Realgar, As2S2Sandarache (Dioscorides, Agricola)Manashila (Ayurveda) Hartal Tabqi (Unani) Rahj al Ghar (Arabic, meaning ‘Powder of the Mine’) Xiong Huang 雄黄 (TCM) Ldong ros ལྡོང་རོས (Tibetan) |
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RealgarPhoto by Rob Lavinsky, iRocks.com
Mineralogical Name:
Arsenic Disulphide
Parts used:
Refined or prepared Mineral
Specimens that are red outside but white inside when crushed, or which contain white crystals within, should not be used as these contain arsenic trioxide.
Temperature & Taste:
Hot, dry, Bitter, Pungent. Very Toxic.
Classifications:
T. External Medicines
Uses:
1. Resists Poison (Ayurveda, TCM, West):
-chronic Fevers and Blood disorders in Ayurveda
-‘remove chronic stagnation and various toxic materials’ (Herbal of the Ming Dynasty)
-tumors and some cancers including Liver and Gastric Cancers, Chronic Granulocytic Leukemia
-Tubercular Lymphadenopathy.
-various Toxic and poisonous conditions including severe Tonsillitis, Fevers etc.
-poison Snake and Insect bites, Dog Bites
-traditionally for negative effects caused by various Spirits, and sudden diseases caused by Evil Spirits and Demons.
2. Clears Phlegm, Stops Cough and Wheezing:
-‘Given with Mulsum to spitters of rotten matter, and it is made a perfume with Resin also for the Old Cough … and being licked in with Honey it doth clear the voice, and it is given with Resin for a Catapotion to the Asthmatical’ (Dioscorides)
-Coughs, Chronic Bronchitis, Bronchial Asthma and Consumption. (Ayurveda)
3. Rasayana:
-prevents and cures senility and physical decay due to old age. (Ayurveda)
-sublimated product was also used in TCM to lighten the body, and promote Immortality. (TCM)
-long used to promote bravery and courage; it has been eaten by tribes for this purpose
-Promotes Digestion, and is used for Anemia. (Purified product) (Ayurveda)
4. Kills Worms:
-Intestinal parasites, especially Roundworm;
-one traditional TCM source said it was used for ‘hundreds of Toxic Worms and Insects’ (Bensky).
5. Externally: Clears Poison, Kills Parasites (TCM, Ayurveda, Tibetan, West):
-scabies, ringworm, damp-type rashes, deep-rooted boils and abscesses, ulcers.
-as a wash for any itchy skin condition
-found very effective into the treatment of Neurodermatitis (TCM, Ayurveda).
-Applied with fat to dissolve small swellings
-ulcers and pustules (Dioscorides).
-mouth sores and ulcers
-ear infection with discharge (Ben Cao Gang Mu)
-Knife Wounds (topically and internally) (Ben Cao Gang Mu)
-applied to Toothache (Ben Cao Gang Mu)
Dose:
The internal use of this medicine is almost obsolete in modern western practice, however it is of more use externally.
1. Always begin with lower doses, increasing as needed.
2. Tolerance is increased with repeated administration.
3. Full doses are only taken twice daily for no more than 2 weeks.
4. Not boiled or added to hot decoctions.
5. Diet while using Arsenic preparations should include milk, ghee, butter, sugar, and Honey. While taking Arsenic preparations, avoid salts, sours, pungent and spicy foods including Chili. (Ayurveda)
6. Triphala, Chebulic Myrobalan or other mild laxatives can be taken intermittently to avoid toxic accumulation.
Powder of PREPARED REALGAR: generally 150–300 mg. Low and starting doses are 10–50mg, moderate doses are 100–150mg (0.1–0.15 gram); full doses are 150–300mg; large doses of 300–900mg have been used in serious cases including Cancer but should only be reached gradually.
