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POSTER
PRESENTATIONS
Tendiomuscular
Meridian Treatment
As Primary Therapy For A Rattlesnake Bite
Dein Shapiro, MD
OBJECTIVE
To describe the treatment of a snake bite using acupuncture.
PROBLEM
A man was bitten by a rattlesnake in a remote wilderness area.
History of
Present Illness
A 38-year-old man was bitten on the right foot by a rattlesnake while
guiding a river-rafting trip in a remote wilderness area. There was
a single fang penetration mark at the base of the second toe. It was
10 pm, no electronic communication was possible, and the river was not
navigable at night. Venom was extracted immediately with a suction device,
and ice was applied to slow the passage of venom into the general circulation.
Acupuncture was not performed immediately for fear that its vasodilatory
and anti-inflammatory effects might reduce swelling acutely and release
venom into the patient's general circulation.
During the next 8-9 hours, the patient experienced nausea, vomiting,
and chills indicative of a grade IIa venomous snake bite that warranted
multiple vials of antivenom, but none was available. During this time,
the foot swelled markedly. Five physicians were present on the rafting
trip; 1 with experience treating snake bites felt that the patient would
probably require fasciotomy.
TREATMENT
The next morning, approximately 10 hours after the bite, the patient
was offered the option of acupuncture to reduce the swelling and pain.
The Ting and Gathering points for the Tendinomuscular Meridians of LI,
ST, and GB were needled. The area of the bite was surrounded with superficial
needles left in place for 35 minutes.
During that time, there was a notable reduction in swelling witnessed
by all 5 physicians. Skin lines and wrinkles appeared again over the
previous tensely swollen dorsum of the foot.
Outcome
Within an hour of treatment, the patient was evacuated by jet boat.
The emergency department physician warned the patient that he would
probably experience some tissue necrosis with this grade of rattlesnake
bite. However, the patient never experienced tissue necrosis and never
required fasciotomy. He had pain and lymphedema in the mid-thigh for
approximately 3 weeks before making a complete recovery.
AUTHORS'
INFORMATION
Dr Dein Shapiro is Board-certified in Family Practice and is Clinical
Professor of Family Practice at the Robert Wood Johnson School of Medicine
in Branchburg, New Jersey.
Dein Shappiro,
MD
3461 US 22
Branchburg, NJ 08876
Phone: 908-526-4499
Fax: 90888-526-4495
E-mail: boxwood@aol.com
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