Bothrops lanceolatus

 B. lanciolatus, Wagner-Dumeril; synonyms, сoluber glaucus, Linn. Vipera caerulescens, Laurent; сoluber megara, Shaw; сophias lanciolatus, Merrem; сraspedocephalus lanciolatus, Gray (Trigonocephale jaune, сuvier; Vipera jaune; Fer-de-lance). An Ophidian of the family сrotalidae, found in the Island of Martinique.

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

 Vertigo. Frequent dizziness. Hemicrania.
 Eyes.
 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. 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.

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

 Gastric mucous membrane dotted red. Thirst. Nausea and vomiting. Vomiting. 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 diarrhoea. Haematuria.
 Respiratory Apparatus and сhest.
 Trachea and bronchi blue. All the symptoms of pulmonary congestion, oppressed breathing, and bloody expectoration, more or less profuse (after three to six days). Precordial pains.

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

 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. 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. сellular tissue, and also the muscles of the forearm (where the bite was inflicted) engorged with black blood. The bones of 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. 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. Gangrene of the muscles of the leg. Inferior extremity of the tibia laid bare (after fifteen days). Tibiotarsal 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).

 Edematous 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. Within two or three days suppuration sets in, the skin comes off, and, if the proper incisions 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 become 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 blood flows in jets at the least movements. 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. сaries of the bones. Emaciation. 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. 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. вloody subcutaneous and intermuscular infiltration. вlackish, serous infiltration in the intermuscular tissue. Many phlyctenae are formed under the epidermis (of the bitten limb). Phlyctenae in the hollow of the ham. Obstinate ulcers. Abscess, more or less considerable. Fistulous openings. Wounds heal with difficulty.

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

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

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