中文摘要：

朱砂（96％HgS）和雄黄（90％As4S4）与其它中药配伍应用于临床已有上千年历史。但由于朱砂含汞，雄黄含砷，其安全性近年来引起了越来越多的关注。一般认为把已知的金属毒物用于医药中不可取，但也有不同的意见认为朱砂和雄黄有长期用药历史，临床有效，其毒副作用可耐受。含朱砂、雄黄的中药是药还是毒？本文就含朱砂和雄黄的中成药的研究进展作一综述，并提出（1）以总砷和总汞为标准进行评价含朱砂、雄黄中药的安全性不妥，（2）朱砂和雄黄的用药量和用药时间决定其毒性反应，（3）朱砂和雄黄是中药复方中的有效成分之一，应作深人研究来决定其取舍。

英文摘要：

Cinnabar（96% of HgS）and realgar（90% of As4S4）have been used in traditional Chinese medicines for thousands of years. Both mercury（Hg） and arsenic（As）are well-known toxic substances and the safety of cinnabar-and realgar-containing traditional Chinese medicines is of concern. It is presumed that any intentional use of known toxic metals in medicine is an unacceptable risk, but an opposing opinion holds that cinnabar and realgar have a long history of clear pharmacological utility with tolerable side effects. Are cinnabar-and/or realgar-containing Chinese medicines remedies or poisons？ This chapter summarizes recent progress of toxicological and pharmacological studies on this issue and highlights that（ 1 ）the use of total Hg and As for risk evaluation of cinnabar and realgar is inappropriate, （ 2 ） the right dose and duration of cinnabar and realer administration differentiate a remedy from a poison, and（3） cinnabar and realgar are active ingredients in Chinese medicines. The well-designed studies are needed to support or to reject their existence in traditional remedies.