Australian venomous and poisonous fishes.

CLINICAL TOXICOLOGY 10(3), pp. 291-325 (1977)

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Australian Venomous and Poisonous Fishes*

A guide to the identification, symptoms and treatment of the effects caused by fishes and s om e other vert ebrat e animals of Australian t er r i t or i al waters. R. V. SOUTHCOTT, M.D., D.Sc.

FOREWORD The sea and the seashore are traditional playgrounds for thousands of Australians every day. With a growing population, it is logical to expect that misadventures and injuries will increase as a result of m a n ' s increasing intrusion into the m ar i ne environment. This handbook, therefore, has been specially written and illustrated to help in the identification of marine life which is hazardous to man. It covers mo re common, important o r typical m em bers of each group of fish in Australian t er r i t or i al w at er s which may be a ri sk to persons coming into contact with them, o r through eating their flesh. It als o covers a number of aquatic higher vertebrates. This handbook is not designed to be a textbook of therapeutics. It is, rather, to make people aw ar e of toxic species of fish with often recognisable external features and behaviour charact eri st i cs and range of symptoms with, in some cas es , m or e o r less clearly defined approaches to treatment. Thus, this publication will have a special in*This article, is reproduced, with permission, from "Australian Venomous and Poisonous Fishes" by Dr. R. V. Southcott, 2 Taylors Road, Mitcham, South Australia 5062 (with the omission of the line illustrations). 291 Copyright @ 1977 hy Marcel Dekker, Inc All Rights Reserved Neither this work nor any pdrt may be reproduced or transmitted in any form or by any means. electronic or mechanicdl including photocopying, microfilming. and recording, or by dny information storage and retrieval systein without permission in writing from the publisher

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t e r e s t f o r amateur fishermen, s u r f life-savers, first-aid attendants, police, scouts, ambulancemen, scuba divers, yachtsmen and members of the medical and nursing professions.


INTRODUCTION Australia lies a t the confluence of the Indian and the Pacific oceans. Its northern seas a r e p a r t of the Indo-west-Pacific marine zone, with a n incredible diversity of m a r i n e fauna. In the south, A u s t r a l i a ' s responsibilities extend to the Antarctic. Around Australia t h e r e is a variety of faunal regions, with many different fishes capable of being harmful to man in s o m e way. It has been estimated that on a world b a s i s at least 1,000 s p e c i e s of fishes are e i t h e r venomous o r poisonous. These occur in the greatest numbers in warm temperate o r tropical waters, the richest fauna being in the Indo-Pacific region. Thus s e v e r a l hundreds of s p e c i e s are potentially harmful in Australian seas. Fishes with such c h a r a c t e r i s t i c s range from the most primitive to the most advanced m e m b e r s of the Class. In t h e i r long evolutionary history fishes have been able to develop a considerable variety of offensive and defensive s t r u c t u r e s . In these present booklet, however, we will not be concerned with traumatic injuries inflicted by s u c h aggressive fishes as s h a r k s and barracudas, nor with fishes such as g r o p e r s , eels and o t h e r s which can a l s o cause important injuries, n o r again with the electrical injuries which can be caused by s o m e of the Australian rays. It is proposed only to survey in s u m m a r y form various important fishes o r groups of fishes (illustrated by common, typical o r important examples) of species causing toxic effects, either from an injection of venom by the defensive apparatus on the fish, o r from an actual toxin contained in the tissues of the fish. The value of a venom gland to a fish is immediately apparent, the sea having been a g r e a t a r e n a of predation f o r hundreds of millions of years. Such glands a r e possessed in primitive but effective form by the r a y s and s o m e s h a r k s , and in m o r e advanced form by stonefishes, scorpionfishes and o t h e r s of the m o r e highly developed of t h e bony fishes. Many species of fishes a r e poisonous, there being a number of different toxins involved. One of the most important types of poisonous fishes is the group of tetrodotoxic fishes, which includes the pufferfishes o r toadfishes (toadoes, toadies, swell-fishes and many other common names) of which t h e r e are about 30 species in Australian waters. Despite the commonness of the pufferfishes, many Australians, including sea-fishermen, are not a w a r e that they contain a lethal poison. This knowledge of their toxicity was traditional to the native inhabi-


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tants of the Indo-Pacific shorelines, and t h e r e are historical r e c o r d s which prove that the ancient Egyptians w e r e a w a r e of this. The rec o r d s of the Chinese and Japanese show that they w e r e a w a r e of this toxicity a t the time of the Norman Conquest of England. However, the e a r l y European e x p l o r e r s of the Indian and Pacific Oceans were unaware of such toxicities, and had to gain the knowledge from their own misfortunes. Thus Captain Cook was twice s e v e r e l y poisoned by eating toxic Pacific fishes. In one c a s e i t was by one of the pufferfishes (tetrodotoxic) and in the other c a s e it was by a ciguatoxic fish ( s e e further below). The recorded instances of pufferfish (toado) poisoning in Australia go back to the beginning of the white settlement, and have o c c u r r e d from time to time down to the present day. The toxin of this group of fishes is a d i m e r f o r which the molecular formula h a s been worked out only in recent years. Curiously enough the s a m e toxin is manufactured in the eggs of a s p e c i e s of North American newt, and i t app e a r s a l s o to be s i m i l a r to the toxin of the blue-ringed octopus of southern Australian waters. Every few y e a r s a tragedy o c c u r s in Australia from s o m e person o r persons eating one of these fishes; generally, then, a f t e r the resulting publicity, it is s e v e r a l y e a r s before another such instance occurs. Another important type of poisoning is in the c a s e of the ciguatoxic fishes; in these the poison, o r ciguatoxin, is not intrinsic to the fishes but is acquired from a preceding plant o r animal in the food-chain. Such ciguatoxic fishes include a great variety of fishes from many different families. Unfortunately t h e r e is no ready way of recognizing whether such fishes a r e in a s t a t e of having acquired the poison, o r not, and in addition the areas affected in the Indo-Pacific change from time to time. In various p a r t s of the Pacific a number of commercially o r economically important fishes may be affected. This type of poisoning has been reported in s o m e instances from fishes caught off Queensland. Predatory fishes, being at the end of a foodchain, a t t i m e s tend to accumulate the toxin, and other fishes which a r e liable to be affected a r e reef-feeding tropical fishes. It is believed the toxin originates in algae eaten by the reef-feeders, and is then passed ( transvected' ) along the food chain. A s i m i l a r p r o c e s s o c c u r s in the acquisition of m e r c u r y by marine fishes, the m e r c u r y accumulating in the predator at the apex of the food-chain, just as DDT a l s o accumulates in certain predatory birds. Such man-made intoxications are now causing concern to governments, but natural poisons accumulated in a s i m i l a r way long before man commenced polluting the seas. Naturally occurring accumulations of vitamin A have a l s o occ u r r e d in various marine animals, including fishes, seals and o t h e r carnivores, and may in s o m e instances c a u s e acute intoxications in man.

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A few species of s h a r k s have been reported as venomous. The P o r t Jackson s h a r k s o r heterodonts are an ancient group of animals which may properly be called living fossils, as s i m i l a r s h a r k s date back to the Carboniferous period. The common P o r t Jackson s h a r k of Australia and New Zealand, Heterodontus portusjacksoni, is commonly inoffensive, but a few stings have been recorded f r o m puncture by a d o r s a l spine (these are found one in front of each of the d o r s a l fins). Symptoms Recorded are local pain, numbness and local muscle weakness, lasting 1-2 hours; the pain may a l s o p a s s along the c o u r s e of the lymphatics. A Californian s p e c i e s of Heterodontus gives s i m i l a r effects. The spiny dogfishes o r squalids are another group of primitive s h a r k s with s i m i l a r d o r s a l spines, and one s p e c i e s which o c c u r s in the Pacific Ocean (Squalus acanthias) h a s been recorded a s venomous. STINGRAYS The stingrays are among the most important venomous fishes. They are essentially marine, but s o m e s p e c i e s can e n t e r estuarine water freely, and even f r e s h water. They are common in shallow coastal waters, but a l s o o c c u r in the depths of the oceans. They are bottom feeders, and burrow into mud and sand to feed on worms, molluscs and crustaceans. Thus i t is e a s y f o r a person to t r e a d on them in shallow water, and this c a u s e s a rapid defensive reaction by the ray, in which it brings i t s tail and attached b a r b vigorously into action. The b a r b is formidable, and carries venom in a c r u d e but effective arrangement along its sides. Death has occured to pers o n s diving onto rays, o r lying on top of them, and receiving a punct u r e of the heart o r peritoneal cavity. Shuffling the feet (securely encased in boots) along in murky w a t e r s is advocated, a s being m o r e likely to make stingrays take evasive than defensive action. Only a few of the Australian r a y s can be r e f e r r e d to here. Gymnura a u s t r a l i s

' Butterfly ray,' ' Rat-tailed ray'

The butterfly r a y s o r Gymnuridae are mainly tropical fishes. They have a poorly developed sting (which may even be absent), originating from n e a r the base of the tail. Gymnura a u s t r a l i s , the rat-tailed o r butterfly ray, o c c u r s in shallow coastal waters of New South Wales and Queensland. It has a v e r y s h o r t tail. This s p e c i e s grows to about 1.3 m across.



