Shi Gao

What is Shi Gao?

Shi Gao (Gypsum Fibrosum) is a fibrous, white mineral composed mainly of hydrated calcium sulfate, mined and used in Chinese medicine since at least the Han Dynasty. In TCM it is classified as a cold, pungent, and sweet substance that enters the Lung and Stomach meridians to purge what practitioners call 'blazing heat.' It appears as the chief ingredient in some of the most famous classical fever formulas, including Bai Hu Tang (White Tiger Decoction).

How does Shi Gao work?

In traditional practice, Shi Gao is thought to work through several overlapping pathways: its calcium content may dampen nerve excitability and is believed to reduce the inflammatory signaling associated with fever. It is also thought to inhibit prostaglandin E2 production, though this mechanism has not been confirmed in rigorous clinical trials. Traditionally, it is also considered to promote fluid secretion in the Lung and Stomach, which may explain its long-standing use for thirst and dry, irritated mucous membranes during febrile illness.

What forms does Shi Gao come in?

Raw Shi Gao is almost always prepared by simmering broken chunks in water for 20–30 minutes before adding other herbs — the mineral does not release its active components well in a cold-water steep. Pre-made granules dissolve directly in hot water and are widely used in modern TCM clinics. Calcined Shi Gao powder is applied topically to weeping eczema, burns, and ulcers. Patent formula tablets (e.g., Bai Hu Tang concentrate) offer a convenient oral option.

Where it comes from:

Shi Gao is documented in the Shennong Bencao Jing, China's oldest herbal classic compiled roughly 2,000 years ago, where it is listed as a top-grade medicine for 'counteracting seasonal febrile disease.' The physician Zhang Zhongjing (c. 150–219 CE) cemented its central role in acute fever management through his landmark work Shang Han Lun, a text that still informs TCM practice today.

What does Shi Gao help with?

• High fever and heat illness: Shi Gao has traditionally been one of TCM's most prominent fever-clearing minerals, reserved in classical practice for high fevers with sweating, intense thirst, and a racing pulse. It is thought to reduce fever partly by influencing prostaglandin-driven temperature elevation, though this mechanism remains preliminary and has not been confirmed in rigorous clinical trials.
• Intense thirst and dry mouth: A hallmark traditional use for Shi Gao is the 'four bigs' syndrome in TCM: big fever, big sweat, big thirst, big pulse. The mineral is thought to promote fluid secretion and cool the Stomach, and practitioners have long used it to address the parched, intense thirst that accompanies serious febrile illness.
• Lung heat with cough and wheezing: When fever is accompanied by a dry, barking cough or breathlessness, Shi Gao is traditionally combined with herbs like Ma Huang and Xing Ren (as in Ma Xing Shi Gan Tang) to clear heat from the lungs and ease airway inflammation. This formula has a long history of use in pediatric respiratory complaints in traditional practice, though well-controlled clinical evidence remains limited.
• Stomach fire with toothache or gum pain: In TCM, 'Stomach fire' is traditionally understood to manifest as toothache, bleeding gums, bad breath, and burning epigastric pain. Shi Gao is directed at the Stomach channel and is a core ingredient in formulas like Yu Nu Jian, which practitioners have long used for these heat-excess oral and digestive complaints.
• Skin inflammation, eczema, and burns (topical): Calcined Shi Gao (Duan Shi Gao) powder has been used topically for centuries to dry weeping wounds, soothe burns, and reduce redness in eczema. Its astringent properties are thought to help protect damaged skin and support healing, and it continues to appear in traditional Chinese dermatology preparations, though clinical trial evidence is lacking.
• Headache with fever: Febrile headaches — especially those experienced as a hot, pounding, front-of-head pain — have long been a classical Shi Gao indication in traditional practice. It is typically paired with Zhi Mu and Gan Cao in classical formulas, with the intent of clearing heat and relieving the accompanying vascular pressure-type headache, though this use remains observational rather than clinically validated.
• Irritability and restlessness from heat: From a TCM perspective, excess heat in the body is traditionally understood to agitate the mind and cause restlessness, difficulty sleeping, and emotional irritability during illness. Practitioners have long used Shi Gao's heat-clearing action with the aim of addressing the root of this agitation, though this framework is traditional and has not been evaluated in clinical trials.
• Respiratory infections with high temperature: Shi Gao-containing formulas have a long history of traditional use for upper respiratory tract infections and febrile respiratory illness in Chinese medicine. While some preliminary and observational reports from China suggest possible benefit, robust, well-controlled clinical evidence confirming efficacy for fever duration or symptom severity in these conditions is not currently established.

What can Shi Gao help prevent?

• Progression of early-stage febrile illness to severe heat-stroke syndrome (within TCM practice, early use is traditionally considered preventive of escalation)

Which foods are rich in Shi Gao?

Shi Gao is a mineral — it is not found in food. However, a diet that supports 'cooling' and anti-inflammatory function can reinforce its effects. Prioritize: (1) Watermelon and cucumber — high water content, traditionally considered cooling foods in Chinese dietary therapy that support fluid replenishment during febrile illness; (2) Mung bean soup — a classic Chinese cooling food used alongside herbal fever formulas; (3) Peppermint tea — mild cooling and fever-dispersing qualities in Chinese food therapy; (4) White pear — moistens the Lung and Stomach, complementing Shi Gao's action in respiratory heat conditions; (5) Tofu — considered a neutral-to-cool food in TCM dietary practice that supports Stomach and Lung channels. Avoid hot, spicy, deep-fried, or heavily processed foods during treatment, as these are thought to add internal heat and work against Shi Gao's cooling purpose.

What are the side effects of Shi Gao?

• Digestive upset, nausea, or stomach discomfort: especially on an empty stomach
• Loose stools or diarrhea: from its cold nature and mineral load
• Excessive cooling: using it when no real heat condition is present can cause fatigue, chills, or worsened digestion
• Constipation: paradoxically possible in some individuals due to calcium content
• Kidney stress: prolonged or very high-dose use is not recommended in people with kidney disease due to calcium load

Good to know:

Shi Gao is considered safe for short-term use in appropriate doses and is classified as a top-grade, low-toxicity substance in classical Chinese pharmacopeia. The main risks come from overuse, prolonged use, or use in constitutionally cold or digestively weak individuals.

How much Shi Gao should you take?

• Recommended daily: 15–60 g of raw mineral per day in decoction (standard TCM clinical range); up to 120 g in severe acute fever under practitioner supervision. Pre-made granule equivalents vary by product — follow label. Topical calcined powder applied directly to skin 2–3 times daily as needed.
• Best time of day: Decoction is typically given warm, in 2–3 divided doses spread through the day during acute illness; not restricted to a specific time of day
• With or without food: Take with or after meals when possible to reduce digestive irritation; raw decoction is often taken warm between meals in acute settings
• Time to effect: Fever reduction: within hours to 1–2 days for acute use; skin healing: several days to 2 weeks for topical application
• How long to take it: Short-term use only — typically 3–7 days for acute fever conditions. Not intended for ongoing daily supplementation. Discontinue once fever and heat signs resolve. Always use under the guidance of a qualified TCM practitioner for correct pattern diagnosis.