What venom does to the body

Venom types and combinations

Snake venom is a mixture of dozens of proteins, each with its own job. Most venoms combine several kinds of toxin, which is why a single bite can paralyse, stop blood clotting and destroy tissue at the same time.

The labels below group toxins by what they do to a person, not by their chemistry. One toxin family can fall under several labels: some phospholipase toxins attack nerves, others break down muscle.

The main types

N

Neurotoxic: stops nerves signalling to muscles

What you might see
Drooping eyelids, double vision, trouble swallowing and speaking, spreading weakness. Death comes from paralysis of the breathing muscles.
How it works
Some toxins block the receptor on the muscle side of the nerve–muscle junction (three-finger toxins in cobras and sea snakes). Others destroy the nerve ending itself (β-neurotoxins in kraits and taipans), and antivenom reverses that kind less well.
Examples in our data
H

Haemotoxic: disrupts blood and blood vessels

What you might see
Bleeding gums, blood in urine or vomit, bruising, bleeding that won’t stop, collapse from blood loss or shock. Kidney injury often follows.
How it works
Two different routes that both end in bleeding. Clot-consuming (procoagulant) toxins trigger clotting inside the blood until clotting factors run out, so the blood can no longer clot. Haemorrhagic toxins (metalloproteinases) damage vessel walls so blood leaks out. A few venoms also block clotting directly.
Examples in our data
C

Cytotoxic: destroys tissue at the bite

What you might see
Severe pain, swelling that spreads up the limb, blistering, and dead tissue that may need surgery. This is the main cause of lasting disability after snakebite.
How it works
Toxins break open cell membranes and dissolve the structures that hold tissue together. Spitting cobras and puff adders are well-known examples.
Examples in our data
M

Myotoxic: breaks down muscle

What you might see
Muscle pain and stiffness, dark brown urine, then kidney failure. Potassium released from damaged muscle can stop the heart.
How it works
Mostly phospholipase toxins that break down skeletal muscle throughout the body, not only at the bite. Common in sea snakes and several Australian elapids.
Examples in our data
Other terms you will seeWhat they mean
CardiotoxicAn old name for cobra cytotoxins, from their effect on heart muscle in the lab. Direct effects on the human heart are less common than the name suggests.
NephrotoxicKidney damage. Usually a result of bleeding, clotting problems or muscle breakdown rather than a separate toxin. Russell’s viper bites are especially known for it.
Spreading factorsEnzymes such as hyaluronidase that help venom move through tissue. They make other toxins act faster but are not very toxic themselves.

Which combinations snakes carry

Counted from the venom effects recorded for the 94 species in our dataset. Most rattlesnake and viper venoms fall under haemotoxic; most cobra, krait and sea snake venoms under neurotoxic.

How some well-known venoms work

These species are often described with the wrong combination. This is what the evidence supports.

SpeciesMain effectsNotes

What makes a bite worse

The same snake can cause a dry bite with no venom or a life-threatening one. These factors make the difference.

How much venom goes in

Snakes control their venom. Many defensive bites are “dry” and inject little or none; others empty the glands.

Where the bite lands

Venom injected straight into a blood vessel acts far faster than venom under the skin.

Body size

The same dose is more concentrated in a smaller body, which is why children are at greater risk.

Moving around

Walking and a racing heart push venom through the lymph system faster. Keeping still is the most useful first aid.

Time to antivenom

How quickly someone reaches a hospital that holds the right antivenom often matters more than the venom itself.