Cryotherapy was used in a case of envenomization by a cobra (Naja naja). The patient, a 17-year-old male snake handler, was bitten on the left index finger. Systemic administration of steroids was also begun at once, but specific antivenin was not obtainable for nine hours. Although death sometimes occurs 8 to 12 hours after cobra envenomization, and in spite of the lack of specific cobra antivenin for 9 hours, no symptoms of systemic intoxication developed. Morbidity was confined to the envenomized arm, which became markedly swollen when cryotherapy was discontinued after 37 hours. Severe local destruction at the site of the bite eventually necessitated amputation of the distal portion of the involved finger.
Mullins JF, Naylor D. Successful Management of Cobra Bite with Cryotherapy. JAMA. 1960;174(13):1677–1679. doi:10.1001/jama.1960.03030130005002