味苦辛酸微寒，无毒。实、壳大略相同。但实气全性烈，故善达下，入足阳明、
太阴经，如少年悍猛之性，勇往直前，而一无回顾者也。壳气散性缓，故行稍迟，是以
能入胸膈，肺胃之分，又入大肠者；因肺脏以及腑也，其性其用皆散结去滞利气之功。
枳实，实小性酷而速，治下主血，凡心腹痞满胀闷，宿食坚积，稠痰积血，有疏通
破结之功，倒壁冲墙之捷。同白术治虚痞。然性暴力猛，无宿滞坚积者，勿轻用之，以伤元气。
主治（痘疹合参） 宜麸炒，治初发热，胸膈有痰癖宿食胀满，脾经积血，不得已暂
用之，以安胃气。凡痘中无故及酿浆之时，皆不可用。
枳壳，壳大性缓，治高，主气。主风痒麻痹，咳嗽风痰，胸膈痞满，肺气滞结。两
肋虚胀，发疹肌表，遍身苦痒，更逐水饮停留，开结并利，破痰癖积聚，宿食亦推，同
甘草瘦胎，和黄连灭痔，能损至高之气，忌接迹服多，虚怯劳伤尤禁，盖苦泄辛散，惟
利肺气之有余，宽大肠之壅滞，故肠风用之。
主治（痘疹合参） 宜麸炒，用利五脏，走大肠，泄肺气，宽膈，治遍身风疹，皮肤
中如麻痘苦痒。凡痘初发热，胸膈不利，有宿食，有滞气，及热盛气粗者，俱可暂用。
多服则损中气。
按∶枳壳、枳实，上世未尝分别，自东垣分枳壳治高，枳实治下，海藏分枳壳主
气，枳实主血，然究其功用皆利气也，气利则痰消积化矣。人之一身，自飞门以至魄
门，三焦相通，一气而已，又何必分上与下气与血乎！但枳实性急，枳壳性缓，为确当
耳。然中气壮实，偶因倍食难消，假此助脾克化则可，若因中气不足，脾虚不能运化
者，则愈消而脾愈虚，及气虚痞满，误投克伐，则无形之气受伤，不惟壅滞更甚，而且
变生别症，至于瘦胎饮，君以枳壳，因治湖阳公主难产则名。然在奉养太过，北方气实
者，或有相宜，否则损害真元，胎子大力，反致难产矣。况脾胃者，乃化生之父母，一
身之墙壁，能经几番推倒乎？！上古伤于六淫者，多或堪抵受，近世禀受既亏，七情弥
害，虚痞虚胀，比比皆然，误投克削，为害益甚，可不慎欤！
味苦、辛、酸，性微寒，无毒。枳实与枳壳大体相似。但枳实气全而性烈，所以善于下行，入足阳明经和足太阴经，就像少年刚猛的性格，勇往直前，毫无回顾。枳壳气散而性缓，所以行气稍慢，因此能入胸膈、肺和胃的部位，以及大肠（因为肺脏与其腑相表里）；其性质和作用都具有散结、去滞、利气的功效。
枳实，果实小，性酷烈且迅速，主治下部，主血分病。凡是心腹痞满胀闷，宿食坚积，稠痰积血，都有疏通破结的功效，如倒壁冲墙般快捷。与白术同用可治疗虚痞。然而其性暴力猛，没有宿滞坚积的患者，不要轻易使用，以免损伤元气。
主治（痘疹合参）：宜麸炒，用于治疗初发热时，胸膈有痰癖、宿食导致的胀满，脾经积血，不得已暂时使用，以安胃气。凡是痘疮中无故出现的情况及酿浆之时，都不可用。
枳壳，壳大，性缓，主治上部，主气分病。主治风痒麻痹，咳嗽风痰，胸膈痞满，肺气滞结。两肋虚胀，发疹肌表，遍身苦痒，更能驱逐水饮停留，开结并利，破除痰癖积聚，宿食也能推动排出，与甘草同用可瘦胎，与黄连同用可灭痔。能损至高之气，忌连续多服，虚怯劳伤尤禁，因为苦泄辛散，只利于肺气之有余，宽大肠之壅滞，所以肠风用之。
主治（痘疹合参）：宜麸炒，用以利五脏，走大肠，泄肺气，宽膈，治疗遍身风疹，皮肤中如麻痘般的苦痒。凡是痘初发热，胸膈不利，有宿食，有滞气，及热盛气粗者，都可暂时使用。多服则损中气。
按语：枳壳、枳实，上古未曾分别，自李东垣开始区分，认为枳壳治高，枳实治下；张元素（海藏）区分，认为枳壳主气，枳实主血。然而究其功用都是利气，气利则痰消积化。人之一身，从飞门（肛门）到魄门（口），三焦相通，一气而已，又何必分上与下、气与血呢！只是枳实性急，枳壳性缓，这才是确当的说法。然而中气壮实，偶尔因倍食难消，借此助脾克化是可以的；若因中气不足，脾虚不能运化者，则愈消而脾愈虚，以及气虚痞满，误投克伐，则无形之气受伤，不惟壅滞更甚，而且变生别症。至于瘦胎饮，君药为枳壳，因治疗湖阳公主难产而得名。然而在奉养太过，北方气实者，或有相宜，否则损害真元，胎子大力，反致难产矣。况且脾胃者，乃化生之父母，一身之墙壁，能经几番推倒乎？！上古伤于六淫者，多或堪抵受，近世禀受既亏，七情弥害，虚痞虚胀，比比皆然，误投克削，为害益甚，可不慎欤！
Bitter, pungent, and slightly sour in flavor, slightly cold in nature, non-toxic. Zhi Shi (Immature Bitter Orange) and Zhi Ke (Mature Bitter Orange) are largely similar. However, Zhi Shi has complete Qi and fierce nature, thus it excels at descending, entering the Foot-Yangming Stomach Meridian and Foot-Taiyin Spleen Meridian, resembling the character of a young and vigorous person who charges forward without looking back. Zhi Ke has scattered Qi and mild nature, thus its movement is slightly slower, allowing it to enter the chest and diaphragm, the regions of the Lung and Stomach, as well as the Large Intestine (due to the exterior-interior relationship between the Lung organ and its paired fu-organ); its nature and function both possess the efficacy of dissipating nodules, removing stagnation, and promoting Qi flow.
