What prevents us from establishing the production of snake venom?

Snake venom - this phrase evokes not the most pleasant associations in humans. It is clear why, because such a waste product of snakes most often leads to a deterioration in health. But this is only in natural conditions, if a snake has bitten a person. Fashionistas and people who care about their health know that snake venom is used in many areas of life. Cosmetology and medicine have long adopted this natural component to create drugs that help people.

What properties does this substance have? When does poison help us? And in what cases should you beware of it? Let's look at some options for using snake venom.

Composition and properties

3. i. - viscous, colorless or yellowish liquid, odorless, with a bitter taste. Its reaction is slightly acidic, sp. weight 1.030–1.090. In liquid form, it is not stable, rots easily, and within 10-20 days it loses its toxicity and many enzymatic properties. Well-dried venom (desiccator, freeze-drying or vacuum drying) loses more than 3/4 of its original weight and turns into a whitish-yellow crystal-like powder that retains the basic properties of the venom for many years. Dry 3. i. dissolves in water, chloroform, saline solutions.

The main component of 3. I are proteins and peptides, which account for approx. 80% of its dry weight. They are carriers of the main toxic and enzymatic properties of the poison. In addition, in 3. i. contains free amino acids, nucleotides, guanine derivatives, mucin, sugars, lipids, pigments, inorganic salts, as well as impurities from the snake’s oral cavity (epithelial cells, bacteria).

Many poisons and their fractions have been studied for their elemental and amino acid composition. It has been established that toxicity and some enzymatic properties 3. i. impart disulfide groups. Glutathione and other reducers of these groups reduce the toxicity of the venoms of cobra, Russell's viper, and rattlesnake by 80-90%, while almost completely eliminating their clotting effect on the blood and the phospholipase activity of the last two venoms.

The biologically active principles of poisons are divided into three groups: 1) highly toxic thermostable polypeptides, or low molecular weight proteins lacking enzymatic properties; 2) large-molecular enzyme proteins that are highly toxic; 3) proteins that have various enzymatic properties, but lack pronounced toxicity. Some of the enzymes of the last group can directly or indirectly potentiate the action of the main toxins 3. i.

Toxins of the first group, mainly related to neurotoxins, are found in the venoms of adders, sea snakes, some tropical rattlesnakes of South America, and in the venom of only one representative of vipers - the Palestine viper. In most adders and sea snakes, these neurotoxins are represented by basic polypeptides with a mol. weighing approx. 6000-7000, consisting of 61 - 62 amino acid residues in one chain with four cross-disulfide bonds, in snakes p. Bungarus - with larger polypeptides (71 - 74 amino acid residues with five disulfide bonds), in the Palestine viper - of 108 amino acid residues with three disulfide bonds. Crotoxin, the most powerful neurotoxin found in the venom of the rattlesnake Crotalus durissus terrificus, is a complex compound of phospholipase A2 and a low molecular weight polypeptide, in combination with which phospholipase A2 acquires high neurotoxicity, losing to a large extent its enzymatic properties.

Polypeptides with cardiotoxic and cytolytic effects were also found in the venoms of some asps (cobras, etc.). Close to them is the low-molecular-weight toxin of tropical rattlers - crotamine. The lethal effect of cobra venom cardiotoxin is 20 times weaker than neurotoxin.

Low-molecular-weight neuro- and cardiotoxins are not detected in the venoms of most vipers and rattlesnakes, including all vipers and cottonmouths of the fauna of the USSR. The active principles of the venoms of these snakes are thermolabile and do not dialyze proteins through semi-permeable membranes with high protease activity, hemorrhagic, necrotizing and blood-clotting effects.

The composition of the venoms of a number of Australian adders and some tropical rattlers is more complex; they contain both non-enzymatic neurotoxins and powerful proteases with hemorrhagic and hemocoagulating effects.

According to the composition of the main toxins and the leading manifestations of intoxication 3. i. can be divided into the following main groups: 1) with a predominance of neuro- and cardiotoxins (venoms of adders, sea snakes and some tropical rattlers); 2) with a predominance of toxic proteases with hemorrhagic, necrotizing and blood-clotting effects (toxins of vipers and most rattlesnakes); 3) poisons of mixed composition, containing both neurotoxins and powerful enzymes of hemorrhagic and blood-clotting action (toxins of a number of Australian adders and tropical rattlesnakes).

3. I. rich in enzymes, many of which are unique in their mechanism and strength of action. It contains proteases (exo- and endopeptidases, etc.), phospholipases, acetylcholinesterases, hyaluronidase, phosphatases (phosphomono- and diesterases, etc.), nucleotidases, oxidases, dehydrogenases, catalases and other enzymes. Related enzymes of different poisons differ in their mechanism of action. Thus, coagulases in some poisons convert fibrinogen into fibrin (thrombin-like effect), in others they activate factor X (thromboplastin-like effect), in others they convert prothrombin into thrombin, etc.