Myliobatis a u s tr al i s

' Eagle

ray,'

' Bat

295 ray'

The eagle r a ys o r Myliobatidae ( al s o called bat r a y s ) have a better developed sting than the butterfly r ays , but even so, only a few injuries have been reported from them. They receive their common name from their birdlike heads, and the winglike extensions of the body disc, through which they "fly" gracefully through the water. Some speci es grow to over 2 m acr os s , and by their weight can upset sm al l boats. They are inoffensive, however, and t hei r teeth are pavement-like, designed for crushing molluscs and other hard-shelled food. Myliobatis a us tr alis is found in al l Australian s t at es , and grows to over 1.3 m a cr o s s . They are found in coastal w at er s down to about 100 m. The "wings" of these rays, as well as those of stingrays, are cut off and sold in the markets as "skate. '' Aetobatus narinari

' Duck bill ray,' ' Beaked eagle ray,' 'Spotted eagle r ay'

The duckbill ray o r beaked eagle ray, Aetobatus nari nari , (al so known as the spotted eagle r ay) is found in the tropical and subtropical w ate r s of New South Wales, Queensland, Northern T erri t ory and Weste r n Australia. It grows to a very l ar ge size, specimens being 3 m a c r o s s and more. It is a handsomely marked species, with white to c r e a m , grey o r blue spots, on a d a r k e r background of brown, olivaceous, grey o r blue-black. The l ar ge open s pi r acl e s behind the eyes a r e a characteristic of this ray. It is very active and may leap c l e a r of the w ate r at times. It is never common. At times it is caught by t raw l ers, and has been taken al s o feeding on oys t er f a r m s on northern New South Wales. Dasyatis thetidis

' Black stingray, Smooth stingray' ' Thorntail stingray'

The Family Dasyatidae, the stingrays proper, which are som et i m es called stingarees, have a strong whip-like tail with a barbed spine, capable of stinging effectively. Nine species are recorded in Australian waters, of which the black stingray (thorntail stingray) Dasyatis thetidis is illustrated, growing to a width of 3.5 m, being recorded from the coastal waters of New South Wales and Western Australia. A s i m i l a r species, Dasyatis breyicaudata, o r the smooth stingray, is common off the coast of southern Australia, from New South Wales a c r o s s t o Western Australia. It is the l ar ges t s pecies of stingray in the world, growing to a length of 4.2 m and a width of 2 m. Urolophus testaceus

' Common stingray,' ' Greenback stingray,' 'Sandyback stingray,' 'Round stingray,' ' Stingray'

The Family Urolophidae o r round stingrays have a comparatively s h o r t tail, which, however, pos s es s es an efficient sting. Mostly these


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a r e small species of rays, less than 1 m long. They occur in coastal waters from the shallows down to depths of 150 m o r even deeper. Eight species a r e recorded for Australia, of which the "common stingaree" o r stingray, Urolophus testaceus, is illustrated. This species is common on sandy flats in shallow waters, and down to depths of about 150 m. It is found also in harbours and estuaries. A viviparous species, it grows to about 80 cm long. From above the disc of the fish is brown, with a lighter rim; from below this ray is white with a wide light brown border. It is probable that this species of ray is the agent responsible for many of the stingray injuries to waders in shallow waters. It occurs from South Australia around the coasts to the eastern side of Australia, a s far a s southern Queensland. Two other common species of round stingrays a r e Urolophus viridis, the greenback stingaree, which has its upper side a uniform light green colour but with a ventral surface which is white with purple edges, and Urolophus bucculentus, the sandyback stingaree, which has a pale brown upper surface marked with white speckles and lines in the mid-dorsal region. Both of these latter two species are common in depths down to 200 m, off the coasts of New South Wales, Victoria and Tasmania. T R E A T M E N T O F S T I N G R A Y WOUNDS An injury from a stingray combines the features of a punctured o r lacerated wound with that of envenomation. If the trauma is severe, damage may be considerable, and extensive wounds may need to be treated with measures to deal with possible severing of arteries o r nerves, apart from muscle and other tissue damage. Thus general surgical principles, a s for other contaminated wounds, may need to be invoked. Symptomatic treatment a s well as treatment by antibiotics is indicated; debridement and other measures may need to be considered. Leaving the wound unsutured appears to be a general wise precaution, unless it can be excised. Local agents such as potassium permanganate, ammonia or cryotherapy have been tried and found ineffective (Russell, 1965 p. 346). Local irrigation with salt water is advocated, with removal of any retained integumentary sheath if it is visible in the wound. Ligature might be useful, as in snakebite, i f it can be applied over a singlebone part of a limb. The venom is sensitive to heat, and hence some detoxication will occur with symptomatic relief if the limb can be placed in hot water for 30-90 mins, with optional addition of NaCl o r MgSO4, to the water. Antitetanus agents a r e also advocated, a s for any open wound. See also the measures against fish envenomation, on page 209, which will not be repeated here.


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VENOMOUS BONY FISHES Among the venomous bony fishes are the scorpion-fishes, stonefishes, stargazers, catfishes, surgeonfishes and others, which are well-represented in Indo-Pacific waters and in the Australian region. From the point of view of injury to man the most significant of these is the group of stonefishes, and hence it is not surprising that the one effective antivenene that has been made against fish venom has been manufactured against stonefish venom. From the point of view of numbers of minor injuries, probably the scorpaenid fishes (scorpionfishes and butterfly fishes) will take precedence. CATFISHES The catfishes receive this common name on account of the welldeveloped sensory barbels ( ' whiskers' ) around the mouth, present in many species. The group is distinct in the absence of true scales, and the skin is either thick and slimy, o r protected by bony plates. For the most part they are freshwater fishes, only a few species living in brackish o r marine waters. The flesh is good eating, but these fishes are often discarded because of their appearance, o r from the risk of handling the venomous spines. Both the pectoral and dors a l fins have venomous spines. Thus while most venomous fishes can be safely picked up by a pectoral fin, this is not so with the catfishes. Family PlotosidaeTandanus tandanus

solid-tailed catfishes

Freshwater catfish'

This is the common Australian freshwater catfish, and is frequently eaten under the name of "jewfish" (not to be confused with the marine fish Sciaena antarctica, at times called Jewfish, Dewfish, o r Mulloway, etc. ). Tandanus tandanus is frequently encountered in the freshwater coastal r i v e r s and lakes of Queensland, New South Wales and South Australia, as well as the Murray-Darling Rivers system. At times T. tandanus is cultivated in inland dams for food. This species is a mud-feeder, eating most organic debris, even cattle manure. It is dark above, and white below; it grows to about 60 cm long. A wound from this species may cause considerable tissue damage, and considerable pain.

298 Tandanus bostocki

SOUTHCOTT Cobbler'


Is the freshwater catfish o r "cobbler" of the freshwater s t r e a m s and water holes of coastal southern Western Australia. Its upper surface is dark, and the fins have a marbled appearance. It grows to about 38 cm long. This species has been responsible for a number of painful woundings. (Note: In Western Australia the catfishes are commonly called "cobblers," but elsewhere in Australia the term "cobbler" is frequently applied to various species of scorpaenid fishes.) [Also see p. 3021. Plotosus anguillaris

Catfish eel,'

Striped catfish'

The "striped catfish" o r "catfish eel" grows to about 90 cm long, and may cause s e v e r e wounds. The juvenile form has three yellowish stripes along the sides of the body, hence the popular names. This fish lives in the estuarine regions and r i v e r s of tropical Western Australia, Northern Territory, Queensland, and northern New South Wales. Cnidoglanis macrocephalus

Estuary catfish'

The "estuary catfish," is a slender species which grows to about 90 cm long. It is found in estuaries and shallow waters n e a r r i v e r mouths. It occurs in all Australian States. It is quite a good fish to eat, but i t s repulsive appearance frequently deters people from eating it. It can cause a painful wound. Euristhmus lepturus

Long-tailed catfish'

It is commonly called the "long-tailed catfish," and is a marine species. It is brown dorsally, lighter below, and with the tail mottled. It grows to 46 cm long. This fish is found in New South Wales and Queensland waters. Family Tachysuridae Netuma thalassina

-

forked-tailed catfishes

Giant salmon catfish'

Belongs to the family of fork-tailed catfishes, o r Tachysuridae, and is the largest species of the family, growing to over 1 m long. This family may be distinguished from the preceding species mentioned, the "solid-tailed catfishes" o r Plotosidae, by, in addition to the tail characteristic, having 6 barbels around the mouth instead of 8.


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This species is commonly known as the giant salmon catfish. Dorsally it is generally reddish-brown, while underneath i t is white o r silvery. The margins of a l l fins are dusky, and the s m a l l adipose fin n ea r the tail has a conspicuous dark mark. This fish inhabits the coastal and estuarine w at ers of northern New South Wales, Queensland, Northern T erri t ory and Western Australia, extending in fact to New Guinea, India and the Red Sea.


STONEFISHES Therapy F o r Stonefish Envenomation The general symptomatic m eas ur es which may be taken for stonefish envenomation are s i m i l a r to those f or the effects of other fish envenomation, and include local heat, cleansing o r surgery, use of antibiotics, as well as pain-relieving agents, such as local anaesthetics, injected around o r into the wound, o r the m ore general administration of anti-pain drugs. The development of an effective antivenene by Wiener of the Commonwealth Serum Laboratories, Melbourne, Australia, the f i r s t antivenene which has been developed for clinical use against any fish venom, has made a profound difference to the treatment of stonefish stingings. The following r e m a r k s are based upon clinical and ot her experience with the antivene. The antivenene is issued in 2 ml ampoules of refined and concentrated hyperimmune hor s e s er um , each 1 ml being capable of neutralising 10 mg of dried venom. Each of the two venom glands of a dorsal spine of Synanceja trachynis contains 5-10 mgm of venom (when dried), hence an initial dose of 2 ml should be capable of neutralising the effect of 1-2 stings. If t her e has been a puncture by mo r e than two spines a l a r g e r dose should be administered. In clinical use the antivenene has been found effective, but clinical evaluation has been rendered difficult by the fact that a stonefish has been actually seen by the victim in less than two thirds of the number of stingings that have been reported on. Laboratory evidence, however, shows that the antivenene will neutralise all observable toxic effects of stonefish venom in laboratory animals. C a s e s of fish stinging have been reported where the fish responsible was not actually seen, and there was no response to antivenene. It appears that there is no strong evidence that Synanceja antivenene is effective against toxins other than stonefish venom. The most interesting report has come from Rarotonga, where stonefish stings are well-known and the victims have invariably needed hospitalisation for s ever al days. After antivenene was introduced in Rarotonga the clinical response was rapid in nearly all cases and the


