Image by Jeffrey Kilpatrick
Cleopatra is regarded as one of the most famous leaders in the ancient world. She was the last pharaoh to rule ancient Egypt, and she nearly succeeded in creating an eastern empire to rival Rome.
Though she was revered as a great beauty, statues and coins may belie the myth. It was her personality and charm that enabled her to achieve what she did. Highly educated and able to speak several languages, Cleopatra was very politically astute and ruthless.
Cleopatra was married to one of her brothers as per Egyptian custom but had no children with him. She eventually became the sole ruler of Egypt and in 48 B.C. began an affair with Julius Caesar - she was 21 and he was 52 when they met.
Her relationship with Caesar enabled her to obtain even more power. She and Caesar would have a son together. Cleopatra would travel with Caesar to Rome in the summer of 46 B.C. and live in Rome until March 15, 44 B.C., when Caesar was assassinated. Obvioulsy his death, ended support for her power, so Cleopatra and her family returned to Egypt.
Suicide by Snake
After Caesar's death, Cleopatra and Mark Antony became involved when he traveled to Egypt on behalf of Rome to determine her loyalty to the empire. They began an affair that would eventually turn into marriage, and they would have three children, including a set of twins.
Ultimately, just like Caesar, Antony would side with Cleopatra against Rome and this would lead to several battles against the Roman Empire.
After losing the Battle of Actium to Roman forces, Antony committed suicide by stabbing himself in the abdomen. He would die a slow death with Cleopatra at this side. (She was sent for when he was found.) Cleopatra would eventually realize her kingdom was lost to Rome and follow Antony's path and commit suicide, as well. According to legend, she killed herself by allowing an asp to bite her Aug. 12, 30 B.C.
The translation from both early Roman and Egyptian languages indicates the snake was most likely the Egyptian cobra, usually indicated as an "aspis." It has neurotoxic venom that affects the nervous system by stopping nerve signals from being transmitted to the muscles. At later stages of envenomation, it stops the heart and lungs, causing death due to complete respiratory failure.
Snakes inflict approximately 45,000 bites each year in the U.S. and approximately 8,000 are poisonous. Fifty percent of bite victims are children. Most bites occur in adolescents and young adults while they are trying to handle or provoke the snake.
Bites usually occur during the summer months and involve the upper extremities. Males are more likely to be bitten than females. Younger children are more likely to be bitten on the lower extremities.
Diagnosis & Treatment
Snake bites usually cause either a laceration or a puncture wound and may become infected, but the major complication is envenomation.
Envenomation is exposure to animal poisoning. Venom contains many enzymes and proteins that can cause local tissue damage, massive tissue edema, hypotension, coagulopathy, shock and death. The first sign of envenomation is burning at the bite site. Swelling and edema may involve the entire area where the bite is located. Depending on the amount of venom dispensed, extensive tissue destruction can occur. There may also be systemic manifestations with envenomation, including metallic taste, fasiculations, weakness, nausea, vomiting, numbness and tingling around the mouth.
Today, Cleopatra would have been taken to the nearest emergency department where local poison control would have been contacted along with perhaps the Antivenom Index (520-626-6016) or the local zoo.
The Antivenom Index is a joint project of the Association of Zoos and Aquariums and the American Association of Poison Control Centers, funded by Health Resource Services Administration through the Poison Center Stabilization and Enhancement Program. The index is administered by the University of Arizona College of Pharmacy, Tucson, AZ.
Zoos, aquariums, etc., are required to keep adequate antivenom stores for any venomous reptiles/creatures in their possession.
These facilities also have knowledge of which zoos, aquariums, and other organizations in North America have what reptiles and antivenom if antivenom is not available at their site.
Cynthia Blank-Reid is a trauma clinical nurse specialist at Temple University Hospital in Philadelphia.