bubble_chart Source

This product is crude lead oxide (Lithargyrum) smelted from lead ore, produced in Guangdong, Hunan, Hubei, Fujian, and other regions, and can be mined throughout the year. Natural litharge ore is extremely rare, and most commercially available products are processed from lead as raw material. In the past, this product was obtained as a byproduct deposited at the bottom of furnaces during the refining of silver and lead from galena. Currently, its production method involves melting lead, rotating a long iron rod in the molten lead several times, allowing some of the molten lead to adhere to the rod. The rod is then removed and immersed in cold water, where the molten lead cools and solidifies into lead oxide (solid), which is litharge.

Ancient records state, "Mituo and Moduo are foreign terms, originating from Persia... litharge, obtained from the refining of silver." The general idea is that the ancients first observed a Persian monk refining silver and named the stone he used for refining as litharge. In reality, litharge is PbO, and the monk was not refining silver but practicing alchemy.

bubble_chart Morphological Characteristics

Isometric crystal system, irregular in shape, varying in size. Orange-red, embedded with small pieces that have a metallic luster, shining brightly when illuminated. The surface is rough, sometimes with one side being orange-yellow and slightly smooth. Hard and heavy, easily broken. The cross-section is reddish-brown. Odorless. Powder is yellow. The best quality is characterized by a yellow color with luster, consistent inside and out, and being hard and heavy. Slightly soluble in water, easily soluble in nitric acid. When exposed to air, it gradually absorbs carbon dioxide and turns into basic lead carbonate.

bubble_chart Properties and Meridians

Salty and acrid, neutral, toxic. Tang Bencao: "Salty and acrid, neutral, slightly toxic." Rihuazi Bencao: "Sweet, neutral, nontoxic."

bubble_chart Efficacy

Reducing swelling, killing worms, astringent and antiseptic, expelling phlegm, calming fright.

bubble_chart Indications

For internal use, it treats chronic dysentery, fright epilepsy; for external use, it treats hemorrhoids, swelling and toxicity, ulcer, vitiligo, scabies, armpit odor, eczema, itching, water from river, and other symptoms.

1. For phlegm that does not disperse in the thoracic accumulation, use one tael of litharge, add vinegar and water, one bowl each, boil until dry, and grind into powder. Take two qian of the powder each time, boil with one small bowl each of wine and water until reduced to one bowl, and take while hot. It is good to expel phlegm and saliva.
2. For consumptive thirst and drinking water, use two taels of litharge, grind into powder, soak in boiling water, take out, add a little steamed cake to make pills the size of Chinese parasol seeds. Take with strong silkworm cocoon salt soup, or eggplant root soup, or wine. On the first day, take five pills, then increase by nine pills each day until reaching thirty pills at a time, do not take more. After five or six times, if nausea from water is seen, stop the medication. When nausea occurs, eat some dry food to suppress it.
3. For red and white dysentery, use three taels of litharge, burn until yellow, take out and grind finely, take one qian each time with vinegar tea, three times a day.
4. For hemorrhoids and fistulas, use one qian each of copper green and litharge, a little musk , grind finely, mix with saliva, and apply to the affected area.
5. For infantile blister sores (resembling fish bladder or crystal all over the body, breaking and releasing water from river, sores regenerate), sprinkle litharge powder, and take Styrax Pill internally.
6. For loss of voice due to fright, take one teaspoon of litharge with tea, and it will cure immediately.
7. For armpit odor, first wash the armpits clean, apply litharge powder mixed with oil. Also, put one qian of litharge powder into a hot steamed cake and place it under the armpit.
8. For fetid mouth odor, use one qian of litharge powder, mix with vinegar, and rinse the mouth.
9. For aphtha, use calcined litharge, grind into powder, and apply to the sores.
10. For sores inside the nose, use equal parts of litharge and Dahurian Angelica , grind into powder, mix with candle wax, and apply to the affected area.
11. For all black spots, use two taels of litharge, grind finely, mix with human milk , and apply at night, wash off during the day.
12. For tinea versicolor like rashes in summer, use eight qian of litharge and Realgar four qian, grind finely. First, rub the skin with a ginger slice to induce fever, then use the same ginger slice to dip in the powder and rub the tinea versicolor. The next day, the macula and papule will dry up.
13. For bone abscess (also known as "multi-bone sore", where small bones occasionally protrude from the sore), mix litharge powder with tung oil and apply to the affected area.
14. For chronic shank ulcer, mix litharge powder with sesame oil to make a paste, spread on oiled paper, and repeatedly apply to the affected area.

