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Jinya Shi (Golden Tooth Stone) belongs to Yang stones. It grows in the streams and valleys of Shu Commandery. It is also found near Yongzhou. Those with a color resembling gold are of the best quality. Occasionally, they can be excavated from the banks of the Shu-Han River. The interior presents a golden color. If rocks collapse into the water, those that have been there for a long time tend to turn black. The taste is salty and sweet. The nature is neutral. It governs Gui Zhu (Ghost Tethering), toxic insect bites, and various Zhu diseases. It treats Leprosy (Lifeng). It also treats all conditions caused by cold wind pathogens, muscle and tendon spasms, and paralysis or inability to move the waist and legs. After being heated red-hot and soaked in wine, it can be taken orally. It warms the waist and knees, tonifies the Kidney Water organ, calms palpitations and fright, and treats pediatric convulsions and epilepsy. It is typically used only in wine preparations, powders, and Wu Zhu Wan (Five Tethering Pills). (Zhenbai) *Zhou Hou Bei Ji Fang* (Emergency Prescriptions Kept Up My Sleeve) treats Wind-Duo Jue (Wind-Toxicity Cold-Reversal) with Da Jin Ya Jiu (Large Golden Tooth Wine) and Xiao Jin Ya Jiu (Small Golden Tooth Wine); one simply soaks them and drinks the juice. *Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) treats Wind-Duo and Ghost Tethering, as well as Southern Miasma Chuan Shi (Transmitted Corpse) etc., each having Da Jin Ya San (Large Golden Tooth Powder) and Xiao Jin Ya San (Small Golden Tooth Powder). (Song) For Feng Zhu (Wind Tethering) causing hundred diseases, deficiency-lao (chronic wasting), damp-cold, limb flaccidity and numbness, and inability to walk, use Xiao Jin Ya Jiu (Small Golden Tooth Wine). The formula consists of: Jinya Shi (Golden Tooth Stone), Xixin (Asarum), Mangcao (Agastache), Fangfeng (Saposhnikovia), Difuzi (Kochia), Dihuang (Rehmannia), Fuzi (Aconite), Yinyu (Ilex), Xuduan (Dipsacus), Shujiao (Sichuan Pepper), and Shuobi Gen (Fatsia Root), each 4 liang; Duhuo (Angelica Pubescens) 1 jin. Pound the Jinya Shi into powder and store separately in a silk bag. Slice the remaining herbs thinly. Place them together into a large cloth bag. Soak in 4 dou of clear wine. Seal the vessel mouth tightly with mud. After four nights, the wine is ready. Take 2 he (approx. 60ml) warm, twice daily, until effective.

[Discussion] As a Yang stone, Jinya Shi indeed condenses by receiving the essence of Metal Qi. Generally, it involves both Qi and Blood, thereby benefiting the whole body. For instance, Jinya Jiu (Golden Tooth Wine) is used to treat tremors, and Taiyi Shenjing Dan (Great One Divine Spirit Elixir) is used to treat delirium; this illustrates the application of the subtle effects of Qi, Blood, and Essence. The phrase "warming the waist and knees and tonifying the Kidney Water" refers to its specific efficacy. Treating all cold wind pathogen conditions, tendon spasms, leg weakness, and curing palpitations represents its extended applications.

