The Five Element Theory in Everyday Life and Clinical Practice


TCM Principles


The Five Element Theory in Everyday Life and Clinical Practice



The five elements are a Chinese method of analysing and organising information, be it in life in general or medicine in particular. Being able to classify all phenomena into five different elements with defined characteristics and patterns of interaction allows us to understand and foresee change.


The ability to foresee or understand change becomes especially valuable in a clinical setting where the patient typically exhibits multiple patterns and we have to discriminate between root and tip, before and after, crucial and by-product.


Depending on their nature, all phenomena on earth are associated with one of the five elements (or five phases, as they are also called). The five elements bear the characteristics of wood, fire, earth, metal and water. All phenomena classified within the same element have the same 'feel', they share similar characteristics and are otherwise connected by a certain 'sameness'. The nature of change of phenomena is determined by the engendering and restraining relationships amongst the five elements.


In Chinese Medicine, the five elements are a method of analysing the cause, location and progression of disease. The five elements enable us to associate the patient's symptoms and signs to particular organ pathologies. By prescribing certain herbs, which are associated with one of the five elements like all natural phenomena, we can restore the equilibrium of the five elements in the human body.


Engendering Relationships

Each of the five elements and their corresponding phenomena have an engendering and nurturing effect on one other element; this cycle is often called the nourishing cycle or the mother-son cycle. Each element is mother to the next element:

  • Wood engenders fire
  • Fire engenders earth
  • Earth engenders metal
  • Metal engenders water
  • Water engenders wood

This naturally feels right, as wood engenders fire by burning it, fire engenders earth by generating ashes, etc



Restraining Relationships

The five elements also have a restraining relationship to ensure that no element becomes too dominating and that all elements stay in harmony.

  • Wood restrains earth (by breaking up the soil)
  • Earth restrains water (by absorbing it)
  • Water restrains fire (by extinguishing it)
  • Fire restrains metal (by melting it)
  • Metal restrains wood (by cutting it)

When balanced these are the healthy relationships of the five elements.



The Search for Our Personal Element

Have you ever wondered why the diet that helped your friend didn't work for you at all? That you just can't get into Yoga or Tai Chi, although 'everybody else' is raving about it? Chances are the diet or exercise doesn't suit your element.


We all have a strong tendency towards one element, which determines our body makeup, our physical strengths and weaknesses, what we love, our goals in life. If we know this element, our true nature, we will feel at home and in control. We are not helplessly confronted with our weaknesses - and it will be easier for us to forgive ourselves.


Every type has different physical and psychological/spiritual strengths. Every type is also susceptible to different bodily or emotional imbalances. Cure and prevention, lifestyle, relaxation exercises and diet are therefore different for each element type.


In terms of our patient's and our own health, we will be able to effectively prevent imbalances we are prone to and diagnose a root cause of a disorder more accurately. The challenge of multiple patterns becomes easier to unravel once you know your patient's basic nature, what strengths drive his health and what weaknesses tend to cause disease.


The Element Wood and Personality Traits

The five elements are a symbol for the five basic energies of the universe. Everything in the universe pertains to one of these five basic energies. The energy associated with 'wood' is also associated with, amongst others, birth, spring, wind, green-blue, sour, gallbladder, liver, eyes, sinews, anger...


In order to get a feel for the characteristics of the wood energy, let us think of spring: Spring energy is a strong, dynamic, young and restless energy of expansion and growth. Plant and animal life that seemed dead in winter explode with life. Suddenly, there is green everywhere - we feel light and full of energy, ready to leave the old behind and embrace the new.


The nature of wood energy is like a sprout that grows to be a tree: It grows upwards towards the light with an amazing energy of expansion, the sprout has to be well rooted in the earth but also flexible to grow around obstacles.


