Shi Gao Tang

Shi Gao Tang

From "Wai Tai Mi Yao"

[Composition] Xiang Chi 9 grams (one sheng), Zhi Zi 6 grams (ten pieces), Ma Huang 9 grams (three liang), Huang Qin, Huang Bo, Huang Lian, and raw Shi Gao each 6 grams (one liang)

[Usage] Brewed in water and taken orally.

[Indications] Exterior symptoms combined with internal heat.

[Indications] Headache without sweat, chills and fever, red face and red eyes, dry nose and thirst, irritability and delirium, nosebleeds, and a slippery, rapid pulse.

[Functions] Resolve exterior and clear interior.

[Formula Explanation] When the Sun-Yang has not yet been resolved and internal heat is accumulating, this formula is used. The headache without sweat and fever indicates that the Sun-Yang cold has not yet been resolved; the red face, red eyes, dry nose, and thirst indicate that internal heat is particularly severe. In both exterior symptoms and internal heat, internal heat is more prominent and urgent. In the formula, Shi Gao’s pungent sweetness and great coldness primarily serve to clear fire and cool heat internally; Ma Huang’s pungent warmth helps to induce sweating, resolving exterior cold and dispersing cold externally as a supporting herb. As heat accumulates internally, over time it can transform into fire and become toxic; the three Huang and Shan Zhi both possess the ability to clear fire and detoxify, making them complementary treatments. Dou Chi’s sweet coldness travels to the exterior, preventing wind-heat from invading the exterior, embodying the principle of preventing illness before it occurs—and also serving as a complementary treatment.

[Clinical Additions and Subtractions] ① Remove Ma Huang, Dou Chi, and Shi Gao, and add Bu Yao Zi and Lian Qiao, known as the Huang Lian Jie Du Tang (from "Wai Ke Zheng Gong"), which clears fire and detoxifies, and can treat three-jiao fire syndromes, such as boils and abscesses.

[Reference Materials] ① Used to treat “when both exterior and interior heat are severe, or when the patient is irritable and thirsty, faces red and noses dry, eyes like fire, body feels stiff and unable to sweat, six pulses are rapid and full, and when poison appears in the form of spots on the skin.” (Cheng Fang Bian Du) ② “Both exterior and interior heat are severe, so Huang Qin clears the fire in the upper jiao, Huang Lian clears the fire in the middle jiao, Huang Bo clears the fire in the lower jiao, and Zhi Zi clears the fire in all three jiao. Ma Huang and Dou Chi help disperse exterior evils, while Shi Gao’s heavy weight clears heat, and Qi’s lightness helps to release the muscles—these are medicines that separate the exterior and interior.” (Cheng Fang Qie Yong)

[Commentary] This formula is often used for various acute and subacute infections, such as boils, erysipelas, and septicemia; it can also be used in combination with other formulas to treat inflammatory diseases of the gallbladder, pancreas, appendix, pelvic cavity, and other areas.

III. Resolving Exterior and Warming Interior

This formula is suitable for cases where exterior symptoms are combined with internal cold. When comparing exterior symptoms with internal cold, internal cold is considered the primary factor, while exterior symptoms are secondary; if exterior symptoms are dominant while internal cold is secondary, then this formula falls under the category of formulas that resolve exterior symptoms.