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Treating cold with heat and treating heat with cold is knowledge shared by all physicians. However, if treating cold with heat causes the cold to intensify, or treating heat with cold causes the heat to flare up further, it is likely that one has failed to examine the yin-yang nature of the five zang organs and has not selected treatments according to their respective categories. Does not the classic state: "If cooling treatment fails to resolve heat, seek it in yin; if warming treatment fails to resolve cold, seek it in yang."

For instance, in a case of febrile disease treated with cold-potent drugs, if the heat is severe, one should nourish the Kidney (Shen). Once the Kidney water is nourished, the heat will naturally dissipate. In a case of cold disease treated with hot-potent drugs, if the cold is severe, one should strengthen the Heart (Xin). Once the Heart fire is robust, the cold will naturally cease. This is what is meant by examining the nature of yin and yang and selecting treatments based on their categorical affinity.

The classic also states: "For excess, investigate the root; for deficiency, investigate the loss. For fullness, hold accountable for what needs purging; for emptiness, hold accountable for what needs tonifying." Why does it speak of "investigating" regarding existence/non-existence and "holding accountable" regarding fullness/emptiness? To "investigate" means to seek the reason for cure and the reason for iatrogenic harm (exacerbation). To "hold accountable" means to identify what ought to be purged and what ought to be tonified.

For example, when symptoms present as either heat or cold, treatment may require diaphoresis (sweating) or purgation. This corresponds to "investigating the excess." If cold is severe but warming treatment fails to reduce it, this results in an exacerbation of Heart fire. If heat is severe but cooling treatment fails to reduce it, this results in an exacerbation of Kidney deficiency. This corresponds to "investigating the deficiency."

For instance, if Heart excess generates heat, one must purge the Heart. If Kidney excess generates cold manifestations, one must purge the Kidney. This corresponds to "holding accountable for fullness." If Heart deficiency leads to excessive cold, one must tonify the Heart. If Kidney deficiency leads to excessive heat, one must tonify the Kidney. This corresponds to "holding accountable for emptiness."

Generally, the principles of the Five Elements involve mutual waxing and waning. Tonification, purgation, reduction, and growth depend on understanding their logical categories.

Diseases vary in severity due to differences in pathogenic invasion. Pathogens penetrate at varying depths. Treatments vary between contrary (ni) and following (cong) approaches depending on the mastery of medical principles. There are standard treatments (zheng) and flexible adaptations (quan). Mild conditions are treated by contraries; contrary treatment is standard treatment, which is the orthodox principle. Severe conditions are treated by followers; follower treatment is counter-treatment, which is the adaptive principle.

For example, if the disease momentum is not urgent, the goal is to break the qi and expel the pathogen. Understanding how heat treats cold and cold treats heat allows for mutual control, making efficacy easier to achieve. If the disease momentum is extreme, the goal is to follow the nature of the disease and harmonize it. Understanding "treating heat with cold administration" (using cold herbs as adjuvants to hot herbs) and "treating cold with heat administration" (using hot herbs as adjuvants to cold herbs) ensures that the drug nature seeks the pathogenic nature, achieving appropriateness.

Furthermore, contrary treatment (standard) has its own degrees of control. Following treatment (counter-treatment) involves variations such as "one same, two different" or "two same, three different," and disparities in the proportion of following agents. Therefore, those who formulate prescriptions must certainly deliberate deeply and plan carefully.