石膏之质原为硫养轻钙化合而成，其性凉而能散，有透表解肌之力，为清阳明胃腑实热之圣药，无论内伤、
外感用之皆效，即他脏腑有实热者用之亦效。《神农本草经》原谓其微寒，其寒凉之力远逊于黄连、龙胆草、
知母、黄柏等药，而其退热之功效则远过于诸药。《神农本草经》谓其微寒，则性非大寒可知。且谓其宜于产
乳，其性尤纯良可知。
盖言其性不甚寒凉，可用于产后也。乃后世注《神农本草经》者，不知产乳之乳字原作生字解，而竟谓石
膏能治妇人无乳，支离殊甚。要知产后无外感之热，石膏原不可用。若确有外感实热，他凉药或在所忌，而独
不忌石膏，以石膏之性非大寒，乃微寒也。是以汉季张仲景所着《金匮》中有竹皮大丸，治妇人乳中虚、烦乱、
呕逆，中有石膏。夫乳中者，生子之时也，其烦乱呕逆必有外感之实热也，此实通《神农本草经》石膏主产乳
之义以立方也。
石膏医者多误认为大寒而 用之，则宣散之性变为收敛（点豆腐者必 用，取其能收敛也），以治外感有
实热者，竟将其痰火敛住，凝结不散，用至一两即足伤人，是变金丹为鸩毒也。迨至误用 石膏偾事，流俗之
见，不知其咎在 不在石膏，转谓石膏 用之其猛烈犹足伤人，而不 者更可知矣。于是一倡百和，遂视用石
膏为畏途，即有放胆用者，亦不过七八钱而止。夫石膏之质甚重，七
八钱不过一大撮耳。以微寒之药，欲用一大撮扑灭寒温燎原之热，又何能有大效。是以愚用生石膏以治外感实
热，轻证亦必至两许；若实热炽盛，又恒重用至四五两，或七八两，或单用，或与他药同用，必煎汤三四茶杯，
分四五次徐徐温饮下，热退不必尽剂。如此多煎徐服者，欲以免病家之疑惧，且欲其药力常在上焦、中焦，而
寒凉不至下侵致滑泻也。盖石膏生用以治外感实热，断无伤人之理，且放胆用之，亦断无不退热之理。惟热实
脉虚者，其人必实热兼有虚热，仿白虎加人参汤之义，以人参佐石膏亦必能退热。盖诸药之退热，以寒胜热也，
而石膏之退热，逐热外出也。是以将石膏煎服之后，能使内蕴之热息息自毛孔透出，且因其含有硫养轻，原具
发表之性，以之煮汤又直如清水，服后其寒凉之力俱随发表之力外出，而毫无汁浆留中以伤脾胃，是以遇寒温
之大热势若燎原，而放胆投以大剂白虎汤，莫不随手奏效。其邪实正虚者，投以白虎加人参汤，亦能奏效。
盖石膏之所以善治寒温者，原恃其原质中之硫养轻也。若 之，其硫养轻皆飞去，所余之钙经 即变质，
若误服之，能将人外感之痰火及周身之血脉皆为凝结锢闭。是以见有服 石膏数钱脉变结代，浸至言语不遂，
肢体痿废者；有服 石膏数钱其证变结胸，满闷异常，永不开通者；有服 石膏数钱其周身肌肉似分界限，且
又突起者。盖自有石膏 不伤胃之语，医者轻信其说以误人性命者实不胜计矣。故凡用生石膏者，宜买其整块
明亮者，自监视轧细（凡石质之药不轧细，则煎不透）方的。若购自药局中难辨其 与不 ，迨将药煎成，石
膏凝结药壶之底，倾之不出者，必系 石膏，其药汤即断不可服。
且尝历观方书，前哲之用石膏，有一证而用至十四斤者（见《笔花医镜》）；有一证而用至数十斤者
（见《吴鞠通医案》）；有产后亦重用石膏
者（见徐灵胎医案然须用白虎加人参汤以玄参代知母生山药代粳米）。然所用者皆生石膏也。
【附案】子××，七岁时，感冒风寒，四五日间，身大热，舌苔黄而带黑。孺子苦服药，强与之即呕吐不
止。遂单用生石膏两许，煎取清汤，分三次温饮下，病稍愈。又煎生石膏二两，亦徐徐温饮下，病又见愈。又
煎生石膏三两，徐徐饮下如前，病遂全愈。夫以七岁孺子，约一昼夜间，共享生石膏六两，病愈后饮食有加，
毫无寒中之弊，则石膏果大寒乎？抑微寒乎？此系愚初次重用石膏也。故第一次只用一两，且分三次服下，犹
未确知石膏之性也。世之不敢重用石膏者，何妨若愚之试验加多以尽石膏之能力乎？
同邑友人赵××之妻，年近六旬得温病，脉数而洪实，舌苔黄而干，闻药气即呕吐。俾单用生石膏细末六
两，以作饭小锅（不用药甑，恐有药味复呕吐）煎取清汤一大碗，恐其呕吐，一次只温饮一口，药下咽后，觉
烦躁异常，病家疑药不对证。愚曰∶“非也，病重药轻故也”，饮至三次，遂不烦躁，阅四点钟尽剂而愈。
同邑友人毛××之三子××，年三十二岁，素有痰饮，得伤寒证，服药调治而愈。后因饮食过度而复，服
药又愈。后数日又因饮食过度而复，医治无效。四五日间，延愚诊视，其脉洪长有力，而舌苔淡白，亦不燥渴，
食梨一口即觉凉甚，食石榴子一粒，心亦觉凉。愚舍证从脉，为开大剂白虎汤方，因其素有痰饮，加清半夏数
钱，其表兄高××在座，邑中之宿医也，疑而问曰∶“此证心中不渴不热，而畏食寒凉如此，以余视之虽清解
药亦不宜用，子何所据而用生石膏数两乎？”答曰∶“此脉之洪实，原是阳明实热之证，其不觉渴与热者，因
其素有痰饮湿胜故也。其畏食寒凉者，因胃中痰饮与外感之热互相胶漆，致胃府转从其化与凉为敌也。”毛××
素晓医学，信用愚言，两日夜间服药十余次，共享生石膏斤余，脉始和平，愚遂旋里。隔两日复来相
迎，言病患反复甚剧，形状异常，有危在顷刻之虑。因思此证治愈甚的，何至如此反复。既至（相隔三里强），
见其痰涎壅盛，连连咳吐不竭，精神恍惚，言语错乱，身体颤动，诊其脉平和无病，惟右关胃气稍弱。愚恍然
会悟，急谓其家人曰∶“此证万无闪失，前因饮食过度而复，此次又因戒饮食过度而复也。”其家人果谓有鉴
前失，数日之间，所与饮食甚少。愚曰∶“此无须用药，饱食即可愈矣。”其家人虑其病状若此，不能进食。
愚曰∶“无庸如此多虑，果系由饿而得之病，见饮食必然思食。”其家人根据愚言，时已届晚八句钟，至黎明进
食三次，每次撙节与之，其病遂愈。
友人毛××妻，年近七旬，于正月中旬，伤寒无汗。原是麻黄汤证，因误服桂枝汤，汗未得出，上焦陡觉烦
热恶心，闻药气即呕吐，但饮石膏所煮清水及白开水亦呕吐。惟昼夜吞小冰块可以不吐，两日之间，吞冰若干，
而烦热不减，其脉关前洪滑异常。俾用鲜梨片，蘸生石膏细末嚼咽之，遂受药不吐，服尽二两而病愈。
一人患梅毒，在东人医院治疗二十余日，头面肿大，下体溃烂，周身壮热，谵语不省人事，东人谓毒已走
丹不可治。其友人孙××，邀愚往东人院中为诊视。疑其证夹杂温病，遂用生石膏细末半斤，煮水一大瓶，伪作
