In Traditional Chinese Medicine, “Imbalance Between Cold and Heat” corresponds to the term “imbalance of cold and heat,” commonly referred to as “intermingled cold and heat”—a condition where both cold and heat pathogenic factors coexist in the body, leading to contradictory symptoms such as “heat above and cold below” or “stomach heat and intestinal cold.”
What Is the Intermingling of Cold and Heat?
Core Manifestations: This condition is not characterized by simple cold or heat alone, but rather by the simultaneous presence of both cold and heat pathogenic factors. For example, one might experience mouth ulcers, a sore throat, and acne in the upper body, while simultaneously having cold feet, diarrhea, and frequent nighttime urination in the lower body.
Common Types: Heat in the upper body and cold in the lower body; heat in the stomach and cold in the intestines; cold and heat intertwined in the spleen and stomach; as well as complex conditions such as external cold with internal heat and true cold with false heat.
A Story About Air Conditioning
When it gets hot in the summer, if you go to a restaurant, they’ll turn on the air conditioning. The cool breeze blows down from above, and you quickly feel refreshed all over.
A little kid asked me, “Why are air conditioners installed at the top of the room instead of on the floor?”
I explained, “Cold air is heavy and sinks downward, while hot air is light and rises upward. By blowing cold air from above, a vertical convection current forms between the cold and hot air, quickly cooling the entire room.”
“What is convection?”
“It’s when hot air rises and cold air sinks. This relative movement is what we call convection!”
The child nodded thoughtfully.
During dinner, we were toasting each other, but one friend didn’t drink a single drop. I asked him if he was feeling unwell.
He said, “Whenever I drink ice-cold beer, I’m bound to get diarrhea!”
I said, “You have cold in your intestines, so you shouldn’t drink cold things!”
“But I also feel a burning heat in my chest. I always want to drink something cold—it makes me feel at ease and calms my restlessness!”
“That’s ‘heat above, cold below’—excessive heart fire above and kidney yang deficiency below, with cold in the intestines!”
“Heat above, cold below? Why can’t the human body have a circulation of cold and heat?” asked the child who had asked the question earlier.
That’s right—there should indeed be a circulation of cold and heat within the human body. Only when a circulation forms between cold and heat will the hot areas avoid prolonged internal heat, and the cold areas avoid prolonged chill! That child’s question made me reflect deeply for a long time and helped me understand the pathogenesis of the intermingled cold and heat within the human body.
I. Chronic cold legs, diarrhea, and menstrual cramps in women can all be caused by an imbalance of cold and heat within the body.
In the human body, the heart corresponds to the Li hexagram and governs fire, much like the sun in the sky; the kidneys correspond to the Kan hexagram and govern water, much like rivers on the earth.
When the weather is hot in summer, standing by a river brings a slight sense of coolness—why is that? Because water evaporates under the sun’s rays, absorbing some of the heat, which is why people feel refreshed. The same principle applies to the human body. Under normal circumstances, kidney water rises upward with the ascending energy of the liver to nourish heart fire, preventing people from feeling an excess of heart fire or becoming irritable. However, when kidney water is deficient, heart fire—unchecked by kidney water—becomes excessive, causing irritability and a craving for cold or chilled foods and beverages.
When we swim in the summer, we can feel that the water is warmer than in winter. This is because sunlight raises the water’s temperature, whereas well water underground, lacking direct sunlight, remains cool. The same principle applies to the human body. Through the downward movement of stomach qi and the gathering and descending action of lung qi, heart fire can descend into the kidneys, warming the lower body. If heart fire cannot descend, the lower body will feel cold; consuming cold foods will cause discomfort, leading to diarrhea and cold legs. Women may also experience irregular menstruation and dysmenorrhea.
Once we understand these principles, we’ll have a solution for treating conditions characterized by “heat above and cold below.” It’s just like letting well water bask in the sun—as long as we guide the heart fire downward to warm the kidney water, the lower part of the body will naturally become warm.