Zhi Shi (Immature Bitter Orange), being small with a fierce and rapid nature, treats lower jiao conditions and governs blood. It is effective for epigastric and abdominal fullness, distension, and oppression, accumulated food masses, thick phlegm, and accumulated blood, possessing the power to unblock and break up nodules, swift as breaking through walls. When combined with Baizhu (Atractylodis Macrocephalae Rhizoma), it treats deficiency-type fullness. However, due to its violent and fierce nature, it should not be used lightly by those without accumulated stagnation or hard masses, so as not to damage Yuan Qi (Original Qi).
Indications (Integrating Smallpox and Rashes): Should be stir-fried with bran. It is used for initial fever accompanied by phlegm-rheum and accumulated food causing fullness in the chest and diaphragm, or blood accumulation in the Spleen meridian. It should only be used temporarily when necessary to stabilize Stomach Qi. It must not be used during spontaneous occurrences in smallpox or during the pus-forming stage.
Zhi Ke (Mature Bitter Orange), being large with a mild nature, treats upper jiao conditions and governs Qi. It treats wind-induced itching and numbness, cough with wind-phlegm, chest and diaphragm fullness, and Qi stagnation in the Lungs. It addresses false distension in the hypochondrium, rashes on the muscle surface, generalized severe itching, and can expel retained fluid retention. It opens nodules and promotes flow, breaks up phlegm-rheum and accumulations, and moves accumulated food. Combined with Gancao (Glycyrrhizae Radix et Rhizoma), it helps slim the fetus; combined with Huanglian (Coptidis Rhizoma), it eliminates hemorrhoids. It can deplete the Qi of the highest region. Continuous heavy use is contraindicated, especially in cases of deficiency, frailty, and overwork. This is because bitter drainage and pungent dispersion benefit only excess Lung Qi and relieve Large Intestine congestion; therefore, it is used for intestinal wind.
Indications (Integrating Smallpox and Rashes): Should be stir-fried with bran. It benefits the five zang organs, travels to the Large Intestine, drains Lung Qi, widens the diaphragm, and treats generalized wind-rashes, such as the severe itching of skin resembling measles or smallpox. It may be used temporarily for initial smallpox fever, chest and diaphragm discomfort, accumulated food, stagnant Qi, and excessive heat with rough breathing. Excessive consumption damages Middle Qi.
Commentary: In ancient times, Zhi Ke and Zhi Shi were not distinguished. Since Li Dongyuan, it was differentiated that Zhi Ke treats the upper body and Zhi Shi treats the lower body; Zhang Yuansu (Haizang) differentiated that Zhi Ke governs Qi and Zhi Shi governs Blood. However, ultimately, their functions all involve promoting Qi flow; when Qi flows, phlegm dissipates and accumulations resolve. The human body, from the Feimen (anus) to the Pomen (mouth), has interconnected Sanjiao (Triple Burner), consisting of one Qi alone. Why distinguish between upper and lower, or Qi and Blood? It is merely accurate to say that Zhi Shi has an urgent nature while Zhi Ke has a mild nature. For individuals with robust Middle Qi who occasionally suffer from indigestion due to overeating, using this to assist the Spleen in transformation and transportation is acceptable. However, for those with insufficient Middle Qi and Spleen deficiency failing to transform and transport, further digestion will further weaken the Spleen. In cases of Qi-deficiency fullness, mistakenly using draining and attacking methods will injure formless Qi, not only worsening stagnation but also generating other pathologies. Regarding Shoutai Yin (Fetus-Slimming Decoction), with Zhi Ke as the sovereign herb, it gained fame for treating difficult labor in Princess Huyang. However, for those who are overly nourished and have strong Qi typical of the North, it might be suitable; otherwise, it damages True Yuan (True Original Qi), and if the fetus becomes too strong, it may反而 cause difficult labor. Moreover, the Spleen and Stomach are the parents of transformation and generation, and the walls of the entire body; how many times can they withstand being overturned?! Those injured by the Six Excesses (Six Evils) in antiquity could often endure it, but in recent times, innate constitution is deficient, and Seven Emotions cause more harm. Deficiency-fullness and deficiency-distension are common everywhere. Mistakenly using draining and reducing methods causes even greater harm. Can one not be cautious!