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results excellent. Thus in two boys antivenene was administered within 2 h r of the sting and there was rapid relief of the pain and swelling, and hospital admission was unnecessary (Trinca, 1967). It should be noted that stonefish antivenene should be protected from light and stored a t between 0 " and 5"C, but not frozen. It should be used immediately on opening, and any unused p a r t discarded. The manufacturers are particularly anxious to receive reports of the effects of their antivenene on sufferers. At one stage the injection of emetine along the track of the sting was found to give relief from the pain. At f i r s t thought to be due to a direct effect of emetine, later it was realised that the detoxication was due to the very acid nature of the solution needed to dissolve the emetine hydrochloride. Other agents which have been used have included local procaine, potassium permanganate and congo red, but it has been found that these agents are effective only i f given promptly a f t e r the stinging, before the venom has had time to diffuse away from the puncture track (Wiener 1958, 1959a, b; Trinca, 1967). Synanceja trachynis

Deadly stonefish'

Synanceja trachynis and S. verrucosa belong to the Family Synancejidae o r stonefishes. These fishes prefer the warm shallow waters of the Indo-Pacific. They like to live in crevices in rocks and corals, where they lie motionless. They a r e the most important venomous fishes of the Indo-Pacific, their venom potential being so great that they appear indifferent to man and other potential assailants. There are possibly two Australian deaths from Synanceja stingings. Synanceja trachynis, commonly called the deadly stonefish, is found in all tropical Australian waters, over the northwestern part of Western Australia around to northern New South Wales. The colour is generally a dull brown o r greenish, somewhat mottled, but other colours are recorded, e.g., reddish. The warty lumps on the skin tend to be lighter coloured, often yellowish, but a t times brown o r reddish. The fish lies concealed on coral reefs, i t s camouflage being so perfect as to make it hard to see on the reef, even when it is pointed out directly. It grows to about 30 cm long, and occasionally attains 38 cm. The dorsum has 13 spines which are erected when the animal is molested. In life these look like small clubs, the spines lying within them, but being brought into action by p r e s s u r e from e.g. being trodden on, which s t r i p s back the skin over the spines. There are also venombearing anal spines, and non-venom-injecting pelvic spines. Synanceja verrucosa is closely related to Synanceja trachynis, being also known as "deadly stonefish. 'I Its geographical distribution is similar. A sting from Synanceja causes immediate and excruciating pain. See above for remarks on treatment.


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In walking over cor al reefs o r other situations where these fishes occur it is sensible to wear stout leather footwear. Prevention is far preferable to a stinging, even though modern treatment is effective in relieving the effects, once the antivenene can be obtained.


Inimicus barbatus

' Bearded

ghoul'

The genus Inimicus contains a number of highly venomous species, with venom effects s i m i l ar t o those from Synanceja. A number of species are important in the Indo-Pacific, e.g., I. japonicus, the "lupo" of Japanese waters. The "bearded ghoul," is common in Queensland waters, and grows to about 33 c m long. The upper surface is a blackish brown, while the underside is light-coloured. It has about 17 dorsal spines, which can cause painful stings. Inimicus c ir r h os us

Western Australian spotted-fin stonefish'

Inimicus c ir rhos us is distinguished by the yellow spots on the inner s u r f a ce of the pectoral fin. A sting from this species in Western Australian waters was recorded a s causing intense pain f o r several hours, with delirium.

S C O R P I O N F I S H E S AND B U T T E R F L Y CODS FAMILY SCORPAENIDAE The scorpion fishes are found in all oceans, from the polar w at ers t o the equator, but probably have their greatest development in the tropics. Many of them have bi zar r e and beautiful patterns, constituting a warning coloration in many instances. Many of them are good eating fishes. All of them have one o r m o r e venom glands developed in association with dorsal spines. There is no duct to the venom gland, the venomous tissue releasing i t s toxin into a wound a f t e r the integument is torn away by the trauma of the encounter and puncture. Many species are involved in Australian w at er s and only a number of important o r common examples can be given. P ter o is volitans

Fire-fish,' ' Butterfly cod,' Zebra-fish,' Feather-fins,'

Lionfish,' etc.

This species of fish is one of s ever al species of the genus Pt eroi s living in the w a r m e r waters around Australia. Pt eroi s volitans occurs in fact quite widely in warm Indo-Pacific waters, including the w at ers of northern Australia and New Guinea. It has been recorded as far south as Sydney, New South Wales. It is mainly an inhabitant of tropical reefs, and is common in north Queensland and the Northern Territory.

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It has a striking red o r brownish-red colouration, with numerous dark-red o r black transverse bands with white borders; fins with dusky spots o r blotches. It grows to about 38 cm long. It is a slow swimmer, but when an enemy approaches it rapidly rotates i t s body and presents its spines to the potential attacker.


Symptoms The long and strong dorsal spines a r e venom-bearing and cause extremely painful stingings, the pain at times lasting for months. Apart from pain, the immediate effects of an envenomation may be hypotension, bradycardia and impairment of respiration. On occasions oxygen therapy has been required for pulmonary oedema and other complications. Tissue necrosis has followed stingings. A s this species of fish is now becoming increasingly popular among tropical marine aquarists there is now quite a possibility of the medical practitioner of the southern Australian States being called upon to treat a sting from one of these firefishes. Hypodytes carinatus Hypodytes carinatus. The "ocellated wasp fish," is recorded from the warmer waters of Queensland and Western Australia at depths of 30-70 metres, thus it is rarely taken except in a trawl-net. It has a lilac-coloured body, silvery-white below, and with a large black spot (''ocellus") n e a r the middle of the dorsal fin, as well as a small dark spot a t the front end of the dorsal fin. It grows to about 17 cm long. Scorpaenopsis gibbosa

False stonefish'

This is a wide-ranging Indo-Pacific species, although rather uncommon. It has been recorded for Queensland, Northern Territory and New Guinea waters, also from eastern Africa, Indian Ocean islands, Red Sea, Indonesia to Japan and Korea, as well as Hawaii and elsewhere in the Pacific. Gymnapiates marmoratus

' Cobbler'

This is a short robust fish, to 20 cm long, the body fawn to light yellow, with dark brown mottling. It is distinguished by the absence of scales on the head and body, the skin being smooth and slippery. It occurs in shallow waters from Western Australia to Victoris and Tasmania. (Note: in Western Australia the catfishes are commonly called "cobblers". ) Puncture of the skin by one of the spines of the head o r back can cause exquisite pain. It is often caught by beach fishermen using seines a t night, but line fishermen also catch the fish and receive similar stings.

VENOMOUS AND POISONOUS FISHES Centropogon au st r al i s

303

' Fortescue'


This is a s im i l ar s m al l but robust fish, to about 15 cm long, brownish in colour but patterned by s ever al d a r k e r m ore o r less vertical bands. It occurs in coastal and estuarine situations in Queensland and New South Wales. The fin and head spines can cause painful stings. As with the preceding species it is often taken in hauling nets, and netfishermen are the most likely to be stung, as it is common among weeds. Even tiny specimens a r e recorded as capable of causing a painful sting. Notesthes robusta

' Bullrout,' ' Kroki'

This species is a common, solidly built fish found in est uari es and upstream f r es h waters in New South Wales and Queensland. Of a dull yellow colour, marbled with dar ker brown o r grey markings, it grows to about 35 c m long. Its markings s e r v e as camouflage among i t s usual weedy habitat, in which i t stays motionless. The flesh is edible. This fish has 15 venomous dor s al spines, and t hree spines on the anal fin, a ls o a single spine on each ventral fin. Each of these spi nes has a paired venom gland. Numerous severe injuries have followed puncture from one o r m o r e of these spines, for example from treading on the fish among weeds o r stones, o r from handling it. Pain is i m mediate and rapidly becomes excruciating. Symptoms The wound may appear as a little s l i t about 2 mm long on the plantar s u r f a ce of the foot, often on its outer edge, o r on a toe. A s i m i l a r sl i t may be seen about a centimetre away, o r possibly puncture marks. Pain rapidly develops in the regional lymph nodes, but no swelling is apparent. The patient is disturbed o r restless, but not shocked o r pyrexial. Around the wound t her e may be a sm al l amount of oedema, o r pallor, o r in some cas es , localised sweating. Children may be greatly disturbed, and even become maniacal. Treatment Local irrigation of the wound through the puncture with 2-5 ml of 1-2% lignocaine has been found to give relief in seconds, with complete relief of symptoms, e. g. , groin pain, in 15-30 minutes (Patkin and Freeman, 1969). Lf, as r ar el y occurs, the pain r e curs, a second injection will give relief. Without treatment pain may l ast hours o r days. Emetine injection into the puncture site has a l s o been found to give relief (see comment on the action of emetine under Therapy for Stonefish Envenomation, page 299).