Wood stands for birth, growth and development, and provides us with the creative energy to implement our vision and ideas, Famous scientists, national leaders, artists and explorers are strong wood types, People who lack wood energy have thousands of ideas but never 'give birth' to these ideas: They remain fantasies that never become reality,


Think of the birth of the universe itself: Formless energy became matter in an explosion and expanded at an incredible rate. Imagine the explosiveness of wood personalities if you don't let them expand: Anger is the emotion associated with wood, Teenagers who are in a strong wood phase of their lives (the spring phase of their life, strong development towards and birth of adulthood) show explosive anger towards the smallest restrictions their parents want to place on the expansion of their character,


Wood personalities feel most comfortable when everything in their lives is free flowing like the wind, the climatic factor associated with Wood, Wind, free flowing, brings change in weather. But if strong wind meets obstacles, it becomes destructive,


Now keep the feel of spring and wind while reading on: Wood personalities

  •  …are driven by an internal force to always remain active and look for new challenges. Once a goal is reached, the achievement becomes uninteresting and a new goal is sought out. Wood personalities need physical or mental activity to feel good and often find it difficult to relax.
  •  …value freedom and independence as essential. To be dependent, even ever so slightly, means imprisonment to the woody.
  •  …are ambitious and love competition. They always want to be the best and feel compelled to win. Woody's love it when they are admired for their success.
  •  ...can be workaholics
  •  …can seem distant in relationships. Their strong drive for independence, freedom and competition sometimes makes it hard for them to be close to others.
  •  …are stimulated by difficulties, deadlines and people doubting their success.
  •  …Iike to be the boss and are good at it. Their enthusiasm and optimism easily motivates others,
  •  ... are impulsive and trust their gut feelings when making decisions, They like to take a jump without thinking much and are good in making quick although sometimes irrational decisions,
  •  ... Iove risk and extreme situations. Leaders of expeditions' or mountain climbers are Woody's. They don't mind strain and hardship in order to explore the unknown.
  • …are loyal and persistent
  • …typically react with anger to any difficult or restrictive situation, e.g. when they meet limits, things don't go their way or when they lose control. Woody's need to express their anger immediately,
  •  …are open and direct in their relation to others, although sometimes they can be insensitive and follow their own interests without consideration for others, Woody's don't like long discussions,

Internal Organs Associated with Wood

When reading about the function unit of the body that the Chinese call the liver, it is helpful to keep two things in mind: One of the main differences between Chinese and Western Medicine is, that internal organs in Traditional Chinese Medicine are not defined as physical matter but as functions, The Chinese liver has six main functions:

1. It maintains the smooth flow of qi

2. It stores blood

3. It controls the 'sinews'

4. It manifests in the nails

5. It 'opens into the eyes'

6. It houses the ethereal soul


1. Maintaining the Smooth Flow of Qi

The nature of wood (and therefore also liver) energy is a strong and dynamic energy of expansion and growth. Consequently, what harms this energy most is obstruction. Personalities that pertain to the wood element can't deal well with any obstruction to their personality, their ideas or projects and they flare up in uncontrolled anger (the wood emotion) and are aggressive and frustrated,


As the liver is part of the same wood energy, it is not surprising that the liver is the internal organ most sensitive to obstruction of qi. Liver qi needs an atmosphere (within and without the body) of harmonious movement, free flow, suppleness and flexibility, the characteristics associated with a healthy wood element and a healthy liver, Any symptoms of an impaired liver will bear opposite characteristics.


An obstruction of the function 'maintaining a smooth flow of qi' is the most predominant pattern of all liver disharmonies and is also called 'liver qi stagnation'. Qi flows in all organs, body tissues, acupuncture channels - in short, everywhere in the body, An impaired flow of qi (liver qi stagnation) can therefore have an effect on the whole body, but it has an especially strong influence on the following three areas:


a) Emotions

Wood personality types are especially prone to this imbalance, but anyone suffering from liver qi stagnation can

experience (repressed) anger, frustration, irritability or depression. These emotional states are often accompanied by a feeling of oppression in the chest or a lump in the throat. Si Ni San [Bupleurum &Zhi Shi Formula], which resolves liver qi stagnation, is often used alone or as an add-on formula with any symptoms which appear due to mental stress or emotional changes, e.g. menstrual disorders, or gastritis that is exacerbated by stress.


Note that this is a reciprocal relationship: Emotional tension, repressed anger and frustration have a very strong impact on the liver function of maintaining a smooth flow of qi and are probably cause number one of liver qi stagnation. As all liver functions are interrelated and dependent on each other, emotional tension may cause other symptoms of liver qi stagnation. It can for example easily affect number two, the digestion.


b) Digestion

In order for digestion to work properly, it is crucial that stomach qi moves downwards and spleen qi moves upwards. A smooth flow of liver qi upholds the proper flowing direction of spleen and stomach qi. Liver qi stagnation may prevent spleen qi from flowing upwards causing diarrhoea and obstructing the proper transformation and transportation of nutrients. If the downward movement of stomach qi is disturbed, nausea, vomiting, no appetite or sour regurgitation this disharmony ring a bell? Within the restricting relationship of the five elements, this disharmony corresponds to wood (liver) over-restricting the earth (spleen/ stomach).


