High Fever with No Sweat at All? Doctor Zhang Xichun’s Gypsum and Rice Decoction (Shi Gao Jing Mi Tang) for Fever Caught in the Cold

The opening: a train with broken windows — and a whole carriage of people frozen into high fevers

This story took place when Doctor Zhang Xichun was serving as a military doctor. He was traveling with a patrol battalion (xun fang ying) — a garrison unit — as it was being transferred from Guangping to Dezhou. The troops boarded a train at Handan and went south, then north, then south again — back and forth for the better part of a day and night.

💬 Note from Doctor Luo: It was the first ten days of the first lunar month — the coldest stretch of the whole year — and every window on that train was broken. The icy wind howled straight in; the cold cut to the bone. By the time they reached Dezhou, five or six of the men traveling together were all sick — sick with what? They had caught cold — wind-cold. And what did it look like? Their bodies were scorching hot, they had high fevers, and not a drop of sweat would come out.

Five or six men down at once — that was a real puzzle for Doctor Zhang Xichun. They’d caught cold, and now they were burning with fever. What do you do?

One formula, one enormous pot: Shi Gao Jing Mi Tang

Doctor Zhang Xichun went to work. He used raw gypsum (sheng shi gao) and japonica rice (jing mi) — about ten-plus liang of each (one liang is roughly 30 g), because with so many patients, he simply brewed it all into one huge pot of porridge, using an ordinary cooking pot. And there was a special rule about how to drink it: you only drink the clear liquid floating on top — you don’t eat the rice, and you don’t eat the gypsum. Three big bowls of water, simmer until the rice is cooked through, then drink that clear liquid. That’s all.

💬 Note from Doctor Luo: Once the rice was cooked, the men drank the soup while it was still hot. And what happened? They began to sweat — gradually, all over. The moment the sweat came out, the fever broke, and everyone was overjoyed. They all said: what skill — truly wonderful!

One pot of porridge saved a whole trainload of people.

Why is this formula so magical? Gypsum and rice, each doing one job

Doctor Zhang Xichun explained it very clearly himself: the two ingredients in this formula each have their own assignment.

💬 Note from Doctor Luo: What does sheng shi gao (raw gypsum) do? It clears the heat on the inside, because it is excellent at penetrating and venting heat. And the rice (jing mi)? First, it supports the stomach qi; second, this is a hot soup — drinking it helps induce sweating and release the exterior. So look: in a single formula, you have something to scatter the exterior cold and something to clear the interior heat — this is a formula especially good for the pattern of exterior cold with interior heat.

When cold is sealed on the outside and heat is burning on the inside, the sweat can’t come out and the fever can’t come down. Shi Gao Jing Mi Tang handles both sides: the hot soup helps you sweat and disperse the cold, the gypsum clears and vents the interior heat, and the rice porridge supports your stomach qi — the thinking is that elegant.

How much should you use? Zhang Zhongjing taught the answer long ago

So what dose should you actually use? One person says two liang, another says two and a half; the original story says ten-plus liang. Who do you listen to?

💬 Note from Doctor Luo: My own habit is 50 g of raw gypsum cooked with rice into porridge. But the key is not the dose — it’s the method of drinking. Following Zhang Zhongjing’s idea, you don’t gulp the whole pot down at once. Instead, drink about a quarter of it first, then check whether you’ve started to sweat: if you’re lightly sweating, you’re done — no need to drink more; if not, keep drinking until the light sweat comes. The moment the slight sweat appears and the fever breaks — that amount was your dose.

This is the most beautiful part of the whole case: the dose is not a fixed number; it is set by your body’s response.

Doctor Luo’s own experiment: gypsum alone just isn’t the same as gypsum plus rice

Doctor Luo has actually tested the secret of this formula himself.

💬 Note from Doctor Luo: I ran the experiment myself: raw gypsum by itself — no rice — boiled into water and drunk. The sweating effect was poor, the fever-reducing effect was poor, and nothing much happened at all. But the moment I put rice in and simmered it together, the sweat came out and the fever went down. So when Doctor Zhang Xichun added rice, he was following Zhang Zhongjing’s reasoning — rice supports the stomach qi and helps you sweat. It is absolutely not a case of “boil a liter of liquid and be done with it”; adding the rice serves a real purpose.

Why does one extra ingredient — rice — make the whole formula so effective? Because sweating depends on stomach qi — when the stomach qi is weak, the sweat simply will not come out.

A frail person needs ten grams; a strong person needs a full liang

So what dose should you use after all? Doctor Zhang Xichun’s and Doctor Luo’s answer is wonderfully practical: it depends on the person.

💬 Note from Doctor Luo: In Chinese medicine, the dose is set by the degree of your body’s response. A frail person cooking Shi Gao Jing Mi Tang with ten grams of raw gypsum will start sweating — the medicine has worked immediately, so no more is needed; that ten grams is your dose. A strong, sturdy person may drink that and feel nothing, and only begin to sweat after a full liang (about 30 g) — that is the dose for that person’s constitution. So in Chinese-medicine thinking, everyone’s dose is different.

So Doctor Luo’s advice is: brew a little extra and drink slowly — the moment the light sweat comes and the fever breaks, that was your dose. This way of thinking matters far more than memorizing one fixed gram number.

Bonus: understand this one idea, and today’s lesson is worthwhile

Finally, Doctor Luo sums up the secret of the formula in a single sentence.

💬 Note from Doctor Luo: Today let me share my experience with you: brewing raw gypsum by itself does not give this effect — you must add the rice, because the rice supports the stomach qi, and only then does the sweating come easily. Your dose is the amount that makes your body sweat lightly. If you can grasp this way of thinking, then this session has already given you something valuable.

The worst thing about a fever is sweat trapped inside that can’t get out — Shi Gao Jing Mi Tang attacks from three directions at once: the hot soup induces sweat, the gypsum clears the interior heat, and the rice porridge nourishes the stomach. When the sweat comes out, the fever goes down. Tomorrow, Doctor Luo continues with how Doctor Zhang Xichun used raw gypsum.

What to take away

• Fever with no sweat: when cold seals the exterior and heat burns inside, sweat can’t escape and the fever can’t break — the treatment must both release the exterior and clear the interior heat.
• The formula: Shi Gao Jing Mi Tang (Gypsum and Rice Decoction) — sheng shi gao (raw gypsum) to clear and vent the interior heat, jing mi (japonica rice) to support the stomach qi, and the hot soup itself to induce sweating. Three jobs, one pot.
• The drinking method (the real key): don’t gulp it all down — drink about a quarter, watch for a light sweat; if it comes, stop; if not, keep sipping until it does. The dose is set by your body’s response, not by a fixed number.
• Doctor Luo’s experiment: gypsum alone barely sweats and barely reduces fever; add rice and the sweat comes — because sweating depends on stomach qi.
• Dose by constitution: a frail person may sweat from just 10 g of gypsum; a strong person may need a full liang (about 30 g). Brew extra, drink slowly, and let your body set the dose.
• Practical tip: if you’re trying this idea yourself, remember the classic pattern — fever with the body burning hot and no sweat after being chilled — and seek proper diagnosis before self-treating.

Compiled from Doctor Luo Dalun’s commentary on Doctor Zhang Xichun’s case records, originally published in Records of Chinese Medicine with Reference to Western Medicine (《医学衷中参西录》, issued serially 1918–1934).