Minton, S. A.

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Injuries by Venomous Animals in IndianaSherman A. Minton, Jr., 1 Indiana University Medical CenterAlthough injuries inflicted by venomous animals are by no meansa major problem in the midwest, the interest and concern shown by thegeneral public requires that the zoologists be able to recognize theseanimals and have some knowledge of their habits.According to data obtained by the Department of Public HealthStatistics of the Indiana State Board of Health, twenty-one deaths dueto poisoning by venomous animals were reported from Indiana duringthe years 1930 to 1949 inclusive. This figure is almost certainly toolow, however, for such deaths occurring in the occupations of agricul-ture or forestry have, since 1934, been merged into the general categoryof agricultural accidents and are not listed separately. The species ofanimal involved is not given in the statistical listings and is knownonly in those cases which have been investigated by the writer or others.At least 3 of the deaths in the series are ascribed to insect stings, oneto spider bite, and 4 to snake bite. The age of the victim is not givenin 12 cases; under 10 years in 5 cases, between the ages of 25 and 64in 3 cases, and over 64 in one case. Males outnumber females aboutthree to one. There has been a marked decline in the number offatalities in recent years; 16 of the cases occurring prior to 1940. It isinteresting to compare the Indiana data with that compiled by Swartz-welder (6) for Louisiana where there were 51 deaths during the years1930 to 1945 inclusive.Of the known venomous animals, only the spiders and snakes arerepresented in the midwest by potentially dangerous species. Stinginginsects present a special case; since serious or fatal injuries resultfrom hypersensitivity, multiple stings, or infection. The scorpions, animportant group in tropical and subtropical regions, are absent exceptfor an occasional accidently introduced individual. The larger of ournative centipedes, particularly the common orange or grey Scolopendrasp., will bite if restrained but produce only local pain and swelling.The dangerous nature of the black widow spider, Latrodectus mac-tans, is well known. The dangerous form of this spider, the adultfemale, is ordinarily easy to recognize. No other medium-sized spiderin our geographic area has such a shiny, black, polished appearance.The bright red hour-glass spot on the underside of the abdomen is agood field mark (Figure 1). In younger females it is often combinedwith a row of red spots along the dorsal midline. All red marks maybe absent in rare cases. I saw one large female Latrodectus that waschocolate brown with cream yellow bars on the sides of the abdomen, a*I am indebted to Mr. and Mrs. John H. Daily, Mr. H. E. Riddell, andmembers of the Illustration Department of the Indiana University MedicalCenter for their aid in the preparation of the photographs.315316 Indiana Academy of Science3.»«|rf|:;|ps-Fig. i. .Black widow spicier Latrodectus mactans. Adult female collected inOhio Co., Indiana.Fig. 2. Copperhead Agkistrodon contortrix mokeson. Adult female collectednear Kurtz, Jackson Co., Indiana.Fig. 3. Massasauga Sistrurus c. catenatus. Adult male collected in Starke Co.,Indiana.Fig 4. Timber rattlesnake Crotalus h. horridus. Adult female collected inJackson Twp., Brown Co., Indiana.midline row of orange spots, and an orange hour-glass. This seems torepresent a case of abnormal persistence of the normal juvenile pat-tern and color.The black widow is known from all parts of Indiana but appearsto be considerably more plentiful in the southern half of the state. Mostspecimens I have encountered have been concealed beneath stones,boards, scraps of metal, cardboard, and other