i "~ Journal of ETHNO PHARMACOI,OGY E k S E V I E R Journal of Ethnopharmacology49 (1995) 17-22 A report on the composition of mercurials used in traditional medicines in Oman A.D. Hardy *a, H.H. Sutherland a, R. Vaishnav b, M.A. Worthing a aCollege of Science, Sultan Qaboos University, Box 36. AI-Khod 123, Sultanate of Oman bCollege of Medicine, Sultan Qaboos University, Box 35, AI-Khod 123, Sultanate of Oman Received 21 November 1994; revision received 24 July 1995; accepted 4 August 1995 Abstract A brick red powder, used by a 'native physician' (a practitioner of traditional medicine in Oman) to treat a female patient for vitiligo, has been analysed by X-ray powder diffraction and scanning electron microscopy (S.E.M.). It was found to be a mixture of cinnabar (HgS) and calomel (Hg2C12). Symptoms of acute mercury poisoning resulted from the patient repeatedly breathing in elemental mercury vapour after this brick red powder and elemental mercury encas- ed in a lime, were thrown on an open fire in a closed room. The patient also presented with central nervous system toxicity which improved gradually after treatment with Dimercaprol was discontinued. The use of mercurials as tradi- tional medicines in Oman is briefly reviewed; as is the variation in literature values for 'normal'/'abnormal'/toxic levels of mercury in human blood. Keywords: Alternative medicine; Mercury poisoning; X-ray diffraction; Scanning electron microscopy 1. Introduction Mercury is one of the oldest industrial poisons. Its toxic properties have been well documented and the famous Mad Hatter of Alice in Wonderland is probably its most famous victim. It has been an important constituent of drugs for centuries as an ingredient in diuretics, an- tibacterials, antiseptic skin ointments and lax- atives. Mercurous chloride or calomel (Hg2C12), is still used in some skin creams. Mercuric ammoni- um chloride in skin lightening creams can cause fa- * Corresponding author. cial mercury pigmentation and elevated blood levels of mercury (Dyall-Smith and Scurry, 1990). The use of mercurials in modern medicine has been replaced by less toxic and more effective modes of therapy. However, they are still used ex- tensively in traditional and local medications in Asia and the Middle East. A recent study has shown that Chinese patent medicine available in North America contains calomel and cinnabar (red HgS). The use of these medicines can cause mercury poisoning (Kang and Oransky, 1992). The toxic potential of Chinese traditional patent medicines for children has been recognised and reference standards set for controlling the content 0378-8741/95/$09.50 © 1995 Elsevier Science Ireland Ltd. All rights reserved SSDI 0378-8741(95)01296-P