The five elements

The five elements refer to five categories in the natural world, namely wood, fire, earth, metal and water. The theory of the five elements holds that all phenomena in the universe correspond in nature either to wood, fire, earth, metal or water, and that these are in a state of constant motion and change. The theory of the five elements was first formed in China at about the time of the Yin and Zhou dynasties ( 16th century - 221 B.C. ) . Historically it derives from observations of the natural world made in early times by the Chinese people in the course of their lives and productive labor. Wood, fire, earth, metal and water were considered to be five indispensable materials for the maintenance of life and production, as well as representing five important states that initiated normal changes in the natural world. As said in A Collection of Ancient Works : " Food relies on water and fire. Production relies on metal and wood. Earth gives birth to everything. They are used by the people. " Although having different characteristics, the five materials depend on each other and are inseparable. Thus in ancient times, people took these five elements with their mutual relationships to explain all phenomena in the natural world. The primitive concept of the five elements was later developed into a more complex theory, which together with the theory of yin - yang, served as a conceptual method and a theoretical tool for understanding and analyzing all phenomena, and ran through various academic classics in ancient times. In traditional Chinese medicine the theory of the five elements is applied to generalize and explain the nature of the zang - fu organs, the inter - relationships between them, and the relation between human beings and the natural world. It thus serves to guide clinical diagnosis and treatment

Classification of Phenomena According to the Five Elements. In early times, the Chinese people recognized that wood, fire, earth, metal and water were indispensable in their daily lives as well as having different natures. For instance, the character of wood is to grow and flourish, the character of fire is to be hot and flare up, the character of earth is to give birth to all things, the character of metal is to descend and be clear, and the character of water is to be cold and to flow downwards. Early doctors applied the theory of the five elements in their extensive study of the physiology and pathology of the zang - fu organs and tissues of the human body, and indeed all phenomena in the natural world that were related to human life. Using analogy, they classified all these, according to their nature, function and form, into the five elements. They applied this theory to explain the complicated physiological and pathological relationships between the zang - fu organs, and between the human body and the external environment. This classification of phenomena was minutely described in the fourth and fifth chapters of Plain Questions. The classification of the meridians according to the five elements is based on the nature of the zang - fu organs :

As for the pericardium and sanjiao, the ancients considered that the pericardium is a protective membrane surrounding the heart, and prevents the heart from being invaded by pathogenic factors. Since the heart pertains to fire, the pericardium also pertains to Fire. The table on the next page shows the five categories of things according to the five elements.

The Law of Movement of the Five Elements

The law of movement of the five elements mainly manifests in the following ways : interpromoting, interacting, overacting, counteracting, and mutual interaction between mother and son. Promoting implies promoting growth. Wood promotes fire, fire promotes metal, metal promotes water, and water, in turn, promotes wood. This interpromoting relationship of the five elements is known as the " mother - son " relationship, with each element being the " son " of the element that promotes it, and the " mother " of the one it promotes.
Acting means bringing under control or restraint. In the interacting relationship, wood acts on earth, earth acts on water, water acts on fire. fire acts on metal, and metal in turn acts on wood. Here each of the five elements occupies the role of " being acted upon " ( known as " under control " ) and of " acting upon " ( known as " controller " ) . The interacting relationship is therefore also known as the " intercontrolling " relationship.

Interpromoting and interacting are two inseparable and indispensable aspects of the five elements, which both oppose and cooperate with each other. Without promotion there can be no growth and development ; without interaction there can be no balance and coordination during development and change. In the promotion of growth there must be control, and in control there must be promotion of growth. The relative balance maintained between promoting and acting thus ensures normal growth and development. When there is excess or insufficiency of any of the five elements, there will be abnormal interpromoting and interacting ( known as " overacting " or " counter - acting " ) and disorders of " the mother affecting the son " and " the son affecting the mother. " Overacting can be likened to launching an attack when a counterpart is weak - it is an excessive acting on the element normally acted upon. It is commonly called " interacting " in the clinic. For example " wood overacting on earth " can also be called " wood acting on earth. " The order of overacting is the same as that of acting, except that overacting is not a normal interaction but a harmful condition occurring under particular circumstances. Counteracting means preying upon other elements. The order of counteracting is just the opposite to that of interacting. For instance, under normal conditions, metal acts on wood. In the case of deficiency of metal qi, or hyperactivity of wood - qi, the wood may counteract on metal. Therefore it is stated in Chapter 67 of Plain Questions : " When the qi of a given element is in excess, it will overact on the acted element and counteract on the acting element. When the qi of a given element is in deficiency, it will be attacked by the acting element and counteracted by the acted element. "

