Bai Hua She
StarDeinagkistrodon acutus (Günther, 1888)
Traditionally used for
- Nerves & recovery
- Pain & joints
- Skin
Cautions & contraindications
- Pregnancy
- Bleeding disorders
- Allergy risk
- Toxic — professional use only
☯ TCM Properties
Dispels Wind; Unblocks the channels and collaterals; Stops spasms and convulsions; Dispels Wind from the skin
Traditional Chinese Uses
Bai Hua She (agkistrodon acutus, hundred-pace snake) is a potent Wind-expelling substance used in Chinese medicine for severe, deep-seated bi obstruction resistant to gentler approaches — including intractable rheumatoid arthritis-type joint disease, facial paralysis, tremors, and convulsions from Wind obstruction. Applied topically, it also addresses stubborn, chronic skin conditions. As a substance considered more penetrating than plant-based Wind-expelling herbs, it is reserved for difficult, long-standing conditions requiring deep channel penetration.
Relationships
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Botanical Description
Bai Hua She is not a plant but the dried body of Deinagkistrodon acutus (Günther), the sharp-snouted pit viper or "hundred-pace snake," a venomous crotaline snake (family Viperidae) native to the hills and mountain forests of southern and central China, Taiwan, and northern Vietnam. Adults reach 0.8-1.5 m in length with a stout body, strongly upturned snout, large triangular head distinct from the neck, and a dorsal pattern of dark brown triangular blotches on a paler grey-brown ground. For medicinal preparation, the captured snake is killed, eviscerated, coiled, and dried whole; in commerce it is sold as a tightly coiled disc. The head, which retains venom, is sometimes removed before clinical use.
Active Constituents
Crude protein and free amino acids
Protein and amino acidsConcentration: Bulk of the dried drug
The dried body is largely muscle and connective tissue, so protein, peptides and free amino acids dominate the mass of the drug. No single protein has been established as the active marker, and the Chinese Pharmacopoeia identifies the drug morphologically and by DNA rather than by a chemical assay.
Bone mineral (calcium phosphate) and collagen
Inorganic phosphate salts and structural proteinConcentration: Present in whole-body material; largely removed in the deboned piece known as Qi She rou
Vertebrae and ribs contribute hydroxyapatite and type I collagen to whole dried snake. The deboned decoction piece removes most of this fraction, so the two piece types are not chemically equivalent.
Acutolysins A, B and C
Zinc-dependent snake venom metalloproteinaseConcentration: Venom-apparatus constituent; the head is removed from the decoction piece
Haemorrhagic metalloproteinases that degrade basement membrane and cause the local haemorrhage and tissue necrosis typical of a bite from this species. They belong to the venom gland, which sits in the head, and are excluded when the head is cut off as the Pharmacopoeia directs.
Thrombin-like serine proteinases (acutobin, AaV-SP-I and AaV-SP-II)
Snake venom serine proteinaseConcentration: Venom-apparatus constituent
Cleave fibrinogen and defibrinogenate blood. Purified enzymes of this class from the species are the basis of licensed injectable haemocoagulase products in China, which is a separate pharmaceutical product and not the crude drug.
Basic (Lys49) phospholipase A2
Phospholipase A2Concentration: Venom-apparatus constituent
Myotoxic membrane-damaging enzyme of the venom. Its crystal structure from this species has been solved. Heating destroys its biological activity while leaving some immunogenic epitopes intact.
L-amino acid oxidase (ACTX-8)
Flavin-dependent oxidoreductaseConcentration: Venom-apparatus constituent
Generates hydrogen peroxide and induces apoptosis in cultured cells. Reported as a cytotoxic component of the venom of this species, not as a constituent of the dried body used as a herb.
Lipids and cholesterol
LipidConcentration: Minor fraction of the dried body
Ordinary animal fat and sterol content of dried snake tissue; no specific pharmacological role has been established for it in this drug.
⚠ Drug Interactions
Jin Qian Bai Hua She (dried young Bungarus multicinctus)
Two separate drugs in the Chinese Pharmacopoeia are called Bai Hua She in ordinary trade speech. This record is Qi She, the dried body of the pit viper Deinagkistrodon acutus (registered in the Pharmacopoeia under the older name Agkistrodon acutus). The other is Jin Qian Bai Hua She, the dried body of the juvenile many-banded krait Bungarus multicinctus, a front-fanged elapid with presynaptic and postsynaptic neurotoxins. They are different families, different toxin chemistry, different dose ranges and different preparation. The pinyin label on this corpus record carries the suffix Qi She on the krait record instead, which is the reverse of the correct assignment and is exactly the confusion this interaction warns about.
Clinical note: Dispense against the binomial and the Latin drug name, not against the pinyin. Confirm whether a prescription for Bai Hua She means Qi She (Deinagkistrodon acutus) or Jin Qian Bai Hua She (Bungarus multicinctus) before filling it; the dose ranges are not interchangeable.