Correctives:
1. Milk, Ghee, Honey (Ayurveda, Unani)
2. Catechu (Unani)
3. Egg White (topically)
Substitutes:
1. Orpiment
2. Sulphur is far less toxic but has similar qualities.
Comment:
‘Arsenic is well known for its toxic manifestations in the body. But by proper purification it is used without any adverse effect in the treatment of several obstinate and otherwise incurable diseases and it becomes a rejuvenating agent’. (Alchemy and Metallic Medicines in Ayurveda, Vaidya Bhagwan Dash, Delhi, 1986)
Preparation:
Purification of Realgar in Ayurveda:
Any of the following processes can be used:
1. Powdered Realgar is kept in Lime Water for 3 days; it is then purified. Another says for it to be impregnated 7 times with Lime water.
2. Realgar is soaked and triturated in Ginger juice, or Lemon juice, or the juice of Eclipta alba, or that of the leaves of Sesbania grandiflora; it may be steeped in any of the above for 7 days, occasionally triturating, and adding fresh juice if needed. It is then dried, powdered, and kept for use.
3. It is also purified by being subjected to Dola Yantra with the juices of Eclipta alba, Sesbania grandiflora and Sesbania sesban.
4. It may be boiled in Dola Yantra with Goat Urine for 3 days, then impregnated (steeped, triturated and dried) in Goat Bile 7 times.
In Ayurveda, Realgar is used after purification, its Bhasma not being necessary. It is Hot, Pungent and Bitter, and is considered Rejuvenating, and improves the complexion.
Used for Chronic Bronchitis, Chronic Fever, Bronchial Asthma, Itching and Anemia. Used for various types of Poison and impurities of the blood.
Dose: 20mg, twice daily with Honey or Ghee.
To Fix and Subdue Realgar, the following herbs have been listed in Daoist texts:
Arum Tian Nan Xing, Lactuca sativa (Wild Lettuce), Acanthopanax Wu Jia Pi, Burnet (Di Yu), Paris polyphylla,
Scutellaria Huang Qin, Angelica Bai Zhi, Sophora Ku Shen,
Main Combinations:
Toxin, Infection and Swellings
1. Abscesses, Furuncles, Carbuncles toxic sores:
i. Realgar with Frankincense (Ru Xiang) and Myrrh (Mo Yao) (TCM)
ii. Furuncle, Realgar with Centipede (Wu Gong) and Scorpion (Quan Xie)
2. Severe heat and toxin, with heat, pain and swelling of the Throat, Mouth or Eyes, Realgar with Bezoar (Niu Huang), Gypsum (Shi Gao), Coptis Huang Lian and Rhubarb (Da Huang) (as in Niu Huang Jie Du Pian)
3. Severe sore throat or Tonsillitis, Realgar with Pearl, Bezoar, Musk, Toad Venom (Chan Su), Borneo Camphor (as in Liu Shen Wan)
4. Typhoid Fever, the wine decoction of Realgar is smelled by the patient. (Ben Cao Gang Mu) NOTE: this should not be repeated.
5. Tuberculosis:
i. the urine solution of Realgar is poured on to a heated stone, then the patient was to sit on the stone. (Ben Cao Gang Mu)
ii. Realgar, Myrrh, Licorice
iii. Realgar, Sulphur (equal parts). Powder, mix with Cow Bile to form pills. Dose: 300 mg three times daily. (TCM)
6. Malaria:
i. Chronic Malaria: Realgar (300mg) is mixed with Liu Yi San (composed of Talcum [6 grams] and Licorice [1 gram]) (2 grams). This is divided into 2 doses, one taken 2 hours before the Fever, the second 4 hours later.
ii. Realgar with Cremastra Shan Ci Gu, Knoxia Hong Ya Da Ji, Euphorbia semen Qian Jin Zi (as in Tai Yi Zi Jin Dan)
7. Rabid Dog Bites:
i. form pills of Realgar and Musk. (Ben Cao Gang Mu)
ii. Realgar, Asarum Xi Xin, Long Pepper (Bi Ba), Musk
8. Insect and Snake bites:
i. apply powder topically, or add the fine powder to sesame oil to apply topically.
