阳石也。生蜀郡溪谷中。近雍州亦有之。如金色者良。在蜀汉江岸，间打出者。内即金
色。岸摧入水。年久者多黑色。味咸甘。气平。主鬼疰毒虫诸疰。治厉风。并一切冷风气。
筋骨挛急。腰脚不遂。烧浸酒服。暖腰膝。补水脏。平惊悸。及小儿惊痫。惟酒散及五疰丸
用之。（贞白） 肘后治风毒厥。有大小金牙酒。但浸其汁饮之。千金治风毒及鬼疰。南方
瘴气传尸等。各有大小金牙散。（颂） 风疰百病。虚劳湿冷。缓弱不仁。不能行步。用小
金牙酒。金牙石细辛莽草防风地肤子地黄附子茵芋续断蜀椒蒴 根各四两。独活一斤。金牙
捣末。别盛练囊。余皆薄切。同入一大囊。以清酒四斗渍之。密器泥口。四宿酒成。温服二
合。日二次。取效。
〔论〕 金牙为阳石。固受金气之精而凝结者。大约由气而兼血。以为周身之益。如金
牙酒于振颤。太一神精丹于谵妄。可以识气血精微之用。所谓暖腰膝补水脏者。是其具体。
而治一切冷风气。筋骨挛急。腰脚不遂。并愈惊悸者。致其用也。
其性大寒如水。故名寒水石。与凝水石同名异物。丹溪云。石膏兼质与能而得名
。苟非有膏。岂能为固济丹炉之用。昔人以方解石当之误矣。膏味甘辛。本阳明经药。阳明
主肌肉。其甘也能缓脾益气。止渴去火。其辛也能解肌出汗。上行至头。又入手太阴少阳。
彼方解石止有体重质坚性寒而已。求其有膏而可为三经之主治者焉在哉。附石膏理石长石方
解石辨。石膏有软硬二种。软者大块生于石中。作层如压扁米糕形。每层浓数寸。有红白
二色。红者不可服。白者洁净。细纹短密如束针。正如凝成白蜡状。松软易碎。烧之即白烂
如粉。其中明洁。又色带微青。而纹长细如白丝者。理石也。与软石膏一物二种。碎之则形
色如一。不可辨矣。硬石膏作块而生。直理起棱。如马齿坚白。击之则段。段横解。光亮如
云母白石英。有墙壁。烧之亦易散。仍硬不作粉。其似硬石膏成块。击之块块方解。墙壁光
明者。乃方解石也。烧之则散。亦不烂。与硬石膏一类二种。碎之则形色如一。不可辨矣。
自来皆以硬者为石膏。软者为寒水石。至丹溪始断然以软者为石膏。而后人遵用有验。千古
之惑始明。盖昔人所谓寒水石者。即软石膏也。所谓硬石膏者。乃长石也。石膏理石长石方
解石四种。性气皆寒。俱能去大热结气。但石膏又能解肌发汗为异耳。理石即石膏之类。长
石即方石之类。俱可代用。（濒湖）按软石膏与硬石膏之别。一生石中作层。一作块而生。
即此已得其概。至理石之别于软石膏。以其色微青。不如软石膏雪白。其文细而长。不如软
石膏短密耳。
味辛甘淡。气寒。气味俱薄。体重而沉。阴中之阳。可升可降。乃足阳明胃经大寒药。
并入手太阴少阳经气分。善除胃热。主中风寒热。心下逆气惊喘。口干舌焦。不能息。腹中
坚痛。（本经）治伤寒阳明经肌肉壮热。头痛目痛。鼻干不眠。口渴饮水。又温热病烦热而
渴。脉洪大且数而长者。又伤暑伏暑暑疟为要药。更疗阳毒发斑本经热头痛。及头风旋晕。
齿痛消渴。嘈杂腹胀。泻胃上痰热食积。清肺热烦逆暴气高喘。咽热。除三焦大热。皮肤热。
骨蒸热。并乍寒乍热。（诸本草） 方书治消瘅痰饮。虚劳燥咳。齿鼻病。痉厥螈 。虚烦。
霍乱。水肿胀满。呕吐噫。吐血溲血。痹痿。疠风痫。黄胆。遗精。禀金水之正。得天地至
清至寒之气。故辛能解肌。甘能缓热。大寒而兼辛甘。则能除大热。所主诸证。多由足阳明
