CHAPTER VIII.

_PHYSIOLOGY OF POISONING_ (_continued_).

ACTION OF VENOMS ON THE BLOOD.

On making an autopsy of an animal which has succumbed to intoxication

by snake-venom, we find that the blood in the heart and large vessels

is sometimes coagulated into a mass, sometimes entirely fluid, and

that, in certain cases, it is as black as prune-juice, while in others

it is of a fine transparent red colour.

These differences in the effects of venom upon the blood are due to the

fact that the various venoms contain in variable proportions, besides

the _neurotoxic_ substance which represents the true venomous _toxin_,

other substances which act, some upon the plasmasia or fibrin-ferment,

or upon the fibrin, others upon the red corpuscles, others on the

leucocytes, and others again on the endothelium of the blood-vessels.

A.--EFFECTS OF VENOM ON THE COAGULATION OF THE BLOOD.

It was observed long ago by Fontana[29] that after viper-bites the

blood remains fluid, and Brainard[30] on the contrary, pointed out

that, in the case of animals that succumb very rapidly after having

been bitten by a _Crotalus_, the blood was always found coagulated into

a mass, while, when a certain interval of time had elapsed since the

bite, it remained fluid. Weir Mitchell[31] explained these differences

by the hypothesis that, in cases of rapid death, the blood had not had

time to become modified by the venom.

Later on it was found by Sir Joseph Fayrer, and subsequently by

Halford,[32] in Melbourne, C. J. Martin,[33] in Sydney, G. Lamb,[34]

in Bombay, and recently by Noc, in my laboratory, that the venoms

of COLUBRIDÆ, especially those of _Naja tripudians_ and

AUSTRALIAN species of this family, always leave the blood

fluid after death, while the venoms of VIPERIDÆ, on the

contrary, are usually coagulant.

On the other hand, it was observed by Phisalix,[35] and at an earlier

date by Mosso, of Turin, that the venom of _Vipera berus_ causes the

blood of the dog to lose its coagulability, while, on the contrary, the

same venom is actively coagulant as regards the blood of the rabbit.

How are these differences of action to be explained? It was found by

Delezenne,[36] who made an excellent study of the phenomena following

the injection of peptone, extracts of organs, and other anticoagulant

substances into the organism, that those of these substances that

render the blood non-coagulable always dissolve the leucocytes, and

thus set at liberty two antagonistic bodies which they contain. One of

these substances is coagulant and is found retained by the liver, while

the other remains in solution in the plasma, and keeps the blood fluid

after issuing from the vessels.

Now, certain extracts of organs, ricin, abrin and certain venoms in

weak doses, retard coagulation, while in large doses, on the contrary,

they produce partial or general intravascular clotting.

It is believed by Delezenne that the explanation of this phenomenon

may be that the doses, which are weak but sufficient to produce the

disintegration of the leucocytes, injure the red corpuscle in only a

slight degree, while the stronger doses are equally destructive to the

two kinds of blood corpuscles.

It follows that we must understand that there are two phases in the

action of venoms: one _negative_, when the dose absorbed does not

injure the leucocytes; the other _positive_, when the leucocytes are

destroyed.

If the blood of the dog remains non-coagulable when mixed with doses of

venom which, on the contrary, are actively coagulant for the blood of

the rabbit, the reason would be that the leucocytes of these animals

are not equally resistant to venom.

This conception, however, does not conform to the facts that I have

myself observed. I have always found that viper-venom, mixed with

citrate- or oxalate-plasma of the dog, rabbit, or horse, coagulates

these various plasmas when the venom is in weak doses, while with

strong doses coagulation is not produced. To be quite accurate, it

should be stated that the quantity of venom necessary to render the

plasma of the dog, or of the horse, non-coagulable is less than that

which must be employed in the case of the plasma of the rabbit.

I have caused Noc to take up anew the study of this question in my

laboratory, with venoms of nine different origins, and I here give a

_résumé_ of the results of his researches.[37]

I. COAGULANT VENOMS.

The venoms of VIPERIDÆ studied range themselves as follows

according to their coagulant power:--

CROTALINÆ: _Lachesis lanceolatus_ (Fer-de-lance, Martinique).

_Lachesis neuwiedii_ (Urutù, Brazil).

_Lachesis mutus_ (Bushmaster, or Surucucu, Brazil).

_Lachesis flavoviridis_ (Japan).

VIPERINÆ: _Vipera russellii_ (Daboia, India).

The venoms of _Ancistrodon contortrix_ and _A. piscivorus_

(CROTALINÆ) proved entirely inactive.