Snake venoms also contain inhibitors of enzyme systems, including inhibitors of tissue respiration (cytochrome oxidase system, succinate dehydrogenase, anaerobic glycolysis enzymes), anticoagulants, etc.

Mithridates of Pontus and his universal antidote

Mithridates VI Eupator of Pontus (132–63 BC) inherited the kingdom of Pontus on the Black Sea (today the northeastern region of Turkey) in 120 BC. e., after his father was poisoned by his enemies. It is believed that Mithridates' mother, Queen Laodice, intended to poison him in order to reign herself, so Mithridates went into hiding for several years as a teenager. His strong passion was poisons. He caught poisonous spiders, wasps and snakes and experimented with poisons. Fearing that he would be poisoned by his rivals, Mithridates took weak doses of arsenic daily in order to develop immunity to large doses. Upon his return, he ascended the throne and used poison to eliminate several relatives and rivals. Mithridates' interest in poisons and antidotes may have been influenced by the works of the last Pergamon king, Attalus III. Pergamon, with its large library, active scientific society, and healing temple of Asclepius, was a center of medical learning. As a child, Mithridates heard rumors that Attalus III poisoned his relatives and enemies and left court life, devoting himself to the study of botany, pharmacology and metallurgy. He died in 133 BC. e. - time close to the date of birth of Mithridates [, ]. Ancient historians report that Attalus grew toxic plants such as henbane, hellebore, hemlock and aconite. The renowned Pergamon physician Galen (129–199) wrote that Attalus experimented with antidotes for the venoms of snakes, spiders and scorpions, and praised his work.

Mithridates' homeland of Pontus was famous for its extraordinary flora and fauna. Wild honey, obtained by bees from the nectar of poisonous rhododendrons and oleanders, so abundant on the Black Sea coast, contained deadly toxins. The flesh of Pontic ducks was poisonous because they ate Caucasian hellebore and other poisonous plants. Mithridates' allies in the east, in Armenia, had lakes with poisonous fish. These facts may have prompted him to look for ways to protect himself from poisons. Mithridates, continuing his toxicological experiments, was looking for a universal antidote. His reserves included arrow poisons, snake poisons, scorpion poisons from Mesopotamia and Libya, poisonous fish from Armenia, poisonous plants and mushrooms, poisonous honey collected by bees from rhododendrons, and other deadly drugs. Mithridates' library contained scientific treatises on poisons, and he conducted extensive correspondence regarding poisons and antidotes. Pliny wrote: “Through tireless research and a variety of experiments, he sought ways to transform poisons into useful medicines” []. Mithridates kept his work on producing a universal antidote secret. It is believed that the recipe contained more than 50 ingredients, many of which were costly substances from distant lands [, ].

Mithridates, after being defeated by Pompey in the Third Mithridatic War, was forced to commit suicide (63 BC). He is recognized as the first experimental toxicologist who performed proto-scientific experiments with poisons and antidotes []. His goal was to create a universal antidote to make himself and his friends immune to all poisons and toxins[].

After Mithridates' death, his personal library and archives were transported to Rome and translated into Latin by Lenaeus (95–25 BC). Pliny, who studied the documents, believed that "Mithridates was a more accomplished researcher in biology than any man before him." Subsequently, the antidote of Mithridates - mithridatium - was improved, and so-called polyvalent antidotes were created. In the Middle Ages, mithridatium became widespread in Europe and became a “long-lived” medicine; it could be purchased back in the 20th century.

Poisoning statistics

According to incomplete data published by WHO, the annual number of people affected by venomous snake bites around the globe is approx. 500 thousand, of which 30-40 thousand (6-8%) die. More than 4/5 of all cases are recorded in Asia, Africa and South America. In India alone, the number of victims reaches 100 thousand people. in year.

As you move away from the tropics, the frequency and severity of venomous snake bites decreases. In the United States, the annual number of victims of snakebites ranges, according to various authors, from 1.2 to 3.7 per 100,000 inhabitants. However, the south and southwest states in these indicators are close to tropical countries: 10.8—

18.8 per 100,000. In Western Europe and in the central zone of the USSR, the frequency of snake bites is lower than in the United States as a whole (no more than 0.7 per 100,000), in South Central Asia and the Transcaucasus it increases by 2-3 times. After the introduction of modern treatment methods, mortality decreased sharply: in Brazil - from 27 to 8%, in the south of Japan - from 15 to 3%, in the USA - from 3.05 to 0.21%, etc. Bites of the most dangerous subtropical snakes fauna of the USSR (viper, sand epha) in the past gave approx. 8% fatalities, this figure has been reduced to almost zero.

The degree of snake danger (ophidism) in each given area is determined both by the number and species composition of venomous snakes, and by socio-demographic factors (population density, degree of urbanization, features of life, clothing, etc.).

The degree of danger of bites from various poisonous snakes of the fauna of the USSR is characterized by the following data: in Tajikistan, with the bites of the viper, an extremely severe form of poisoning was observed in 8.1% of cases, severe - in 40.4%, moderate - in 27.4%, mild - in 24 ,1%; In the Altai Territory, an extremely severe form of poisoning was not observed in cases of viper bites, severe - was observed in 6.4% of cases, moderate - in 36.2%, mild - in 57.4%.

