| China has a long history of the treatment of snakebite.A large number of single and tested prescriptions have been recorded in herbal and prescription books of past dynasties.There is also a tradition of using medicinal wine to treat snakebite,which is still used in contempoary age.In the late 19th century,the invention of antivenom opened a new chapter in the history of snakebite treatment.During the period of the Republic of China,antivenom knowledge began to be introduced into China.Since China was poor and weak at that time,there was no ability to develop and produce antivenom,thus nothing was done in this regard.At the beginning of the founding of the People’s Republic of China,in order to protect Chinese pharmaceutical companies,the government banned the import of biological product,and also ruled out the possibility of importing antivenom.At that time,China was in the early stages of development and large-scale infrastructure and manufacturing had just begun,while poisonous snakebite were common.Due to the lack of medical institutions and specific medicines,people had to turn to civilian snake herbalist for treatment.After the promulgations of the new TCM(traditional Chinese medicine)policy,the government began to attach importance to the treatment techniques of TCM,and encouraged TCM practitioners to offer prescriptions by holding TCM representative meetings at all levels.Meanwhile,TCM practitioners were recruited into hospitals.Among them,Nantong Hospital of Traditional Chinese Medicine recruited Ji Desheng,a folk snake herbalist,who donated the secret recipe for snakebite from his ancestors,causing a stir in the society.Therefore,health authorities began to pay attention to the technique of snakebite in traditional medicine.At the same time,pharmacists actively assisted TCM in sorting out and researching traditional Chinese medicine,and began to study antivenom.After the Great Leap Forward began,antivenom research was suspended.In the Medical and Health Technology Revolution,medical experts were asked to assist TCM doctors,nomal herbalists and snake herbalists in sorting out and studying formulas for snakebite,and thus the ancient formulas for snakebite began to receive scientific discipline.During the period of national economic adjustment,medical experts no longer assisted TCM doctors for sorting out and studying formulas for snakebite.Instead,they focused on the research of antivenom and chemical medicine.The development of biological product and chemical medicine such as antivenom returned to the right track.Due to previous influences and inadequate preparation,the trial production of antivenom in this period failed,thus being interrupted.On the eve of the "Cultural Revolution",the medical circles held the first National academic conference on snakebite to discuss the scientific research on biological product and chemical medicine such as antivenomand.However,the scientific research achievements had not been formed at that time,and the grassroots still had to rely on snakebite prescription for treatment.Since the beginning of the "Cultural Revolution",TCM doctors and western medicine doctors had cooperated to conduct research on Chinese and western medicine for snakebite once again,screen and improve formulas for snakebite.Local health authorities formulated cooperative research plans for the prevention and treatment of snakebite between Chinese and Western medicine.In the Chinese Herbal Medicine Campaign,the government encouraged the prescription offering again by the same time promoted the method of independent research and development of traditional Chinese medicine to solve the drug demand.The snakebite formulas emerged in the research and cooperation of various places were improved into traditional Chinese medicine snakebite preparations,completing the scientific transformation of snakebite formulas.At the same time,the latest foreign refined antivenom technology was introduced into China.Medical experts restarted the research on antivenom,and carried out trans-regional clinical research collaboration on domestic refined antivenom and other biological product,while screening other chemical medicine that also treated snakebite.New Chinese and western snakebite medicine and integrated chinese and western medicine snakebite therapy began to appear in the mid 1970s,and achieved good clinical results.In the early stage of reforming and opening up,China’s science and technology entered a stage of rapid development,and the pedigalogy of domestic refined antivenom was gradually improved.During this period,there was the greatest variety of snakebite medicines on the market.In addition to antivenom,other biological product and chemical medicine,some provinces,cities and counties in southern China developed a wide range of TCM snakebite preparations through previous research and cooperation.All of these preparations had a significant effect on the bite of the local snake species in their origin,and passed the evaluation and entered mass production after the reforming and opening up.With the abundance of clinical medicine,chinese and western snakebite medicine formed a competitive relationship in clinical application.Because of the better effect of antivenom detoxification,the clinical snakebite treatment mode soon changed from mainly snakebite prescription(preparation)and supplemented by western medicine to a new treatment maily with antivenom and supplemented by snakebite prescription(preparation).The clinical application of Chinese and Western snakebite medicine reversed,a "irresolution" for the first time.In addition,after the national Conference on Chinese and Western medicine,general hospitals and TCM departments of specialized hospitals was held in 1982,the policy of" the development and long-term coexistence of the three forces of TCM,western medicine and the integration of TCM and Western Medicine" was formally established.This policy led to the differentiation of Chinese and Western snakebite treaters,and integration of different medical academic groups.From the 1980s to the 1990s,national medical academic societies and their sub-professional groups on snakebite were established one after another,which played an important role in the academic research on snakebite treatment and the continued development and promotion of snakebite medicine.Since the 1990s,with the continuous acceleration of urbanization in China,the incidence of snakebite in urbans and countries have risen rapidly,and so has the incidence of severe snakebite.The existing snakebite prevention system was gradually replaced by the snakebite first aid system from the 1990s to the early 21st century.The achievements of the academic TCM groups on snakebite in the 1990s made the treatment of snakebite in TCM receive attention again in the early 21st century.During this period,the academic circles of snakebite in China established the first aid classification standards of snakebite and the diagnostic standards of snakebite in both Chinese and Western medicine.Antivenom was also popularized in general hospitals of both Chinese and Western medicine,basically realizing the modernization of snakebite treatment at all levels in China.At the same time,some hospitals still adhered to TCM therapy for snakebite,and Chinese medicine preparations