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。）
泻下、破气行痰。
味苦、酸，性微寒。枳实与枳壳都能破气。气机顺畅则痰液运行、喘息停止、痞满胀气消除。（脾脏没有积血，心下就不会痞塞；浊气停留在上部，就会产生胀气。李东垣说：枳实主治下部且主血分，枳壳主治上部且主气分。）刺痛缓解，呼吸平顺，里急后重消除。治疗胸痹（胸部闷痛）、结胸（邪热与水饮互结于胸脘）、食积、五膈（五种膈证）、痰癖（痰饮停聚胁肋）、症结（腹内结块）、呕吐逆气、咳嗽、水肿、胁肋胀满、泄痢、淋证闭阻、痔疮肿痛、肠风（便血）。两者的主治功效大致相同。只是枳实善于通利胸膈，枳壳善于宽舒肠胃，枳实力道猛烈。（朱丹溪说：枳实泻除痰饮，力量大得能冲墙倒壁。）枳壳力道缓和，这是细微的区别。（李时珍说：壳与实在上古时期并未区分，魏晋时期才开始分别使用，张洁古、李东垣开始区分枳壳治上、枳实治下，王海藏开始区分枳壳主气、枳实主血。然而张仲景治疗上焦胸痹痞满时用枳实，古方治疗下焦血痢痔疮、肠秘后重用枳壳，那么枳实并不只治下部，而枳壳也不只治上部。大概从肛门到魄门，都由肺所主管，三焦相通，只是一股气而已。）枳实枳壳大损人体真元之气。如果是因邪气实盛导致的胀满，可以使用。如果是因为脾气虚弱不能制水，肺气虚弱不能行气，而误用它们，那么灾祸就会立刻降临。气弱脾虚，导致食物停滞、痞满，治法应当补益中气、升举阳气，那么食物自然消化，痞满自然消除。如果再用这种破气的药，就像是抱着柴草去救火一样危险。孕妇体质虚弱者尤其禁忌。（张元素说：枳壳泄气，走大肠，损伤胸中至高之气。从前湖阳公主难产，方士进献瘦胎饮，用枳壳四两、甘草二两，怀孕五月后每天服用一钱。张洁古将其改为枳术丸，名为束胎丸。寇宗奭阐明这不对，因为孕妇全赖气血来滋养胎儿，气血充实，胎儿才容易生产。那位公主供养太过，气实有余，所以可以服用，如果一概施用就错了。吕用晦说：瘦胎、束胎的名目，也开启了粗劣医生攻伐的大门。李时珍说：八九月胎气旺盛，壅滞时用枳壳、苏梗来顺气，产前无滞塞，产后就不会虚弱。气弱者，非常不适合使用。）皮厚而小的是枳实。壳薄而虚大的是枳壳。陈久的质量好。用麦麸炒制后用。（现在有人在六七月采摘小的香栾，伪造成枳实和枳壳，又有采摘枸橘伪造成的。）
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.)