Shigao (Gypsum Fibrosum) has a nature very cold like water, hence its name Hanshui Shi (Cold Water Stone). It shares the same name but is a different substance from Ningshui Shi (Congealed Water Stone). Zhu Danxi stated that Shigao derives its name from both its texture and function. If it did not possess the "paste-like" quality, how could it serve to seal and cement alchemical furnaces? In the past, some people mistakenly used Fangjieshi (Calcite) to substitute for it. Shigao tastes sweet and acrid; it originally enters the Yangming Meridian. The Yangming Meridian governs the muscles. Its sweet flavor can moderate Spleen Qi, benefit Qi, stop thirst, and remove fire. Its acrid flavor can release the muscle layer and induce sweating, with medicinal power ascending to the head, and then entering the Hand-Taiyin Lung Meridian and Shaoyang Gallbladder Meridian. Fangjieshi only possesses characteristics of heavy weight, firm texture, and cold nature. Where else can one find a drug with paste-like qualities that can primarily treat these three meridians? Attached is a differentiation of Shigao, Lishi (Magnesium Silicate), Changshi (Orthoclase), and Fangjieshi. Shigao comes in soft and hard varieties. Soft Shigao grows in large blocks within rock strata, appearing layered like flattened rice cakes. Each layer is several cun thick, existing in red and white colors. The red variety is unfit for consumption; the white variety is pure, with short, dense textures resembling bundled needles, just like solidified white wax. It is soft and brittle. When calcined, it turns white and crumbles into powder, becoming clear inside, sometimes with a slight greenish tint. Those with long, fine textures like white silk are Lishi. Lishi and soft Shigao are two types of the same substance; once crushed, their shape and color become indistinguishable. Hard Shigao grows in blocks with straight,棱-like textures, hard and white like horse teeth. When struck, it breaks transversely, shining like Muscovite or Baiyuanying (White Quartz), with wall-like structures. Calcination causes it to scatter but remain hard, not turning to powder. Those resembling hard Shigao in block form, breaking into square pieces when struck, with bright, wall-like surfaces, are Fangjieshi. Calcination causes them to scatter without crumbling. They are one category with two species; once crushed, they are indistinguishable. Historically, it was believed that the hard type was Shigao and the soft type was Hanshui Shi. It was not until Zhu Danxi who definitively identified the soft type as Shigao, and subsequent generations found it effective, clarifying this millennium-old confusion. Essentially, what was previously called Hanshui Shi is actually soft Shigao. What was called hard Shigao is actually Changshi. Shigao, Lishi, Changshi, and Fangjieshi all share a cold nature and qi, capable of removing severe heat and stagnant Qi. However, Shigao uniquely releases the muscle layer and induces sweating. Lishi belongs to the Shigao category, and Changshi belongs to the Fangjieshi category; they can be used interchangeably. (Li Shizhen) Regarding the difference between soft and hard Shigao: one grows in layers within stone, the other in blocks; this alone provides a general overview. As for distinguishing Lishi from soft Shigao, Lishi has a slightly greenish hue, unlike the snow-white soft Shigao; its texture is fine and long, unlike the short and dense soft Shigao.

Shigao tastes acrid, sweet, and bland. Its nature is cold. Its aroma and taste are both faint. It is heavy and sinking. It belongs to Yin containing Yang. It can ascend and descend. It is a major cold drug for the Foot-Yangming Stomach Meridian. It also enters the Qi aspect of the Hand-Taiyin Lung Meridian and Hand-Shaoyang Sanjiao Meridian. It excels at clearing Stomach Heat. It governs Wind-Cold-Heat alternating symptoms. Counterflow Qi in the epigastrium, palpitations, and panting. Dry mouth and scorched tongue. Difficulty breathing. Hard and painful abdomen. (*Shennong Ben Cao Jing*) It treats Muscle Hyperthermia in the Yangming Meridian stage of Shanghan (Cold Damage). Headache, eye pain, dry nose, insomnia. Thirst and desire to drink water. It is also a key drug for Wenre (Warm Heat) disease with irritability, thirst, and a pulse that is洪大 (Surging), fast, and long. It is essential for Shangshu (Summerheat Injury), Fushe (Latent Summerheat), and Shunu (Summerheat Malaria). It further