泻，破气，行痰。枳实小，枳壳大
苦酸微寒。其功皆能破气。气行则痰行喘止，痞胀消（脾无积血；心下不痞；浊气在上
，则生腹胀。东垣曰∶枳实治下而主血，枳壳治上而主气），痛刺息，后重除。
治胸痹结胸，食积五膈，痰癖症结，呕逆咳嗽，水肿胁胀（肝郁），泻痢淋闭，痔肿肠
风。除风去痹（辛散风），开胃健脾。所主略同，但枳实利胸膈，枳壳宽肠胃。枳实力猛（大、
小承气汤皆用之。丹溪曰∶枳实泻痰，能冲墙倒壁），枳壳力缓为少异。孕妇及气虚人忌用
（按∶《本草》壳、实皆云明目。思之不得其解，然目疾方中多用之，岂以其破浊气？即能
升清气乎？《本经》又言枳实益气，想亦同此理也。故浓朴调中，亦有益气明目之文。王好
古曰∶枳实佐以参、术、干姜则益气，佐以硝、黄、牵牛则破气，此本经所以言益气，而复
言消痞也。张元素曰∶枳壳泄肺、走大肠，多用损胸中至高之气。昔湖阳公主难产，方士进
瘦胎饮，用枳壳四两，甘草三两，五月后日服一钱。张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。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（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；诸方治下血、痢、痔、肠秘、后重用枳壳，则实不独治下，而壳不独治高
也。盖自飞门至魄门，皆肺主之，三焦相通，一气而已。飞门，口也。魄门，即肛门）。
Purgative, breaks Qi, moves phlegm. Zhi Shi (Immature Bitter Orange) is small, Zhi Ke (Mature Bitter Orange) is large.
Bitter, sour, slightly cold. Their function is to break Qi. When Qi moves, phlegm moves and wheezing stops; fullness and distension resolve [Spleen has no accumulated blood; the epigastrium is not obstructed; turbid Qi staying in the upper part causes abdominal distension. Li Dongyuan said: Zhi Shi treats the lower part and governs the Blood aspect, while Zhi Ke treats the upper part and governs the Qi aspect], pain is relieved, breathing becomes smooth, and tenesmus is removed.
Treats chest bi (Chest Bi), chest binding, food stagnation in the five diaphragms, phlegm retention and mass formation, vomiting, regurgitation, coughing, edema, and hypochondriac distension [Liver Qi stagnation], dysentery, strangury, obstruction, hemorrhoids, swelling, and intestinal wind. Dispels wind and removes bi [Acrid disperses wind], opens the stomach and strengthens the Spleen. Their indications are roughly the same, but Zhi Shi benefits the chest and diaphragm, while Zhi Ke expands the stomach and intestines. Zhi Shi has a strong force [Da Cheng Qi Tang (Major Order the Qi Decoction) and Xiao Cheng Qi Tang (Minor Order the Qi Decoction) both use it. Zhu Danxi said: Zhi Shi purges phlegm and can demolish walls], whereas Zhi Ke has a milder force, which is a slight difference. Pregnant women and those with Qi deficiency should avoid using it [Note: The Ben Cao texts state that both Zhi Ke and Zhi Shi brighten the eyes. I pondered this without finding an explanation, yet they are frequently used in formulas for eye diseases. Could it be that by breaking turbid Qi, they promote the ascent of clear Qi? The Ben Jing also states that Zhi Shi tonifies Qi, which likely shares this logic. Therefore, Hou Po (Magnolia Bark), which regulates the middle, also contains references to tonifying Qi and brightening the eyes. Wang Haogu said: Zhi Shi tonifies Qi when combined with Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala Rhizome), and Gan Jiang (Dried Ginger); it breaks Qi when combined with Mang Xiao (Mirabilite), Da Huang (Rhubarb Root and Rhizome), and Qian Niu Zi (Pharbitis Seed). This explains why the Ben Jing mentions both tonifying Qi and resolving masses. Zhang Yuansu said: Zhi Ke drains the Lung and travels to the Large Intestine; excessive use damages the highest Qi in the chest. In the past, Princess Huyang had difficult labor, and a physician prescribed Shou Tai Yin (Fetus-Thinning Decoction), using four liang of Zhi Ke and three liang of Gan Cao (Licorice Root), taken daily after the fifth month of pregnancy. Zhang Jiegu modified this into Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Pill), naming it Shu Tai Wan (Fetus-Binding Pill). Kou Zongshi clarified that this was incorrect, as pregnant women rely entirely on Blood and Qi to nourish the fetus; only when Blood and Qi are sufficient is the fetus easy to deliver. That princess was over-nourished and had excess Qi, so she could take it, but applying it generally would be a mistake. Li Shizhen said: In the eighth and ninth months of pregnancy, Qi is abundant and stagnant; using Zhi Ke and Su Geng (Perilla Stem) to smooth Qi ensures no stagnation before birth, thus no deficiency after birth. For those with weak Qi, it is highly unsuitable].
The peel is thick and the fruit is small, hence Zhi Shi; the peel is thin and the fruit is hollow and large, hence Zhi Ke. Aged material is superior. Use after stir-frying with bran [Li Shizhen said: Zhi Ke and Zhi Shi were not distinguished in ancient times; differentiation began in the Wei and Jin dynasties. Jiegu and Dongyuan began distinguishing Zhi Ke for the upper part and Zhi Shi for the lower part. Haicang began distinguishing Zhi Ke for governing Qi and Zhi Shi for governing Blood. However, Zhang Zhongjing used Zhi Shi for upper jiao chest bi and fullness; various formulas used Zhi Ke for lower bleeding, dysentery, hemorrhoids, intestinal constipation, and tenesmus. Thus, Zhi Shi does not exclusively treat the lower, nor does Zhi Ke exclusively treat the upper. From Fei Men (the mouth) to Po Men (the anus), all are governed by the Lung; the San Jiao (Triple Burner) is interconnected, constituting one Qi. Fei Men refers to the mouth. Po Men refers to the anus].