邪热炽盛所致。其手太阴肺手少阳三焦。固其同气以为病者也。（仲淳） 按伤寒太阳证。
惟风寒郁热之甚。投大青龙汤。先哲譬之亢热已极。一雨而凉者。正谓石膏气极清寒。味却
甘辛。为从阴达阳之剂。入肺胃而散其郁热。与麻桂相助为理。以尽解表之功。又阳明经中
热。发热更恶热。躁。日晡潮热。肌肉壮热。小便赤浊。大渴引饮。自汗。当用石膏。若无
以上诸证勿服之。石膏善治阳明本经头痛牙痛。止消渴。去中暑潮热。然能寒胃。令人不食。
非腹有极热者。不宜轻用。（洁古） 石膏发汗。辛寒入手太阴经。邪热在阳明。肺受火制。
故用辛寒以清之。若伤寒热病。大汗后脉洪大。口舌燥。头痛。大汗不已。或着暑热。身疼
倦怠。服白虎汤无有不效。（海藏）大抵伤寒之用石膏。惟大青龙解阴寒所郁之躁热。至于
阳明诸证之治。是皆直涤其本经之热耳。若夫暑证。则亦不离于胃也。海藏又云。伤寒表证。
发热恶热而渴。与杂证同。但头痛身热目痛鼻干不得卧。乃阳明经病也。杂病里证发热恶热
而渴。但目赤者。病藏也。手太阴气不足。不能管领阳气也。治暑疟及斑毒。此为要药。值
热盛邪炽各证。起死回生。功同金液。若用之鲜少。则难责其功。（仲淳） 除热泻火。非
甘寒不可。故有大热脉洪大。服苦寒剂而热不退者。加石膏。如证退而脉数不退。洪大而病
有加者。宜减苦寒加石膏。如大便软或泄者。加桔梗。食后服。此药误用。为害非细。用者
旋旋加之。如食少者。不可用石膏。石膏善能去脉数。如病退而脉数不退者。不治。（洁古）
古今录验方。治诸蒸病有五蒸汤。亦是白虎加人参茯苓地黄葛根。因病加减。外台秘要治骨
蒸劳热久嗽。用石膏文如束针者一斤。粉甘草一两。细研如面。日以水调三四服。杨寺丞女
病骨蒸。内热外寒。众医不瘥。用此方而体遂凉。按此皆少壮肺胃火盛能食而病者也。若衰
暮及气血虚胃弱者。恐非所宜。（濒湖） 仲景白虎汤专解阳明邪热。其证头疼壮热。口渴
烦躁。鼻干目 不得眠。畏人声木声。畏火。若劳役人病此。元气先虚者。可加人参。名
人参白虎汤。发斑阳毒盛者。白虎加麦冬竹叶。以石膏为君。自一两至四两。麦冬亦如之。
知母自七钱至二两。竹叶自百片至四百片。粳米自一大撮至四大撮。甚则更加连柏芩。名三
黄石膏汤。自一剂至四剂。妇人妊娠病此者亦同。伤寒汗后。烦热不解。竹叶石膏汤主之。
痧疹发热。口渴唇焦。咳嗽多嚏。或多痰。或作泄。竹叶石膏汤加赤柽木两许。贝母栝蒌根
各二三钱主之。发斑亦同。甚者加三黄。暑疟头痛壮热。多汗发渴。亦用竹叶石膏汤二三剂
主之。虚者加人参。后随证施治。按此是暑疟。暑气本与心包络之气相感。而包络又与胃相
应。石膏入手少阳三焦。固与手厥阴包络为表里者。况其又入胃乎。此所以为暑病要药。中
暑。用白虎汤。虚者加人参。太阳中 。亦用竹叶石膏汤。胃家实热。或嘈杂消渴善饥齿痛。
皆须竹叶石膏汤主之。研为末。醋丸绿豆大。以泻胃火痰火食积。殊验。（丹溪） 风热心
躁。口干狂言。浑身壮热。熟石膏半斤。入甘草末天竺黄各二两。龙脑二分。糯米糕丸弹子
大。蜜水磨下。热劳附骨蒸热。四肢微瘦。有汗。脉长者。石膏散主之。石膏一味。细末如
面。每夕新汲水服方寸匕。取身无热为度。按热劳之证。不尽属于阴虚。亦有阳邪外袭。传
入于骨。不能泄越。内作骨蒸。令人先寒后热。久久渐成羸瘦。有汗者胃家实也。脉长者阳