No COLUBRINE venom exhibited coagulant power, whatever the

dose employed.

There is, therefore, a very decided difference between venoms of divers

origins as regards their effects upon the coagulation of the blood.

Noc has determined more especially the coagulant action of the

venom of _Lachesis lanceolatus_ (Fer-de-lance of Martinique) upon

1 per cent. citrate-plasmas, 1 per cent. oxalate-plasmas, 4 per

cent. chloridate-plasmas, and upon blood rendered non-coagulable by

extract of leeches’ heads. He found that, while weak doses of venom

(1 milligramme per cubic centimetre of horse- or rabbit-plasma)

produce coagulation in a few minutes in the citrate-plasmas,

chloridate-plasmas, or those treated with extract of leeches, the doses

of the same venom greater than 4 milligrammes on the contrary suppress

the coagulability of these plasmas, even when there be added to them

doses of chloride of calcium (for the citrate- and oxalate-plasmas), or

of distilled water (for the chloridate-plasma), or of fibrin-ferment

(for the plasma treated with leech-extract) sufficient to cause rapid

coagulation in the control tubes that do not contain venom.

Noc also observed that the venom of the same species of snake

(_Lachesis lanceolatus_), when heated to 75° C., entirely loses its

coagulant properties; and that, with a temperature of 58° C., its

coagulant power already commences to diminish. When heated for thirty

minutes at a temperature of 65° C., a dose of 1 milligramme does not

coagulate more than 1 c.c. of citrate-plasma in one hour. G. Lamb has

likewise found that the venom of _Vipera russellii_ loses its coagulant

power when heated to 75° C.

The coagulant substance in these venoms is precipitable by alcohol at

the same time as the _neurotoxin_ and other active substances. The

precipitate, when dissolved again in physiological water, preserves all

the properties of the original solution.

Antivenomous _anticolubrine_ serum, that is to say, that furnished by

horses vaccinated against the venoms of the _Cobra_ and the _Krait_,

does not prevent coagulation by coagulant venoms. This need not

surprise us, since the coagulant substances in venoms are destroyed by

heating, and the animals vaccinated in order to obtain antitoxic serum

are usually inoculated exclusively with heated venoms.

It is easy, however, to obtain active serums specific against

the coagulant venoms; it is sufficient to treat these animals by

inoculation with progressively increasing doses of the same venoms

unheated. I have had no difficulty in achieving this result with

small laboratory animals (guinea-pigs and rabbits) and also with the

horse, but I have never had at my disposal a sufficient amount of the

venoms of _Lachesis_ or _Vipera russellii_ to undertake with them

the regular acquisition of large quantities of horse-serum, at once

_antineurotoxic_ and _anticoagulant_. The preparation of such a serum,

nevertheless, presents much interest for certain countries, such as

Burma, where the Daboia (_Vipera russellii_) is almost as common as

the Cobra, and Brazil, where nearly all the casualties due to venomous

snakes are produced by _Lachesis_.[38]

II.--ANTICOAGULANT VENOMS.

Contrary to what is observed with the venoms of VIPERIDÆ

in general, all the venoms of COLUBRIDÆ and, as exceptions

to the rule, the venoms of some North American CROTALINÆ

(_Ancistrodon contortrix_ and _A. piscivorus_) suppress the

coagulability of the blood _in vivo_ and _in vitro_. It is, however,

important to observe that, _in vivo_, the blood remains fluid after

death only if the dose of venom absorbed has been sufficient. _In

vitro_ this phenomenon is easier to study, and has been the subject of

several important memoirs.

Halford,[39] Sir Joseph Fayrer,[40] C. J. Martin,[41] Delezenne,[42]

Phisalix,[43] and lastly Noc,[44] have shown that the venoms of

COLUBRIDÆ exert a manifestly anticoagulant action upon

citrate-, chloridate-, or oxalate-plasmas, and also upon blood mixed

with venom on issuing from the vessels.

On adding 1 milligramme of _Cobra_-, _Bungarus_-, Australian

_Pseudechis_-, or _Ancistrodon_-venom to 1 c.c. of citrate-, oxalate-,

or chloridate-plasma, and supplementing the mixture, after varying

periods of contact, with a quantity of chloride of calcium (for the

citrate- or oxalate-plasmas), or distilled water (for the saline

plasma) sufficient to produce coagulation in a few minutes in the

control tubes without venom, we find that coagulation no longer

takes place after one hour in the tubes containing _Cobra_- or

_Bungarus_-venom, and after ten minutes in those that contain the venom

of _Ancistrodon_.