Substituted snake species in dried snake products (Zaocys dhumnades, Ptyas mucosa, Elaphe and Lycodon species)
Dried, coiled, descaled snake is one of the hardest crude drugs to identify morphologically, and substitution is documented rather than hypothetical. DNA-based methods have been developed specifically because of it: species-specific and rapid PCR assays for medicinal snakes, a fluorescent specific PCR method using cationic conjugated polymers, and capillary electrophoresis multiplex PCR that separates the krait drug from Bungarus fasciatus and from the red-banded snake Lycodon rufozonatus. Shotgun sequencing of retail traditional Chinese medicine preparations has also found undeclared animal species with legality and safety consequences.
Clinical note: Buy from suppliers who can produce a DNA-based identity certificate for animal drugs. Morphological inspection of a dried coil is not sufficient evidence of species.
Warfarin, direct oral anticoagulants and antiplatelet drugs
The venom of this species is dominated by haemostatically active proteins: haemorrhagic metalloproteinases, thrombin-like serine proteinases that defibrinogenate blood, and a factor X inhibitor. Purified venom enzymes from the species are marketed in China as injectable haemostatics. There is no evidence that meaningful quantities of these proteins survive into the decoction piece, from which the head and venom glands are removed, and orally administered snake venom proteins are digested rather than absorbed intact; heating has also been shown to abolish the biological toxicity of the venom and its fractions. The concern is therefore mechanistic and applies most to head-on material, powdered preparations swallowed without decoction, and patients with oral or gastrointestinal mucosal breaches.
Clinical note: No case of clinically significant coagulation disturbance from the herb is documented. In anticoagulated patients, prefer material processed as the Pharmacopoeia directs (head and scales removed), avoid raw powder, and check the INR or a full blood count if a patient reports unexpected bruising.
Beta-adrenergic blockers and ACE inhibitors
This drug is a whole animal body and is therefore a concentrated source of foreign protein. Snake venom and snake tissue proteins are documented human allergens: IgE-mediated hypersensitivity to airborne cobra venom has been reported, and heating a viper venom destroys its toxicity while leaving immunogenicity partly intact, so cooking or decocting does not remove allergenic potential. Patients taking beta-blockers have anaphylaxis that responds poorly to adrenaline, and ACE inhibitors impair bradykinin clearance; both make a reaction to any protein allergen harder to treat.
Clinical note: Ask about reptile, snake and general animal-protein allergy before prescribing. Avoid whole animal drugs in patients with a history of anaphylaxis, particularly those on a beta-blocker. Powdering the drug creates an inhalable protein aerosol, so dispensary staff should handle it with respiratory protection.
Wild-caught and illegally traded snake material
Deinagkistrodon acutus is not listed in any CITES Appendix, so international trade is not CITES-controlled. Within China it is a protected species: it was added in 2023 to the national list of terrestrial wildlife of important ecological, scientific and social value, which brings wild take and trade under permit requirements of the Wildlife Protection Law, though it is not on the National Key Protected Wild Animals List. The IUCN Red List assesses it as Vulnerable. Most commercial supply comes from captive breeding rather than wild collection, and the demand is driven by medicinal and culinary use; farmed and wild material cannot be told apart in a dried coil, which is the practical problem for a purchaser.
Clinical note: Require documentation of captive-breeding origin and the domestic permits for any snake drug. Practitioners outside China should also check national wildlife and animal-product import rules, which are frequently stricter than CITES.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction, or powder/pills | 3–9 g | Daily | — | — | 中国药典 2020 monograph 【蕲蛇】【用法与用量】3～9g；研末吞服，一次1～1.5g，一日2～3次。 【性味与归经】甘、咸，温；有毒。归肝经。 — Matched by hand: Record species Deinagkistrodon acutus IS ChP 蕲蛇. 白花蛇 is its common name — NOT 金钱白花蛇, which is Bungarus multicinctus, a different snake. Chinese Pharmacopoeia 2020, quoted verbatim. |
Evidence Tier
Moderate evidence · 5 studiesRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
0
Randomized controlled trial
0
Other clinical trial
0
Observational / case report
1
0 verified · 1 unverified
In vitro / animal
4
2 verified · 2 unverified
Show 4 studies
- Effects of heating on the immunogenicity and biological toxicity of Deinagkistrodon acutus venom and its fractions
- Exploring the five-paced viper (Deinagkistrodon acutus) venom proteome by integrating a combinatorial peptide ligand library approach with shotgun LC-MS/MS
- Homogeneous fluorescent specific PCR for the authentication of medicinal snakes using cationic conjugated polymers
- Application of rapid PCR to authenticate medicinal snakes
Other / unclassified
0
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Effects of heating on the immunogenicity and biological toxicity of Deinagkistrodon acutus venom and its fractions
Laboratory study of the venom of this species, not of the herb. Heating progressively destroyed the biological toxicity of whole venom and of its separated fractions, while a proportion of immunogenic activity survived. This is the most directly relevant published evidence for two practical questions about the drug: heat processing removes the toxicological hazard of residual venom protein, but it does not reliably remove the allergenic hazard.