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Sebastapistes bynoensis

Marbled rock cod'

This is a somewhat small species of scorpaenid fish, growing to about 15 cm long. Its colour is variable but generally the body is a greyish-brown, with superimposed irregular dark transverse bands. The fins a r e either pale, barred, dusky o r mottled reddish-brown. The lips and underside of the head are usually marked with brown and paler bands. This species is found in the w a r m e r coastal waters of New South Wales, Queensland, Northern Territory and northern Western Australia, and more widely in Indo-Pacific waters. Despite its small s i z e i t can inflict a s e v e r e sting; i t s venomous armament consists of the 12 dorsal spines. Neosebastes thetidis

' Thetis fish'

The genus Neosebastes contains a number of species capable of inflicting painful stings. A typical member of the genus is the "Thetis fish," Neosebastes thetidis. This species grows to about 33 cm long. Robustly built, it is reddish-brown, with black mottling. This species of fish occurs widely around the southern half of Australia, being found from Western Australia eastwards to Tasmania and New South Wales. As i t is mainly an inhabitant of deeper water it is normally encountered during trawling operations. Neosebastes pandus

Gurnard perch'

Another species, is also a robust fish, growing to the s a m e length. It has a greater variety of colour in i t s markings, including a light buff body mottled with brown, with other markings on the body o r fins of blue, orange, pale green, dark brown and reddish. It is quite a common species of fish off southern Australian coastlines, its distribution being in fact from Western Australia to Queensland and Tasmania. It lives in rocky areas and submerged reefs, in deep water, but is not often encountered, as it does not readily take the hook. Neosebastes nigropunctatus

' Black-spotted

gurnard perch'

The black-spotted gurnard perch, is a more slender species, growing to 36 c m long. It is reddish, with numerous small black dots. It has a recorded distribution of Western Australia, South Australia and Tasmania. Generally obtained by trawling, as it prefers deeper waters, but is occasionally taken by fishermen with a line. An injury from five of the dorsal spines of this species has come to notice. A specimen 3 1 . 5 cm long caught by a line fisherman in S.A. waters had just been taken off the hook and was on the floor of a small boat. It gave a flip and five spines penetrated the skin of the b a r e foot and ankle, causing severe pain, spreading up the right leg a s far as the knee. The pain remained for 6-7 hours, and the ankle became swollen,


305

becoming 1 cm g r eat er in circumference. The tenderness and the swelling of the ankle lasted over t hr ee months.


Ruboralga ergastulorum

' Red

rock cod'

This is a scorpaenid fish which grows to about 38 cm long, and is found in the waters of the south-eastern coasts of Australia. It is reddish in colour, with d a r k e r reddish-brown markings, and a black spot on the d o r s al fin membranes from the 9th to 11th dorsal spines. All species belonging to the genus Ruboralga are stingers; they are commonly r e f er r ed to as red rock cods. A species considered as one of the commonest rock fishes off the New South Wales coast is the red rock cod, Ruboralga cardinalis. Symptoms Commonly fishermen receive s cr at ches in handling them, and these s c r atc h e s may be trivial o r remain s o r e for a few days. At times a puncture from a spine causes the s e v e r e r effects of envenomation, being recorded by Watkins (1969) as immediate and almost unendurable pain. If the wound is in the hand, as is commonly the case, the pain s p r e ad s up the a r m and a c r o s s the chest, over about half an hour. General symptoms occur at the s a m e time, such as pallor, writhing, vomiting and collapse. Presumably in these s e v e r e r cases a toxic dose of venom has been injected into the d e r m i s , while in the trivial ones venom has not penetrated to the dermis. Helicolenus papillosus

Red gurnard perch'

This is another, robustly built, scorpaenid fish, which occurs from Western Australia a c r o s s the southern w at ers of Australia to New South Wales and Tasmania. It grows to about 30 cm long. It is reddish above, white below, and the body is marked with dark, i r r e g u la r cross-bars. O T H E R STINGING FISH Family Triglidae Chelidonichthys kumu

' Red

gurnard'

This species of fish, commonly called the red gurnard, belongs to the Family Triglidae. It is a v er y widely distributed fish, ranging from China to New Zealand and South Africa, and occurs in all Australian States. It is one of the most abundant of the gurnards in southern Australian waters, and is extensively trawled for s a l e as a food fish. The flesh is very good eating.

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The colour of this fish is reddish above, white below. The outer surface of the pectoral fins is dark red; while the inner surface is green with a large dark spot a t the lower edge. Scattered white spots are also seen on the pectoral fins. Although a venom gland has not been demonstrated, various memb e r s of the Family Triglidae have been reported in Europe as causing stings. One South Australian record of a painful sting, lasting 1 1/2-2 hours, with painful swelling of the hand, has come to notice, from a puncture "from the spines under the head". Family Enoplosidae Enoplosus armatus

Old wife,' Bastard dory,' Zebra fish'

' Double scalare,'

This is a silvery compressed fish with a deep body; it grows to about 23 cm long. Its body is marked with s ever al vertical black st ri pes, while i t s graceful fins may have s om e red o r pink colouration. It occurs in all Australian States, and is a common fish of harbours and sheltered foreshores, and commonly occ urs in schools. Its flesh is good eating, but as it r ar el y takes the hook it is not well-known to anglers. It is frequently taken by spearfishermen. Symptoms Puncture from a spine causes a s har p pricking sensation, followed in a few minutes by aching and swelling, with local flushing. More general symptoms have not been recorded.

Fa m i l y U r a n 0 s c o p i d a e Kathetostomalaeve

'Stonelifter'

This fish belongs to a family of robust bottom-dwelling species known as the Uranoscopidae, the stargazers of stonelifters. They are ugly fishes, with a depressed body and protruding mouth, the gape being transverse and vertical. The body has a single dorsal fin, without spine. The young fish live in the open sea, and have lateral eyes. As the fish mature, the eyes become dorsal, and the animals bury themselves in sand on the bottom, with only the mouth and eyes exposed. A s prey approaches, it is rapidly gulped into the wide mouth. Some members of the family have even an electrical capability, and shock their prey with an electric discharge. Two strong shoulder spines, a rmed with venom glands, are present. Fatalities have been recorded f o r a Mediterranean species.

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The species illustrated, Kathetostoma laeve, is a l a r g e species of Australian s ta r gazer , growing to a length of about 7 5 cm. It is sandycoloured, with three broad t r ans ver s e bands around the body and tail. This is quite a common species, ranging from Western Australia a c r o s s southern Australia to Tasmania, Victoria and New South Wales. The flesh is edible.


Family Aploactidae Aploactisoma milesi

Velvet fish,'

' Little

velvet fish'

This is a v e r y distinct fish which grows to about 23 cm long. It h a s a high short anterior dor s al fin, which can be elevated much as a cockatoo e r e c t s its crest. This species is brown, marked with d a r k e r spots, which are nearly black, but it may al so be marked with purple and white marblings. Its velvety skin is slightly warty, and the head is slightly knobbly from its projecting outgrowths. It is a sedentary weed-dweller of temperate Australian waters, ranging (in two subspecies) from Western Australia to New South Wales and Tasmania. P er s o n s handling this fish have reported that its spines can cause a stinging sensation.

Fa m i l v G n a t h a n a c a n t h i d a e Gnathanacanthus goetzeei

Red velvet fish'

This is a striking fish which grows to about 28 cm long. The body is a dusky red colour, perhaps with orange tints. Young specimens tend to orange, while older ones are reddish o r brown. Its range is in the deeper waters of the cooler southern coastline of Australia. Unlike the little velvet fish t her e are two large and distinctly sepa ra te d d o r s al fins; the anal fin is al s o large. Symptoms A painful sting has been recorded from contact with a dorsal spine, leading to considerable pain and l o s s of consciousness. Hand swelling was marked. (In a case reported from South Australian waters.) Family Scatophagidae Selenotoca multifasciata

' Striped butter-fish,' ' Scat, ' 'Northern butter-fish,' ' Poison bone'

This species of fish is commonly known as the northern butterfish, the striped butter-fish, poison bone, scat, etc. It belongs to the


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fish Family Scatophagidae, and is found in the warm northern waters of Australia from Western Australia a c r o s s to north Queensland, and further to New Guinea and New Caledonia. It is a good food fish but tends to be despised, possibly on account of i t s feeding habits. Its food consists of crustaceans, weeds and offal. It is a la r g e fish growing to about 41 cm long. It is a common species in sandy coastal situations, particularly around estuaries and bays. The dorsal spines may cause a painful sting lasting several hours. The juveniles of this species may be acclimatised to fresh water, and as aquarium fishes, being known as "scats." They have a s m a l l e r number (5-6) of vertical bands. Neither of these fish subspecies should be confused with several other Australian and New Zealand fishes popularly known as "butterfish. I t Family Siganidae Siganus spinus

Black spinefoot'

This species is a member of the fish Family Siganidae, which are commonly called spinefeet, rabbit fishes, black trevally, and al so "Mi mi" and "happy moments. I ' The best known common name, o r spinefoot, is derived from the characteristic s h a r p spine a t the front and back of each ventral fin and the 6 o r 7 anal spines. In al l m em bers of the family these spines, as well as the numerous dorsal spines, are capable of inflicting a painful wound, from attached venom glands. Fishes of this family all live in schools, and are found on coral reefs and in rocky situations. They a r e feeders upon m ari ne algae. About 19 species occur in Australian coastal waters. Most are found in Queensland, but s om e are found in Western Australia, Northe r n Territory, New South Wales and Victoria. The black spinefoot, Siganus spinus grows to a length of about 36 cm. It is usually coloured olive o r dark brown, with scattered lighter patches; generally al s o the dor s al half of the body has a number of light blue spots, while the ventral part has l a r g e r dark brown o r black spots. However, the pigmentation of the fish is reported to be quite variable, even while the fish is under observation. It is a very common species along the Queensland and New South Wales coasts. Another species, Siganus javus, the blue-spotted spinefoot, grows to a length of about 33 cm. It is brownish above, silvery underneath, and has many s m al l grey spots over the head and dorsal surface, and with grey longitudinal bands on the ventral surface. It is a widely spread Indo-Pacific species, including New Guinea and Queensland waters, and on occasion has been recorded in New South Wales waters and even Victorian.