bubble_chart Usage and Dosage

For external use: Apply an appropriate amount, grind into powder and sprinkle or mix for application, or prepare as a plaster, ointment, oil, etc. For internal use: Grind into powder, 0.2～0.5g; or incorporate into pills or powders.

bubble_chart Cautions and Contraindications

This product is primarily for external use. Prolonged and excessive use may lead to lead poisoning. Oral administration should be cautious and not excessive. It is contraindicated for those with weak constitution, pregnant women, and children.

bubble_chart Modern Pharmacology

At a concentration of 2%, Litharge Ointment exhibits inhibitory effects in test tubes against Trichophyton concentricum, Trichophyton mentagrophytes, Trichophyton rubrum, and Microsporum ferrugineum. At a 4% concentration, it also inhibits Epidermophyton floccosum, Trichophyton gypsum-like, and Trichophyton pedis, among others. The water extract (1:3) shows varying degrees of inhibition against multiple skin fungi in test tubes. It can combine with proteins to form protein-lead, which has a local astringent effect on mucosal blood vessels, protecting ulcer surfaces and reducing mucus secretion.

Acute poisoning

• is commonly seen in individuals who have ingested excessive amounts of soluble lead salts. Symptoms include nausea, vomiting, drooling, a metallic taste in the mouth, blood streaks in vomit, diarrhea, abdominal pain, black stools, and paroxysmal colicky pain around the navel, which is alleviated by hand pressure. During episodes, there is dysphoria, elevated blood pressure, increased white blood cell count, and sometimes symptoms resembling biliary colic or cystitis, with frequent urination. Severe vomiting and diarrhea can lead to dehydration, hemoconcentration, acidosis, or electrolyte imbalance. Intense abdominal pain may cause shock, directly leading to circulatory failure.
• Toxic encephalopathy may present with persistent headache, delirium, hallucinations, mania, tremors in the eyes, eyelids, tongue, and fingers, and sometimes epileptic-like seizures or paralytic dementia. Children often exhibit brain edema and increased intracranial pressure symptoms, such as refusal to eat, projectile vomiting, bulging fontanelle, cranial suture separation, increased head circumference, neck stiffness, strabismus, lethargy, and convulsions. Fundus examination may reveal optic disc edema. Multiple lead neuritis can cause numbness in fingers and toes, limb paralysis, and if intercostal muscles are paralyzed, respiratory difficulty or failure may occur.
• Blood tests show a significant decrease in red blood cells, with an increase in reticulocytes and stippled cells. Patients may experience dizziness, fatigue, pale complexion, markedly pale nails, massive gastrointestinal bleeding, and shock.
• Toxic hepatitis manifests as hepatomegaly, elevated transaminases, jaundice, and tenderness.
• Toxic nephropathy, with laboratory findings of protein, pus cells, and casts in urine, can lead to severe renal failure.
• Temporary hypertension may occur due to lead-induced vascular spasms.

Chronic poisoning

• Lead facies: a sallow or grayish complexion due to spasms of facial small blood vessels.
• Digestive system: metallic taste in the mouth, lead line on gums, frequent colicky abdominal pain, and severe constipation. The lead line, a characteristic of lead poisoning, results from the reaction of absorbed lead with residual decaying food in dental crevices, forming black particles deposited in the oral mucosa, appearing as a 1mm-wide band or irregular patches composed of bluish-gray microdots, often along the gum margins of canines and first molars, and sometimes on buccal mucosa. The presence of a lead line indicates lead absorption but is not necessarily diagnostic of poisoning.
• Hematopoietic system: increased stippled cells, reticulocytes, and basophilic granular cells. Grade I and II hypochromic normocytic or microcytic anemia may occur.
• Nervous system: early symptoms include neurasthenic syndrome, such as dizziness, insomnia, lack of strength, decreased appetite, and muscle arthralgia. Advanced stages may present with multiple neuritis, lead paralysis, and typical wrist and ankle drop. Grade III poisoning involves mental and neurological dysfunction, including insomnia, depression, sensory dullness, hallucinations, delirium, mild paralysis, tremors, convulsions, and even unconsciousness.
• Other complications include interstitial nephritis, hepatomegaly, jaundice, uremia, menstrual disorders, late abortion, or premature labor.