I once treated a 35-year-old patient who had suffered from dysmenorrhea for three years. Every time she menstruated, she experienced lower abdominal pain and a sensation of coldness; when the pain was severe, she would turn pale, break out in a cold sweat, and nearly faint. She had taken countless herbs to promote blood circulation and dispel blood stasis—such as peach kernels, safflower, motherwort, angelica root, and corydalis—and while her condition improved slightly during the month she took them, the pain would return with her next menstrual cycle. She was usually irritable and restless, with a particular fondness for cold drinks; she said that only after consuming them did she feel a slight sense of calm.
I used Aconite, Mugwort, Fennel, and Amethyst to warm the lower jiao, and Gardenia and Raw Rehmannia to clear the upper jiao. At the same time, I combined them with Sichuan Achyranthes to direct heart fire downward to alleviate kidney cold, and Bupleurum to lift liver qi and draw kidney water to nourish heart fire; Finally, I used Angelica sinensis root and Corydalis to disperse blood stasis and relieve pain. After one week of treatment, she was cured. When I saw her again six months later, she said the condition had not recurred, and her irritability had improved significantly.
The treatment for this patient involved directing fire downward and promoting the counterflow of cold and heat.
II. When Cold and Heat Are Out of Balance, It Is Not Enough to Merely Tonify Kidney Yang; the Liver, Lung, and Stomach Must Also Be Regulated
For every disease in the human body, corresponding therapeutic principles can be found in nature.
Many patients suffer from chronic coldness in the lower back and legs. When they consult a TCM practitioner, they are often told, “You have kidney yang deficiency and severe cold-dampness in your body. You need to take herbs that tonify kidney fire, dispel cold, and remove dampness!”
These medications work immediately, but not long after finishing the course, the cold returns! Take them again, and within a few days, the cold is back! Treating the illness becomes a never-ending tug-of-war—why is that? Because the body’s cold is limited!
Once you grasp this principle, the cold in your body is considered completely cured! If you don’t understand it, you’ll remain forever trapped in this endless cycle of tonifying fire and dispelling cold!
As I mentioned earlier, the cold in the lower half of the body needs to be warmed by kidney yang, and the source of kidney yang is heart fire!
There’s a saying we’re all familiar with: “Help in an emergency, but don’t treat the root cause of poverty.” Poverty cannot be solved by temporary relief; the key is to lift people out of poverty! Only by empowering the poor to create wealth on their own can they truly escape poverty!
“Teaching a man to fish” is far more important than “giving a man a fish”!
Nourishing kidney yang can dispel deficiency-cold in the lower jiao—this is beyond doubt. However, knowing how to prevent one’s kidney yang from becoming deficient and weak is a complex art in itself.
We all know that in nature, fire rises and water flows downward; these are the inherent properties of the elements. Consequently, in the human body, fire tends to surge upward while cold seeps downward. To prevent cold pathogens from becoming severe in the lower jiao, one must guide water to flow upward and fire to move downward.
For water to rise, the ascending action of liver qi is required. Therefore, one must maintain a cheerful disposition and spend time in nature, drawing on the regulating and dispersing properties of trees to keep one’s liver qi flowing smoothly. Only then can kidney water ascend to nourish heart fire, and one’s mood remain free from restlessness. At the same time, avoid staying up late, as this easily damages the body’s kidney yin. Once kidney yin is damaged and depleted, even if liver qi remains regulated, it will be ineffective and unable to nourish heart fire.
For fire to descend, one must rely on the descending force of the lung and stomach qi. Often, irregular eating habits and a restless, agitated state of mind can hinder the downward movement of heart qi, preventing it from communicating with the kidneys.
“The heart of a sage is like a pearl in the depths; the heart of an ordinary person is like a gourd floating on water!”
Observe those who are calm and composed—they rarely suffer from excessive fire in the upper burner, because the fire there is gathered and directed downward by lung qi, warming the kidney water and nourishing kidney yang.
III. Eat Less Spicy Food and More Sour Food
The five flavors nourish the five organs; an excessive bias in dietary flavors can also affect the rise and fall of the body’s qi mechanisms and the circulation of cold and heat.
For example, the pungent flavor enters the lungs; eating too much spicy food can lead to excessive dispersion of lung qi, hindering the downward flow of heart fire. At the same time, according to the theory of the Five Elements’ mutual restraint, the lungs belong to Metal, and the liver belongs to Wood—Metal overcomes Wood. Excessive consumption of spicy foods leads to hyperactivity of Lung Metal, which in turn suppresses Liver Wood. When the regulating and dispersing nature of Liver Wood is inhibited, it also prevents Kidney Water from ascending to support Heart Fire. Therefore, eating too many spicy foods not only hinders the downward movement of Heart Fire but also impedes the upward movement of Kidney Water.
