The Science and Tradition Behind Hot and Cold Herbs

In this blog post, I will explore the concepts of hot and cold herbs, and the common uses of specific characteristics. I’ll also show how they are paired for balanced treatments, and the modern scientific perspective on these ancient practices. 

In Chinese Medicine, herbs are categorized as “hot” or “cold” , based on their inherent properties and the kind of energy they provide to the body. Understanding the hot and cold properties of herbal medicine is essential in TCM as they help form an integral part of diagnosis and treatment. 

It’s not just about the herb’s temperature that it feels like when you taste it, but also the effect the herbs have on our bodies, that determines the hot and cold properties of the herb.  

The Principle of Balance in TCM

Balance is a key principle in TCM. Health is achieved through creating harmony within the body. Disease and discomfort occurs when there’s an imbalance within the body. 

In Traditional Chinese Medicine, diseases are often categorized as “hot” or “cold.” These terms refer not only to the physical temperature you feel in your body but also a complex set of symptoms, body conditions, and overall energy states described within the framework of TCM. Chinese Herbal Medicine uses herbs with opposing properties–cold for hot diseases and hot for cold diseases– can help restore the body’s balance and alleviate symptoms. 


Hot Diseases

Hot diseases are characterized by symptoms that indicate an excess of heat in the body. These can include fever, inflammation, redness, constipation, dry mouth, restlessness, and a rapid pulse. Other symptoms might include feelings of heat or burning, a flushed face, and a preference for cold drinks.

To treat hot diseases, TCM practitioners often employ herbs with cooling properties. For example, dandelion (Taraxacum officinale) is a cooling herb known for its ability to clear heat and detoxify the body. It’s frequently used in TCM to treat conditions such as infections or inflammation that present ‘hot’ symptoms.


Cold Diseases

On the other hand, cold diseases are associated with symptoms suggesting a lack of heat or an excess of cold energy in the body. Symptoms can include feelings of cold, cold limbs, pale complexion, fatigue, diarrhea, slow metabolism, slow pulse, and a preference for hot drinks or food.

Warm or hot herbs are used to address these cold diseases. Ginger (Zingiber officinale), a hot herb, is a common choice. It is known to warm the body, dispel cold, and boost the body’s Yang energy, making it effective in treating conditions with ‘cold’ symptoms, such as certain types of digestive issues or cold extremities.  

Understanding Hot and Cold Herbs

The classification of an herb as hot or cold in Traditional Chinese Medicine (TCM) is based on its inherent properties and the effects it has on the body, as well as the temperature which is felt when tasting the herbs. 

Hot herbs are generally used to stimulate the body’s functions,boost qi, invigorate the circulation of Qi, and dispel cold.  While cold herbs, on the other hand, have a cooling effect on the body and are used to clear heat, reduce inflammation, and calm overactivity. 

The classification of herbs as hot or cold is part of a complex system of diagnosis and treatment in TCM. It requires a deep understanding of the properties of each herb, the patient’s overall health, and the nature of their illness. Therefore, the use of these herbs should always be guided by a trained TCM practitioner.


Hot and cold are not just classifications but also dictate the function of the herbs.  For example, many herbs which are antiinflammtory and antibacterial tend to be cold because infections and inflammation cause heat. 

The properties of herbs includes five categories – hot, warm, neutral, cool, and cold. 

Hot and Warm Herbs

Hot herbs, like cinnamon bark (Cortex Cinnamomi) and dried ginger (Rhizoma Zingiberis), are used to combat extreme cold symptoms or severe deficiency of Yang energy in the body. These herbs can also be more drying so need to be used with caution if using for a long period of time. 

Warm herbs, such as fennel (Foeniculi Fructus) and cloves (Caryophylli Flos), are milder and are often used to treat less severe Yang deficiency conditions. These herbs, which are also spices, also help improve poor digestion by aromatically warming up the digestive system. 

Ginseng (Radix Ginseng) is a warm and stimulating herb for which is effective for improving energy, immune system boost, and sexual function. However, it can often be too hot for some people, leading to feelings of heat and discomfort. This is why it is always important to take herbs that match your needs and constitution. 


Neutral Herbs

Neutral herbs strike a balance. They neither cool nor warm the body significantly. Examples of neutral herbs include coix seed, Chinese dates (da zao), and poria (fu ling). Licorice (gan cao) is also a neutral herb that tonifies the qi and harmonizes other herbs in the formula. It is used widely and mostly at a much lower dosage than other herbs.  

Cool and Cold Herbs

On the other side of the spectrum, we have cool and cold herbs. Cool herbs like peppermint and peony are milder and often used to gently cool down minor heat symptoms. Cold herbs, including rhubarb and the very cold coptis, are used when there’s an extreme heat condition, such as high fever, severe inflammation, or other serious heat-related symptoms.


Herbal Pairing in Chinese Medicine

“Dui Yao” is a concept in Traditional Chinese Medicine (TCM) that refers to the pairing of two herbs (medicinal substances) in a formula. The term “Dui Yao” translates to “pair of herbs”.When two herbs are paired together, they can either enhance each other’s effects, mitigate certain side-effects, or target different aspects of the same illness.

The pairing is designed to create a synergistic effect that is greater than the sum of the effects of the individual herbs.

