Zhi Zhu Wan - 枳术囊 - Unripe Bitter Orange And Atractylodes Pill

English:	Unripe Bitter Orange and Atractylodes Pill
Also Known As:	Pills of Immature Bitter Orange and White Atractylodes

Herbs And Actions

Pharmaceutical Latin	Pin Yin	Dosage	Actions
Rz. Atractylodis Macrocephalae	Bai Zhu	10-18g 60g decoction	Tonifies the Spleen, augments Qi, dries Dampness and promotes water metabolism. With Zhi Shi, for Spleen Deficiency with Qi Stagnation with anorexia, epigastric focal distention, and fullness.
Fr. Aurantii Immaturus	Zhi Shi	5-9g 30g decoction	Breaks up Stagnant Qi, Descends Qi, Reduces accumulation, Reduces distention, Removes Stagnant Food, Resolves hardenings, Transforms Phlegm, Unblocks the bowels.

Formula Actions

• Tonifies the Spleen
• Reduces focal distention

Syndromes

• Spleen Qi Deficiency with epigastric and abdominal distention
• Spleen Qi Deficiency with Qi Stagnation and Food Retention
• Spleen deficiency with food stagnation (Secondary source)

Clinical Manifestations

Loss of appetite Chest, epigastric and abdominal focal distention Acid regurgitation

T: Normal C: White or Yellow and greasy P: Deficient or Slippery

Treats

Obesity Chronic gastritis Anorexia Gastroptosis Gastroenteritis Acid reflux Urticaria Indigestion

Chronic colitis Peptic ulcer Indigestion in children Cholecystitis Abdominal fullness and distention Chronic hepatitis Rectal prolapse

Contraindications And Herb/Drug Interactions

Notes

• Grind into a powder and mix with rice fried in Fol Nelumbinis He Ye and form into pills.
• Take 6-9g twice per day.

Modifications

For general debility:		For prolapse or ptosis:
+ Rx. Codonopsis	Dang Shen	+ Raise the Sunken Decoction Sheng Xian Tang
+ Poria	Fu Ling
For gastric ptosis:		For uterine prolapse:
+ Raise the Sunken Decoction Sheng Xian Tang		+ Raise the Sunken Decoction Sheng Xian Tang
+ Rx. Salviae Miltiorrhizae	Dan Shen	+ Hb. Leonuri	Wu Yao
+ Fr. Amomi	Sha Ren	+ Rx. Angelicae Sinensis	Dang Gui
For rectal prolapse:		For diarrhea:
+ Raise the Sunken Decoction Sheng Xian Tang		+ Poria	Fu Ling
+ Sm. Coicis	Yi Yi Ren
+ Per. Granati	Shi Liu Pi	For more pronounced Food Stagnation:
For indigestion in children:		+ Massa Medicata Fermentata	Shen Qu
+ Per. Citri Reticulatae	Chen Pi
+ Fr. Oryzae Germinatus	Gu Ya	+ Fr. Crataegi	Shan Zha
+ Fr. Hordei Germinatus	Mai Ya	+ Fr. Hordei Germinatus	Mai Ya
For Spleen Qi Deficiency With Damp Stagnation:		For Spleen Yang Deficiency:
+ Rz. Pinelliae Preparatum	Zhi Ban Xia	+ Fr. Amomi	Sha Ren
+ Exocarpium Citri Grandis	Hua Ju Hong	+ Rx. Aucklandiae	Mu Xiang
For urticaria:
+ 6g Fr. Amomi (add last)	Sha Ren
+ 6g Per. Citri Reticulatae	Chen Pi
+ 6g Hb. Schizonepetae	Jing Jie
+ 6g Rx. Saposhnikoviae	Fang Feng
+ 10g Rz. Cyperi	Xiang Fu
+ 10g Rx. Linderae	Wu Yao
+ 10g Rx. Aucklandiae	Mu Xiang