Book Review and Related Research
Alchemy, Medicine, Religion in the China of A.D. 320:
The Nei P’ien of Ko Hung (Pao-p’u tzu)
by James R. Ware, translator.
My dear aunt Jan shares my interest in Chinese art and history, and encouraged it by taking me to Powell’s Books in Portland, Oregon for help in developing our collections. One Christmas years ago, she let me pick this rare translation of an important early work on Daoist alchemy by “The Master who Embraces Simplicity.” In today’s standard Pin Yin, this text is referred to as the Bao Pu Zi. In the earlier, Wade-Giles system (created by academics for academics to keep academia out of reach of normal people), this is Romanized “Pao-p’u tzu.” This is still pronounced ‘Bao Pu Zi’ if you know how to decipher it, much like Taoist has always been meant to be pronounced Daoist, and would only be pronounced with a T as in Town if it were T’aoist. Thank the Harvard and Yale guys for that brilliant system.
The Wade-Giles “Ko Hung” is thus “Ge Hong” in Pinyin, pronounced “Ge” as in Garage and “Hong” as in Holy (or Hongry Horse). ”Ko” would only be pronounced like Cobra if it were “K’o.” The apostrophe represents what linguists call ‘aspiration.’ This is not “a goal or a higher purpose,” but air leaving the mouth. Try it out and you’ll see that a G and K have roughly the same tongue position but the K has more air coming out (an “egressive glottalic airstream mechanism,” if you are headed to a Harvard cocktail party and want to impress Mr. Wade or Mr. Giles). The Nei P’ien (Nei Pian) means Inner Chapters, and is the more esoteric of Ge Hong’s writings.
James Ware did this first full translation of the Bao Pu Zi in 1966 via the MIT press. I’ve read through Ware’s version a few times now, spending more time with the chapters on alchemy and medicine. Many of the chapters are somewhat rambling lectures on why we should believe that ancient alchemists attained true immortality, lived thousands of years, flew up into the air, rode on dragons, grew back lost teeth, made real gold from other minerals, etc. There are some gems of insight and history, but also some great examples of thinking errors. Many of the things Ge Hong claims are factual are clearly legends he was told and took as truth. Many of the formulas for alchemical elixirs were likewise things he didn’t actually make, but memorized from his teachers.
Joseph Needham, the great scholar who compiled the encyclopedic _Science and Civilization in China_ was a huge admirer of Ge Hong as an early contributor to the literature of scientific history. The Bao Pu Zi is the first written work to document the distillation of alchohol, for example, and also discusses many mineral/metal experiments, such as melting cinnabar (a red mineral, Mercury sulfide [HgS]) to obtain the shiny liquid metal mercury.
It is the Potable Gold (Gold Juice or Jin Yi/Chin I) that interests me most now, though the high place of the medicinal mushrooms (such as the Ling Zhi/Spiritual Fungus/Ganoderma lucidum) in the Genie’s Pharmacopoeia is also key to my appreciation of Classical Chinese Medicine and Daoist Alchemy.
The premise and point of this review, however, is to emphasize how our current world view is thankfully based on the scientific filters such as modern chemistry. Most of us take it as common knowledge that mercury, arsenic, and lead are not suitable ingredients in our diet or medicines, especially intentionally or in large amounts. Additionally, we would want to be more species specific than ‘rock mushroom’ or ‘wood mushroom’ before preparing a meal from a fungus we found that matched one of Ge Hong’s descriptions. Many of my readers are particularly interested in the concept of ‘avoiding grains’ or ‘Bi Gu’ as an early Daoist dietary practice, since so many have found that avoiding gluten clears up a lot of symptoms such as sore joints and foggy mind.
Here is a section from later in the Nei Pian (Ware, page 243) dealing with avoiding grains:
Interlocutor: I should like to inquire whether a man can attain Fullness of Life by mearely dispensing with starches. How many methods for this are there altogether, and which is the best?
Ko: By dispensing with starches a man can only stop spending money on grains, but by that alone he cannot attain Fullness of Life. When I inquired of people who had been doing without starches for a long time, they replied that they were in better health than when they were eating starches. When they took thistle and nibbled mercury and when they also took pills of brown hematite twice a day, this triple medication produced an increase in breaths, so that they gained the strength to carry loads on long trips, for their bodies became extremely light in weight. One such full treatment protected the patients’ inner organs for five to ten years, but when they swallowed their breaths, took amulets, or drank brine, only loss of appetite resulted, and they did not have the strength for hard work.
The Taoist writings may say that if one wishes Fullness of Life the intestines must be clean, and if immortality is desired the intestines must be without feces; but they also say that those eating greens will be good walkers, but at the same time stupid; that those eating meat will be very strong, and also brave. Those eating starches will be wise, but they will not live to an old age, while those eating breath will have gods and spirits within them that never die. This last, however, is only a biased claim advanced by the school that teaches the circulation of breaths. One has no right to claim to use this method exclusively. If you wish to take the great medicines of gold or cinnabar, they will act more quickly if you fast for the preceding hundred days or so. If you cannot fast that long, take them straightwaway; this will do no great harm, but it will take more time to acquire geniehood.
You can see in the above quote the great tradition of bickering between schools of thought in Taoist medicine and alchemy. Ge Hong has no problem pointing out the biased claims of self-promoting schools. This is a part of the tradition I am in 100% agreement with! In many of these types of works, fasting doesn’t mean going without all food. It often means avoiding grains and meats. A simple diet of greens and mushrooms could constitute “fasting” in Taoist tradition.
Personally, I have been taking colloidal gold and silver on and off for a couple years, and have had fabulous experiences with them. Research in the International Journal of Neuroscience found that taking a small amount of colloidal gold increases IQ scores by 20% within 30 days (
http://www.meridianinstitute.com/ceu/ceu25gol.html). This no longer seems far-fetched to me, as I have repeatedly felt a significant cognitive boost very quickly after starting a colloidal gold cycle. I’ve had others report it as well. Again, it is through looking at modern scientific research that I am convinced that colloidal gold is not toxic and is beneficial. While I have some ‘purified’ Cinnabar powder I picked up in Taiwan, I’m not interested in ingesting it despite my fascination with it.
Pure colloidal gold is a beautiful red color, an ancient secret of stained glass makers and alchemists.
This exploration seems very pertinent to write about now as I have chosen to confront some dangerous fads I see in the Traditional Chinese Medicine/Classical Chinese Medicine worlds–i.e. promoting a product line based largely on the toxic herb Aconite because of its traditional symbolic attribution of ‘Increases Yang Fire’ while ignoring the research showing it has strong but poorly understood opiod effects and is both neurotoxic and cardiotoxic.
As I read Ge Hong’s confident proclamations of top substances in the Genie’s Pharmacopoeia (Ware translates Immortal as Genie or Genii and Tao as God through most of this work), I found myself wondering how other modern students of Daoism and Chinese Medicine make their own decisions about what to try and what not to try, and what to believe as true. Someone truly convinced that the ancient Daoists had it all figured out may choose to believe that Cinnabar or Arsenic were suitable for long-term use. Certainly it’s not so far away from promoting Aconite-containing formulas to pregnant women without any mention of the potential adverse reactions. I’m unfortunately certain that many modern acupuncturists have gone out of their way to get traditional bright red patent teapills rolled in Cinnabar powder and given them to unsuspecting patients for insomnia without bothering to tell them that the red coloring is over 50% mercury.
When I started studying Chinese Medicine seriously in 1993 there was no Internet. My first school, the International College of Traditional Chinese Medicine in Victoria, BC had but one bookshelf with far fewer texts than I have in my own collection today. For this article, I was able to use the invaluable resource of
Pubmed.gov, the vast resource of research abstracts from the US National Library of Medicine, to pull up hundreds of articles for ‘cinnabar’ and ‘mercury’ and found several pertinent to this discussion of Chinese medicines.