treats Yangdu (Yang Toxin) with macules, Benjing Re Tou Tong (Headache due to Heat in the Meridian), Toufeng Xuanyun (Vertigo due to Head Wind), toothache, Xiaoke (Wasting-Thirst), Za Chao (Epigastric Discomfort), Abdominal Distension. It drains Phlegm-Heat and Food Stagnation from the Stomach. Clears Lung Heat, irritability, sudden Qi rebellion, high panting, throat heat. Eliminates severe Heat in the Sanjiao, Skin Heat, Bone-Vapor Fever, and alternating chills and fever. (Various Materia Medica texts) Medical books treat Xiao Dan (Wasting-Thirst), Tan Yin (Phlegm-Retention), Xu Lao Zao Ke (Deficiency-Lao Dry Cough), dental and nasal diseases, Jing Jue (Convulsions and Coma), Yu Zhong (Emaciation), Xu Fan (Empty Irritability), Huoluan (Cholera-like disorder), Shui Zhong (Edema), Abdominal Fullness, Vomiting, Belching, Hematemesis, Hematuria, Bi Wei (Numbness and Paralysis), Lifeng Xian (Leprosy and Epilepsy), Huang Dan (Jaundice), Yi Jing (Spermatorrhea). Shigao inherits the upright Qi of Metal and Water, obtaining the clearest and coldest Qi of Heaven and Earth. Thus, Acrid can release the muscle layer, Sweet can moderate Heat. Major Cold combined with Acrid and Sweet can eliminate severe Heat. The various syndromes it governs are mostly caused by blazing Pathogenic Heat in the Foot-Yangming Meridian. The Hand-Taiyin Lung and Hand-Shaoyang Sanjiao are indeed diseased due to similar Qi resonance. (Zhongchun) According to Shanghan Taiyang syndrome, only when Wind-Cold stagnates Heat severely should Da Qing Long Tang (Major Green Dragon Decoction) be administered. Ancients compared this to extreme hyperthermia cooling down after rain; this precisely refers to Shigao's extremely clear-cold nature yet sweet-acrid taste, acting as an agent reaching Yang from Yin. Entering the Lung and Stomach to dissipate stagnant Heat, assisting Mahuang (Ephedra) and Guizhi (Cinnamon Twig) to complete the exterior-releasing function. For Heat in the Yangming Meridian, characterized by fever with aversion to heat, irritability, afternoon tidal fever, muscle hyperthermia, turbid red urine, intense thirst with excessive drinking, and spontaneous sweating, Shigao should be used. Do not take it if these symptoms are absent. Shigao excellently treats Yangming primary meridian headache and toothache, stops Wasting-Thirst, and removes Summerheat Tidal Fever. However, it can chill the Stomach, leading to loss of appetite. It is not suitable for casual use unless there is extreme Heat in the abdomen. (Jiegu) Shigao induces sweating; its Acrid-Cold nature enters the Hand-Taiyin Meridian. When Pathogenic Heat is in the Yangming, the Lung is controlled by Fire, so Acrid-Cold is used to clear it. If Shanghan or Re Bing (Heat Disease) presents with a Surging pulse after profuse sweating, dry mouth and tongue, headache, unceasing sweating, or exposure to Summerheat causing body ache and fatigue, Baihu Tang (White Tiger Decoction) will invariably be effective. (Haizang) Generally, the use of Shigao in Shanghan is limited to Da Qing Long Tang resolving the irritant Heat constrained by Yin-Cold. For treating various Yangming syndromes, it directly purges the Heat of the primary meridian. Regarding Summerheat syndromes, it also pertains to the Stomach. Haizang further stated that Shanghan exterior syndromes presenting with fever, aversion to heat, and thirst are similar to miscellaneous diseases. However, headache, body heat, eye pain, nasal dryness, and inability to sleep indicate Yangming Meridian disease. Miscellaneous internal syndromes with fever, aversion to heat, and thirst, but with red eyes, indicate disease in the Zang organs. Insufficiency of Hand-Taiyin Qi fails to command Yang Qi. Treating Summerheat Malaria and Macule-Toxin, this is a key drug. In cases of severe Heat and blazing Pathogens, it brings the dying back to life, with merit equal to Jin Ye (Golden Liquid). If used sparingly, its efficacy cannot be expected. (Zhongchun) To eliminate Heat and purge Fire, Sweet-Cold is indispensable. Therefore, in cases of High Fever with a Surging pulse where Bitter-Cold agents fail to reduce Heat, add Shigao. If symptoms subside but the pulse remains rapid, and the Surging pulse worsens the condition, reduce Bitter-Cold drugs and add Shigao. If stool is soft or diarrheic, add Jiegeng (Platycodon). Take after meals. Misuse of this drug causes significant harm. Users should increase the dosage gradually. Those with poor