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June 26, 1967

The Most Critical Aspects Of Snake Envenomization

Author Affiliations

San Francisco

JAMA. 1967;200(13):1186. doi:10.1001/jama.1967.03120260082022

To the Editor:—  A letter to the editor on snakebite treatment1 noted the tragedy of Dr. F. A. Shannon's death. Two of the most critical aspects of snake envenomization are the species of snake involved and the route of venom inoculation. Dr. Shannon was bitten by Crotalus scutulatus scutulatus, and one of its fangs entered a blood vessel, greatly accelerating absorption of the venom. He was in shock within a few minutes, was unable to perform effective first aid treatment, and died that evening. The median lethal dose of the venom from the snake that bit him was 0.2 mg/kg, 20 times that of C atrox.2C s scutulatus venom is strongly neurotoxic. It shares one antigen with the highly lethal neurotoxic South American rattler C durissus terrificus. This antigen is absent in cytotoxic crotalid venoms.3From my research experience I can testify that venom of C