ii. Realgar and Flying Squirrel Feces (Wu Ling Zhi) are powdered and taken internally. (TCM)
9. Tetanus, Realgar, Saposhnikovia Fang Feng, Aconitum Cao Wu taken with alcohol. (TCM)
10. Food Poisoning, combine Realgar and Indigo (Qing Dai) (Ben Cao Gang Mu)
11. Diarrhea, Dysentery:
i. pills made of Realgar and steamed cakes. (Ben Cao Gang Mu)
ii. Dysentery with mucus, Realgar, Rhubarb, Phellodendron Huang Bai (equal parts), powdered. Dose: 1500mg three times daily for 10 days. (TCM)
12. Chronic Granulocytic Leukemia, Promyelocytic Leukemia, Acute Myeloid Leukemia, Realgar with Indigo (TCM)
13. Cancer, Realgar has been combined with Nux Vomica
Other
14. Abdominal pain from Parasites, Realgar, Pharbitis seed Qian Niu Zi, Betel nut ()
15. Chronic disease with Pain, Realgar, prepared Croton, Scorpion tails, made into pills with flour and water. (Ben Cao Gang Mu)
16. Asthma: mix Realgar powder (1 part) with flour (4 parts) and water to make a mass, make pills of 500mg each. Dose 1 pill for an adult, half pill for a 10–15 year old. (TCM)
17. Convulsions, Epilepsy, Realgar with Cinnabar (Zhu Sha)
18. Worms:
i. Pinworms, Realgar, Croton seed (Ba Dou), Quisqualis Shi Jun Zi, Bitter Apricot kernel (Ku Xing Ren), Licorice, form honey pills.
Externally:
19. Migraine, Realgar with Asarum Xi Xin as a snuff for Migraine (Ben Cao Gang Mu)
20. Sores with redness, swelling, itching and pain, Realgar with Alum topically as a powder. (TCM)
21. Abscesses and hard lesions, Realgar with Myrrh, Frankincense. (TCM)
22. Toxic Sores with Pus:
i. drain the pus and apply Realgar in powder (TCM)
ii. Realgar, Aloe, Myrrh topically
iii. Realgar, Sulphur, Alum
23. Eczema, Scabies, prepare a wash with Realgar and Alum (Bai Fan) and apply topically on cloth.
24. Fungal Infection, Tinea, Mix a paste of Realgar with Coptis Huang Lian and apply. (TCM)
25. Herpes Zoster, Realgar is made into a tincture with Borneo Camphor for topical application
26. Mouth or Throat Sores or Ulcers, Realgar with Borax topically
27. Abdominal lumps, Realgar and Alum applied topically (Ben Cao Gang Mu)
28. Vaginal Swelling, Realgar, Alum, Licorice decocted, use as a wash. (Ben Cao Gang Mu)
29. Cervical Cancer, Realgar topically with Alum and Myrrh
30. Infected Wounds, Realgar with Yellow Lead topically (Ben Cao Gang Mu)
31. Head Sores, apply Realgar and Pig Bile. (Ben Cao Gang Mu)
32. Ear infection with discharge, Realgar with Sulphur applied topically
33. Red swollen nose, Realgar, sulphur, flour, (human) milk applied as a paste. (Ben Cao Gang Mu)
Major Formulas:
Niu Huang Jie Du Pian
Niu Huang Shang Qing Wan
An Gong Niu Huang Wan
Zhi Bao Dan
Dian She Wan
Liu Shen Wan
Cautions:
1. Very toxic. Avoid overdose. Do not heat as the fumes are extremely toxic. Toxic doses cause myocardial, gastrointestinal and renal damage.
2. Not used in Pregnancy, during Breastfeeding or the very young.
3. Not suitable for use in Yin deficiency due to its strong Heating nature.
4. Use cautiously in Hot constitutions although it is used for Fever and Hot Toxic conditions for short periods when combined with appropriate herbs.
5. Not suitable for long-term use. Arsenic is an accumulative poison, accumulating in the bones, skin, nails and hair. Tolerance develops with continued use. Should not be used for more than 2 weeks without a break.
6. Arsenic oxide is absorbed through the skin where its toxicity is about ten times greater. It should therefore not be used long term externally, nor should it be applied to large areas of skin.
7. Specimens that are red outside but white inside when crushed, or which contain white crystals within, should not be used as these contain arsenic trioxide.
Toxicity.