葡萄酒携之至其院中，托言探友，盖不欲东人知为疗治也。及入视病患，其头面肿而且红，诊其脉洪而实，知
系夹杂温病无疑，嘱将石膏水徐徐温服。翌日，又往视，其头面红肿见退，脉之洪实亦减半，而较前加数，仍
然昏愦谵语，分毫不省人事。所饮石膏之水尚余一半，俾自购潞党参五钱，煎汤兑所余之石膏水饮之。翌日，
又往视之，则人事大清，脉亦和平。病患遂决意出彼院来院中调治，后十余日其梅毒亦愈。此证用潞党参者，
取其性平不热也。
一人，年五十，周身发冷，两腿疼痛。医者投以温补之药，其冷益甚，欲作寒战。诊其脉，甚沉伏，重按
有力。其舌苔黄浓，小便赤涩。当时仲春，知其春温之热，郁于阳明而未发，故现此假象也。欲用白虎汤加连
翘治之，病患闻之，骇然。愚曰∶但预购生石膏四两，迨热难忍时，煎汤饮之可乎？病者曰∶恐无其时耳。愚
曰∶若取鲜白茅根，煎汤饮之，则冷变为热，且变为大热矣。病者仍不确信，然欲试其验否，遂剖取鲜白茅根，
去净皮，细锉一大碗，煮数沸，取其汤，当茶饮之。有顷热发，若难忍。须臾再诊其脉，则洪大无伦矣。愚将
所预购之四两生石膏煎汤，分三次温饮下，其热遂消。
石膏之性，又善清瘟疹之热（参阅清疹汤后附案），又善清头面之热（参阅青盂汤后附案），又善清咽喉
之热（参阅“详论咽喉证治法”所载治沧州友人董××一案）。
外感痰喘，宜投以《金匮》小青龙加石膏汤。若其外感之热，已入阳明之府，而小青龙中之麻、桂、姜、
辛诸药，实不宜用。曾治刘××，年八岁。孟秋患温病，医治十余日，病益加剧。表里大热，喘息迫促，脉象
洪数，重按有力，知犹可治。问其大便，两日未行，投以大剂白虎汤，重用生石膏二两半，用生山药一两以代
方中粳米。且为其喘息迫促、肺中伏邪，又加薄荷叶一钱半以清之。俾煎汤两茶盅，作两次温饮下，一剂病愈
强半，又服一剂全愈。
从来产后之证，最忌寒凉。而果系产后温病，心中燥热，舌苔黄浓，脉象洪实，寒凉亦在所不忌。然所用
寒凉之药，须审慎斟酌，不可漫然相投也。愚治产后温证之轻者，其热虽入阳明之府，而脉象不甚洪实，恒重
用玄参一两，或至二两，辄能应手奏效。若系剧者，必用白虎加人参汤方能退热。然用时须以生山药代粳米，
玄参代知母，方为稳妥。医方篇中白虎加人参以山药代粳米汤下附有验案可参观。盖以石膏、玄参，《神农本
草经》皆明言其
治产乳，至知母条下则未尝言之，不敢师心自用也。
友人毛××曾治一少妇，产后十余日，周身大热，无汗，心中热，而且渴。延医调治，病势转增。甚属危
急。毛××诊其脉，甚洪实，舌苔黄而欲黑，撮空摸床，内风已动。治以生石膏三两，玄参一两，野台参五钱，
甘草二钱。为服药多呕，取竹皮大丸之义，加竹茹二钱，煎汤一大碗，徐徐温饮下，尽剂而愈。观此案，则外
感之热，直如燎原，虽在产后，岂能从容治疗乎？孙思邈曰∶智欲圆而行欲方，胆欲大而心欲小。世俗医者，
遇此等证，但知心小，而不知胆大。岂病患危急之状，漠不关于心乎？
在女子有因外感之热内迫，致下血不止者，亦可重用白虎加人参汤治之。邻村李氏妇，产后数日，恶露
已尽，至七八日，忽又下血。延医服药，二十余日不止，其脉洪滑有力，心中热而且渴。疑其夹杂外感，询之
身不觉热，舌上无苔，色似微白，又疑其血热妄行，投以凉血兼止血之药，血不止而热渴亦如故。因思此证实
夹杂外感无疑，遂改用白虎加人参汤，方中生石膏重用三两，更以生山药代粳米煎汤三盅，分三次温饮下，热
渴遂愈，血亦见止。又改用凉血兼止血之药而愈。
痢证身热不休，服一切清火之药，而热仍不休者，方书多诿为不治。夫治果对证，其热焉有不休之理？
此乃因痢证夹杂外感，其外感之热邪，随痢深陷，弥漫于下焦经络之间，永无出路，以致痢为热邪所助，日甚
一日而永无愈期。夫病有兼证，即治之宜有兼方也，斯非重用生石膏更助以人参以清外感之热不可（通变白虎加
人参汤后载有治王××验案可参阅）。
表兄张××之妻高氏。年五十余，素多疾病。于季夏晨起偶下白痢，至暮十余次，秉烛后，忽然浑身大热，
不省人事，循衣摸床，呼之不应。其脉洪而无力，肌肤之热烙手。知其系气分热
痢，又兼受暑，多病之身不能支持，故精神昏愦如是也。急用生石膏三两、野党参四钱，煎汤一大碗，徐徐温
饮下。至夜半尽剂而醒，痢亦遂愈，诘朝煎渣再服，其病脱然。
上所载痢证医案，皆兼外感之热者也。故皆重用生石膏治之，非概以其方治痢证也。拙着《衷中参西录》
中，治痢共有七方，皆随证变通用之，确有把握，前案所用之方，乃七方之一也。愚用此方治人多矣，脉证的
确，用之自无差忒也。
疟疾虽在少阳，而阳明兼有实热者，亦宜重用生石膏。曾治邻村李××，年四十许，疟疾间日一发，热时
若燔，即不发之日亦觉表里俱热，舌燥口干，脉象弦长，重按甚实。此少阳邪盛，阳明热盛，疟而兼温之脉也。
投以大剂白虎汤加柴胡三钱，服后顿觉清爽。翌晨疟即未发，又煎服前剂之半，加生姜三钱，温、疟从此皆愈。
至脉象虽不至甚实，而按之有力，常觉发热懒食者，愚皆于治疟剂中，加生石膏两许以清之，亦莫不随手奏效也。
石膏之性，又善治脑漏。方书治脑漏之证，恒用辛夷、苍耳。然此证病因，有因脑为风袭者，又因肝移热
于脑者。若因脑为风袭而得，其初得之时，或可用此辛温之品散之，若久而化热，此辛温之药即不宜用，至为
肝移热于脑，则辛温之药尤所必戒也。近治奉天郭××，得此证半载不愈。鼻中时流浊涕，其气腥臭，心热神昏，恒
觉眩晕。其脉左右皆弦而有力，其大便恒干燥，知其肝移热于脑，其胃亦移热于脑矣。恐其病因原系风袭，先与西
药阿斯匹林瓦许以发其汗，头目即觉清爽，继为疏方，用生石膏两半，龙胆草、生杭芍、玄参、知母、花粉各四钱，
连翘、金银花、甘草各二钱，薄荷叶一钱。连服十剂，石膏皆用两半，他药则少有加减，其病遂脱然全愈。
石膏的质地原本是由硫、氧、轻钙化合而成的，其性质凉而能发散，具有透达肌表、解除肌邪的力量，是清除阳明胃腑实热的圣药，无论是内伤还是外感疾病，使用它都有效，即使是其他脏腑有实热证，使用它也有效。《神农本草经》原来说它微寒，它的寒凉力量远远比不上黄连、龙胆草、知母、黄柏等药物，但它退热的功效却远远超过这些药物。《神农本草经》说它微寒，可知其性质并非大寒。并且说它适宜于产后（产乳），可知其性质尤为纯良温和。