We have all experienced this disharmony when somebody or something has made us so angry or given us an emotional shock that we suddenly have no appetite and feel like we can't even take one bite disturbed emotions affecting the smooth flow of liver qi, which in turn is causing stomach qi not to flow downwards, so that food won't go down. In Chinese Medicine there is no separation of body and mind: A disharmonious mind can impair the body and vice versa, and a harmonious mind can cure the body, while harmonising the body can cure the mind. Formulas such as Xiao Yao San [Bupleurum & Dang Gui Formula], which resolve liver qi stagnation, also contain herbs that strengthen the spleen to address woodearth disharmony.


c) Gallbladder

The gallbladder is the second organ associated with wood. Stagnant liver qi can obstruct the flow of bile excreted by the gallbladder, bringing about belching, a bitter taste, or jaundice. Long Dan Xie Gan Tang [Gentiana Combination] addresses a liver-gallbladder heat pattern.


2. Storing Blood

The liver's function of storing blood has two aspects:

a) The liver is regulating the blood volume throughout the body according to our level of activity. During activity, blood streams to the extremities to nourish the muscles and provide them with energy; during rest the blood returns to the liver and we are able to Iegenerate ourselves.


b) The liver's function of storing blood is of great importance in gynaecology. If the liver stores blood normally, menstruation is normal. If liver blood is hot, this may cause an excessive flow of menses or irregular uterine bleeding not associated with menstruation. Deficient liver blood may lead to a diminished flow during the menstrual period, infrequent occurrence of menstruation, or absence of menstruation.


Liver qi disharmonies can also influence menstruation, since the correct flow of qi in the blood vessels affects the blood flow. Liver qi stagnation can lead to blood stagnation, resulting in symptoms like painful periods, clotted blood, premenstrual tension. Jia Wei Xiao Yao San [Bupleurum & Peony Combination] addresses liver qi stasis leading to fire and blood vacuity, (and also spleen vacuity). The formula resolves liver qi depression, strengthens the spleen and supplements blood, and clears heat and cools blood. Hence it is an excellent formula to regulate menstruation. Blood nourishes and moistens the body tissues, including the skin and hair. An impaired liver affecting the blood can also cause skin rashes or other skin diseases, and make the hair lose its healthy shine.


3. Controlling the Sinews

The term 'sinews' includes the tendons and, in part, the muscles. Liver blood nourishes and moistens the 'sinews' and ensures smooth, harmonious and flexible movements. If liver blood is deficient and can't nourish the 'sinews', muscle cramps, contraction of the tendons, inflexibility of the joints, weakness, or numbness of the limbs, tremors or convulsions may be the consequence. As an example formula, Shao Yao Gan Cao Tang [Peony &Licorice Combination] is used for any type of pain connected to liver blood vacuity or yin vacuity. It is often used as a general muscle relaxant and added to other formulas when there is pain present. In combination with other formulas, Shao Yao Gan Cao Tang relieves dysmenorrhea. On its own it is frequently used for calf muscle cramps due to dehydration, overstrain of the muscle or circulatory disturbances of the lower limbs.


4. Manifesting in the Nails

Abundant liver blood produces healthy, moist, flexible, pink nails. Deficient liver blood causes the nails to be pale, thin, dry, cracked or indented.


5. Opening into the Eyes

Every internal organ in Chinese Medicine has a sense organ connected to it. The liver is connected to the eyes, and when liver blood is sufficient the eyes will have good vision and be well lubricated. An impaired liver is the cause for many eye problems or visual defects: Deficient liver blood may cause dry eyes, bad or blurred vision, myopia, night blindness, or colour blindness. Liver fire may cause the eyes to be blood shot. As an example, Qi Ju Di Huang Wan [Lycium, Chrysanthemum and Rehmannia Formula] supplements liver yin (and blood) and kidney yin, and brightens the eyes. It is often used for eye disorders such as red, burning, swollen itchy eyes (but not eye infections), dizziness and blurring of vision after prolonged use of eyes, photophobia, tearing of eyes on exposure to wind, or cataracts. Interestingly, the health of the liv

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