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T r e a t m e n t of F i s h E n v e n o m a t i o n The treatment of an injury resulting from the entry of a fish spine and associated venom depends upon the s i z e of the wound and the complications o r potential complications such as haemorrhage and infection. In the c a s e of a l ar ge and jagged wound from a stingray the a r r e s t of haemorrhage may well be the most important action required. Most stings however will be of much l e s s severity, and in many cases a l l that will have occurred is the penetration of the skin by a single spine with s o me degree of envenomation. In only one cas e has an antivenene been developed against a fish venom; this is in the cas e of the stonefishes (Synanceja spp.) of northe r n Australian and other tropical Indo-Pacific waters. Otherwise treatment is non-specific, and amounts t o that required for shock, haemorrhage, infection and wound management, and detoxication of the venom by applied heat. From the first-aid point of view the most effective m easure worth doing, where th e r e is pain, is the immersion of the stung a r e a in water as hot as can be borne. Fish venom is sensitive to heat, and practical experience has shown that in many instances this treatment has given considerable relief. Treatment by cold packs, in an effort to delay absorption of the venom, has generally given much l e s s relief. Local irrigation by s al t water is advocated for l ar g e open wounds from stingr ay s , and removal of any retained part of the spine, including i t s investing integumentary sheath. Vigorous treatment by st ronger chemicals, such as potassium permanganate, o r formaldehyde solution ( "Formalin"), is not advocated, as they tend to cause extensive tissue damage. For other than minor injuries such m eas ures as antibiotic therapy, antitetanus precautions, and relief of pain by the injection of local anaesthetic, may need to be considered. POISONOUS FISHES Tetrodotoxic Fishes and Allied Forms The Order Tetraodontiformes contains a considerable variety of fishes, distinguished from other bony fishes by the body lacking t rue s cale s , as well as bearing projecting spines, scutes and fused bony plates, and in other characters. Among the diverse f o r m s of the o r d e r are a number of highly poisonous fishes, as well as others which are nontoxic, such as the leatherjackets. The Suborder Tetraodontoidei contains known lethally poisonous fishes, while the Subo r d e r Moloidei (sunfishes and their allies) contains species which are believed to be poisonous.

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The Suborder Tetraodontoidei contains three families of fishes, these being the toadfishes o r pufferfishes, Family Tetraodontidae, which have a variety of other common names, such as globefishes, swellfishes, toadoes and others; the porcupine fishes o r Diodontidae (also called swellfishes and globefishes), and the sharp-nosed puffers o r Canthigasteridae. The most important of these families from a medical point of view is that of the Tetraodontidae. These fishes all appear to have four teeth, on account of the teeth being fused together, but may have an upper and lower midline division. The body is capable of being inflated with either sea-water o r air to a nearly spherical shape, no doubt a defensive mechanism. The skin lacks the normal scales of the bony fishes, and may be quite smooth o r covered with small prickles. They are weak swimmers, and hence easily caught. Most species do not grow longer than about 20 cm, but a few species may attain 60 c m in length. The shape is mostly ovoid, o r somewhat angular. The colour is diverse. Probably the majority of these fishes are poisonous, and from a practical point of view it is wisest to refrain from eating any of them. Even though in Japan there are restaurants which a r e licensed to cook and sell these fishes ( f'fuguf' in Japan), it is to be noted that every year a number of Japanese die from eating them. In the fish the toxin occurs mainly in the skin, liver, ovaries and intestines. The musculature is usually safer to eat than other p a r t s of the fish, but a t times may be toxic. Toxicity has apparently some relationship to the gonadal state of these fishes, as they are most dangerous to eat immediately prior to and during their reproductive season. On a world basis there are some hundreds of species of these pufferfishes; about 30 occur in Australian waters. A few of the commoner o r more important can be described and are illustrated below. Arothron reticularis

Lined toado'

This species is characterised by dark brown o r brownish-yellow lines on the back, sides and ventral surfaces of the body, and in addition the lower margin of the caudal fin is black. The dorsal and posterior parts of the body are marked by small white spots o r lines. The background colour of the body is greyish brown. The lined toado is found in Queensland and New Guinea waters, a s well as more widely in the Indo-Pacific, ranging from India to Guam. It grows to 56 cm long. Gastrophysus sceleratus

Giant toadfish,'

' Silvercheeked

toadfish'

The dorsum of this species is greenish, overlain with dark brown spots, while the belly is a uniform greyish-white. A broad silver band runs along the middle of each side of the body, while there is a


311


triangular s ilv e r spot in front of each eye. The tail-fin is crescentic in outline. This is one of the l ar ges t species of the pufferfishes, growing to 76 cm long. It is widely distributed in the tropical Indo-Pacific regions, inclusing New Guines. In Australia it has been recorded for a l l States. This species was responsible f or s e v e r e paralytic illnesses in Captain Cook and the two F o r s t e r s of his scientific staff, on the second expedition of discovery, when they a t e s om e of i t s meat in New Caledonia in September 1774. SDhaeroides hamiltoni

' Common

toado'

This species is greenish-brown above, with a close mottling of d a r k e r spots and blotches, and a row of l ar g e dark blotches along the s id es , from mouth to tail. The undersurface is white. The'common toado is ver y common in shallow water along the c oas ts of south Queensland and New South Wales, and h a s al so been reported from Tasmania, South Australia and Western Australia. It o cc u r s als o mo re widely in Pacific waters. Although this is a typical saltwater fish, on occasions i t has been found in freshwater s t r e a m s opening into the sea. It grows to only about 13 cm long. Sphaeroides liosomus

' Smooth toadfish'

The body is s hor t and flattened, of a general greenish colour with dark spots dorsally, s o that there the green is broken up into a fine network. In addition t her e are three broad dark bands placed transversely on the back, and a l ar ge dark spot at the side behind the tip of the pectoral fin. The undersurface is whitish. This is a very common species in shallow coastal waters, and is often caught in beach seine nets. The fish inflates itself rapidly on being captured. It is recorded f or all southern Australian waters, from Western Australia to New South Wales and Tasmania. It grows to a length of about 15 cm. This species of fish was responsible f or the death of a boy in Tasmania in December 1950. Some had been caught in a n estuarine c reek at Castle Forbes Bay. Two s m al l fish were eaten by the boy, and symptoms commenced about 40 minutes later, with numbness and paralysis of the limbs, difficulty in swallowing, l oss of consciousness, and death 2 hours after the ingestion. Canthigaster cinctus

' Striped toby'

This species is one of the family of snouted pufferfishes o r tobies, m o r e technically the Canthigasteridae. Members of this family are all small, none of them exceeding a length of 20 cm. The bodies are


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somewhat compressed toward a vertical plane, and the snout is relatively long. These fishes have only single nostrils, which are weakly developed. A l l species are brilliantly coloured, but even with the individual species t her e is much variation in colour and pattern. The striped toby has three o r four blackish-brown st ri pes running transversely over the dorsum, which narrow ventrally. There are l ar g e orange o r brown spots resembling eyes between the bands; these tend to be s mall er around the head and venter. Narrow dark st ri pes radiate from the eye, and are al s o present on the cheek and a c r o s s the snout. The abdomen is marked by pale t r ansverse bands. The striped toby is widely distributed in Indo-Pacific waters. In Australia it is found only amongst the cor al reefs of Queensland, being found als o similarly in New Guinea. It grows to only 13 cm long. Diodon holocanthus

' Long-spined

porcupine fish'

The porcupine fishes, o r Family Diodontidae, are closely related to the puffers (Tetraodontidae), having the s a m e ability to inflate themselves with air o r water when faced with some danger. This process e r e c t s the spines, which may then constitute a formidable defence. Despite this, these fishes have been reported in a shark' s stomach, having been swallowed whole and hence unharmed. It has not been proved, however, that the spines were erect when the fish was being swallowed by the shark. There are considerably fewer r ecor ds of poisoning from porcupine fishes than from the toadoes, perhaps because the spines make them far less attractive-looking to the uninitiated than is the case with the tetraodontids. They are widely distributed in the w a r m e r waters of the world, They mostly range up to 45 c m long, although one species has been recorded to 91 cm long. The long-spined porcupine fish, Diodon holocanthus, is readily recognizable from the length of i t s spines, which are exceptionally well-developed. This species of fish has s mal l dark spots scattered over the body, and a dark band is usually present around the throat. The general background colour is brownish dorsally, and greyishwhite ventrally. This species is widely distributed in the w a r m e r waters of the Atlantic, Pacific and Indian Oceans. It occurs in the coastal waters of Queensland (although rarel y seen), and is recorded al s o for northwest Australia and New South Wales. Although recorded also f o r Victoria and South Australia, these records are perhaps doubtful. This species grows to a length of about 51 cm. Mola ramsayi

Giant Sunfish'

The EZamily Molidae contains very l ar ge fishes which receive their common name of "sunfishes" because they are at t i m es observed



3 13

"basking" in the sunshine at the surface of the sea. Possibly, however, this behaviour occurs only when these fishes are ill, and critical observations are required. In their normal swimming posture the deep and compressed body as s um es a vertical position in the water. To casual observation they appear "all head," the tail, although present, being short, and scolloped into about 6 lobes which s e r v e a s a rudder. Propulsion is mostly by means of the greatly enlarged dorsal and anal fins. Some species grow to over 3 m long, and may weigh a ton. The skin is dark grey and leathery, overlying thick l ayers of white and oily flesh. These fishes are generally found in tropical oceanic waters, but a r e often c ar r ie d by cur r ent s into temperate zones, and a r e occasionally stranded along shores. Three species of sunfishes have been recorded from Australian waters. The two l ar ger are Mola ram say (illustrated) and Masturus lanceolatus, both being particularly l arge fishes. They a r e reported as feeding upon jellyfishes and Portuguese man-of-war (Physalia, bluebottle). Often these fishes tend to occur in pairs, and wave from side to side in swimming, with the dorsal fin protruding above the water. These ocean sunfishes have been reported as poisonous to eat, although a recent search for confirmed r ecor ds of this has not been successful. Nevertheless, and although it would seem that few fishermen in Australia are likely to be in a position to t r y out these l a r g e r sunfishes a s food, and keeping i n mind the known close relationship of the sunfishes to the pufferfishes, it would s eem the wisest course is not to eat them. In addition to the l ar ge oval sunfishes, there is a s m a l l e r oblong species Tr iu r u s laevis, the s hor t sunfish, which grows to about 1 m long. It is a brilliant s i l ver colour with a series of curving st ri pes, as well as spots. The tail is truncate, and the dorsal and anal fins are almost in line with the r e a r end of the animal, giving it almost the appearance of a modern jet-engined plane. This species occurs in schools, and is a very swift swimmer. Sometimes it st rands along s h o r e s , either singly o r in l ar ge numbers. It would be wise to regard the flesh of this species of fish with equal caution, even though no actual r eco r d s of poisoning have been located. T r e a t m e n t of T e t r o d o t o x i c ( P u f f e r f i s h , T o a d o ) Poisonintz As there is no known antidote to tetrodotoxiri, the treatment of the effects of poisoning from this cause is purely symptomatic. Routine emetics a r e considered helpful, but apomorphine has been claimed to give the best results. Sodium bicarbonate ingestion has been advocated both as an emetic agent and a s an agent to attenuate the effects of tetrodotoxin, but there has been no experimental support for the