Poisons in service with the army

Since ancient times, various peoples have used snake venom to treat arrows. Such arrows were used in hunting - the poison is safe, as it is digested in a healthy stomach. But if a poisonous arrow hit an enemy's body, it guaranteed him a painful death or an incurable wound. Venomous snakes are found throughout the Mediterranean, as well as in Africa and Asia. According to ancient Greek and Roman sources, various tribes, including the Gauls, Dalmatians, Dacians, and peoples living between the Indus and Euphrates rivers, had arrows containing snake venom.

Various methods for making poison arrows are recorded in Greek and Latin texts. Snake venom crystallizes and can therefore remain unchanged on wood, bone and metal tips for considerable periods of time. One of the most terrible drugs in antiquity is the Scythicon, created by the Scythians. To prepare it, the poison was mixed with bacterial pathogens from animal manure, human blood and putrefactive remains of vipers. Even with a superficial wound from an arrow treated by a Scythion, toxins began to act very quickly and doomed the victim to a painful death. The Scythians had access to several species of vipers: steppe viper ( Vipera ursinii renardi

), Caucasian (
V. kasnakovi
), European (
V. berus
) and sandy (
V. ammodytes transcaucasiana
).

The Roman historian and naturalist Claudius Aelianus (170–222) described one of the most fearsome poisons in India, obtained from the venom and rotting corpses of the so-called white-headed, or purple, snake. From Elian's detailed description, herpetologists identified the purple snake as the rare white-headed viper ( Azemiops feae

), discovered in South Asia in the late 1880s.

In the Aegean Sea, off the coast of modern Turkey, in the 2nd century. BC e. the famous Carthaginian commander Hannibal had to fight at sea with the Pergamon king Eumenes II, whose army was more numerous. Hannibal used a trick: he ordered his people to go ashore, collect live vipers and place them in clay pots. Then, as the enemy ships approached the Carthaginian ships, Hannibal's men began throwing pots. The ejected pots crashed onto the decks of enemy ships, releasing masses of snakes. The Pergamon sailors were horrified by the new weapon and fled. So Hannibal cunningly defeated the Pergamon army []. This battle can be seen as an example of the use of biological weapons in ancient times.

Pathogenesis and clinical picture of poisoning

Pathogenesis and features of the wedge, manifestations in case of poisoning 3. i. are determined primarily by the composition of the poison - the predominant content of neurotoxins, neuro-cardiotoxins or hemorrhagic coagulants. At the same time, when bitten by even the most dangerous snakes, the severity of intoxication varies. The dose and concentration of the released poison are of decisive importance. Like the secretions of other glands, 3. i. is released either in a more or less concentrated form, and the amount of poison entering the victim’s body can range from 0.4 to 65% of its total supply.

The severity of intoxication also depends on the age and health of the victim, the location of the bite and the tissue in which the poison entered. Children, especially those under 3 years of age, suffer from poisoning much more severely than adults; bites to the head and torso are more dangerous than bites to the limbs, and if the poison gets directly into a blood vessel, it can cause the death of the victim in 5-10 minutes. after a bite. Intramuscular ingestion of viper and rattlesnake venoms is almost twice as dangerous as subcutaneous ingestion, and intramuscular ingestion of asp venom gives the same effect as subcutaneous ingestion.

Injuries from poisons of predominantly neurotoxic action

Neurotoxic effects are caused by the venoms of adders and sea snakes (in the USSR - only the venom of the Central Asian cobra), Neurotoxic - by the venoms of some tropical rattlers.

Venoms of asps and sea snakes block neuromuscular and interneuron synapses, increase and then suppress the excitability of sensory and chemoreceptors, inhibit the cortex, subcortical and stem centers of the c. n. With. Symptoms of the lesion develop quickly, because neuro-toxins 3. i. easily enter the bloodstream from tissues. At the same time, these toxins are quickly eliminated from the body, appearing in large quantities in the urine within 13-20 minutes. after the administration of the poison, and in the next 16 hours. they are almost completely excreted.

Clinically, intoxication is manifested by a variety of sensory disorders, early development of impaired coordination of movements and peripheral paralysis, disorders of consciousness (stupor, coma), and in severe cases - increasing respiratory depression until it stops. Respiratory cessation is caused not only by paralysis of the respiratory muscles (curare-like effect), but also by depression of the respiratory center.

Circulatory disorders are of a phase nature. In the first 15-20 minutes. shock develops, caused by the intense release of histamine from the tissues into the bloodstream, and then the inhibitory effect of the poison on the vasomotor center. After 1-2 hours, blood pressure normalizes or even increases above the initial level. After 6-12 hours. The cardiotoxic effect of the poison may manifest itself: arrhythmia, atrioventricular block occurs, the systolic and cardiac outputs progressively decrease, cardiogenic shock develops, and sometimes pulmonary edema. In severe poisoning, the neurotoxic effect outstrips the cardiotoxic effect, and death occurs from respiratory paralysis.