Before we look at the current Chinese Materia Medicas or Pubmed abstracts,let’s look at what Ge Hong has to say about Cinnabar, Gold and Silver, the main minerals that I will explore today.
From page 177 of James Ware’s book (all parenthesis and brackets are in the original):
Chapter 11
The Genie’s Pharmacopoeia
In Shen-nung’s Classic we read: ”Medicines of the highest type put the human body at ease and protract life so that people ascend and become gods in heaven, soar up and down in the air, and have all the spirits at their service. Their bodies grow feathers and wings, and the Traveling Canteen comes whenever they wish.” –”The various five excresences [mushrooms, lichens, etc.] may be nibbled, and cinnabar, jade flakes, laminar malachite, realgar, orpiment, mica, and brown hematite may be taken singly, and any of them can enable a man to fly and to enjoy Fullness of Life.” — “Medium-grade medicines nurture life. Low-grade medicines banish illness and prevent poisonous instects from attacking and savage beasts from harming us. They immobilize bad vapors, and put evil influence to flight.” Hsiao-ching yuan-shen ch’i reads ”Pepper and ginger protect against the effects of dampness, sweet flag sharpens the hearing, sesame protracts the years, and resin puts weapons to flight.”
The foregoing are words of the greatest import from the highest sages, a factual list of recipes. They are documented in the clearest of writing, but the people of our generation are lost in disbelief. This situation is pitiable.
At the top of the genie’s pharmacopoeia stands cinnabar. Second comes gold; third, silver, fourth, excrescences; fifth, the jades; sixth, mica; seventh, pearls; eighth, realgar; ninth, brown hematite; tenth, conglomerated brown hematite; eleventh, quartz; twelfth, rock crystal; thirteenth, geodes; fourteenth, sulphur; fifteenth, wild honey; and sixteenth, laminar malachite. After these come resins, truffles, yellow dock, Liriope graminifolia, “tree sesame,” Salomonia, goldthread, fern mulberries, and hsiang-ch’ai. This last is known as ch’un-lu. Other names for it are genie staff (Lycium), western-queen staff, sky sperm, age dispeller, earth bone, and grass willow.
Chinese herbal medicine’s textual origin is attributed to Shen Nong, the Divine Farmer. While legend states he lived 5000 years ago, the book attributed to him, the Shen Nong Ben Cao Jing (Ware calls it Shen-nung’s Classic), is from between 300 BC and 200 AD, according to Wikipedia (
http://en.wikipedia.org/wiki/Shennong_Ben_Cao_Jing). It contains 365 herbs (many things in Traditional Chinese Medicine have been forced to fit the calendar to make the microcosm match the macrocosm). They are divided into three categories, which are also found often in Chinese categorization as representing Heaven, Man, and Earth. The top (Heaven) category is non-toxic things which extend life and can be taken for a long time. The middle category are somewhat toxic but useful for many diseases. The lower category are highly toxic things suitable for short-term use to treat very specific diseases. Aconite/Fu Zi was placed in the lower category, which is part of why I’ve decided to write extensively about it to caution those who have been talked into taking or prescribing it long-term or in high doses as a part of a ‘Classical Chinese Medicine Revival’ that claims that the ‘Classics’ state Aconite is the ‘King of 100 Herbs.’ According to legend, Shen Nung’s face turned black from taking toxic herbs and he had a window in his belly button so could see where the herbs went and what they did. Let us not repeat the hard-learned lessons of the Divine Farmer, but simply take his word for it that the third category of herbs is toxic and for short term use for specific diseases. Growing feathers and wings is an example of the fantastical claims made all over the ancient alchemical literature, and hopefully serve as a clear example of why we should not take these claims as true or based on direct observation.
Ge Hong is clear in many parts of the Bao Pu Zi that Gold and Potable Gold are the best preparations for becomming an Immortal. However, he reports that gold is expensive and rare, so gives many recipes for making gold from more common minerals. Another fine book on this subject is _The Great Clarity_, which you can read about in another post at
http://ancientway.com/blog/?p=114. Ge Hong didn’t have much access to real gold, but apparently had plenty of cinnabar (Mercury Sulfide) and realgar (Arsenic Sulfide) to cook and eat. Part of my insight from Ge Hong’s writings is that they represent one of the earliest recorded records of the psychological effects of heavy metal poisoning.
There is a consistent recommendation of combining a number of exercises and lifestyle choices along with taking the Divine Medicines. Here’s one summary (Ware, 252):
Ko: If you are going to do everything possible to nurture your life, you will take the divine medicines. In addition, you will never weary of circulating your breaths; morning and night you will do calisthenics to circulate your blood and breaths and see that they do not stagnate. In addition to these things, you will practice sexual intercourse in the right fashion; you will eat and drink moderately; you will avoid drafts and dampness; you will not trouble about things that are not within your competence. Do all these things, and you will not fall sick.
Before you go out and start nibbling on realgar, mica, and random mushrooms, let me state my personal refined list of the top substances of interest from this tradition:
1. Gold
2. Silver
3. Medicinal Mushrooms (Reishi, Shiitake, Cordyceps, Turkey Tail, & normal store mushrooms sauteed in butter, garlic, and salt/pepper. Mmmmm…)
4. Wild Honey/Royal Jelly/Bee Pollen
5. Deluxe Mixed Nuts (no peanuts)
These 5 have been much of my personal “Divine Medicines” intake for the past couple years. The most frequent are the mixed nuts, the second most are the bee products. Colloidal silver I have used on and off (it’s not suitable to take all the time). The colloidal gold I feel I could take every day. I tend to cycle things especially if they’re expensive. Lately, I’ve felt that the benefits of colloidal gold are more valuable to my productivity than the cost, and may take 1/2-2 oz per day, currently of MediGold. I just set up a wholesale account and will be stocking their fine colloidal gold and colloidal silver products in my clinic and on my site.
Since cinnabar is the top of Ge Hong’s list and also is still in many of the Chinese Materia Medica books, I thought it appropriate as the main subject for this research-based discussion. One of my favorite herb teachers, Dr. Guo-Hui Liu, taught that properly prepared cinnabar just goes through the intestinal tract and isn’t absorbed systemically, so in his understanding it may mainly kill parasites in the gut and be excreted. Certainly in Ge Hong’s day parasites were far more common. Parasites are more common than most Americans think, but some in alternative medicine have exaggerated their importance, particularly Hulda Clark with her bombastic _The Cure for All Cancers_ and _The Cure for All Diseases_ books. Even though she also wrote _The Cure for All Advanced Cancers_ and had a Mexican clinic where she insisted cancer patients have most of their teeth pulled to get rid of “Clorox” traces and mercury, Hulda died of cancer herself. I bring this sort of thing up to emphasize that these are life-and-death matters for many people, and taking ideas too seriously on a whim can easily lead to early death.
Ge Hong himself was skeptical regarding areas of magical practice that didn’t measure up to his standards. Here is an example which makes me more comfortable in my role as “The Skeptical Alchemist” who both appreciates some aspects of classical Daoist alchemy while insisting on a modern scientific world view (Ware, page 254):
Interlocutor: Are there any procedures for determining the good and bad fortunes that lie ahead, the risks, the failures and successes, so that we can keep ourselves whole?
Ko: Astrology, geomancy, austromancy, arithmancy, deductions from The Three Marvels, movements on a design representing the nine divisions of space, comparison of the eight trigrams, study of the places where birds and animals gather, judging misfortune from creature types, and prognosticating through the tortoise and milfoil–all these are common, low-class arts, troublesome and untrustworthy.
