High Fever So Severe She Fell into a Coma and Wouldn’t Wake Up? Doctor Zhang Xichun Brought Her Back with Shigao Jingmi Tang (Gypsum-Rice Decoction)
Patient search terms: high fever / fever causing coma / high fever that won’t come down / burning up so badly you can’t wake the person / cold with fever and sore throat / external-contraction fever — what to do
Medical terms for this condition: febrile disease (wen bing, excess heat in the Yangming level) · external-contraction heat syndrome · high fever with loss of consciousness
Opening: one herb — sheng shi gao (raw gypsum) — used to perfection by Doctor Zhang Xichun
Hello, friends. Today we continue our discussion of how Doctor Zhang Xichun used sheng shi gao (raw gypsum). In his hands, raw gypsum was handled with total mastery — yet people today have grown unfamiliar with it, even a little afraid when it comes up.
💬 Note from Doctor Luo: Among all the herbs Doctor Zhang Xichun used best in his life, raw gypsum absolutely ranks in the top few. He was bold, he used large doses — but he always knew exactly what he was doing. The formula we’re looking at today is one he created himself, and its name is wonderfully plain — Shigao Jingmi Tang (Gypsum-Rice Decoction) — raw gypsum and rice boiled into a soup. Sounds simple, doesn’t it? And yet this congee-like soup saved a life.
Who was the patient? The wife of the county magistrate of Shenyang County, over fifty
The patient in this case was the wife of Zhu Aiting, the county magistrate of Shenyang County — the county’s top official — and she was over fifty years old.
💬 Note from Doctor Luo: Zhu Aiting was a fellow townsman of Doctor Zhang Xichun. At that time Doctor Zhang Xichun had just arrived in Fengtian (today’s Shenyang) to practice medicine. When his fellow townsman’s wife fell ill, of course they hurriedly called in Doctor Zhang Xichun to take a look.
What illness did she have? A febrile disease (wen bing) — a heat syndrome caused by an external contraction. She caught a cold, the external evil came in, and what happened? Her throat became swollen and painful, her tongue turned red, her pulse beat fast, her breathing grew rapid and hurried — and then the high fever hit. A textbook febrile-disease presentation.
The first doctors to treat her were Japanese: an ice bag for a pillow, physical cooling
But the first people to treat this illness were not Chinese physicians — they were Japanese doctors.
💬 Note from Doctor Luo: In those days in Shenyang, Japanese doctors were quite active. They had their “modern methods,” so the family first called in a Japanese doctor. How did the Japanese doctor treat her? Physical cooling — he put an ice bag (a bag filled with ice) under her head as a pillow, and hung another ice bag above her head to cool the patient down. As for what medicine she was given, Doctor Zhang Xichun never learned.
And what was the result? She only grew worse.
How sick was she by then? Shout at her loudly — no response at all
By the time Doctor Zhang Xichun arrived, this was the scene: the patient lay with eyes closed, drowsy, like someone in a coma — shout at her loudly and there was no response at all. They called her name, and she gave no reaction whatsoever. She had fallen into a coma.
💬 Note from Doctor Luo: Listen, everyone — this is what physical cooling produced. The heat was trapped inside with no way out, all pushed back in by the ice. This is a demonstration of what not to do: with high fever from an external contraction, you can’t just rely on ice packs to force the heat down. When the heat is depressed inside, it sinks inward instead, and the illness turns serious.
Then Doctor Zhang Xichun felt her pulse: hong da wu lun — the pulse was extremely large, beating very fast, with an unsteady rhythm; an zhi shen shi — pressed deeply, the pulse remained large and solid.
What did Doctor Zhang Xichun think? This is the most crucial moment of the whole case
Doctor Zhang Xichun knew where he stood. He told his fellow townsman Zhu Aiting: this illness is excess heat in the Yangming level — the heat has entered the Yangming (Stomach/Intestine) and reached its extreme; and then the ice packs pushed it further, so the heat became depressed and sank inward, going even deeper. The illness is grave — but it can still be treated!
How to treat it? Raw gypsum must be used in heavy dosage. Doctor Zhang Xichun asked directly: “Do you dare to use it?”
💬 Note from Doctor Luo: Look at Doctor Zhang Xichun’s boldness — the patient was already in a coma, and his opening move was to use raw gypsum in a heavy dose. Where did that confidence come from? From pattern identification. A pulse that is extremely large and solid on deep pressure means the heat is in the Yangming and the upright qi (zheng qi) is still fighting the evil with everything it has. As long as the direction is right and the dose is sufficient, the heat can be driven out.
Zhu Aiting responded: what would I dare not use? If you think it will work, then it will work! I’ll do whatever you say.