Lead poisoning patients may experience acute episodes triggered by illness, acidosis, alcohol consumption, hunger, or hypocalcemia within 1-2 years after ceasing lead exposure, leading to alternating latent and acute phases.

Treatment methods:

1. Acute poisoning caused by ingesting a large amount of lead-containing substances through the digestive tract should be immediately treated by gastric lavage with a 1% to 3% sodium sulfate or magnesium sulfate solution to form insoluble lead sulfate and prevent absorption. Alternatively, an emetic formula can be administered first, followed by 20g of magnesium sulfate or sodium sulfate, and then gastric lavage to remove the precipitated lead sulfate. After gastric lavage, 15 to 30g of sodium sulfate or magnesium sulfate can be administered to induce diarrhea.
2. Drink milk and egg whites to protect the gastric mucosa.
3. For those with toxic encephalopathy, intravenous injection of calcium gluconate should be administered immediately. For cerebral edema, mannitol and cortisone can be used. The application of calcium agents can promote the precipitation of lead in the blood into the bones, thereby reducing blood lead levels and alleviating acute symptoms. Use 10ml of 10% calcium gluconate, added to 20ml of 25% glucose injection, and administer by slow intravenous injection, 2 to 4 times daily, for 2 to 3 days. This treatment is also effective for abdominal colicky pain. Additionally, 1g of calcium lactate can be taken orally, three times a day, for 3 days.
4. Lead removal therapy should only be initiated after acute poisoning symptoms have subsided. The first-choice drug is calcium disodium edetate (CaNa₂-EDTA), which can combine with lead to form a stable, soluble complex that is excreted in the urine. After administration, the amount of lead excreted in the urine increases sharply (up to 14 to 30 times), and symptoms of chronic lead poisoning are significantly reduced or even disappear, without the side effect of reduced blood calcium. Generally, a short-course intermittent therapy is adopted, where adults receive 1 to 2g daily, and children receive 25 to 50mg/kg body weight daily, dissolved in 500ml of 5% glucose solution for intravenous drip, or dissolved in 40ml of 25% glucose solution for slow intravenous injection. Continuous treatment for 3 to 4 days constitutes one course, with a break of 3 to 4 days before repeating. A total of 3 to 4 courses can be administered until urinary lead levels return to normal. For chronic poisoning, tablets can be taken orally.
5. Sodium dimercaptosuccinate: 1g daily, added to 20ml of saline for slow intravenous injection before use. This drug should not be used for intravenous drip, and if the solution appears yellowish or cloudy, it should not be used. Use for 3 days, then stop for 4 days as one course. The first dose is 2g.
6. Pentetate calcium trisodium (CaNa₃-DTPA) 0.5 to 1g daily, dissolved in 500ml of saline for intravenous drip. Use for 3 days, then stop for 4 days. Administer 3 to 4 courses.
7. 5% sodium dimercaptopropanesulfonate solution 2 to 3ml, intramuscular injection, followed by 1 to 2ml every 4 to 6 hours, after 2 days, 2.5ml per dose, 1 to 2 times daily, for about 1 week.
8. Penicillamine: 0.2 to 0.3g each time, 3 to 4 times daily, along with 60mg of vitamin B6 daily, continuous use generally not exceeding 4 weeks.
9. Administer 20 to 40g of sodium bicarbonate and 2 to 3g of sodium iodide daily to promote lead excretion from the body.
10. To reduce side effects from medication, take compound vitamin B, 1 to 2g of halide, three times daily. Middle-Tonifying Qi-Replenishing Decoction with modifications and oral trace metal mixture can also be used. The mixture consists of: 0.2g copper sulfate, 0.6g potassium permanganate, 30g ferrous citrate, 1g zinc sulfate, 0.1g cobalt chloride, and an appropriate amount of syrup, diluted to 1000ml with water, take 10ml orally, three times daily.