Gold is mentioned more than silver in the Bao Pu Zi. However, Chapter 16 is titled The Yellow and The White. It begins (Ware, page 261):
In the gods-and-genii classics we find more than a thousand prescriptions in twenty-five scrolls dealing with the Yellow and White. Yellow means gold; white silver. Keeping their procedures secret and treasuring them, the Ancients refrained from speaking openly and resorted to language known only to the initiates.
Is it a minor matter that gold and silver are not in the modern Chinese Materia Medica? It would seem that their use was indeed a well-guarded secret, passsed by oral tradition and kept out of most books. Does this tradition continue today in China? Since colloidal silver and colloidal gold are now avaialble in pure forms made with modern laboratory methods, do we really need to know how Ge Hong would have prepared them if we are interested in their use? Gold and silver appear to be timeless minerals of great importance, though they have indeed been kept secret and perhaps forgotten for centuries at a time, much as they have been forgotten as money for decades but are experiencing a global grassroots resurgence.
Ge Hong admits that he had little experience with real gold and silver (page 262):
I suffer from poverty and lack of resources and strength; I have met with much misfortune. There is nobody at all to whom I can turn for help. The lanes of travel being cut, the ingredients of the medicines are unobtainable. The results is that I have never been able to compound these medicines I am recommending. When I tell people today that I know how to make gold and silver, while I personally remain cold and hungry, how do I differ from the seller of medicine for lameness who is himself unable to walk? It is simply impossible to get people to believe you. Nevertheless, even though the situation may contain some unsatisfactory elements, it is not to be rejected in its entirety. Accordingly, I am carefully committing these things to writing because I wish to enable future lovers of the extraordinary and esteemers of truth, through reading my writings, to consummate their desires to investigate God.
Ge Hong then brings up the difference between real gold and silver and counterfeited precious metals (Ware, page 267):
It is for this reason that the classic says, ‘Gold can be created, and geniehood attained.” Silver too can be taken, but it is inferior to gold.’
I then countered, “Why produce it by transformation instead of nibbling mundane gold and silver? If you make it, it will not be genuine, and if it is not genuine, it is counterfeit.” His reply was this: ”Mundane gold and silver are acceptable, but as a rule processors are poor. As the adage has it, ‘There are no fat genii and no rich processors.’ A group consisting of a teacher and his pupils may amount to five or ten persons. How could so many be supplied with gold and silver? Further, since they cannot travel far and wide to gather them, it is fitting that they create them themselves. In addition, gold created by transformation, being the very essence of a variety of ingredients, is superior to natural gold.”
…
They also say that those who make gold from cinnabar and achieve geniehood by taking it are first class. Those enjoying Fullness of Life through roots, mushrooms, calisthenics, and breathing disciplines are second class. Those who subsist on herbs and live for less than a thousand years, are third class. They also tell us that it is in the nature of gold and silver that one can make them, whereas, Fullness of Life is something that can be obtained through study.
It is important to note that Ge Hong regularly states “cinnabar or gold” in his work as the highest Divine Medicines. There are several sections dealing with turning cinnabar into gold, but none about turning gold into cinnabar. It seems reasonable to conclude that he put gold as the the true highest substance, but elevated cinnabar to the first spot because it was easier for him to get and work with, and he believed he could turn it into gold.
As we look at the Materia Medica entries for cinnabar it will be noted that psychological effects are often the intended effect of its use. Thus the notion that it simply passes through the intestinal tract does not line up with the empirical and clinical experiences of the centuries.
My Cinnabar powder from Taiwan
Starting with one of the most current texts of the Chinese Materia Medica, John Chen’s _Chinese Medical Herbology and Pharmacology_, we find no entry for gold or silver, but Cinnabar is the first listing under “Sedative Herbs that Calm the Shen (Spirit).” This book also has Rhinoceros Horn and Seal Genitals, hopefully for “historic interest” only. With Silver and Gold both being legal, obtainable, useful, and the highest of the traditional Daoist pharmacopoeia, they would seem to merit more inclusion than endangered animal parts with more symbolic than chemical import (while seal testicles are bound to have testosterone, they can’t be that much better than bull or goat balls, which are often discarded from conventional meat production).
Here are some excerpted notes from Chen’s entry on Cinnabar/Zhu Sha, (Chen, page 755):
Chinese Therapeutic Actions
1. Sedates the Heart and Calms the Shen (Spirit)
Sinking, heavy and cold in nature, Zhu Sha (Cinnabaris) enters the Heart channel to sedate Heart fire, arrest fright, and calm the shen. It is one of the most essential medicinal substances when treating excess fire conditions associated with the Heart. The Heart houses the shen: when fire accumulates, symptoms of restlessness, irritability, and insomnia occur. In more severe cases of phlegm and heat misting the Heart, epilepsy, delirium, convulsions, mania, schizophrenia and seizures may occur.
Chen doesn’t seem to be categorizing Cinnabar as something included for historical interest, but says it is essential, and goes on to give combinations recommended for treating schizophrenia and epilepsy in children.
2. Clears Heat and Toxins
Sores, swelling, carbuncles: Whether taken internally or applied topically, Zhu Sha clears heat and toxins. It treats sores, carbuncles, toxic swellings, infectious epidemic diseases like malaria, unsconsicousness, intake of toxic substances, and abdominal pain with diarrhea.
Here we see the confusing use of the term ‘toxins’ in TCM. Many natural health followers avoid amalgam fillings and vaccines due to traces of mercury in them. This is a concern I have as well. However, if a patient approaches a Chinese Herbalist for ‘detoxing’ and report inflammed sores as part of the toxic condition, it is in accordance with Chinese Medical tradition to give Mercury Sulfide to ‘Clear Toxins.’ I recommend acupuncturists avoid putting cinnabar in the mouths of unconscious patients.
Dosage
0.3 to 1.0 gram. Internally, Zhu Sha is taken in pill form only. The toxicity of Zhu Sha increases significantly when processed with heat (such as in decoction).
Cautions/Contraindications
To prevent cumulative toxicity, Zhu Sha should not be used at a large dosage or for a long period of time.
Zhu Sha should be used with extreme caution for those with compromized liver and kidney functions.
Do not process Zhu Sha with heat, as this increases the risk of mercury poisoning.
Overdosage
Acute overdose of Zhu Sha is characterized by disturbance of the central nervous system, with nervousness, a metallic taste in the mouth, swollen gums, poor appetite, abdominal pain, diarrhea, tremor, sexual dysfunction, and liver and kidney damage.
Treatment of Overdosage
Toxicity of Zhu Sha may be treated by gastric lavage with warm water or sodium bicarbonate, ingestion of milk, egg whites, or Lu Dou (Semen Phaseoli Radiati) soup. Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity) plus Jin Yin Hua (Flos Lonicerae) and Tu Fu Ling (Rhizoma Smilacis Glabrae) may also be used for detoxification.
Chronic overdose due to long-term consumption can be treated with the following two methods:
1. Ingestion of 10 to 15 grams of tea (green, oolong or black) one or two times daily. Tea clears heat, promotes urination, and facilitates the elimination of mercury.
2. Ingestion of one dose of an herbal decoction at room temperature containing 250 grams of Tu Fu Ling (Rhozoma Smilacis Glabrae), for 10 days (this process can be repeated after 3 to 4 days of rest).
Lastly, adverse reactions characterized by nausea, vomiting, salivation, moist tongue coat, and slow pulse can be treated with 15 grams Hua Jiao (Pericarpium Zanthoxyli) and 30 grams Yi Tang (Saccharum Granorum).
The last line has a footnote for a Chinese book from 1989 called _Toxicology of Chinese Herbs_. Yi Tang is standard sugar. Yes, Chen states that if you overdose someone with mercury to the point of vomiting and slow pulse, you can give them a spicy pepper (Hua Jiao) and an ounce of sugar. Medically supervised IV chelation is the standard treatment.
