主治结实之毒也。旁治胸满胸痹、腹满腹痛。
考 证
枳实汤证曰∶心下坚大如盘。
以上一方，枳实七枚。
枳实芍药散证曰∶腹痛烦满。
以上一方，枳实诸药等分。
桂枝枳实生姜汤证曰∶心悬痛。
大承气汤证曰∶腹胀满。
浓朴三物汤证曰∶痛而闭。
浓朴七物汤证曰∶腹满。
栀子大黄豉汤证曰∶热痛。
以上五方，枳实皆五枚。
大柴胡汤证曰∶心下急、郁郁微烦。
枳实薤白桂枝汤证曰∶胸满。
栀子浓朴汤证曰∶心烦腹满。
以上三方，枳实皆四枚。
小承气汤证曰∶腹大满不通。
枳实栀子豉汤，证不具也。（说在互考中）
橘皮枳实生姜汤证曰∶胸痹。
以上三方，枳实皆三枚。
上历观此诸方，枳实主治结实之毒也明矣。
互 考
仲景氏用承气汤也，大实大满，结毒在腹，则大承气汤，其用枳实也五枚；唯腹满不通，
则
枳实栀子豉汤，其证不具也。为则按∶栀子香豉，主治心中懊 。而更加枳实，则其有
胸满之证明矣。
品 考
枳实 本邦所产称枳实者，不堪用也。汉土之产，亦多赝也，不可不择焉。《本草纲目》
诸家，岐枳实、枳壳而为之说，非古也。吾则从仲景氏也。
主治心烦也，旁治发黄。
考 证
大黄硝石汤证曰∶黄胆。
栀子柏皮汤证曰∶身黄。
以上二方，栀子皆十五枚。
栀子豉汤证曰∶烦。
栀子甘草豉汤，证不具也。（说在香豉部中）
栀子生姜豉汤，证不具也。（说在香豉部中）
枳实栀子豉汤，证不具也。（说在枳实部中）
栀子浓朴汤证曰∶心烦。
栀子干姜汤证曰∶微烦。
茵陈蒿汤证曰∶心胸不安、久久发黄。
以上七方，栀子皆十四枚。
栀子大黄豉汤证曰∶黄胆。
以上一方，栀子十二枚。
上历观此诸方，栀子主治心烦也明矣。发黄者，其所旁治也，故无心烦之证者而用之，
则未见其效矣。
互 考
栀子大黄豉汤，栀子十二枚。为则按∶当作十四枚，是栀子剂之通例也。
为则按∶香豉，以心中懊 为主，栀子则主心烦也。
辨 误
本草诸说，动辄以五色配五脏。其说曰∶栀子色赤，味苦入心而治烦。又曰∶栀子治发
黄，黄是土色，胃主土，故治胃中热气。学人取其然者，而莫眩其所以然者，斯为可矣。
品 考
栀子 处处出焉。锉用。
Treats the toxicity of solid accumulation. Adjunctively treats chest fullness, chest bi-syndrome (obstruction), abdominal fullness, and abdominal pain.
Evidence
The syndrome of Zhishi Decoction presents as: hardness in the epigastrium as large as a plate.
In the above one formula, seven seeds of Aurantii Fructus Immaturus (Zhishi) are used.
The syndrome of Zhishi Shaoyao Powder presents as: abdominal pain, vexation, and fullness.
In the above one formula, Aurantii Fructus Immaturus (Zhishi) is used in equal proportion with other herbs.
The syndrome of Guizhi Zhishi Shengjiang Decoction presents as: hanging pain in the heart region.
The syndrome of Dachengqi Tang presents as: abdominal fullness.
The syndrome of Houpo Sanwu Tang presents as: pain with constipation.
The syndrome of Houpo Qiwu Tang presents as: abdominal fullness.
The syndrome of Zhizi Dahuang Chi Decoction presents as: painful heat.
In the above five formulas, five seeds of Aurantii Fructus Immaturus (Zhishi) are all used.
The syndrome of Da Chaihu Tang presents as: urgency in the epigastrium and slight depression/vexation.
The syndrome of Zhishi Xiebai Guizhi Decoction presents as: chest fullness.
