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September 20[edit]

Three step viper[edit]

What sort of snake was the one that American soldiers in Vietnam called the "three step viper"? Supposedly if bitten you'd make it three steps before either dying or being incapacitated.

Apparently in reality it was more like "you'd make 100 steps before you started begging for someone to shoot you", but the name stuck. According to a book I read. 146.200.128.134 (talk) 03:23, 20 September 2020 (UTC)[reply]

Maybe there was no particular snake that people called by that name and they just used it as a nickname for a strongly venomous snake. I did a simple Google phrase search for "three step viper". I found this question, similar anecdotes from Vietnam, a work of fiction apparently set in China, and a site where someone says the phrase refers to the fer-de-lance, which is not found in Vietnam. Nothing that says it refers to a particular real snake. --174.89.48.182 (talk) 06:23, 20 September 2020 (UTC)[reply]

It seems it was a more optimistic name for what others called the "two-step snake", which could refer to the many-banded krait or the green bamboo viper,^[1] both of which are extremely venomenous snakes found in Vietnam. --Lambiam 09:20, 20 September 2020 (UTC)[reply]

You are yet too optimistic: Bamboo Viper (Step-and-a-Half Snake) Extremely posionous greenish/yellow snake that called Vietnam home. The venom contained a powerful nerve toxin. Called a step-and-a-half by U.S. troops because that's about how far you got after being bitten before your terribly painful, agonized death began. Clark, Gregory R. (1990). Bamboo Viper. p. 46. {{cite encyclopedia}}: |work= ignored (help) Others highly poisonous snakes mentioned are Asiatic cobra, Malayan krait, Russell's viper, Malayan pit viper, hook-nosed sea snake, Hardwick's sea snake, brown krait, banded krait and paradise flying snake. fiveby(zero) 12:58, 20 September 2020 (UTC)[reply]

Probably Trimeresurus popeiorum and not the Chinese green tree viper Trimeresurus stejnegeri. Toxicity and identification of Trimeresurus seems pretty complicated, the article says they are primarily hemotoxic rather than neurotoxic. Lambiam's link says there were few actual bites, so the name might not be much related to actual toxicity. fiveby(zero) 13:06, 20 September 2020 (UTC)[reply]

@Fiveby: I know little about Trimeresurus but I'd note our article on T. popeiorum says Northern and northeastern India (Mizoram), Burma, Thailand, West Malaysia and Vietnam. In Indonesia, it occurs on the islands of Sumatra, Mentawai Islands (Siberut, Sipora, North Pagai) and Borneo. The type locality, designated by lectotype, is listed as "Khasi Hills, Assam" (India).[2] Gumprecht et al. (2004) consider records for Bangladesh, Cambodia and Vietnam to be highly questionable, as they are likely based on misidentifications involving other species of Trimeresurus.[5] whereas I don't see any mention of a dispute of T. stejnegeri occurring in Vietnam in our article. True that it's claimed T. popeiorum is neurotoxic but T. stejnegeri is hemotoxic (and there seems to be dispute whether these even all belong in Trimeresusrus although I guess that's neither here nor there) but I'm not sure we can be certain from this story that it was neurotoxic. Nil Einne (talk) 21:00, 21 September 2020 (UTC)[reply]

Damn ophidiologists letting us down, "[Trimeresurus] are notoriously difficult to classify." Mulcahy, Daniel; Lee, Justin L.; Miller, Aryeh H.; Zug, George R. (2017). "Troublesome Trimes". Zootaxa. 4347 (2): 301–15. {{cite journal}}: Unknown parameter |displayauthors= ignored (|display-authors= suggested) (help) mentions north of Thailand and into Laos for T. popeiorum but not Vietnam. Looks like some work to do on the articles. fiveby(zero) 15:38, 22 September 2020 (UTC)[reply]

WCH toxicology has been 503 since the question was asked, see lots of links to that site and was hoping for some refs there. fiveby(zero) 15:46, 22 September 2020 (UTC)[reply]

BTW Many-banded krait claims the two-step snake was that with a source, but the source doesn't seem good enough to suggest Lambiam's one is wrong. Frankly I wonder whether there was actually a specific snake tied to the legend or whether it's more likely different bites from different snakes all combined. Nil Einne (talk) 21:13, 21 September 2020 (UTC)[reply]

There are stories from the area of children playing with kraits, with none of the elders in the village even realizing they're poisonous despite the fact that the mortality rate is supposedly 50% with antivenom, as they're so docile that no-one's been bitten in living memory. Begging to be put out of your misery sounds more like a viper, but though viper bites tend to be nasty due to necrosis, few vipers are as deadly as the stories that people tell. And since kraits would likely only bite if stepped on, and US soldiers wore boots, we're probably talking about an aggressively defensive climbing snake that might bite your hand as you're pushing through foliage, again suggesting a viper like Trimeresurus. Our unreferenced claim at Trimeresurus_stejnegeri#Venom sounds like it would be excruciating within a few steps. — kwami (talk) 07:33, 21 September 2020 (UTC)[reply]

surgery before antibiotics, and appendicitis in infants[edit]

WP's biographical article about Simone Weil (born in 1909) mentions:

Weil was a healthy baby for her first six months, but then suffered a severe attack of appendicitis; thereafter, she struggled with poor health throughout her life.