Please note that Zhu Sha/Cinnabar is not listed in the online catalogs of my two favorite herb suppliers, Mayway and Spring Wind. This indicates that anyone getting Cinnabar for clinical use is doing it via an underground, word-of-mouth network (generally called a smuggling ring). This, as with all underground drug dealing, increases the chance that the drug is of poor quality. I find it disturbing that Chen states it is “essential,” recommends it for epileptic children and schizophrenia, and then gives methods for correcting mercury poisoning that are likely ineffective, such as tea and sugar. I suppose if an acupuncturist buys Cinnabar from the black market and poison someone’s kid, he probably doesn’t want them to go to the hospital with a sample of the “herbs” you gave them, so may try to talk them into doing a folk remedy for mercury poisoning to protect himself against legal actions. That doesn’t sound very smart to me.
A close up of my Cinnabar powder
In Chen’s favor, he concludes with the Author’s Comments (page 756): ”Zhu Sha is rarely used as a medicinal substance now. Its discussion here is included primarily for academic purposes, to reflect the historical use of this substance. Interestingly, western culture also used mercury in the past, for treatment of syphilis.” This tagged-on disclaimer isn’t very convincing for something put as the first in a major category and described as “essential.”
Dan Bensky and Andrew Gamble’s _Chinese Herbal Medicine: Materia Medica (Revised Edition–mine is from 1993 and was the main herb text at OCOM–there is a newer version) also has Cinnabar and doesn’t have Gold or Silver. As I’ve pointed out elsewhere, Bensky (as the book is called) also contains Rhino Horn, Asbestos, and some other questionable “herbs.” From page 400, the entry on Zhu Sha:
Actions & Indications
Sedates the Heart and calms the spirit: for symptoms associated with disturbed spirit such as restlessness, palpiations with anxiety, insomnia, or convulsions. Depending on the herbs with which it is combined, this substance can be used in treating patterns of heat excess, hot phlegm, or blood deficiency.
Major combinations are given, including “with pig’s heart for restlessness and palpitations with anxiety due to Heart blood deficiency,” “With Cornu Rhinoceri (xi jiao) and Calculius Bovis (niu huang) for high fever, loss of consciousness, and convulstions associated with internal wind,” and “With Realgar (xiong huang) or Borneol (bing pian), applied topically as a powder, for pain and swelling of the throat and ulcerations of the tongue and mouth.”
Following the Major Combinations, Bensky states:
Cautions and Contraindications: Should not be used in large amounts or long-term. To prevent mercury poisoning, do not heat.
Dosage: 0.3-2.7g…
Pharmacological & Clinical Research: None of significance noted.
No notes about ‘historical interest only’ or symptoms of mercury poisoning are given. The recipe of Mercury Sulfide and Rhino Horn for unconsciousness trumps Chen’s, but Chen gets the prize for recommending it to children and schizophrenics.
Moving on to Hong-Yen Hsu’s 932 page _Oriental Materia Medica: A Concise Guide_ we take a brief break from Cinnabar to go back to Gold, as this is my only Chinese herbal with an entry for actual gold. Page 633 states:
Gold Foil (Gold-Leaf, Chin-Po, Jin-Bo)
Origins
Chin-po, also called chin-po, first appeared in Pen tsao meng chuan. It is the paper made from processed native gold.
Essence and flavor
Bitter flavor, neutral property
Channels entered
The heart and the liver meridians
Traditional uses
Actions: Tranquilizes heart and spirit, removes toxin
Applications: Epilepsy due to fright, mania, palpitations, toxic furuncle
Dosage
To be compounded into either pellets or powder for oral intake
Hsu’s ‘Concise Guide’ has Cinnabaris two pages previous:
Origins
Chu-sha appears in Shen nung pen tsao ching as a high-grade drug under the name tan-sha. Because ‘tan’ is red, it is now called chu-sha. That produced in Chenchou is named chen-sha.
Essence and flavor
Sweet flavor; mild, cold property
Channels entered
The heart meridian
Traditional uses
Actions: Tranquilizes the spirit, calms fright, removes toxin
Applications: Restlessness, epilepsy, manic-depressive syndrome, insomnia, excessive dreaming, sore throat, carbuncle, deep-rooted furuncle
Chemical constituents
Mercuric sulfide: mercury 86.2%, sulfur 13.8%
Pharmacology
(1) Effect on body weight: Rabbits fed with small amounts of the drug have a higher nitrogen level in their urine, and their body weight increases after a period of time.
(2) Sedative effect: Natural cinnabar tranquilizes by restraining excitation of the central nervous system.
(3) Antifungal effect: In vitro it inhibits verious dermatophytes.
Dosage
0.3 to 1.8g.
That is the entire entry on Cinnabar–no mentions of overdose symptoms at all, only the mention that it works by “restraining excitation of the central nervous system.”
The last of our herbal texts is _Handbook of Chinese Herbs_ by Him-che Yeung, L.Ac., O.M.D., Ph.D. This book doesn’t have any listings for Gold or Silver, but has the following entry on Cinnabar (page 557):
Zhu Sha (Chu Sha)
Common name: Cinnabar
Pharm. Name: Cinnabaris
Used Part: Mineral
Taste and Property: Sweet, cold, toxic
Therapeutic Meridian: Heart
Action: 1. Sedative and tranquilizing
2. Anti-convulsive
3. Detoxicant
Indications: 1. Insomnia, palpitation
2. Epilepsy, infantile convulsion due to high fever
3. Boils, furuncles and carbuncles
Contra-indication: For a person with no symptoms of true heat
Chemical Component: Red mercuric sulfide, magnesium oxide, ferric oxide
Recommended dosage: 0.3-1 gm.
Prescription: Ci Zhu Wan
Zhu Sha An Shen Wan
Pharm. Action:
1. Anti-spasmodic and anti-convulsive.
2. Internally it is a sedative and tranquilizer.
3. Externally it is anti-bacterial and anti-parasitic, and it is used for boils and furuncle.
That is the complete entry for Cinnabar. It does recommend Zhu Sha for babies in convulsions due to high fever, but no mentions of adverse reactions, signs and symptoms of mercury poisoning, etc.
So far we have seen that Ge Hong recommended Cinnabar and Gold as Divine Medicines and made great claims about their abilities to make people live forever and fly after growing feathered wings. We have established that Ge Hong preferred gold, but rarely if ever had any, so he used the cheaper cinnabar instead, convinced that it could be made into real gold. Ge Hong states that silver and gold are higher substances, but that they are kept secret. We then have seen that silver and gold are absent from modern texts, but cinnabar still has a place, where it is even regarded as “essential” and recommended for epileptic and feverish babies, as well as schizophrenics and unconscious people. The one text that describes mercury poisoning advises treating it with tea and sugar.
A Year of the Dragon .9999 fine 1/10th oz gold coin
I know there are acupuncturists out there who think I’m an overcautious wimp for my opinions about giving Aconite to pregnant women (i.e. the
Classical Pearls line by Heiner Fruehauf) and the irresponsibility of treating gonorrhea with an herbal “wash” imported as a soap (i.e.
Yin Care Effective Herbal Wash). I know that some of these acupuncturists also believe Cinnabar to be relatively safe and perhaps even “essential” in TCM, as that is what they were taught. So now we will look to the actual available research to see what has been discovered about Cinnabar in Chinese Patent Medicines by modern scientists.
Searching
PubMed.gov for relevant articles, we see that this has been a topic of interest in the toxological field:
Vet Hum Toxicol. 1992 Jun;34(3):235-8.
Chinese patent medicine as a potential source of mercury poisoning.
