Mercury and Mercury-Containing Preparations: History of Use, Clinical Applications, Pharmacology, Toxicology, and Pharmacokinetics in Traditional Chinese Medicine

Abstract

Historically, mercury and mercury-containing preparations have been widely used in traditional Chinese medicine and applied in many clinical practices mainly in the form of mercury sulfides. The clinical application, toxicity manifestations, and symptoms of these preparations largely depend on the route of administration and the dosage form. Commonly used mercury-containing medicinal materials and preparations in traditional Chinese medicine include Cinnabar, an excellent medicine for tranquilizing the nerves; Hongsheng Dan and Baijiang Dan, which have antibacterial, anti-inflammatory, promotion of tissue repair and regeneration and other pharmacological effects. Tibetan medicine commonly uses Zaotai and Qishiwei Zhenzhu pills, which have pharmacological effects such as sedation, anti-inflammatory, anti-convulsant, and improvement of cerebral apoplexy. Menggen Wusu Shibawei pills, commonly used in Mongolian traditional medicine, have the muscle growth and astringent effects. In India and Europe, mercury is often used for treating syphilis. This article summarizes the history, clinical application, pharmacology, toxicology, and pharmacokinetics of mercury and mercury-containing preparations in traditional medicines. In terms of clinical application, it provides suggestions for the rational use and safety of mercury-containing drugs in clinical practices and in public health issues. It will further provide a reference for formulation strategies related to mercury risk assessment and management.

Heavy Metals, Halogenated Hydrocarbons, Phthalates, Glyphosate, Cordycepin, Alcohol, Drugs, and Herbs, Assessed for Liver Injury and Mechanistic Steps

“…Mercury, or Hg for formerly named hydrargyrum from the Greek words hydor, water, and argyros, silver [23] has been commonly used or is still rarely used in the industry as mercury barometers and thermometers, as electrodes for electrolysis, and in electronic switches [168]. In addition, with methylmercury and ethylmercury as organic mercury forms, it is or was widely used in agriculture for antifungal purposes in seed grains [168]. As a result, mercury can be detected in the atmosphere [169], solid municipal mills [69], historical attic dust [109], soil [69,170], and water [168].…”

“…In addition, with methylmercury and ethylmercury as organic mercury forms, it is or was widely used in agriculture for antifungal purposes in seed grains [168]. As a result, mercury can be detected in the atmosphere [169], solid municipal mills [69], historical attic dust [109], soil [69,170], and water [168]. Due to its worldwide use it became a global pollutant [171,172] with health hazards, shown also at the occasion of the 1956 Minamata tragedy in Japan caused by methylmercury [172,173].…”

“…Due to its worldwide use it became a global pollutant [171,172] with health hazards, shown also at the occasion of the 1956 Minamata tragedy in Japan caused by methylmercury [172,173]. Generated as byproduct during chemical acetaldehyde production in a fertilizer company [172], methylmercury was released for a long time via the Agana River [168] to the nearby shore of Minamata Bay and reaching finally the East China Sea [168,172]. This incident polluted as a classic case of environmental mercury poisoning the marine ecosystem, affecting also fishes such as shellfishes, and humans [172,173].…”

Comparative pharmacokinetics and urinary excretion of arsenic and mercury after oral administration of realgar, cinnabar and AnGongNiuHuang Pill to rats

“…Conversely, AGNHP significantly reduced the excretion of mercury in urine and increased its exposure in blood. Urinary excretion was not the dominant excretion pathway of arsenic and mercury, and most of them excreted in feces in the form of As 2 S 2 and HgS without metabolic transformation ( Wu et al, 2022 ; Zhao et al, 2022 ). As reported, realgar-containing TCMs significantly inhibited the absorption of arsenic and promoted its excretion, which was responsible for the toxicity-reducing effect ( Xu et al, 2022 ).…”

“…The urinary concentrations of arsenic and mercury were in the safe range after oral administration of AGNHP, and there were no significant toxic effects. Urine was not the main excretion route for arsenic and mercury ( Wu et al, 2022 ; Zhao et al, 2022 ), and the limited excretion of arsenic and mercury could not accurately reflect the toxic exposure in vivo . Hence, the diagnosis of poisoning should be combined with the concentrations of arsenic and mercury in blood and urine.…”