Exploring the five-paced viper (Deinagkistrodon acutus) venom proteome by integrating a combinatorial peptide ligand library approach with shotgun LC-MS/MS
Proteomic characterisation of the venom of the species that supplies this drug. Snake venom metalloproteinases, C-type lectins, serine proteinases and phospholipases A2 dominate the venom proteome. It defines what is present in the venom apparatus of the head, which the Pharmacopoeia removes from the decoction piece, and so bounds what could in principle contaminate head-on material.
Homogeneous fluorescent specific PCR for the authentication of medicinal snakes using cationic conjugated polymers
Developed and validated a homogeneous fluorescent species-specific PCR assay to authenticate the snake drugs of the Chinese Pharmacopoeia, including this one, directly from processed material. The existence and adoption of such assays is itself evidence that morphological identification of dried snake is unreliable in practice.
Application of rapid PCR to authenticate medicinal snakes
Applied a rapid PCR protocol to discriminate the official medicinal snake species from substitutes in commercial samples. Supports species-level verification of dried snake drugs as routine quality control rather than as a research exercise.
The Epidemiology and Clinical Features of Deinagkistrodon acutus Envenomation: A Retrospective Study from a Medical Center in Hangzhou, Southeast China
Retrospective hospital cohort of envenomation by this species, describing coagulopathy, local necrosis and systemic bleeding. It concerns bites, not ingestion of the herb, and is included only to document what the venom of this animal does when it enters the circulation; it is not evidence about the oral drug.
⚠ Safety & Contraindications
- Pregnancy
- Bleeding disorders
- Allergy risk
- Toxic — professional use only
Contraindications
Contraindicated in pregnancy. Not for use in yin deficiency with internal heat.
Safety Warnings
- Allergy is possible in patients sensitive to animal proteins.
⚠ Toxicity Information
Uncommon at therapeutic dose; allergic reaction is the main risk, and overdose has produced dizziness and hypotension.
Historical Texts
Kai Bao Ben Cao (Materia Medica of the Kaibao Era)
Northern Song dynasty, 973 to 974 CEBen Cao Gang Mu (Compendium of Materia Medica), beast and scaly-animal sections
Ming dynasty, 1596Pharmacopoeia of the People's Republic of China, monograph Qi She (Agkistrodon)
Modern, 2020 editionReferences
- Chen, Po-Chuan; Huang, Ming-Nan; Chang, Jia-Feng; Liu, Chien-Chun; Chen, Chun-Kuei; Hsieh, Cheng-Hsien. Snake venom proteome and immuno-profiling of the hundred-pace viper, Deinagkistrodon acutus, in Taiwan . Acta Tropica (2019) [DOI]
- Tsai, Tein-Shun; Tsai, Inn-Ho; Qiu, Jing-Lin; Chan, Yuen-Ying; Chiang, Yu-Wei. Comparative analysis of Deinagkistrodon acutus venom from Taiwan and China utilizing chromatographic, electrophoretic, and bioinformatic approaches, along with ELISA employing a monospecific antivenom . Toxicon (2024) [DOI]
- Li, Xiang-Mo; Su, Shan; Zhang, Lu-Wen; Wu, Yan-Qing; Ji, Xiang. Patterns and Risks of China’s Snake Trade Driven by Medicinal and Culinary Traditions . Animals (2026) [DOI]
- Coghlan, Megan L.; Haile, James; Houston, Jayne; Murray, Dáithí C.; White, Nicole E.; Moolhuijzen, Paula; Bellgard, Matthew I.; Bunce, Michael. Deep Sequencing of Plant and Animal DNA Contained within Traditional Chinese Medicines Reveals Legality Issues and Health Safety Concerns . PLoS Genetics (2012) [DOI]
- Prescott, Ruth A.; Potter, Paul C.. Hypersensitivity to airborne spitting cobra snake venom . Annals of Allergy, Asthma & Immunology (2005) [DOI]
- Zhang, Weiye; Zhang, Zhubin; Bian, Ziwen; Zuo, Qi; Quan, Xue; Gong, Jiahao; Ju, Bingling; Feng, Liang; Jia, Xiaobin; Yang, Bing. Processing-induced detoxification of toxic Traditional Chinese Medicines: a systematic review of attenuation mechanisms at physical, chemical, and in vivo levels . Chinese Medicine (2026) [DOI]
- Pook, C. E.; McEwing, R.. Mitochondrial DNA sequences from dried snake venom: a DNA barcoding approach to the identification of venom samples . Toxicon (2005) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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