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INDIVIDUAL HERBS

NAME: ZHI SHI - 枳实 - FRUCTUS AURANTII IMMATURUS - IMMATURE BITTER ORANGE

Pharmaceutical Latin:	Fructus Aurantii Immaturus
Common English:	Immature Bitter Orange Unripe Bitter Orange Chih-Shih Ponciri Citrus

PROPERTIES

Taste	Temperature	Entering Meridians	Dosage
Bitter Acrid (Sour)	Slightly Cold (Cool) (Lukewarm)	Large Intestine Spleen Stomach (Lung)	3-10g Visceroptosis: 12-30g Tincture: 1-4ml Essential Oil: 2-3drops

ACTIONS AND INDICATIONS

Actions

Indications/Syndromes

Breaks up Stagnant Qi, reduces accumulation, descends Qi, unblocks the bowels and removes Stagnant Food

Qi Stagnation and accumulation with epigastric or abdominal pain and distention or indigestion with focal distention or gas

Food Stagnation

Transforms Phlegm, reduces distention and resolves hardenings

Turbid Phlegm Obstructing the Qi with focal distention and fullness in the chest and epigastrium

CONTRAINDICATIONS, INCOMPATIBILITIES AND HERB/DRUG INTERACTIONS

CONTRAINDICATIONS

Use caution during pregnancy.
Use caution if Qi is weak.
Use caution for those with Stomach Deficiency Cold.
Use caution for those with gastric or peptic ulcers.

INCOMPATIBILITIES

HERB/DRUG INTERACTIONS

Concurrent use with diuretics such as chlorothiazide, hydrochlorothiazide, furmoside (Lasix), bumetinide (Bumex) and torsemide (Demadex) may lead to increased elimination of water and/or electrolytes.

MAJOR COMBINATIONS

Qi Tonics	Cx. Magnoliae Hou Po	Cx. Magnoliae Hou Po Rx. et Rz. Rhei Da Huang
Gastrectasis, gastroptosis, rectal prolapse, or uterine prolapse.	Distention, swelling and pain due to Food Stagnation and Qi Stagnation. Patients recovering from chronic illness with epigastric fullness and distention.	Abdominal distention, pain and fullness from Heat clumping with the stool. Constipation with abdominal fullness and pain.
Cx. Magnoliae Hou Po Rz. Coptidis Huang Lian Rz. Pinelliae Preparata Zhi Ban Xia	Rx. et Rz. Rhei Da Huang	Fr. Crataegi Shan Zha Massa Medicata Fermentata Shen Qu (Fr. Hordei Germinatus) (Mai Ya)
Focal distention and fullness in the upper epigastrium, lack of appetite, fatigue and weakness from a Cold-Heat complex secondary to Spleen and Stomach Deficiency.	Constipation and abdominal swelling due to Food and Qi Stagnation. Diarrhea, dysentery and abdominal pain due to Damp-Heat.	Focal distention, swelling and pain along with foul-smelling belching associated with Food Stagnation and Qi Obstruction.
Rz. Atractylodis Macrocephalae Bai Zhu (Caul. Perillae) (Zi Su Geng)	Rx. et Rz. Rhei Da Huang Rx. Scutellariae Huang Qin (Rz. Coptidis) (Huang Lian)	Rx. Paeoniae Alba Bai Shao
Distention in the epigastrium and abdomen due to Spleen and Stomach Deficiency with Food Stagnation.	Dysenteric diarrhea with tenesmus due to Damp-Heat, especially due to Food Stagnation transforming into Damp-Heat.	Abdominal pain due to Qi and Blood Stagnation.
Bul. Allii Xie Bai Ram. Cinnamomi Gui Zhi (Sm. Trichosanthis) (Gua Lou Ren)	Fr. Gardeniae Zhi Zi	Cx. Magnoliae Officinalis Hou Po Rz. Pinelliae Preparata Zhi Ban Xia Rz. Atractylodis Macrocephalae Bai Zhu
Painful chest with epigastric distention due to Upper Jiao Yang Deficiency with Phlegm-Cold Obstructing the chest.	A stifling sensation and distention in the epigastrium with feverishness after a febrile disease.	Epigastric distention and fullness, anorexia and fatigue due to a Cold-Heat complex obstructing the Qi and leading to Damp Accumulation.
Per. Citri Reticulatae Chen Pi	Fr. Aurantii Zhi Ke	Caulis Bambusae in Taeniam Zhu Ru
Strengthens the Middle Jiao.	Strongly promotes Qi flow and breaks up clumps, unblocks both upper and lower parts of the trunk to stop wheezing due to Phlegm, eliminate focal distention and alleviate tenesmus.	Phlegm-Heat obstructing the flow of Qi with focal distention in the chest and epigastrium, hiccup, dry retching, nausea and acid regurgitation. Palpitations, irritability, insomnia and emotional problems due to Gallbladder constraint with Phlegm Disturbing the Heart.
Fr. Gardeniae Zhi Zi Sm. Sojae Preparata Dan Dou Chi	Rx. Aucklandiae Mu Xiang Sm. Arecae Bing Lang Massa Medicata Fermentata Shen Qu	Rx. Bupleuri Chai Hu Rx. Scutellariae Huang Qin Rz. Pinelliae Preparata Zhi Ban Xia
Feelings of Heat in the body.	Abdominal fullness, pain, gas, and irregular bowel movements.	Cholecystitis.

NOTES

This herb has recently used to raise blood pressure.
It is often used in purgative and diuretic formulas.
Zhi Shi is the unripe fruit. The ripe fruit is called Fr. Aurantii Zhi Ke. The two are used synergistically.
The descending action of this herb is intense.
The husk Zhi Qiao is from a larger fruit and is gentler in action. It is used for Yin deficiency patients.
This herb is primarily used for Stagnation of Qi in the Spleen/Stomach.
This herb is used for stagnant Qi that is hot in nature.
This herb is also appropriate for Stagnation in the chest and upper back.
Using a moderate dosage, this herb can treat allergies.
Both Zhi Shi and Fr. Aurantii Zhi Ke are the same fruit at different stages of development. Zhi Shi is unripe and Zhi Ke is almost ripe. Both break up Qi , disperse clumps and Phlegm and reduce focal distention. Zhi Ke governs the upper trunk, including disorders of the chest, diaphragm, skin and body hair while Zhi Shi governs the lower trunk, including disorders of the Heart, abdomen, Spleen and Stomach. Its nature is violent and excels at thrusting downward, while Zhi Ke is gentler and slower in promoting the movement of Qi through the chest, diaphragm, Lungs, Stomach and Large Intestine.
Dry-fried unripe Bitter Orange Chao Zhi Shi is slightly warmer and not so strong in nature and can be used in both Hot and Cold disorders.
Dry-fried Goose-Eyed Unripe Bitter Orange Chao E Yan Zhi Shi is slightly stronger than Chao Zhi Shi.
Charred Unripe Bitter orange Zhi Shi Tan is slightly less cold and enters the Blood level to stop bleeding and is often used for Qi Blockage associated with bleeding such as Intestinal Wind.