This article was converted by SimpRead, original at mp.weixin.qq.com
Hello everyone, I am Li Hongzheng.
A while ago, I debated with a major medical influencer on Weibo about what to do after a venomous snake bite. His view was to go to the hospital first thing and wait for antivenom serum. My view was to immediately use the snake medicine tablets carried with you, and then go to the hospital to wait for the antivenom serum.
After ten rounds of debates over two days, with tens of thousands of spectators, most people finally realized that the correct approach is to use the snake medicine tablets immediately and then wait for the serum. Because the snake medicine tablets are effective, portable, convenient, and can be used within minutes after injury, showing good results. But if you go straight to the hospital, there’s no guarantee that the serum will be available, and any delay might be fatal. If you first use the tablets, or use them while waiting for the serum, even if the serum is not available, the worst outcome can be avoided.
The essence of this debate is: does traditional Chinese medicine (TCM) and Chinese herbal medicine have an effect in treating venomous snake bites?
The answer is: unless one is blind or foolish, everyone knows that TCM and snake medication tablets are effective in treating venomous snake bites.
Below I will provide strong evidence to support this.
But today we have a more prominent contradiction to resolve.
Someone sent me two guideline documents, which state:
(1) Antivenom serum is the only effective and safe treatment?
I was truly blinded by this.
These two documents are the “Chinese Expert Consensus on Snakebite Treatment” and the “Chinese Guidelines for Snakebite Treatment”. The former was published in “Herpetologica” (2018, Li Qibin), and the latter was published in the “Chinese Journal of Emergency Medicine” (2024).
Both documents state that antivenom serum is the only effective and safe drug for treating snake bites.
I really can’t help but laugh.
First, let me introduce the journal “Herpetologica”. It was established by the Chinese Herpetological Association in 1989. The association itself was founded in 1984, with its first president being Shu Purong (1931-2016).
Shu Purong is a very important senior figure; let’s remember him.
To understand why they said this, I reviewed all related literature in “Herpetologica” from 1989 to 2025, spending two days on it.
After reading, I felt very distressed.
In simple terms, since the founding of the country, there have been many capable people treating venomous snake bites, especially in Lingnan regions like Jiangsu, Fujian, Jiangxi, Guangdong, Guangxi, Hunan, where there are many snakes and thus many experts.
(2) Three generations of snakebite treatments
First generation: Jiangsu’s Ji Desheng (1899-1982), Guangdong’s He Xiaosheng (1883-1970), Fujian’s Huang Shoulin (? - 1993), and others. These people used to be humble snake healers without much social status. Although highly skilled in treating venomous bites, they were not respected. After the founding of the PRC, especially following Chairman Mao’s advocacy of TCM, they were gradually recognized, employed as hospital doctors, and their experience was summarized. Their snake medicine tablets such as Ji Desheng’s snake tablets, Zhanjiang snake tablets, and emergency snake powder were developed and benefited the public. However, these elders were mostly illiterate, wrote no specialized books or papers, and their efficacy was passed down orally, widely recognized by society. Their treatment was exclusively TCM, Chinese herbal medicine. It was state-recognized, even used as military medical supplies, e.g., Ji Desheng’s snake tablets.
Second generation: prominent figures include Shu Purong (1931-2016), Yu Peinan (1941 - alive), Qin Gongping, Wu Lisun, Tan Xinhua, etc. Shu Purong did most of the work, as he led the founding of the Chinese Herpetological Association in 1984, and the launch of “Herpetologica” in 1989.
This generation, around the 1980s, inherited both the TCM knowledge from the first generation, and the Western medicine method of antivenom serum. They acknowledged antivenom serum’s efficacy and safety but also recognized that serum is not omnipotent. TCM and snake tablets are also highly effective. Selection of treatment depends on specific analysis. From my reading of their writings, they regarded TCM and Western medicine as roughly equal. Serum is efficient but difficult to preserve and expensive. TCM and snake tablets are cheap, affordable, portable, and can be used immediately.
