Five elements

Foundation of Acupuncture and Oriental Medicine :

The Five Elements

A fundamental concept in Acupuncture and Oriental medicine is the idea that nature exists not only on the outside, but also within your body. Ancient Chinese philosophers and doctors, observed nature as a dynamic balance between five elements: wood, fire, earth, metal, and water. In combination with the Yin Yang theory, the Five Elements provides the theoretical basis of Oriental Medicine.

Regulating Balance: The Generation and Control Cycles

Each of the five elements was arranged in relationship to each other to represent the generation and control of all the elements. These two major relationships formed a self-regulating balance between the five elements.

These relationships can be seen in this diagram. The outer circle represents the generation cycle of the five elements: Wood nourishes Fire to burn stronger, Fire burns things into ash to generate Earth, Earth creates Metal as it is extracted from the land, Metal generates steam which collects into Water, and Water nourishes Wood to grow. For example, if the Wood element is weak, it will not nourish and generate enough Fire, leading to an imbalance in nature or in the body. In Oriental Medicine, we tend to say that Wood is the Mother of Fire and the Child of Water to describe this relationship.

A second relationship called the Controlling sequence is shown with the inner lines of the diagram. This relationship shows how one element is controlled by another to prevent one element from dominating the cycle. You can observe that Water controls Fire, as Water would be able to calm a Fire that was burning too hot. Metal controls Wood, as a metal axe can chop down trees that are overgrown. Earth controls Water, as the Earth controls the flow of Water since digging a canal can drain water and control its direction. Fire controls Metal, as Fire can melt Metal and be used to form Metal into useful shapes. And finally, Wood controls Earth, as trees dominate the land.

Five Element Manifestations

Each of the five elements is related to the 12 Primary meridians and their associated organs. This allows a generation and controlling relationship to be applied between these organs and meridians. A pathological disruption in one organ or meridian can affect the other meridians and organs through their five element relationships. The Wood element corresponds with the Liver and Gallbladder. Fire relates to the Heart and Small Intestine, and the Pericardium and Triple Heater. Earth is associated with the Stomach and Spleen. Metal regulates the Large Intestine and Lung. And finally, Water is in charge of the Kidney and Urinary Bladder. Remember, that these organs are the Chinese energetic organs and have physiological functions in the body that only applies to Oriental Medicine and maybe different from the Western Medical viewpoint.

The chart below details some of the correspondences of each of the five elements, including the related organs. These attributes show how each element is represented in various aspects of nature, and in our mind and body.

	Wood	Fire	Earth	Metal	Water
Color	Green	Red	Yellow	White	Black
Direction	East	South	Center	West	North
Climate	Wind	Heat	Damp	Dry	Cold
Season	Spring	Summer	Late  Summer	Autumn	Winter
Yin  Organ	Liver	Heart /  Pericardium	Spleen	Lung	Kidney
Yang  Organ	Gall  Bladder	Small Intestine /  Triple Heater	Stomach	Large  Intestine	Urinary  Bladder
Senses	Eyes	Tongue	Mouth	Nose	Ears
Tissues	Sinews	Vessels	Muscles	Skin	Bones
Emotions	Anger	Joy	Singing	Crying	Groaning

Pathological Sequences

There are two additional sequences that create pathological conditions between the five elements: the Over-acting and Insulting sequences. The Over-acting sequence follows the same pathway as the Controlling sequence, the inner lines of the diagram. However, in this case the relationship becomes pathological when the controlling element becomes excessive and over-controls. For example, Wood overacting on Earth can cause the Liver to weaken Spleen and its associated functions in our body. The Insulting sequence occurs in reverse of the Controlling sequence. In this case, Wood can insult Metal, causing the Liver to disturb the function of the Lung. In some cases, the Generation cycle can also become pathological. This occurs with the mother element does not support the child element, or the child element takes too much from the mother element. If Wood cannot feed the Fire, the Fire will be weak. If the Fire burns too strong, all the Wood will be consumed.

The Five Elements and Acupuncture

In clinical practice, an Acupuncturist would be able to determine the unbalanced element through signs/symptoms and examination of the pulse and tongue. For instance, issues with your tendons or eyes would correlate to a Wood imbalance, so the Acupuncturist would consider treating the Liver and Gall Bladder meridians, especially if the pulse and tongue examination supported this diagnosis.

When using the Five Elements for acupuncture point selection, we must keep in mind each of the five element sequences to determine the proper pathology we are treating. Most commonly, we apply theory from the NanJing, the Classic of Difficulties. NanJing chapter 69 states: in cases of deficiency, tonify the mother; and in cases of excess, sedate the son. This follows the Generation sequence to select which meridian and points to treat based upon the meridian that is unbalanced. Following this theory, we can use the Pericarium Fire meridian to tonify the Spleen Earth element; and we can use the Large Intestine Metal Meridian to sedate the Stomach Earth element. More complicated point selection methods involve five element relationships to specific points on each meridian; these methods will be discussed in subsequent articles on Acupuncture Point Selection Theory.

The Five Element theory has an important impact on all aspects of Oriental Medicine, including Acupuncture and Chinese Herbal Medicine. The proper balance of each of these elements in the body is critical for effective treatment. Understanding of the Five Element relationships increases in depth with additional study and clinical experience.