HERB FORMULAS

ZHI SHI XIAO PI WAN - 枳实消痞囊 - UNRIPE BITTER ORANGE PILL TO REDUCE FOCAL DISTENTION

English: Unripe Bitter Orange to Reduce Distention
Also Known As:

HERBS AND ACTIONS

Pharmaceutical Latin
Pin Yin
Dosage
Actions
Fr. Aurantii Immaturus Zhi Shi 15g Breaks up Stagnant Qi, reduces accumulation, descends Qi, unblocks the bowels, removes Stagnant Food, transforms Phlegm, reduces distention and resolves hardenings.
With Zhi Hou Po, for distention, swelling and pain due to Food Stagnation and Qi Stagnation.
With Zhi Hou Po, Huang Lian, Bai Zhu and Zhi Ban Xia, for distention and fullness in the upper epigastrium, lack of appetite, fatigue and weakness from a Cold-Heat complex secondary to Spleen and Stomach Deficiency.
With Bai Zhu, for distention in the epigastrium and abdomen due to Spleen and Stomach Deficiency with Food Stagnation.
Fried Cx. Magnoliae Officinalis Zhi Hou Po 12g Promotes the movement of Qi in the Middle Jiao, resolves Stagnation, descends Qi, dries Dampness and transforms Phlegm.
With Zhi Shi, for abdominal or chest distention, focal epigastric distention, wheezing, shortness of breath, nausea, rebellious Qi or constipation from Cold, Heat, Dampness or Phlegm as long as clumped Qi is at the root of the problem.
With Gan Jiang, for acute diarrhea from Cold attacking the Middle.
With Huang Lian, for acute diarrhea associated with sudden turmoil disorder from Damp-Heat.
Rz. Coptidis Huang Lian 15g Clears Heat, drains Dampness and drains Stomach Fire.
With Zhi Ban Xia and Gan Jiang, for Cold and Heat complexes in the Intestines and Stomach marked by focal distention, nausea, vomiting and feelings of oppression in the chest.
Rz. Pinelliae Preparata Zhi Ban Xia 9g Dries Dampness, transforms Phlegm, descends Rebellious Qi and stops vomiting.
With Huang Lian, for epigastric distention and indigestion due to a simultaneous invasion of Hot and Cold pathogenic influences into the Stomach.
With Zhi Hou Po, for Phlegm-Dampness with Qi Stagnation to open Phlegm and Qi Obstruction with a sensation of fullness in the chest with coughing and wheezing, nausea, vomiting and a sensation of distention in the hypochondrium.
Rx. Ginseng Ren Shen 9g Tonifies Spleen, Stomach and Lung Qi.
With Bai Zhu, tonifies the transformation and transportation functions of the Spleen.
(Rx. Codonopsis) (Dang Shen) (18g) (Substitutes for Ren Shen.)
Rz. Atractylodis Macrocephalae Bai Zhu 6g Tonifies the Spleen, augments Qi, dries Dampness and promotes water metabolism.
With Dang Shen and Gan Jiang, for Deficiency Cold of the Middle Jiao with abdominal pain, distention, vomiting and diarrhea.
With Zhi Shi, for Spleen Deficiency with Qi Stagnation with anorexia, epigastric focal distention and fullness.
With Fu Ling and Zhi Gan Cao, for Spleen and Stomach Qi Deficiency.
With Zhi Shi, Ren Shen, Fu Ling and Zhi Gan Cao, for Spleen and Stomach Qi Deficiency with Qi and Food Stagnation.
With Gan Jiang, Ren Shen and Zhi Gan Cao, for Spleen and Stomach Deficiency Cold.
Poria Fu Ling 6g Promotes urination, leaches out Dampness, strengthens the Spleen and harmonizes the Middle Jiao.
With Bai Zhu, strengthens the Spleen and resolves Dampness.
With Ren Shen and Bai Zhu, for a weak and deficient Spleen with fatigue, anorexia and loose stools.
With Zhi Ban Xia, expels Phlegm and stops nausea and vomiting, hiccups, coughs with clear, profuse Phlegm and loose and watery stools.
Fr. Hordei Germinatus Mai Ya 6g Reduces Food Stagnation, improves digestion, strengthens the Stomach and facilitates the smooth flow of Liver Qi.
With Gan Jiang, for indigestion due to Spleen and Stomach Deficiencies.
Rz. Zingiberis Gan Jiang 3-6g Warms the Middle and expels Cold.
With Bai Zhu, for diarrhea due to Spleen Deficiency.
With Bai Zhu and Ren Shen, for Spleen Yang Deficiency with a cold abdomen, vomiting and diarrhea.
With Zhi Ban Xia, for vomiting of saliva or dry heaves due to Cold-induced congested fluids.
With Zhi Gan Cao, for epigastric pain and vomiting due to Spleen and Stomach Deficiency Cold.
With Zhi Ban Xia and Ren Shen, for vomiting due to Deficiency Cold.
Rx. Glycyrrhizae Preparata Zhi Gan Cao 6g Tonifies the Spleen, augments Qi, moderates and harmonizes the harsh properties of other herbs and guides the herbs to all twelve channels.
With Dang Shen, for anorexia, fatigue and loose stools due to Spleen Deficiency.