Shu Purong combined predecessors’ experiences and developed Qinglong (Blue Dragon) snake medicine, conducting many high-quality studies, even cooperating with Air Force units as emergency medications for paratroopers. Research showed that using snake tablets within 2 hours after a venomous bite had a cure rate over 98%. This was a randomized double-blind study.
(3) Qinglong snake medicine VS Ji Desheng snake medicine
Ji Desheng snake tablets are highly reputed first-generation tablets. For Qinglong tablets to prove themselves, they had to compare with Ji Desheng’s tablets, just like before 2018, any new mid-size SUV had to be compared with the Highlander; and by 2025, large SUVs must be compared with the Li Xiang L9 or Wenjie M9 because they’re the benchmarks.
Similarly with snake tablets, the benchmark was Ji Desheng’s tablets (though Ji Desheng personally treating would be more effective, because tablets aren’t as flexible, but still, they solved many problems).
In 1988, the Aviation Medical Research Institute of the PLA conducted research on pilot survival gear, including “snake medicine self-rescue.” They collected 12 snake tablets nationwide and performed animal tests, finding Qinglong snake medicine gave the highest protection rate, hence it was selected.
In 1992, approved by the Ministry of Health, Phase II clinical trials were conducted at the Shanghai University of TCM Pharmacology Base for Qinglong snake tablets (composed of 13 herbs like Qingmuxiang, Gentian, Scutellaria, Coptis, Rhubarb, Andrographis, Hemiptera, Xu Changqing). The research was completed in 1995.
502 patients bitten by venomous snakes were enrolled. 280 were randomized: treatment group using Qinglong tablets, control group using Ji Desheng tablets (initially double-blind). Each group had 140 patients. The remaining 222 patients were in an open group, non-randomized treatment.
All received same treatment: first oral dose of 20 tablets after enrollment, then 10 tablets every 6 hours, or nasogastric if oral intake was impossible. After wound debridement, tablets ground and mixed with water to apply to surrounding tissues. Treatment lasted 3 days per course, for 3 courses total. If the first course was ineffective, combined treatments (TCM + Western medicine) were applied; these were classified as ineffective cases.
Results were:
At first glance, the results seem good: in treatment group (Qinglong tablets), 110 showed marked effect, 16 effective, 14 ineffective; total effective rate 90%, quite good.
Control group (Ji Desheng tablets) had 62 marked effect, 49 effective, 29 ineffective; total effective rate 79.95%.
Open group (also Qinglong tablet, doctors and patients knew the drug) had 184 marked effect, 29 effective, 9 ineffective; effective rate 95.95%.
This looks quite good overall.
But upon closer inspection, it’s not perfect, as dozens didn’t respond.
Why?
It turns out it’s about the timing of treatment — whether it was given promptly.
Further analysis found patients treated within 2 hours of bite had effective rates of 98.21%, 94.55%, and 99.15% in the treatment, control, and open groups respectively.
See? The success rate improved significantly with early treatment. Both tablets exceeded 95% effective rates if given within 2 hours. I believe if treatment is given even earlier, say within a few minutes (having the tablets on hand), efficacy would be even better.
It’s safe to say both snake tablets are outstanding. In fact, there are many other snake tablets with excellent and affordable quality. I won’t list those studies here, as Western medical authorities might argue the lack of control groups. I’m only citing Qinglong tablets, because those are based on randomized double-blind research that they have no arguments against.
Unfortunately, the tide of the times drowned the second generation of snake medicine doctors, because the economic benefits of traditional Chinese medicine were too poor, far less than serum. No one can deny this fact. Talking about treatment ideals while ignoring economic interests is nonsense.
This brings us to the third generation.
(4) Third generation: I’ll mention only one person, Li Qibin.
Li Qibin (1954 - present), who is he?
In terms of age, I must respectfully call him a senior.
