The adder, Vipera berus, is a short grey snake with bold black V-shaped marks on its back, and is the only venomous snake found in Britain. In England and Wales the adder may be confused with the larger but venomless grass snake; Ireland, the Channel Islands and the Isle of Man are snake-free. Imported foreign venomous snakes are sometimes mistaken for adders; their bites usually require different treatment. Adders may abound in rocky or dry country, but are sometimes seen in residential areas. If disturbed, an adder may bite with its twin hollow fangs, from which the venom flows. The Ministry of Health no longer lists envenomation separately as a cause of admission to hospital, but Morton1 saw 18 cases during 8 years as an area pathologist in Cornwall and Walker2 recorded 50 cases and 7 deaths up to 1945. In 1961 about 400 requests for Pasteur Institute antivenom were made.3
Surgical Treatment of Adder Bite
