The “Four Qi” originally referred to the “Qi of the Four Seasons” and gradually evolved to signify the perception of the cold and heat of food, ultimately transforming into the cold and heat properties of traditional Chinese medicine (TCM). Traditional Chinese medicine holds that the Four Qi consists of four different medicinal properties: cold (han), heat (re), warm (wen), and cool (liang), also known as the Four Natures. These properties reflect the tendency of medicinal substances to influence the balance of Yin and Yang and the changes in cold and heat within the human body.
Question 1: What role do the “Four Qi” of Chinese medicine play in the treatment of diseases?
When internal and external factors disrupt the body’s temperature balance, leading to disease, the balance of heat production and dissipation in the body is also affected. If heat production exceeds dissipation, symptoms such as fever and hyperfunction may occur; conversely, if dissipation exceeds production, symptoms such as chills and functional decline may arise. This indicates that diseases can be categorized into two major types—heat syndrome and cold syndrome. The Four Qi of Chinese medicine is used to correct the imbalance of cold and heat in the body during illness. Cold and cool medicines can suppress the body’s metabolism, slow down the activity of organs and blood circulation, thus being used to treat heat syndromes. Warm and hot medicines can enhance the body’s metabolism, accelerate the activity of organs and blood circulation, thus being used to treat cold syndromes. The earliest pharmacological text in TCM, the “Shen Nong Ben Cao Jing,” states, “Treat cold with hot medicine, treat heat with cold medicine,” which refers to the therapeutic effects of the Four Qi on cold and heat syndromes.
Question 2: How to distinguish between cold, cool, warm, and hot?
Cold is the extreme of cool, and heat is the extreme of warm. There is no essential difference between cold and cool, or warm and hot; they are merely concepts of gradual classification. Neutral properties have the characteristic of being applicable to both cold and heat, lying between the two natures.
Question 3: How to correctly use Chinese medicines with cold, heat, warm, and cool properties?
Warm and hot properties of Chinese medicines: These have effects such as warming the interior and dispersing cold, warming the liver and resolving masses, supplementing fire and assisting Yang, warming Yang and promoting water metabolism, warming the meridians and unblocking collaterals, guiding fire back to its source, and rescuing Yang from reversal. They are mainly used for cold syndromes or symptoms of functional decline. Examples include Gan Jiang (Dried Ginger), Dang Gui (Angelica Sinensis), He Shou Wu (Fo-Ti), Di Huang (Rehmannia), Hong Zao (Red Dates), Gui Yuan (Longan), Lu Rong (Deer Antler), and Hai Ma (Seahorse).
Cold and cool properties of Chinese medicines: These have effects such as clearing heat and draining fire, cooling the blood and detoxifying, nourishing Yin and eliminating steaming, draining heat and promoting bowel movements, clearing heat and promoting urination, clearing and transforming heat phlegm, calming the heart and opening the orifices, and cooling the liver and extinguishing wind. They are mainly used for heat syndromes or diseases of hyperfunction. Examples include Sang Ye (Mulberry Leaf), Ge Gen (Kudzu Root), Jin Yin Hua (Honeysuckle Flower), Lu Dou (Mung Bean), Zhi Zi (Gardenia), Pu Gong Ying (Dandelion), Ban Lan Gen (Isatis Root), and Huang Lian (Coptis).
Neutral properties of Chinese medicines: These have a balanced nature and are mostly tonics, used for individuals with weakened constitutions or those who cannot tolerate cold or hot properties. Examples include Dang Shen (Codonopsis), Tai Zi Shen (Pseudostellaria), Ling Zhi (Reishi Mushroom), Honey, E Jiao (Donkey-hide Gelatin), Gan Cao (Licorice), and Gou Qi Zi (Goji Berries).
Question 4: What are common warm, hot, cold, and cool foods?
Warm and hot foods: Ginger, scallions, cilantro (suitable for those with wind-cold colds); dried ginger, black tea (to stop vomiting and relieve abdominal pain), chili peppers, alcohol (suitable for those with cold limbs and rheumatic joint pain); sorghum, pumpkin, garlic sprouts, lentils, garlic shoots, lychee, longan, durian, sugarcane, and black dates.
Cold and cool foods: Bitter melon (clears heat and drains fire), lotus root, kelp, tomatoes, winter melon, spinach, white radish, coix seed, watermelon, bananas, and pears.
Neutral foods: Rice, flour, meats, black sesame, lotus seeds, peanuts, yam, carrots, napa cabbage, honey, soy milk, goji berries, white fungus, and apples.
Question 5: How to determine the “Four Qi” of food?
From the perspective of taste, foods with stimulating flavors tend to be more pungent and warm, such as garlic, ginger, cilantro, and chili peppers. Foods with bitter or sour tastes tend to be more cold in nature, with representative examples being bitter melon, plums, bitter herbs, purslane, and dandelion. Sweet foods are generally those that have been exposed to sunlight for longer periods, thus being warm in nature, such as pomegranates.
From the perspective of growing environment, foods that grow in water tend to be more cold in nature, such as lotus root, kelp, freshwater fish, and duck meat. Foods that grow on land tend to be more warm in nature, such as chicken, beef, lamb, peanuts, and potatoes.
From the perspective of geographical location, fruits that grow in tropical regions tend to be more warm in nature, such as lychee, longan, and durian. Foods that grow in temperate or northern regions tend to be more cool in nature, such as pears, persimmons, and watermelons.
From the perspective of growing season, foods that grow in winter tend to be more cold due to the heavy cold air, such as napa cabbage, white radish, and winter melon; foods that grow in summer tend to be more cold due to receiving more rain, such as watermelon, pears, and cucumbers.
Due to the procedural differences between cold and cool, and warm and hot, it is important to pay attention when using medicines. For example, using warm medicine when hot medicine is needed, or using cold medicine when cool medicine is needed, may not achieve the desired therapeutic effect. Conversely, using hot medicine when warm medicine is needed may harm Yin, and using cold medicine when cool medicine is needed may harm Yang. For diseases with mixed cold and heat symptoms, both cold and hot medicines should be used to balance the two. It is especially important to distinguish between true and false cold and heat, and not to confuse them. Additionally, since each medicine possesses both properties and flavors, the Four Natures should also be matched with the Five Flavors (pungent, bitter, sweet, sour, salty) to maximize their efficacy.
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Author: Shen Pengrui | Editor: Nie PingtingChief Editor: Chen Shiwu | Review: Dang Feng