The prescription: four liang of raw gypsum, boiled into a pot of rice congee
Doctor Zhang Xichun’s prescription was so simple it was hard to believe: sheng shi gao (raw gypsum) fine powder, 4 liang — about 120 grams in today’s measure — plus jing mi (rice), 8 qian (about 24 g), boiled together into congee.
💬 Note from Doctor Luo: When Doctor Zhang Xichun used this formula on ordinary occasions, he generally used 2 liang of raw gypsum with 2.5 liang of raw rice — that’s the normal ratio. In today’s case, the amount was beyond that — four liang of raw gypsum, clearly increased. Why? Because the illness was too severe. The heat had entered the Yangming and reached its extreme; nothing less than a heavy dose would do.
How was it cooked? Boiled until the rice was completely cooked soft. How many bowls of water? Generally three bowls. Boil until the rice is soft, then drink the clear liquid — the clear rice-water on top.
💬 Note from Doctor Luo: Note there’s a fine point here: you don’t eat the rice, and you don’t eat the raw gypsum powder settled at the bottom — you just drink that bowl of clear rice-water. Some friends ask in the comments: how do you eat raw gypsum? It’s hard as a rock, how do you swallow it? — Folks, nobody told you to eat the gypsum! What you drink is the rice-water. The heat-clearing power is all in that clear liquid — easy to absorb, and it doesn’t harm the Stomach.
Four teacups of clear rice-water, spooned in slowly
The clear rice-water came to four teacups in all. How was it given? To the lady it was spooned in slowly, little by little, while still warm — not poured down all at once, but fed gradually, keeping the warmth going.
💬 Note from Doctor Luo: The patient was unconscious, so giving the medicine took patience. The four cups of rice-water were spooned in, and then they waited for the medicine’s power to dissolve and work inside.
As soon as the medicine was finished, she suddenly woke up clear-headed: one bowl of rice-water pulled a person back from a coma
The medicine had barely been finished when, after a short while — she suddenly woke up clear-headed! The lady opened her eyes at once, and she was back!
💬 Note from Doctor Luo: Everyone, look at this result! A person who had been treated into unconsciousness by the Japanese doctors — Doctor Zhang Xichun brought her back with a single bowl of Shigao Jingmi Tang. That is the power of using raw gypsum in heavy doses with the direction correctly identified. Once the heat is cleared, the spirit (shen ming) returns, and the person naturally wakes up.
But waking up wasn’t the end. Doctor Zhang Xichun prescribed a follow-up formula: zhi mu (anemarrhena), tian hua fen (Trichosanthes root), xuan shen (figwort), and bai shao (white peony) — all herbs that nourish yin, moisten dryness, and clear heat — with a small amount of lian qiao (forsythia) added to clear whatever residual heat remained. She took two doses in all, and the illness was completely cured.
An unexpected bonus: the young Master Zhu became a disciple of Doctor Zhang Xichun
Once the patient recovered, Zhu Aiting was overjoyed. Right then and there he made a decision: “My son Zhu Liangzuo — you will do nothing else. From today you study medicine with Doctor Zhang Xichun!”
💬 Note from Doctor Luo: Why did he send his son to study medicine? In two words: he was convinced. He had watched this truly save a life! Doctor Zhang Xichun’s skill could genuinely pull people back from the brink in a crisis. And so from that day on, Doctor Zhang Xichun gained a disciple named Zhu Liangzuo. Because his mother’s illness was cured, the son set out on the path of medicine — this, perhaps, is the greatest sense of accomplishment a physician can have.
Bonus: Shigao Jingmi Tang — when does it work best?
Finally, Doctor Luo Dalun sums up this formula created by Doctor Zhang Xichun. Why did he create it? He felt that formulas like Baihu Tang (White Tiger Decoction) were comparatively complex in their combination, so he simplified — raw gypsum and rice boiled into a soup together, and that is Shigao Jingmi Tang.
💬 Note from Doctor Luo: What does this formula treat? Doctor Zhang Xichun said: first, a febrile disease just contracted — pulse floating and forceful, beating fast, the body feverish — it can be used; second, after a cold from exposure to chill, when a couple of days later the heat begins to rise, no longer afraid of cold but simply feverish — it can also be used. But there is one iron rule: it must be the kind of fever where the body is vexed and hot, the heart is vexed and hot, the whole body blazing with high fever. If the fever comes with chills all over, shivering with cold — then this won’t do; that’s a different path. Doctor Zhang Xichun used this formula to cure many such patients; the cases are numerous.
That’s all for today. Tomorrow we’ll continue with how Doctor Zhang Xichun used raw gypsum to clear heat outward for his patients.
Compiled from Doctor Luo Dalun’s commentary on the case records of Doctor Zhang Xichun; the case is from Records of Chinese Medicine with Western Reference (《医学衷中参西录》), published in installments 1918–1934.