邪证也。石膏散主之。东垣言血虚身热。证象白虎。误服白虎者。必死。此惟新产失血。饥
困劳倦之病为然。若内热而有汗脉长。则不在所禁也。寻常搽牙。石膏补骨脂同为末用之。
〔论〕三焦为气之所终始。始之者在命门。生之者在胃。统之者在肺。其由下而上也。
自命门以极于肺。由上而下也。复自肺以归命门。而总不离于胃。却又以三焦为下而上上而
下者之主也。（三焦为命门元气之使）惟三焦之气。根于至阴。际于至阳。而石膏萃清寒之
精。有合于三焦元气。根于至阴者。其味辛甘发散。更有合于由至阴而彻至阳者。然则石膏
之致其清寒于肺胃。固犹是元气之上布。但阴胜于阳耳。其举甘寒之气锤为甘辛。阴得随阳
而入胃至肺以际于天。举甘辛之冲味致其清寒。阳得随阴而由肺降胃以极于地。是其所疗诸
证。似以三焦为体。肺胃为用。而三焦为元气之别使。亦自完其阴中达阳之用也。顾何以又
为阳明主药。盖缘水火之气。附于中土。以为用耳。（如伤寒传经由太阳而次阳明。可以思
矣。）本经首主中风者。其义云何。曰。人生有形。不离阴阳。阴不足而阳有余。即谓风之
淫。阳不足而阴有余。即谓风之虚。兹味之阴有余者。正以对待阳有余之证而治其风淫也。
（真阴之丽于阳以升者。易为六淫之所侵。七情之所耗。侵之耗之。阳乃独亢而化风矣。是
为风之淫。淫者阴不能为阳守也。）方书主治诸证。属于风者强半。而热即次之。（能化亢阳
之淫气而静其风。更能散风化之厉气而除其热。）凡热留而不散。致销烁真阴已甚。非此不
能息酷烈之焰。而置清冷之渊。缪氏所谓功同金液。且云用之鲜少难责其功也。夫人身元气
之用。用于离中。坎以心为火主。而火实藉水以为用也。元气之根。根于坎中。离以肾为水
主。而水实藉火以为体也。三焦主元气。而元气之根柢在命门。然则投此清寒之气味。得不
留意于三焦之根柢。而只于足阳明胃经论治哉。（兹味从皮肤而散热。即从阳归阴之功。从
骨空而祛热。即从阴达阳之功。举五脏六腑。或气或血。皮肤脉肉筋脑髓骨与胞皆及之。）
或曰。元气之说是矣。第其为胃经大寒药而用之。有宜有忌者何故。曰。石膏所宜。正以救
元气也。盖阳炽于肺胃之间。则火与元气不两立。经所谓至阳盛则地气不足。故宜石膏以泻
阳而存阴。至其所忌。亦以救元气也。盖肺胃之阳未亢。相火即是元气。经所谓通天者生之
本。故忌石膏以存阳而达阴也。审于斯义。则中土握升降之枢以为元气转关者。其宜否
当自了然。东垣所云立夏前不宜多服。正为宜升之时耳。虽然。用此味全要认定是气分除热
之药。与血分全无涉。即其能退数脉。亦以甘味为血生化之原。更有辛以达之。而气为血主
。正合于内经化原之义。先哲谓血虚发热禁用者。又恐气虚不能胜此味。更绝血之化原耳。
即如除热不偏用苦寒。因苦寒固入血分。令阳之郁者愈不得散。亦欲救化原之意也。若夫内
伤之证。（食积痰火）由于阳分壅遏其正气。以成有余之热者。皆能治之。如头痛齿痛是也。
若由于元气不足以生痰热。则未可概施。又如内伤消渴。有劳伤脾脏。以致心火乘土。善消
水谷为糟粕。而不能化为精血以养五脏者。与内伤实热之消渴。自难例治。然则何以三焦蒸
热在脏腑之中者亦用石膏。曰。诸蒸皆因热病后食肉饮酒。或犯房事而成。（五蒸汤分属脏
腑形证。投治药味。历历不同。具见准绳虚劳中。）惟于益气补血中。更入石膏以清散其结