for snakebite were still widely used.However,compared with the early stage of reforming and opening up,the variety of TCM snakebite preparations in circulation on the market is greatly reduced.With the gradual popularization of antivenom,the snakebite of TCM clinical research also gradually turned to use antivenom wounded early treatment and the use of snakebite complications study.The formulas to use snakebite preparations in the early treatmentof snakebite and first aid research is becoming increasingly indifferent,which laid a hidden danger for the loss of treatment of snakebite under the shortage of antivenom in the future.However,with the deepening of the understanding of snakebite prescriptions and traditional Chinese medicine snakebite preparations in improving the sequelae of snakebite,the Chinese Government has once again attached importance to the treatment of snakebite in traditional Chinese medicine,and has transferred the National Snakebite Academic Conference and the Snakebite Academic Exchange Journal to the Snake Association and the Snakebite and Snake Venom Professional Committee of the Surgical Branch of the All-China Association of Traditional Chinese Medicine,which promoted the revival of Chinese medicine snakebite treatment in the first decade of the 21st century.Snakebite prescription and traditional Chinese medicine snakebite preparation have once again become the most important auxiliary means for snakebite treatment.Leading by the Snake Association and the Snakebite and Snake Venom Professional Committee of the Surgical Branch of the All-China Association of Traditional Chinese Medicine,Chinese snakebite experts also helped ASEAN countries formulate the Snakebite Clinical First Aid Classification Standard and Snakebite Clinical Diagnosis Standard of Integrated Traditional Chinese and Western Medicine,which promoted the establishment of traditional medicine snakebite research and snakebite treatment system in ASEAN countries.Since the beginning of the 21st century,the number of units using antivenom has increased,and the amount of unit reserves has decreased.Affected by market rules,manufacturers reduced varieties and had unstable output,which led to the shortage of antivenom in emergencies.This phenomenon is enhancing with the deepening of the pharmaceutical market reform in the new century.Therefore,China strengthened the government’s intervention in the medical and health reform in 2009,and gradually established the national shortage medicine guarantee mechanism from the local to the central government.Academic circles were also actively exploring countermeasures,including developing new TCM snakebite preparations and antivenom,prolonging the preservation period of antivenom,and saving the dosage of antivenom by combining the purification of TCM with antivenom and utilizing the cross-neutralization characteristics of antivenom.In sharp contrast to the shortage of antivenom,the sales volume of the few remaining TCM snakebite preparations rose sharply in recent years,and their clinical application and research became active again.The clinical application of Chinese and western snakebite medicine reversed again,showing the second "irresolution".Some hospitals reestablished snakebite departments or snakebite clinics,even resumed the practice of using TCM as the main ingredient,antivenom,other biological product and chemical medicine as supplements,with the practice of using ventilators in severe and critical cases.In addition,in recent years,provincial and trans-provincial snakebite treatment centers have been established in various regions as a centralized reserve of antivenoms to alleviate the difficulty of seeking treatment for snakebite through cross-regional collaboration.Nevertheless,compared with many other diseases at the forefront of the disease spectrum,snakebite has been greatly reduced,so it is no longer a national priority.In recent years,China’s snakebite work has been fully taken over by the Chinese Medical Association Emergency Medicine Branch.Under the leadership of the Chinese Medical Association Emergency Medicine Branch,Chinese and Western snakebite workers have formulated the 2018 Chinese Expert Consensus on Snakebite Treatment.Since then,China’s snakebite work has been fully in line with international standards,and the characteristics of snakebite research cooperation and treatment between Chinese and Western medical personnel that have lasted for decades have gradually faded.Combining the changes of contemporary Chinese medical policy,this paper reviews the history of contemporary snakebite prevention and treatment,and discusses the ebb and flow of Chinese and Western medicine in this process,so as to understand an important aspect of the development of contemporary Chinese medicine.In this historical process,social,political and economic factors have played an important role.It was precisely because of the long-term lack of material conditions in New China and the slow progress of modernization that traditional healing techniques could continue to function.The intervention of political factors has allowed traditional treatment techniques that were not taken seriously by the health authorities to be accepted and become a formal medical method recognized by the government.Later,modern science,as an imported culture,was given the legitimacy of transforming local culture by the health authorities,and traditional Chinese medicine became the object of scientific discipline.The relationship between Chinese and Western medicine in the historical process of snakebite treatment research and application constitutes the inner tension that promoted its development and evolution.In addition,social factors have also become the determinants of the evolution of snakebite medicine in contemporary China:before the completion of the general scientific discipline,the grass-roots society was more accustomed to snakebite prescriptions;after the completion of the scientific discipline,the grassroots society successfully accepted the traditional Chinese medicine snakebite preparations;after the advent of antivenom,the grassroots society is more inclined to choose antivenom when economic conditions permit.It should be pointed out that the deepening market-oriented reform in the pharmaceutical field also depended on political factors.After the enterprise ownership reform at the end of the 20th century,a batch of traditional Chinese medicine snakebite preparations researched by Chinese and Western medicine was discontinued and abandoned in the dust of history.From 1978 to 2015,the pricing of antivenoms still depended on health authorities rather than the market,also reflecting the influence of political factors.To sum up,the history of the development and application of contemporary snakebite medicine is not simply the history of medical technology and drug development,but a dynamic historical process formed under the influence of political,economic,cultural,social and other factors in a specific era.This thesis also presents a complex historical dimension.The historical situation of contemporary snakebite medicine is also a microcosm of the development and application history of Chinese and Western medicine in contemporary China. |
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