But judging by his actions, I really cannot find words to express my feelings.
Professor Li is from Guangxi, working in the Emergency Department of the First Affiliated Hospital of Guangxi Medical University. He is a bona fide Western medicine doctor, but he joined the Chinese Herpetological Association as early as 1989 (perhaps earlier), and served as secretary-general of “Herpetologica” for many years, later becoming vice president of the association.
Around 1990, the president Shu Purong and vice-president Li Qibin parted ways in their philosophy on snakebite treatment.
Shu Purong emphasized TCM is good, snake tablets are effective, with a very high success rate. Serum is also good. For an individual, whether to use Western medicine, TCM, or combined treatment depends on the situation. Early use of serum may be more effective (the question is, can you get serum early at a hospital?). Mid-stage favors TCM for effective, flexible, and reliable treatment with syndrome differentiation. Late stage requires combined therapy. That was Shu Purong’s view.
Li Qibin, on the other hand, never really accepted TCM from beginning to end. Being Western-trained and having worked closely with Japanese researchers studying snakes and serum, he has consistently supported antivenom serum. Since 1989, all his publicly available views emphasize serum and never mention TCM or snake tablets.
In 1992, President Shu Purong wrote an article in “Herpetologica” titled “Prospects for Treating Snakebites with Chinese Herbs,” fully affirming the efficacy of TCM, Chinese herbs, and snake tablets, as well as serum. He advocated a two-pronged approach, analyzing specific circumstances. Shu Purong was 61 years old then; Li Qibin was 38 (same age as me now — impressive to be vice president at that age), a senior and a junior.
Shu Purong stated: Practice shows China has a long history of treating snakebites using Chinese herbs, with rich experience and definite effects. Currently, the majority of rural snakebite patients are cured with Chinese herbs. Especially after research advances in the 1980s, total cure rates are not inferior to antivenom serum. Serum can neutralize free snake venom directly and quickly in early poisoning, which Chinese herbs cannot match. However, when venom is bound to cells and pathological damage caused, serum is powerless but Chinese herbs can indirectly mobilize innate anti-toxic factors, protect organs, enhance detoxification and toxin elimination ability, prevent venom spread and absorption, interfere with venom activity — achieving symptom relief and cure.
But obviously, Shu Purong’s call had little effect because his treatment approach became out of step with social conditions in 1990. Heh, at that time, everyone was after money.
I reviewed subsequent “Herpetologica” papers, which mostly introduced serum efficacy analyses for snakebites, occasionally discussing TCM and snake tablets, and also many analyses of combined treatments.
Objectively, I must say Shu Purong did a lot of work. During the height of the Association, it had over 4,000 members with good economic benefits. At their conferences, they always talked about building economic entities to become strong, meaning more people and more money. To be strong, relying solely on TCM was impossible; only the serum path was feasible.
But I regret to say Shu Purong’s work had a shortcoming: he wrote the book “Snakebite Treatment” in 1983 objectively evaluating TCM and serum treatments, followed by revisions in 1988, 1992 (third edition), and 1997 (fourth edition), selling hundreds of thousands of copies. However, as president, he never organized peers to compile an official snakebite treatment guideline or expert consensus.
Shu Purong passed away in 2016, and before his death no snakebite expert consensus or guidelines were published.
Until 2018, third generation representative Li Qibin emerged, organizing and editing the “Chinese Expert Consensus on Snakebite Treatment.” In this consensus, Li and others almost exclusively introduced serum, giving only brief mention to TCM, saying it might have some effect. Ha. Even for pre-hospital emergency care, they didn’t promote snake tablets, which have good efficacy — this deeply saddened me. These people’s factional and interest battles have reached outrageous levels.
They even confidently claimed: serum is the only practical effective antivenom medicine.
This statement, upon scrutiny, has some logic because TCM and snake tablets do not directly neutralize venom but improve overall resistance by mobilizing the body’s strength, differing from serum’s mechanism.