热。如虚烦消瘅之治。诸方固可稽也。故在胃气虚者。不可投。至气血不足而有结热在气分
者。果使补泻得宜。主辅中节。安能惩噎废食。舍此中病之味哉。
石膏本解实热。祛暑气。散邪热。止渴除烦之要药。温热二病。多兼阳明。若头痛遍身
骨痛而不渴不引饮者。邪在太阳也。未传阳明。不当用。七八日来。邪已结里。有燥粪。往
来寒热。宜下者。弗用。暑气兼湿作泻。脾胃弱甚者。弗用。疟邪不在阳明则不渴。亦不宜
用。产后寒热由于血虚。或恶露未尽。骨蒸劳热。由于阴精不足。而不由于外感。并弗误用。
（仲淳）
〔辨治〕 生石中作层者真。石臼中捣成粉。密绢罗过。生甘草水飞过。水澄令干。重
研用之。近人因其性寒。火 过用。或糖拌炒过。则不妨脾胃。作散者 熟。入煎剂半生半
熟。凡入煎剂。碎之如粟米大。先煮数十沸。乃入余药。以其气味难出故也。
金牙石属于阳石。生长在蜀郡的溪谷中。雍州附近也有出产。颜色像黄金的质地最好。在蜀汉江岸，偶尔能挖掘到。内部呈现金色。若岩石崩塌落入水中，年代久远的多变为黑色。味道咸而甘。药性平。主治鬼疰、毒虫及各类疰病。治疗麻风病。以及一切冷风气引起的病症。筋骨拘挛抽搐。腰脚瘫痪不能随意运动。将其烧红后浸泡在酒中服用。可温暖腰膝。补益肾水脏。平息惊悸。以及小儿惊风癫痫。通常只在酒剂散剂和五疰丸中使用。（贞白）《肘后备急方》治疗风毒厥逆，有大、小金牙酒两种，只需浸泡其汁液饮用即可。《千金方》治疗风毒及鬼疰，南方瘴气传尸等症，各有大、小金牙散。（颂）对于风疰百病，虚劳湿冷，肢体缓弱麻木，不能行走的症状，使用小金牙酒。配方为：金牙石、细辛、莽草、防风、地肤子、地黄、附子、茵芋、续断、蜀椒、蒴藋根各四两，独活一斤。将金牙石捣成粉末，另外装在丝织袋中。其余药材薄切，一同放入一个大布袋中。用清酒四斗浸泡。密封容器口并用泥封口，经过四个夜晚酒即制成。每次温服二合，每日两次，以见效为准。
〔论述〕 金牙石作为阳石，确实承受了金的精气而凝结而成。大致是由气兼带血的作用，从而发挥对全身的益处。例如金牙酒用于治疗震颤，太一神精丹用于治疗谵妄，可以看出气血精微的作用。所谓“温暖腰膝、补益肾水”，是其具体的功效体现；而治疗一切冷风气、筋骨拘挛、腰脚不遂，并治愈惊悸，则是其应用的延伸。
石膏的性质大寒如水，所以名叫寒水石。它与凝水石同名但实物不同。朱丹溪说，石膏兼有质地与功能而得名。如果不是因为有膏状特质，怎么能起到固济丹炉（炼丹炉）的作用呢？过去有人用方解石来代替它，这是错误的。石膏味甘辛，本是阳明经的药物。阳明经主司肌肉，它的甘味能缓和脾气、益气、止渴去火；它的辛味能解除肌表之邪、发汗，药力上行至头部，又入手太阴肺经和少阳胆经。而方解石只有体重、质坚、性寒的特点罢了。哪里能找到像石膏那样既有膏质又能主治这三条经脉的药物呢？附上关于石膏、理石、长石、方解石的辨析。石膏有软、硬两种。软的石膏大块生于石头中，呈层状，像压扁的米糕形状。每层厚达数寸，有红、白两种颜色。红色的不可服用，白色的洁净，纹理短密如束针，正如凝固的白蜡状，松软易碎。烧过后立刻变白烂如粉，其中明洁，又略带青色，而纹理长细如白丝的，是理石。理石与软石膏是一物两种，打碎后形状颜色一样，无法分辨。硬的石膏成块生长，纹理直起棱角，像马齿一样坚硬洁白，敲击则断裂，断面横向解开，光亮如云母或白石英，有墙壁般的结构。