In doses less than 1 milligramme for 1 c.c. of plasma, these venoms

by themselves never produce coagulation as do those of _Lachesis_

or _Vipera russellii_. They are thus sharply differentiated in this

respect.

If fresh blood issuing from the arteries of an animal be received in

a vessel containing a sufficient quantity of COLUBRINE-venom

(that of the Cobra for example), and steps be immediately taken to

ensure the perfect mixture of the venom and the blood, we find that the

latter has entirely lost its coagulability, just as though it had been

mixed with peptone or extract of leeches’ heads.

Again, if a mixture be made _in vitro_ of coagulant venoms, such as

that of the _Lachesis_, with anticoagulant venoms such as that of the

_Cobra_ or of _Ancistrodon_, it is found that these mixtures, when

properly effected, become neutral, so that the respective effects of

the component venoms are entirely destroyed. Assuming, for instance,

that 1 milligramme of _Lachesis_-venom coagulates in two minutes 1 c.c.

of 1 per cent. citrate rabbit-plasma, if we add to the plasma firstly

1 milligramme of _Ancistrodon_-, or 1 milligramme of _Cobra_-venom,

and then 1 milligramme of _Lachesis_-venom, the plasma remains

non-coagulated, yet coagulates perfectly on the subsequent addition of

1 c.c. of a ½ per cent. solution of chloride of calcium.

There is, therefore, a real antagonism between the actively coagulant

substance contained in certain VIPERINE venoms and the

anticoagulant substance comprised in the venoms of certain other

VIPERIDÆ (_Ancistrodon_), belonging to the subfamily

CROTALINÆ, and in those of all the COLUBRIDÆ.

The conclusion to be deduced from the foregoing facts is that the

venoms of COLUBRIDÆ and those of certain VIPERIDÆ

are decidedly _anticoagulant_, while the majority of the venoms

of VIPERIDÆ, on the contrary, possess strong _coagulant_

properties, even when mixed with blood in infinitesimal doses.

The question therefore arises why these _coagulant_ VIPERINE

venoms suppress the coagulability of the blood when mixed with it

_in vitro_ in strong doses (for example, in doses beginning from 4

milligrammes of _Lachesis_-venom, or 7 milligrammes of the venom of

_Vipera russellii_ for 1 c.c. of 1 per cent. citrate rabbit-plasma).

The explanation of this apparently contradictory phenomenon is

furnished by the intense proteolysis that these VIPERINE

venoms exert upon fibrin, in solution or coagulated. This proteolysis

actually manifests itself with weak coagulant doses, for the compact

clots formed at the outset soon become soft and then dissolve, like

a cube of egg-albumen in an experiment in artificial digestion by

trypsin. We shall revert to the subject later on.

III.--MECHANISM OF THE ANTICOAGULANT ACTION OF VENOMS ON THE

BLOOD.

The anticoagulant action of the venoms of COLUBRIDÆ and of

_Ancistrodon_ upon the blood appears to take effect in the first place

upon the fibrin-ferment, and afterwards upon the fibrin by proteolysis.

The action on the fibrin-ferment seems manifest when we experiment with

anticoagulant venoms which are feebly proteolytic, like the venom of

the _Cobra_.

I have already stated that a mixture of fresh blood with a sufficient

dose of _Cobra_-venom is non-coagulable, as though the blood on issuing

from the animal had been mixed with peptone or leech-extract. But,

while blood when peptonised or mixed with leech-extract coagulates

readily on the subsequent addition of fibrin-ferment, blood mixed with

venom remains positively non-coagulable. It is the same with citrate-

or oxalate-plasmas, which no longer coagulate when chloride of calcium

is added to them, and with 4 per cent. saline plasma on the addition of

distilled water.

The anticoagulant substance in the venoms of COLUBRIDÆ and

_Ancistrodon_ is precipitable by alcohol, like the coagulant substance

in the venoms of VIPERIDÆ and like the _neurotoxins_, from

which it is difficult to separate them. The separation can nevertheless

be effected by the aid of heat, if we make use of certain venoms that

are particularly resistant to high temperatures, such as those of the

_Cobra_ or the _Krait_. These latter venoms, when heated for one hour

at 70° C., cease to be anticoagulant, and _preserve their toxicity

unimpaired_. It is, however, impossible to suppress the toxicity

without at the same time destroying the anticoagulant substance.

