'Dear Dr Graydon,
Many thanks for yours of 10 October. All cases of snakebite I treated happened between 1920 and 1930. I don't think antivenom was available at that time. Several bitten on legs or arms I injected with potassium permanganate solution and left the intermittent tourniquet release to the nursing staff. They recovered, but I don't remember any details.
Two that I paid a lot of attention to, I remember well. One, in Mildura, I treated in conjunction with the late Dr Neil Henderson, [ involved] a young Methodist parson. In 1926, they had the pan system of lavatories with a trap-door at the back, often left ajar by the nightman. The young parson was perched on a seat when a snake fastened onto his glans penis. [Groans]
He yelled, stood up and had to pull the snake from his penis. The senior parson who was in the yard saw the snake leave the outhouse and described it as brown and about six feet long. The senior parson tied a tape around the penis and telephoned us. We infiltrated each puncture with potassium permanganate solution and personally attended to the on-and-off application of the tourniquet. [Laughter]
I forget the time factors but I think tolerance and the colour of the appendage was the guide. And it was several hours before the tourniquet was dispensed with. The penis recovered quite well from this hazardous treatment.'

'A snake bite usually occurs a long way from antivenom and bush folk place great credence in tourniquet, often badly applied, and Condy's. A slough due to treatment is nothing if it saves life. The lethal dose of snake poison treated with potassium permanganate or other chemical before injection does not cause death. There may be some rationale in infiltration. Personally, I always thought that snake venom was taken up by the tissues and the lymph during the application of the tourniquet. Surely there are less irritating chemicals that destroy snake venom produced by infiltration at the same time as the tourniquet. I would like to see Dr Wiener but I am busy...and so on. Many thanks for your letter. I am sure you will enjoy the episode of the young parson. After all, it happened to someone else' [Laughter]

So perhaps we might ask Peter. As someone who's physically had to use pressure immobilisation on themselves or had it applied, do you recall how things were amongst the herpetologists before, and then immediately after, Struan publicised his work. What was the teaching before that, and the impact of the change in approach?

Peter Mirtschin: As I said before, Struan's work was pretty widely publicised. Most of the herpetologists who kept snakes were aware of Struan's pressure-immobilisation method of first aid in one way or another. The first time I had to use it was after an inland taipan bite. This was very shortly after the toxicity of that venom was publicised and, having been bitten by this species, I thought to myself that I was the first person known to have been bitten by an inland taipan, apart from the guy who was involved in its discovery. So I applied the first aid myself and then I jumped in my car and drove myself to hospital. Now, that's a subject all on its own and I'm open to valid criticism for driving after being bitten. By the time I got to the hospital and was lying down, I had started to feel the effects of the venom. In my opinion, the first aid was beneficial in that case. I went on later and used it a number of other times - after a death adder bite and a rough-scaled snake bite. In all those cases I believe it worked for me.

Figure 11 Peter Mirtschin
Photograph courtesy of Ann Wetsmore

Struan was a wonderful communicator and I think most herpetologists knew of this pressure-immobilisation technique because of all the publicity that he attracted at this time, and still does even today. You'd probably go a long way to find a herpetologist dealing with dangerous snakes in Australia who is not aware of the first aid method.

I started accumulating a large collection of snakes about the time pressure-immobilisation was replacing the use of tourniquets.

Witness to the History of Australian Medicine