appetite should not use Shigao. Shigao excellently eliminates rapid pulses. If the illness subsides but the pulse remains rapid, it is incurable. (Jiegu) *Gu Jin Lu Yan Fang* treats various Vaporization Diseases with Wu Zheng Tang (Five Vaporizations Decoction), which is also Baihu Tang plus Renshen (Ginseng), Fuling (Poria), Dihuang (Rehmannia), and Gegen (Pueraria), modified according to the disease. *Wai Tai Mi Yao* (Secret Essentials of the Outer Cabinet) treats chronic Bone-Vapor Labor Heat and cough using 1 jin of Shigao with needle-like textures and 1 liang of Fen Gancao (Powdered Licorice), finely ground like flour, taken 3-4 times daily mixed with water. Lady Yang, daughter of Chancellor Yang, suffered from Bone-Vapor with internal Heat and external Cold. Physicians failed to cure her. Using this formula, her body cooled. These cases involve young and robust individuals with盛 (abundant) Lung-Stomach Fire and good appetite. For the elderly or those with deficient Qi-Blood and weak Stomachs, it is likely unsuitable. (Li Shizhen) Zhongjing's Baihu Tang specifically resolves Yangming Pathogenic Heat. Symptoms include headache, hyperthermia, thirst, irritability, nasal dryness, dizziness, insomnia, aversion to human/wooden sounds, and aversion to fire. For laborers suffering from this with prior Yuan Qi deficiency, add Renshen, naming it Renshen Baihu Tang. For severe Macule-Toxin with eruption, add Maidong (Ophiopogon) and Zhuye (Bamboo Leaf) to Baihu Tang, using Shigao as the sovereign herb (1-4 liang), Maidong similarly, Zhimu (Anemarrhena) 7 qian to 2 liang, Zhuye 100-400 leaves, Jingmi (Rice) 1-4 large pinches. In severe cases, add Huanglian (Coptis), Huangbo (Phellodendron), and Huangqin (Scutellaria), naming it Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction), 1-4 doses. Pregnant women with this condition are treated similarly. After Shanghan sweating, if irritant Heat persists, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) governs. For Rash Fever with thirst, scorched lips, cough, sneezing, phlegm, or diarrhea, use Zhuye Shigao Tang plus Chichengmu (Clematis) approx. 1 liang, Beimu (Fritillaria) and Gualougen (Trichosanthes Root) 2-3 qian. Eruption is treated similarly. Severe cases add the Three Yellows. For Summerheat Malaria with headache, hyperthermia, profuse sweating, and thirst, use Zhuye Shigao Tang 2-3 doses. Deficient cases add Renshen, followed by symptom-based treatment. This is Summerheat Malaria; Summerheat Qi resonates with Pericardium Qi, and the Pericardium corresponds to the Stomach. Shigao enters the Hand-Shaoyang Sanjiao, which is exterior-interior related to the Hand-Jueyin Pericardium, and furthermore enters the Stomach. Hence, it is a key drug for Summerheat diseases. For Zhongshu (Heat Stroke), use Baihu Tang, adding Renshen for deficiency. For Taiyang Zhong Yue (Sunstroke), use Zhuye Shigao Tang. For Stomach House Excess Heat, or Za Chao, Wasting-Thirst, hunger, and toothache, Zhuye Shigao Tang governs. Grind into powder, make pills the size of mung beans with vinegar, to drain Stomach Fire, Phlegm-Fire, and Food Stagnation; highly effective. (Danxi) For Wind-Heat with Heart Irritability, dry mouth, delirium, and whole-body hyperthermia, use 8 liang of cooked Shigao, mixed with 2 liang each of Gancao end (Licorice powder) and Tianzhu Huang (Calculus Bovis), and 2 fen of Longnao (Borneol). Make pills the size of bullet seeds with glutinous rice paste, grind with honey water before taking. For Heat-Lao (Labor) with Bone-Vapor Fever, slight emaciation of limbs, sweating, and long pulse, use Shigao San (Gypsum Powder). Use only Shigao, finely ground like flour, taken nightly with fresh well water using a square-inch measure, stopping when body Heat subsides. Heat-Lao syndromes are not entirely due to Yin deficiency; some result from External Yang Pathogens penetrating the bone, failing to vent, causing internal Bone-Vapor, leading to initial chills then fever, eventually becoming emaciated. Sweating indicates Stomach House Excess. Long pulse indicates Yang Pathogen. Treat with Shigao San. Dongyuan stated that Blood Deficiency Body Heat mimics White Tiger syndrome; misusing White Tiger Tang leads to death. This applies only to postpartum blood loss, starvation, exhaustion, and fatigue. If there is internal Heat with sweating and a long pulse, it is not contraindicated. For routine tooth brushing, mix Shigao and Buguzhi (Psoralea) into powder.

