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Millwoods Acupuncture Center
102, 2603 Hewes Way
Edmonton AB,   Canada

Phone: (780) 466-8683




Chapter 4, Shigao series

Shigao, its English name is Gypsum, is a monoclinic mineral, the main chemical composition is calcium sulfate (CaSO 4).  It works to deplete fever from the body, a fever reducing herbal formula ingredient. Its fever reducing effect is much stronger than ordinary medications used by the western medicine, as better as the steroid medications. However, it has been found that highly purified calcium sulfate has no such fever-reducing effect. It is therefore suggested that its fever-reducing function might be due to some contaminated mineral in it.

Shigao clears the fever that is caused by strong body reaction to a Xieqi invasion in the deep side of the body. Such clinic conditions can been seen in acute inflammation and infectious disease, such as acute pneumonia, septicemia, dysentery, typhoid fever, scarlet fever, diphtheria, renal pelvis nephritis, etc.,

TCM doctor must learn how to use the Shigao in clinic. Otherwise he would not be able to work in a TCM emergency department.


(1). 白虎汤方

Baihu Tang

知母六两, 石膏(碎)一 斤,甘草(炙)二两, 粳米六合

Zhimu 90 gram, Shigao 248 gram, Gancao (processed) 30 gram, Genmi 124 gram.


Add the ingredients and 2500 ml water into a herbal pot until the Genmi is eatable. Remove the herbal residue. Drink 250 ml of the supernatant. Repeat three times a day.  

18  伤寒脉浮滑,此以表有热,里有寒,白虎汤主之。

If Cold-invasion Shanghan has floating and slippery pulse, it suggests the person has hot both inside and outside. [1] Herb Baihu Tang is used.

14  伤寒脉滑而厥者,里有热,白虎汤主之

If the person has Cold-invasion Shanghan disease and has slippery pulse, it suggests he has Fire inside of the body, use Baihu Tang. [2]

阴盛者属阴经,则下利为虚寒,即论中所谓少阴下利反发热不死,少阴下利清谷, 里寒外热,不恶寒而面赤者是也。盖阳与阳合,不合於阴,为三阳合病,则不下利而自汗出,乃白虎汤证也;阴与阴合,不合於阳,为三阴合病,则不发热而吐利厥逆,乃四逆汤证也。诚以人之藏府互根,阴阳相合,三阳既有合并之病,则三阴亦有合并之病,不待言矣。

If the condition shows more as Yin stages, the diarrhea belongs to weak Cold, as indicated in the book as Shaoyin diarrhea but with fever; as Shaoyin diarrhea with non-digested food in the stool; as cold inside but surface hot, the person has no chilly but the face is red in color. Usually if a Yang stage co-exists with another Yang stage, not with any Yin stage, it is the Yang co-exist condition. The person has no diarrhea but has sweat, indicating a Baihu Tang condition; if a Yin stage co-exists with another Yin stage, not with any Yang stage, it is Yin co-exist condition, the person has no fever, but nausea, diarrhea and has Jue condition, indicating a Sini Tang condition. This is because in the body, the Zang and Fu[3] organs are linked, associated functionally each other, if the three Yang stage (which is the disorder in the Fu, such as urine bladder – Taiyang; large intestine – Yangming; and gall bladder – Shaoyang) have disorder, the three Yin stage can have disorders at the same time. This is easy to understand.

06   三阳合病,腹满身重,难以转侧,口不仁,面垢,谵语,遗尿,发汗则谵语,下之则额上生汗,手足逆冷,若自汗出者 ,白虎汤主之。

In co-exist of Taiyang-Shaoyang-Yangming stages, one may feel fullness in Stomach, heavy in the body so that it is hard to turn the body, feel strange taste in mouth, has dark-dirty color on the face, Chattering syndrome, leak in the urine, and sweat. In this condition, use Baihu Tang[4]. If the sweat therapy is used, the person will have Chattering syndrome. If the bowel-cleansing therapy is used, he will have sweat on the front head and reverse-developing cold hands and feet.