大概是指它的性质不十分寒凉，所以可以用于产后。然而后世注释《神农本草经》的人，不知道“产乳”的“乳”字原作“生”字解释，竟然说石膏能治疗妇人没有乳汁，这种说法荒谬至极。要知道产后如果没有外感的热邪，石膏原本是不可用的。如果确实有外感实热，其他的凉药或许有所禁忌，唯独不忌石膏，因为石膏的性质不是大寒，而是微寒。所以在汉末张仲景所著的《金匮要略》中有竹皮大丸，治疗妇人在生产期间虚损、心烦意乱、呕吐逆气，方中含有石膏。所谓“乳中”，就是生产的时候，此时的心烦呕吐逆气必定是有外感的实热，这实际上是通晓《神农本草经》中石膏主治产后生产的含义来组方的。
医生们大多误认为石膏是大寒之药而不敢用，或者用了之后，其宣散的性质变成了收敛（点豆腐必须用石膏，就是取它能收敛的特性），用来治疗外感有实热的人，竟然把痰火收敛住，凝结不散，用到一两就足以伤人，这是把金丹变成了毒药。等到误用石膏导致事情败坏后，世俗的看法，不知道过错在于是否使用了石膏，反而说石膏如果使用得当，其猛烈程度还足以伤人，而不使用它就更不用说了。于是一唱百和，于是把使用石膏视为畏途，即使有大胆使用的人，也不过只用七八钱罢了。石膏的质地很重，七八钱不过是一大撮而已。用微寒的药，想用一大撮去扑灭像燎原大火一样的寒温病高热，又怎么会有大的疗效呢？所以我用生石膏治疗外感实热，轻症也必须要用到一两；如果实热炽盛，常常重用至四五两，或七八两，或者单用，或者与其他药物同用，一定要煎成三四茶杯的汤，分四五次慢慢温热服下，热退了就不必喝完所有的药。这样多煎煮、慢慢服用的目的，是为了免除病人的疑虑和恐惧，而且希望药力常停留在上焦、中焦，而寒凉之气不至于向下侵袭导致滑肠腹泻。大概生石膏用于治疗外感实热，绝对没有伤人的道理，而且大胆使用，也绝对没有不退热的道理。只有那些热象实证但脉象虚弱的病人，其人必定是实热兼有虚热，仿照白虎加人参汤的意义，用人参辅助石膏，也一定能退热。大概各种药物的退热，是以寒胜热，而石膏的退热，是将热邪驱逐出体外。所以将石膏煎服之后，能使体内蕴积的热气通过毛孔一丝丝透出，而且因为它含有硫、氧、轻钙，原本具有发表的性质，用它煮汤又直如清水，服用后其寒凉之力都随着发表之力外出，而毫无汁浆留在中间损伤脾胃，所以遇到寒温病的大热势如燎原时，大胆投以大剂量的白虎汤，没有不随手奏效的。对于邪实正虚的病人，投以白虎加人参汤，也能奏效。
大概石膏之所以善于治疗寒温病，原本依靠的是其原质中的硫、氧、轻钙。如果煅烧石膏，其中的硫、氧、轻钙都会飞散消失，剩下的钙经过煅烧就变质了，如果误服煅石膏，能将人外感的痰火及周身血脉都凝结锢闭。所以见到有人服用煅石膏几钱后脉象变得结代，逐渐发展到言语不利，肢体痿废的；有服用煅石膏几钱后病症变成结胸，满闷异常，永远不通畅的；有服用煅石膏几钱后周身肌肉似乎有了界限，并且又突起的。自从有人说煅石膏不伤胃的话以来，医生们轻信这种说法而误人性命的实在数不胜数啊。所以凡是使用生石膏的人，应该购买整块明亮的，自己监督轧细（凡是石质的药物如果不轧细，就煎不透）才放心。如果从药局购买，难以辨别是否煅过，等到药煎好后，石膏凝结在药壶底部，倒不出来的，一定是煅石膏，这种药汤绝对不可服用。
而且我曾经遍观方书，前贤使用石膏，有一个证候用到十四斤的（见《笔花医镜》）；有一个证候用到几十斤的（见《吴鞠通医案》）；有产后也重用石膏的（见徐灵胎医案，但须用白虎加人参汤，以玄参代替知母，生山药代替粳米）。然而所使用的都是生石膏。
【附案】我的儿子××，七岁时，感冒风寒，四五天间，身体大热，舌苔黄而带黑。小孩子苦于服药，强行给他喝就呕吐不止。于是单用生石膏一两许，煎取清汤，分三次温热饮下，病稍好。又煎生石膏二两，也慢慢温热饮下，病又见好转。又煎生石膏三两，慢慢饮下如同之前，病就全好了。对于一个七岁的孩子，大约一昼夜之间，共用生石膏六两，病愈后饮食增加，完全没有寒中之弊，那么石膏究竟是大寒呢？还是微寒呢？这是我初次重用石膏的案例。所以第一次只用一两，且分三次服下，当时还不确定石膏的性质。世上不敢重用石膏的人，何妨像我一样试验多加剂量以穷尽石膏的能力呢？
同乡朋友赵××的妻子，年近六十得温病，脉数而洪实，舌苔黄而干，闻到药气就呕吐。让她单用生石膏细末六两，用做饭的小锅（不用药甑，恐怕有药味再次引起呕吐）煎取清汤一大碗，怕她呕吐，一次只温热饮一口，药咽下去后，觉得烦躁异常，家属怀疑药不对症。我说：“不是这样，是病重药轻的缘故。”饮到三次，就不再烦躁了，过了四个小时喝完所有药而痊愈。
同乡朋友毛××的第三个儿子××，三十二岁，素有痰饮，得了伤寒证，服药调理而愈。后来因为饮食过度又复发，服药又好。几天后又因饮食过度复发，医治无效。四五天间，请我诊治，脉象洪长有力，但舌苔淡白，也不燥渴，吃一口梨就觉得非常凉，吃一粒石榴子，心里也觉得凉。我舍证从脉，为他开了大剂白虎汤方，因为他素有痰饮，加了清半夏几钱。他的表哥高××在座，是县里的老医生，怀疑地问：“这个证心中不渴不热，却如此畏惧食用寒凉之物，在我看来虽然清解药也不宜用，你凭什么用生石膏几两呢？”回答说：“这个脉象洪实，原是阳明实热的证候，他不觉得渴与热，是因为他素有痰饮湿胜的缘故。他畏惧食用寒凉之物，是因为胃中的痰饮与外感的热互相胶结，导致胃府转而顺从其化，与凉性为敌。”毛××素来懂医学，信任我的话，两天夜里服药十几次，共用生石膏一斤多，脉象才开始平和，我就回家了。隔两天他又来迎接，说病患反复很剧烈，形状异常，有危在旦夕的忧虑。我想这个证治愈得很确切，怎么会如此反复。到了那里（相隔三里强），看见他痰涎壅盛，连连咳吐不停，精神恍惚，言语错乱，身体颤动，诊他的脉平和无病，只有右关胃气稍弱。我突然恍然大悟，急忙对他的家人说：“这个证绝对不会有闪失，之前是因为饮食过度而复发，这次又是因为戒断饮食过度而复发的。”他的家人果然说有鉴于之前的失误，几天之间，给他的饮食很少。我说：“这不需要用药，吃饱就可以好了。”他的家人担心他病状如此，不能进食。我说：“不用如此多虑，如果是由于饥饿得的病，见到食物必然想吃。”他的家人根据我的话，当时已经是晚上八点，到黎明进食三次，每次节制地给他，病就好了。