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SOUTHCOTT

latter use. Naturally to induce vomiting in the presence of severe respiratory paralysis is dangerous, and if it is decided to induce vomiting in the presence of respiratory paralysis then protection of the airway by a cuffed endotracheal tube would be necessary. Respiratory failure and fall in blood pressure a r e the major effects a s the poisoning progresses. Lobeline and sodium bicarbonate have been found to prolong life and reduce mortality in mice. There appears, on pharmacological grounds, little justification for the use of analeptics. However, experimentally these have been tried singly and in combination, and from such laboratory studies it has been claimed that only pentylenetrazol (Metrazol) appears to be significantly effective; hence it is thought that these reports should be mentioned. Artificial respiration is important, a s it is clearly one of the few positive things that can be done in treatment. A claim has been made that anticholinesterase therapy is useful, based on the response to treatment of a single human case (Torda et al., 1973). So far experimental support is lacking for the use of anticholinesterase therapy. There a r e records of spontaneous recovery, following apparent death from tetrodotoxin poisoning ( Akashi, 1880). C I G U A T E R A P O I S O N I N G AND C I G U A T O X I C FISHES A s mentioned at the beginning of this account of harmful fishes, ciguatera o r ciguatoxic poisoning is an important acquired toxicity of a great number of species of Indo-Pacific fishes, and occurs also in the West Indies. The term originated in the West Indies, the poison being attributed to the eating of a local species of marine snail known in Spanish a s "cigua." In the Indo-Pacific this type of toxicity is of considerable medical and economic importance, since over large a r e a s many species of fishes may be dangerous to eat, and in any case in a r e a s where fishes come under suspicion they cannot be sold. An important aspect is that the poisonous quality of the fish is variable and unpredictable and often curiously localized. Thus instances a r e on record where a species of fish on one side of an island is harmless and nutritious, and on the other, dangerously toxic. In addition the a r e a s affected appear to be changing, so that over a few years, with a r e a s not previously affected one may find the toxicity has spread to fishes there. It is now believed that the toxin (ciguatoxin) originates in some reef plant, possibly one of the more primitive algae, and is then passed from herbivorous fish to carnivorous fish, and then successively through various carnivorous fishes. The fishes a r e apparently unaffected by the toxin. The chemical nature of the toxin is still under analysis.


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Symptoms


The clinical effects may be mild o r severe. The f i r s t symptoms are a tingling of the lips, tongue and throat, followed by numbness (anaesthesia o r hypaesthesia). Symptoms usually originate within 4 hours of a meal, but exceptionally are delayed as long a s 30 hours. Similar paraesthesias o r anaesthesia may occur in other p a r t s of the body, e. g., fingers and toes. There is, however, a gr eat variety of symptoms which may occur in ciguatoxic poisoning, which cannot be fully listed here. Prominent among them however are gastrointestinal symptoms, such as nausea, abdominal cr amps and diarrhoea, a metallic taste in the mouth, o r a sensation of dryness. Muscle tightness around the mouth may be noticed, and pain in the teeth and jaws. In s e v e r e r c a s e s muscular weakness and inco-ordination may occur, with cyanosis, dizziness, pallor, exhaustion and insomnia. There may be muscle pains, a point of differentiation from tetrodotoxic poisoning. However, like tetrodotoxic poisoning, there may be pupillary dilatation and paralysis of the extraocular muscles and of the general body musculature, as well as skin affections. The variability of the symptoms has in the past led to Gymnothorax poisoning (from tropical reef eels) being separated from ciguatera, but now they a r e considered to be the same. This type of poisoning may be of gr eat severity, and t here is one record of 1500 men dying from such a poisoning. This was in 1748, in a British naval expedition against Mauritius, leading to the l oss of the campaign. In general, however, the death rate is low, around 10% o r le s s , but recovery may be prolonged. A s over 300 species of fishes may be affected, it is impossible to indicate any other than a very few of the important ones. Perhaps it is best to s t r e s s here that any intestinal upset after eating tropical reef fish should be suspected as possible ciguatoxic poisoning. Sweating is an important sign and of value in the diagnosis. The range of fishes is wide: tropical reef and semi-pelagic m ari ne fishes, including gropers, moray eels, barracudas, surgeonfishes, w r as s es , triggerfishes, and many others. Most of these fishes are normally edible, and many are important food fishes, but apart from the test of eating them ( o r feeding them to a dog, cat, pig, chicken o r mongoose) there is no way of telling whether they are poisonous o r not. Local knowledge, of course, will be the bes t guide. So far only a few instances of this type of poisoning have been reported from tropical Australian waters. Nevertheless, Barnes ( 1966) reported over 100 c a s e s of poisoning in the C ai r ns district over a t hree y e a r period, and Tonge et al. (1967) reported two outbreaks and a probable fatal c a s e in Queensland. These l at t er outbreaks w er e unusual in that they have been associated with the Spanish mackerel, Cybium commerson, a species not previously incriminated in ciguatoxic poisoning.

316


Lutjanus bohar

SOUTHCOTT 'Red bass,' 'Kelp sea perch,' 'Two spot sea perch'

Members of the Fdmily Lutjanidae are "carnivorous, voracious, gamy, shore fishes, and abundant in all warm seas. Their food cons i s t s largely of smaller fishes. They are common in rocky, coral reef areas. ' I Many species of the family are important food fishes. Unfortunately a number of species are susceptible to ciguatera. Lutjanus bohar is widely distributed in the Pacific, being known under a variety of local names in Tahiti, Samoa, Marshall Islands, Phillipines, Indonesia, Japan and Fiji, and other islands. It is commonly referred to as red bass in Australia, but the U.S.A. name is "red snapper. I ' There appears to have been a good deal of confusion in the identification of this species, and some authors believe that Lutjanus coatesi, also known as red bass in north Queensland, is really the s a m e species. Apart from this consideration, L. bohar may a l s o be confused with the adult form of Lutjanus nematophorus, the "Chinaman fish," to which toxicity has a t times been attributed, e.g. by Paradice ( 19241, but denied by Flecker ( 1946). Whitely ( 1934) reported a Lutjanus coatesi as toxic. Despite these differences of opinion, there is no doubt that the lutjanid fishes are important members of the ciguatoxic species. The best-reported early case of ciguatoxic poisoning in the Pacific was that of Captain Cook a t Malekula, New Hebrides, in July 1774, this being the first of two occasions on which h e suffered fish poisoning. The fish responsible is ncjw believed to have been a Lutjanus bohar. Cybium commerson

' Narrow-barred

mackerel'

The narrow-barred ( o r "narrow-banded") (Spanish) mackerel has been incriminated as a cause of ciguatoxic poisoning on one occasion, by Tonge et al. (1967). Several large specimens had been caught off Gladstone, Queensland in October 1967, and two of them, weighing each about 10 kg dressed, were sold professionally in Brisbane, being cut into steaks and sold to a number of people. Thirty three persons ranging in age from 22 months to 59 years became ill; in each case the fish was cooked by frying o r grilling within 2 hours of being purchased. A s large numbers of these fishes get to the fish markets of eastern Australia, while others are eaten without being sold professionally, it is probable that the general incidence of ciguatoxic poisonings following the eating of Spanish mackerels and allied fishes in Australia is comparatively low, Roughley (1966) states that the Spanish mackerel rates as one of the best food-fishes found in Australian waters, commanding a high price in markets in Queensland. In Brisbane, i t is sold in transverse cuts known as "mackeral steaks. 'I This species grows to about 2 m long, and may weigh over 40 kg.

3 17


It has a world-wide range, between 40"N and 40% latitude. It may occur in great schools, and will occasionally leap up to 10 m out of the water, even a thousand of these fishes making such leaps simultaneously.


Gymnothorax undulatus

Moray eel,'

Reef eel,'

' Mullet

moray'

The moray eels, o r Family Muraenidae, are reef-dwelling speci es of temperate and tropical waters. They are savage fishes which live from intertidal reef flats to moderate depths. They are largely nocturnal, and inhabit a variety of ecological situations, from surge channels, co r a l reefs, reef flats, etc. They tend to hide in crevi ces and under rocks during the daytime, foraging out freely at night. They have powerful j a w s and long fang-like depressible teeth which a r e ideal f o r seizing prey and can cause s e v e r e lacerations. Some of the l a r g e r morays grow to over 3 m long, and may be a hazard to divers, particularly in putting a hand in a hole o r crevice on a reef. Although the flesh of a number of species is used as food, these eels are among the most important ciguatoxic fishes, and in fact som e of the most violent outbreaks of ciguatoxic poisoning have followed the eating of moray eels (Halstead, 1967). THERAPY O F CLINICAL POISONINGS FROM CIGUATOXIN Ear lier c la im s based on in vitro studies, that ciguatoxin has an anticholinesterase action (Li, 1965a, b) have not been supported by mo r e recent in vivo studies. Hence proposals that treatment should be by cholinesterase reactivators are no longer considered valid. In the most recent studies (Rayner, 1972), it has been proposed that the pharmacological actions of ciguatoxin a r e related to i t s di rect effect on excitable membranes r at her than to the previously reported anticholinesterase activities. This author regarded the toxin as a competitive inhibitor of the membrane-polarising action of Ca" ions. In frog skin it in cr eas es the permeability to Na' ions running down a concentration gradient. By opening the "sodium pores" in excitable membranes, it allows the freer flow of Na' ions and the disruption of ionic membrane potential. This effect is opposed by tetrodotoxin. It is believed at the present time that the effects of ciguatoxin on resting membrane potential a r e due to the replacement of calcium by ciguatoxin a t receptor sites which regulate steady st at e sodium perm eability. In fatal human cases, death appears to result from respi rat ory paralysis. In animal experiments, the respiratory paralysis has been considered to be of central origin, since even in complete respiratory failure diaphragmatic twitch results from stimulation of the phrenic nerve, unlike the situation with tetrodotoxic poisoning.

