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Bitter, pungent, and slightly sour in flavor, slightly cold in nature, non-toxic. Zhi Shi (Immature Bitter Orange) and Zhi Ke (Mature Bitter Orange) are largely similar. However, Zhi Shi has complete Qi and fierce nature, thus it excels at descending, entering the Foot-Yangming Stomach Meridian and Foot-Taiyin Spleen Meridian, resembling the character of a young and vigorous person who charges forward without looking back. Zhi Ke has scattered Qi and mild nature, thus its movement is slightly slower, allowing it to enter the chest and diaphragm, the regions of the Lung and Stomach, as well as the Large Intestine (due to the exterior-interior relationship between the Lung organ and its paired fu-organ); its nature and function both possess the efficacy of dissipating nodules, removing stagnation, and promoting Qi flow.

Zhi Shi (Immature Bitter Orange), being small with a fierce and rapid nature, treats lower jiao conditions and governs blood. It is effective for epigastric and abdominal fullness, distension, and oppression, accumulated food masses, thick phlegm, and accumulated blood, possessing the power to unblock and break up nodules, swift as breaking through walls. When combined with Baizhu (Atractylodis Macrocephalae Rhizoma), it treats deficiency-type fullness. However, due to its violent and fierce nature, it should not be used lightly by those without accumulated stagnation or hard masses, so as not to damage Yuan Qi (Original Qi).

Indications (Integrating Smallpox and Rashes): Should be stir-fried with bran. It is used for initial fever accompanied by phlegm-rheum and accumulated food causing fullness in the chest and diaphragm, or blood accumulation in the Spleen meridian. It should only be used temporarily when necessary to stabilize Stomach Qi. It must not be used during spontaneous occurrences in smallpox or during the pus-forming stage.

Zhi Ke (Mature Bitter Orange), being large with a mild nature, treats upper jiao conditions and governs Qi. It treats wind-induced itching and numbness, cough with wind-phlegm, chest and diaphragm fullness, and Qi stagnation in the Lungs. It addresses false distension in the hypochondrium, rashes on the muscle surface, generalized severe itching, and can expel retained fluid retention. It opens nodules and promotes flow, breaks up phlegm-rheum and accumulations, and moves accumulated food. Combined with Gancao (Glycyrrhizae Radix et Rhizoma), it helps slim the fetus; combined with Huanglian (Coptidis Rhizoma), it eliminates hemorrhoids. It can deplete the Qi of the highest region. Continuous heavy use is contraindicated, especially in cases of deficiency, frailty, and overwork. This is because bitter drainage and pungent dispersion benefit only excess Lung Qi and relieve Large Intestine congestion; therefore, it is used for intestinal wind.

Indications (Integrating Smallpox and Rashes): Should be stir-fried with bran. It benefits the five zang organs, travels to the Large Intestine, drains Lung Qi, widens the diaphragm, and treats generalized wind-rashes, such as the severe itching of skin resembling measles or smallpox. It may be used temporarily for initial smallpox fever, chest and diaphragm discomfort, accumulated food, stagnant Qi, and excessive heat with rough breathing. Excessive consumption damages Middle Qi.

Commentary: In ancient times, Zhi Ke and Zhi Shi were not distinguished. Since Li Dongyuan, it was differentiated that Zhi Ke treats the upper body and Zhi Shi treats the lower body; Zhang Yuansu (Haizang) differentiated that Zhi Ke governs Qi and Zhi Shi governs Blood. However, ultimately, their functions all involve promoting Qi flow; when Qi flows, phlegm dissipates and accumulations resolve. The human body, from the Feimen (anus) to the Pomen (mouth), has interconnected Sanjiao (Triple Burner), consisting of one Qi alone. Why distinguish between upper and lower, or Qi and Blood? It is merely accurate to say that Zhi Shi has an urgent nature while Zhi Ke has a mild nature. For individuals with robust Middle Qi who occasionally suffer from indigestion due to overeating, using this to assist the Spleen in transformation and transportation is acceptable. However, for those with insufficient Middle Qi and Spleen deficiency failing to transform and transport, further digestion will further weaken the Spleen. In cases of Qi-deficiency fullness, mistakenly using draining and attacking methods will injure formless Qi, not only worsening stagnation but also generating other pathologies. Regarding Shoutai Yin (Fetus-Slimming Decoction), with Zhi Ke as the sovereign herb, it gained fame for treating difficult labor in Princess Huyang. However, for those who are overly nourished and have strong Qi typical of the North, it might be suitable; otherwise, it damages True Yuan (True Original Qi), and if the fetus becomes too strong, it may反而 cause difficult labor. Moreover, the Spleen and Stomach are the parents of transformation and generation, and the walls of the entire body; how many times can they withstand being overturned?! Those injured by the Six Excesses (Six Evils) in antiquity could often endure it, but in recent times, innate constitution is deficient, and Seven Emotions cause more harm. Deficiency-fullness and deficiency-distension are common everywhere. Mistakenly using draining and reducing methods causes even greater harm. Can one not be cautious!