The clinic of poisoning by the venom of the Central Asian cobra has been little studied due to the extreme rarity of bites by this snake. Available isolated observations show that it is not qualitatively different from the picture of poisoning by Indian cobra venom. Immediately after a snake bite, victims experience acute pain in the affected area, spreading to the entire affected limb and other parts of the body. After a few minutes, progressive general weakness, adynamia, then a feeling of numbness in the limbs, torso and face, and general stiffness develop. Coordination of movements is impaired, and after 20-30 minutes. the patient loses the ability to move independently and stand on his feet. During the same period, initial signs of collapse appear (see). Then paresis quickly progresses, and in severe cases - complete paralysis of the muscles of the limbs, trunk (see Paralysis, paresis), as well as the face, tongue, larynx and organ of vision, which leads to aphasia (see), aphonia (see), diplopia (see), swallowing disorders. Sensory disturbances are varied: diffuse pain with skin hyperesthesia and paresthesia (see) are combined with a feeling of stiffness, numbness, a sharp weakening of sensitivity and proprioception. Body temperature rises to 38-39°, heart sounds are muffled, extrasystole is possible. The most dangerous sign of poisoning is progressive depression and decreased breathing. The threat of death from respiratory arrest is especially great in the first 2-10 hours. poisoning Then changes in the heart progress: dullness of sounds, decreased voltage of ECG waves, extrasystole, atrioventricular block I-II degree. Late cardiogenic shock and pulmonary edema are possible.

Local changes in the bite area when affected by adders and sea snakes are negligible: two points of puncture of the skin by the snake’s teeth and slight swelling around them are visible. Hyperemia, hemorrhages, hemorrhagic edema, blisters, lymphadenitis and vein thrombosis, inherent in poisoning with the venoms of vipers and rattlesnakes, never occur, which has differential diagnostic significance.

With a favorable course of intoxication, all neurol disorders undergo reverse development after 2-5 days, but muscle weakness, numbness and aching pain in the extremities, and deafness of heart sounds can persist for several weeks.

In case of poisoning with neurotoxic venoms of tropical rattlesnakes, respiratory paralysis does not develop, muscle paresis is combined with convulsive twitching, even convulsions; in the pathogenesis and wedge, the picture of intoxication is dominated by the phenomena of severe shock.

Injuries caused by poisons with predominantly hemorrhagic and blood-clotting effects

These lesions are caused by the poisons of most vipers and rattlesnakes, including the toxins of all vipers and copperheads of the fauna of the USSR.

The pathogenesis of intoxication is dominated by local tissue destruction and an edematous-hemorrhagic reaction to poison, a systemic increase in vascular permeability, general hemorrhagic phenomena, disseminated intravascular coagulation with the subsequent development of hypo- or afibrinogenemia (thrombohemorrhagic syndrome), hypovolemia, shock, acute posthemorrhagic anemia and degenerative changes in parenchymal organs.

Local changes in the area of ​​poison injection are pronounced, rapidly progress and largely determine the degree of general intoxication. Already in the first minutes after a snake bite, which causes slight pain and a burning sensation, hyperemia, multiple hemorrhages and rapidly spreading hemorrhagic edema occur around the injection site of the poison. In severe forms of poisoning, swelling and multiple spotty hemorrhages involve the entire affected limb and often spread far to the torso. The limb becomes purple-bluish in color, blisters with serous-hemorrhagic contents may appear on the skin, lymphangitis, lymphadenitis and thrombosis of the draining veins often occur. This reaction reaches its maximum development after 8-36 hours. after inoculation of poison, when the volume of the affected limb increases sharply and abundant hemorrhagic penetration of all soft tissues is determined. Exudate differs little from whole blood in terms of hematocrit, red blood cell, hemoglobin and protein content. Thus, in the affected part of the body there is a huge loss of blood from the vascular bed, which largely determines the development of hypovolemia, shock, hypoproteinemia and anemia. The wounds at the site of the bite sometimes bleed for a long time; later, ulcerations and necrosis may form here, the appearance of which is facilitated by improper provision of first aid to patients (application of a tourniquet, cauterization of the bite site, etc.).

The general picture of intoxication is dominated by shock phenomena: weakness, dizziness, pale skin, nausea, vomiting, sometimes repeated fainting, low and rapid pulse, decreased blood pressure. In the early stages of intoxication (within the first hour), shock is associated mainly with the entry of histamine and other shockogenic substances into the bloodstream, as well as with disseminated intravascular coagulation (hemocoagulation shock), and later with abundant internal blood and plasma loss and hypovolemia (posthemorrhagic shock ). Blood clotting in the first 30-90 minutes. rises sharply; Fibrin deposition in the capillaries and multiple microthrombosis are noted. Then comes a long phase of hypocoagulation with severe hypofibrinogenemia and bleeding (nasal, gastrointestinal bleeding, hematuria, hemorrhages in organs, meninges, serous membranes, etc.). Thrombohemorrhagic syndrome lasts 1 - 3 days and is accompanied by signs of acute posthemorrhagic anemia (see).