Many patients present with frequent sore throats and swelling, accompanied by persistent lower back soreness and weakness in the legs. Taking Xiaochaihu Granules in combination with Liuwei Dihuang Pills can effectively alleviate these symptoms.
Xiao Chaihu Granules are produced using modern technology based on the Xiao Chaihu Decoction formulated by Zhang Zhongjing, a renowned physician of the Han Dynasty. Their function is to soothe the liver and harmonize the stomach—specifically, Bupleurum (Chaihu) ascends liver qi, while Pinellia (Banxia) descends stomach qi. Through this interplay of ascension and descent, the body’s disrupted qi dynamics are restored. Heart fire then follows the downward flow of stomach qi into the kidneys, warming kidney water. Taking Liuwei Dihuang Pills nourishes kidney water, which, aided by the ascending liver qi, ascends to support heart fire.
Although medication can provide temporary relief, without changing one’s lifestyle habits, a complete cure will remain elusive. There is a saying in rural areas: “If a patient doesn’t watch what they eat, the doctor will run himself ragged!” This captures the essence of the matter.
Spicy foods have a dispersing effect, while sour foods have an astringent effect. Therefore, people who particularly love spicy food might benefit from eating more sour foods in their daily diet to use the sour taste to astringe lung qi—this is beneficial for the body.
IV. Two Dietary Remedies: Peppermint-Loquat Drink and Peppermint-Almond Porridge
For patients with excessive heart fire rising upward, deficient kidney water below, a lack of communication between the heart and kidneys, and an imbalance between cold and heat, are there any other remedies besides medication?
Peppermint and Loquat Drink
Let me share a herbal tea recipe with you: Peppermint and Loquat Drink. It consists of 10 grams of peppermint, 10 grams of raw loquat leaves, and a small amount of brown sugar.
Here, the peppermint helps to soothe the liver and regulate qi, much like a spring breeze caressing willow branches, promoting the upward rise of liver qi. Once liver qi is properly regulated, kidney water can be channeled upward to nourish heart fire; with heart fire properly nourished, one will no longer feel restless and irritable. Loquat leaves descend the qi of the lungs and stomach; as stomach qi descends and lung qi is gathered and directed downward, heart fire can descend to the kidneys. When kidney water is warmed by heart fire, it naturally avoids becoming excessively cold. Brown sugar has a sweet taste that both harmonizes the properties of the herbs and neutralizes the cooling nature of peppermint. As a result, this formula is neither cold nor hot—it is balanced and moderate, with ascending and descending qi in harmony—making it suitable for regular consumption.
Peppermint and Almond Porridge
For those who generally dislike drinking tea, you can also prepare and consume peppermint and almond porridge.
Ingredients: 10 grams of bitter almonds, 100 grams of japonica rice, and 10 fresh peppermint leaves.
Preparation: First, grind the bitter almonds into a powder. Once the japonica rice has cooked to a thick consistency, add the almond powder and continue boiling. Then, add the washed and chopped peppermint leaves, stir until well combined, and it’s ready. Consume once daily.
The bitter almonds in this recipe help consolidate lung qi, while the mint promotes the rise of liver qi. This balance of ascending and consolidating energies facilitates the harmonious interaction between the heart and kidneys. Not only does it alleviate symptoms of heat above and cold below, but it also benefits skin health, regulates liver qi, and helps prevent depression (since almonds have the effect of moisturizing and brightening the skin, and mint helps regulate the liver and relieve depression).
However, since bitter almonds contain a small amount of amygdalin, consuming too much can be harmful to the body; therefore, adults should not exceed 10 grams per day.
V. Breathing Exercises and Meditation Are One Way to Overcome Imbalances Between Heat and Cold
Health preservation is a vast field of study; once we understand its underlying principles, there are many methods available. Below, I’ll introduce a very simple practice. As long as you persist with it for a period of time, most pathological mechanisms associated with “heat above, cold below” will be transformed, and your mind will gradually become calm.