烧后也容易散开，但仍保持坚硬不成粉。那些像硬石膏成块，敲击时块块方形解开，墙壁光明的，乃是方解石。烧后散开，也不烂。它与硬石膏是一类两种，打碎后形色如一，无法分辨。自古以来都以为硬的是石膏，软的是寒水石。直到朱丹溪才断然认定软的是石膏，而后人遵照使用有效，千古疑惑才得以澄清。大概过去所说的寒水石，就是软石膏。所说的硬石膏，乃是长石。石膏、理石、长石、方解石这四种，药性气机皆寒，都能去除大热结气。但石膏又能解肌发汗，这是它的独特之处。理石即属于石膏一类，长石即属于方解石一类，都可以替代使用。（李时珍）按软石膏与硬石膏的区别，一个生于石中呈层状，一个成块而生，仅凭这一点已得其大概。至于理石与软石膏的区别，在于理石颜色微青，不如软石膏雪白；其纹理细而长，不如软石膏短密。
石膏味辛、甘、淡。药性寒。气味都很淡薄。体重而沉。属于阴中之阳。可升可降。是足阳明胃经的大寒药。并入手太阴肺经和少阳胆经的气分。善于清除胃热。主治中风寒热。心下逆气惊喘。口干舌焦。呼吸困难。腹中坚硬疼痛。（《本经》）治疗伤寒阳明经肌肉壮热。头痛目痛。鼻干失眠。口渴饮水。以及温热病烦热而渴，脉象洪大且数而长的症状。又是伤暑、伏暑、暑疟的要药。更治疗阳毒发斑、本经热头痛，以及头风眩晕。牙齿疼痛、消渴、嘈杂腹胀。泻除胃上痰热食积。清肺热烦逆暴气高喘。咽喉热痛。消除三焦大热、皮肤热、骨蒸热，以及忽冷忽热的症状。（历代本草著作）医书治疗消瘅、痰饮、虚劳燥咳、齿鼻疾病、痉厥抽搐、虚烦、霍乱、水肿胀满、呕吐噫气、吐血尿血、痹痿、麻风癫痫、黄疸、遗精。石膏禀受金水之正气，得天地至清至寒之气，所以辛能解肌，甘能缓热。大寒而兼辛甘，则能除大热。所主治的各种证候，多由足阳明邪热炽盛所致。手太阴肺经和手少阳三焦，固然是同气相求而发病的。（仲淳）按伤寒太阳证，只有风寒郁热非常严重的情况，投用大青龙汤。先哲比喻为亢热已到极点，一场雨后就凉爽了，正是指石膏气极清寒，味道却甘辛，是从阴达阳的药剂。入肺胃而疏散其郁热，与麻黄、桂枝相助为理，以尽解表之功。又有阳明经中的热证，发热更怕热，烦躁，日晡潮热，肌肉壮热，小便赤浊，大渴引饮，自汗，应当使用石膏。如果没有以上诸证不要服用。石膏善于治疗阳明本经头痛牙痛，止消渴，去中暑潮热。然而它能寒凉胃部，令人食欲不振。如果不是腹部有极热者，不宜轻易使用。（张元素）石膏发汗，辛寒入手太阴经。邪热在阳明，肺受火克制，所以用辛寒来清解。如果伤寒热病，大汗后脉象洪大，口舌干燥，头痛，大汗不止，或者感受暑热，身体疼痛倦怠，服用白虎汤没有不有效的。（王好古）大抵伤寒使用石膏，只有大青龙汤是解除阴寒所郁遏的躁热。至于阳明各种证候的治疗，都是直接涤荡本经的热邪罢了。如果是暑证，也离不开胃。王好古又说，伤寒表证，发热恶热而渴，与杂病相同。但头痛身热目痛鼻干不得卧，乃是阳明经病。杂病里证发热恶热而渴，但眼睛红的，是病在脏腑。手太阴气不足，不能统领阳气。治疗暑疟及斑毒，这是要药。遇到热盛邪炽的各证，起死回生，功效如同金液。如果使用量很少，就难以指望其功效。（仲淳）除热泻火，非甘寒不可。所以有大热脉洪大，服用苦寒剂而热不退的，加石膏。如果证候退了但脉数不退，洪大而病情有加重的，宜减少苦寒药加石膏。