In milder forms, general toxic symptoms are mild, and a local edematous-hemorrhagic reaction to the poison predominates. Damage to the body by hemorrhagic poisons is often complicated by the formation of necrotic ulcers in the bite area and gangrene of the affected limb, which delays recovery and can lead to disability for some victims. In uncomplicated cases, recovery occurs 4-8 days after the snake bite.

Toxinology in the Middle Ages

In the Middle Ages, the center of the study of poisonous animals moved to the East - to Southeast and Central Asia. The founder of this trend was Avicenna (980–1037). A significant contribution to the study of poisonous animals was made by his follower, Ismail Jurjani (1042–1136), who, in the sixth book of his work “Treasure of Khorezmshah,” published in 1110, was the first to notice an important fact: “Snake venom kills quickly because it causes short period of blood clotting in the heart,” and this corresponds to modern scientific data [].

Avicenna’s comprehensive “Canon of Medicine,” which had a huge influence on his followers, contained a number of general sections devoted to snakes and special chapters describing individual types of snakes []. Avicenna's canon was supplemented by the work of Maimonides (Moshe ben Maimon, 1135–1204) “On poisons and protection from deadly drugs” []. The work, intended for non-specialists, discussed remedies for treating people who have been poisoned or bitten by poisonous animals, including snakes. The work was translated into Latin three times at the end of the 13th and beginning of the 14th centuries. and became the basis for such specialized treatises on poisons as, for example, Sertum Papale de Venenis

("Pontifical Garland of Poisons", 1362) by William of Marra. In this work, the author calls for proper protection from poisons and poisonous animals, describes the basilisk, asp, horned snake, dragon, viper, etc. In general, at that time, the works of Avicenna and Maimonides had a huge influence both in the theory and in the practice of treating poisonous bites []. To achieve this, a variety of medical procedures were used, including plasters, various theriacs, special diets, ligatures, cupping and cauterization. Additionally, in order to provide proper treatment, doctors would have to identify the biting animal. Likewise, they needed to recognize the patient's specific symptoms, which varied depending on the type of snake that bit him.

The foundations of modern toxicology were laid by Paracelsus (Philip Aureolus Theophrastus Bombastus von Hohenheim, 1493–1541), who proved that poison is a chemical substance with a certain structure on which its toxicity depends []. In his medical practice, Paracelsus used extracts of snake venoms, described extraction methods and strongly recommended the use of scales when preparing medicinal compositions. However, Paracelsus not only contributed to the introduction of chemicals into medicine, but also influenced the subsequent development of scientific knowledge (it is not for nothing that he is considered the founder of modern science). The followers and opponents of the famous Swiss doctor and scientist, trying to prove or disprove his theories, brought significant benefits to natural science [].

Treatment and prevention of poisoning

When providing first aid to victims, tying the affected limb with a tourniquet, cauterizing the bite site with gunpowder, acids, alkalis, boiling oil, etc., local injections of strong oxidizing agents (potassium permanganate, etc.) are strictly contraindicated. All these methods not only do not weaken or delay the effects of the poison, but, on the contrary, significantly enhance both general and local manifestations of intoxication and contribute to the occurrence of a number of serious complications (necrotic ulcers, gangrene, etc.).

First aid should begin with immediate vigorous suction of the contents of the wounds, which makes it possible to remove, as experimentally and clinically proven, from 28 to 46% of all poison introduced into the body. If the wounds are dry, they are first “opened” by pressing on a fold of skin. Suction can be done by mouth (3. I. if it gets on intact mucous membranes does not cause intoxication) or using a rubber bulb, breast pump, etc. It should be continued for 15-20 minutes. (in the first 6 minutes, about 3/4 of the total extracted poison is removed), after which the wounds are treated with brilliant green, iodine or alcohol. When providing first aid, the affected limb is immobilized and the victim is provided with complete rest in a horizontal position, which reduces the outflow of lymph containing poison from the affected part of the body.

Drinking plenty of fluids (tea, coffee, broth) is beneficial. Drinking alcohol in any form is contraindicated. Among the medications prescribed are antihistamines, sedatives and drugs that affect vascular tone.

It is important to quickly transport patients to the nearest hospital. an institution where the earliest therapy with immune mono- and polyvalent antidote serums (PS) is possible - antigyurza, antiefa, anticobra, etc. Treatment is carried out according to the general rules of serotherapy (see). In severe forms of poisoning, the dose of PS ranges from 80 to 130 ml or more, in moderate poisoning - 50-80 ml (M. N. Sultanov, 1963, etc.).

