Shi Gao Tang, Gypsum Decoction

The seven ingredients in Shi Gao Tang

Shi Gao is a king ingredient in Shi Gao Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

1. Gypsum (Shi Gao)

Part used: The mineral itself

Nature: Cold

Taste(s): Pungent Sweet

Meridian affinity: Lung Stomach

Category: Herbs that clear Heat and purge Fire and/or clear Summer Heat

In general Shi Gao's main actions are as follows: "Clears Heat and drains Fire. Clears Lung Heat. Relieves thirst and restlessness. Clears Stomach Heat."

In the context of Shi Gao Tang, it is used because it is cold. It clears Heat and eliminates irritability.

Learn more about Gypsum (Shi Gao)

Ma Huang is a deputy ingredient in Shi Gao Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

2. Ephedra (Ma Huang)

Part used: Dried herbaceous stems

Nature: Warm

Taste(s): Bitter Pungent

Meridian affinity: Bladder Lung

Category: Warm/Acrid herbs that release the Exterior

In general Ma Huang's main actions are as follows: "Releases the surface through sweating. Promotes the circulation of Lung Qi and stop wheezing. Promotes urination."

In the context of Shi Gao Tang, it is used because it is strong and warm. It releases the Exterior by inducing sweating.

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Dan Dou Chi is a deputy ingredient in Shi Gao Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

3. Fermented Soybeans (Dan Dou Chi)

Part used: Fermented preparation obtain from the ripe bean

Nature: Cool

Taste(s): Bitter Pungent

Meridian affinity: Lung Stomach

Category: Cool/Acrid herbs that release the Exterior

In general Dan Dou Chi's main actions are as follows: "Relieves the Exterior and scatters Wind, Cold and Heat, especially when there is Yin Deficiency. Relieves stuffy sensation in the chest and irritability."

In the context of Shi Gao Tang, it is used because it releases the Exterior and relieves irritability.

Learn more about Fermented Soybeans (Dan Dou Chi)

Huang Lian is an assistant ingredient in Shi Gao Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

4. Goldthread Rhizomes (Huang Lian)

Part used: Dried rhizome

Nature: Cold

Taste(s): Bitter

Meridian affinity: Gallbladder Heart Large intestine Liver Spleen Stomach

Category: Herbs that clear Heat and dry Dampness

In general Huang Lian's main actions are as follows: "Expels Damp-Heat especially in the Lower Burner. Eliminates Fire toxicity especially when there is associated Dampness. Acts as a sedative by eliminating Heart Fire. Eliminates Stomach Fire. Expel parasites"

In the context of Shi Gao Tang, it is used because it is bitter and very cold and it excels at draining Heat and resolving Toxicity in the Interior.

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Huang Qin is an assistant ingredient in Shi Gao Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

5. Baikal Skullcap Roots (Huang Qin)

Part used: Dried root

Nature: Cold

Taste(s): Bitter

Meridian affinity: Gallbladder Heart Large intestine Lung Small intestine Spleen

Category: Herbs that clear Heat and dry Dampness

In general Huang Qin's main actions are as follows: "Expels Heat and Dampness. Clears Upper Burner Heat, especially of the Lung. Clears Heat and stops reckless movement of Blood. Clears pathogenic Heat which is upsetting the fetus. Cools the Liver, reducing Liver Yang rising syndrome."

In the context of Shi Gao Tang, it is used because it is bitter and very cold and it excels at draining Heat and resolving Toxicity in the Interior.

Learn more about Baikal Skullcap Roots (Huang Qin)

Huang Bo is an assistant ingredient in Shi Gao Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

6. Phellodendron Bark (Huang Bo)

Part used: Dried bark

Nature: Cold

Taste(s): Bitter

Meridian affinity: Bladder Kidney Large intestine

Category: Herbs that clear Heat and dry Dampness

In general Huang Bo's main actions are as follows: "Expels Damp-Heat in the Lower Burner. Clears Kidney Yin Deficient Heat. Applied externally or toxic Fire, especially associated with Dampness."

In the context of Shi Gao Tang, it is used because it is bitter and very cold and it excels at draining Heat and resolving Toxicity in the Interior.

Learn more about Phellodendron Bark (Huang Bo)

Zhi Zi is an assistant ingredient in Shi Gao Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

7. Cape Jasmine Fruits (Zhi Zi)

Part used: Dried ripe fruit

Nature: Cold

Taste(s): Bitter

Meridian affinity: Gallbladder Heart Lung Sanjiao

Category: Herbs that clear Heat and purge Fire and/or clear Summer Heat

In general Zhi Zi's main actions are as follows: "Clears Heat and calms spirit. Drains Damp-Heat affecting the Liver and Gallbladder. Clears Heat in the Blood and stops bleeding. Anti-inflammatory."

In the context of Shi Gao Tang, it is used because it is bitter and very cold and it excels at draining Heat and resolving Toxicity in the Interior.

Learn more about Cape Jasmine Fruits (Zhi Zi)

Conditions and patterns for which Shi Gao Tang may be prescribed

It's important to remember that herbal formulas are meant to treat patterns, not "diseases" as understood in Western Medicine. According to Chinese Medicine patterns, which are disruptions to the body as a system, are the underlying root cause for diseases and conditions.

As such Shi Gao Tang is used by TCM practitioners to treat two different patterns which we describe below.

But before we delve into these patterns here is an overview of the Western conditions they're commonly associated with:

Tonsilitis Pertussis Measles Pneumonia

Again it wouldn't be correct to say "Shi Gao Tang treats tonsilitis" for instance. Rather, Shi Gao Tang is used to treat patterns that are sometimes the root cause behind tonsilitis.

Now let's look at the two patterns commonly treated with Shi Gao Tang.

The Exterior in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Exterior in Chinese Medicine

Exterior-Heat

Pulse type(s): Rapid (Shu), Floating (Fu)

Symptoms: Fever Thirst Sweating Headaches Body aches Stiff neck Aversion to cold

Shi Gao Tang is sometimes prescribed by TCM practitioners to treat Exterior-Heat. This pattern leads to symptoms such as aversion to cold, fever, sweating and thirst. Patients with Exterior-Heat typically exhibit rapid (Shu) or floating (Fu) pulses.

This pattern is classified as ‘Exterior’ not because it derived from an external pathogenic factor but because its manifestations are located in the ‘Exterior’ of the body such as the skin, muscles and Channels.

The Defensive Qi reacts to the external Heat Evil and the battle between the two gives... read more about Exterior-Heat

The Interior in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Interior in Chinese Medicine

Wind Cold with Internal Heat

Pulse type(s): Overflowing (Hong), Rapid (Shu), Slippery (Hua)

Tongue coating: Yellow coating

Tongue color: Red

Symptoms: Thirst Red face Red eyes Insomnia Delirium Headaches Nosebleeds No sweating Strong fever Irritability Strong chills Coughing blood Dry nasal passages Blotches dotted over the skin General sensation of heaviness General sensation of tightness

Shi Gao Tang is sometimes prescribed by TCM practitioners to treat Wind Cold with Internal Heat. This pattern leads to symptoms such as strong fever, strong chills, no sweating and headaches. Patients with Wind Cold with Internal Heat typically exhibit overflowing (Hong), rapid (Shu) or slippery (Hua) pulses as well as a red tongue with yellow coating.

This pattern represents a complex condition where an External Cold invasion coexists with blazing Internal Heat. This pattern starts with cold damage, often marked by symptoms like fever and chills, absence of sweating, headache, and sensations of heaviness and tightness, indicating... read more about Wind Cold with Internal Heat