Tracing the Origin and Interpretation of the Therapeutic Principle"Using Cold Away from Cold,Using Heat Away from Heat"

XIN Jingyi; HE Juan

doi:10.3969/j.issn.1006-3250.2026.01.018

Abstract：The principle"Using Cold Away from Cold,Using Heat Away from Heat"is a fundamental therapeutic rule in traditional Chinese medicine(TCM).Historically,it has often been interpreted as selecting herbal formulas and medications according to the seasonal variations in temperature throughout the year—i.e.,avoiding warm or hot-natured herbs in summer and cold or cool-natured herbs in winter.However,this interpretation contradicts actual clinical practice.This principle originates from the seven major discourses on Yunqi in the Basic Questions,and its meaning must be understood within the theoretical framework of the Five Circuits and Six Qi.The source chapter,"On the Regular Patterns of the Six Yuan"(Basic Questions·Liu Yuan Zheng Ji Da Lun Pian),describes the climate,phenology,and pathological manifestations under the influence of the Six Qi governing the heavens and the six steps of guest Qi,subsequently proposing corresponding treatment methods.After each discussion of the guest Qi governing the heavens,the text states:"Use cold away from cold,use cool away from cool,use warm away from warm,use heat away from heat,and the same method applies to diet.If there is a false manifestation,act contrary;acting otherwise will cause disease."Therefore,this principle addresses the appropriate use of medications based on the Qi transformation states manifested by the Six Qi when they serve as the heaven-governing Qi,earth-governing Qi,or the six steps of guest Qi.The principles for using medications in accordance with the prevailing and retaliatory Qi of the Six Qi are also consistent with this rule.This therapeutic principle is notably embodied in Chen Wuze's formulas for the Six Qi governing the heavens,where medications are selected based on the cold or heat nature of the heaven-governing and earth-governing Qi,with modifications made according to the attributes of the guest Qi in the six Qi steps.Returning to the classics to interpret the original meaning of the theory is essential for correctly understanding it and guiding clinical application.