Kang-Yum E, Oransky SH.
Source
Hudson Valley Poison Control Center, Nyack, NY 10960.
Abstract
This research is an effort to create an awareness of the potential hazards of some Chinese patent medicines which contain mercurial ingredients. This should be of consideration when screening symptomatic patients who are of Asian ethnic background or other users of these medicines. This research discusses reported cases of mercury poisoning related to the use of Chinese patent medicines and the potential toxicity of cinnabar (red mercuric sulfide) and calomel (mercurous chloride), 2 mercurials commonly used in these medicines. A list of mercurial-containing Chinese patent medicines available on the open market in North America has been compiled, together with their traditional uses and mercurial contents and is presented as a quick reference for Specialists in Poison Information. This class of medicine may not pose a problem when used appropriately; however, its misuse, abuse, overdosage and improper storage can lead to serious mercury poisoning.
PMID: 1609495 [PubMed - indexed for MEDLINE]
Several articles compare Cinnabar to more toxic forms of mercury (methylmercury and mercury chloride). Cinnabar is indeed far less toxic than those forms, as reported in this abstract:
Exp Biol Med (Maywood). 2008 Jul;233(7):810-7. Epub 2008 Apr 29.
Mercury in traditional medicines: is cinnabar toxicologically similar to common mercurials?
Liu J, Shi JZ, Yu LM, Goyer RA, Waalkes MP.
Source
Inorganic Carcinogenesis Section, NCI at NIEHS, Mail Drop F0-09, Research Triangle Park, NC 27709, USA.
Liu6@niehs.nih.govAbstract
Mercury is a major toxic metal ranked top in the Toxic Substances List. Cinnabar, which contains mercury sulfide, has been used in Chinese traditional medicines for thousands of years as an ingredient in various remedies, and 40 cinnabar-containing traditional medicines are still used today. Little is known about toxicology profiles or toxicokinetics of cinnabar and cinnabar-containing traditional medicines, and the high mercury content in these Chinese medicines raises justifiably escalations of public concern. This minireview, by searching the available database of cinnabar and by comparing cinnabar with common mercurials, discusses differences in their bioavailability, disposition, and toxicity. The analysis showed that cinnabar is insoluble and poorly absorbed from the gastrointestinal tract. Absorbed mercury from cinnabar is mainly accumulated in the kidneys, resembling the disposition pattern of inorganic mercury. Heating cinnabar results in release of mercury vapor, which in turn can produce toxicity similar to inhalation of these vapors. The doses of cinnabar required to produce neurotoxicity are 1000 times higher than methyl mercury. Following long-term use of cinnabar, renal dysfunction may occur. Dimercaprol and succimer are effective chelation therapies for general mercury intoxication including cinnabar. Pharmacological studies of cinnabar suggest sedative and hypnotic effects, but the therapeutic basis of cinnabar is still not clear. In summary, cinnabar is chemically inert with a relatively low toxic potential when taken orally. In risk assessment, cinnabar is less toxic than many other forms of mercury, but the rationale for its inclusion in traditional Chinese medicines remains to be fully justified.
This abstract reports that cinnabar is largely insoluble and poorly absorbed, but accumulates in the kidneys over time. While it is less toxic that other forms of mercury, the rationale for using it isn’t justified.
While its low solubility and poor absorption from the intestines is partly reassuring, the fact that most of its intended actions are on the central nervous system mean that some of it does indeed get to the brain. Comparison to other mercury compounds is tricky, as Dimethylmercury “is so toxic that even a few microliters spilled on the skin, or even a latex glove, can cause death.” (
http://en.wikipedia.org/wiki/Mercury_poisoning). Thus to say that Cinnabar is less than 1/1000th less toxic than dimetylmercury isn’t very reassuring.
Several abstracts from both China and the Journal of Ethnopharmacology make the point that Cinnabar and Realgar are far less toxic than other mercury and arsenic compounds, though they don’t provide reasons to promote their use. For example:
J Ethnopharmacol. 2011 Apr 12;134(3):839-43. Epub 2011 Feb 1.
Chemical form of metals in traditional medicines underlines potential toxicity in cell cultures.
…
Source
Zunyi Medical College, Zunyi, China.
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE:
Mercury (Hg) and arsenic (As) are frequently found in traditional medicines as sulfides, such as cinnabar (HgS) and realgar (As(4)S(4)). There is a general perception that any medicinal use of such metal-containing remedies is unacceptable. An opposing opinion is that different chemical forms of arsenic and mercury have different toxic potentials.
…
CONCLUSIONS:
Chemical forms of metals are important factor in determining their toxicity in traditional medicines, both cinnabar and realgar are much less toxic than well-known mercurial and arsenicals.
Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
As I delve deeper into the research, we get to some that does show mercury accumulating in the brain and kidneys from taking Cinnabar:
Zhongguo Zhong Yao Za Zhi. 2009 Dec;34(23):3068-72.
[Study of mercury cumulation in Cinnabar-treated rats].
[Article in Chinese]
Liang A, Li C, Xun B, Wang J, Zhao Y, Liu T, Cao C, Yi Y, Hao R.
Source
Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China.
liangaihua@sina.comAbstract
OBJECTIVE:
To investigate the mercury cumulation following single dose or long-term use of Cinnabar to rats.
METHOD:
The Cinnabar which was used in the study contains 98% insoluble mercuric sulfide (HgS) and 21.5 mg x kg(-1) soluble mercuric compounds. Two separate experiments were performed: (1) Tweenty-eight fasting SD rats were orally given a single dose of Cinnabar at the dose of 0.8 g x kg(-1) and the other four rats were given ultra-filtrated water served as control group. Blood, livers, kidneys and brains of four rats were taken out at 0.5, 1, 2, 4, 8, 16, 36 h respectively after treatment. Mercury quantity of each organ or blood sample was measured. (2) Forty SD rats were randomly divided into four groups: control group and Cinnabar 0.1, 0.4, 0.8 g x kg(-1) groups, each group containing 5 females and 5 males. The rats were intra-gastrically treated with Cinnabar once a day for successively 90 days, while the control group was given ultra-filtrated water. Mercury contents in blood, livers, kidneys and brain of each rat were measured at 16 h of fasting after last dosing.
RESULT:
Mercury contents of blood, liver, kidney and brain increased slightly after single dosing of Cinnabar at dose of 0.8 g x kg(-1), with the order from high to low liver > blood > brain > kidney. Whereas 90-day oral treatment of Cinnabar led to significant cumulation of mercury in organs but not in blood. Kidney’ s cumulation of mercury was much higher than any other tested organs and blood. Brain’s mercury cumulation was also very high. The contents of mercury in kidney and brain of 0.8 g x kg(-1) group (total intake of soluble mercury within 90 days was 1 548 microg x kg(-1)) were respectively 71.2 and 27.4 times higher than control group. Even though in the lowest dose 0.1 g x kg(-1) group (total intake of soluble mercury 194 microg? kg(-1)), the mercury cumulation folds in kidney and brain were 16.77 and 20.43 respectively. However, liver got lower mercury cumulation than kidney and brain, which led to only 2 folds mercury cumulation at dose of 0.8 g x kg(-1). Our previous study showed that 90-day administration of Cinnabar at the dose > or = 0.1 g x kg(-1) (total intake of soluble mercury 194 microg x kg(-1)) could cause pathological changes in kidney and liver, indicating both were the toxicity targets for Cinnabar. Those manifested that liver could be more sensitive than kidney to mercury. Though brain got 20 times mercury cumulation after 90 day treatment, the animals showed no abnormal signs in general behavior and brain histomorphology,which indicated that rat brain was not sensitive to mercury.