_Antivenomous serum_ completely protects citrate- or chloridate-plasmas

against the anticoagulant action of venoms. It is sufficient to mix

½ c.c. of 4 per cent. saline antivenomous serum with 1 c.c. of 4

per cent. saline plasma to ensure that the subsequent addition of 1

milligramme of _Cobra_-venom to this mixture remains without effect

upon the coagulability of the latter. If, after a contact of two hours

or more, 2 c.c. of distilled water be added, coagulation is produced

just as in saline plasma without venom.

B.--EFFECTS OF VENOM UPON THE RED CORPUSCLES.

(1) _Hæmolysis._--The hæmolytic properties of venoms, that is to say,

their faculty of dissolving the red corpuscles, have been the subject

of very important researches on the part of a number of investigators

during the last few years (W. Stephens,[45] Flexner and Noguchi,[46]

Calmette,[47] Phisalix,[48] Preston Kyes and Hans Sachs,[49] Noc[50]).

The different venoms are all hæmolytic, but in very variable doses.

It is possible to make a very precise comparative study of them from

this special point of view by taking as a base for each venom, as was

done by Noc, the unital dose of 1 milligramme (or one-tenth of a cubic

centimetre of a 1 per cent. solution freshly prepared and not filtered,

the filtration through porcelain retaining an appreciable part of the

active substance), and noting the time strictly necessary for this dose

of 1 milligramme to dissolve completely, _in vitro_, 1 c.c. of a 5 per

cent. dilution of red corpuscles of the horse in physiological saline

solution.

It is very important, before allowing the venom to act on the red

corpuscles, to first wash the latter by means of several successive

centrifugings with 8 per 1,000 physiological saline solution.

It is also better to choose the corpuscles of the horse in preference

to those of other species of animals, since they exhibit a nearly

constant mean sensitivity. The corpuscles of the ox, goat, sheep, and

rabbit are less sensitive. Those of man, the guinea-pig, and the rat,

on the contrary, are more so.

On experimenting with _washed_ corpuscles, it is found that venom alone

is incapable of dissolving them. In order that dissolution may take

place, we are obliged to add to the mixture either a small quantity of

normal horse-serum, preferably _heated_, and, consequently, deprived of

alexin (Calmette), or ½ c.c. of a 1 in 10,000 solution of _lecithin_ in

physiological saline water (P. Kyes).

Venom, therefore, is capable of hæmolysing red corpuscles only when

it is _quickened_, either by heated normal serum, or by lecithin. The

solution of lecithin employed for this purpose should be prepared

by dissolving 1 gramme of lecithin in 100 grammes of pure methylic

alcohol. Taking 1 c.c. of this dilution we add it to 9 c.c. of 8 in

1,000 saline solution, and make a second dilution of 1 c.c. of the

foregoing mixture in 9 c.c. of saline water. This latter dilution of 1

in 10,000 is utilised as the reagent.

Let us now see how the serum or lecithin acts. It has been shown by

P. Kyes that with either of these substances the mechanism of the

hæmolytic action is the same, for the serum quickens the venom only

through the agency of the free lecithin it contains. The lecithin takes

part in the reaction by combining with the venom to form a hæmolysing

_lecithide_ more resistant to heat than its two components, for it may

be heated for several hours at a temperature of 100° C., without the

loss of any of its properties.

When venom is brought into contact with certain kinds of highly

sensitive red corpuscles, those of the rat for example, these

corpuscles, although washed and freed from serum, may undergo

hæmolysis. This result is due to the fact that these corpuscles contain

sufficient quantities of lecithin, which becomes liberated from

their protoplasm and, uniting with the venom, constitutes the active

_lecithide_.

It was already known that lecithin is capable of combining with various

albuminoid matters and with sugars to form _lecithides_. We must not,

therefore, be surprised to find that such a combination may take place

with the proteic substances in venom. The combination in this case is

a truly chemical one. Lecithin in its natural state, or that which is

normally found in serums which quicken venom, such as horse-serum,

even when heated to 65° C., therefore plays the part of _complement_

according to Ehrlich’s theory, or that of _alexin_ according to the

theory of Bordet, while venom itself would be an _amboceptor_ or

_sensitiser_.

This is not, however, the way in which the phenomenon should be

understood, for it is impossible to admit the identification of heated

serum or lecithin with the complementary substances or alexins, seeing

that the essential characteristic of the latter is that they are

intolerant of heat and become entirely inactive on being raised to a

temperature of 58° C., or even by simply being kept for a few days

exposed to the air and light. We must therefore suppose, with P. Kyes

and H. Sachs, that the red corpuscles themselves contain substances

capable of playing the part of complements (_endo-complements_), and

that it is with these that the venom combines when quickened by the

presence of lecithin or heated serum, the latter only acting because it

contains free lecithin.

