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Zhi Shi (Immature Bitter Orange)

Bitter, sour; cold, slightly cold; non-toxic. Mainly treats severe wind in the skin causing itching like hemp seeds or beans, eliminates cold-heat nodulation, stops dysentery, promotes muscle growth, benefits the five zang organs, tonifies qi and lightens the body, eliminates phlegm-rheum in the chest and hypochondrium, drives away stagnant water, breaks solid accumulations, reduces distension and fullness, relieves urgency and stifling pain below the heart and rebellious qi, treats wind-pain in the hypochondrium, stabilizes stomach qi, stops loose stools, brightens the eyes. Grows in the rivers and marshes of Henei. Harvested in the ninth and tenth lunar months, dried in the shade.

Tao Hongjing said: It is now found everywhere. After harvesting, break it open and dry it for use. Remove the central core, lightly roast until fragrant. Like Chen Pi (Aged Tangerine Peel), those that are aged are superior. The stems and bark of the Zhi tree treat edema and acute bone-joint pain caused by sudden wind. Zhi Shi is widely used in secular prescriptions but not required by Daoists. The *Xinxiu Bencao* (Newly Revised Materia Medica) notes: If Zhi Shi is sun-dried, it tends to rot due to dampness. When used, it is best to remove the core and the inner pith. Some people now use Zhi Qiao (Ripe Bitter Orange) instead. If one calls it Zhi Shi, it must be used with the core and pith; otherwise, it is incorrect. Current Zhi Shi in August has thick skin and a pungent flavor. Old texts say that in Jiangnan it is called Ju (Citrus reticulata), while in Jiangbei it is called Zhi. Now, both Zhi and Ju exist in Jiangnan, while only Zhi exists in Jiangbei without Ju. This is naturally due to different species, not transformation. Minister Yuxi et al. according to *Yaoxing Lun* (Treatise on the Properties of Medicinals): Zhi Shi is a minister herb, bitter, pungent. Resolves chest binding from Shanghan (Cold Damage). Used in Xianxiong Tang (Chest-Trap Decoction), mainly treating upper jiao wheezing and cough, cold injury inside the kidney, impotence with qi stagnation, added for use.

*Tujing* says: Zhi Shi grows in the rivers and marshes of Henei; Zhi Qiao grows in the valleys of Shangzhou. Now they are available in Jingxi and various prefectures in Jianghu, with those from Shangzhou being the best. Similar to Ju trees but smaller, about 5-7 chi high. Leaves resemble Cheng leaves, thorny. White flowers bloom in spring, fruits mature in autumn. Harvested in the ninth and tenth lunar months, dried in the shade. Old theories state that harvested in the seventh and eighth months are "Shi" (immature), while those in the ninth and tenth are "Qiao" (ripe). Currently, physicians consider those with thick skin and small size as Zhi Shi, and those complete and large as Zhi Qiao. Those that turn inside out like a bowl rim and are aged are considered superior. Those from nearby regions,俗称 stinking ju, are unsuitable. Zhang Zhongjing treated hardness and fullness below the heart the size of a plate, caused by fluid retention, using Zhi Shi Bai Zhu Tang (Immature Bitter Orange and Atractylodes Macrocephala Decoction). Seven pieces of Zhi Shi, three liang of Bai Zhu, decocted in ten sheng of water to yield three sheng, divided into three doses. Reduce dosage slightly when the abdomen softens. Also for Xiongbi (Chest Bi syndrome), with palpable hardness in the heart, trapped qi forming chest binding, chest fullness, sub-hypochondrial pain, and rebellious qi rushing to the heart, use Zhi Shi Xiebai Guizhi Tang (Immature Bitter Orange, Allium Macrostemon, and Cinnamon Twig Decoction). Four pieces of aged Zhi Shi, four liang of Houpo (Magnolia Bark), half a jin of Xiebai (Allium Macrostemon), chopped, one Gua Lou (Trichosanthes Fruit), one liang of Guizhi (Cinnamon Twig). Decoct in five sheng of water, first decoct Zhi Shi and Houpo to yield two sheng, strain, add remaining herbs, boil for three boils, divide into three warm doses, should heal. There are also Jupi Zhi Shi Tang (Tangerine Peel and Immature Bitter Orange Decoction) and Guishengjiang Zhi Shi Tang (Cinnamon, Fresh Ginger, and Immature Bitter Orange Decoction), both treating Xiongbi and heart pain. Ge Hong treated sudden Xiongbi pain using single Zhi Shi, pounded into powder, one fangcun bi per dose, three times daily and once at night. The root bark treats hematochezia, taken as powder. Can also be boiled as juice for regular drinking. Also treats sudden wind stroke where the body is straight and cannot bend or stretch. Scrape Zhi wood bark dust, called Zhi Ru, one sheng, soak in one sheng of wine overnight, take five ge, repeat if necessary for good effect.

*Waitai Miyao*: Apply for Fengzhen (Wind Rash). Take Zhi Shi, soak in vinegar until wet, roast over fire until hot, apply at moderate temperature as a compress, which will dissipate. *Qianjin Fang*: Treats Xiongbi with qi oppression and fullness, discomfort in the heart and diaphragm. Two liang of Zhi Shi, bran-fried until slightly yellow, powdered. Taken with clear porridge drink, two qian per dose, as needed. *Shenghui Fang* is the same. Another formula treats chronic dysentery with rectal prolapse. Zhi Shi, ground smooth on a stone, attached to a handle, coated with honey, roasted warm, applied repeatedly to the anus until retraction occurs. *Jingyan Fang*: Treats Changfeng Xiaxue (Intestinal Wind with Bleeding). Half a jin of Zhi Shi, bran-fried, pith removed; half a jin of Huangqi (Astragalus Root), washed, cut, and powdered. Taken with rice drink, two qianbi per dose, as needed. If difficult to swallow, make into pills with paste, take 30-50 pills with soup, effective. *Jiyan Fang*: Treats Wuzhi (Five Hemorrhoids) regardless of duration. Powder Zhi Shi, refine honey, make pills like tung seeds, take twenty pills on an empty stomach with water. *Jizhong Fang*: Treats sudden chest and diaphragm closure pain after Shanghan. One ingredient Zhi Shi, chopped, bran-fried yellow, powdered. Take two qian, mixed with rice drink, twice daily. *Guangli Fang*: Treats prolonged dripping dysentery in children with indigestion. Six fen of Zhi Shi, powdered, mixed with juice, two qianbi per dose; one qian for two-year-olds. *Zimu Milu* formula is the same. *Zimu Milu*: Treats firm and painful swelling of the female yin. Use half a jin, crushed and fried thoroughly.

*Yanyi* says: Zhi Shi and Zhi Qiao are the same substance. Small ones have a harsh and rapid nature; large ones have a mild and slow nature. Therefore, Zhang Zhongjing used Zhi Shi in Chengqi Tang (Order-Quieting Decoction) to treat sudden Shanghan diseases, reflecting this intent. Both aim to unblock, drain, and break solid accumulations. Other formulas: merely guiding obstructed qi from wind, suitable for long-term use, thus use Zhi Qiao, such is the intent.