[Discussion] The Sanjiao is the beginning and end of Qi. Its origin is in the Mingmen (Gate of Life), its generation in the Stomach, and its command by the Lung. Ascending from below, it goes from Mingmen to the Lung; descending from above, it returns from the Lung to Mingmen, always centering on the Stomach. Yet, the Sanjiao acts as the master of ascending and descending. (The Sanjiao is the envoy of Mingmen Yuan Qi.) Only the Qi of the Sanjiao, rooted in Extreme Yin and interfacing with Extreme Yang. Shigao gathers the essence of Clear-Cold, aligning with the Sanjiao Yuan Qi rooted in Extreme Yin. Its Acrid-Sweet dispersing nature aligns with penetrating from Extreme Yin to Extreme Yang. Thus, Shigao delivering Clear-Cold to the Lung and Stomach is essentially the upward distribution of Yuan Qi, albeit with Yin prevailing over Yang. It refines Sweet-Cold Qi into Sweet-Acrid; Yin follows Yang to enter the Stomach and Lung, interfacing with Heaven. It elevates the pungent Sweet-Acrid taste to deliver Clear-Cold; Yang follows Yin to descend from the Lung to the Stomach, reaching Earth. The syndromes it treats seem to take the Sanjiao as the substance (Ti) and the Lung/Stomach as the function (Yong). The Sanjiao, as a distinct envoy of Yuan Qi, completes its function of reaching Yang from Yin. Why is it the primary drug for Yangming? Because Water and Fire Qi attach to Central Earth to function. (Consider how Shanghan transmits from Taiyang to Yangming.) *Ben Jing* first mentions treating Feng (Wind). What is the meaning? Humans have form, inseparable from Yin and Yang. Insufficient Yin and Excess Yang is termed Wind's Luxuriance (Yin); Insufficient Yang and Excess Yin is termed Wind's Deficiency. This drug, rich in Yin, treats Wind-Luxuriance by countering Yang-Excess. (True Yin attaching to Yang for ascent is easily invaded by Six Evils and consumed by Seven Emotions. Invasion and consumption cause Yang to stand alone and transform into Wind. This is Wind-Luxuriance. Luxuriance means Yin cannot guard Yang.) Half of the syndromes governed in medical books belong to Wind, with Heat following closely. (It transforms the Luxuriant Qi of Hyperactive Yang to calm Wind, and scatters the harsh Qi transformed by Wind to remove Heat.) When Heat lingers and does not disperse, severely consuming True Yin, only this drug can extinguish fierce flames and place them in a cold abyss. Miao's statement that its merit equals Jin Ye, and that low dosage yields little effect, holds true. The function of Human Yuan Qi operates in Li (Heart/Fire); Kan (Kidney/Water) has Heart as Fire Master, but Fire relies on Water for function. The root of Yuan Qi is in Kan; Li has Kidney as Water Master, but Water relies on Fire for substance. The Sanjiao commands Yuan Qi, whose root lies in Mingmen. Therefore, administering this Clear-Cold drug requires attention to the root of the Sanjiao, not just the Foot-Yangming Stomach Meridian. (This drug dissipates Heat from the skin, achieving the功 of returning Yang to Yin; it removes Heat from bone spaces, achieving the功 of reaching Yang from Yin. It covers all Zang-Fu, Qi-Blood, skin, vessels, flesh, sinews, brain, marrow, bones, and uterus.) One might ask: The Yuan Qi theory is sound. But why does its use as a major cold drug for the Stomach Meridian have appropriate and inappropriate indications? Answer: Shigao is appropriate precisely to save Yuan Qi. When Yang blazes between Lung and Stomach, Fire and Yuan Qi cannot coexist. The Classic states: "When Extreme Yang is abundant, Earth Qi is insufficient." Thus, Shigao is suitable to drain Yang and preserve Yin. Its contraindication is also to save Yuan Qi. When Lung-Stomach Yang is not hyperactive, Minister Fire is Yuan Qi. The Classic states: "Connecting to Heaven is the root of life." Thus, Shigao