Traditionally used for
- Cough & breathing
- Colds & fever
- Digestion
- Mood & calm
- Skin
☯ TCM Properties
Clears Heat and Drains Fire; Eliminates Irritability and Relieves Thirst; Clears Lung Heat; Clears Stomach Heat; Promotes Tissue Regeneration and Heals Sores
Traditional Chinese Uses
Shi Gao (gypsum fibrosum, calcium sulfate) is a very cold, pungent-sweet mineral herb that powerfully clears Internal Heat and Heat from the Qi level of the body. It is the primary herb for high fever with intense thirst, profuse sweating, and a rapid, surging pulse — the classic Yangming Heat presentation. It also clears Lung Heat for cough and wheezing with Heat, and topically treats burns, eczema, and inflammatory skin conditions. It must be decocted first for internal use.
Used In Formulas (7)
Relationships
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Botanical Description
Shi Gao is not a plant but a naturally occurring mineral, the hydrous calcium sulfate gypsum (CaSO4 . 2H2O). It occurs as massive, fibrous or crystalline aggregates in sedimentary evaporite deposits and is mined in many parts of China, particularly Hubei, Anhui, Shandong and Henan provinces. In its raw medicinal form it is presented as irregular, heavy, white to pale grey-white blocks, often with a faintly silky or fibrous fracture and a chalky texture; pure specimens are translucent on thin edges. The material is largely odourless and tasteless, with a hardness of about 2 on the Mohs scale, easily scratched by a fingernail. For use as Sheng Shi Gao it is simply broken into pieces, while Duan Shi Gao is prepared by calcining the raw mineral until it loses its water of crystallisation and becomes a friable, dehydrated, anhydrous form.
Active Constituents
Calcium sulfate dihydrate
Sulfate mineral (gypsum group)Concentration: Dominant phase; pharmacopoeial-grade Gypsum Fibrosum is essentially monomineralic gypsum
The bulk mineral of the drug. It is only sparingly soluble in water (roughly 2 g per litre at room temperature), so a decoction extracts far less calcium than the raw weight of 15 to 60 g suggests; this low solubility is the main reason gypsum has so little intrinsic toxicity compared with the other minerals in this class.
Water of crystallisation
Structural (lattice) waterConcentration: 2 mol per mol CaSO4, about 20.9% by mass
Distinguishes gypsum from anhydrite (CaSO4) and from the calcined drug. Heating drives the lattice water off to hemihydrate and then anhydrite, and in an LPS fever model in rats calcined gypsum lost the antipyretic effect that raw gypsum retained, so the hydrate state is not a cosmetic distinction.
Magnesium, zinc and molybdenum
Trace metal impuritiesConcentration: Trace; varies with the deposit
Metal profiling of gypsum serum fractions nominated Mg, Ca, Zn and Mo as the candidate antipyretic substances, and these elements reproduced the antipyretic effect in rats. On this evidence the activity of Shi Gao tracks its impurity load rather than its calcium sulfate content, which is why reagent-grade CaSO4 is not a substitute.
Anhydrite and calcite
Accessory sulfate and carbonate mineral phasesConcentration: Variable accessory phases
Mineralogical neighbours that occur alongside gypsum in the same evaporite deposits. Anhydrite (Ying Shi Gao) has no lattice water and calcite is a carbonate that effervesces with dilute acid; both are commerce-level contaminants of, and substitutes for, gypsum.
Clay minerals, quartz and iron oxides
Silicate and oxide gangue mineralsConcentration: Variable, deposit-dependent
Insoluble gangue carried with the mined mineral. Iron oxide staining is what gives the pinkish material sold in northern China as red gypsum its colour, and clay fractions carry the adsorbed heavy metal burden.
Arsenic, lead, cadmium and mercury
Heavy metal contaminantsConcentration: Deposit-dependent trace levels, controlled by pharmacopoeial limit tests
Not intrinsic to gypsum but present at variable trace levels in mined mineral drugs generally. Limit tests constrain them rather than exclude them, so the contaminant load is a property of the batch and its source, not of the species.
⚠ Drug Interactions
Gypsum Fibrosum Preparatum (Duan Shi Gao, calcined gypsum)
Calcination converts the dihydrate to hemihydrate and anhydrite. In an LPS-induced fever model in rats, raw gypsum and its key elements lowered body temperature and reduced hypothalamic COX-2 expression, while calcined gypsum did not. The calcined drug is an external astringent for weeping sores and burns, a different drug with a different indication.
Clinical note: Specify raw (sheng) Shi Gao on any internal prescription. If a dispensary supplies the calcined product for an internal heat-clearing formula, treat the prescription as not filled rather than as filled with a variant.
Tetracycline and fluoroquinolone antibiotics
Free Ca2+ chelates tetracyclines and fluoroquinolones in the gut lumen and markedly reduces their bioavailability; this is an established class effect of calcium salts. Gypsum's low solubility caps the calcium released, but the large doses used in Bai Hu Tang and Ma Xing Shi Gan Tang still put appreciable Ca2+ into the gut at the same time as the antibiotic.
Clinical note: Separate the decoction from the antibiotic dose by at least two hours, and take the antibiotic first. This matters most in the febrile respiratory infections in which the two are most likely to be co-prescribed.
Calcitum (Han Shui Shi, Fang Jie Shi, calcite)
In Chinese commerce the name Han Shui Shi covers red gypsum (CaSO4·2H2O) in the north and calcite (CaCO3) in the south, and calcite (Fang Jie Shi) is also a recognised contaminant of gypsum consignments. Calcite is a carbonate, not a sulfate, and neutralises gastric acid rather than acting as gypsum does. It is harder than gypsum, cannot be scratched with a fingernail, and effervesces vigorously with dilute hydrochloric acid.
