I am teaching a short class on zhīzi, February 18th at noon, EST as part of the single herb series. I hope you can come and spend some time with this wonderful herb! Though zhīzǐ does not lead one of the famouns Ten Key Formula Families, it is a profoundly important and I would say KEY medicinal in my clinic. In this class you will learn how to recognize when to use zhīzǐ and how it is used in classical formulas.  It is free to White Pine Inner Circle members and you can register HERE.

In preparation for the class and to show zhīzǐ’s use for esophageal pain, I am publishing the following case by Dr. Qi:  

我喜欢吃糯米黏糕，而且不管吃什么速度都很快，是急性子。在宴会上或者和朋友一起吃饭，我搁下筷子时，再看周围的人，一般刚刚吃一半。鉴于这种情况，我努力让自己慢慢吃饭，可是这种小时候形成的习惯，很难改变。因为这种急性子，就不时有被热茶烫嘴或喉咙被烫疼的事情发生。

I enjoy eating sticky rice cakes, and I eat quickly no matter what I am having. I have an impatient temperament. At banquets or when dining with friends, by the time I put down my chopsticks, I often notice that others have only finished half their meal. Although I try to slow myself down, habits formed in childhood are difficult to change. Because of this impatience, I have occasionally burned my mouth or throat

一次，当急急忙忙地吃下 1 块热的烤年糕时，感觉食道疼痛，大概是引起了食道烫伤。随后即使进流食也感觉胸口堵塞样疼痛。

Once, when I hurriedly swallowed a piece of hot baked rice cake, I felt pain in my esophagus—likely an esophageal burn. After that, even when taking liquid food, I experienced a sensation of obstruction and pain in the chest.

我想起了《伤寒论》栀子豉汤条对“胸中窒者”和“心中结痛者”应用栀子豉汤的论述，便想试用栀子豉汤治疗。栀子豉汤为栀子和香豉二味药物组成，但不凑巧手头没有香豉，便代之以甘草入了药，之所以用甘草是想到了它具有的镇痛作用。没想到服药一次就感觉到了显著的效果，为其如此好的效果吃了一惊。

I recalled the passage in the Shāng Hán Lùn describing the use of zhīzǐ chǐ tāng (栀子豉汤) for “chest congestion” (胸中窒者) and “knotting pain in the heart.” I decided to try it.

zhīzǐ chǐ tāng consists of two ingredients: zhīzǐ (栀子) and xiāng chǐ (香豉, also called dàndòuchǐ). Unfortunately, I did not have xiāng chǐ on hand, so I substituted gāncǎo (甘草), considering its analgesic effect. To my surprise, after taking the decoction just once, I experienced a remarkable improvement. I was astonished by its effectiveness.

基于这一经验，我写了一篇关于栀子豉汤治疗食管炎疗效的报告，发表于1933年顺天堂出版的《汉方临床医话摘要》。三四年后，福冈的一位药剂师江本氏读到此文，在九州大学成功治愈了一位被诊断为食管息肉的患者。该患者进食必须借助牛奶帮助吞咽，本已准备手术。江本氏采集自家庭院所种栀子果实，煎汤服用。后来我在药学杂志上看到此案报道，仍以“胸中窒”为应用指征。

Based on this experience, I wrote a report on the effectiveness of zhīzǐ chǐ tāng in treating esophagitis, which was published in 1933 in the Summary of Kampo Clinical Practice (《汉方临床医话摘要》) by Shunyodo.

Three or four years later, a pharmacist named Ekimoto in Fukuoka read the report. Because of the report, he then successfully treated a patient at Kyushu University who had been diagnosed with esophageal polyps. The patient could only swallow food with the aid of milk and was scheduled for surgery. Ekimoto gathered zhīzǐ fruit grown in his family’s yard and prepared a decoction. The case was later published in a pharmaceutical journal, again citing “chest oppression”  as the indication.

(From Thirty Years of Chinese Medicine Diagnosis and Treatment 《中医诊疗三十年》)

柒大夫, Dr. Qi

Commentary by Dr. Qi

【评述】

本案很有趣！不仅医者使用栀子甘草汤有效，而且发表后有人进行了验证。不同的是前者治疗食管炎，后者治疗食管息肉。这2例共同诠释了栀子对于食管疾病的良好治疗作用。对于药剂师来说，不可能像医师那样进行辨方证，只是依葫芦画瓢地照搬经验。从这个角度来看，栀子治疗食管疾病的经验很直接，也很单纯，不需要进行复杂的辨证分析。事实上，古方有许多经验就是来自于野蛮的试验，有些功效，就是药物的特异性治疗，没有那么多道理可讲的。

This case is fascinating. Not only was the physician’s use of zhīzǐ gāncǎo tāng effective, but the experience was later independently verified. The first case treated esophagitis; the second treated esophageal polyps. Together, they illustrate the therapeutic potential of zhīzǐ for esophageal disease.

For a pharmacist, it may not be possible to differentiate patterns and formulas in the same way a physician does. Instead, experience may simply be applied directly. From this perspective, the use of zhīzǐ for esophageal disorders appears straightforward and uncomplicated, without requiring complex pattern analysis.

In fact, many classical formula experiences arose from direct and sometimes crude experimentation. Certain therapeutic effects may reflect the herb’s specific action rather than an elaborate theoretical explanation. Not every effective treatment requires an intricate rationale.

By 柒大夫, Dr. Qi, published on https://www.jingfangpai.cn/p/10053716/  2/15/26