But this claim makes all viewers mistakenly believe serum is the only effective treatment. Moreover, their portrayal of TCM is like this:
They said: TCM might have some effect on mild to moderate cases.
This completely erases Shu Purong’s research achievements and those of other peers.
Can you tolerate that?
As an outsider, I find this intolerable.
(5) Questioning: Is TCM really useless?
Li Qibin (1954 - present), I name him specifically.
What qualification does he have to say, “TCM might have some effect”?
Why didn’t he say this before Shu Purong passed away?
Why did he wait for the old senior to die before organizing an expert consensus to support serum (which is understandable) but disparage TCM?
What does “might have some effect” mean?
Have they not seen Shu Purong’s Qinglong snake tablets study? That was a double-blind randomized controlled trial with excellent results — a life-saving remedy to be carried in the field for immediate use. Besides Shu Purong, many others have done plenty of research. Why does he look down on this?
Ji Desheng snake tablet studies show over 95% cure rate if used within 2 hours, even up to 99.5% cure rate. Such success rates, even if not quite serum-level (are they really worse?), are very helpful. Why in an official Chinese expert consensus is TCM or snake tablets not mentioned at all in snakebite emergency care?
Can you get antivenom serum immediately? No!
But you can use snake tablets immediately! Why not say that?
I know why. Because if patients use snake tablets first, they might not need antivenom afterward.
Right?
Again, all these snake tablets have been proven effective, but because they make little money compared to serum, doctors do not favor them. Especially with promotion by experts like Li Qibin, TCM and snake tablets have no future, manufacturers stop production, and currently only Ji Desheng’s tablets remain, a pitiful situation.
Even if snake tablets don’t match serum efficacy, carrying and using them immediately is still very helpful. Why not introduce this? Haha, they are just unwilling to.
Would they say this when Ji Desheng was alive?
Would they say this when Huang Shoulin was alive?
Would they say this when He Xiaosheng was alive?
Would they say this when Shu Purong was alive?
Even now, there is a respected figure, Yu Peinan (1941 - present), also from Guangxi like Li Qibin, but Yu is at Wuzhou Chinese Medicine Hospital, probably not in close business with Li, who is at Guangxi Medical University’s affiliated hospital. Yu is not part of the Chinese Herpetological Association; he founded the Asian Society of Snakebite Prevention and Treatment, ha. His view is integrated TCM and Western medicine: early snake tablets for immediate use or herbal dressings, serum effective mainly in the early stages, but less effective in middle or late stages due to venom-cell binding. Here, TCM can play a role, especially for late-stage wound ulceration and necrosis, which are TCM specialties.
Thus, Yu Peinan advocates integrated treatment: early serum is better (pre-hospital emergencies can definitely use snake tablets or Chinese herbs), mid-stage uses stable reliable TCM, late stage uses integrated treatment, especially for wounds with ulceration and suppuration, TCM is strong.
But Li Qibin?
Hehe, he completely and thoroughly abandoned TCM. The expert consensus he led is purely Western medicine, so how can it be called a Chinese expert consensus? Does he represent China?
As for the 2024 Chinese Journal of Emergency Medicine publishing the “Chinese Snakebite Emergency Treatment Guidelines,” even less needs saying. The guidelines are based on the 2018 consensus, written by Western emergency specialists with few snake experts. They nonsensically claim serum is the only effective and safe drug — nonsense.
You say serum is effective and safe, I agree. But why claim it is the only one? Why emphasize exclusivity? Isn’t it to form a monopoly?
In short, serum is profitable. Snake tablets are not. Chinese herbs are even less valuable. They are to be eliminated.
These intellectuals, I openly name. If they think I’m wrong or insulted them, feel free to sue me. Fine by me; I will fight to the end and stir public opinion to expose who is distorting the facts.
The internet has memory.
Papers published in journals have even more memory. Check them out, the truth is clear at a glance.