Zhi Shi Dao Zhi Wan - 枳實導滯丸 - Unripe Bitter Orange Pil To Guide Out Stagnation

English:	Unripe Bitter Orange Pill to Guide out Stagnation
Also Known As:	Immature Bitter Orange Pill to Guide out Stagnation

Herbs And Actions

Pharmaceutical Latin	Pin Yin	Dosage	Actions
Fr. Aurantii Immaturus	Zhi Shi	9-15g	Breaks up stagnant Qi, Descends Qi, Reduces accumulation, Removes stagnant food, Transforms Phlegm, Unblocks bowels. With Da Huang, for constipation, dysentery, distention and pain due to Food Stagnation and Blockage due to Damp-Heat.
Rx. et Rz. Rhei	Da Huang	9-30g	Drains Damp-Heat and purges accumulations. With Huang Lian, for fullness and distention due to Heat Accumulation.
Massa Medicata Fermentata	Shen Qu	9-15g	Reduces Food Stagnation and harmonizes the Stomach. With Bai Zhu, for Food Stagnation and diarrhea due to Spleen Deficiency
Poria	Fu Ling	6-9g	Drains Dampness, Harmonizes the Middle Jiao and transforms Phlegm, Strengthens the Spleen. With Bai Zhu, strengthens the Spleen and resolves Dampness.
Rx. Scutellariae	Huang Qin	6-9g	Clears Heat and dries Dampness. With Da Huang and Zhi Shi, for dysentery with tenesmus due to Food Stagnation transforming into Damp-Heat.
Rz. Coptidis	Huang Lian	6-9g	Clears Heat, drains Dampness and drains Stomach Fire.
Rz. Atractylodis Macrocephalae	Bai Zhu	6-9g	Strengthens the Spleen and resolves Dampness. With Zhi Shi, for epigastric and abdominal distention due to Spleen and Stomach Deficiency with Food Stagnation.
Rz. Alismatis	Ze Xie	6g	Clears Heat and promotes urination.

Formula Actions

• Reduces and guides out Stagnation and Accumulation
• Clears Heat
• Dispels Dampness

Syndromes

• Food Stagnation in the Stomach transforming into Damp-Heat with Intestinal Obstruction
• Diarrhea due to Injury by Food
• Accumulation of food that transforms into Damp-Heat (Secondary source)

Clinical Manifestations

Abdominal pain (worse with pressure) Abdominal and epigastric distention Dysentery Scanty dark urine

Constipation T: Red C: Yellow and greasy or slippery P: Deep and forceful

Treats

Diarrhea due to Food injury Acute or chronic gastroenteritis Urinary tract infection Acute indigestion Acute enteritis Asthma Constipation Abdominal fullness and distention Abdominal pain Hematemesis Gastric ulcer Bad breath Epstein-Bar syndrome

Dysenteric disorders Chronic hepatitis Acute hepatitis Cirrhosis of the Liver Trigeminal neuralgia Acid reflux Oliguria Bronchitis Nausea/Vomiting Anorexia Gastritis Myalgic encephalomyelitis

Contraindications And Herb/Drug Interactions

Notes

Modifications

For dysenteric disorders with Damp-Heat in the Intestines:		For abdominal fullness and distention:
+ Rx. Sophorae Flavescentis	Ku Shen	+ Rx. Aucklandiae	Mu Xiang
+ Sm Arecae	Bing Lang
+ Rx. Sanguisorbae	Di Yu	For loss of appetite:
For abdominal pain:		+ Fr. Crataegi	Shan Zha
+ Endothelium Corneum Gigeriae Galli	Ji Nei Jin
+ Rx. Paeoniae Alba	Bai Shao
+ Rx. Glycyrrhizae	Gan Cao
For diarrhea and dysentery due to Toxic Heat:		For nausea and vomiting:
+ Flos Lonicerae	Jin Yin Hua	+ Caulis Bambusae in Taeniam	Zhu Ru
+ Rx. Pulsatillae	Bai Tou Weng
For trigeminal neuralgia with constipation:		For trigeminal neuralgia with Yin Deficiency:
+ More Rx. et Rz. Rhei	Da Huang	+ Rx. Rehmanniae	Sheng Di Huang
For trigeminal neuralgia with chronic Blood Stagnation:		For hematemesis:
+ 12g Cacumen Platycladi	Ce Bai Ye
+ Sm. Persicae	Tao Ren
+ Flos Carthami	Hong Hua	+ 12g Rx Rehmanniae	Sheng Di Huang
For hematemesis with severe vomiting and bleeding:		For hematemesis with Blood Stagnation:
+ 12g Cacumen Platycladi	Ce Bai Ye
+ 12g Cacumen Platycladi	Ce Bai Ye
+ 12g Rx Rehmanniae	Sheng Di Huang
+ 12g Rx Rehmanniae	Sheng Di Huang	+ 9-12g Pollen Typhae	Pu Huang
+ 30g Rz. Imperatae	Bai Mao Gen	+ 3-6g Rx. Notoginseng	San Qi
+ 9-15g Rz. Bletillae	Bai Ji	For hematemesis in patients with alcohol problems:
+ 9-12g Cx. Moutan	Mu Dan Pi
+ 12g Cacumen Platycladi	Ce Bai Ye
+ 12g Rx Rehmanniae	Sheng Di Huang
+ Flos Puerariae	Ge Hua