22  形作伤寒,其脉不弦紧而数,数者必渴,被火者必谵语,数者,发热脉浮,解之当汗出愈[5](【注】若脉浮数,发热,解之当以汗,汗出可愈,宜大青龙汤。脉沉数发热,解之当以下,下之可愈,宜调胃承气汤。若脉数无表 证,惟发热而渴谵语者,不可汗下,宜白虎汤、黄连解毒汤,清之可也。)

The person’s condition appears as Shanghan disease. The pulse is not string and tight, but frequent. Person with a frequent pulse must have thirsty. The person will have also Chattering syndrome if he is roasted with fire. Person with the frequent pulse has hot and floating pulse too. Use sweat therapy. If the pulse is floating and frequent, the person has hot, use Da Qinglong Tang to create sweat therapy; if the pulse is deep and frequent, the person has hot, use Tiaowei Chengqi Tang to create a bowel-cleansing therapy; if the pulse is frequent but no Taiyang or Yangming inside condition, the person has only hot and thirsty and Chattering syndrome, use Baihu Tang, Huanglian Jiexu Tang to clear the Xieqi).

其温病、热病无汗者,宜大青龙汤;时无汗、时有汗者,宜桂枝二越婢一汤;有汗者,宜桂枝合白虎汤。内热者,防风通圣散。表实者,倍麻黄;里实者,倍大黄。量其病之轻重,药之多少而解之,三日之前,未有不愈者。其有外感邪重,内早伤阴,已经汗下而不愈者,则当审其表 ,随其传变所见之证,治之可也。此法惟西、北二方四时皆可行之,无不随手取效。若江淮间地偏暖处,冬月初春乃可用之。若春末秋前,即脉证允合,当用麻、桂、青龙等汤者,亦必轻而减之,随证消息,适可即止,慎不可过,过则反致变逆。经所谓同病异治者,此之谓也。

For person with Wenbing, if he has fever but no sweat, use Da Qinglong Tang; if he has sweat only from time to time, use Guizhi two Yuebi one Tang; if he has continuous sweat, use the combination of Guizhi Tang and Baihu Tang. If he has inside hot, use Fangfen Tongshen San. If the body surface condition is strong, double the amount of Mahuang; if the abdomen is hard and pain with difficult in bowel movement, double the amount of Dahuang. Adjust the amount of herb ingredients according to the severity of the disease. It should be solved within three days.

For person has had depletion of Yinye inside before a heavy attack of Xieqi from outside of the body, and if he has had a sweat therapy, or a bowel-cleansing therapy but has no improvement, pay attention to his body surface condition to use a proper treatment. This is the principle for person living in the north and west of China. It usually works well. For person who lives in the Yangzi River and Huai River in China, where the weather is warmer, such a principle in the treatment can be applied in winter and in early spring only. Between the later spring and autumn, use it only if the clinic condition and pulse match the use of Mahuang, Guizhi and Qinglong Tang but with less amounts. Don’t let it work over to cause various wrong-conditions. This is what the << Nei Jing >> said, the same disease also needs to be treated in a different way.


(2). 白虎加人参汤

Baihu jia Renshen Tang


Add herb Renshen 45 gram into the Baihu Tang. Cook and drink as Baihu Tang.

20 服桂枝汤,大汗出後,大烦渴不解,脉洪大者,白虎加人参汤主之。

After drinking of Guizhi Tang, if person has strong sweat, feels very annoyed, very thirsty and drinking water does not help to calm down the thirsty, pulse is big, Baihu jia Renshen Tang should be used.