PS is administered intramuscularly, and only in cases of extremely severe poisoning and late delivery of patients for life-saving reasons is it permissible to administer one dose intravenously. Homologous PS are used, however, due to the similarity of the antigenic structure of venoms of snakes belonging to the same genus, cross-use of PS is also permissible. Thus, anti-viper serum can also be used for bites of other vipers of our fauna (except for those affected by the poison of the sand epha, which belongs to another genus of the viper family). Treatment of PS can be complicated by allergic reactions - urticaria, angioedema, serum encephalitis, severe anaphylactic shock (according to Campbell, 3% of cases), etc. Therefore, serotherapy, as a rule, should not be used for bites of common and steppe vipers, copperheads and other low-danger snakes , in which a quick cure can be achieved by pathogenetic and symptomatic means. Even with viper bites, injection of PS is not resorted to in all cases. Concentrated PS purified from ballast proteins are more effective and somewhat less dangerous than native ones. To prevent and reduce the complications of serotherapy, it is recommended to administer intravenous glucocorticoids (hydrocortisone, prednisolone, etc.), antihistamines and blood transfusions to victims simultaneously with PS.

Pathogenetic therapy depends on the type of poison that has entered the body. In case of damage by poisons of hemorrhagic-coagulative action, massive jet and then drip transfusions of blood and plasma, as well as blood substitutes, are most effective and quickly improve the condition of patients. In case of severe poisoning, 800-1500 ml of hemotherapy is administered on the first day, and 200-600 ml in subsequent days. For milder poisonings and when treating children, the dose is reduced by 2-4 times. Otherwise, treatment is carried out according to the general rules for the treatment of posthemorrhagic shock (see). Symptomatic therapy includes the prescription of anti-inflammatory drugs, tetracycline antibiotics, antihistamines, and antianemic drugs.

Pathogenetic therapy for poisoning with neurotoxic venoms of asps (cobras) and other snakes consists of using, along with PS, anti-shock drugs and, in the event of respiratory paralysis, artificial respiration devices. The last method is very important, because Pharmakol and respiratory stimulants do not prevent or relieve respiratory paralysis caused by cobra venom.

For snake bites of all types, prophylactic administration of anti-tetanus serum is necessary.

Individual prevention of poisonous snake bites is ensured by protecting the limbs with high leather shoes and thick clothing, and a thorough inspection of parking areas or overnight accommodations. Usually snakes are not aggressive and bite only in self-defense, so people who are bitten are mainly those trying to catch or kill a snake, often children and adolescents. In this regard, education about the dangers of chasing snakes is necessary; Non-specialists, especially teenagers, should not be involved in catching poisonous snakes. Children's institutions (pioneer camps, etc.) should not be located in areas where snakes accumulate. Herpetologists can carry out the relocation of snakes from such places to nature reserves or snake nurseries.

First aid for a snake bite

If the poison enters the body through a bite, it can be extremely dangerous for a person. In this case, you need to take several actions:

1. It is important to ensure peace for the person who has been bitten. The main goal is to get him to the doctor as quickly as possible.
2. Immediately after the bite (within 10 minutes), drops of poison must be removed from the wound. This can be done by squeezing or sucking. A syringe with a cut off spout is suitable for this purpose.
3. Ensuring that you drink plenty of fluids is one of the basic requirements. You can drink any liquid - water, tea, juices - whatever is at hand. The exception is alcohol.

A snake without poison is completely safe for humans.

Use of snake venom in medicine

3. I. used in medicine:

1) for the preparation of toxoids and immunization of animals in order to obtain antidote serums;

2) as an independent treatment. drugs;

3) as reagents for laboratory diagnosis of certain diseases;

4) for experimental modeling of a number of pathols, syndromes (neurotoxic, hemorrhagic, disseminated blood coagulation and afibrinogenemia, etc.).

Apply 3. i. how to treat the remedy began in the 16th century; Paracelsus promoted it as a therapeutic agent. Wide practical application 3. i. began in the 20th century.

Rattlesnake venom has been used to treat epilepsy (with problematic effects). Cobra venom and its neurotoxic fraction have a pronounced analgesic, antispastic and anticonvulsant effect; The cytolysins contained in it have a resolving effect on granulations and on the cells of some tumors. Attenuated cobra venom neurotoxin has been shown to reduce the effects of the polio virus and likely other neuroviruses.

A number of preparations from viper venoms that have a thromboplastic effect are used as a local hemostatic agent. For the prevention and treatment of thrombosis, the defibrinating component of the venom of the Malayan copperhead, Arvin or Ancrod, is used. This is a glycoprotein that cleaves peptides A (but not B) from fibrinogen and causes incomplete polymerization of fibrin monomers without simultaneous activation of the fibrin-stabilizing factor. These loose fibrin monomer complexes quickly undergo fibrinolysis with the formation of a large number of protein fragments that have a pronounced anticoagulant effect. After a single intravenous injection of ancrod, a sharp hypo-coagulation occurs, which persists for approx. 24 hours, blood viscosity decreases.

The possibility to lay down remains unexplored. the use of anticoagulants contained in the venoms of adders and some other snakes.