CONCLUSION:
Soluble mercury in Cinnabar can be absorbed causing high cumulated in some organs, such as kidney and brain after long-term use of Cinnabar. Liver had also mercury cumulation, but was much lower than kidney. Total intake of soluble mercury for > or = 194 microg x kg(-1) within 90 days could cause toxicosis by mercury cumulation.
PMID: 20222426 [PubMed - indexed for MEDLINE]
That study showed significant brain accumulation of mercury in rats after 90 days, but suggests that rats aren’t that sensitive to neurological problems from mercury poisoning.
Here we have another Chinese study that states that “intoxication” has resulted from intentional overuse of Cinnabar but that the mechanisms of Cinnabar’s clinical effects are still unknown:
Zhongguo Zhong Yao Za Zhi. 2009 Nov;34(22):2843-7.
[Progresses on mechanisms of pharmacological and toxicological effects of cinnabar].
[Article in Chinese]
Zhou X, Wang Q, Yang X.
Source
Abstract
Cinnabar has been an important traditional Chinese medicine as a sedative and soporific agent for more than 2000 years. It is a naturally occurring mercuric sulfide and containing more than 96% mercuric sulfide (HgS). There are about 10% -30% Chinese patent medicines containing cinnabar according to the Pharmacopoeia of China (2005). It’s hard to deny that cinnabar has therapeutic effect in clinic practice. However, cinnabar’s extraordinary high containing mercury makes people hesitate to use. Furthermore, the abuse of cinnabar, which caused intoxication cases, has been reported occasionally. The safety and toxicity of cinnabar has been debated for centuries. The exact mechanism of cinnabar is still largely unknown. The present review focused on researches about cinnabar’s mechanisms of pharmacological and toxicological effects since 2000.
PMID: 20209942 [PubMed - indexed for MEDLINE]
This next study suggests that Cinnabar use should be limited to less than 2 weeks and have a far smaller dose than my texts recommend:
Zhongguo Zhong Yao Za Zhi. 2009 Feb;34(3):312-8.
[Study on hepatoxicity and nephrotoxicity of cinnabar in rats].
[Article in Chinese]
Liang A, Wang J, Xue B, Li C, Liu T, Zhao Y, Cao C, Yi Y.
Source
Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China.
liangaihua@sina.comAbstract
OBJECTIVE:
To investigate hepatoxicity and nephrotoxicity of cinnabar to provide the scientific basis for safe uses in clinic.
METHOD:
Maximally tolerated dose of cinnabar (MTD) was tested by single oral administration. Chronic toxicity of cinnabar at different dose level (0.025, 0.05, 0.1, 0.4, 0.8 g x kg(-1) x d(-1)) corresponding to 1/2, 1, 2, 8, 16 times of clinic doses of cinnabar was investigated. The rats were treated with the cinnabar through oral administration once a day for successive 90 days. Urinary qualitative test, blood routine examination, serum chemistry measurement and histomorphologic observation were conducted at day 30, 60 and 90. Toxic changes related to the treatment of cinnabar and no-observed adverse effect level (NOAEL) were evaluated.
RESULT:
For the content of 98.1% total Hg and 21.5 microg x g(-1) absoluble Hg, MTD of cinnabar with oral administration was 24 g x kg(-1) (corresponding to 516 microg x kg(-1) absoluble Hg), equivalent to 3,000 times of clinical daily dose for an adult, and no obvious adverse effect was showed at this dose. Cinnabar can cause kidney and liver pathological changes when it is repeatedly administrated for over 30 days. The kidney was more sensitive to cinnabar than liver. Based on repeated dose toxicity study, NOAELs were 0.1, 0.05 g x kg(-1) x d(-1)) respectively for 30 day and 90 day treatment, and those were approximately accumulative intake of absoluble Hg 64.5 microg x kg(-1) and 96.76 microg x kg(-1). Thus, for safe use of cinnabar, the acceptable daily intake (ADI) of cinnabar was 0.0009-0.0017 g x kg(-1) x d(-1), namely daily dose 0.05-0.1 g for an adult with body weight about 60 kg. Considering the difference of drug sensitivity and lifecircle between human and rats, we suggest that cinnabar which contains absoluble Hg < or = 21 microg x g(-1) should be used for no longer than 2 weeks at daily dose 0.05-0.1 g.
CONCLUSION:
Long term use of cinnabar can cause kidney and liver pathological change, so the dose and administration duration should be limited. The suggestion is as follows: cinnabar which contains absoluble Hg < or = 21 microg x g(-1) should be used less than 2 weeks at the daily dose below 0.05-0.1 g.
PMID: 19445157 [PubMed - indexed for MEDLINE]
Now we move into studies that look at cases of mercury poisoning from Chinese medicines. The first is an infant in Hong Kong:
Hong Kong Med J. 2009 Feb;15(1):61-4.
Mercury poisoning: a rare but treatable cause of failure to thrive and developmental regression in an infant.
Koh C, Kwong KL, Wong SN.
Source
Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Laichikok, Hong Kong.
kohc1@ha.org.hkAbstract
An infant presented with failure to thrive and developmental regression. Physical examination revealed an irritable child with swollen, erythematous extremities, and elevated blood pressure. Extensive investigations, including a metabolic work-up and neuroimaging, were unrevealing. Exposure to self-purchased medication was initially denied. The physical signs were suggestive of acrodynia. Mercury poisoning was ultimately established by measuring paired blood and urine mercury levels. On further enquiry, it was revealed that the child had been given a Chinese medicinal product for 4 months. He responded well to a chelating agent. Acrodynia is a childhood disease considered to be of historical interest only, but making a diagnosis of mercury poisoning is rewarding because the response to treatment is good. This case highlights the common misconception that alternative medicines are safe and benign.
PMID: 19197099 [PubMed - indexed for MEDLINE]
In that case, at first the parents denied giving any Chinese medicines, but after blood and urine tests showed mercury, they admitted that had given something for 4 months. The researchers reported good effects with standard chelating agents (not using tea or sugar!).
An Australian study found that mercury was the highest heavy metal in tested TCM supplements:
J Toxicol Environ Health A. 2007 Oct;70(19):1694-9.
Public health risks from heavy metals and metalloids present in traditional Chinese medicines.
Cooper K, Noller B, Connell D, Yu J, Sadler R, Olszowy H, Golding G, Tinggi U, Moore MR, Myers S.
Source
National Research Centre for Environmental Toxicology, University of Queensland, Coopers Plains, Queensland, Australia.
Abstract
Out of 247 traditional Chinese medicines (TCM) investigated, a proportion were contaminated with arsenic (5-15%), lead (approximately 5%), and mercury (approximately 65%). Some preparations exceeded the tolerable daily intake (TDI) for males and females for arsenic (4 and 5 products, respectively), lead (1 and 2 products), and mercury (5 and 7 products). These exceedances were as high as 2760-fold, which posed a potential danger to public health. As many users are known to self-prescribe, there is a substantial risk of poisoning from the consumption of these contaminated TCM.
PMID: 17763088 [PubMed - indexed for MEDLINE]
This Chinese study is very apologetic and seems to support the use of Cinnabar, without describing why it is useful:
Zhongguo Zhong Yao Za Zhi. 2005 Dec;30(23):1809-11.
[Analysis of adverse effects of cinnabar].
[Article in Chinese]
Liang AH, Xu YJ, Shang MF.
Source
Institute of Chinese Materia Medica, China Academy of Traditional Chinese Medicine, Beijing.
Abstract
This article made a brief analysis of clinical adverse effects of cinnabar. Except for allergic reaction, almost all the adverse events of cinnabar were caused by unreasonable application. The majority of the poisoning cases were associated with excessive and/or long-term dosage, and improper preparation methods, such as decocting, heating or fumigating. Children showed to be prone to poisoning. The poisoning caused by unreasonable use of cinnabar should be considered to be drug alert, but not advert effect. And the toxicity of cinnabar could be avoided by normalizing the preparation method, controlling the dosage and duration.