3 18

SOUTHCOTT


Therapy for ciguatoxic poisoning should therefore be directed to the management of respiratory failure, and possibly the administration of Ca" and Mg" salts would be of benefit. Usually atropine has been advocated in the c a s e of ciguatoxic poisoning, based on the cholinomimetic actions of the toxin. A l l drugs, however, should be used with caution. As there is no specific antidote, the treatment must be symptomatic. Various local native remedies have been used in many of the Pacific islands in ciguatoxic poisonings (Halstead 1967, pp. 182-3). However, the pharmacology of the substances contained in these plants does not appear to have been submitted to laboratory study. OTHER T Y P E S O F FISH INTOXICATIONS On a world basis there are an undefined number of biointoxications that may be traced to fishes. In a n article such as this, however, it is not possible to cover these comprehensively, and if such information is required the l a r g e r works on the subject should be consulted. Among these, such instances as toxicity from eating fish liver ("hepatotoxic fishes") is known, apart from the effects of hypervitaminosis A ( s e e elsewhere in this article). Another defined category is fish-roe poisoning, reported from Europe with barbel-roe, and a further one is poisoning from ingestion of fish-blood, a s occurs in the case of a t least a number of European eels. Better known to the medical practitioner are bacterial intoxications from eating fish, the fish having previously been contaminated with bacteria, such a s a staphylococcus. Botulism from imperfectly canned tuna has been recorded, although not s o far in Australia. Such contamination does not necessarily occur with the fishes, but may be a result of imperfections in the canning process. Among these bacterial contaminations is one known as "scombroid poisoning," due to contamination of fishes of the tuna and mackerel families from the bacterium Proteus morganii. These bacteria have the ability to break down the histidine of fish muscle to histamine and saurine (a related substance), without causing putrefaction. The resulting intoxication is an acute allergic response from the histamine, but this is apparently not the whole story. One of the rather uncommon but very distinct types of poisoning which may come to notice is that of hallucinatory f i s h poisoning, which may follow the eating of about 10 Indo-Pacific species of fishes, in very circumscribed areas, on the evidence a t present available. So far no confirmed reports of hallucinatory fish poisoning have been received from Australian waters. Reports, however, have come from Norfolk Island as well as Hawaii, Mauritius and South Africa. The agent responsible for the hallucinations is not known.


3 19

About 10 species of fishes have been incriminated in these outbreaks, these including rock cods (Family Serranidae), grey mullets (Mugilidae), d r um m er s , rudderfish (Kyphosidae), damselfish o r sergeant-majors (Pomacentridae), and surgeonfishes o r unicorn fish (Acanthuridae), as well as the goatfishes.


Symptoms The symptoms in these outbreaks a r e dizziness and inco-ordination, coming on within minutes o r up to 2 hours after the ingestion. Hallucinations and depression are part of the symptoms; if the patient is asleep he experiences nightmares. At t i m es various other symptoms s i m i l a r to those from other fish poisonings are reported, e.g., c i r cumoral paraesthesias and abdominal pain. The toxin is not destroyed by boiling o r frying the fish. Upeneus tragula

Mottled goatfish,'

Surmullet'

The goatfishes o r surmullets belong to the fish Family Mullidae, which are carnivorous s hor e fishes of tropical waters. Many of them a r e brilliantly coloured. The barbels behind the lower jaw have earned them the name goatfishes. Illustrated is the mottled goatfish, which is a species widely found in Queensland coastal waters, and which al so e n te r s New South Wales waters. It grows to a length of about 36 cm. DISTASTEFUL FISHES Apart from the unpalatability o r toxicity conferred upon som e fishes by industrial wastes emptied into s t r e a m s and harbours, and from other s o u r ces , such as oil and other discharges from ships, t h er e are a number of species of fishes which are inherently unpalatable. One such fish is mentioned below. Callionymus calauropomus

' Common

stinkfish'

This is a striking fish, with prominent fins. The head is depressed, and the mouth s m al l and weak, opening almost ventrally. The head is brown above, light orange below, with blue spots on the cheek. The body is pale orange, marked with brown bands, and a reddish brown spot n e ar the base of the pectoral fins. The male is m o r e brightly coloured than the female, with blue spots on the fins. The species grows to about 30 cm long. This fish is found in the temperate w at er s of the southern half of Australia, and is often taken by trawling. Its flesh has a bitter flavour, and in persons who have gone ahead and eaten it, nausea has resulted (Scott, 1962). There a r e various other Australian stinkfishes.

SOUTHCOTT

320


HY P E R V I T A M I N O S I S A The Eskimos have known traditionally that the livers of polar bears, dogs (huskies), Arctic foxes and wolves, as well as of certain species of seals, a r e poisonous to eat. Such knowledge has slowly been obtained by European explorers, but it has not been known until comparatively recent times that these illnesses are due to the ingestion of toxic doses of vitamin A. Reports of acute intoxications have been made following the eating of liver of some of the southern Australian seals, and surveys have confirmed that the liver of certain of these seals, as well as of some other mammals, such a s whales and Antarctic huskies, have also toxic levels of vitamin A. These findings have supported a suggestion that the illnesses of Mertz and Mawson in the Antarctic in 1911-1914 were due to eating toxic amounts of vitamin A from husky liver. Some illnesses following eating of the flesh of certain Pacific s h a r k s a r e also highly suggestive of hypervitaminosis A. The clinical features following such toxic meals include drowsiness, sluggishness, irritability, vertigo, s e v e r e headaches, vomiting and diarrhoea. These commence 2-12 hours after the ingestion. In 24 hours o r longer the skin may begin to peel around the mouth, and this desquamation may spread over the whole body. The symptoms resemble those of scurvy, as well as of arsenical poisoning. The skin desquamation is, however, a major diagnostic pointer. The mortality is low. Ingestion of a toxic dose of vitamin A (1,000,000 IU o r more, perhaps up to 3,000,000 IU in an adult) causes an abrupt elevation of the cerebrospinal fluid pressure. The other symptoms of nausea and vomiting, headache, and others, may be suggestive of brain tumour, hence hypervitaminosis A is one of the causes of "pseudotumor cerebri. '' POISONOUS AND VENOMOUS MAMMALS AND MARINE R E P T I L E S The last section mentioned possibilities of poisoning from the high vitamin A content of the liver of certain marine and t e r r e s t r i a l vertebrates which are part of a food chain living ultimately on marine fishes and smaller plankton. A few reports exist of poisonings from eating liver and other flesh of some species of Pacific mammals, notably dolphins and whales, in which the poisoning appears to be from some toxin other than vitamin A. As none of these have been reported from the waters immediately around Australia they will not be considered here.


321

The only venomous mammals on r ecor d are certain species of s h r e ws (not Australian) and the Australian freshwater primitive mammal, the platypus (Ornithorhynchus anatinus). Ornithorhynchus anatinus

' Platypus'


The platypus has, in the male, a c r u r a l venom gland connected to a movable horny s pur on the inner side of each hind foot. The gland is connected to the s pur by a duct which leads to a venom r e s e r v o i r about 6 mm a c r o s s near the base of the spur. When the platypus is held, e.g. by a fisherman trying to free it from a fishing line o r net, it is likely to drive its s p u r into the w r i s t of the fisherman. If venom is injected there is immediate intense pain and swelling, which may s p r e ad a considerable distance up the a r m . No fatalities are on record, but the swelling may l as t 1-2 days, and the pain may al so be persistent. Shock and faintness are al s o on record. Turtles Intoxications from marine reptiles are of two possible sources, the turtles and the sea-snakes. Although turtles have long been esteemed as food, there are records of occasional di sast rous consequences after eating turtle meat. The nature of the toxin o r toxins concerned is not known, but, a t least clinically, there is a resemblance to the ciguatoxin of ciguatoxic fishes. Most report s have come from the Indo-Pacific, particularly the Malayan region, as well as westwards to Ceylon and southern India. Initial clinical features are nausea, vomiting, epigastric pain, diarrhoea, sweating, tachycardia, vertigo and coldness of the extremities. Burning of the lips, mouth and throat may occur, leading to dysphagia and hypersalivation. Stomatitis and mouth ulceration may follow, with foetid breath and mouth ulceration, taking weeks o r months to heal. Hepatomegaly and icterus, and skin desquamation may a l s o be important. In fatal cases hepatic n ec r o s is with centrilobular congestion and fatty degeneration is marked, as well as erosions o r ulcerations of the upper gastro-intestinal tract. Five species of turtles are reported as poisonous, these being Caretta caretta, the loggerhead, Eretmochelys imbricata, the hawksbill, Chelonia mydas, the green turtle, Dermochelys coriacea, the leathery turtle, and Pelochelys bibroni, the softshell turtle. All these species are widespread in the Indo-Pacific, except for the last, which o c cu r s from S.E. Asia to New Guinea. ~

Sea-snakes The sea-snakes, Family Hydrophiidae, are a specialised group of snakes in which the tail is compressed to form a vertical oar-blade. T her e are about 50 species in the family, of which about 25 are found


