Zhǐ Shí (枳实) — Immature Bitter Orange
On this page
- Overview
- Properties
- Actions and indications
- Modern research
- Cautions and contraindications
- Treatment at my clinic
1. Overview
Zhǐ Shí (枳实) is the immature fruit of Citrus aurantium, the bitter orange. It belongs to the category of Herbs that regulate Qi in the Chinese Materia Medica and is one of the strongest Qi-breaking herbs in Chinese herbal medicine, used for severe food stagnation, abdominal distension and stuck phlegm with constipation. The mature fruit is Zhǐ Ké, which is gentler.
I prescribe Zhǐ Shí as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.
2. Properties
| Pinyin name | Zhǐ Shí |
|---|---|
| Chinese characters | 枳实 |
| Latin name | Citrus aurantium (immature fruit) |
| English name | Immature bitter orange / Unripe bitter orange |
| Nature | Slightly cold |
| Flavour | Bitter, acrid, sour |
| Channels entered | Spleen, Stomach, Large Intestine |
| Category | Herbs that regulate Qi |
3. Actions and indications
Principal actions
- Breaks up stagnant Qi and reduces accumulation
- Transforms phlegm and unblocks the chest
- Drains downward to unblock the bowels
Indications
- Severe food stagnation with abdominal fullness, distension, belching and constipation
- Stagnant Qi with painful epigastric distension
- Phlegm and Qi stagnation in the chest with oppression and tightness
- Rectal prolapse and uterine prolapse with sinking Spleen Qi (paradoxically used in modern formulae)
4. Modern research
Zhi Shi contains flavonoids (hesperidin, naringin, neohesperidin) and synephrine. Pharmacological studies report a prokinetic effect on gastrointestinal smooth muscle, a mild positive inotropic action on the heart, and bronchodilator effects. Synephrine is a sympathomimetic that mildly raises blood pressure; modern Sun Ten granules are standardised and used at conventional doses.
5. Cautions and contraindications
Avoid in pregnancy. Use with caution in patients with weak constitution, low blood pressure or arrhythmias because of synephrine content. Avoid concurrent grapefruit-style juices and certain CYP3A4-metabolised drugs without herbalist supervision.
Important: Chinese herbs should always be prescribed by a fully qualified herbalist who is a member of the Register of Chinese Herbal Medicine (RCHM).
6. Treatment at my clinic
I prescribe Zhǐ Shí as part of tailored herbal formulas for stubborn epigastric and abdominal distension, food stagnation with constipation, functional dyspepsia with bloating, and post-cholecystectomy bloating with Qi stagnation. Every prescription is individually formulated following a full TCM assessment.
I see patients in person at my clinic in Wokingham, Berkshire. Online Chinese herbal medicine consultations are available.
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