The mutual condition of " affecting between mother and son " refers to the phenomenon of abnormal interpromoting between the five elements. The promoted element is considered as the son, and the promoting element as the mother. " Affecting " means influencing in a harmful way, including both " the mother affecting the son " and " the son affecting the mother. " The order of " mother affecting the son " is the same as the interpromoting relationship, and the order of " son affecting the mother " is the reverse. Under normal conditions, water promotes wood. Abnormally, " water affecting wood " is known as " the mother affecting the son, " and " wood affecting water " is known as the " son affecting the mother. "

The Application of the Theory of the Five Elements in Traditional Chinese Medicine. When the theory of the five elements is applied in traditional Chinese medicine, the classification of phenomena according to the properties of the five elements and their interpromoting, interacting, overacting and counteracting relationships are used to explain both physiological and pathological phenomena, and to guide clinical diagnosis and treatment.

The five elements and the inter - relationship between the zang - fu organs. In this theory, each of the internal organs pertains to one of the five elements. The properties of the five elements serve as an analogy to explain some of the physiological functions of the five zang. In addition, the interpromoting and interacting relationships are used to explain some of the interconnections between the zang - fu organs. The liver may serve as an example, it is promoted by the kidney, promotes the heart, is acted on by the lung, and acts on the spleen. The roles of the other organs can also be explained in the same way, and thus an integral relationship between the internal organs is generalized. The meridians have a close relationship with the zang - fu organs. They are the passages by which the zang - fu organs connect with one another according to the interpromoting and interacting relationships of the five elements. In general, the zang - fu organs connect with each other directly through the meridians, according to the cycles of the five elements. The relationships between the liver, heart, spleen, lung and kidney can serve as an example. In the meridian system, the Liver Meridian of Foot - Jueyin and the Gallbladder Meridian of Foot - Shaoyang run through the heart ; the Liver Meridian of Foot Jueyin runs on both sides of the stomach which is externally - internally related with the spleen ; the Kidney Meridian of Foot - Shaoyin ascends and runs through the liver ; the Liver Meridian of Foot - Jueyin ascends to the lung ; the Kidney Meridian of Foot - Shaoyin ascends through the liver and lung, etc. By means of the interconnecting system of the meridians, the five elements maintain a relative balance and coordination.

The five elements and pathological relationships among the zang - fu organs. The occurrence of disease is the pathological manifestation of the dysfunction of the zang - fu organs and their related tissues, which may be due to a number of factors. The human body is an organic whole, and both interpromoting and interacting relationships exist among the viscera. Thus when one internal organ is afflicted, other organs and tissues may become involved. This is called " transmission. " According to the theory of the five elements, intertransmission may follow either the interpromoting or the interacting cycles. Transmission following the interpromoting cycle involves disorders of " the mother affecting the son " and " the son affecting the mother. " For example, when liver disease is transmitted to the heart, it is called a disorder of " the mother affecting the son, " and when liver disease is transmitted to the kidney, it is called a disorder of " the son affecting the mother. " Transmission following the interacting cycle involves " overacting " and " counteracting. " When a liver disease is transmitted to the spleen, it is called " wood overacting on earth, " and when a liver disease is transmitted to the lung, it is called " wood counteracting on metal. " It must be pointed out that mutual pathological influences among the viscera exist objectively. Some of them can be explained by disorders of " the mother affecting the son, " the son affecting the mother, " overacting " and " counteracting. " Therefore the theory may serve to explain the pathological transmissions which are observed in clinical practice.

The five elements and clinical diagnosis and treatment. The theory of the five elements is applied to synthesize clinical data obtained through the four diagnostic methods, and determine pathological conditions according to the natures and laws of the five elements. For instance, a patient with redness and pain of the eye and irritability suggests a liver problem ; a red complexion accompanied by a bitter taste in the mouth suggests hyperactivity of heart - fire. In treatment, the five Shu - Points correspond to the five elements. The Jin - Well, Ying - Spring, Shu - Stream, Jing - River and He - Sea points of the yin meridians correspond to wood. Fire, earth, metal and water respectively, whilst those of the yang meridians correspond to metal, water, wood, fire and earth respectively. Clinically they are selected for treatment according to the principle of " reinforcing the mother " and " reducing the son. " In addition, it is common clinical practice to determine the principle of treatment and selection of points according to pathological influences among the zang - fu organs, which follow the cycle of the five elements. For instance, in case of a disharmony between the liver and stomach, " wood overacting on earth, " the principle of treatment should be to promote earth and restrain wood. Points such as Zhongwan ( Ren 12 ) , Zusanli ( S 36 ) and Taichong ( Liv 3 ) will be selected