友人毛××的妻子，年近七十，在正月中旬，伤寒无汗。原本是麻黄汤证，因为误服桂枝汤，汗没有出来，上焦突然觉得烦热恶心，闻到药气就呕吐，只喝石膏煮的清水和白开水也呕吐。只有昼夜吞食小冰块可以不吐，两天之间，吞冰若干，而烦热不减，脉象关前洪滑异常。让他用鲜梨片，蘸生石膏细末嚼咽，于是受药不吐，服完二两而病愈。
一人患梅毒，在东人医院治疗二十多天，头面肿大，下体溃烂，周身壮热，谵语不省人事，东人说毒已走丹，不可治。他的朋友孙××，邀请我去东人院中诊治。怀疑他的证夹杂温病，于是用生石膏细末半斤，煮水一大瓶，伪装成葡萄酒携带到他的院中，托言探友，盖不想让东人知道是在治疗。等到进去看病患，他头面肿而且红，诊他的脉洪而实，知道是夹杂温病无疑，嘱咐慢慢温热服用石膏水。第二天，又去查看，他头面红肿见退，脉的洪实也减半，但比以前更数，仍然昏愦谵语，分毫不省人事。所喝的石膏水还剩一半，让他自己去买潞党参五钱，煎汤兑入剩余的石膏水饮用。第二天，又去查看，则人事大清，脉也和平。病患遂决定出院到我这里调治，后十余日他的梅毒也好了。这个证用潞党参，是取其性质平和不热的缘故。
一人，五十岁，周身发冷，两腿疼痛。医生投以温补的药物，他的冷更加厉害，想要作寒战。诊他的脉，甚沉伏，重按有力。他的舌苔黄浓，小便赤涩。当时是仲春，知道是春温的热，郁于阳明而未发，所以出现这种假象。想用白虎汤加连翘治疗，病患听了，骇然。我说：“只要预先购买生石膏四两，等到热难忍时，煎汤饮用可以吗？”病者说：“恐怕没到时候吧。”我说：“如果取鲜白茅根，煎汤饮用，那么冷就会变为热，而且会变为大热。”病者仍不相信，但想试试是否灵验，于是剖取鲜白茅根，去掉皮，切碎一大碗，煮几沸，取它的汤，当茶饮。过了一会儿热发，若难忍。一会儿再诊他的脉，则洪大无比了。我将预先购买的四两生石膏煎汤，分三次温热饮下，热就消了。
石膏的性质，又善于清瘟疹的热（参阅清疹汤后附案），又善于清头面的热（参阅青盂汤后附案），又善于清咽喉的热（参阅“详论咽喉证治法”所载治疗沧州友人董××一案）。
外感痰喘，适宜投以《金匮》小青龙加石膏汤。如果外感的热，已经入阳明之腑，而小青龙中的麻黄、桂枝、生姜、细辛诸药，实在不宜用。曾治疗刘××，八岁。孟秋患温病，医治十多天，病更加加剧。表里大热，喘息迫促，脉象洪数，重按有力，知道还可以治。问他的二便，两天未行大便，投以大剂白虎汤，重用生石膏二两半，用生山药一两代替方中的粳米。而且因为他喘息迫促、肺中伏邪，又加薄荷叶一钱半以清之。让他煎汤两茶盅，分两次温热饮下，一剂病好大半，又服一剂全愈。
从来产后之证，最忌寒凉。但如果果真是产后温病，心中燥热，舌苔黄浓，脉象洪实，寒凉也在所不忌。然而所用的寒凉药物，须审慎斟酌，不可随意投用。我治疗产后温证的轻者，其热虽入阳明之腑，但脉象不甚洪实，常常重用玄参一两，或至二两，就能应手奏效。如果是剧者，必须用白虎加人参汤才能退热。然而使用时须以生山药代替粳米，玄参代替知母，方为稳妥。医方篇中白虎加人参以山药代粳米汤下附有验案可参观。大概石膏、玄参，《神农本草经》都明确说它们治产乳，至于知母条下则未曾提及，不敢师心自用。
友人毛××曾治疗一少妇，产后十多天，周身大热，无汗，心中热，而且渴。延医调治，病势转增。甚属危急。毛××诊她的脉，甚洪实，舌苔黄而欲黑，撮空摸床，内风已动。治疗用生石膏三两，玄参一两，野台参五钱，甘草二钱。因为服药多呕吐，取竹皮大丸的意义，加竹茹二钱，煎汤一大碗，慢慢温热饮下，喝完所有药而痊愈。看这个案例，外感的热，直如燎原，即使在产后，难道能从容治疗吗？孙思邈说：智欲圆而行欲方，胆欲大而心欲小。世俗的医生，遇到这种证，只知心小，而不知胆大。难道病患危急的状况，漠不关心于心吗？
在女子有因外感的热内迫，导致下血不止的，也可以重用白虎加人参汤治疗。邻村李氏妇，产后几天，恶露已尽，到七八天，忽然又下血。延医服药，二十多天不止，脉洪滑有力，心中热而且渴。怀疑她夹杂外感，询问她身不觉热，舌上无苔，色似微白，又怀疑她是血热妄行，投以凉血兼止血的药，血不止而热渴也如故。心想这个证实夹杂外感无疑，于是改用白虎加人参汤，方中生石膏重用三两，更以生山药代替粳米煎汤三盅，分三次温热饮下，热渴遂愈，血也见止。又改用凉血兼止血的药而愈。
痢证身热不休，服一切清火的药，而热仍不休的，方书多推诿为不治。如果治疗果对症，那热怎么有不休的道理？这是因为痢证夹杂外感，外感的热邪，随痢深陷，弥漫于下焦经络之间，永无出路，以致痢为热邪所助，日益严重而永无痊愈期。病有兼证，治疗就应该有兼方，这不是重用生石膏更辅以人参以清外感的热不可（通变白虎加人参汤后载有治疗王××验案可参阅）。
表兄张××的妻子高氏。五十多岁，素多疾病。在季夏晨起偶下白痢，到傍晚十多次，秉烛后，忽然浑身大热，不省人事，循衣摸床，呼之不应。脉洪而无力，肌肤的热烙手。知道她是气分热痢，又兼受暑，多病之身不能支持，所以精神昏愦如此。急用生石膏三两、野党参四钱，煎汤一大碗，慢慢温热饮下。到半夜喝完所有药而醒，痢也遂愈，第二天早上煎药渣再服，病就脱然痊愈。
上面所载的痢证医案，都是兼外感的热。所以都重用生石膏治疗，不是概以其方治痢证。拙著《衷中参西录》中，治痢共有七方，都是随证变通用之，确有把握，前案所用的方，乃是七方之一。我用此方治人多矣，脉证的确，用之自然无差错。
疟疾虽然在少阳，而阳明兼有实热的，也宜重用生石膏。曾治疗邻村李××，四十岁左右，疟疾间日一发，热时如火烧，即不发之日也觉表里俱热，舌燥口干，脉象弦长，重按甚实。这是少阳邪盛，阳明热盛，疟而兼温的脉。投以大剂白虎汤加柴胡三钱，服后顿觉清爽。第二天早晨疟即未发，又煎服前剂的半量，加生姜三钱，温疟从此皆愈。至于脉象虽不至甚实，但按之有力，常觉发热懒食的，我都于治疟剂中，加生石膏一两许以清之，也没有不随手奏效的。
