A Study on the Effectiveness of Traditional Thai and Folk Medicine in Treating Malayan Pit Viper Bite Wounds by the Local Healer, Thongkham Phlapyai

Abstract

Background The venom of the Malayan pit viper (Calloselasma rhodostoma) exerts its most severe impact on the hematological system, leading to snake venom-induced consumption coagulopathy (VICC). This condition disrupts blood coagulation mechanisms, resulting in systemic hemorrhage, and is a primary cause of mortality. Beyond systemic toxicity, local inflammation-characterized by pain, edema, and wound-related complications-frequently impairs the patient’s quality of life. In clinical practice, these localized symptoms are considered secondary manifestations that may be managed symptomatically or through integrative alternative medicine. Although modern medicine provides established clinical guidelines for antivenom administration, Thai Traditional Medicine (TTM) plays a significant role in managing local lesions, emphasizing detoxifying and anti-inflammatory herbal formulas such as topical herbal poultices and oral decoctions to alleviate pain, reduce swelling, and accelerate wound recovery. However, empirical evidence regarding the clinical efficacy of these traditional treatments remains limited.

Methods This evaluation research studied 12 patients (N=12) bitten by Malayan pit vipers who sought folk medicine treatment; participants were recruited by purposive sampling. Data were collected via questionnaires and in-depth interviews. Outcomes including swelling, pain scores, complications, recovery time, and satisfaction were assessed before and after treatment. Qualitative data were analyzed using content analysis and quantitative data using the paired    t-test.

Results After three days of treatment, mean swelling scores decreased significantly from 1.67 ± 0.65 to 0.50 ± 0.52 (mean difference 1.17, 95% CI 0.70–1.63; t=5.513, p<0.001), and mean pain scores decreased from 5.42 ± 2.84 to 1.33 ± 2.15 (mean difference 4.08, 95% CI 2.98-5.19; t=8.150, p<0.001), with 66.7% of patients reporting complete pain relief. Both effect sizes were large (Cohen’s dz=1.59 and 2.35). No wound infection and no new or progressive necrosis were observed. Most patients (83.3%) recovered within two weeks, and all reported high satisfaction.

Conclusions Treatment of Malayan pit viper bite wounds by the local healer Thongkham Phlapyai was associated with rapid reduction of local pain and swelling and a favorable local safety profile. Given the small purposive sample, the absence of a control group, and the predominantly mild-to-moderate envenoming, these findings should be interpreted as preliminary evidence supporting further study of this practice as an adjuvant to, not a replacement for, standard antivenom care.