13 伤寒,若汗[6]若吐若下後,七、八日不解,热结在里,表里俱热,时汗恶风,大渴,舌上乾燥而烦,欲饮水数升者,白虎加人参汤主之。

After sweat therapy, vomiting or bowel-cleansing therapy, if the Cold-invasion disease lasts for seven or eight days without improvement, and if the person still feel hot/fever, sweat and dislike-wind feeling from time to time, very thirsty, dry mouth, annoyed emotionally and willing to drink liters of water, herb Baihu jia Renshen Tang should be used mainly. [7]

10 伤寒,无大热,口燥渴,心烦,背微恶寒者,白虎加人参汤主之。

After drinking Guizhi Tang in a Cold-invasion, if person has strong sweat, feels very annoyed emotionally, very thirsty and drinking water that however does not help to calm down the thirsty, pulse is big, Baihu-jia-Renshen Tang should be used.

17 伤寒脉浮,发热无汗,其表不解,不可与白虎汤;渴欲饮水,无表证者,白虎加人参汤主之。

For Cold-invasion Shanghan stage, if the person feels hot, no sweat but his pulse is floating, it suggests that the Xieqi is still in the Taiyang stage[8]. Herb Baihu Tang should not be given. If he feels thirsty and wants to drink, and no signs for Taiyang stage, herb Baihu jia Renshen Tang is used mostly.

40 阳明病,脉浮而紧,咽燥口苦,腹满而喘,发热汗出,不恶寒反恶热,身重。若发汗则躁,心愦愦反? y。若加温 ,必怵惕烦躁不得眠。若下之,则胃中空虚,客气动膈,心中懊倄,舌上胎者,栀子豉汤主之。若渴欲饮水,口乾舌燥者,白虎加人参汤主之。若脉浮发热,渴欲饮水,小便不利者,猪苓汤主之。阳明病,汗出多而渴者,不可与猪苓汤,以汗多胃中燥,猪苓汤复利其小便故也。

In Yangming stage, if the person has floating and tight pulse, dry mouth and throat, fullness in Stomach and asthma, hot and sweat, no chilly but dislike hot, and heavy feeling in the body, sweat therapy will cause annoyed and irritable physically (due to depletion of Jingye); a warm therapy will cause annoyed emotionally and physically, and a phobia, scaring feeling; bowel-cleansing therapy will cause empty in the stomach, reverse pushing feeling to the diagram, annoyed in the upper stomach. For such complex condition, if the person has thick tongue covering, use Zhizi Zhi Tang; if he feel dry in mouth and want to drink water, use Baihu Tang jia Renshen Tang; if his pulse is floating and he feels hot, thirsty and want to drink, but has hard in urine, Zhuling Tang should be used. For Yangming stage, if person’s thirsty is due to big sweat, Zhuling Tang should not be given, because the sweat caused dryness in stomach, a depletion of Jingye in the body. The use of Zhuling Tang will further more deplete the Jingye to make the condition worse. 


If the Taiyang stage is caused by invasion of Hot (weather, or environment), it is called Ye disease. The person feels sweat and chilly, hot in the body and thirsty. Use Baihu jia Renshen Tang.

18  太阳中暍者,发热恶寒,身重而疼痛,其脉弦细芤迟,小便已,洒洒然毛耸,手足逆冷,小有劳,身即热,口开,前板齿燥。若发汗则恶寒甚,加温针则发热甚,数下之则淋甚。(宜以人叁白虎汤主治之。或人参汤调辰砂六一散亦可.中暍证禁用汗、下、温针)

With the Ye disease, the person feels fever and chilly, feels pain and heavy in the body. Pulse feels string, thin, and slow. After urination, he could feel as the hair on the body straight and has cold feeling in the hands and feet. Little bit labor work could makes him more hot feeling. With mouth open, the front teeth feel very dry. In this condition, sweat therapy could make him more chilly; hot needle acupuncture makes him more hot; and repeated bowel-cleansing therapy makes him feel pain and hot in the urine. [9]


If the person feels thirsty and want to drink water, feels dry in mouth, use Baihu jia Renshen Tang.


