Zhi Shi, also known as Aurantii Fructus Immaturus or Immature Bitter Orange, is a bitter, slightly acrid, and slightly cold herb used in Traditional Chinese Medicine (TCM) to break up Qi stagnation, reduce focal distension, resolve phlegm, and support downward movement of Qi. It is commonly used in digestive disorders, chest and abdominal fullness, and conditions involving phlegm or constipation from Qi obstruction. Zhi Shi is a dynamic herb suitable for excess-type conditions and post-illness recovery when stagnation is present.
Functions & Benefits
Breaks Up Qi Stagnation & Reduces Accumulation
Zhi Shi is a primary herb for abdominal and epigastric bloating, distension, and pain caused by Qi stagnation or food retention. It helps relieve obstruction in the middle burner, often used in excess or mixed excess-deficiency patterns with visible distension or tension.
Transforms Phlegm & Relieves Chest Congestion
Zhi Shi reduces focal accumulations caused by phlegm and Qi stagnation in the chest or upper abdomen. It is useful in treating oppression of the chest, nodules, and phlegm-related obstructions due to damp-heat or Qi constraint.
Promotes Bowel Movement & Relieves Constipation
Its strong descending action helps move Qi downward, easing constipation and abdominal discomfort caused by stagnant heat, Qi binding, or intestinal dryness following illness or surgery.
Raises Blood Pressure in Qi Collapse
In some clinical settings, Zhi Shi is combined with tonics to help restore Yang and support Qi in cases of collapse, such as sudden hypotension or shock following trauma or major illness.
Indications
Abdominal fullness, bloating, or pain from food retention or Qi stagnation
Constipation or sluggish bowel movement with distension and discomfort
Chest oppression, nodules, or phlegm obstruction in the chest and upper abdomen
Digestive stagnation following illness or surgery
Support in prolapse or collapse when used with Qi tonics
Tongue & Pulse Diagnosis in TCM
Tongue: Thick greasy yellow coating, or red with signs of stagnation and heat
Pulse: Slippery and forceful in excess; wiry in Qi stagnation patterns
Common TCM Patterns Treated by Zhi Shi
Zhi Shi treats Qi Stagnation in the middle burner, Damp-Phlegm with Focal Distension, Food Accumulation, Intestinal Heat with Constipation, and Qi Collapse. These patterns often involve abdominal bloating, focal nodules, sluggish digestion, or sinking Qi.
Precautions & Contraindications
Contraindicated during pregnancy due to strong downward movement
Use cautiously in Spleen Qi Deficiency without stagnation
Not suitable in cold-type diarrhea or weak digestion unless combined with warming herbs
Avoid long-term use in frail or elderly patients without balancing tonics
Conclusion
Zhi Shi is a powerful herb for resolving Qi and food stagnation, transforming phlegm, and restoring the natural downward flow of Qi. It is especially effective for treating distension, fullness, constipation, and phlegm accumulations in the chest or abdomen. With careful use, it can also be incorporated into formulas for prolapse and Qi collapse when paired with appropriate tonic herbs.