All substances that contain lecithin, such as bile, hot milk, or

cephalin, are capable of exerting the same quickening action, but do

not themselves possess any inherent hæmolytic power.

_Cholesterin_, on the contrary, represents a kind of antidote to

lecithin, as also to normal serums. It prevents hæmolysis of the red

corpuscles in a mixture of washed corpuscles and venom, yet it does not

in any way modify the properties of true alexins or complements.

Moreover, no correlation exists between _lecithides_ and the

_neurotoxin_ in venoms. The combination lecithin + venom possesses

_hæmolytic_ action, but is in no way _neurotoxic_. Conversely, venom

can be freed from its groups of molecules combinable with lecithin, and

remain _neurotoxic_.

_Lecithide_ is insoluble in ether and acetone, but soluble in

chloroform, alcohol, toluene, and water. Its properties are therefore

entirely distinct from those of its two components. It precipitates

slowly from its aqueous solutions, without losing its hæmolytic power;

it does not show _biuret_-reaction; it dissolves with equal readiness

the red corpuscles of all species of animals, and its effects, like

those of venom, are impeded by cholesterin.

Kyes has succeeded in obtaining lecithides with all the hæmolytic

venoms that he was able to study: thus he has prepared lecithides

from _Lachesis lanceolatus_, _Naja haje_, _Bungarus_, _Lachesis

flavoviridis_, and _Crotalus_. It is therefore probable that the

_lecithinophile_ group exists in all venoms, even when these differ as

regards their other properties.

A wide range of difference is exhibited by the various venoms, as

regards their hæmolysing power in the presence of normal heated serum

or lecithin. The venom of _Naja_ and that of _Bungarus_ are the most

active. The action of the venoms of VIPERIDÆ, and especially

of those of _Crotalus_, is very weak. For example, while 1 milligramme

of _Cobra_-venom dissolves in from five to ten minutes 1 c.c. of a 5

per cent. dilution of red corpuscles in the presence of lecithin or

normal heated serum, the same dose of the venom of _Vipera russellii_

takes thirty minutes to effect the dissolution, and the venom of

_Lachesis lanceolatus_ takes three hours.

P. Kyes and H. Sachs have discovered the apparently paradoxical

fact that, if to the red corpuscles of certain species of animals

_Cobra_-venom be added in increasing doses, hæmolysis augments up

to a certain point, beyond which the destruction of the corpuscles

shows progressive diminution. In a large dose _Cobra_-venom no

longer produces any effect upon the corpuscles of the horse, for

example, even when the venom is added in presence of a great excess

of lecithin or heated serum. It would seem, then, that, according to

the theory of Ehrlich, under the influence of an exaggerated amount

of venom-amboceptor there is produced a deviation on the part of the

complement (serum or lecithin), and that the latter, instead of fixing

itself upon the corpuscles, becomes united with the surplus fraction of

the amboceptors, which has remained free in the liquid.

Noguchi,[51] resuming the study of this extremely curious action of

strong doses of venom, observed that the red corpuscles of certain

species of animals (such as the horse for example), when previously

washed and held in suspension in a physiological solution of sea-salt

containing 4 per cent. of _Cobra_-venom, acquire a considerable

augmentation of resisting power with regard to various physical and

chemical agents. In consequence of this they are no longer hæmolysed by

distilled water, ether, or saponin.

Nevertheless, acids or alkalies, except ammonia, destroy corpuscles

treated with venom more easily than those in their normal condition.

If corpuscles, previously treated with a strong dose of venom, are

subjected to repeated washings in physiological saline solution,

the special resistance acquired by them in the presence of the

venom disappears; they even become more sensitive to the action of

destructive agents, such as water, ether, or saponin.

The principle contained in venom, to which must be attributed the

protective action, is not destroyed by heating to 95° C., although

at this temperature _Cobra_-venom becomes partially coagulated.

Moreover, the protective substance is contained in the coagulum, while

the _hæmolysin_ remains entirely in the filtrate. The agglutinin of

venom, on the other hand, is destroyed at a temperature of 75° C. The

protective substance, therefore, can be identified neither with the

hæmolysin nor with the agglutinin.

