Zhi Shi Treats Stomach Gas, Distention, And Discomfort

△ If a patient complains of bloating with mild indigestion and shows depression Zhi Shi could be the vital herb to take care of the patient’s symptoms. imageⓒAdobeStock_eddows

Yin Personality and Depression Are Good Clues For Applying The Herb

By Hyunchang Cho, L.Ac., Ph.D ([email protected])

Zhi Shi: Symptom Indicator Score ++, Frequency of Use ++

Abdominal Symptoms

  • Main Symptoms: ①Stomach gas, distention, and discomfort
  • Possible Symptoms: ② (Due to stomach gas) stomach pain, mild indigestion, and constipation

Chest Symptoms

  • Main Symptoms ③ Chest fullness
  • Possible Symptoms ④ Chest tightness and pain

CAPE ⑤ Yin Personality ⑥ Depression is the main emotion

  1. Pharmacological Hypothesis of Zhi Shi

Dysfunction of the vagus nerves that regulate smooth muscles in the chest and abdominal cavities


Synephrine is used as an antidepressant



Chest Cavity


Abdominal Cavity


Myocardial relaxation, decreased contractility → decreased cardiac output


Decreased contractility and motility of the intestinal smooth muscles


Pharmacological hypothesis for Zhi Shi’s Yin Personality and emotions of depression, social disconnection, sadness, and such



Circulatory dysfunction in the chest


Food stagnation in the GI tract




Chest fullness

Chest discomfort of cardiac origin

Chest tightness and pain


Stomach gas and pain

Mild indigestion



Mental disorders with depression as the main emotion

1) Zhi Shi’s chest fullness and pain are caused by circulatory dysfunction of the chest due to myocardial relaxation and decreased cardiac output. Zhi Shi can treat such symptoms by contracting the myocardium and promoting cardiac output, enhancing thoracic circulation.

2) Zhi Shi’s stomach fullness, pain, mild indigestion, constipation, and such are caused by food stagnation due to decreased contractility and motility of the intestinal smooth muscles. Zhi Shi can treat such symptoms by increasing contractility and motility of the intestinal smooth muscles.

3) Zhi Shi contains synephrine, a natural antidepressant that can offer a pharmacological explanation for Zhi Shi’s clinical signs of Yin Personality and emotions of depression, social disconnection, sadness, and such. In clinical practice, Zhi Shi can treat various mental disorders that manifest depression as the main emotion. 

  1. Clinical Signs of Zhi Shi

(1) Stomach Symptoms

  • Main Symptoms: Stomach gas, distention, and discomfort
  • Possible Symptoms: (Due to stomach gas) stomach pain, mild indigestion, and constipation

Stomach symptoms of Zhi Shi seem to be caused by ‘decreased vagus nerve functions → decreased contractile movement of the intestines → retention of food in the intestines’.

(1) This will cause stomach gas retention, bloating, discomfort, and sometimes pain. It explains why Zhi Shi patients tend to dislike tight clothes or belts.

(2) Retention of food in the intestines can cause mild indigestion as this is more indigestion induced by stress rather than overeating.

(3) Zhi Shi’s symptoms are caused by decreased contractile movement of the GI tract, leading to constipation, as the bowel cannot push out the feces. Zhi Shi’s constipation must be discerned from Da Huang’s constipation which is accompanied by stomach fullness and mental discomfort

(2) Chest Symptoms

  • Main Symptoms: chest fullness
  • Possible Symptoms: chest tightness and pain

Zhi Shi’s chest discomfort seems to be caused by decreased vagus nerve function leading to the decreased circulation of the chest.

Zhi Shi can treat chest discomforts such as chest fullness and pain. Chest fullness is tightness of the chest. Chest pain refers to chest discomfort of the cardiac origin. Chest pain (of Zhi Shi) means obstruction of the chest. Patients complain of chest fullness, discomfort, a sense of obstruction, and in severe cases, pain.

Clinical Expressions

  • My chest is full and stuffy. Sometimes it’s also tight and painful.
  • Chest discomfort tends to appear in the left.
  • It tends to be triggered and aggravated by stress.
  • Sometimes, chest fullness is accompanied by stomach fullness, and there are also cases in which stomach fullness triggers/aggravates chest discomfort.

(3) CAPE

*Zhi Shi patients are Yin-natured, and in terms of emotions, they usually appear depressed.

Zhi Shi patients are Yin-natured people who tend to be down-to-earth, static, weak-willed, and gloomy, who speak softly and slowly. We also get the impression that they are mild-tempered, keeping to themselves, quiet, unexpressive, elusive, solitary, dependent, calm, gentle, tender, low-spirited, oppressed, and such.

The main emotion of Zhi Shi is depression. Patients will say that they are often emotionally down, devoid of positive emotions such as joy or happiness, and we can observe such emotions/behaviors of melancholy, seclusion, evasion, passiveness, and lethargy in clinical practice.

(4) Tendency

  • Mild edema can be present. It would be so mild that only the patient will be aware of it, and the doctor may not notice it.
  • Patients dislike tight clothes around the chest and stomach, such as bras and belts, and prefer loose, comfortable clothes.
  • On the surface of the rectus abdominis, there would be small lumps the size of rice grains or peas that can be felt, and the patients will also feel pain upon touch. Since these lumps are not always present, we should only consider this sign a tendency