The syndrome of Zhizi Houpo Tang presents as: vexation and abdominal fullness.
In the above three formulas, four seeds of Aurantii Fructus Immaturus (Zhishi) are all used.
The syndrome of Xiao Chengqi Tang presents as: severe abdominal fullness and obstruction.
The syndrome of Zhishi Zhizi Chi Decoction is not fully described. (See Mutual Examination).
The syndrome of Jupi Zhishi Shengjiang Decoction presents as: chest bi-syndrome.
In the above three formulas, three seeds of Aurantii Fructus Immaturus (Zhishi) are all used.
Having reviewed these various formulas, it is clear that the primary indication for Aurantii Fructus Immaturus (Zhishi) is to treat the toxicity of solid accumulation.
Mutual Examination
When Zhang Zhongjing uses Chengqi Decoctions, if there is extreme excess and fullness with toxic accumulation in the abdomen, Dachengqi Tang is used, employing five seeds of Aurantii Fructus Immaturus (Zhishi); if there is merely abdominal fullness and obstruction, it involves Zhishi Zhizi Chi Decoction, whose syndrome description is incomplete. Based on this analysis: Fermented Soybean (Chi) primarily treats mental restlessness (Ao Nao); when Aurantii Fructus Immaturus (Zhishi) is added, it indicates that treating chest fullness is an explicit symptom.
Product Examination
Aurantii Fructus Immaturus (Zhishi) produced locally [in Japan] is unsuitable for use. Those produced in China also contain many fakes; careful selection is necessary. The *Bencao Gangmu* and other authorities distinguish between Zhishi and Zhike and offer explanations, which is not ancient practice. I follow Zhang Zhongjing.
Primary indication: Vexation. Adjunctive indication: Jaundice.
Evidence
The syndrome of Dahuang Xiaoshi Tang presents as: jaundice.
The syndrome of Zhizi Bopi Tang presents as: yellowing of the body.
In the above two formulas, fifteen pods of Gardeniae Fructus (Zhizi) are all used.
The syndrome of Zhizi Chi Decoction presents as: vexation.
Zhizi Gancao Chi Decoction, syndrome description incomplete. (See section on Fermented Soybean).
Zhizi Shengjiang Chi Decoction, syndrome description incomplete. (See section on Fermented Soybean).
Zhishi Zhizi Chi Decoction, syndrome description incomplete. (See section on Aurantii Fructus Immaturus).
The syndrome of Zhizi Houpo Tang presents as: vexation.
The syndrome of Zhizi Ganjiang Tang presents as: slight vexation.
The syndrome of Yinchen Hao Tang presents as: mental uneasiness and gradual development of jaundice.
In the above seven formulas, fourteen pods of Gardeniae Fructus (Zhizi) are all used.
The syndrome of Zhizi Dahuang Chi Decoction presents as: jaundice.
In the above one formula, twelve pods of Gardeniae Fructus (Zhizi) are used.
Having reviewed these various formulas, it is clear that the primary indication for Gardeniae Fructus (Zhizi) is to treat vexation. Jaundice is its adjunctive indication; therefore, using it without the symptom of vexation has not been seen to be effective.
Mutual Examination
In Zhizi Dahuang Chi Decoction, the dosage of Gardeniae Fructus (Zhizi) is twelve pods. Based on this analysis: It should be fourteen pods, which is the standard dosage for Zhizi formulas.
Based on this analysis: Fermented Soybean (Chi) primarily treats mental restlessness (Ao Nao), whereas Gardeniae Fructus (Zhizi) primarily treats vexation.
Correction of Errors
Various Bencao theories often map the five colors to the five zang organs. They state: "Gardeniae Fructus (Zhizi) is red, bitter in taste, enters the Heart, and thus treats vexation." They also say: "Gardeniae Fructus (Zhizi) treats jaundice; yellow corresponds to Earth, the Stomach governs Earth, so it treats heat qi in the Stomach." Scholars accept what appears correct but do not explore the underlying rationale; this suffices.
Product Examination
Gardeniae Fructus (Zhizi) grows everywhere. Use after chopping.