rubbish. Rather open,dry, warm situations are preferred; deep, moist woods and swampyareas are usually avoided. Reasonably clean, well-kept houses do notafford a favorable habitat for this spider; however, specimens may beintroduced in baskets of vegetables, firewood, etc. Several allegedZoology 317black widows found in houses have been identified as Phidipptcs audax,a small blackish jumping- spider with an orange dorsal spot. Barns,garages, tool sheds, and other outbuildings are better refuges forLatrodectus and may be quite heavily infested in some cases. Theweb of the black widow is never neat and geometrical and rarelylocated in the open. The construction of the web is very irregular; thestrands coarse and unusually strong.Most published data on cases of black widow poisoning have beenobtained in the southern and southwestern United States and in tropicalregions. This may be the result of greater interest in the problem,more accurate case finding, or greater abundance of the spiders. It isalso possible that there may be geographic variation in potency andquantity of venom and with respect to the readiness with which thespiders attack man. In most published accounts, bites occurred whenthe spiders became entangled in clothing or when webs, particularlywebs containing egg sacs, were accidentally touched. Several authorsstress a high incidence of accidents among persons using outdoor privies.It has been my experience that the black widow almost invariably at-tempts to escape when disturbed in the field. An attack reaction maysometimes be elicited by touching the web of captive spiders particularlyduring the period of egg-guarding.Bogen (1) reported 17 deaths in a series of 380 cases of blackwidow poisoning from 18 states. Stahnke (5) reports 7 fatal cases ofspider bite in Arizona in a 20-year period. Three were definitelyascribed to the black widow. Data for Indiana and the surroundingterritory are meagre. Cases of spider bite do occur; however, theoffending arachnid is rarely identified. About four years ago, a fatalcase occurred in Ripley County, the victim being an 81 year old woman.The spider was said to have been "probably a tarantula", but this wouldseem rather unlikely. I know of at least two non-fatal cases ascribed tothe black widow and two cases ascribed to the wolf spider (Lycosa sp.).The latter were not accompanied by symptoms of generalized toxemia;although there was considerable local pain and swelling. It may bementioned in passing, that severe cramping abdominal pain withmarked muscular rigidity is perhaps the most pronounced symptom ofarachnidism due to the black widow and may lead to confusion withsuch conditions as acute appendicitis or ruptured peptic ulcer especiallysince the bite may not be particularly painful and produce little localswelling or discoloration. Greer (3) considers burning sensations inthe soles of the feet a highly significant symptom which may permitdiagnosis when the history of a bite cannot be obtained.Control of these spiders in the vicinity of dwellings requires thecleaning up of such trash as may shelter the animals with destructionof adults and eggs as found. Insecticides including DDT are notparticularly effective. A spray of 15% unslaked lime in kerosene isrecommended by Gowanloch (2) but must come in direct contact withthe spiders. Creosote is repellent to Latrodectus and may be used forthe treatment of privies.The incision and suction treatment recommended as a first aid318 Indiana Academy of Sciencemeasure in snake-bite seems to be of little value in arachnidism. Infact, no first aid treatment except possibly the local application of coldappears useful. The intravenous injection of 10% calcium gluconate,which is readily available and stable indefinitely, often gives dramaticrelief from