如果大便软或泄泻的，加桔梗。饭后服用。此药误用，危害不小。使用者应逐渐增加剂量。如食少者，不可用石膏。石膏善于去除脉数。如果病退了但脉数不退，属不治之症。（张元素）《古今录验方》治疗各种蒸病的有五蒸汤，也是白虎汤加人参、茯苓、地黄、葛根，因病加减。《外台秘要》治疗骨蒸劳热久嗽，用纹理如束针的石膏一斤，粉甘草一两，细研如面粉，每天用水调服三四次。杨寺丞的女儿患骨蒸，内热外寒，众医不愈，用此方而身体遂凉。按这些皆是少壮时期肺胃火盛能进食而患病的人。如果是衰老暮年及气血虚弱胃弱者，恐怕不适合。（李时珍）仲景的白虎汤专门解除阳明邪热。其证候头疼壮热，口渴烦躁，鼻干目眩不得眠，畏人声木声，畏火。如果是劳役之人患此病，元气先虚的，可加人参，名人参白虎汤。发斑阳毒盛的，白虎汤加麦冬、竹叶，以石膏为君药，自一两至四两，麦冬也如此。知母自七钱至二两，竹叶自百片至四百片，粳米自一大撮至四大撮，严重时再加黄连、黄柏、黄芩，名三黄石膏汤，自一剂至四剂。妇人妊娠患此病也一样。伤寒发汗后，烦热不解，用竹叶石膏汤主治。痧疹发热，口渴唇焦，咳嗽多嚏，或多痰，或作泄，用竹叶石膏汤加赤柽木约一两，贝母、栝楼根各二三钱主治。发斑也一样。严重时加三黄。暑疟头痛壮热，多汗发渴，也用竹叶石膏汤二三剂主治。虚者加人参，之后随证施治。按这是暑疟，暑气本来与心包络之气相感，而包络又与胃相应。石膏入手少阳三焦，固与手厥阴心包络为表里关系，何况它又入胃呢。这就是为什么它是暑病要药。中暑，用白虎汤，虚者加人参。太阳中暍，也用竹叶石膏汤。胃家实热，或嘈杂消渴善饥齿痛，都需要竹叶石膏汤主治。研为末，醋丸绿豆大，以泻胃火、痰火、食积，效果显著。（朱震亨）风热心躁，口干狂言，浑身壮热，用熟石膏半斤，入甘草末、天竺黄各二两，龙脑二分，糯米糕丸弹子大，蜜水磨下服用。热劳附骨蒸热，四肢微瘦，有汗，脉长的，用石膏散主治。石膏一味，细末如面粉，每晚用新汲水服方寸匕，以身无热为度。按热劳之证，不尽属于阴虚，也有阳邪外袭，传入于骨，不能泄越，内作骨蒸，令人先寒后热，久久渐成羸瘦。有汗者是胃家实。脉长者是阳邪证。用石膏散主治。李东垣说血虚身热，证象白虎，误服白虎必死。这只有在新产失血、饥困劳倦的病中才适用。如果内热而有汗脉长，则不在禁忌之列。寻常搽牙，石膏与补骨脂同为末使用。
〔论述〕 三焦是气的终始所在。起始于命门，生成于胃，统摄于肺。其由下而上，从命门直达于肺；由上而下，复自肺回归命门，而总离不开胃。却又以三焦为下而上、上而下的主宰。（三焦是命门元气的使者）只有三焦之气，根于至阴，际于至阳。而石膏萃集清寒的精气，符合三焦元气根于至阴的特点。它的味辛甘发散，更符合由至阴彻达至阳的过程。那么石膏将清寒之气致于肺胃，固然是元气上布的表现，只是阴胜于阳罢了。它举起甘寒之气锤炼为甘辛，阴得以随阳而入胃至肺以际于天；举起甘辛的冲味致其清寒，阳得以随阴而由肺降胃以极于地。这是它所治疗的诸证，似乎以三焦为体，肺胃为用，而三焦作为元气的别使，也完成了其阴中达阳的作用。为何又成为阳明主药？大概因为水火之气依附于中土而发挥作用耳。（如伤寒传经由太阳而次传阳明，可以思考其中的道理。）《本经》首先主治中风，这是什么意思？回答说：人生有形，不离阴阳。