石膏的性质，又善于治脑漏。方书治脑漏的证，常用辛夷、苍耳。但这个证病因，有因脑为风袭的，又有因肝移热于脑的。如果因脑为风袭而得，初得之时，或许可以用此辛温之品散之，如果久而化热，此辛温的药就不宜用，至于因肝移热于脑，则辛温的药尤其必须戒除。最近治疗奉天郭××，得此证半年不愈。鼻中时常流浊涕，气味腥臭，心热神昏，常觉眩晕。脉左右皆弦而有力，大便常干燥，知道他是肝移热于脑，胃也移热于脑了。恐怕病因原系风袭，先给西药阿斯匹林瓦许以发其汗，头目即觉清爽，继为疏方，用生石膏一两半，龙胆草、生杭芍、玄参、知母、花粉各四钱，连翘、金银花、甘草各二钱，薄荷叶一钱。连服十剂，石膏都用一两半，其他药则少有加减，病就脱然全愈。
The substance of Gypsum Fibrosum (Shigao, 石膏) is originally formed by the combination of sulfur, oxygen, and light calcium. Its nature is cool and dispersing, possessing the power to penetrate the exterior and release the muscle layer. It is the supreme medicine for clearing excess heat in the Yangming Stomach Fu organ. Whether used for internal injury or external contraction, it is effective; even if there is excess heat in other Zang-Fu organs, it remains effective. The *Shennong Bencao Jing* (Divine Farmer's Materia Medica) originally states that it is slightly cold. Its cooling power is far inferior to that of Coptidis Rhizoma (Huanglian, 黄连), Gentianae Radix (Longdancao, 龙胆草), Anemarrhenae Rhizoma (Zhimu, 知母), and Phellodendri Cortex (Huangbai, 黄柏), yet its efficacy in reducing fever far surpasses these herbs. The statement in the *Shennong Bencao Jing* that it is "slightly cold" indicates that its nature is not severely cold. Furthermore, its suitability for postpartum women ("chan ru") reveals that its nature is particularly pure and mild.
This implies that because its nature is not excessively cold, it can be used during the postpartum period. However, later commentators on the *Shennong Bencao Jing*, failing to understand that the character "ru" (milk/nursing) in "chan ru" was originally interpreted as "sheng" (birth), absurdly claimed that Gypsum Fibrosum treats women with insufficient lactation. One must realize that if there is no external heat contraction after childbirth, Gypsum Fibrosum should originally not be used. If there is indeed external excess heat, while other cooling herbs might be contraindicated, Gypsum Fibrosum is uniquely not forbidden because its nature is not severely cold but slightly cold. Therefore, in Zhang Zhongjing's *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) from the late Han Dynasty, there is a formula called Zhupi Dawan (Bamboo Peel Large Pill) for treating women with deficiency during childbirth, accompanied by restlessness and vomiting/reversal. This formula contains Gypsum Fibrosum. "Ru zhong" refers to the time of childbirth; the restlessness and vomiting at this time must be due to external excess heat. This actually formulates a prescription based on the meaning in the *Shennong Bencao Jing* that Gypsum Fibrosum governs postpartum birth conditions.