the symptoms. Commercially prepared antivenin or theserum of patients who have recovered from bites has been used withgood results but is rarely available.The species of poisonous snakes known to inhabit Indiana are thetimber rattlesnake, Crotalus h. horridus, the massasauga or swamprattlesnake, Sistrurus c. catenatus, and the copperhead, Agkistrodoncontortrix mokeson. None of these snakes pose much of a recognitionproblem except the copperhead whose rather distinctive pattern andform (Fig. 2) may be learned by the observation of a few captive orfreshly-preserved specimens and the very young massasauga with itstiny rattle and markings like a young fox snake or hog-nosed snake.Dead specimens of any of these snakes may, of course, be readilyidentified by the presence of fangs, loreal pits, elliptical pupils, and un-divided sub-caudal plates. All of the numerous Indiana reports ofwater moccasins I have investigated have been based upon harmlessspecies; however, the venomous moccasin is common in parts of south-ern Illinois and may occur in Posey and adjoining counties. Olderwriters sometimes include Indiana in the range of the coral snake onthe basis of a specimen from Ripley County reported by Bigney in 1891.There have been no further reports from the state, although a specimenturned up recently in the suburbs of Cincinnati.The massasauga (Fig. 3) originally inhabited wet prairies, peatbogs, and swamps throughout the northern half of Indiana. It hasnever been reported in the state south of Indianapolis. Its present-daydistribution is very local and spotty. Drainage and agriculture havegreatly reduced its numbers particularly in the Till Plains where it isvirtually extinct. Copperheads occur throughout the southern part ofthe state and range northward in the west at least to the Turkey Runarea. I have records for 20 counties. Dry, rocky, wooded ridges arethe preferred habitat, and the species may be quite numerous locally.The timber rattlesnake (Fig. 4) has similar habitat preferences, andits original range in Indiana was probably much the same as that ofthe copperhead. It is now quite rare except in a few wild areas.Specimens are regularly taken in sections of Brown, Monroe, Morgan,and Martin Counties with a few reports from other places. The re-forestation of considerable tracts in southern Indiana with restorationof much of the original biota may well cause both these reptiles toincrease in number.Information on 30 cases of snake bite in Indiana has been collectedand is presented in Table I. The mortality rate in the series is prob-ably too high; for it is the severe and complicated cases that are re-oorted or remembered. The copperhead and the massasauga, whichaccount for 25 of the cases reported, are probably unable to inflict afatal bite upon an adult unless the picture is complicated by infection,Zoology 319-pPcoO)«^pcdB-p030)uHPhCDPh£13fH cdT3 .sP '5P HPCO05 3CD COp >>-pfn309s .s3OPu«HocO 1)aCD PCOco<p >>o Ehcd 3HP •i-»pCO h-1<% >»-p Hpp PH•2 03'4303PhoOO) „<pCOPh*co<1)>>fncdobJOCD"5p>o 13 So 'oj FH£s02CD" >a;0)4H3 BOo3P-H >> 13PCD>0)p CDCD -M>o'/J'co T3P CD U a)3 Ph ft sPoCD '-P-P o03 pP COP PS p03 O OP O "Sfiph Oh £ <J <J03P!m<vUP03oo-4->bJOshoftcdnaPpo ^35 Pft 3a p<D P-P 'J*13 oU o3 «p pscp 03OAh ^O Ph ^m u <ej 03>» h3>>.fHCD 0)'oa fHCO* I> £> 0) pj h fH > £ oO o <D <x> o o •pO o o3 s CX u +J ftCD o> 1—'s Pi CD ft £P P COPI03© cpS fH p"3 "3 >>03CO«H 'pcoCO-Hp>CDpi-PPSCD>CDPS1303O)o'-Pin's>ucuOBQCO(1)Pis«P-Pc<D>CDpX3CDCD>OaCDzo>5fHCD>Ooo3 p Q K '-P p Q ^ Ph P, tfX) 13 13 13o3 03 03 o3CD CD CD CDpti ^ ^C XfH fH fH fHCD CD CD CD CDft bJO ft ft ftft fH ft ft ftO 03 O O OO >A O O OhH L^CD3 a>^ Ph^^CD ^3Ph <J«8o <u o> pP Pco .p.^ KH<^^^<^PPS §•H 5jP 3§ a-p pCO o-§ afH CD PrfI13 Ph^ 03 Po 3 PCDPh03PCOCD>"-Pft03y13CDPoPh.sPpftPbJOPH co HrPPPo13CDftftCDPCD>*^3 cdco-rtp S ah3 6j03 .SP -E^ CD jjP w 43P 03 ft-a a>03 PPh <PCOCM? 