Clinical note: Do not accept Han Shui Shi as a stand-in for Shi Gao and do not assume the two named drugs are the same mineral across suppliers. Verify a consignment by hardness, fibrous silky habit and the acid effervescence test before dispensing.
Levothyroxine and oral bisphosphonates
Both drug classes are documented to have their absorption cut substantially by concurrent calcium salts through luminal binding. No study has tested gypsum specifically, so this is extrapolated from the calcium class effect and is limited by gypsum's poor solubility.
Clinical note: Keep at least four hours between the decoction and levothyroxine or an oral bisphosphonate. Check thyroid function if a patient stabilised on levothyroxine starts a long course of a gypsum-containing formula.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction (pre-decocted) | 15–60 g | Daily | — | — | 中国药典 2020 【用法与用量】15～60g，先煎。 【性味与归经】甘、辛，大寒。归肺、胃经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Dui Yao — Herb Pairs
The classical two-herb combinations this herb appears in, each with an action neither herb has alone.
Dispersing lung qi is joined with clearing lung heat, so wheezing from heat constrained in the lung is relieved while the warmth of the dispersing herb is restrained.
Cough and wheezing with fever from heat lodged in the lung.
Core pair of a classical formula — Ma Xing Shi Gan Tang, Shang Han Lun (Zhang Zhongjing)
Clearing stomach fire is combined with nourishing kidney yin, treating the pattern of stomach heat above with yin deficiency below.
Toothache, bleeding gums and thirst from stomach heat with kidney yin deficiency.
Core pair of a classical formula — Yu Nu Jian, Jing Yue Quan Shu (Zhang Jingyue)
Acrid-cold and bitter-cold together clear qi-level and yangming heat strongly while protecting fluids, so high fever and thirst are cleared without drying yin.
Classic for yangming channel or qi-level heat with high fever, sweating, thirst and a surging pulse.
Core pair of a classical formula — Bai Hu Tang, Shang Han Lun (Zhang Zhongjing)
Clearing heat from the qi level is combined with clearing heart and stomach heat and relieving irritability, suited to lingering heat after febrile disease.
Residual heat with damaged qi and fluids, irritability, thirst and nausea.
Core pair of a classical formula — Zhu Ye Shi Gao Tang, Shang Han Lun (Zhang Zhongjing)
Evidence Tier
Moderate evidence · 4 studiesRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
0
Randomized controlled trial
1
0 verified · 1 unverified
Other clinical trial
0
Observational / case report
0
In vitro / animal
3
2 verified · 1 unverified
Show 3 studies
- The discovery of the material basis and mechanism of gypsum as an antipyretic based on the theory of the diverse applications of raw and processed products
- Beneficial Bacterial Modulation by Gypsum Fibrosum and Terra Flava Usta in Gut Microbiota
- Effect of Shin'iseihaito (Xinyiqingfeitang) on MUC5AC expression in cultured pulmonary epithelial cells and the role of its component gypsum
Other / unclassified
0
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
The discovery of the material basis and mechanism of gypsum as an antipyretic based on the theory of the diverse applications of raw and processed products
Metal profiling plus an LPS-induced fever model in rats. Mg, Ca, Zn and Mo were identified as the candidate antipyretic substances; raw gypsum and those elements lowered temperature and reduced hypothalamic COX-2 expression, while calcined gypsum did not. Serum metabolomics and faecal microbiota transplantation implicated a mineral-gut microbiota-host metabolism axis. Preclinical only, and it does not establish an antipyretic dose in humans.
Beneficial Bacterial Modulation by Gypsum Fibrosum and Terra Flava Usta in Gut Microbiota
Mice fed a diet with 2% Gypsum Fibrosum for four weeks showed a shifted gut microbiota on 16S rRNA sequencing, with significant enrichment of Lactobacillus reuteri. A mechanistic feeding study in mice, not a clinical result, and the dietary exposure does not correspond to a therapeutic decoction dose.
The rational dose for MaXingShiGan decoction is crucial for its clinical effectiveness in treating bronchial pneumonia: three randomized, double-blind, dose-parallel controlled clinical studies
Three randomised, double-blind, dose-parallel trials in bronchial pneumonia found effectiveness to depend on the dose of the whole Ma Xing Shi Gan decoction, in which gypsum is the largest single component by weight. Evidence for the formula at a given dose, not for gypsum in isolation, and it cannot be read as a trial of Shi Gao.
Effect of Shin'iseihaito (Xinyiqingfeitang) on MUC5AC expression in cultured pulmonary epithelial cells and the role of its component gypsum
Extract of the nine-herb Kampo formula Shin'iseihaito suppressed PMA-induced MUC5AC mucin production in NCI-H292 human pulmonary mucoepidermoid cells, and the study examined the specific contribution of the gypsum component. A cell-culture study only; it speaks to a mucin-suppressing role for the mineral within a formula, not to clinical benefit.
Historical Texts
Shen Nong Ben Cao Jing
Han dynasty, compiled c. 200 BCE to 200 CEShang Han Lun (Zhang Zhongjing)
Eastern Han, c. 200 to 210 CEBen Cao Gang Mu (Li Shizhen)
Ming dynasty, completed 1578, first printed 1596Yi Xue Zhong Zhong Can Xi Lu (Zhang Xichun)
Republican China, published in instalments 1918 to 1934References
- Dai Min; Wang Ding. Mineral medicines of the East: an analysis of records in historical Chinese and Japanese medical texts . Frontiers in Pharmacology (2025) [DOI]
- Li Xiang. Comparative study of the effects of Gypsum Fibrosum and Gypsum Fibrosum Preparatum in promoting granulation . Journal of Chinese Integrative Medicine (2006) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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