1. 125mg of unpurified (pure) Arsenic (not Realgar) has been reported to cause death in some people.
2. Acute Arsenic poisoning manifests with severe diarrhea, vomiting and prostration.
3. Chronic Arsenic poisoning (as seen in dyers and painters in the past) manifests with cough, nose and throat irritation, diarrhea, headache, skin eruption and tremors or paralysis.
4. Data on the sub-chronic toxicity in rats after 30 days of oral realgar administration and the accumulation and distribution of arsenic species
Antidotes:
NOTE: mild overdose can be treated with the following. Severe overdose requires urgent hospital care.
1. In modern TCM, a decoction of Mung Bean (100 grams) and Licorice (15 grams) is given.
2. Ayurveda treats overdose of Realgar by giving Milk (or water) with Honey for 3 days, while keeping on a wholesome diet.
3. Vomits were given if the can be take soon after administration: Butter in warm water, a decoction of Radish seed, or Milk mixed with Sweet Almond Oil was previously used in the west.
4. Milk can be liberally drunk, and reportedly helped avoid death.
5. A paste of Catechu in Milk, or repeated doses of Catechu in water is used for Arsenic poisoning. (Ayurveda)
6. Black Pepper is used in Ayurveda for Arsenic poisoning; ninety grains of the powder of Black Pepper is taken with 4 oz. of butter; or an infusion is taken.
7. Pine Kernel Oil is speedily given; (4 oz.–1 lb.) and then vomiting is procured. (De venenis, Petrus, 1487)
8. Herb Paris (True Love) or Viper flesh were both used for Arsenic poisoning in the West.
9. Salmon said a strong Lixivium of Sal. Regale or Tartar is taken as an antidote.
10. Bezoar gained a reputation for being an effective antidote.
11. In more modern time: Freshly made moist Ferric Hydroxide or large amounts of calcined Magnesia; emetics; Mucilaginous drinks, Olive or Carron Oils; stimulants if prostrated.
Main Preparations used:
Various preparations of arsenic compounds have been used.
GENERAL / REVIEW
–Mineral arsenicals in traditional medicines: Orpiment, realgar, and arsenolite
ANTI-CANCER
–Arsenic sulfide as a potential anti-cancer drug
NANOPARTICLE
–Enhanced antitumor activity of realgar mediated by milling it to nanosize
–Realgar, a traditional Chinese medicine, induces apoptosis of HPV16-positive cervical cells through a HPV16 E7-related pathway
–Properties of realgar bioleaching using an extremely acidophilic bacterium and its antitumor mechanism as an anticancer agent
–Effect of size and processing method on the cytotoxicity of realgar nanoparticles in cancer cell lines
–Realgar-induced apoptosis and differentiation in all-trans retinoic acid (ATRA)-sensitive NB4 and ATRA-resistant MR2 cells
–Arsenic in Cancer Treatment: Challenges for Application of Realgar Nanoparticles (A Minireview)
BRAIN
–Preparation and characterization of realgar nanoparticles and their inhibitory effect on rat glioma cells
BREAST
–Anticancer efficacies of arsenic disulfide through apoptosis induction, cell cycle arrest, and pro-survival signal inhibition in human breast cancer cells
GASTRIC
–Arsenic sulfide, the main component of realgar, a traditional Chinese medicine, induces apoptosis of gastric cancer cells in vitro and in vivo
LEUKEMIA
–Dissection of mechanisms of Chinese medicinal formula Realgar-Indigo naturalis as an effective treatment for promyelocytic leukemia
–Multicenter randomized trial of arsenic trioxide and Realgar‐Indigo naturalis formula in pediatric patients with acute promyelocytic leukemia: Interim results of the SCCLG‐APL clinical study
–Long-term outcome of 31 cases of refractory acute promyelocytic leukemia treated with compound realgar natural indigo tablets administered alternately with chemotherapy
LYMPHOMA
–Enhancing effects of indirubin on the arsenic disulfide-induced apoptosis of human diffuse large B-cell lymphoma cells
MYELOMA
–Realgar nanoparticles versus ATO arsenic compounds induce in vitro and in vivo activity against multiple myeloma