FORMULA ACTIONS

  • Moves Qi
  • Reduces focal distention
  • Eliminates fullness
  • Strengthens the Spleen
  • Harmonizes the Stomach

SYNDROMES

  • Spleen Qi Deficiency with Liver Qi Stagnation with Cold and Heat

CLINICAL MANIFESTATIONS

  • Distention and fullness in the upper epigastrium
  • Lack of thirst
  • Lack of appetite
  • Fatigue
  • Weakness
  • Maybe focal distention in the chest and abdomen
  • A wan complexion
  • Lethargy
  • Poor digestion
  • Irregular bowel movements (sometimes loose, sometimes hard)
  • P: Wiry at the right middle position
  • T: Normal
  • C: Greasy and maybe yellow

TREATS

CONTRAINDICATIONS AND HERB/DRUG INTERACTIONS

CONTRAINDICATIONS
  • Use with caution for those with severe Qi Deficiency.
HERB/DRUG INTERACTIONS

NOTES

MODIFICATIONS

For severe Cold and pain: For a chronic, productive cough with wheezing and a sense of fullness and distention in the chest and diaphragm:
+ less Rz. Coptidis Huang Lian
+ more Rz. Zingiberis Gan Jiang
+ Rz. Alpiniae Officinarum Gao Liang Jiang - Rz. Coptidis Huang Lian
+ Per. Citri Reticulatae Chen Pi
+ Cx. Cinnamomi Rou Gui + Fr. Amomi Sha Ren
For parasite accumulation: or
+ Fr. Quisqualis Shi Jun Zi + Per. Citri Reticulatae Chen Pi
+ Sm. Arecae Bing Lang + Fr. Amomi Sha Ren
For more pronounced Food Stagnation:
+ Rx. Platycodi
+ Fr. Crataegi Shan Zha
For more pronounced Qi Stagnation with pain:
+ Massa Medicata Fermentata Shen Qu + Rx. Aucklandiae Mu Xiang
+ Per. Citri Reticulatae Chen Pi
For more pronounced Dampness: For chronic gastritis due to Liver Qi Attacking the Stomach:
+ Rz. Atractylodis Cang Zhu
For chronic gastritis due to Spleen and Stomach Deficiency Cold: - Rz. Zingiberis Gan Jiang
+ Rx. Bupleuri Chai Hu
- Rz. Coptidis Huang Lian + Per. Citri Reticulatae Chen Pi
+ Rz. Zingiberis Preparata Pao Jiang + Rx. Salviae Miltiorrhizae Dan Shen
+ Ram. Cinnamomi Gui Zhi For chronic gastritis due to Damp-Heat Affecting the Spleen and Stomach:
For chronic atrophic gastritis with Excess Heat:
+ less Rz. Zingiberis Gan Jiang + Cx. Moutan Mu Dan Pi
+ more Rz. Coptidis Huang Lian + Fr. Gardeniae Zhi Zi
For chronic atrophic gastritis with Excess Cold: For chronic atrophic gastritis with frequent belching:
+ less Rz. Coptidis Huang Lian
+ more Rz. Zingiberis Gan Jiang + Flos Inulae Xuan Fu Hua
For indigestion due to Stomach Yin Deficiency: For indigestion with constipation:
- Rz. Pinelliae Preparata Zhi Ban Xia + Rx. et Rz. Rhei Da Huang
- Rz. Zingiberis Recens Sheng Jiang + Fr. Trichosanthis Gua Lou
+ Rz. Polygonati Odorati Yu Zhu For indigestion with upper abdominal pain:
+ Hb. Dendrobii Shi Hu + Rx. Aucklandiae Mu Xiang
For indigestion with burning sensations in the Stomach and acid reflux: + Rz. Corydalis Yan Hu Suo