Many physicians mistakenly believe Gypsum Fibrosum is severely cold and thus hesitate to use it. If used improperly, its dispersing nature becomes astringent (calcium sulfate is used to coagulate tofu, taking advantage of its astringent property). When treating external excess heat, it may trap phlegm-fire, causing it to condense and stagnate. Using just one liang (approx. 30-50g depending on era/region, here implying a significant dose relative to misconception) can injure the patient, turning a golden elixir into poison. After mishaps caused by improper use of Gypsum Fibrosum, common opinion fails to identify whether the fault lies in the herb itself or its misuse. Instead, they claim that even when used correctly, Gypsum Fibrosum is too fierce and harmful, making non-use seem safer. Thus, one voice leads to hundred echoes, and using Gypsum Fibrosum becomes a dreaded path. Even those who dare to use it limit themselves to seven or eight qian (approx. 20-30g). Given the heavy density of Gypsum Fibrosum, seven or eight qian is merely a large handful. How can a small handful of a slightly cold herb extinguish the raging fire-like heat of a Hanwen (warm disease)? Therefore, when I use raw Gypsum Fibrosum to treat external excess heat, even for mild cases, I must use at least one liang. If excess heat is blazing, I often use heavy doses of four to five liang, or seven to eight liang. It may be used alone or combined with other herbs, decocted into three or four teacups of liquid, taken in four to five portions slowly and warm. Once the fever subsides, the entire dose need not be consumed. Decocting heavily and administering slowly aims to alleviate the patient's suspicion and fear, and to ensure the medicinal power remains in the Upper and Middle Jiao, preventing the cold nature from descending and causing loose stools. Raw Gypsum Fibrosum used for external excess heat absolutely does not injure the body, and bold usage absolutely ensures fever reduction. Only in cases where heat is excess but the pulse is deficient—indicating excess heat combined with deficiency heat—one should follow the principle of Baihu Tang with Ginseng (Baihu Jia Renshen Tang, White Tiger Decoction plus Ginseng), adding Ginseng to assist Gypsum Fibrosum in reducing fever. Generally, herbs reduce fever by overcoming heat with cold, whereas Gypsum Fibrosum reduces fever by driving heat outwards. After decocting and taking Gypsum Fibrosum, the internally accumulated heat escapes gradually through the pores. Because it contains sulfur, oxygen, and light calcium, it inherently has exterior-releasing properties. Decocted, it resembles clear water; after ingestion, its cooling power exits along with the exterior-releasing action, leaving no viscous residue in the middle to damage the Spleen and Stomach. Thus, when facing the raging heat of severe warm diseases, boldly administering a large dose of Baihu Tang yields immediate results. For patients with excess pathogen and deficient healthy qi, Baihu Tang with Ginseng is also effective.
The reason Gypsum Fibrosum excels in treating warm diseases relies on the sulfur, oxygen, and light calcium in its original substance. If calcined (burnt), these components dissipate, and the remaining calcium changes quality upon calcination. Misuse of calcined Gypsum Fibrosum can congeal external phlegm-fire and block all blood vessels in the body. Cases have been seen where taking a few qian of calcined Gypsum Fibrosum led to knotted and intermittent pulses, progressing to speech impediments and limb flaccidity; where it transformed the condition into Jie Xiong (chest binding) with extreme fullness and obstruction; or where muscles seemed to have distinct boundaries and protruded. Since the claim arose that calcined Gypsum Fibrosum does not hurt the stomach, many physicians have blindly trusted this and caused fatal errors, which are countless. Therefore, when using raw Gypsum Fibrosum, one should buy whole, bright pieces and supervise the grinding process oneself (mineral drugs must be ground finely to extract fully). If bought from a pharmacy, it is hard to distinguish raw from calcined. If, after decoction, the gypsum solidifies at the bottom of the pot and cannot be poured out, it is definitely calcined Gypsum Fibrosum, and the decoction must not be taken.
I have observed ancient medical texts where predecessors used Gypsum Fibrosum: one case used fourteen jin (approx. 6-7 kg); another used dozens of jin (*Wu Juzhong Medical Cases*); some postpartum cases also used heavy doses (*Xu Lingtai Medical Cases*, using Baihu Tang with Ginseng, substituting Scrophulariae Radix for Anemarrhenae Rhizoma and raw Dioscorea Rhizome for Rice). In all these cases, raw Gypsum Fibrosum was used.
[Attached Case] My son XX, at age seven, contracted wind-cold. After four to five days, he had high fever, with a yellow tongue coating tinged with black. The child suffered from taking medicine; forcing it caused incessant vomiting. So, I used only about one liang of raw Gypsum Fibrosum, decocted to obtain clear liquid, divided into three doses taken warm. The illness improved slightly. Then, two liang of raw Gypsum Fibrosum were decocted and taken slowly warm; the illness improved further. Then, three liang were decocted and taken similarly; the illness completely resolved. A seven-year-old child consuming six liang of raw Gypsum Fibrosum in roughly one day and night, recovering with increased appetite and no signs of cold-damage to the middle, proves: Is Gypsum Fibrosum severely cold or slightly cold? This was my first experience of using heavy doses. The first dose was only one liang, divided into three parts, as I was still uncertain of its nature. Why do people today dare not use heavy doses? They might as well test it more extensively to exhaust its capabilities, as I did.
The wife of my fellow townsman Zhao XX, nearly sixty years old, contracted a warm disease. Her pulse was rapid, surging, and solid; her tongue coating was yellow and dry; she vomited upon smelling medicine. I instructed her to take six liang of fine raw Gypsum Fibrosum powder, decocted in a small rice-cooking pot (not a medicine steamer, to avoid medicinal odor triggering vomiting) to yield one large bowl of clear soup. To prevent vomiting, she took only one mouthful warm at a time. After swallowing, she felt extremely restless, and the family suspected the prescription was incorrect. I said, "No, the disease is severe and the medication light." After three doses, the restlessness ceased. Four hours later, having finished the dose, she recovered.