PMID: 16499013 [PubMed - indexed for MEDLINE]
This Taiwanese study looks at long term neurological harm from Cinnabar (called mercuric sulfate in the abstract):
Acta Neurol Scand. 1998 Dec;98(6):461-5.
Chronic inorganic mercury induced peripheral neuropathy.
Chu CC, Huang CC, Ryu SJ, Wu TN.
Source
Department of Neurology, Chang Gung Memorial Hospital and Chang Gung University, Taipei, Taiwan.
Abstract
We report the clinical features, electrophysiological studies, and morphometric analysis of sural nerve pathology in a patient with polyneuropathy due to inorganic mercury intoxication. He developed slowly progressive generalized paralysis of all limbs after 3 months ingestion of herb drugs which contained mercuric sulfate. Electrophysiologic studies revealed axonal polyneuropathy involving both motor and sensory fibers. Sural nerve biopsy demonstrated axonal degeneration with demyelination and a predominant loss of large myelinated fibers. His muscle strength showed only mild improvement after 2 years’ follow-up. We concluded that inorganic mercury exposure may induce severe axonal sensorimotor polyneuropathy in humans and that neurological deficits may persist in severe cases.
PMID: 9875628 [PubMed - indexed for MEDLINE]
Demyelination refers to the nerves losing their protective insulation, similar to what happens with Multiple Sclerosis. The patient had some paralysis and long-term loss of muscle strength.
While living in Taiwan, I had an eye-opening conversation with 2 Western trained Taiwanese doctors who told me of their ongoing struggle to educate people in rural areas about the dangers of heavy metal poisoning in TCM products. Here’s one baby that died as a result:
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1993 May-Jun;34(3):181-90.
[Heavy metals in traditional Chinese medicine: ba-pao-neu-hwang-san].
[Article in Chinese]
Chi YW, Chen SL, Yang MH, Hwang RC, Chu ML.
Source
Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Abstract
Heavy metal intoxication of newborn infants fed with “Ba-Pao-Neu-Hwang-San” has been reported every year by many hospitals in Taiwan. About nine years ago, the National Laboratories of Foods and Drugs of the Department of Health, Executive Yuan, received one case report of a five month old female infant who died as a result of long term feeding with “Ba-Pao-Neu-Hwang-San”. The drug was found to have contained lead 44,000 ppm. Although this unfortunate incident was propagated by most newspapers, the prescription of this ancient Chinese medicinal preparation is still widely accepted by ordinary people. Herbal medicine doctors prefer complex mineral drugs as did their ancestors thousands of years ago. In the last two years, we have collected 5 samples of “Ba-Pao-Neu-Hwang-San” from different manufacturers and measured the concentration of 16 heavy metals (including Cadmium, Mercury, Arsenic, Lead, Chromium, Manganese, Selenium, Germanium, Nickel, Calcium, Magnesium, Aluminum, Iron, Copper, Zinc, and Vanadium) in these drugs with Inductively-Coupled Plasma Atomic Emission Spectrometry and Graphite Furnace Atomic Absorption Spectrometry. The result of our survey revealed that the first sample (from Tainan) contained mercury 52,800 ppm, the fourth (from Ping-tung) contained mercury 34,500 ppm, and the fifth (from Sin-chu) contained mercury 65,700 ppm. The mercurial contents of these samples were apparently too high to be a safe drug.
PMID: 8368065 [PubMed - indexed for MEDLINE]
The area of the brain that Cinnabar seems to target is discovered in this study on guinea pigs:
Naunyn Schmiedebergs Arch Pharmacol. 2001 Sep;364(3):249-58.
Neurotoxicity of mercury sulfide in the vestibular ocular reflex system of guinea pigs.
Chuu JJ, Young YH, Liu SH, Lin-Shiau SY.
Source
Institute of Toxicology, College of Medicine, National Taiwan University, No. 1, Section 1, Jen-Ai Road, Taipei, Taiwan, ROC.
Abstract
A traditional Chinese mineral medicine, cinnabar, naturally occurring mercuric sulfide (HgS), is still occasionally prescribed, but the neurotoxic effects of HgS have not been elucidated. In this paper, an animal model of the purified HgS intoxication was established in guinea pigs in order to study neurotoxicity and pathophysiology of the vestibular ocular reflex system (VOR). Guinea pigs were dosed with HgS by gastric gavage (0.01, 0.1 and 1.0 g/kg per day) for 7 consecutive days. By means of caloric testing coupled with the electronystagmographic (ENG) recording in guinea pigs, we have found that HgS at a dose of 0.1 g/kg induced reversible caloric hypofunction pattern and at a higher dose of 1.0 g/kg induced irreversible hypofunction of caloric test. Monitoring the mercury contents of various tissues (blood, kidney, liver and cerebellum) by continuous flow and cold vapor atomic absorption spectrometry (AAS) revealed that a certain amount of HgS could be absorbed from the gastrointestinal tract and was detectable in these tissues. In addition to the induced dysfunction of VOR system, HgS also caused disturbance of motor performance in guinea pigs. In enzyme assay, Na+/K+-ATPase activity of cerebellum was also significantly inhibited by HgS. Morphological studies showed partial cell loss only in the cerebellar Purkinje cell layer, but not in the granule cell layer, nor in the vestibular labyrinth. All of these findings suggest that cerebellar Purkinje cells are the sensitive target site responsible for HgS-inducing dysfunctions of both VOR system and the motor performance in guinea pigs. Thus, it is concluded that caloric test coupled with ENG recording in VOR system is certainly a sensitive biomarker for monitoring the neurotoxicity of HgS.
PMID: 11521168 [PubMed - indexed for MEDLINE]
Purkinje cells are some of the biggest neurons in the brain, are a major control center for motor function (movement) and damage to them can cause essential tremors and ataxia (loss of control of body movements).
The following study claims to be one of the first times neurotoxicological effects of cinnabar have been tested, and reports significant intestinal absorption and transportation to brain tissue:
Toxicol Appl Pharmacol. 2007 Oct 15;224(2):192-201. Epub 2007 Jul 14.
Neurotoxicological effects of cinnabar (a Chinese mineral medicine, HgS) in mice.
Huang CF, Liu SH, Lin-Shiau SY.
Source
Institute of Toxicology, National Taiwan University, Taipei 100, Taiwan.
Abstract
Cinnabar, a naturally occurring mercuric sulfide (HgS), has long been used in combination with traditional Chinese medicine as a sedative for more than 2000 years. Up to date, its pharmacological and toxicological effects are still unclear, especially in clinical low-dose and long-term use. In this study, we attempted to elucidate the effects of cinnabar on the time course of changes in locomotor activities, pentobarbital-induced sleeping time, motor equilibrium performance and neurobiochemical activities in mice during 3- to 11-week administration at a clinical dose of 10 mg/kg/day. The results showed that cinnabar was significantly absorbed by gastrointestinal (G-I) tract and transported to brain tissues. The spontaneous locomotor activities of male mice but not female mice were preferentially suppressed. Moreover, frequencies of jump and stereotype-1 episodes were progressively decreased after 3-week oral administration in male and female mice. Pentobarbital-induced sleeping time was prolonged and the retention time on a rotating rod (60 rpm) was reduced after treatment with cinnabar for 6 weeks and then progressively to a greater extent until the 11-week experiment. In addition, the biochemical changes in blood and brain tissues were studied; the inhibition of Na(+)/K(+)-ATPase activities, increased production of lipid peroxidation (LPO) and nitric oxide (NO) were found with a greater extent in male mice than those in female mice, which were apparently correlated with their differences in the neurological responses observed. In conclusion, these findings, for the first time, provide evidence of the pharmacological and toxicological basis for understanding the sedative and neurotoxic effects of cinnabar used as a Chinese mineral medicine for more than 2000 years.