For indigestion with a thick, greasy tongue coat:
+ Left Metal Pill
Zuo Jin Wan
- Rz. Atractylodis Macrocephalae Bai Zhu
For Intestinal Obstruction: + Rz. Atractylodis Cang Zhu
- Rx. Ginseng Ren Shen + Fr. Amomi Rotundus Bai Dou Kou
+ Rx. Panacis Quinquifolii Xi Yang Shen For Intestinal Obstruction with severe abdominal pain:
For Intestinal Obstruction with severe Food Stagnation: + Fr. Toosendan Chuan Lian Zi
+ Rz. Corydalis Yan Hu Suo
+ Massa Medicata Fermentata Shen Qu For Intestinal Obstruction with severe damage to Body Fluids:
+ Fr. Crataegi Shan Zha + Hb. Dendrobii Shi Hu
For cholecystitis and cholelithiasis with Excess Heat: + Rx. Trichosanthis Tian Hua Fen
For cholecystitis and cholelithiasis with stabbing pain in the hypochondrium:
+ Rx. et Rz. Rhei Da Huang
For cholecystitis and cholelithiasis with nausea and vomiting: + Rx. Bupleuri Chai Hu
+ Rx. Curcumae Yu Jin
+ Caulis Bambusae in Taeniam Zhu Ru For cholecystitis and cholelithiasis with constipation and dry stools:
For cholecystitis and cholelithiasis with jaundice: + Rx. et Rz. Rhei Da Huang
+ Fr. Trichosanthis Gua Lou
+ Hb. Artemisiae Scopariae Yin Chen Hao For Cushing's syndrome:
- Rz. Coptidis Huang Lian
+ Fr. Gardeniae Zhi Zi - Rz. Pinelliae Preparatum Zhi Ban Xia
For Cushing's syndrome with a headache and dizziness:
- Fr. Hordei Germinatus Mai Ya
- Rz. Coptidis Huang Lian - Rz. Zingiberis Gan Jiang
- Rz. Pinelliae Preparatum Zhi Ban Xia + 30g Fr. Crataegi Shan Zha
+ 30g Rx. Stephaniae Tetrandrae Han Fang Ji
- Fr. Hordei Germinatus Mai Ya
- Rz. Zingiberis Gan Jiang + 15g Sm. Raphani Lai Fu Zi
+ 30g Fr. Crataegi Shan Zha + 9g Sm. Sinapis Bai Jie Zi
+ 30g Rx. Stephaniae Tetrandrae Han Fang Ji + 9g Rz. Alismatis Ze Xie
For Cushing's syndrome with constipation:
+ 15g Sm. Raphani Lai Fu Zi - Rz. Coptidis Huang Lian
+ 9g Sm. Sinapis Bai Jie Zi - Rz. Pinelliae Preparatum Zhi Ban Xia
+ 9g Rz. Alismatis Ze Xie
+ 9g Flos Magnoliae Ju Hua - Fr. Hordei Germinatus Mai Ya
+ 15g Rx. Chuanxiong Chuan Xiong - Rz. Zingiberis Gan Jiang
For Cushing's syndrome with Kidney Yang Deficiency: + 30g Fr. Crataegi Shan Zha
+ 30g Rx. Stephaniae Tetrandrae Han Fang Ji
- Rz. Coptidis Huang Lian
- Rz. Pinelliae Preparatum Zhi Ban Xia + 15g Sm. Raphani Lai Fu Zi
+ 9g Sm. Sinapis Bai Jie Zi
- Fr. Hordei Germinatus Mai Ya + 9g Rz. Alismatis Ze Xie
- Rz. Zingiberis Gan Jiang + 6g Natrii Sulfas Mang Xiao
+ 30g Fr. Crataegi Shan Zha + up to 15g Rx. et Rz. Rhei Da Huang
+ 30g Rx. Stephaniae Tetrandrae Han Fang Ji
   
+ 15g Sm. Raphani Lai Fu Zi    
+ 9g Sm. Sinapis Bai Jie Zi    
+ 9g Rz. Alismatis Ze Xie    
+ 9g Rx. Aconiti Lateralis Preparata Zhi Fu Zi    
   
+ 6g Rz. Zingiberis Gan Jiang