Mao XX's third son, XX, aged thirty-two, had a history of phlegm-fluid retention. He contracted a cold injury, treated and cured. Relapsed due to overeating, cured again. Relapsed again days later due to overeating; treatment failed. I consulted him after four to five days. His pulse was surging, long, and forceful, but his tongue coating was pale white, not dry, and he did not feel thirsty. Eating one bite of pear made him feel very cold; eating one pomegranate seed made his heart feel cold. Discarding symptoms for the pulse, I prescribed a large dose of Baihu Tang (White Tiger Decoction). Due to his phlegm-fluid retention, I added several qian of prepared Pinellia Tuber (Qing Banxia, 清半夏). His cousin, Gao XX, present and a senior physician in the county, questioned suspiciously: "This patient feels no thirst or heat in the chest and fears cold foods so much. In my view, even clearing and resolving herbs are unsuitable. What is your basis for using several liang of raw Gypsum Fibrosum?" I replied: "The surging and solid pulse indicates Yangming excess heat. The absence of thirst and heat sensation is due to his chronic phlegm-fluid retention and dampness dominance. His aversion to cold food is because the gastric phlegm-fluid interacts with external heat, causing the Stomach Fu to transform according to this mixture and oppose cold." Mao XX understood medicine and trusted me. He took the medicine over ten times in two nights, consuming over one jin of raw Gypsum Fibrosum, until his pulse became peaceful. I returned home. Two days later, he came to welcome me, reporting severe relapse with abnormal symptoms, fearing imminent death. I wondered how such a definitively cured case could relapse so drastically. Upon arrival (three li away), I saw excessive phlegm-saliva, continuous coughing and spitting,恍惚 mental state, confused speech, and body tremors. His pulse was peaceful and normal, except for slightly weak Stomach Qi at the Right Guan position. I suddenly realized and urgently told his family: "There is absolutely no danger here. Previously, he relapsed due to overeating; now he relapses due to under-eating/starvation." His family confirmed they had given very little food for days to avoid repeating past mistakes. I said: "No medicine is needed; eating will cure him." They worried he couldn't eat given his state. I said: "Do not worry. If the illness is caused by hunger, he will naturally desire food." Following my advice, from 8 PM until dawn, he ate three times, with controlled portions each time, and recovered.
Friend Mao XX's wife, nearly seventy, contracted cold injury in mid-January with no sweating. Originally a Mahuang Tang (Ephedra Decoction) pattern. Mistakenly treated with Guizhi Tang (Cinnamon Twig Decoction); sweat did not emerge. Suddenly, upper Jiao felt hot and nauseous; vomiting occurred upon smelling medicine. Even drinking plain water boiled with Gypsum Fibrosum or boiled water caused vomiting. Only swallowing small ice cubes throughout day and night prevented vomiting. Despite consuming considerable ice over two days, the heat and irritability persisted. Her pulse at the Guan position before was exceptionally surging and slippery. I instructed her to chew fresh pear slices dipped in fine raw Gypsum Fibrosum powder. She then tolerated the medicine without vomiting. After finishing two liang, she recovered.
A man with syphilis was treated in a Japanese hospital for over twenty days. His head and face were swollen, lower body ulcerated, body had high fever, and he delirious and unconscious. The Japanese doctors said the toxin had spread to Dan (erysipelas) and was incurable. His friend Sun XX invited me to diagnose him in the hospital. Suspecting the condition involved a concurrent warm disease, I used half a jin of fine raw Gypsum Fibrosum, boiled in a large bottle of water, disguised as wine to enter the hospital under the pretext of visiting a friend, so the Japanese staff wouldn't know I was treating him. Upon seeing the patient, his head and face were swollen and red. His pulse was surging and solid, confirming concurrent warm disease. I instructed him to drink the Gypsum water slowly and warm. The next day, his swelling and redness subsided, the surging/solid pulse halved but became faster, and he remained delirious and unconscious. Half the Gypsum water remained. I advised buying five qian of Radix Codonopsis Pilosae (Ludangshen, 潞党参), decocting it, and mixing it with the remaining Gypsum water. The next day, his consciousness cleared, and his pulse normalized. He decided to leave the hospital for recovery elsewhere. Ten days later, his syphilis also healed. Codonopsis was used for its neutral, non-heating nature.
A fifty-year-old man felt cold all over, with pain in both legs. Doctors administered warming and tonifying medicines, worsening the cold, leading to chills. His pulse was deep and hidden, but forceful upon heavy pressure. Tongue coating was thick and yellow; urination was red and difficult. It was mid-spring; I knew this was Spring-Warmth heat depressed in Yangming, not yet erupted, presenting as a false sign. I wanted to use Baihu Tang with Forsythiae Fructum (Lianqiao, 连翘). The patient was terrified. I said: "Just pre-purchase four liang of raw Gypsum Fibrosum. When the heat becomes unbearable, decoct and drink it, okay?" Patient: "It won't happen." I said: "If you decoct fresh Imperata Rhizome (Baimaogen, 白茅根) and drink it, the cold will turn to heat, even severe heat." Still skeptical, he tried it to verify. He peeled fresh Imperata Rhizome, chopped a large bowl, boiled it, and drank the soup as tea. Soon, heat erupted, becoming unbearable. Re-checking the pulse, it was extremely surging and large. I decocted the pre-purchased four liang of raw Gypsum Fibrosum, divided into three warm doses. The heat subsided.
Gypsum Fibrosum's nature also excels at clearing heat from epidemic rashes (see attached case after Qingzhen Tang), clearing heat from the head and face (see attached case after Qingyu Tang), and clearing heat from the throat (see case of Dong XX from Cangzhou in 'Detailed Discussion on Throat Disease Treatment').
For external contraction with phlegm-wheezing, Jin Gui Xiao Qinglong Jia Shigao Tang (Minor Green Dragon Decoction plus Gypsum Fibrosum) is appropriate. If the external heat has entered the Yangming Fu, the Ephedra, Cinnamon Twig, Ginger, and Asarum in Xiao Qinglong Tang are truly unsuitable. I once treated Liu XX, aged eight. In early autumn, he contracted a warm disease. After ten days of treatment, the condition worsened. Exterior and interior had high heat, wheezing was urgent, pulse was surging and rapid, forceful upon heavy pressure. Knowing it was still treatable, I asked about bowel movements; none for two days. I prescribed a large dose of Baihu Tang, using heavy dose of two and a half liang raw Gypsum Fibrosum, replacing rice with one liang raw Dioscorea Rhizome (Shanyao, 山药). Due to urgent wheezing and latent pathogen in the lungs, I added one and a half qian Mentha Haplocalyx (Boheye, 薄荷叶) to clear it. Decocted into two teacups, taken warm in two doses. One dose improved the condition significantly; a second dose cured it completely.
