Shi Gao

What Is Shi Gao (Gypsum)?

Shi Gao, listed as Gypsum Fibrosum, is not a plant but a mineral, consisting mainly of the crystalline form of calcium sulfate dihydrate. It is mined from white or colorless, fibrous, silky masses, which are crushed before use; the raw form is used in decoctions, while a calcined, powdered form is reserved mainly for external application. In English it is known as gypsum. In traditional practice it is one of the coldest and most important substances for clearing strong, blazing heat from the qi level, and it is considered heavy and descending in character.

TCM Properties and Actions

Shi Gao is very cold in nature, with sweet and acrid (pungent) flavors, and it enters the Lung and Stomach channels. It strongly clears Stomach and Lung fire, and it is traditionally used for profuse sweating, severe thirst, and a heavy chest.

In the traditional framework, its primary target is the yangming or qi-level heat pattern, in which a person has a high fever without chills, a flushed face, profuse sweating, an intense craving for cold fluids, a forceful pulse, and a red tongue with a thick coating. Shi Gao is used to drain that blazing heat directly. Through the Lung it is used for heat in the lung producing cough, wheezing, fever, and a feeling of fullness or pressure in the chest. Through the Stomach it addresses fire signs such as severe thirst, headache, swollen or painful gums, and mouth ulcers. It clears excess heat rather than nourishing the body, so it is not appropriate for cold or deficient patterns. These are classical pattern distinctions, not modern fever management advice.

Traditional Use and Common Combinations

For overwhelming qi-level heat with the four classic signs of high fever, profuse sweating, severe thirst, and a large forceful pulse, Shi Gao is classically paired with Zhi Mu, or anemarrhena, in a famous heat-clearing formula. For lung-heat wheezing with fever, it is combined with Ma Huang, apricot kernel, and licorice, where its cold nature balances the warm ephedra while both address the breathing pattern. After a fever when both qi and fluids have been damaged, it may appear with bamboo leaf and ophiopogon in a gentler, generating formula. As a mineral, it is always adjusted to the strength of the person and the pattern.

Safety, Contraindications, and Interactions

Shi Gao is contraindicated in cold stomach and weak spleen. Because it is extremely cold and heavy, it can further injure digestion in people who already have abdominal coldness and pain, poor appetite, persistent loose stools, or a pale, swollen tongue, and it should not be self-selected in such cases. It must be decocted first, meaning the crushed mineral is simmered before the other ingredients are added, so that its properties enter the liquid properly. Pregnant or breastfeeding women, children, older adults, and people taking chronic medication should consult a qualified practitioner; the calcined form is for external use and is not substituted for the raw form in decoction.

How TCM Practitioners Use It Today

The standard dosage is 15-60 grams, decoct first, with the amount chosen according to the severity of the heat pattern and the strength of the patient. Practitioners use the raw mineral internally in decoctions and granules and reserve calcined gypsum for topical, professionally directed applications. It is prescribed as part of a formula after the practitioner confirms true excess heat rather than a cold or deficient condition.

This content is for educational purposes only and does not substitute for medical advice, diagnosis, or treatment from a licensed clinician.

Frequently asked questions

Is Shi Gao safe during pregnancy? Pregnant or breastfeeding women should not use Shi Gao on their own because of its very cold nature. If a qualified practitioner who knows about the pregnancy judges it necessary, it should be used only in the prescribed dose and form, with the rest of the formula balancing its coldness.

Can Shi Gao replace prescription medication? No. Shi Gao is a traditional mineral substance used within pattern-based TCM formulas and cannot replace antipyretic, antibiotic, or other prescribed treatment for fever, infection, or any other illness. Do not stop or change medication without speaking with the prescribing clinician.

What is the difference between Shi Gao and Zhi Mu? Both are very cold and enter the Lung and Stomach, and they are a famous pair for severe heat with profuse sweating and intense thirst. Shi Gao is a heavy mineral whose strength is forcefully draining blazing excess fire; it acts quickly on outward, vigorous heat but does not nourish the body. Zhi Mu is a plant root that is bitter and sweet; while it clears fire, it also nourishes yin and generates fluids, so it is preferred when heat has damaged moisture, causing dry cough and persistent thirst, and it additionally addresses Kidney deficiency fire.