is contraindicated to preserve Yang and reach Yin. Understanding this principle makes the appropriateness clear, as Central Earth holds the pivot of ascending/descending for Yuan Qi transformation. Dongyuan's advice against excessive use before Start of Summer is precisely because it is a time suitable for ascending. Nevertheless, using this drug requires recognizing it as a Heat-clearing agent for the Qi aspect, unrelated to the Blood aspect. Even its ability to reduce a rapid pulse is because Sweet flavor is the source of Blood generation, aided by Acrid to reach it, and Qi commands Blood, aligning with the *Neijing* principle of Transformation Origin. Ancients said Blood Deficiency Fever is contraindicated because Qi Deficiency may not withstand this drug, cutting off the Blood generation source. Similarly, avoiding Bitter-Cold for Heat removal is because Bitter-Cold enters the Blood aspect, making stagnant Yang harder to disperse, aiming to save the Transformation Origin. For Internal Injury syndromes (Food Stagnation, Phlegm-Fire) caused by Yang aspect obstruction of Zheng Qi, creating Excess Heat, it can treat them, such as headache and toothache. However, if caused by Yuan Qi insufficiency generating Phlegm-Heat, it should not be applied generally. For example, Internal Injury Wasting-Thirst due to Spleen injury causing Heart Fire to invade Earth, digesting food into waste without transforming it into Essence-Blood to nourish Zang-Fu, differs from Internal Injury Excess Heat Wasting-Thirst and cannot be treated identically. Then why is Shigao used for Sanjiao Vaporization Heat within Zang-Fu? Answer: All Vaporizations result from eating meat/drinking alcohol or sexual misconduct after Heat diseases. (Wu Zheng Tang categorizes Zang-Fu syndromes; prescribed ingredients vary distinctly, see *Zhun Sheng · Xu Lao*). Only by adding Shigao to Tonify Qi and Blood to clear scattered stagnant Heat. Treatments for Empty Irritability and Wasting-Thirst are recorded in various formulas. Therefore, it should not be given to those with Stomach Qi Deficiency. For those with Qi-Blood insufficiency but stagnant Heat in the Qi aspect, if tonification and purgation are balanced and主次 (primary/secondary) are appropriate, how can we abandon this curative drug due to fear of side effects?

Shigao is essentially a key drug for resolving Excess Heat, dispelling Summerheat, scattering Pathogenic Heat, stopping thirst, and removing irritability. Warmth and Heat diseases often involve Yangming. If headache and whole-body bone pain occur without thirst or desire to drink, the Pathogen is in Taiyang. Not yet transmitted to Yangming, it should not be used. After 7-8 days, if the Pathogen has consolidated internally with dry feces, alternating chills and fever, requiring purgation, do not use it. If Summerheat combines with Dampness causing diarrhea, especially in those with weak Spleen-Stomach, do not use it. If Malaria Pathogen is not in Yangming, there is no thirst, and it is unsuitable. Postpartum chills and fever due to Blood Deficiency or incomplete Lochia discharge, and Bone-Vapor Labor Heat due to Yin-Essence insufficiency rather than external contraction, must not be mistakenly used. (Zhongchun)

[Differentiation and Treatment] Growing in layers within stone indicates authenticity. Pounded into powder in a stone mortar, sifted through fine silk. Processed with raw Gancao (Licorice) water flotation. Settled with water, dried, and repeatedly ground. Recent practitioners, due to its cold nature, calcine it or stir-fry with sugar to avoid damaging the Spleen-Stomach. Powders use cooked Shigao. Decoctions use half-raw, half-cooked. For decoctions, crush to millet size, boil dozens of times first, then add other herbs, as its aroma and taste are difficult to extract.