11. Symptomatic treatment: For convulsions, nitrazepam can be used; for lead colicky pain, 0.5mg of atropine sulfate can be injected subcutaneously, or large amounts of calcium agents and vitamin C can be taken orally. If necessary, pethidine or morphine can be used, and children can take compound camphor tincture orally. Acupuncture can also be used, targeting Zhongwan, Tianshu, Zusanli, and Sanyinjiao points. If necessary, apply hot compresses or sublingual nitroglycerin tablets.
12. For toxic hepatitis, in addition to liver-protecting therapy, regular insulin 10-16U and 10% potassium chloride 10ml can be added to 500ml of 10% glucose solution for intravenous drip (referred to as G, I, K therapy), once daily, for a course of 1-10 days, extended if necessary. This has the effect of reducing transaminase and improving appetite. Alternatively, an energy mixture therapy can be used, which involves adding one ampoule of energy mixture (containing 20mg of adenosine triphosphate, 50U of coenzyme A, and 4U of regular insulin) to 500ml of 10% glucose solution for intravenous drip, once daily.
13. For toxic encephalopathy, in addition to using detoxifying agents and dehydrating agents, diuretics can also be used, and attention should be paid to water and electrolyte balance. To improve brain cell metabolism, energy mixtures can be used early, with an appropriate amount of cytochrome C added, and administered intravenously in glucose infusion. For those with obvious psychiatric symptoms, perphenazine can be used. For those with tremor symptoms, Artane can be used.
14. For toxic nephropathy, kidney protection measures are mainly adopted.
15. For gastrointestinal bleeding, hemostatic drugs are first used, along with gastrointestinal mucosal protective agents. If there is anemia, after the acute phase and when the condition is stable, various blood tonics are applied.
16. Large amounts of white radish natural juice, white granulated sugar water, and duck blood can be taken to treat lead poisoning.
17. Fresh Chinese tallowtree root-bark 120g, chopped, mashed, and squeezed for juice, mixed with 1kg of ground water, divided into 4 doses, taken every 4 hours.
18. White honey and sesame seeds, chewed and taken in large amounts, or large amounts of mung bean soup can also be consumed.
19. Forsythia 12g, Lonicera 15g, Akebia Stem 6g, Plantain Seed 3g (wrapped), Indian buead tuckahoe 15g, Alisma 9g, decocted with water and taken, one dose per day, 7 doses as one course.
20. Christina Loosestrife 30g, Liquorice Root 6g, seaweed, kelp, Sichuan Hypoglaucous Yam, and chicken blood vine each 12g, Scouring Rush Herb 15g, Lonicera 18g, Akebia Stem 6g, Alisma 9g, decocted with water and taken, one dose per day, continuously for 4 to 6 doses.
21. Christina Loosestrife 21g, Liquorice Root, seaweed, kelp each 9g, Lonicera 21g, Akebia Stem 6g, Alisma 9g, Prunella 15g, Glabrous Greenbrier 30g, chicken blood vine 15g, water chestnut juice as needed. Decocted with water and taken, one dose per day, continuously for one week.
22. Kelp 90g, seaweed 75g, decocted and taken frequently. Or take Golden Chrysanthemum Leaf Soup (Christina Loosestrife 30g, Chrysanthemum Flower, Liquorice Root each 15g, decocted with water and taken).
23. For toxic hepatitis and elevated transaminase, use Gentian 12g, European Verbena Herb 9g, Cinnamon Twig 9g, Atractylodes Rhizome 9g, Curcuma Root 9g, Gardenia 9g, Dried Tangerine Peel 9g, Indian buead tuckahoe 12g, Virgate Wormwood 15g, Salvia 9g, Chinaberry Fruit 9g, White Atractylodes Rhizome 9g, Liquorice Root 6g, decocted with water and taken morning and evening.
24. Universal Detoxifying Soup: Cyperus seeds 9g, large and small blood vine, slender dutchman's pipe root, and Guang Aucklandia Root each 15g, Sanqi powder (dissolved), borneol (dissolved) each 1g, golden powder fern 250g, decocted with water twice, combined, taken every 4 hours, finished in 2 doses.