Traditional Chinese medicine has a long history of using minerals as medicine. Cinnabar is a common mineral Chinese medicine. About 10% of Chinese patent medicines contain cinnabar, among which there are many famous medicines such as Angong Niuhuang Pills. In recent years, with people's increasing attention to the side effects of traditional Chinese medicine, the toxicity of cinnabar has also surfaced. At present, although the mechanism and medical practitioners in China have a certain understanding of the toxicity of cinnabar, it still needs to be improved. As a mercury agent, cinnabar should be closely monitored: it should be re-evaluated frequently and its clinical application should be limited according to the benefit/risk ratio. In particular, the quality standard of cinnabar safety in Chinese Pharmacopoeia should be revised to avoid mercury poisoning caused by preparations containing cinnabar. The understanding of cinnabar toxicity has gradually deepened. Cinnabar is mainly used in traditional Chinese medicine to soothe the nerves, relieve convulsions and resist microorganisms. "Shen Nong's Classic of Materia Medica" says: "Cinnabar can cure all diseases of the five internal organs, nourish the mind and soothe the nerves, invigorate qi and improve eyesight, kill ghosts and ward off evil spirits, and if it is taken for a long time, the spirit will not grow old." It can be seen that Chinese medicine first thought that cinnabar could be taken for a long time. With the deepening of clinical practice, there are records of dementia and boredom caused by cinnabar poisoning in ancient books such as Compendium of Materia Medica and Materia Medica from the New. Modern research believes that cinnabar is a kind of mercury agent, which can cause chronic poisoning, and long-term use can cause organism accumulation, especially harmful to children. Pharmacopoeia before 1985 in China didn't know enough about the toxicity of cinnabar or the semantics of describing its toxicity were vague. With the increasing reports of chronic mercury accumulation poisoning caused by long-term use of cinnabar preparations, the 1985 edition of Pharmacopoeia confirmed that cinnabar was toxic, but the understanding was vague. The 1995 edition of Pharmacopoeia has improved its understanding in this respect. The daily dosage of cinnabar was reduced from 0.3 ~ 1.5g to 0. 1 ~ 0.5g, and the dry ground cinnabar powder with high toxic water-soluble mercury salt was removed, leaving only the cinnabar powder processed by water flying method. The toxicity of cinnabar has been further understood in the 2000 edition of Pharmacopoeia, which stipulates that the temperature during processing and drying must be below 40℃, and no water-soluble mercury salt can be detected in medicinal cinnabar. The 2005 edition of Pharmacopoeia has not changed the relevant contents of the 2000 edition of Pharmacopoeia. There are different opinions about the effective components of cinnabar. Mercury sulfide is the main component of cinnabar, but whether it is the effective component of cinnabar is still inconclusive. Ye Zuguang, deputy director of the National Engineering Research Center for the Development of Compound Chinese Medicine, and others tested the feces of experimental animals taking Angong Niuhuang Pills (containing cinnabar) in the experiment, and converted the detected total mercury into mercury sulfide. The results showed that mercury sulfide accounted for 98.5% of the dose, indicating that mercury sulfide was not absorbed by the intestine, but was completely excreted. Therefore, it is considered that mercury sulfide is actually an ineffective and non-toxic component and cannot be absorbed by human body. The mercury contained in cinnabar is 65438. Some scholars have different views on this. Because the Pharmacopoeia stipulates that medicinal cinnabar powder (that is, water-flying cannon products) does not contain water-soluble mercury salts, but can contain free mercury. It is reported that the content of free mercury in water fly cinnabar is lower than 65438 0 μ g/g (0.05438 0%). Even if the content of free mercury in water fly cinnabar is 18 ~ 35 μ g/g as stipulated in Pharmacopoeia 2000, the free mercury only accounts for 0.00 18 ~ 0.0035%, which is much lower than 1.5%. This shows that most of the absorbed 1.5% mercury comes from mercury sulfide. Others think that mercury sulfide should not be an ineffective and non-toxic component, but a precursor of effective and toxic components. The reasons are as follows: Chinese scholars have studied the absorption and distribution of cinnabar in mice by gavage, and found that the amount of mercury absorbed by mice is much higher than the highest amount of soluble mercury and free mercury contained in cinnabar, indicating that some mercury sulfide is transformed into absorbable mercury compounds in some environments of gastrointestinal tract. It is reported that cinnabar can produce methylmercury when it meets methyl-containing substances in the dark environment at pH 7 and temperature 37℃ under anaerobic sulfur conditions, and the absorption rate of methylmercury can reach 100%. The human intestine has the above conditions, and digestive enzymes and intestinal bacteria in the gastrointestinal tract may contain enzymes such as oxidoreductase and methyltransferase, which is more conducive to the transformation of mercury sulfide into methylmercury or mercury cysteine, mercury glutathione and other small molecular complexes to be absorbed in the digestive tract. It is worth noting that medicinal cinnabar powder not only contains more than 98% mercury sulfide, but also contains many metal elements, such as magnesium, bismuth, iron, silicon, barium, calcium, copper, manganese, antimony, arsenic, zinc, selenium, tellurium and lead, some of which are heavy metal elements harmful to human body. Whether these ingredients should be specified in processing methods and limit standards should also be paid attention to. middle
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