Zhi Ke – Zhi Qiao – Mature Bitter Orange

Nature: bitter, cool

Enters: Spleen, Stomach (according to Wei Li, also enters San Jiao)

Actions: Moves/regulates Qi; directs Qi downward; eliminates food retention (particularly in the large intestine), breaks up stagnation and accumulation; resolves phlegm; relieves distention; unblocks the bowels. In all respects, milder than Zhi shi.

Indications:
• Milder, perhaps more often used than Zhi shi, especially for weak or deficient patients – less energy than the unripe fruit and less potential to damage the Qi.
• Frequently used to move Qi and reduce distention and pressure.
• Stifling sensation in the chest with belching.
• Particularly useful for stagnation in the flanks.
Zhi shi is more appropriate than Zhi ke when there is constipation.
Li: Zhi ke is more liver-oriented than Zhi shi, which is more spleen-oriented.
[Bensky/Gamble corroborates this idea, stating that Zhi shi is used for stagnant Qi of the spleen and stomach while Zhi ke is used for constrained liver Qi with symptoms of stagnant Qi.]
Hsu: Stomachic; contracts the uterus; increases blood pressure.
DY: This is one of six medicinals which have been traditionally aged for the purpose of reducing secondary effects and reinforcing their therapeutic actions. Generally, the longer it is kept, the more efficient.
• With Jie geng to effectively regulate upbearing and downbearing, regulate the upper and middle burners, diffuse the Lung Qi, and loosen the chest and diaphragm. For indications such as:
– 1. Chest and diaphragm oppression or distention or chest Bi due to accumulation of phlegm and Qi stagnation. (Jie Geng Zhi Ke Tang)
– 2. Epigastric distention, stomach rumbling, and difficult defecation due to disturbance of ascending and descending. Note: Zhi ke and Jie geng do not moisten the intestines, do not soften the stools, and do not precipitate the bowels. However, Zhi ke moves and descends the Qi in the large intestine in order to improve evacuation of the stools, while Jie geng disperses and descends Lung Qi. When the Lung Qi correctly descends, the large intestine Qi does the same. Therefore, although Zhi ke and Jie geng do not have a direct action on peristalsis, they can treat constipation due to Lung-large intestine Qi stagnation. Hence, this pair may be used to advantageously reinforce any formula that specifically treats constipation.

K&R: (maturity not stated) Sedative (CNS), antispasmodic, expectorant, eupeptic, sympatholytic.
• Bitter-cooling; fire excess, wood excess.
Fire: tachycardia, anguish, nervousness, anxiety, insomnia, epilepsy.
Wood: aerophagia, dyspepsia, digestive spasms, tachycardia of emotional origin, anxiety, insomnia.
• Good for cooling liver fire stemming from heart fire.

Dose: 3-9g

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