Fillers A memorable patient

A unique case of snake bite

BMJ 2000; 321 doi: http://dx.doi.org/10.1136/bmj.321.7263.758 (Published 23 September 2000) Cite this as: BMJ 2000;321:758
  1. Sadananda Naik, physician (krishi{at}bigfoot.com)
  1. Moodbidri, India

    It was one of those midnight calls. My resident called me and said, “Sir, I have a very peculiar case of snake bite. I haven't seen anything like this before.”

    On reaching the ward, I found a middle aged villager, extremely restless, tachypnoeic, and with his legs and arms jerking intermittently. He had reportedly been bitten by a snake a few hours before. The findings were quite amazing. He was febrile with a temperature of 40°C and a pulse rate of 150/minute. His pupils were dilated, and there was mild local swelling at the bite site.

    “What could this be?” I struggled to find the answer to the puzzle. Then, almost unbidden, my pharmacology lecturer's words started ringing in my ears: “As dry as a bone, as mad as a hen, as hot as a hare, and as blind as a bat.”

    That was how datura (Datura alba) poison was described. “That's it.”

    On inquiry, we found that the patient's relatives had made him drink a preparation made from the locally available datura (known as thorn apple or devil's weed) leaves, which contain atropine as the principal active alkaloid. Their intention was to neutralise the snake venom. The funniest part of the episode was that the snake which had bitten him was not poisonous.

    The patient made a complete recovery after a stomach wash and supportive treatment.

    We welcome articles of up to 600 words on topics such as A memorable patient, A paper that changed my practice, My most unfortunate mistake, or any other piece conveying instruction, pathos, or humour. If possible the article should be supplied on a disk. Permission is needed from the patient or a relative if an identifiable patient is referred to. We also welcome contributions for “Endpieces,” consisting of quotations of up to 80 words (but most are considerably shorter) from any source, ancient or modern, which have appealed to the reader.

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