How would they have treated this issue in those days, and what about now? If they didn't do an appendectomy, would the appendicitis be likely to recur? I have the impression that appendix rupture was almost always fatal in the pre-antibiotic era, and is a serious condition even now. Thanks. 2602:24A:DE47:BB20:50DE:F402:42A6:A17D (talk) 05:02, 20 September 2020 (UTC)[reply]

This is a quote from the biography Simone Weil by Francine du Plessix Gray, page 6:

In this ritualistically hygienic family, Simone, who had been born a month premature, spent a very sickly infancy and childhood. When the baby was six months old, her mother continued to breast-feed her while recovering from an emergency appendectomy. Simone began to lose a great deal of weight and grew very ill. When she was eleven months old Mme Weil was persuaded to wean her, but Simone, in an early struggle of conflicting wills, refused to eat from a spoon. She became so thin that several doctors gave her up for lost; until the age of two she did not grow in height or weight, and had to be fed mush from bottles into which increasingly large holes were pierced. Reflecting, as an adult, on these early crises (which might have played a role in the severe eating problems she developed in adolescence), Simone sometimes speculated that she had been "poisoned" in infancy by her mother's milk: "C'est pourquoi je suis tellement ratée," she'd say, "That's why I'm such a failure."

(I think a better translation for tellement ratée is "so messed up".) So apparently it was her mother who had the appendectomy. The techniques for maintaining asepsis were still under development in those days, but the concepts and philosophy were basically in place. --Lambiam 07:48, 20 September 2020 (UTC)[reply]

Thanks both. So maybe there is an error to fix in the Simone Weil biography, though maybe I'd want to consult another few sources first. Is the theory plausible, that Mme Weil's appendectomy (or some infection that caused the appendicitis) got toxins or pathogens into her milk? 2602:24A:DE47:BB20:50DE:F402:42A6:A17D (talk) 08:08, 20 September 2020 (UTC)[reply]

Some reliable sources say that the mother's milk affecting the child was the "family belief".^[2] Another expresses the hope that Simone's blaming her mother was "in jest".^[3] Interestingly, Simone Weil herself developed appendicitis at the age of three-and-a-half that was eventually, but apparently not quickly, attended to surgically, after which it took her a long time to convalesce.^[4] Sources differ on her age at the time of the operation; some say three, others four. --Lambiam 09:01, 20 September 2020 (UTC)[reply]

Surgery for appendicitis must have been fairly routine by 1909. Joseph Lister had pioneered aseptic surgery in the 1870s and his theories had been widely accepted by the 1890s. In 1902, Edward VII underwent surgery to treat what was widely reported as appendicitis but was described by his doctors as perityphlitis (which may well have been the same thing). The operation was carried out in the Music Room at Buckingham Palace two days before his planned coronation, which was postponed for six weeks. Alansplodge (talk) 16:01, 20 September 2020 (UTC)[reply]

See also The early days in the history of appendectomy. Alansplodge (talk) 16:09, 20 September 2020 (UTC)[reply]

Lister pioneered antiseptic surgery - basically dousing everything (including the open wound) in carbolic acid. That was a giant improvement to the previous technique of taking your unwashed hand from the gangrenous leg of one patient into the open body cavity of the next, then cover it up and hope for the best. But it had a number of negative side effects. In particular, carbolic acid is a fairly aggressive substance. The modern technique of aseptic surgery goes to great lengths to avoid microbiological contamination in the first place, not to try to control it after the fact. --Stephan Schulz (talk) 19:24, 21 September 2020 (UTC)[reply]

I'll try to find the link again but while looking around about this yesterday, I saw an article mentioning that appendicitis back then was usually treated by icing it down and hoping it got better. Appendectomy may have been reserved for very severe cases. 2602:24A:DE47:BB20:50DE:F402:42A6:A17D (talk) 23:02, 21 September 2020 (UTC)[reply]

Appendicitis doesn't always progress to rupture of the appendix. There was a study a little bit ago suggesting mild cases can be treated with antibiotics and watchful waiting rather than immediate surgery. Rupture of the appendix is indeed serious, usually leading to peritonitis, and requires immediate surgery and intravenous antibiotics. --47.146.63.87 (talk) 07:53, 23 September 2020 (UTC)[reply]

The WP article on the Appendix seems to support this, "Recently, practitioners reported good results in treating appendicitis without appendectomy. Managing appendicitis using only antibiotic treatment and cooling of the appendix was successful in first occurrence acute appendicitis without complication.[24]". Similiar info in lede of Appendicitis: "Antibiotics may be equally effective in certain cases of non-ruptured appendicitis.[7]". But, prior to the use of good antibiotics, surgery would probably have been the safest course of treatment.Tribe of Tiger ^{Let's Purrfect!} 01:14, 25 September 2020 (UTC)[reply]