It follows that it is impossible to accept the hypothesis of the

“deviation of the complement” suggested by Kyes and Sachs to explain

the innocuousness of strong doses of venom. Besides, it would be

difficult to reconcile this hypothesis with the fact, observed by

Noguchi, that venom in a strong dose protects corpuscles, not only

against the action of lecithin (complement), but also against distilled

water, ether, &c.

Noguchi, seeking more thoroughly to elucidate the mechanism of this

protective action, finds that _Cobra_-venom forms a precipitate with

blood-serum, when the latter is relatively poor in salts or when it is

dilated with water. It likewise forms a precipitate with the aqueous

extract of red corpuscles, and precipitates the globulins, hæmoglobin,

or globin of the corpuscle, when treated separately. The precipitates

are insoluble in water, but dissolve with the assistance of a small

quantity of acid or alkali, and also in a great excess of saline

solution.

Noguchi supposes that red corpuscles, when treated with strong

solutions of venom, are protected against destructive agents on account

of the formation by the venom and certain constituents of the corpuscle

(chiefly hæmoglobin) of a compound insoluble in water. When this

compound is removed by repeated washings in physiological solution, the

corpuscles can easily be hæmolysed afresh by the ordinary destructive

agents. Venom, none the less, exerts a noxious influence upon the

corpuscles in all cases; but when strong solutions are employed, this

effect is masked by the protective action.

All kinds of red blood corpuscles are not equally sensitive to the

protective action of strong doses of venom. In this respect all degrees

are observed in the action of venom. Thus the corpuscles of the dog are

not protected at all by _Cobra_-venom. But it is interesting to observe

that this venom in no way precipitates either the aqueous extract of

dog’s corpuscles, or the hæmoglobin, or the globin of this animal.

The venom of _Crotalus_ and that of _Ancistrodon_ likewise possess

protective power, which is, however, less marked than in the case of

_Cobra_-venom.

Noguchi finally points out that corpuscles treated with venom are

not hæmolysed by fluorescent substances such as eosin. They are also

refractory to the hæmolysing action of tetanolysin.

The resistance of the hæmolysins of venom to heat (which, according to

Morgenroth, may extend to heating for thirty minutes at a temperature

of 100° C.) explains how it is that the serum of horses immunised by

means of venoms heated to 72° C. is distinctly antihæmolysing, and

capable of perfectly protecting the red corpuscles _in vitro_ and _in

vivo_.

I have been able to prove that the _antineurotoxic_ property of

antitoxic serums with regard to the venoms of COLUBRIDÆ is

pretty much on a par with their antihæmolysing property, so that

it is possible to measure _in vitro_ the antitoxic activity of a

serum by establishing the degree of its antihæmolysing activity.

Thus we see that a serum, which is antitoxic and antihæmolytic with

respect to the venom of _Naja_, is likewise antihæmolytic as regards

the other COLUBRINE-venoms, and even certain venoms of

VIPERIDÆ. Here we have a very important fact, for it enables

us to measure _in vitro_ the activity of antivenomous serums.

(2) _Precipitins of Venoms._--The serum of rabbits treated with

increasing doses of _Cobra_-venom precipitates the latter in more

or less concentrated solution. It has no effect as regards other

venoms. On the other hand, the serum of a strongly immunised horse,

the antivenomous power of which was pretty considerable, gave no

precipitate with _Cobra_-venom; the formation of precipitate is

therefore entirely independent of that of antitoxins (G. Lamb).[52]

(3) _Agglutinins of Venoms._--Besides their hæmolytic action,

it is easy to observe that certain venoms, especially those of

VIPERIDÆ, agglutinate the red corpuscles, and that the

substance that produces this agglutination is different from the

hæmolysing substance; for it acts rapidly at a temperature of O° C.,

at which hæmolysin manifests its effects only with extreme slowness.

Heating to 75° C. destroys this agglutinant property (Flexner and

Noguchi).

C.--EFFECTS OF VENOM UPON THE WHITE CORPUSCLES: LEUCOLYSIN.

The white corpuscles themselves do not escape the action of venom. It

is possible _in vitro_ to prove this action upon leucocytic exudations

obtained, _e.g._, by injecting sterilised cultures of _Bacillus

megatherium_ into the pleura or peritoneum of the rabbit. After a few

hours this exudation is removed by means of capillary tubes, and, on

mixing these with weak doses of venom, we see, in the course of a

microscopic examination, that the large mononuclear cells are the first

to be dissolved, then the polynuclears, and lastly the lymphocytes. The

leucolysis is much more intense and more rapid with _Cobra_-venom than

with that of _Crotalus_ (Flexner and Noguchi, Noc).

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