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Li Zhengyu, physician/doctor of Chinese medicine

Modern Cinnabar production differs from ancient methods. High-speed, high-temperature grinding can easily oxidize the root of the nose, producing highly toxic substances. Additionally, some pharmaceutical companies fail to properly identify and use hydrargyri oxydum rubrum or Minium as substitutes, leading to numerous cases of poisoning. Under the premise of medication safety, banning its use is indeed the only feasible solution.

Since the Chinese Medicine Drug Committee of the Department of Health announced the ban on "Cinnabar," many practitioners and researchers in the Chinese medicine field have sought my opinion. I privately agreed and supported the decision, which surprised many, as they thought I, who has been tirelessly promoting and researching Chinese medicine, would vote in favor. I explain as follows:

If Cinnabar is made according to ancient methods, using old-fashioned foot-operated grinding troughs, finely ground, and thoroughly washed with water to remove attached marble, without high-speed or high-temperature processes, it indeed will not cause poisoning no matter how it is consumed. Cinnabar ore is formed after volcanic eruptions expelling pathogens from the exterior and then refined at high temperatures, making its structure extremely stable. As those who study chemistry know, aluminum oxide is composed of six molecules bonded together, very stable, not hydrolyzed, not absorbed in the gastrointestinal tract, and not deposited in the liver or kidneys.

However, there are several issues with the Cinnabar currently sold in Taiwan. If these problems are not resolved, even if Jingshui is fully used, long-term consumption can still lead to poisoning, damaging the liver, kidneys, brain, and spinal cord nerves. First, pharmacy practitioners often misidentify the drug, using "hydrargyri oxydum rubrum" or "Minium" as substitutes for Cinnabar, leading to lead poisoning after consumption. The chemical structure of Cinnabar is HgS, which contains no lead. The reason for lead poisoning is that pharmacies are deceived by middlemen and lack sufficient drug identification capabilities.

Secondly, the highly efficient machinery of modern industrial society poses a problem. The high-speed grinding machines generate high temperatures, burning the "sulfur-S" in the Cinnabar ore, similar to car tires on highways, forming S₂₀₃. HgS has two possibilities: one is Hg combining with 0₂, and the other is Hg forming free mercury ions Hg⁺. Both are highly toxic, easily absorbed by the epithelial cells of the human digestive tract, and deposited in the brain and spinal cord nerves, affecting nerve activity, neuroendocrine and neurotransmitter components and quantities, and hindering nerve conduction speed. They also cause significant damage to liver and kidney functions, with small amounts potentially leading to liver and kidney failure, agitation, epilepsy, convulsion, spleen qi irritability, rage, or chronic diseases, hallucinations, auditory hallucinations, and life-threatening conditions. If consumed in large quantities, one might not even know how they died.

Taking Emperor Taizong of Tang as an example, he originally suffered from "foot taiyin phlegm syncope head disease" (Note: i.e., vertigo, but it is unclear whether it was caused by the brain, eyes, ears, neck muscles and blood vessels, or water retention in the organs above or below the diaphragm membrane, or insufficient blood sugar... in any case, he suffered from vertigo). After taking the "elixir" brought back by the alchemist Naroshabami, who was captured by Wang Xuance during his campaign against North India, he "suddenly deteriorated," meaning he died abruptly. The royal physician arrived but did not know how to administer emergency treatment, and the emperor died immediately. This incident is recorded in the Tang historical records. After Taizong, seven or eight out of ten Tang emperors died from consuming "vermilion pills." In the "Treatise on Cold Damage Diseases (Zabing Lun)," it is mentioned that "Realgar near fire is as poisonous as arsenic. In fact, both Realgar and Cinnabar near fire are as poisonous as arsenic. Realgar is As₂

S₃, and when heated and refined, it becomes As₂₀₃ or As₂O₂, which is 100% arsenic. Many folk medicines involve finely grinding Cinnabar with water and then refining it in a pot, believing that this enhances its warming and tonifying medicinal properties. However, they do not realize that once subjected to high heat and dry frying, the self-activating smoldering causes the sulfur to burn completely, forming mercury oxide and mercury ions. How could one not be poisoned? People are being 'tonified' to death. Unless large-scale Cinnabar merchants in the market can adopt three methods when grinding Cinnabar, it would be best to ban Cinnabar altogether.

The first is to restore the ancient foot-pedal grinding method, followed by thorough grinding with water.

The second is that high-speed grinding is permissible, but a large amount of cooling water must be continuously injected into the grinder, flushing out continuously to maintain the temperature inside the grinding machine at or below room temperature, preventing the sulfur in mercury from burning and volatilizing, and preventing mercury from forming mercury ions or mercuric oxide.

The third is that pharmacy staff must never roast Cinnabar.

However, it is currently extremely difficult to meet these three requirements, so it might be better to just ban it, but the right for physicians/doctors of Chinese medicine to prescribe and dispense Cinnabar in emergency situations should be retained, with the condition that it be replaced by other medications as soon as symptoms alleviate.