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Treatment of Crotalid Envenomation

Mahlon Z. Bierly, MD; Eleanor E. Buckley
JAMA. 1966;195(7):575. doi:10.1001/jama.1966.03100070119035.
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Arecent communication, "Treatment of Snakebite,"1 which recommends "cryotherapy," and claims that "no harm is done to an [envenomated] extremity packed in freshwater ice for... six days in the absence of vascular impairment," warrants some comment, particularly in the light of conflicting published concepts.2

The communication referred to contains a direct quotation: "The big advantage of cryotherapy is its reversibility. In the temperature range of 15 C to 0 C, tissue temporarily shows all of the physiologic inhibitory effects of freezing without producing permanent destruction." This is lifted, inaccurately, and out of context, from Medical World News of Sept 25, 1964, pp 79-86. The term used in the article in Medical World News is "cryosurgery," not "cryotherapy," the surgeon uses a probe chilled by liquid nitrogen or some other coolant to perform various types of operations. The subsequent sentence is as follows, "This phenomenon allows the surgeon to


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