is shown, and afterwards profuse salivation ; but the salivation may precede. But whichever may occur first, the tongue and the larynx become speedily paralysed; the patient is unable to speak or to clear his throat or to swallow ; and the saliva, which is profusely poured forth, trickles down the lips, the patient being no longer able to eject it voluntarily. In dogs it is not unusual for the saliva- Jy tion to be manifested before any other constitutional symptom, and in them a chewing movement of the jaw and lips is often seen immediately before the salivation. Nausea,.retching, and vomiting are of frequent occurrence both in men and dogs.

The paralysis now becomes more general and decided. The patient lies on his back, almost incapable of movement. He threatens to be suffocated by the saliva running into his paralysed larynx ; should, however, the head be placed on one side, the abundant secretion will flow down his lips. His limbs at this time may be subject to startings and muscular twitchings. His breathing becomes slower and slower, and the respiratory excursus is lessened. He appears to be conscious, but is unable to express himself, through the paralysis of his larynx and tongue; but it is not unfrequently the case for the victim to become quite unconscious. The action of the heart is somewhat quickened, but the organ acts with fair strength. At length the breathing, too slow and too slight to support life, ceases, and with or without general convulsions the heart shortly after stops.

In dogs, as might be expected, convulsions are much more common than in man, being very generally present ; and while in man the extinction of the respiratory act is, as a rule, a very slow and gradual process, in dogs itis not unusual for respiration to stop quite suddenly, and almost immediately after for its place to be taken by violent convulsions.: c

In birds the symptoms are usually very regular in their occurrence. There is the same appearance of local pain. The bird then generally seems drowsy, from its being unable to keep the eyes open, the head droops as if the neck were unable to support it, but the bird constantly recovers itself with a jerk. It at last sinks down to the ground, ultimately falling over on its side, unable to raise either its head or itself. The pupils are, as a rule, somewhat contracted, the eye often watering. The respirations finally become exceedingly slow, and then cease, convulsions and death following. It sometimes happens, as in mammals, that the respiratory centre is almost simultaneously stimulated and paralysed, the bird dying at once.

In the amphibia, there can scarcely be said to be any symptoms of cobra-poisoning ; the frog, for instance, only becomes more and more sluggish and paralysed, and is at last found to be dead.

It will be necessary to consider some of the more important conditions in detail, after having noticed the appearances to be found after death.

_ PosT-MorTEM APPEARANCES IN CasES OF DEATH BY CoBRA-BITE.

Rigor mortis generally comes‘on about the usual time ® . . . . and is as well marked as it is in death from ordinary causes. The blood in man is fluid, as a rule, and in the lower animals coagulated. If examined directly after death no changes can be recognised by the microscope. After a time the corpuscles may change in shape, become crenated, and blood-crystals may form, but at the moment of death no change can be recognised. The, parotid glands may be swollen. The brain presents no marked deviation from normal. The veins of the pia mater are usually gorged with blood, and the ventricles often contain turbid fluid. The muscles are often of a dirty red colour. The sub-cutaneous veins bleed freely” on section. The lungs may be pale and contain but little blood, but in the human subject they are generally found congested, the bronchi and the smaller tubes being often filled with a thin frothy fluid, and their lining membrane intensely injected. Occasionally portions of food or of remedies are to be found in the air-tubes, the result of administratiou while the larynx was paralysed. The heart is distended with blood, especially the right side. The liver bleeds freely on incision, and is quite dark from contained blood, but this is not universal. The kidneys vary from normal to excessive congestion, being seen in all stages. The stomach may, or may not, contain food—a proof that cobra-poisoning in the human subject does not always cause evacuation of the contents of the stomach. There is no regular change in the intestinal tract, which may be injected in places. The bladder is generally firmly contracted. :

LocaL Errects oF COBRA-POISON.

