Zhi Shi Xiao Pi Wan枳实消痞丸

Unripe Bitter Orange Pill to Reduce Focal Distention

Reducing Food Stagnation 消食剂Strengthen the Spleen and Reduce Food Stagnation 健脾消食

Ingredients10 herbs

HerbDosageRoleWhat it does in this formula

干Gan Sheng Jiang干生姜Zingiberis Rhizoma6g佐 AssistantWarms the cold side of the tangle and opens the middle burner with Huang Lian

炙Zhi Gan Cao炙甘草Glycyrrhizae Radix Praeparata6g佐使 Assistant–EnvoyAugments qi and harmonizes the warming and cooling halves

麦Mai Ya Qu麦芽曲Hordei Fructus Germinatus fermentatus6g佐 AssistantReduces residual food accumulation and wakes the Stomach

白Fu Ling白茯苓Poria6g佐 AssistantLeaches damp out and supports the Spleen

白Bai Zhu白术Atractylodis Macrocephalae Rhizoma6g佐 AssistantStrengthens the Spleen and dries damp 半Ban Xia Qu半夏曲Pinelliae Rhizoma fermentata9g佐 AssistantTransforms phlegm-damp and settles counterflow, in its gentler fermented form 人Ren Shen人参Ginseng Radix9g佐 AssistantAugments the qi so the opening herbs do not exhaust the middle burner 厚Hou Po厚朴炙Magnoliae Officinalis Cortex12g臣 DeputyDirects qi downward, dries damp and relieves distension 枳Zhi Shi枳实Aurantii Fructus Immaturus15g君 ChiefBreaks up the knotted qi below the heart and removes the fullness 黄Huang Lian黄连Coptidis Rhizoma15g佐 AssistantClears the heat side of the tangle and dries damp

Indications

Reduces focal distention and unblocks the middle burnerStrengthens the Spleen and augments qiHarmonizes cold and heat in the middle burnerTransforms damp and reduces food accumulation

Focal distention from Spleen deficiency with qi stagnation, damp and mixed cold and heat. The middle burner has lost its up-and-down movement, so fullness persists without any substantial mass behind it.

Clinical Manifestations

Chronic focal distention and fullness below the heart
Reduced appetite with fatigue
Fullness that presses soft, without hard pain
Nausea with a greasy coating
Loose stools alternating with a blocked, distended feeling

TonguePale with a greasy, slightly yellow coating

PulseWiry and weak

Health Categories

Digestive Health

Modern Applications

Functional dyspepsia Chronic gastritis Gastroparesis Bloating Loss of appetite

Common adjustments

Cold predominant — increase Gan Jiang 干姜 and reduce Huang Lian 黄连
Heat predominant — bitter taste, yellow coating — increase Huang Lian 黄连 and reduce the warming herbs
Food accumulation prominent — add Shan Zha 山楂 and Shen Qu 神曲
Marked qi deficiency — increase Ren Shen 人参 and add Huang Qi 黄芪
Distention with belching and hiccup — add Chen Pi 陈皮 and Sha Ren 砂仁

Contraindications

Not for a hard, painful, substantial accumulation with constipation, which needs a guiding-out formula. Not for pure excess heat or pure deficiency cold — the mixed cold-and-heat design is what makes it appropriate, and either extreme is better served by a simpler prescription. Focal distention that is new, progressive, or accompanied by weight loss, vomiting or blood needs a medical diagnosis before it is treated as a functional pattern.

For licensed practitioners’ reference only — not a self-treatment guide.

Pregnancy

Used in pregnancy only under a practitioner's supervision. Zhi Shi and Hou Po both break and descend qi and are traditionally restricted during pregnancy, and Ban Xia Qu is a processed Ban Xia preparation that requires professional judgment. Do not self-prescribe while pregnant.

References

Source Lan Shi Mi Cang 《兰室秘藏》 · Jin

《兰室秘藏》(classical source, public domain) — the recorded composition, also known as 失笑丸.
2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
3. 《方剂学》（全国中医药行业高等教育规划教材）— pattern analysis cross-checked.

Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.