3 out of the 14 species of Korean snakes are poisonous. These species are Agkistrodon Saxatilis
Agkistrodon Blomboffii Brevicaudus and Agkistrodon Calaginosus.
The present study includes a summary of 110 consecutive cases of snake poisoning, who were treated in Wonju Christian Hospital, Wonju, Korea, between January 1960 and July 1974. Eighty males and thirty females, a ratio of 2.7 1, were included in the series of cases. Patients were between 1 and 70 years of age.
Snake bites occurred most frequently in the summer time especially in July and August.
36 patients were bitten on the upper extremities, 70 patients on the lower extremities, 2 patients on the face and 2 patient on the, abdomen.
Tourniquets were applied by the patients in 48 cases amputations were later required in 3 of 10 patients who had tourniquet in place for longer than 24 hours.
Systemic symptoms were fever, dyspnea, nausea and vomiting, haziness of visual field, distur-bance of consciousness, abdominal pain, ptosis of eyelids, diarrhea, dizziness, hyposthesia, dysar-thria, melena and petechia. Local symptoms and signs consist of pain, swelling, discoloration of skin, bleeding from the wound, bullae formation, skin ulceration, subcutaneous necrosis and osteomyelitis. One to 8 fang marks were found; 5 cases had over two fang marks.
Anemia was found 32 cases (40.2%), this may have resulted from hemorrhage, hemolysis and secondary infection of the wound. Bleeding times were within normal range, but coagulation times were prolonged in 5 severe cases. The prothrombin time was prolonged in 43 cases (86%a). Sereum amylase, SGOT, SGPT and total bilirubin were markedly increased, but total protein and serum albumin were decreased. BUN and blood sugar were increased in, critical cases. RBC fragility was increased in 5 cases. Urine protein was detected in 38 cases (52.8%). Skin biopsies showed hyperkeratosis, bullae formation, telangiectasis, edema and non-specific inflammations.
There were 2 death in 110 cases for a mortality of 1.8%. Two cases of autopsy revealed pulmonary edema, hyaline change and hemorrhage in the myocardium.
These result suggests that poisoning from venomous Korean snake bites may be partially caused by the enzymatic component of the venom acting in concerts with the hematoxin, neuro-toxin and cytolysin.
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