322

SOUTHCOTT

in the waters around Australia. These snakes are found widely in the tropical Indian and Pacific Oceans, but one species ranges from Siberia to Tasmania. All species are marine o r estuarine, except f o r one freshwater Philippine species. Some species are reported as docile, while others are considered aggressive. No Australian deaths have been proven as from a sea-snake bite (one Western Australian case, so deemed by the coroner, appears to have been due to a stonefish envenomation); however many deaths have occurred in Malaysia and elsewhere in southeast Asia from fishermen handling nets at night, o r bitten by a snake concealed among the f i s h catch being handled. Symptoms The main action of the venom of sea-snakes is upon skeletal muscle. The fangs are short and the bite is usually no m o r e than a prick, without pain o r local reaction. The venom is small in yield, but very potent. ,Symptoms follow the site from between 5 minutes and 8 hours. Symptoms increase after the onset. Muscles tend to ache o r be stiff. The tongue s e e m s thick to the patient, and swallowing and speech become difficult, with nasal regurgitation. Euphoria may be present, o r malaise and anxiety. Muscular paralysis increases insiduously, ascending from the legs, with flaccid paralysis, ptosis, sweating, trismus, and other neurological and m o r e general features. Haemoglobinuria with albuminuria and myoglobinuria are com mon. The painf u l muscle movements and myoglobinuria are the outstanding clinical features of sea-snake envenomation. Myoglobinuria may be distinguished from haemoglobinuria by spectroscopy and electrophoresis. A small proportion of bites are fatal, from respiratory and bulbar paralysis, with inhalation of vomit o r secretions, and hypoxia, o r hyperkalaemia and acute renal failure. Treatment Sea-snake envenomation is a medical emergency of great significance, requiring urgent and c o r r e c t treatment. Suction and incision are of little value. Limbs should be moved as little as possible, and tourniquets used to prevent absorption of venom. The snake should be captured and preserved if possible and attempts a t positive identification made. Antivenene therapy is available, but it is important to establish whether the bite was from a sea-snake o r not. Important positive criteria are the marine exposure of the victim, absence of pain from the bite, the presence of fangmarks (1-20,but commonly 4. Teeth may remain in the wound, and be extractable by running a hair over it; the teeth are small), positive snake identification, and characteristic symptomatology, particularly painful muscle movements, leg paralysis, trismus and ptosis. If antivenene is used, the usual precautions against hypersensitivity reactions a r e required,


323

and the antivenene should not be administered until these have been taken. P ela mis platurus

Yellow-bellied sea-snakef


Pelamis platurus, the yellow-bellied sea-snake, which can cause human fatalities. It is the most widespread of all the sea-snakes, occurring over much of the Jhdo-Pacific, ranging from southern Siberia to Tasmania, and from East African shores to the western s h o r e s of central America. REFERENCES Akashi, T. 1880. Experiences with fugu. (In Japanese.) Iju Shimbun (27):19-23, quoted by Halstead, 1967. Barnes, J. H. 1966. Ciguatera in Australia. Med. J. Aust. 1:1136. Calaby, J. H. 1968. The platypus (Ornithorhynchus anatinus) and i t s venomous characteristics. Chapter 1, pp. 15-29, in Venomous animals and t hei r venoms, Ed. by W. Biicherl et al., Vol. 1 (Academic Press: New York and London). Cameron, Ann M., and Endean, R 1966. The venom apparatus of the scorpion fish Notesthes robusta. Toxicon 4: 111- 121. Cook, J. 1777. A voyage towards the South Pole and round the world, (Ed. 3) 2112-13 teste Whitley and Halstead (1955). Evans, H. M. 1943. Sting-fish and seafarer ( F a b e r and Faber Ltd.: London). Evans, M. H. 1969. Mechanism of saxitoxin and tetrodotoxin poisoning. Brit. med. Bull. 25(3):263-7. Flecker, H. 1946. Thread finned sea perch, Lutjanus nematophorus (Bleeker). I s this fish poisonous? ( Fisheries Newsletter (Cronulla) 5( 4): 18. Gilbert, P. W. (Ed.) 1963 Sharks and survival (D. C. Heath and Company: Boston). Halstead, B. W. 1965- 1970. Poisonous and venomous m ari ne animals of the world, Vols. 1-3 (U.S.Govt. Printing Office: Washington). Kao, C. Y. 1972. Pharmacology of tetrodotoxin and saxitoxin. Federation Proc. 31(3):1117-23. Li, K. M. 1965a. Ciguatera fish poison: A cholinesterase inhibitor. Science 147( 3665): 1580- 1. Li, K. M. 1965b. A note on ciguatera fish poison and action of i t s proposed antidotes. Hawaii med. J. 24:358-61. Marshall, T. C. 1964 Fishes of the Great B a r r i e r Reef and coastal wate r s of Queensland (Angus and Robertson: Sydney). Morgan, A. D. 1966. Australian catfish injuries with report of a typical case. 'Platypus envenomation. Med. J. Aust. 2:383-4


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Munro, L S. R. 1960-1. Handbook of Australian fishes (published in Fisheries Newsletter, incomplete). Narahashi, T., Moore, J. W., and Scott, W. R. 1964. Tetrodotoxic blockage of sodium conductance i n c r e a s e in l o b s t e r giant axons. J. gen. Physiol. 47:965-74. Paradice, W. E. J. 1924. Injuries and lesions caused by the bites of animals and insects. Med. J. Aust. 2:650-2. Patkin, M., and Freeman, D. 1969. Bullrout stings. Med. J. Aust. 2: 14- 16. Rayner, M. D. 1972. Mode of action of ciguatoxin. Federation Proc. 3 1( 3): 1139-4 5. Reid, H i A. 1956. Sea-snake bite research. Trans. Roy. SOC. Trop. Med. & Hyg. 50(6):517-42. Brit. Reid, H. A. 1961. Myoglobinuria and sea-snakebite poisoning. med. J. 1:1284-9. Roughley,T. C. 1966. Fish and f i s h e r i e s of Australia (Revised Edition) (Angus and Robertson: Sydney). Russell, F. E. 1965. Marine toxins and venomous and poisonous marine animals. Adv. m a r i n e Biol. 3:255-384. Russell, F. E. 1967. Pharmacology of animal venoms. Clin. P h a r m a col. & Therap. 8(6):849-73. Russell, R. E. 1968. Poisonous m a r i n e animals, in The safety of foods (Avi Publ. Co.), Chapter 14, pp. 68-81. Scott, T. D. 1962. The marine and freshwater fishes of South Australia (Government Printer: Adelaide). S c o q T. D., Glover, D. J. M., and Southcott, R. V. 1974. The m a r i n e and freshwater fishes of South Australia (Government P r i n t e r : Adelaide). Southcott, R. V. 1970. Notes on stings of s o m e venomous Australian fishes. Med. J. Aust. 2:722-5. Southcott. R. V. 1975. The n e u r o l o d c a l effects of noxious m a r i n e c r e a t u r e s in Contemporary Neurology Series: Topics on tropical Neurology (Ed. R. W. Hornabrook) (F. A. Davis and Co.: Philadelphia). Stead,-D. G. 1963. Sharks and r a y s of Australian seas (Angus and Robertson: Sydney). Tonge, J. I., Battey, Y., Forbes, J. J., and Grant, E. M. 1967. Ciguatera poisoning: a report of two outbreaks and a probable fatal case in Queensland. Med. J. Aust. 1:1088-90. Torda, T. A. Sinclair, Elizabeth, and Ulyatt, D. B. 1973. Pufferfish ( Tetrodotoxin) poisoning. Clinical r e c o r d and suggested management. Med. J. Aust. 1:599-602. Trinca, J. C. 1967. The Stonefish. (Mimeographed, 9 pages, from a symposium on Some Queensland m a r i n e s p e c i e s of pharmacological interest, Brisbane, July, 1967.



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Watkins, A. B. K. 1969. B u l l r o u t s t i n g s , Med. J. Aust. 1:212. Whitley, G. P. 1934. A new fish, r e p u t e d to b e poisonous, f r o m Queensland Mem. Queensland Mus. 10( 4): 175- 9. Whitley, G. P. 1962. M a r i n e f i s h e s of A u s t r a l i a ( 2 v o l s . ) ( T h e Jacaranda Press: Brisbane). Whitley, G. P. 1963. D a n g e r o u s A u s t r a l i a n fishes. Bull. P o s t - G r a d . C o m m i t t e e Med., Univ. Syd., Suppl. 18( 12):41-63. Whitley, G. P., a n d Halstead, B. W. 1955. An annotated bibliography of t h e poisonous a n d v e n o m o u s f i s h e s of Australia. Rec. Aust. Mus. 23( 5):211-27. W i e n e r , S. 1958. Stonefish s t i n g a n d its t r e a t m e n t . Med. J. Aust. 2: 218-222. W i e n e r , S. 1959a. O b s e r v a t i o n s on t h e venom of t h e s t o n e f i s h (Synanc e j a trachynis). Med. J. Aust. 1:620-7. W i e n e r , S. 1959b. T h e production a n d a s s a y of s t o n e f i s h antivenene. Med. J. Aust. 2715-9.

Venomous and poisonous Australian animals of veterinary importance: a rich source of novel therapeutics.

Poisonous and venomous marine animals and their toxins.

Microsatellite primers for Australian recreationally and commercially important estuarine fishes.

Venomous mammals.

Poisonous Snakes.

Poisonous polonium.

Venomous but not villainous.

Poisonous Holds and Store-Rooms.

The most poisonous mushrooms.

Institutions housing venomous animals.

Identification of Poisonous Snakes.

Poisonous red tide organisms.

Diversification of a single ancestral gene into a successful toxin superfamily in highly venomous Australian funnel-web spiders.

Are ticks venomous animals?

[Poisonous plants: An ongoing problem].

Poisonous Principle in Indian Liquo-Arice Root.

Black Bear Reactions to Venomous and Non-venomous Snakes in Eastern North America.

Characterization of MHC class IIB for four endangered Australian freshwater fishes obtained from ecologically divergent populations.

Global perspectives on poisonous plants: the 9th international symposium on poisonous plants.

Venomous snake bites, scorpions, and spiders.

Dr. Fayrer on Venomous Snakes.

Bites by foreign venomous snakes in Britain.

A Successful Case of Venomous Snake-Bite.

Clothing for protection against venomous Hymenoptera.