It has been mentioned that severe pain is generally felt in the region of the cobra-bite. There are, however, gases on record which seem to prove that the intense mental shock of snake-bite renders the victim occasionally. insensible to the pain. This pain is accompanied by, or rather is dependent upon, a very characteristic local condition, which is of the utmost practical import- ‘ance. If the body of a man or animal killed by snake-bite be examined, there may be scarcely a sign on the skin to mark the spot where the snake inflicted its bite ; or possibly one or two small punctures, or even ascratch, may be found, especially if the part bitten be the fingers, which, of course, are apt to be forcibly and involuntarily retracted when the bite is felt. It may even happen that the part is slightly swollen or discoloured. But whatever may be the condition of the external aspect,

* there will be found a distinct change in the state of the parts beneath. Jf an incision be made through the skin and carried through the punctures made by the snake’s fangs, very little difference will be found in the true skin. It may be alittle more injected than normal, and the punctures will be found to be intensely so just at the edges, and a small quantity of blood may be effused there. But the areolar tissue lying beneath the true skin ‘is the site of the chief change. It will generally be seen to be of a purple colour, and to be infiltrated with alarge quantity of coagulable purple blood-like fluid. In addition to this effusion the whole of the neighbouring vessels are intensely injected, which injection gradually fades as the site of the poisoned part is receded from, so that a bright scarlet ring surrounds the purple area, and this in itsturn gradually fades into the normal colour of the veighbouring tissue. At the margin, also, the purple blood-like effusion is replaced by a pinkish effusion, which wells out as the incision is made. This effusion of pinkish fluid may often be traced up in the tissues surrounding the vessels which conveyed to the system the poison they had absorbed from the part. In one case, in which the victim was bitten on the hand, the effusion from the veins could be traced as high as the elbow. These are the essential characters of the local effects produced by cobra-bite ; but they may vary a good deal in degree, depending, probably, upon the amount of poison injected and the time the subject lived after being bitten. It has been asserted that the nature of these local changes in snake-bite is merely a hemorrhage into the tissues from vessels that have been divided by the fangs of the snake, with effusion of blood from the vessels around. But though it is true that sometimes a very small amount of blood may be found at the site of the punctures, yet it is clear that this explanation will not account either for the great pain that is felt in the part, or for the intense injection of the neighbouring vessels. To determine the

THEIR NATURE AND EFFEOTS. 19 nature of these changes, dissections were made both on the human subject and on the lower animals of individuals that had died of snake-bite ; also incisions were made into the tissues at the place where snakes had éitten at various intervals after the bite. The result of these observations is to show that directly after the poison is injected into the tissue its vessels become enlarged and gorged with blood, effusion is poured out dammediately; and as the engorgement and stagnation of blood increase the effusion becomes more blood-like, from its containing more of the contents of the vessels. Now, these processes are singularly rapid in occurring. In an animal that only lived thirty seconds after the injection of the poison, a well-marked circle of vascular injection was found at the site of the poison. In another case, in one minute sufficient effusion had been poured out to attract the attention of a casual observer.

Should the animal recover from the constitutional effects of the poison, the result of these local changes will be profuse suppuration and sloughing of the parts in which the poison was deposited. Now, simple effusion of blood is very rarely followed by suppuration. In scurvy and allied diseases, and after injuries, we constantly see effusions of blood rapidly absorbed as recovery proceeds. Again, effusion of blood is seldom attended by pain. Moreover, by using solutious of cobra-poison of different strengths any degree of local mischief can be produced—from an engorgement and

9 * od acute effusion that scarcely differs from blood, to a slight hyperemin attended with a pale serous-like effusion.

From these considerations it appears evident that the local effect of cobra-poison is simply severe and acute inflammation, to which the pain attending cobra-bite ig due, with a more than ordinary tendency to effusion from the blood-vessels. Corroborative testimony to what is here advanced must be present to the mind of everyone who has had much to do in the manipulation, of cobra-poison. A very frequent, but involuntary, experiment is to get some of ‘the poison into the eye. Should the circumstance not be at once noticed, so as to permit the eye being washed out immediately, after a very short time a smarting pain is felt in it; and if it is examined it will be found red and watering, the vessels becoming rapidly enlarged, and, in fact, an acute attack of conjunctivitis with chemosis is set up, which may last for days.