'O&o «P CD03 ^CO ^CD o3 cdU) £ ft03 k2 °J S o1303CD,PfHCDftftOU<U -T3•3 *03 CDfH |flCD CD CDPh- ^3 ftP -^ ft.5 03 OEh Ph" OCDftftOfHCDbjop^ppCDptpbJOPX CD.P° oP «Hboo73CDo a-5 <t!oa °1 &Ph h, & PP 03 OS O P5 ~CO nroOpOX) fc"Fh hhOes o p ^ ^ -h ^ .- hopO PPQ PQco320 Indiana Academy of Science£ .5poUoO f-i03 P°3 >»p a03 o3g gJ 8.8S « Q>» PS >t5-1 ^o Fh0> <D>oC30)c3CL>Fhoo03Fh Fh,__,oo,__,3>» 53 b~M>oP03>o>0)>O CDy >osoa Ph m tt w tf £>Fha->ooCDPhooFhasCL>CD »«H> Po cr1 a> <z>3 S .3 £>> pOtNxio3CD-PPhcU9 c© c3rsOPP"d03 Og P03Ph ^C ag _« flp. bo 03•3 >= g£ P £«!I.Ss RIIhi0)03 w C$S ^ PrPg 03bo +3P fto as03rPFhCl>ftoOcubjoC<PT3030)rfiFh03ftftoObOP<P03i033'to1)>mi °o p '-P0) 03• f—' Ph &J50) ^ Ph ^3 cu 03 0303 tn ?H r^ZJ rdPh03bjo ^.S gPwPhP03UC303 o3pbJOPbo.scuWOCDo3aPOO <+H^03Po3P SoPPS O*-+HC<1H Fh<hh03 Td c3 03 CJ ^p 03^1 e3 bJO rO ^ a bJOo3 03 P "2 c3 cuPp rS3 03 P x 03Fh W03 03 03 c3^HCD 03£i T3 P ry} p +3 Ph 03§ tsPho 030303fto 03H « O £ s P^ U«+H CM rPf sis| &W Mft^3 S03 r-O Fho3bfip03W3bO o3P «3O 58FhybJOC03p srH ^ £fc^ " p6opo'S so3 T3oO J5 jL( rr^03 o2 o^ dp° 03P fl T^ .rHT-» W = .rt r-H » ^4 W "* ^ r-H -^ r—I < ' '.^pFHpgpl^r-H^PFHSgt*.(2S^S^pq^PHOfe^^<^MWyp 13 y .bJO oP US ^ozJZoology 321SftS>>s >a 8S «oca>? ^c &o> boC «$<J 6«« 1•2 g.2 3fl H S <s>oM0)to o3toa *ftfto^3 +3>owA ^S g?§O) WrC C/j-M Wc3 oH ftfH>~'3 to.24JgS T38 &o0) ACU>•H oo30>« 5 «T3-a-sI Io -5+j 0313o3O0)ftftooT3ftftoOS to Cp2S X <R X0)T303a>JCJJha>ftftoO03° s>> UO 03PQ PQa ~ * cJ* ISoI &i -> >o oo Ua> a>OT fi "* ™^ *R r^Soo3ft08oC03&fl 03g ftCOa03to W 03 W ft1 o 3 o o o rf> C030)O<* i—ih—1 03 S03CUfH<vftftoo^S >> +J >>•r? w *C! wS O B o&J0 o3 bjo 03C f-1 C f*^ 03 M 03O i—iO i—i£ .5 £ .SH <U 03a a 3[j Id 09T3 0) ,_ 03S M OT §eM X ,2j SH XoO 6S °8S .S o5 o>. ~J"1 ^oftftor "0> 0)322 Indiana Academy of Sciencepsychogenic shock, marked debility, or the results of injudicious treat-ment. Some cases are so mild a doctor may not be consulted. Thebite of a large timber rattlesnake is much more serious, but the rarityand rather mild disposition of this snake make accidents uncommon.In this series of cases, almost one third involved individuals at-tempting to capture venomous snakes or persons engaged in handlingthese animals. Two additional cases were the result of picking up avenomous snake that had been mistaken for a harmless species. Poison-ous snakes should be captured and maintained in captivity only byresponsible individuals aware of the danger involved and willing to takeall due precautions. The handling of snakes purely as a display ofbravado is deplorable.Eleven cases, three of them fatal, occurred in children of ten yearsor less. In addition to the child's greater susceptibility to the venom,small stature and a greater tendency to assume the quadrupedal posturepredispose to bites high upon the limbs or upon the body or face.Many of the snake-bites in this series were sustained close tohome. Snakes become abundant about dwellings only if there is aplentiful supply of food—usually small rodents—and suitable shelter.A loosely-constructed stone wall or foundation, a pile of old lumber,or a tumble-down shed if located in a favorable spot will attract snakesin surprising numbers. Thorough search of a large log pile in FloydCounty revealed six copperheads and six other species of reptiles andamphibians including a black kingsnake that had eaten a seventhcopperhead. The cleaning up of such habitats will greatly reduce theincidence of snakes about dwellings. It is safer to remove boards andother litter during the winter or early spring when snakes are inactive;however, a campaign in mid-summer may dispose of gravid femalesbefore young are born. Occasionally country residents report