Shi Di (柿蒂) — TCM Persimmon Calyx for Hiccup Relief

At a Glance

• Herb: Shi Di
• Chinese name: 柿蒂 (Shì Dì)
• Latin name: Kaki Calyx
• Nature: Neutral
• Taste: Bitter / Astringent
• Meridian: Stomach
• Category: Herbs that Regulate Qi
• Introduction: Shi Di (Calyx Kaki) is the dried persistent four-lobed star-shaped calyx of Diospyros kaki (Japanese persimmon), easily collected when fruit is harvested, first recorded in the Ji Sheng Fang (12th century CE). This bitter, astringent, and neutral herb has one exceptionally focused clinical use: stopping hiccup by descending rebellious Stomach Qi — making it the most single-purpose herb in the TCM materia medica. Its bitter quality descends Qi; its astringent quality consolidates the Stomach to prevent upward rebellion. Tannins, shibuol, and betulinic acid contribute to antispasmodic and antiemetic properties in modern research, confirming the traditional application.

Action

• Descends rebellious Stomach Qi and stops hiccup — the singular defining clinical action

Clinical Application

• Hiccup of all etiologies — Shi Di is appropriate regardless of Cold, Heat, or deficiency pattern when combined with suitable adjunct herbs
• Cold-type hiccup — combined with Ding Xiang and Ren Shen in Ding Xiang Shi Di Tang
• Heat-type hiccup — combined with Zhu Ru and Huang Lian
• Deficiency-type chronic hiccup — combined with Ren Shen, Gan Jiang, and Ding Xiang
• Nausea and belching from Stomach Qi rebellion (secondary use)

Precautions

• Dose: 6–12 g in decoction
• Broadly safe; neutral temperature makes it suitable for multiple hiccup patterns with appropriate combination
• Always combine with herbs that address the underlying pattern — Shi Di alone treats the symptom; the combination treats the root
• No significant contraindications at standard doses
• Astringent nature — avoid in patterns of accumulation requiring outward dispersal

Formula

• Ding Xiang Shi Di Tang (丁香柿蒂汤) — Shi Di + Ding Xiang + Ren Shen + Sheng Jiang, for stubborn hiccup from Stomach Cold deficiency — the most classical formula for persistent hiccup
• Shi Di Tang (柿蒂汤) — Shi Di decocted alone or as primary herb, for simple hiccup
• Combined with Zhu Ru and Huang Lian for heat-type hiccup with thirst and yellow tongue coat

Combinations

• Persimmon Calyx (柿蒂) + Clove (丁香) → Ding Xiang Shi Di Tang (丁香柿蒂汤): warm stomach, descend qi, stop hiccup — cold-type persistent hiccup
• Persimmon Calyx (柿蒂) + Bamboo Shavings (竹茹) + Fresh Ginger (生姜) → descend stomach qi, clear heat, stop hiccup — heat-type hiccup
• Persimmon Calyx (柿蒂) + Ginseng (人参) + Fresh Ginger (生姜) → tonify qi, warm stomach, descend qi, deficiency-cold hiccup
• Persimmon Calyx (柿蒂) + Inula Flower (旋覆花) + Hematite (代赭石) → descend rebellious qi, stop stubborn hiccup from any cause
• Persimmon Calyx (柿蒂) + Pinellia Rhizome (半夏) + Aged Tangerine Peel (陈皮) → descend qi, transform phlegm, hiccup from phlegm obstruction

Pharmacological Effects

• Antiemetic / anti-hiccup
  • triterpenoids — inhibit diaphragm spasm and vagal stimulation
• Anti-inflammatory
  • ursolic acid, oleanolic acid — potent
• Antitumor
  • ursolic acid, betulinic acid — induce apoptosis in multiple cancer types
• Antioxidant; antimicrobial; antifungal; pattern-neutral:柿蒂 itself is neutral — its warming or cooling action depends entirely on what it is combined with
  • 丁香 = warm
  • 竹茹 = cool
  • 人参 = tonifying
• the single most targeted herb for hiccup in TCM

Classic Description

• Dian Nan Ben Cao: ‘Treats qi obstruction with stomach counterflow; harmonizes the stomach and descends qi; stops nausea and counterflow; treats incessant qi counterflow and hiccup.’
• Ben Cao Gang Mu: ‘Persimmon Calyx — ancient formulas used it alone for hiccup, drawing on its bitter-warm qi-descending action, sharing function with Clove (丁香); modern practitioners mostly combine the two, further increasing efficacy.’
• Ben Cao Bei Yao: ‘Bitter, astringent, and neutral; descends qi; treats hiccup and upward counterflow of stomach qi. Combined with Clove (丁香), most effective; suitable for both cold and heat patterns — but its thermal nature changes according to what it is combined with.’
• Ben Cao Qiu Zhen: ‘Persimmon Calyx, although it stops hiccup, must be used according to the accompanying cold-heat-deficiency-excess pattern — one cannot be rigid: for cold, combine with Clove (丁香); for heat, with Bamboo Shavings (竹茹); for deficiency, with Ginseng (人参) — only then will it be effective.’