Traditionally, postpartum conditions strictly forbid cold herbs. But if it is truly a postpartum warm disease with dry heat in the chest, yellow thick tongue coating, and surging solid pulse, cold herbs are not forbidden. However, cold herbs must be chosen carefully, not thrown in randomly. For mild postpartum warm cases where heat enters Yangming but the pulse is not strongly surging/solid, I often use heavy doses of Scrophulariae Radix (Xuan Shen, 玄参), one to two liang, achieving immediate results. For severe cases, Baihu Tang with Ginseng is necessary. Use raw Dioscorea Rhizome instead of rice, and Scrophulariae Radix instead of Anemarrhenae Rhizoma for safety. See the verified case under Baihu Tang with Ginseng substituting Yam for Rice in the Medical Formulas section. Both Gypsum Fibrosum and Scrophulariae Radix are explicitly stated in the *Shennong Bencao Jing* to treat postpartum conditions, whereas Anemarrhenae Rhizoma is not mentioned in its entry. I dare not act arbitrarily.
Friend Mao XX once treated a young woman, ten-plus days postpartum, with high fever all over, no sweat, hot chest, and thirst. Medical treatment worsened the condition, becoming critical. Mao XX diagnosed a surging, solid pulse; yellow tongue coating turning black; grasping at empty air and touching the bed, indicating internal wind stirring. He treated with three liang raw Gypsum Fibrosum, one liang Scrophulariae Radix, five qian wild ginseng (Yetaishen, 野台参), two qian Licorice Root (Gancao, 甘草). Due to frequent vomiting, following the principle of Zhupi Dawan, he added two qian Bamboo Shavings (Zhuru, 竹茹), decocted in one large bowl, taken slowly warm. Finished the dose and recovered. Looking at this case, external heat raging like a wildfire, even postpartum, how can one treat it leisurely? Sun Simiao said: "Wisdom should be round, conduct square; courage should be great, caution small." Secular doctors encounter such cases with only caution, lacking courage. How can they remain indifferent to the patient's critical state?
In women, external heat pressing inward can cause persistent bleeding. Baihu Tang with Ginseng can be used heavily. Li family's wife from a neighboring village, a few days postpartum, lochia had stopped. On day seven or eight, sudden bleeding resumed. Medicine taken for twenty-plus days failed. Pulse surging, slippery, forceful; hot chest and thirst. Suspected concurrent external contraction; she felt no body heat, tongue had no coating, color slightly white. Suspected blood-heat reckless movement; cooled blood and stopped bleeding meds failed; heat and thirst persisted. Concluded definitely concurrent external contraction. Switched to Baihu Tang with Ginseng, using three liang raw Gypsum Fibrosum, raw Dioscorea Rhizome instead of rice, decocted in three bowls, taken warm in three doses. Heat and thirst resolved, bleeding stopped. Later switched to blood-cooling and hemostatic meds for final cure.
Dysentery with unceasing fever, unresponsive to all fire-clearing herbs, is often deemed untreatable in texts. If the treatment matches the syndrome, why would the fever not cease? This is because dysentery involves concurrent external contraction; the external heat pathogen sinks deep with the dysentery, filling the Lower Jiao meridines with no exit, aiding the dysentery, worsening daily without end. Diseases with concurrent syndromes require concurrent treatments. Heavy use of Gypsum Fibrosum supplemented with Ginseng to clear external heat is essential (See verified case of Wang XX after Tongbian Baihu Jia Renshen Tang).
Gao Shi, wife of cousin Zhang XX, over fifty, chronically ill. Early summer morning, started passing white dysentery; by evening, ten-plus times. After candlelight, suddenly high fever all over, unconscious, picking at clothes, unresponsive. Pulse surging but weak, skin hot to touch. Diagnosed as Qi-level heat dysentery with summerheat invasion; frail body could not sustain it, hence confusion. Urgently prescribed three liang raw Gypsum Fibrosum, four qian wild Codonopsis (Yedangshen, 野党参), decocted in one large bowl, taken slowly warm. Woke up at midnight after finishing the dose; dysentery also stopped. Decocted dregs next morning; recovered completely.
All the above dysentery cases involved concurrent external heat. Hence, heavy Gypsum Fibrosum was used. It is not a general dysentery formula. In my book *Zhongzhong Canxi Lu*, there are seven formulas for dysentery, used flexibly based on syndrome, with certainty. The formula used in the previous case is one of them. I have used this formula on many people; if pulse and syndrome match, there is no error.
Malaria, though in Shaoyang, if Yangming has concurrent excess heat, heavy Gypsum Fibrosum is suitable. I treated neighbor Li XX, around forty, malaria every other day. During fever, burning hot; even on non-fever days, felt heat in exterior and interior, dry tongue/mouth, pulse string-like and long, solid upon heavy pressure. This is Shaoyang pathogen excess, Yangming heat excess, malaria concurrent with warm disease pulse. Prescribed large dose Baihu Tang plus three qian Bupleurum Root (Chaihu, 柴胡). Felt refreshed immediately. Next morning, malaria did not recur. Took half the previous dose plus three qian Ginger, warm malaria cured thereafter. For cases where pulse is not strongly solid but forceful upon pressure, with constant feeling of fever and poor appetite, I add about one liang raw Gypsum Fibrosum to malaria prescriptions, always effective.
Gypsum Fibrosum's nature also excellently treats nasal discharge (naozhou). Texts often use Xin Yi Hua (Magnolia Flower) and Cang Er Zi (Xanthium Fruit). Etiology varies: wind attacking the brain, or liver transferring heat to the brain. If wind attack, early stage might use these acrid-warm herbs to disperse. If heat develops over time, acrid-warm herbs are unsuitable. If liver transfers heat to brain, acrid-warm herbs are strictly contraindicated. Recently treated Guo XX from Fengtian, suffering for half a year. Nose flows turbid mucus, foul smell, hot heart, confusion, frequent dizziness. Pulses left and right string-like and forceful; stool often dry. Diagnosed liver transferring heat to brain, stomach also transferring heat to brain. Fearing initial etiology was wind, first gave Aspirin to induce sweat; head/eyes felt refreshed. Then prescribed: one and a half liang raw Gypsum Fibrosum, four qian Gentianae Radix (Longdancao, 龙胆草), raw Paeoniae Radix Alba (Sheng Baishao, 生杭芍), Scrophulariae Radix (Xuan Shen, 玄参), Anemarrhenae Rhizoma (Zhimu, 知母), Trichosanthis Radix (Guafen, 花粉) each four qian; Forsythiae Fructum (Lianqiao, 连翘), Honeysuckle Flower (Jinyinhua, 金银花), Licorice Root (Gancao, 甘草) each two qian; Mint Leaf (Boheye, 薄荷叶) one qian. Taken ten doses consecutively. Gypsum Fibrosum maintained at one and a half liang; other herbs adjusted slightly. Recovered completely.