Shi Gao Tang石膏汤

Gypsum Decoction

Releasing Exterior and Interior Together 表里双解剂Release the Exterior and Clear the Interior 解表清里

Ingredients7 herbs

HerbDosageRoleWhat it does in this formula

石Shi Gao石膏Gypsum Fibrosum30 g君 ChiefClears blazing qi-level heat and quiets agitation 麻Ma Huang麻黄Herba Ephedrae9 g臣 DeputyOpens the closed exterior so heat has a way out through sweat 淡Dan Dou Chi淡豆豉Sojae Semen praeparatum9 g臣 DeputyLightly vents the exterior and eases the chest heat that keeps the patient awake 黄Huang Lian黄连Coptidis Rhizoma6 g佐 AssistantDrains fire from the middle burner and the Heart 黄Huang Qin黄芩Scutellariae Radix6 g佐 AssistantDrains fire from the upper burner and the Lung 黄Huang Bai黄柏Phellodendri Chinensis Cortex6 g佐 AssistantDrains fire from the lower burner 栀Zhi Zi栀子Gardeniae Fructus9 g佐 AssistantSweeps fire through all three burners and leads it out with the urine

Indications

Drains fire and resolves toxin in all three burnersClears blazing heat at the qi levelOpens the exterior and promotes sweating

An unresolved cold exterior with fire toxin flooding the interior— heat is trapped both outside and inside, so neither a purely diaphoretic nor a purely heat-clearing approach can reach it.

Clinical Manifestations

High fever with no sweating and aching, heavy limbs
Agitation with sleeplessness, delirious speech
Dry nose, red face, great thirst
Nosebleed or rash appearing at the height of the fever
Severe febrile illness where sweating alone has failed

TongueRed with dry yellow coating

PulseSlippery and rapid

Health Categories

Cognitive & Memory SupportImmune SupportCold & Flu Relief

Modern Applications

High fever Sepsis-like presentation Delirium Epistaxis Acute febrile illness

Common adjustments

Thirst and qi-level heat predominate — increase Shi Gao 石膏 and add Zhi Mu 知母
Rash or bleeding from heat entering the blood — add Sheng Di Huang 生地黄 and Mu Dan Pi 牡丹皮
Some sweating already present — reduce or omit Ma Huang 麻黄 and keep Dan Dou Chi 淡豆豉 as the lighter exterior-opening herb

Contraindications

Not for fever from deficiency, from yin depletion, or for anyone already sweating freely — the acrid-warm exterior herbs would drain fluids further. The bitter-cold core injures the Stomach, so it is a short-course formula only, stopped once the fever breaks.

For licensed practitioners’ reference only — not a self-treatment guide.

Pregnancy

Contraindicated in pregnancy — it combines Ma Huang with a heavy bitter-cold core. A febrile illness in pregnancy needs a practitioner's direct assessment, not this formula.

References

Source Wai Tai Mi Yao 《外台秘要》, citing Shen Shi Fang 《深师方》 · Tang

「今直用解毒汤则挛急不瘥，直用汗药则毒因加剧，而方无表里疗者，意思以三黄汤以救其内，有所增加以解其外。」
— 《外台秘要》引《深师方》(classical source, public domain)

Classical source (public domain), cited in the source-quote section.
2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
3. 《方剂学》（全国中医药行业高等教育规划教材）— pattern analysis cross-checked.

Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.