阴不足而阳有余，就称为风的淫邪；阳不足而阴有余，就称为风的虚邪。这种味之阴有余的，正是为了对待阳有余的证候而治疗风淫。（真阴依附于阳以升者，容易被六淫所侵扰，被七情所耗损。侵扰耗损，阳乃独亢而化风矣。这就是风之淫。淫者，阴不能为阳守也。）医书主治诸证，属于风的占大半，而热紧随其后。（能化亢阳之淫气而静其风，更能散风化之厉气而除其热。）凡是热留而不散，导致销烁真阴已经很严重，非此药不能熄灭酷烈之焰，而置于清冷之渊。缪氏所谓功效同金液，且说使用量少难责其功。人身元气之用，用于离中（心），坎以心为火主，而火实藉水以为用。元气之根，根于坎中（肾），离以肾为水主，而水实藉火以为体。三焦主元气，而元气之根柢在命门。那么投用此清寒的气味，能不留意于三焦之根柢，而只于足阳明胃经论治吗？（此药从皮肤散热，即从阳归阴之功；从骨空祛热，即从阴达阳之功。举五脏六腑，或气或血，皮肤脉肉筋脑髓骨与胞皆涉及。）有人说：元气之说是对的。但它作为胃经大寒药而使用，有适宜有禁忌，是什么原因？回答说：石膏适宜，正是为了救元气。盖因阳炽于肺胃之间，则火与元气不两立。经所谓至阳盛则地气不足，故宜石膏以泻阳而存阴。至于其所忌，也是为了救元气。盖因肺胃之阳未亢，相火即是元气。经所谓通天者生之本，故忌石膏以存阳而达阴也。审察于此义，则中土握升降之枢以为元气转关者，其宜否自然了然。李东垣所说立夏前不宜多服，正是适宜升发之时。虽然如此，使用此药全要认定是气分除热之药，与血分全无涉。即使它能退数脉，也是因为甘味为血生化之源，更有辛以达之，而气为血主，正合于内经化原之义。先哲谓血虚发热禁用者，又恐气虚不能胜此药，更绝血之化原耳。就像除热不偏用苦寒，因为苦寒固入血分，令阳之郁者愈不得散，也是欲救化原之意。如果是内伤之证（食积痰火），由于阳分壅遏其正气，以成有余之热者，都能治疗。如头痛齿痛是也。如果由于元气不足以生痰热，则不可一概施用。又如内伤消渴，有劳伤脾脏，以致心火乘土，善消水谷为糟粕，而不能化为精血以养五脏者，与内伤实热之消渴，自然难以同样治疗。那么为什么三焦蒸热在脏腑之中者也用石膏？回答说：诸蒸皆因热病后食肉饮酒，或犯房事而成。（五蒸汤分属脏腑形证，投治药味，历历不同，具见《准绳·虚劳》中。）只有在益气补血中，更入石膏以清散其结热。如虚烦消瘅之治，诸方固然可查考。所以在胃气虚者，不可投用。至气血不足而有结热在气分者，果使补泻得宜，主辅中节，怎能因噎废食，舍此中病之味呢。
石膏本是解实热、祛暑气、散邪热、止渴除烦的要药。温热二病，多兼阳明。如果头痛遍身骨痛而不渴不引饮的，邪在太阳也。未传阳明，不当用。七八日来，邪已结里，有燥粪，往来寒热，宜下者，弗用。暑气兼湿作泻，脾胃弱甚者的，弗用。疟邪不在阳明则不渴，也不宜用。产后寒热由于血虚，或恶露未尽，骨蒸劳热，由于阴精不足，而不由于外感，并勿误用。（仲淳）
〔辨治〕 生于石中呈层状的是真品。石臼中捣成粉，用密绢筛过。生甘草水飞过。水澄令干，重研使用。近人因其性寒，火煅过用，或用糖拌炒过，则不妨碍脾胃。作散剂者用熟石膏。入煎剂者半生半熟。凡入煎剂，碎之如粟米大，先煮数十沸，乃入余药。以其气味难出故也。
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.