Snake venoms are widely used in laboratory diagnostic practice, chap. arr. to recognize various bleeding disorders. Thus, tests with the venom of Russell's viper (steepven) or viper (lebetox) are used for the differential diagnosis of deficiency of factors VII and X (the poisons contain an analogue of factor VII), as well as for the quantitative determination of factor X and platelet factor 3. Prothrombin is determined using the venom of the Australian taipan snake or sand ephas. Reptilase (a drug from the venom of Brazilian rattlesnakes) is used to monitor blood clotting and fibrinogen content in it against the background of heparinization (its effect, unlike thrombin, is not blocked by heparin), and together with the thrombin test - to differentiate various antithrombins, etc. d.

3. I. serves as a source for obtaining a number of enzymes used to study the structure and function of biol systems, to obtain biologically active substances (bradykinin, etc.) and other purposes.

How to collect poison

Science has not yet figured out a way to synthesize snake venom, so those with venom glands are still “milked” by hand. Venom is taken from snakes kept in snake nurseries and serpentariums, and from those living in natural conditions.

The latter are caught by snake catchers, and after collecting the poison, the reptiles are returned to the wild. Each snake can be milked no more than once a month. The amount of emulsion obtained depends on factors such as the type of snake, age, size, season and conditions of detention.

Indications and contraindications for use

Epilepsy

Snake venoms are included in medicines for external and internal use. Indications for their use are as follows:

• bleeding;
• pain syndrome of varying intensity;
• wounds;
• tumor diseases;
• inflammation of joints and muscles;
• spasms of blood vessels of the heart muscle;
• bronchial asthma;
• epilepsy (drugs used in a number of countries);
• metabolic disorders.

For medicinal purposes, poison is always used in a processed state due to its toxic properties.

Snake venom is prohibited for the following contraindications:

• chronic kidney disease;
• chronic liver diseases;
• heart failure;
• increased blood clotting (contraindication for a number of drugs);
• tuberculosis;
• pregnancy;
• breast-feeding;
• allergic reaction.

All contraindications are associated with the presence of strong toxins in medications containing snake venom.

What does viper venom consist of?

Viper venom is a thick aqueous solution that contains a complex mixture of toxic proteins. From an evolutionary point of view, this is a dangerous weapon that greatly increases the animal’s chances of survival. The common viper does not need to be physically strong to ensure its safety: it can defend itself with a single bite.

Snake toxin is a complex of biologically active components. The most important of them:

• proteases are enzymes that destroy peptide bonds between amino acids inside a protein molecule;
• peptide hydrolases - enzymes that accelerate the process of cleavage of peptide bonds;
• hyaluronidases - components that break down acidic mucopolysaccharides;
• Phospholipases are components that catalyze the process of hydrolysis of phospholipids.

The chemical composition and level of toxicity of a viper's venom may depend on the age of the snake, its habitat, and other factors.

Treatment for a cobra bite

Treatment after a cobra bite should be carried out in a medical facility. It is important that:

1. The patient was administered at least 10 vials of antidote. Tiger Snake serum acts as an antidote. It is effective for removing all components of the venom of king and other types of cobras.
2. Intravenous administration of Ringer's solution was provided at a rate of at least 250 ml over 60 minutes.
3. Neutralization of the poison in the medical facility was carried out without interruption. For small wounds, four to six ampoules of serum are used. For deeper and more complex ones, at least eight and sometimes up to 20 units of antivenom for a king cobra bite are used.

It is necessary to constantly monitor the condition of blood and urine during treatment. In this case, the victim must remain in a hospital for at least 24 hours after symptoms have stabilized. The sooner he receives medical assistance, the less pronounced the complications will be.

Symptoms of a cobra bite

Clinical signs of poisoning develop quickly. At the initial stage, excessive excitement occurs, which is replaced by apathy and drowsiness. Difficulty breathing, shortness of breath, and severe nausea may occur.

Often after a cobra bite the following appear:

• gagging and vomiting;
• episodes of dizziness and fainting;
• blurred vision;
• leg and arm cramps;
• paralysis of the throat and pharynx.

After a cobra bite, numbness of the lips occurs . Speech functions are impaired. Swelling in the eyelid area and increased salivation become noticeable. Further, after a poisonous cobra bite, symptoms such as:

• fecal incontinence;
• rapid decrease in blood pressure;
• heart rhythm disturbances.

This negatively affects the condition of pregnant women. The poison penetrates the blood, poisoning the unborn child. Timely and complete treatment will help to avoid critical consequences.

In what cases does a viper attack?

The viper rarely attacks first: when a person approaches, it tries to hide or crawl away. Moreover, to reproduce the poison it requires a lot of energy, so the snake will not waste it again. But in extreme heat, its activity decreases: the viper becomes inactive and crawls out into the sun, where it can be accidentally stepped on. Such a bite will be a defensive rather than an aggressive reaction.

When meeting a snake, it is not recommended to make sudden movements or try to grab it by the tail. She may perceive these actions as a threat and attack in response. It is better to step aside and wait for the snake to crawl away.

Essential medicines

Snake venom is used in the pharmacology of all countries in the production of many medicines. Medicinal compositions with poison can be divided into 2 large groups.

