Bitter oranges

Chinese: 枳壳

Pinyin: Zhǐ Ké

Parts used: Dried ripe fruit

TCM category: Herbs that regulate Qi

TCM nature: Warm

TCM taste(s): BitterPungentSour

Organ affinity: Spleen Stomach

Scientific name: Citrus aurantium

Use of bitter oranges (Zhi Ke) in TCM

Please note that you should never self-prescribe TCM ingredients. A TCM ingredient is almost never eaten on its own but as part of a formula containing several ingredients that act together. Please consult a professional TCM practitioner, they will be best able to guide you.

Preparation: Remove impurities, wash, cut and dry.

Dosage: 3 - 10 grams

Main actions according to TCM*: To regulate the flow of Qi, remove its stagnation, and alleviate distension.

Primary conditions or symptoms for which bitter oranges may be prescribed by TCM doctors*: Chest pain Indigestion Phlegm Constipation Rectal prolapse Uterine prolapse

Contraindications*: Use with caution when pregnant

Common TCM formulas in which bitter oranges (Zhi Ke) are used*

Xing Su San

Source date: 1798 AD

Number of ingredients: 11 herbs

Formula key actions: Clears Dry-Cold. Disseminates the Lung Qi and relieves cough. Transforms thin mucus.

Conditions targeted*: Common coldBronchitis and others

Zhi Ke is a deputy ingredient in Xing Su San. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

In Xing Su San, Zhi Ke moves the Qi, expands the chest, and stops the coughing by regulating the Qi.

Read more about Xing Su San

Hao Qin Qing Dan Tang

Source date: Qing Dynasty

Number of ingredients: 10 herbs

Formula key actions: Clears Heat and relieves acute conditions of the Gallbladder. Relieves acute Damp-Heat syndromes. Resolves Phlegm. Harmonizes the Stomach.

Conditions targeted*: CholecystitisIcteric hepatitis and others

Zhi Ke is a deputy ingredient in Hao Qin Qing Dan Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

In Hao Qin Qing Dan Tang, Zhi Ke , together with Crow-dipper rhizome (Ban Xia) and Tangerine peel (Chen Pi), other deputies of this formula, drains Gallbladder and Stomach Heat, directs rebellious Qi downward, harmonizes the Stomach, and transforms Phlegm.

Read more about Hao Qin Qing Dan Tang

Xue Fu Zhu Yu Tang

Source date: 1830 AD

Number of ingredients: 11 herbs

Formula key actions: Invigorates the Blood. Dispels blood Stagnation. Spreads the Liver Qi. Unblocks the channels.

Conditions targeted*: Coronary artery diseaseRheumatic valvular heart disease and others

Zhi Ke is an assistant ingredient in Xue Fu Zhu Yu Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

In Xue Fu Zhu Yu Tang, Zhi Ke it expands the chest and supports Qi movement together with other assistant herbs. They eliminate Qi Stagnation in the chest and supports the Qi movement so as to facilitate Blood circulation. 

Read more about Xue Fu Zhu Yu Tang

Cang Fu Dao Tan Wan

Source date: 1817 AD

Number of ingredients: 8 herbs

Formula key actions: Resolves Dampness and Phlegm.

In Cang Fu Dao Tan Wan, Zhi Ke moves Qi and eliminates Qi Stagnation which will help to resolve Phlegm

Read more about Cang Fu Dao Tan Wan

Ge Xia Zhu Yu Tang

Source date: 1830 AD

Number of ingredients: 12 herbs

Formula key actions: Invigorates Blood. Eliminates Blood Stagnation below the diaphragm. Stops pain. Promotes Qi movement.

Conditions targeted*: AmenorrheaPainful menstruations and others

In Ge Xia Zhu Yu Tang, Zhi Ke invigorates Blood below the diaphragm

Read more about Ge Xia Zhu Yu Tang

Huai Jiao Wan

Source date: 1107 AD

Number of ingredients: 6 herbs

Formula key actions: Clears heat from the Intestines. Stops bleeding. Disperses wind. Regulates Qi.

Conditions targeted*: HemorrhoidsBleeding hemorrhoids and others

In Huai Jiao Wan, Zhi Ke promotes the movement of Qi and thereby relaxes the Intestines

Read more about Huai Jiao Wan

Zhu Yu Zhi Xue Tang

Source date: 1826 AD

Number of ingredients: 8 herbs

Formula key actions: Invigorates Blood. Stops bleeding.

In Zhu Yu Zhi Xue Tang, Zhi Ke invigorate Qi to move Blood

Read more about Zhu Yu Zhi Xue Tang

Key TCM concepts behind bitter oranges (Zhi Ke)'s properties

In Traditional Chinese Medicine (TCM), bitter oranges are plants that belong to the 'Herbs that regulate Qi' category. Herbs in this category typically treat a TCM condition called 'Qi Stagnation'. Concretely it means that Qi is blocked in the body's Organs and Meridians, most typically the Stomach, Liver, and to a lesser extent, the Lungs. In modern medicine terms, Qi Stagnation often translates into psychological consequences such as depression, irritability or mood swings. It's also frequently associated with conditions such as premenstrual syndrome (PMS), menopausal symptoms, the development of breast swellings as well as various digestive disorders.

Furthermore bitter oranges are plants that are Warm in nature. This means that bitter oranges tend to help people who have too much 'Cold' in their body, although with less effect than a plant that would be Hot in nature. Balance between Yin and Yang is a key health concept in TCM. Those who have too much Cold in their body are said to either have a Yin Excess(because Yin is Cold in nature) or a Yang Deficiency (Yang is Hot in Nature). Depending on your condition bitter oranges can help restore a harmonious balance between Yin and Yang.

Bitter oranges also taste Bitter, Pungent and Sour. The so-called 'Five Phases' theory in Chinese Medicine states that the taste of TCM ingredients is a key determinant of their action in the body. Bitter ingredients like bitter oranges tend to have a cleansing action on the body by clearing Heat, drying Dampness and promoting elimination via urination or bowel movements. On the other hand Pungent ingredients tend to promote the circulations of Qi and Body Fluids. That's why for instance someone tends to sweat a lot when they eat spicy/pungent food. Lastly Sour ingredients help with digestion and restrain abnormal discharges of Fluids from the body, such as diarrhea or heavy sweating.

The tastes of ingredients in TCM also determine what Organs and Meridians they target. As such bitter oranges are thought to target the Spleen and the Stomach. In TCM the Spleen assists with digestion, Blood coagulation and Fluids metabolism in the body. The Stomach on the other hand is responsible for receiving and ripening ingested food and fluids. It is also tasked with descending the digested elements downwards to the Small Intestine.