a briefbut rather striking invasion of their premises by snakes usually duringthe late summer. There is good evidence that timber rattlesnakes andcopperheads as well as certain harmless species follow rather well-defined routes between summer ranges and hibernating areas. Thesnakes will continue to use these routes despite the presence of humanhabitation. On the Morgan-Monroe State Forest there is a rattlesnakecrossing where one or more of these reptiles is killed each August innearly the same spot on the black-top road.Observations on the copperhead in southern Indiana indicate thatthe snakes hibernate on wooded, rocky hillsides. They emerge fromhibernation late in April but remain close to the hibernating area forabout a month before gradual dispersal to summer ranges. Duringthe summer, the reptiles hide by day and forage actively by night.Late in August, the snakes return to the hibernating area ratherpromptly and remain there basking on mild days until the middle ofOctober. It is probable that both local species of rattlesnake follow asimilar schedule. Nearly all snake-bites in this series excluding thoseby captive reptiles were sustained during the period of summer activitywhich also coincides with the peak of human outdoor activity. AlthoughZoology 323*information is available in only a few cases, the majority of bites seemto occur between the hours of six and nine in the evening. It is for-tunate that, during the summer, the snakes are feeding frequently thusreducing the possibility of receiving a maximum dose of venom.Since the treatment of snake bite is unpleasant and not withoutdanger in itself, it is important to determine first that the suspectedbite was really caused by a venomous snake and second that an ap-preciable amount of venom was injected. Much unnecessary alarm andundeservedly vigorous treatment has been occasioned by bites of harm-less snakes or even wounds by inanimate objects. There are also a fewwell-authenticated cases where actual bites by venomous snakes havenot been accompanied by any indications of poisoning. Insofar as ourspecies are concerned, an effective bite is promptly followed by pain,marked local swelling, and discoloration.In the treatment of snake bite, opinion is divided as to the relativemerits of surgical treatment—ligature, incision, and suction—and theuse of antivenin. Although further clinical observations and experi-mental work are required, it appears that antivenin may be used tosupplement surgical treatment but should never supplant it. If atourniquet is used as a first aid measure, it must be loosened at inter-vals. Gangrene has resulted from improper use of ligatures. Potas-sium permanganate has no place in the treatment of snake bit. Weaksolutions are inferior to epsom salts as a wet dressing while strongsolution can cause great damage. The definitive treatment of snakebite, particularly the injection of antivenin, should be entrusted to aphysician except in the most dire emergency.Literature CitedBogen, E. 1926. Arachnidism : Study in spider poisoning. Jour. Amer. Med." Assn. 8«:1S94-1S96.Gowanloch, N. J. and C. A. Brown. 1943. Poisonous snakes, plants, andblack widow spider of Louisiana. Publ. La. Dept. of Conservation 1-90.Greer, W. M. R. 1949. Arachnidism. New England Jour. Med. 240:5-S.Lyons, M. W. and C. A. Bishop. 1935. Bite of the prairie rattlesnake,Sistmriis catenatus. Proc. Ind. Acad. Sci. 45:253-256.Stahnke, H. L. 1949. Scorpions. Ariz. State College Bookstore 1-23.Swartzwelder, J. C. 1950. Snake-bite accidents in Louisiana: with data on306 cases. Amer. Jour. Trop. Med. 30:575-587.

Injuries by venomous animals in Indiana

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Injuries by venomous animals in Indiana

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