伏气化热证也，盖因冬日或春初感受微寒，未能即病，所受之寒伏藏于三焦脂膜之中，阻塞升降之气化，久
而生热，至春令已深，而其所伏之气更随春阳而化热，于斯二热相并，而脏腑即不胜其灼热矣，此原与外感深入
阳明者治法相同，是以宜治以白虎汤也。病者闻愚言而颔之，遂为开白虎汤方，方中生石膏用三两，为其呕
吐为加生赭石细末一两，为其小便不利为加滑石六钱，至大便旬余不通，而不加通大便之药者，因赭石与石
膏并用，最善通热结之大便也。俾煎汤一大碗，徐徐温饮下，服后将药吐出一半，小便稍通，大便未通下。
翌日即原方将石膏改用五两，赭石改用两半，且仿白虎加人参汤之义，又加野台参三钱，复煎汤徐徐温饮下，
仍吐药一半，大便仍未通下。于是变汤为散，用生石膏细末一两，赭石细末四钱和匀，为一日之量，鲜白茅
根四两，煎汤分三次将药末送服，服后分毫未吐，下燥粪数枚，小便则甚畅利矣。翌日更仿白虎加人参汤之
义，又改用野党参五钱，煎汤送服从前药末，又下燥粪数枚，后或每日如此服药，歇息一日不服药，约计共
服生石膏细末斤许，下燥粪近百枚，病始霍然全愈。其人愈后，饮食增加，脾胃分毫无伤，则石膏之功用及石
膏之良善可知矣。愚用石膏治大便之因热燥结者实多次矣，或单用石膏细末，或少佐以赭石细末，莫不
随手奏效，为此次所用石膏末最多，故特志之。
这是伏气化热证。大概是因为冬天或初春感受了轻微的寒邪，当时没有立即发病，所受的寒邪潜伏藏匿在三焦脂膜之中，阻碍了气机的升降运行，时间久了便产生内热。到了深春时节，潜伏的邪气随着春季阳气的升发而进一步化为热邪，此时内外两股热邪相合，脏腑便无法承受这种灼热之苦。这种情况原本与外感病邪深入阳明经的病证治法相同，因此适宜用白虎汤来治疗。
病人听了我的话表示赞同，于是我为他开具了白虎汤方。方中重用生石膏三两；因为病人有呕吐症状，所以加入生赭石细末一两；因为病人小便不利，所以加入滑石六钱。至于病人已经十多天大便不通，却没有加入通便的药物，是因为赭石与石膏配合使用，最善于通泄因热结导致的大便闭塞。
让病人煎取一大碗药汤，慢慢温热服用。服药后吐出了一半的药液，小便稍微通畅了一些，但大便仍未排出。
第二天，在原方基础上将生石膏改为五两，赭石改为两半，并且仿照白虎加人参汤的意义，又加入了野台参三钱，再次煎汤慢慢温热服用，仍然吐出了一半的药液，大便依然没有排出。
于是改变剂型，由汤剂改为散剂。用生石膏细末一两、赭石细末四钱混合均匀，作为一天的用量；再用鲜白茅根四两煎汤，分三次用药末送服。服药后完全没有呕吐，排出了几枚干燥的粪便，小便则非常通畅顺利。
第二天，再次仿照白虎加人参汤的意义，将野党参改为五钱，煎汤送服之前的药末，又排出了几枚干燥的粪便。此后每天如此服药，休息一天不服药。大约总共服用了生石膏细末一斤左右，排出了近百枚干燥的粪便，病这才霍然痊愈。
这个人病愈之后，饮食增加，脾胃丝毫未受损伤，由此可见石膏的功效及其优良性质。我使用石膏治疗因热燥结导致的大便不通的情况实在多次了，有时单用石膏细末，有时少量佐以赭石细末，无不随手奏效。因为这次使用的石膏末最多，所以特别记录下来。
This is a syndrome of latent pathogenic qi transforming into heat. It is generally caused by contracting slight cold in winter or early spring, which does not immediately manifest as disease. The contracted cold lies hidden within the fatty membranes of the Sanjiao (Triple Burner), obstructing the ascending and descending movements of Qi transformation. After a long time, internal heat is generated. By deep spring, the latent pathogenic qi transforms further into heat along with the rising Yang energy of spring. At this point, the two heats combine, and the Zang-Fu organs cannot withstand the scorching heat. This condition originally shares the same treatment principle as exogenous pathogens penetrating deeply into the Yangming channel; therefore, it is appropriate to treat it with Baihu Tang (White Tiger Decoction).
The patient heard my words and nodded in agreement. I then prescribed Baihu Tang. In the formula, Sheng Shigao (Raw Gypsum Fibrosum) was used in an amount of 3 liang. Because the patient suffered from vomiting, 1 liang of finely powdered Sheng Zheshi (Raw Hematitum) was added. Because the patient had difficulty urinating, 6 qian of Huashi (Talcum) was added. Regarding the fact that the patient had not had a bowel movement for more than ten days, no laxatives were added because the combination of Zheshi and Shigao is particularly effective in unblocking dryness-heat accumulation in the intestines.
The decoction was prepared as one large bowl and taken slowly while warm. After ingestion, half of the medicine was vomited out. Urination became slightly freer, but the bowels remained unopened.
On the following day, the original formula was modified: Shigao was increased to 5 liang, and Zheshi to 2.5 liang. Furthermore, imitating the principle of Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng), 3 qian of Yetaishen (Wild Codonopsis Root) was added. The decoction was again prepared and taken slowly while warm. Half of the medicine was still vomited, and the bowels remained unopened.
Consequently, the dosage form was changed from decoction to powder. One liang of finely powdered Shigao and 4 qian of finely powdered Zheshi were mixed evenly to constitute one day's dose. Fresh Baimaogen (Rhizoma Imperatae) weighing 4 liang was decocted in water. The powder was administered in three divided doses using the Baimaogen decoction. After taking the medicine, there was no vomiting at all, several pieces of dry feces were passed, and urination became very smooth and profuse.
On the next day, again imitating the principle of Baihu Jia Renshen Tang, Yedangshen (Codonopsis Radix) was increased to 5 qian. The previous powder was taken with a decoction, resulting in the passage of several more pieces of dry feces. Thereafter, the medication was continued daily, with a rest day every other day when no medicine was taken. Approximately 1 jin (roughly 500g) of finely powdered Shigao was consumed in total, leading to the passage of nearly 100 pieces of dry feces. Only then did the illness completely resolve.
After recovery, the patient's appetite increased, and the Spleen and Stomach were not harmed in the slightest. Thus, the efficacy and benevolent nature of Shigao can be understood. I have used Shigao many times to treat constipation caused by dryness-heat accumulation. Sometimes Shigao powder was used alone, and sometimes a small amount of Zheshi powder was added as an adjuvant. In all cases, immediate efficacy was achieved. Since the maximum amount of Shigao powder was used in this case, I specifically recorded it.