Sit upright with your back straight and your legs hanging naturally. Breathe in slowly and breathe out slowly. As you exhale, focus on your knees and feel a wave of warmth slowly moving downward through your body. After continuing this for about ten minutes, you’ll feel warmth in your knees. Those with arthritis will also feel relief in their knee joints as the cold energy dissipates outward. Women suffering from dysmenorrhea who practice this regularly will feel warmth gradually spreading through their lower abdomen, and their menstrual cramps will gradually subside.
You might ask, what is the principle behind this?
In fact, this practice works by regulating your breath and utilizing the lungs’ descending function to guide the body’s “heart fire” downward, using your own internal heat to dispel internal cold. It is not merely a method for treating illness but also a wonderful way to strengthen the body and promote health. This simple movement not only dispels cold from the lower jiao but also, by directing heart fire downward, nourishes deficient kidney yang. Once kidney yang is no longer deficient, the lower jiao naturally becomes free of cold.
Through this practice, as heart fire descends, a restless mind can find calm. Not only does it treat illness, but one’s state of mind will also gradually change; When one’s mindset toward life changes, restlessness and impatience fade, and one begins to view matters with a longer-term perspective—just as Zhuge Liang wrote in his *Admonitions to His Son* to his son Zhuge Zhan: “Without simplicity and detachment, one cannot clarify one’s aspirations; without tranquility, one cannot achieve far-reaching goals!”
When the mind is calm, one’s thoughts become far-reaching!
VI.Standing on One Leg: Activating the Body’s “Mini Air Conditioner”
For some people who are chronically impatient, practicing this type of stillness exercise may be difficult to adapt to at first, and they might not feel its benefits right away. Are there any other methods? For such individuals, the “Golden Rooster Stance” is a suitable option.
The “Golden Rooster Stance” involves standing on one foot while lifting the other, letting your arms hang naturally at your sides, and gently closing your eyes. Maintain this position for 3 to 5 minutes, then switch to the other foot. Practicing this twice a day is sufficient.
Why does the “Golden Rooster Stands on One Leg” pose promote the circulation of heat and cold in the body?
If you try standing in this position a few times yourself, you’ll notice that balancing on one leg creates a sense of instability. This requires you to focus your attention on your calf and foot. To maintain the “Golden Rooster Stands on One Leg” posture, the body’s energy shifts downward, allowing the “heart fire” to descend and merge with the “kidney water,” thereby achieving health benefits!
This exercise is not only suitable for those with a lack of communication between the heart and kidneys, but also for people with liver yang hyperactivity, high blood pressure, dizziness, and a sensation of heaviness in the head, as well as patients who frequently experience lower back pain and weak legs. Why is that?
As qi and blood flow downward, the lower jiao of the body is nourished, liver yang hyperactivity is suppressed, and kidney deficiency improves!
There was once a patient who suffered from dizziness and headaches, with blood pressure that was essentially normal. Western medicine diagnosed him with insufficient cerebral blood supply. He received intravenous injections of Danshen Injection for a week, but it was completely ineffective—not only did his condition fail to improve, but it actually worsened. After he came to see me, I took his pulse and discovered that his qi and blood were surging upward, indicating deficiency in the liver and kidneys of the lower jiao, caused by deficient fire rising upward. I recommended he take Chinese herbal medicine, but he was skeptical. So I had him practice the “Golden Rooster Stands on One Leg” exercise, standing on one foot for half an hour at a time. That very night after practicing, his headache subsided significantly. After a week of practice, his condition had improved by eighty to ninety percent, and his lower back pain had also improved considerably!
What has been discussed above are all “techniques”—that is, methods of treating illness. While there are many methods, one must understand the meaning behind them, the guiding principles, and the pathogenesis of the disease.
“There are countless techniques, but principle comes first.” Once you understand the principle, many methods can solve the problem.
Some patients may ask: “I have knee pain. I’ve followed the exercises mentioned above and feel slightly better, but the pain is still severe, and I have difficulty bending and straightening my knee. Why is that?”
This involves issues with the tendons. Below, we’ll use another short story—The Story of Making a Bow—to discuss how to treat tendon disorders!
Always believe this: for the onset of any disease, there is certainly a corresponding treatment principle to be found in our daily lives!
