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Home > Education > Theory > Five Elements

The Five Elements of Traditional Chinese Medicine

By Victoria Dragon

TCM uses different perspectives to analyze health problems - the 8 Principal Patterns (Exterior/Interior, Excess/Deficiency, Hot/Cold, Yang/Yin), Pernicious Evils (Wind, Heat, Dampness, Dryness, Cold, and Fire), etc. The 5 Elements is another of those approaches.

Central to understanding the 5 Elements is to realize that Chinese medical therminology often is at the same time very poetic and very literal. For example Wind Cold imbalances are those in which wind and cold do play a role. The Chinese worldview is far more integrated than the typical Western viewpoint. The Western perspective tends to be linear; the Chinese perspective tends to be holistic or weblike. The title of a very famous book on TCM is The Web That Has No Weaver. Pull on any strand in a web, and it will affect all parts of the web. Whereas Western thought tends to look at just what is happening along one strand (linear), holistic thought considers all parts of the web.

The 5 Elements can sound very esoteric to Westerners, and there are some esoteric aspects to it. One way to look at the 5 Elements are they are descriptions of different aspects of energy. But these descriptions of aspects of energy go beyond the Western idea of kinetic-potential energy. And these descriptions are at once both symbolic and literal, and the symbolism grew out of a culture very close to nature.

Think for a movement about what happens in the spring. The weather is starting to WARM. Plants are PUSHING UPWARD out of the soil. Trees are leafing OUT. There is a lot of BIRTH and NEW LIFE in the animal kingdom. ENERGY levels are RISING (in contrast to the winter when people were withdrawn, sleepy, gathered in, slow, etc.). There are new BEGINNINGS in the spring. There is an explosion of newfound energy released in new growth. This is the element Wood. The spring is the time of increasing Yang (warm, upward, outward, rapid) in contrast to the winter which is the most Yin (cold, downward, inward, slow) time of the year.


The predominate atmospheric energy in the spring, the Wood time of year, is Wind. The summer is the most Yang time of the year. In fact, Yang enrgy gets so intense at this time of year that it starts to change into its opposite. Whereas people (and animals) tend to be bursting with energy and activity in the spring, at the height of summer the Heat is so much that people start to wear out and slow down. The fall is the time of waning Yang and increasing Yin. People start to slow down, gather inward for the approaching winter. Winter is the most Yin time of year, but after several weeks of being restricted indoors, people begin to long for increased activity and letting loose and getting out. Cabin fever as it's called in the West. Get me out of this house!!!!! I want to go somewhere, do something. Yin begins to decrease and Yang increases in the spring.

If this were just a description of the seasons of the year and their effects on people and animals, there wouldn't be a 5 Elements theory in TCM. As it is, thinking in terms of the 5 Elements has some very practical applications - in terms of understanding some imbalances and in terms of being able to fine-tune treatment. There are relationships between the 5 Elements which can be used in healing.

The 5 Elements are Wood, Fire, Earth, Metal, and Water. Wood is linked to the spring, the Liver (Yin Wood), the Gall Bladder (Yang Wood), the East, and Wind. Fire is linked to the summer, the Heart (Yin Fire), the Small Intestine (Yang Fire), the South, and Heat. Earth is linked to late summer, the Spleen (Yin Earth), the Stomach (Yang Earth), the center, and Dampness. Metal is linked to the fall, the Lungs (Yin Metal), the Large Intestine (Yang Metal), the West, and Dryness. Water is linked to the winter, the Kidneys (Yin Water), the Bladder (Yang Water), the north, and Cold.