Injections

Medicines are injected subcutaneously or into a muscle to relieve pain, cramps, inflammation and spasms.

• Vipraxin is a water-based solution (0.06%) of dry venom of the common viper. Used to relieve pain and inflammation in neuralgia, polyarthritis, myositis. Activates the immune system.
• Cobrotoxin is a substance based on cobra venom. Prescribed for the treatment of neuralgia, spasms of the heart vessels, diseases of the central nervous system and severe epileptic seizures, and is a pain reliever for people with cancer.
• Viperalgin is the venom of the common viper in a sterile solution. An anesthetic for severe and particularly severe pain, including cancer. It is also used to relieve spasms in bronchial asthma, when other means are ineffective.
• Epileptoside is a composition from rattlesnake venom. It is used for mild forms of epilepsy, migraines, disturbances of consciousness, chorea and vegetative dystonia.

Snake venom easily disintegrates if the medicine is not stored correctly and loses its healing properties. The drugs are available by prescription.

Drugs are prescribed to relieve joint and muscle pain accompanied by inflammation.

• Viprosal is an ointment containing viper poison. Additional medicinal components - camphor, salicylic acid.
• Viprosal B - contains viper venom, the rest of the composition is the same as the previous ointment.
• Vipracutan - contains the venom of various snakes, salicylic acid and methyl alcohol.
• Vipratox is a liniment containing venom from several species of snakes.
• Vipletox – contains viper poison.
• Viprazide – contains sand viper venom.

Ointments are available over the counter, but you should not prescribe them yourself.

Folk remedies with snake venom

You can prepare medications with an aqueous solution of poison (vipraxin) for home therapy.

For significant pain in the joints and muscles, it is recommended to mix 2 drops of the poison solution with 3 lemons twisted using a mincer, 1 chopped head of garlic and 1 glass of boiled cold water. Then the medicine is infused in the dark overnight. Take ½ teaspoon on an empty stomach.

A mixture containing apple cider vinegar and vipraxin helps relieve megraine headaches. To do this, 3 drops of an aqueous solution of poison are combined with 3 teaspoons of vinegar. The composition is applied to a terry cloth and applied to the forehead.

The emergence of toxicology

Modern scientific ideas about poisonous snakes and their venoms began to take shape relatively recently thanks to two Italian scientists who worked in Pisa in the 17th and 18th centuries. Physician, biologist, linguist and poet Francesco Redi (1626–1697) published a treatise on poisonous snakes in 1664, Osservazioni intorno alle vipere

[]. He established that the source of toxicity is not the snake’s bile, but the poison released from the teeth during a bite. As proof, Redi and his student, in the presence of other scientists, swallowed the bile of vipers (however, even if they swallowed snake venom, they would still remain alive, since in the absence of cuts and wounds in the mouth and gastrointestinal tract, the swallowed poison is safe). Redi is considered one of the founders of toxinology as a science. In 1967, the International Society of Toxinology established the F. Redi Prize for scientists who have made contributions to toxicology. The prize is awarded at every world congress and is considered the highest honor of the society. To date, more than 20 scientists have become recipients of the Redi Prize.

Portrait of Francesco Redi (1626–1697) and frontispiece of his book

Physicist, naturalist and chemist Felice Fontana (1730–1805) discovered the venom glands in snakes and was the first to obtain snake venom in its pure form, which he used for various experiments with animals. To top it all off, he tasted snake venoms, finding that they were tasteless and did not cause a burning sensation in the mouth or swelling of the tongue. It is important that Redi and Fontana opened a new era in the study of snakes in general and their venom in particular.

The first scientific work on herpetology was the dissertation of the Viennese physician Laurenti, published in 1784 []. The book was published in Latin and became the first systematization of amphibians and reptiles. It contains a description of 242 species from 30 genera of amphibians and reptiles of the Old and New Worlds, as well as experiments with poisons, which were recorded in detail. Poisonous animals were allowed to bite experimental animals, poisonous secretions were injected into the blood or applied to the skin. The book also describes experiments to find antidotes. Overall, the research was cutting-edge for its time, and the proposed taxonomy remains relevant to this day.

100 years later, in 1898–1905, French scientists Albert Calmette (1863–1933) and Caesar Fisali (1852–1906) obtained antisnake serums from animal blood, which saved the lives of hundreds of thousands of people bitten by snakes. Calmette discovered that if poison is injected into animals in small doses, their blood serum becomes a powerful antidote []. From this time on, the real use of snake venom began - at first only for the production of antisera, but then the range of drugs expanded. Scientists noticed that patients with epilepsy stopped having seizures after being bitten by a rattlesnake. And in 1934, it was discovered that cobra venom in small doses has a strong analgesic activity - many times greater than morphine, while the venom is not addictive. Poisons began to be included in drugs against asthma, hypertension and even leprosy. Until now, ointments and creams are produced in many countries ( Cobroxin

,
Cobratoxan
, viprosal, etc.) based on poisons.