For example, in TCM, the pairing of “Ma Huang” (Ephedra) and “Gui Zhi” (Cinnamon Twig) is a famous “Dui Yao”. Ephedra has the effect of inducing sweating and relieving exterior symptoms (like those found in common cold), while Cinnamon Twig warms the channels and collaterals to support Ephedra’s actions. Together, they create a stronger, more balanced therapeutic effect for treating cold diseases. 

Another famous combination is Jin Yin Hua (Honeysuckle) and Lian Qiao (Forsythia). Both are used for their heat-clearing and detoxifying properties, making them useful in the early stages of fever diseases.

Anti-Inflammatory and Antimicrobial Functions of Cold Herbs 

Cold herbs in Traditional Chinese Medicine (TCM) are widely recognized for their anti-inflammatory and antimicrobial properties. They are often used in the treatment of conditions characterized by heat, inflammation, and infection.

Anti-Inflammatory Functions of Cold Herbs

Inflammation is viewed in TCM as a condition of ‘heat’ in the body. Cold herbs are used to ‘clear’ this heat, effectively reducing inflammation. They work on the principle of balancing the body’s energy or Qi to restore health.

For example, Scutellaria baicalensis, commonly known as Chinese skullcap, is a cold herb often used for its potent anti-inflammatory effects. It contains a compound called baicalin, which has been scientifically proven to exert anti-inflammatory effects by inhibiting certain pathways that lead to inflammation (1).

Similarly, Honeysuckle (Lonicera japonica), another cold herb, is used in TCM to clear heat and relieve toxicity. It’s often used for a wide range of conditions with both infection and inflammation such as sore throat, pelvic pain, eczema, or acne.

Antimicrobial Functions of Cold Herbs

Apart from their anti-inflammatory properties, many cold herbs also possess antimicrobial effects, which makes them effective in combating various types of infections.

One such example is the herb Isatis indigotica, or Woad Root, which is used traditionally for its antiviral and antibacterial properties. Modern studies have shown that this herb contains alkaloids and other compounds that can inhibit the growth of microorganisms (2).

Another example is Forsythia, used in TCM to clear heat and expel wind-heat. It has been found to possess antimicrobial activities against a range of bacteria and fungi (3).

These examples highlight how cold herbs in TCM, with their anti-inflammatory and antimicrobial properties, contribute to restoring the body’s balance and promoting health. 

Hot Herbs Stimulate the Body

Warming and aromatic herbs tend to stimulate the digestion and body’s functions. Ginger is classified as a hot herb in TCM and is used for its warming properties and ability to stimulate digestion and the free movement of Qi. Modern research has found evidence supporting these traditional uses. In a study published in the “International Journal of Preventive Medicine” in 2013, ginger showed significant anti-inflammatory and antioxidant effects (4). Another study published in the “European Journal of Gastroenterology & Hepatology” found that ginger can help with gastric emptying, reducing the symptoms of dyspepsia (5). 

Ginger is commonly added to formulas to wake up the digestion for bloating and IBS.  It can also be used to counter herbs which are too cold in a formula. However, taking too much ginger, particularly in juicing, can cause the body to accumulate too much heat.  Also if you have a hot condition, such as psoriasis, too much ginger may exacerbate the heat. 


Understanding the hot and cold nature of herbs is essential to grasp the depth of this ancient practice. This concept not only guides me in my patient’s diagnosis and treatment strategies but also serves as a reminder of the importance of balance and harmony in health. 


This blog post aims to inform and educate readers about the concept of hot and cold herbs in TCM. However, it’s not a substitute for professional medical advice. Always consult a healthcare provider or a trained TCM practitioner before starting any new treatment or health practice.


  1. Gao, Z., Huang, K., & Xu, H. (2001). Protective effects of flavonoids in the roots of Scutellaria baicalensis Georgi against hydrogen peroxide-induced oxidative stress in HS-SY5Y cells. Pharmacological Research, 43(2), 173-178.
  2. Xiao, P., Huang, H., Chen, J., & Li, X. (2014). In vitro antioxidant and anti-inflammatory activities of Radix Isatidis extract and bioaccessibility of six bioactive compounds after simulated gastro-intestinal digestion. J Ethnopharmacol, 157, 55-61.
  3. Zhang, R., Zhu, X., Bai, H., & Ning, K. (2019). Network Pharmacology Databases for Traditional Chinese Medicine: Review and Assessment. Front Pharmacol, 10, 123.
  4. Mashhadi, N. S., Ghiasvand, R., Askari, G., Hariri, M., Darvishi, L., & Mofid, M. R. (2013). Anti-Oxidative and Anti-Inflammatory Effects of Ginger in Health and Physical Activity: Review of Current Evidence. International Journal of Preventive Medicine, 4(Suppl 1), S36–S42.
  5. Hu, M. L., Rayner, C. K., Wu, K. L., Chuah, S. K., Tai, W. C., Chou, Y. P., Chiu, Y. C., Chiu, K. W., & Hu, T. H. (2011). Effect of ginger on gastric motility and symptoms of functional dyspepsia. European Journal of Gastroenterology & Hepatology, 23(1), 32–38.
Joseph Alban

Joseph Alban, L.Ac.

Joseph Alban is a Doctor of Acupuncture, New York Licensed Acupuncturist, and NCCAOM Board Certified Herbalist providing the highest quality Acupuncture and Chinese medicine care tailored to your needs.

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