This is not just an artificial system of correspondences that sounds nice and poetic. The Kidneys do tend to be very vulnerable to Cold. The Liver does tend to be particularly vulnerable to Wind, the Spleen to Dampness, the Heart to Heat, and the Lungs to Dryness. In many places in the world the spring does tend to be the most windy time of the year, the summer the hottest, the late summer the most humid, the fall dry, and the winter cold. One thing one learns quickly to do in TCM is to pay attention to the weather - especially very extreme weather (like an unusually windy spring) and unseasonable weather (like cold snaps in the summer or warm spells in the winter). Extreme and/or unseasonable weather will tend to trigger health imbalances in many people. There will tend to be an increase in certain problems during or immediately following certain seasons. For example, the Liver is the Yin Wood Organ, and cases of infectious hepatitis and cases of pink eye do tend to be more numerous in the spring than at other times of the year. (In TCM the Liver is said to "open into the eyes".) Some people do tend to have kidney and bladder problems more often and more severe in the winter than at other times of the year. Some people do tend to have more digestive system problems when it's very humid. Etc.

But this is not all there is to the 5 Element Theory. The 5 Element Theory also maps relationships between Elements which have practical applications both in diagnosis and treatment.

One of the best known of these 5 Element relationships is the Mother-Son rule. This states that if one tonifies the Mother, the Son automatically is tonified. If one sedates the Mother, the Son automatically is sedated. Wood is the Mother of Fire, Fire is the Mother of Earth, Earth is the Mother of Metal, Metal is the Mother of Water, and Water is the Mother of Wood. A good way to remember part of this sequence is that when one burns Wood with Fire, ash (Earth) results. Metal is found within Earth - Earth is the Mother of Metal. Water makes possible the growth of Wood. Water is the Mother of Wood.

Now, let's take this from the realm of the merely poetic to the realm of the practical. Let's look a little closer at Water is the Mother of Wood. The Kidneys is the Yin Water Organ; the Liver is the Yin Wood Organ. There is a condition in TCM called Liver Yin Deficiency. There also is a condtion called Liver and Kidney Yin Deficiency. In some cases of Liver Yin Deficiency, the Deficiency of Yin is just in the Liver, and treatment is directed toward increasing Liver Yin. Simple, straightforward. But what about those cases where both Liver and Kidney Yin Deficiency are present? What happens if one just tonifies Liver Yin? You have to keep on and keep on and keep on tonifying Liver Yin because the Root of the problem is that there's not enough Yin in the Kidneys for the Kidneys (the Mother) to pass onto the Liver (the Son). The Kidneys supply the Yin for the Liver (and for the entire body for that matter). The Liver and Gall Bladder may be weak and prone to problems because the Kidneys are weak and not supplying what the Liver needs. The Organ Theory in TCM states that the Liver and Gall Bladder almost never are Qi Deficient. (Maciocia, Foundations, p. 303) But in the real world, one will run into cases where weak Kidneys appear to be dragging down Liver function. The Organ Theory doesn't account for many of these cases, but the 5 Elements Theory does, and what is more important, the 5 Elements Theory gives general guidelines for treatment. Tonify/ sedate the Mother in order to tonify/ sedate the Son. When one starts to look at some findings from Western medicine from a TCM 5 Elements perspective, the 5 Elements Theory starts to look even more valid. For example, certain liver problems can be traced to problems in the kidneys and urinary system. One role of the liver recognized by Western physiology is to detoxify certain things in the body. The kidneys get rid of certain waste products. If the kidneys are not doing their job of waste excretion properly, this can cause an overload on the liver and lead to some liver problems. Likewise, a poorly functioning liver can overburden the kidneys. Sometimes, a big part of effective healing is knowing which problem(s) to start with, to concentrate on first, and the 5 Elements Theory can give extra insight into this.

There are other guidelines in the 5 Elements Theory, but I won't go into those today. I recommend learning the basics of 5 Elements Theory, and starting to consider this perspective when analyzing and correcting imblances. Being able to use this theory can add that little extra understanding that can make a great deal of difference in proper treatment, especially when faced with "knotty" (complicated) problems that aren't responding satisfactory to treatment. The 5 Elements Theory is used primarily in acupuncture, but being aware of certain relationships and general treatment guidelines per the 5 Elements Theory can give herbalists that little extra insight that can make the difference between satisfactory and unsatifactory outcomes.

Victoria Dragon

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