(3). 白虎加桂枝汤方

 Baihu jia Guizhi Tang

知母(六两), 甘草(二两,炙), 石膏(一斤), 粳米(二合), 桂枝(去皮,三两)

Zhimu 90 graml, Gancao (processed) 30 gram, Shigao 248 gram, Genmi 40 gram, Guizhi 45 gram.


Grind the herbs into powder. Add 6.5 gram of the powder and water 200 ml. Bring to boil and keep in mild boiling until there is 150 ml liquid left in the pot. Collect the herbal tea, drink the tea when it is warm to get sweat to solve the problem.


If the person feels hot/fever but no cold or chilly, feels pain in the (small) joints and nausea from time to time, and his pulse is normal, this condition is called Wennue[1]. Use Baihu jia Guizhi Tang

[1] Wen here means warm. Nue means malaria like disease. The Nue disease has Wennue (hot Nue disease and Hannue (cold Nue disease).

(4). 竹叶石膏汤方

Zhuye Shigao Tang

竹叶 二把,  石膏 一斤, 半夏(洗)半升, 人参二两, 甘草(炙)二两, 粳米半升, 麦冬(去心)一升

Zhuye 24 gram, Shigao 150 gram, Banxia (washed) 65 gram, Renshen 30 gram, Gancao (processed) 30 gram, Genmi 124 gram, Maidong (remove kernel) 250 gram.


Add the ingredients (except Genmi) and 2500 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 1500 ml liquid left. Remove the resides, add the Genmi into the collected herbal tea and continue to cook until the rise is eatable. Remove the rice, drink the herbal tea 250 ml each time, three times a day.

05 伤寒解後,虚羸少气,气逆欲吐,竹叶石膏汤主之。

After recovery from Shanghan disease, the person feels short of breath, weakness, nausea, willing to vomit, use Zhuye Shigao Tang. 



[1] In original version, it said the person has hot outside but cold inside with the floating-slippery pulse. Most later scholars believe that it might be a wrong written. Slippery pulse suggests hot, floating-slippery pulse indicates hot in both inside and outside.

[2] This is another kind of Jue condition – caused by pure Fire inside of the body, so Baihu Tang is used. If the Fire has developed deeper into Fullness Stomach condition (the person feels fullness and pain in whole stomach, hard in bowel movement), Chengqi Tang should be used. For such Baihu Tang condition, the person’s skin is cold when touch slightly, but warm when touch hard.

[3] In TCM, the body organs are separated into the non-hollow organs, called Shi organs, such as heart, lung, liver, kidney, and spleen, the hollow organs, such as small intestine, large intestine, gall bladder, urine bladder, and stomach. The hollow organs belong to Yang organ, and the non-hollow organs belong to Yin organ.

[4] If there is no sweat, Baihu Tang should not be used. If no sweat, use Huangqin Tang.

[5] 【按】三「弱」字,当俱是「数」字,若是「弱」字,热从何有?不但文义不属,且论中并无此说。

[6] In original version, there is no “sweat therapy”.

[7] Da Qinglong Tang is also for the hot in both body surface and inside in Taiyang stage, but more hot in the surface but less in the inside, so the person does not feel very thirsty. Baihu Tang is for hot/fever in the surface and inside in the Yangming stage, more hot in inside, so the person feels thirsty.  Here, the person feels hot, thirsty, sweat with dislike wind, all suggest the disease in both Taiyang (e.g. dislike wind) and Yangming stages, so the Baihu jia Renshen Tang is used. The addition of Renshen is to improve the defense system.

[8] If the disease is in both Taiyang stage (the person feels hot, not sweat, but the pulse is floating), and Yangming stage (very thirsty and madness), herb Da Qinglong Tang is needed. If he is in pure Yangming stage, and has thirsty, herb Baihu jia Rensheng Tang is used.

[9] Sweat, warm needle acupuncture, bowel cleansing therapy, all are commonly used therapies in Shanghan disease. Here the Master warms us to be careful in the distinguishment between the Shanghan disease and the Ye disease. They need different treatment principle.