PMID: 17707451 [PubMed - indexed for MEDLINE]
Finishing with the abstracts, we finally have a reference to colloidal gold in Chinese Alchemy:
Am J Chin Med. 1984 Summer;12(1-4):50-4.
Tan, cinnabar, as drug of longevity prior to alchemy.
Mahdihassan S.
Abstract
Alchemy as the art of gold making never existing and had no beginning. It arose as the cult of longevity using simples, like gold and cinnabar, as drugs of longevity. It became alchemy on making the first synthetic drug, Chin-Yeh, Gold-plus-herbal juice, and reached its ideal with Chin-Tan, Gold-plus-cinnabar. The former was red colloidal gold, the latter vermilion with traces of gold. As inscribed character Tan shows crude cinnabar, pulverized, lavagated and filtered on a rectangular piece of cloth.
PMID: 6388309 [PubMed - indexed for MEDLINE]
It appears that Cinnabar is still in fairly common use in China, Hong Kong, and Taiwan. Users are secretive about it, and Chinese medicine research organizations are likely to suggest that Cinnabar use is acceptable because it’s far less toxic than some other forms of mercury. Only a little research has shed light on its methods of action as a sedative. Such research shows it has a toxic effect on both the nerves through demyelination and the area of the brain responsible for motor control. No research I found shows it is safe and effective for treating anxiety, insomnia, or schizophrenia, and no known method of action is proposed that is beneficial.
The claims of early Daoist alchemists that Cinnabar was the key to immortality have led to its long-term inclusion in many TCM formulas. Lost to the TCM tradition was Ge Hong’s explanation that gold was the best substance and that cinnabar was used because it was cheaper than gold but could be turned into it. Now we know for certain that cinnabar can’t be turned into gold. The symbolism of gold still persists in Chinese folk tradition and Daoist mystical teachings, such as the Golden Flower, the Gold Sycee held by wise statues, and the gold gilding on temples.
This old fisherman is holding a gold ingot called a sycee
Given that the higher class of Shen Nung’s drugs was intended to be non-toxic things with a gentle effect and we now recognize that cinnabar does indeed cause damage to the kidneys, liver, brain and nerves, it appears to be a case of a mistaken substitution when gold is the accurate mineral to take the top place as a non-toxic substance with known benefits to health. Please read my post ‘
The Story of Gold Juice‘ for more info on colloidal gold research and history.
The current herbal texts and research abstracts haven’t given us a thorough picture of what is known about mercury toxicity, so let us explore that a bit more before moving on.
Wikipedia reports (
http://en.wikipedia.org/wiki/Mercury_poisoning) that there are several different mercury compounds with different manifestations of toxicity. ”Symptoms typically include sensory impairment (vision, hearing, speech), disturbed sensation and a lack of coordination.” Peripheral neuropathy is a common symtpom: tingling, numbness, burning or pain of the extremities. High blood pressure, fast heart rate, sweating, increased salivation, and shedding of the skin can occur as well. Children may have loss of hair, teeth, or nails, rashes, weak muscles, and light sensitivity. Emotional lability, which is uncontrolled mood swings including crying and laughing jags, impaired memory, and insomnia can occur. It is curious that some of these are the symtpoms Cinnabar is propsed to treat, and that may indicate a low dose affecting those areas of the brain differently than a high dose. But because mercury bioaccumulates in the food chain, it can’t be recommended to go for a mild case of mercury poisoning in the hopes that helps with sleep or anxiety by suppressing those areas of the brain before it excites them. As usual, fetuses and infants are more susceptible to mercury poisoning, and pregnant women exposed to mercury can have babies with birth defects. Wikipedia states: ”Mercury exposure in young children can have severe neurological consequences, preventing nerve sheaths from forming properly. Mercury inhibits the formation of myelin.” This confirms the Taiwanese report of myelin damage in the man who had taken cinnabar for three months.
Mercury vapors are the most dangerous common exposure. Melting cinnabar, something Ge Hong recommends in many recipes, will lead to dangerous vapors that can cause significant poisoning via inhalation. This can easily cause tremors, memory loss, shyness, paranoia, and weak or twitching muscles.
Methylmercury is the most common exposure modern humans have, as it climbs the food chain and is in higher amounts in larger and older fish. One of my Chinese teachers said that turtles/tortoise are a major exposure risk in Chinese medicine, as they live so long and eat smaller fish. Researchers have found (
http://www.postandcourier.com/news/2007/nov/03/turtles_shell_out_info_on_mercury21071/) that they can check turtle shells as an indicator of local mercury pollution. This casts suspicion on the use of turtle shell as a safe ‘yin tonic’ in TCM, especially to balance out ‘hot’ herbs like Aconite. Even with a high dose single exposure to methylmercury, the symptoms can take several months to show up. After months, the symptoms of tingling and numbness can show up, followed by coma or death. This reduces the reliance on traditional ‘clinical observations’ that Cinnabar is safe or doesn’t cause side effects. Kidney damage can accumulate over time as well, and then lead to apparently sudden renal failure months after the damage occured. This was the case with the Aristolochic acid containing Chinese herbs. Like Aristolochic acid, mercury can also increase the chances of cancers developing later, and has been banned in paints, pesticides, fungicides, etc.
Mad Hatter’s Disease, named after the hat factory workers in the 1800′s and the character in Lewis Carroll’s Alice in Wonderland, specifically refers to the neurological effects of chronic mercury poisoning. This class of symptoms includes “slurred speech, anxiety, hallucinations, irritability, depression, lack of coordination, and tremors.” (
http://en.wikipedia.org/wiki/Mad_hatter_disease). Excessive shyness is also a symptom of mercury toxicity.
Ge Hong exhibited several symptoms of mercury poisoning. Throughout his writings there are signs of auditory and visual hallucinations (hearing voices, seeing fairies, goddesses, etc.), shyness and paranoia (he insists on avoiding being seen by women and hiding in the mountains), and clearly has some cognitive impairment which leads him to conclude that stories of immortality, growing wings and flying, regrowing lost teeth, and summoning the Travelling Canteen (which is like a magical buffet from the immortal realm) are all true.
While cinnabar has lower toxicity than many other forms of mercury, Ge Hong clearly had exposure via both eating cinnabar as well as to mercury vapors from his alchemical experiments. It’s ironic that his delusional state from heavy metal poisoning led to cinnabar having an enduring “essential” place in the Chinese Materia Medica for treating the very conditions that it is likely to cause (anxiety, insomnia, tremors).
In conclusion, the lost tradition of the highest substances of Classical Chinese Medicine that were sought after by the early Daoist alchemists is none other than true Potable Gold, now available as a safe, non-toxic colloidal gold, made in the USA and legal to buy and use. Cinnabar is still referenced in the texts and used, especially in Asia, but it was originally just a cheap substitute for Gold. Cinnabar has known toxic effects, no hint of a healthy method of action, and is thankfully hard to get anyhow. The fact that Cinnabar shows up in every Chinese Materia Medica and Silver and Gold can only be found in the most obscure older books is an indicator of the secrecy attached to the oral tradition of those substances. Chinese culture still has a high regard for gold as money and gold as a symbol, and I wouldn’t be too surprised if there are still some secret traditions of preparing medicines out of gold. Perhaps the true Golden Age of Daoist Alchemy is just beginning, and required the Periodic Table as a prerequisite.
—
Ancient Way Acupuncture & Herbs, Inc.
Kevin O’Neil, Licensed Acupuncturist
541-884-6377
@ancientwaykevin
