Summary of case history,　Patient YU, male, 52 years old, chief complaint:"toe snake bitten for 4 hours,dyspnea for more than 3 hours", and was admitted to the hospital on August 26,2018. On the day of admission, the patient was bitten on his left foot by Bungarus Multicinctus snake, and felt tingling and numbness at the bite site. One hour after injury, he developed dizziness, blepharoptosis,sore throat,and numbnessand weakness of limbs.Then he cut the wound by himself and went to ,The First Hospital of Sanming City, immediately, but he had difficulty breathing on the way. Three hours after injury, the patient had disturbance of consciousness and dyspnea, and was sent to ICU after mechanical ventilation. After intramuscular injection of TAT,intravenous drip of anti-agkistrodon venom serum,external application of "Ji de sheng snake medicine",anti-inflammatory and anti-infection treatments, the patient was still in acoma after 3 days of treatment, without spontaneous breathing and relying on a ventilator to maintain breathing. The family was informed that the patient was critically ill and would probably not be revived. On August 29,2018, the family requested WANG Shijun,co-chief physician of ,The People's Hospital of Fujian University of Traditional Chinese Medicine, to consult and guide the rescue treatment.At the time of consultation, the patient was in a deep coma, GCS score:EIVTM1,bilateral pupils of equal size, 5.0 mm in diameter, no light reflection, no spontaneous breathing,ventilator to maintain breathing.,TCM diagnosis,　Snakebite (Yin Syndrome),Western medicine diagnosis,　left foot Bungarus Multicinctus snakebite critical illness;pulmonary infection,Therapeutic methods,　First visit (2018.8.29),1.Prescription:12 g cassia twig,20 g Radix paeoniae alba, 15 g cassiae semen,12 g celosiae semen,9 g Belamcanda chinensis,9 g dried ginger,12 g evodia fructus, 30 g processed fuzi(decocted first),9 g asarum,20 g codonopsis, 12 g Xu Changqing,9 g rhizoma mori,9 g rhubarb, 6 g Chuanxiong, 12 g arecanut,9 g liquorice, a total of 3 doses, decocted in water, 1 dose daily, divided into 2 times. 2.Acupuncture:philtrum,Neiguan,Sanyinjiao, and acupoints: Tianshu, Guanyuan, Zusanli, Lianquan, Jinjin, Yuye, Jiquan, Chize, Hegu, Weizhong, Taichong, Taixi,Yongquan. Manipulation: Tianshu,Guanyuan,Zusanli and Sanyinjiao are used as supplementary acupoints. Neiguan, Jiquan, Chize, Weizhong with reducing method; For the other acupoints,mild reinforcing and mild reducing.the needles were kept for 15 minutes, and the needles were appliedonce every 10 minutes. Moxibustion method: Moxibustion was applied to Baihui points for 30 minutes. 3.Western medicine treatment: pantoprazole to prevent acute stress ulcer, ambroxolto resolve phlegm,cefuroxime to prevent infection,fentanyl,midazolam sedation and rehydration support treatment. Second visit (2018.9.1): the patient developed a high fever, with a temperature as high as 39.5 ℃. When called, the patient could shake his head and move his thumb slightly. His spontaneous breathing recovered,only 8~10 times/min,and he needed ventilator assisted breathing. The bilateral light reflex still disappeared, the muscle strength of both lower limbs was still grade 0, and the prescription was kept above.The dose of aconitum was reduced to 10g, deleted asarum,add 30g poria, a total of 3 doses. She was instructed to take one Angong Niuhuang pill,red ginseng 30g frequently soaked in water, and musk fill the ear to wake up. Third visit (2018,9.4): The patient woke up, and the sound of phlegm could be heard in the throat, but the patient was unable to produce phlegm.The sputum aspirator could suck out more viscous yellow phlegm, and it was difficult to open the mouth.The pupil size returned to normal, and the light reflex was improved compared with before. The patient could not speak but could nod and shake his head.The fingers of both hands could move slightly inflexion and extension, but the muscle strength of both lower limbs was still grade 0. strength of both 1ower limbs was sti1l grade 0,and the spontaneous breathing was 10-12 times/min,and the ventilator was still needed to assist breathing. The prescription was adjusted to invigorate qi and spleen, dispel wind and clear collaterals,clear lung and dissipate phlegm.Prescription:astragali 30 g,poria 30 g, atractylodes 15 g, angelica dahurica 15 g, rhizoma curculiformis 15 g, angelica sinensis 15 g,bidens 60 g,Dioscorea 30 g, one centipede,chuanxiong 9 g,scutellaria 15 g,Houttuynia cordata 30 g,Trichosanthes fructus 30 g,Pinellia farinae 12 g, Rhizoma coptidis 9 g, Licorice 3 g, a total of 3 doses, decoction,1 dose daily, divided into 2 times. Fourth visit (2018.9.7) : through telephone consultation,the doctor complained that the patient's spirit recovered, and he could respond by blinking and nodding and shaking his head.There was much sputum in the throat, but he was still unable to cough sputum, and the sputum suction machine could suck out more sticky yellow sputum. The pupil size returned to normal, and the light reflex was normal. The finger flexion and extension function of both hands was further improved, but the muscle strength of both lower limbs was still grade 0, and the spontaneous breathing was 12-15 times/min, and the ventilator was still needed to assist breathing. Kept prescription, and the treatment was to invigorate qi and spleen, dispel wind and clear collaterals, clear lung and dissipate phlegm a total of 7 doses were decocted with water, one doseper day, and taken twice. Later follow-up showed that the patient's upper limb function recovered and the muscle strength of both lower limbs was grade 2 .The family were asked to make a capsule with BuyangHuanwu decoction powder and take it for 3 months.During the follow-up on 2019.1.8, the patient could walk with a cane, but the walking was not steady and the pace was sluggish, and he was asked to continue taking capsule.,Clinical outcomes,　The patient gradually recovered spontaneous breathing, the ventilator was removed on 2018.9.15, and the patient was discharged on 2018.9.21. At discharge, the patient's upper limb function recovered, and the muscle strength of both lower limbs was grade 2. During the follow-up on August 8, 2019, the patient could walk with crutks, bu this walking was unstable and his pace dragged.At the follow-up on 2019.7.23, the patient could walk normally without crutks, and his walking pace returned to normal.