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Immature Bitter Oranges

Chinese: 枳实

Pinyin: Zhǐ Shí

Parts used: Dried unripe fruit

TCM category: Herbs that regulate Qi

TCM nature: Cool

TCM taste(s): BitterPungentSour

Organ affinity: Spleen Stomach Large intestine

Scientific name: Citrus aurantium

Other names: Fructus Aurantii Immaturus

Use of immature bitter oranges (Zhi Shi) in TCM

Please note that you should never self-prescribe TCM ingredients. A TCM ingredient is almost never eaten on its own but as part of a formula containing several ingredients that act together. Please consult a professional TCM practitioner, they will be best able to guide you.

Preparation: Pick the fruit when unripe. Dry it and cut in slices

Dosage: 3 - 9 grams

Main actions according to TCM*: Regulates the flow of Qi in the Middle Burner and reduces Food Stagnation. Moves Qi downward and helps constipation. Reduces Stagnant Phlegm and lessens distention and pain. For prolapse of organs when used with the appropriate herbs.

Primary conditions or symptoms for which immature bitter oranges may be prescribed by TCM doctors*: Indigestion Abdominal bloating Constipation Chest pain Chest congestion Rectal prolapse Uterine prolapse

Contraindications*: This herb should be used with caution during pregnancy, when there is Q! Deficiency or when there is Cold in the Stomach.

Common TCM formulas in which immature bitter oranges (Zhi Shi) are used*

Zhi Shi Dao Zhi Wan

Source date: 1247 AD

Number of ingredients: 8 herbs

Formula key actions: Reduces and guides out stagnation and accumulation. Drains heat. Dispels dampness.

Zhi Shi is a king ingredient in Zhi Shi Dao Zhi Wan. Like the name indicates, it means it has more power than other ingredients in the formula.

In Zhi Shi Dao Zhi Wan, Zhi Shi breaks up stagnant Qi and reduce accumulation

Read more about Zhi Shi Dao Zhi Wan

Si Ni San

Source date: 220 AD

Number of ingredients: 4 herbs

Formula key actions: Regulates Liver and Spleen. Eliminates Internal Heat.

Conditions targeted*: CholecystitisCholelithiasis and others

Zhi Shi is a deputy ingredient in Si Ni San. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

In Si Ni San, Zhi Shi drains Stagnation, breaks up Stagnant Qi, and reduces accumulation in the Middle Burner to facilitate the transportive and transformative functions of the Spleen and Stomach.

Its descending action pairs it well with the ascending action of Chai Hu (the key herb): the effect of the different directions is to disentangle Heat in the Liver, Stomach and Spleen territories.

Read more about Si Ni San

Wen Dan Tang

Source date: 1174 AD

Number of ingredients: 8 herbs

Formula key actions: Clears Hot-Phlegm. Clears Gallbladder heat. Regulates Qi. Harmonizes the Stomach.

Conditions targeted*: HypertensionAngina and others

Zhi Shi is an assistant ingredient in Wen Dan Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

In Wen Dan Tang, Zhi Shi reverses the flow of Rebellious Qi and is particularly effective in treating focal distention.

Read more about Wen Dan Tang

Da Cheng Qi Tang

Source date: 220 AD

Number of ingredients: 4 herbs

Formula key actions: Purges Heat from the Stomach and Intestines. Relieves constipation.

Conditions targeted*: PancreatisAppendicitis and others

Zhi Shi is an assistant ingredient in Da Cheng Qi Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

In Da Cheng Qi Tang, Zhi Shi dissipates clumps and reduces focal distention.

Read more about Da Cheng Qi Tang

Qing Qi Hua Tan Wan

Source date: 1584 AD

Number of ingredients: 8 herbs

Formula key actions: Clears Heat. Transforms Phlegm. Directs Rebellious Qi downwards. Stops coughing.

Conditions targeted*: PneumoniaChronic bronchitis and others

Zhi Shi is an assistant ingredient in Qing Qi Hua Tan Wan. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

In Qing Qi Hua Tan Wan, Zhi Shi work together with Tangerine peel (Chen Pi), another assistant herb here, to regulate the Qi, dispelling the focal distention and dissipating the clumps of Phlegm.

Read more about Qing Qi Hua Tan Wan

Huang Lian Wen Dan Tang

Source date: 1852 AD

Number of ingredients: 7 herbs

Formula key actions: Clears Hot Phlegm. Clears Gallbladder Heat. Regulates Qi. Harmonizes the Stomach.

Zhi Shi is an assistant ingredient in Huang Lian Wen Dan Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

In Huang Lian Wen Dan Tang, Zhi Shi reverses the flow of Rebellious Qi and is particularly effective in treating focal distention.

Read more about Huang Lian Wen Dan Tang

Ma Zi Ren Wan

Source date: 220 AD

Number of ingredients: 7 herbs

Formula key actions: Moistens the Intestines. Invigorates Qi. Unblocks the bowels. Drains Heat.

Conditions targeted*: Incomplete intestinal obstructionPostoperative ileus and others

Zhi Shi is an assistant ingredient in Ma Zi Ren Wan. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

In Ma Zi Ren Wan, Zhi Shi breaks up accumulation, particularly in the Intestines. 

Read more about Ma Zi Ren Wan

Key TCM concepts behind immature bitter oranges (Zhi Shi)'s properties

In Traditional Chinese Medicine (TCM), immature bitter oranges are plants that belong to the 'Herbs that regulate Qi' category. Herbs in this category typically treat a TCM condition called 'Qi Stagnation'. Concretely it means that Qi is blocked in the body's Organs and Meridians, most typically the Stomach, Liver, and to a lesser extent, the Lungs. In modern medicine terms, Qi Stagnation often translates into psychological consequences such as depression, irritability or mood swings. It's also frequently associated with conditions such as premenstrual syndrome (PMS), menopausal symptoms, the development of breast swellings as well as various digestive disorders.

Furthermore immature bitter oranges are plants that are Cool in nature. This means that immature bitter oranges tend to help people who have too much 'Heat' in their body, although with less effect than a plant that would be Cold in nature. Balance between Yin and Yang is a key health concept in TCM. Those who have too much Heat in their body are said to either have a Yang Excess (because Yang is Hot in nature) or a Yin deficiency (Yin is Cold in Nature). Depending on your condition immature bitter oranges can help restore a harmonious balance between Yin and Yang.

Immature Bitter Oranges also taste Bitter, Pungent and Sour. The so-called 'Five Phases' theory in Chinese Medicine states that the taste of TCM ingredients is a key determinant of their action in the body. Bitter ingredients like immature bitter oranges tend to have a cleansing action on the body by clearing Heat, drying Dampness and promoting elimination via urination or bowel movements. On the other hand Pungent ingredients tend to promote the circulations of Qi and Body Fluids. That's why for instance someone tends to sweat a lot when they eat spicy/pungent food. Lastly Sour ingredients help with digestion and restrain abnormal discharges of Fluids from the body, such as diarrhea or heavy sweating.

The tastes of ingredients in TCM also determine what Organs and Meridians they target. As such immature bitter oranges are thought to target the Spleen, the Stomach and the Large intestine. In TCM the Spleen assists with digestion, Blood coagulation and Fluids metabolism in the body. The Stomach on the other hand is responsible for receiving and ripening ingested food and fluids. It is also tasked with descending the digested elements downwards to the Small Intestine. The Large Intestine receives the "impure" parts of the digested food from the Small Intestine, absorbs the remaining fluids and excrete the remainder as feces.