泻、破气行痰。
苦酸微寒。皆能破气。气顺则痰行喘止。痞胀消。（脾无积血、心下不痞、浊气在上、
则生
胀、东垣曰∶枳实治下而主血、枳壳治上而主气。）刺痛息。后重除。治胸痹结胸。食积
五膈。痰癖症结。呕逆咳嗽。水肿胁胀。泻痢淋闭。痔肿肠风。所主略同。但枳实利胸膈。
枳壳宽肠胃。枳实力猛。（丹溪曰∶枳实泻痰、能冲墙倒壁。）枳壳力缓为少异。（时珍曰∶
壳实、上世未分、魏晋始分用、洁古东垣始分壳治上、实治下、海藏始分壳主气、实主血、
然仲景治上焦胸痹痞满、用枳实、古方治下血痢痔、肠秘后重、用枳壳、则实不独治下、而
壳不独治上也、盖自飞门至魄门、皆肺主之、三焦相通、一气而已。）大损真元。胀满因于
邪实者可用。若因土虚不能制水。肺虚不能行气。而误用之。则祸不旋踵。气弱脾虚。以致
停食痞满。法当补中益气。则食自化痞自消。若再用此破气。是抱薪救火矣。孕妇虚者尤忌
。（元素曰∶枳壳泄气、走大肠、损胸中至高之气。昔湖阳公主难产、方士进瘦胎饮、用
枳壳四两、甘草二两、五月后日服一钱、洁古改以枳术、名束胎丸、寇宗 明其不然、盖孕
妇全赖血气以养胎、血气充实、胎乃易生、彼公主奉养太过、气实有余、故可服之、若概施
则误矣。吕用晦曰∶瘦胎束胎名目、亦启粗工攻伐之门。时珍曰∶八九月胎气盛、壅滞
用枳壳苏梗以顺气、胎前无滞、则产后无虚也、气弱者、大非所宜矣。）皮浓而小为枳实。
壳薄虚大为枳壳。陈者良。麸炒用。（今人于六七月采小香栾、伪为枳实枳壳、又有采枸
橘伪为者。）
Purgative, breaks Qi, moves phlegm.
Bitter, sour, slightly cold in nature. Both [Zhi Shi and Zhi Ke] can break Qi. When Qi flows smoothly, phlegm moves, wheezing stops, and epigastric fullness and distension resolve. (When the Spleen has no accumulated blood, there is no epigastric stuffiness; when turbid Qi stays in the upper part, distension arises. Li Dongyuan said: Zhi Shi treats the lower part and governs Blood; Zhi Ke treats the upper part and governs Qi.) Stabbing pain ceases, breathing becomes smooth, tenesmus is removed. It treats Chest Bi (chest obstruction), Jie Xiong (accumulation of heat and fluid in the chest/epigastrium), food stagnation, Wu Ge (five types of diaphragmatic disorders), Tan Pi (phlegm-fluid retention in the hypochondrium), Zheng Jie (abdominal masses), vomiting and regurgitation, cough, edema, hypochondriac distension, diarrhea and dysentery, stranguria and urinary retention, hemorrhoid swelling, and Chang Feng (wind in the intestines causing bleeding). Their indications are roughly the same. However, Zhi Shi benefits the chest and diaphragm, Zhi Ke widens the stomach and intestines, and Zhi Shi has a stronger action. (Zhu Danxi said: Zhi Shi purges phlegm with such power it can knock down walls.) Zhi Ke has a milder action, which is the slight difference. (Li Shizhen said: The shell and the fruit were not distinguished in ancient times; they began to be used separately during the Wei and Jin dynasties. Zhang Jiegou and Li Dongyuan began to distinguish that Zhi Ke treats the upper part and Zhi Shi treats the lower part. Hai Zang began to distinguish that Zhi Ke governs Qi and Zhi Shi governs Blood. However, Zhang Zhongjing used Zhi Shi for upper Jiao Chest Bi and epigastric fullness; ancient prescriptions used Zhi Ke for lower Jiao bloody dysentery, hemorrhoids, intestinal constipation, and tenesmus. Thus, Zhi Shi does not only treat the lower part, nor does Zhi Ke only treat the upper part. Generally, from the Fei Men (anus) to the Po Men (rectum/anus), all are governed by the Lung. The Triple Burner communicates, and it is all one Qi.) They severely damage True Yuan (True Origin/Essential Qi). They may be used if distension and fullness are due to excess pathogenic factors. If they are mistakenly used when the cause is Spleen Earth deficiency failing to control Water, or Lung deficiency failing to move Qi, disaster will follow immediately. For Qi deficiency and Spleen deficiency leading to food stagnation and fullness, the method should be to tonify the Middle and benefit Qi, so that food digests naturally and fullness resolves. Using this Qi-breaking herb in such cases is like carrying firewood to put out a fire. Pregnant women with deficiency are especially contraindicated. (Zhang Yuansu said: Zhi Ke drains Qi, travels to the Large Intestine, and damages the highest Qi in the chest. In the past, Princess Huyang had difficult labor; a physician prescribed Shou Tai Yin (Thin Fetus Decoction) using four liang of Zhi Ke and two liang of Gancao, taken daily after the fifth month of pregnancy. Zhang Jiegou modified it into Zhi Zhu Wan, naming it Shu Tai Wan (Bind Fetus Pill). Kou Zongshi clarified this was incorrect, as pregnant women rely entirely on Blood and Qi to nourish the fetus; when Blood and Qi are sufficient, birth is easier. That princess was over-nourished and had excess Qi, so she could take it, but applying it generally would be a mistake. Lü Yonghui said: Names like "Thin Fetus" and "Bind Fetus" also open the door for crude physicians to use attacking methods. Li Shizhen said: In the eighth and ninth months, fetal Qi is vigorous; if there is stagnation, Zhi Ke and Su Geng are used to smooth Qi. If there is no stagnation before birth, there will be no deficiency after birth. For those with weak Qi, it is highly unsuitable.) The variety with thick skin and small size is Zhi Shi. The variety with thin shell and large, hollow interior is Zhi Ke. Aged material is good. Use wheat bran stir-fried. (Currently, people pick small Xiang Luan in June and July to fake Zhi Shi and Zhi Ke, and some pick Ju Ju to fake them.)