Five Elements

The theory of the Five Elements, brief introduction

The brilliance of Chinese philosophical and medical thinking lies in that all phenomena in nature as well as human physiology and even causes of disease could be understood through three simple yet profound theories of Qi (chi), Yin-Yang, and Wu Xing.

Simplistically, Wu Xing means "five elements", "five agents", "five qualities", "five properties" "five states of change", "five courses", "five phases".

In a more accurate sense, Wu Xing is actually the short form of "Wu zhongliuxingzhi chi" or "the five types of Qi dominating at different times", by way of example:

1. Water (Shuĭ) dominates in winter
2. Wood (Mù in spring
3. Fire (Huŏ) in summer
4. Metal (Jīn) in autumn
5. Earth (Tǔ) in late summer and is a transitional periodthat marks the intersection between the two seasons
Earth does not correspond to any season, as it is the centre, the neutral term of reference around which the four seasons and the other elements spin.

The names of substances such as Water, Wood, Fire, Metal and Earthserve as five symbols whose properties resemble. The respective Qi (matter, energy and its transformations) in the closest possible way that help us understand. The properties of the five types of Qi, (however they also can mislead us if we take everything in the literal sense).

Various traditional practices (e.g. philosophy, cosmology, fengshui, martial arts, music, and medicine) use the conceptual scheme of the Five Elementsto explain interactions and relationships between phenomena and the. Various stages of transformation in the recurring natural cycles of seasonal change, growth and decay, shifting climatic conditions, colours, flavors, emotions, human activity emotions andphysiology, etc.

Five Elements and the Internal Organs, brief intro

In Chinese medicinethe Five Elements symbolize five different inherent qualities and states of the Internal Organs, including their Yin-Yang polarity, their interaction and their12 aspects, that is:

1) Vital Substances (Qi, Blood, Essence, Body Fluids)
2) tissues (of the body)
3) sense organs

4) emotions
5) spiritual aspects
6) climates

7) external manifestations
8) fluids
9) odors

10) colours
11) tastes
12) sounds

Wu Xing —Internal Organs: Yin + Yang — tissue — sense organ —colour — season — weather — direction — emotion — taste — rancid — shape — movement — quality — Spiritual Aspect:

Water — Kidney, Bladder—bones—ears, hearing (audition) — black, dark blue — winter — cold — North — fear —salty — rotten — wavy — runs downwards — liberal — Zhi

Wood — Liver, Gall Bladder — sinews—eyes+eyesight (vision) — green/blue — spring—windy — East — anger — sour — rancid—rod like, beam like — grows upwards — enduring — Hun

Fire — Heart, Small Intestine — vessels — tongue, its movement and sense of taste — red, orange, pink — summer — hot —South— joy —bitter— scorched— triangular — spreads in all directions —radiant, hot— Shen

Earth — Spleen, Stomach—muscles—mouth, taste — yellow, brown —end of each season—humid, damp—Center —meditation, pondering — sweet — fragrant—cubic —attracts, concentrates —stable—Yi

Metal — Lungs, Large Intestine—skin—nose, sense of smell —white, silver—autumn —dry —West—worry, sorrow —pungent — putrid— spherical — inwards — sharp, pointing — P

Five-Element model of correspondences is exten¬sively used in Chinese medical diagnosis.
This is based mostly on the correspondence between Elements and to them pertaining emotions, smell, colour, taste and sound, by way of example:

A greenish colour of the face indicates an imbalance in Wood, which could be due to stagnation of Liver-Qi.

A Red colour indicates an imbalance in fire, which could be due to an excess of Heart-Fire

A Yellow, sallow complexion indicates an imbalance in Earth, which could be due to deficiency of Spleen-Qi.

A white colour indicates an imbalance in Metal, which could be due to deficiency of Lung-Qi.

A Dark, purplish colour, sometimes greyish, some¬times nearly black, indicates an imbalance in Water, which could be due to Kidney-Yin deficiency.

The qualities and dynamics of the Five Elements

The theory of Five Elements originated at about the same time as that of Yin-Yang andfirst refer¬ences toYin-Yang and the Five Elements date back to the Zhou dynasty (about 1000-770 BC).

It was developed by the same philosophical school that developed the theory of Yin-Yang, that is, the 'Yin-Yang School', sometimes also called the 'Naturalist School' and mark the beginning of what one might call 'scientific' medicine and a departure from shamanism.

No longer healers looked for a supernatural cause of disease: they now observed Nature and, with a combination of the inductive and deductive methods, they set out to find patterns within it and, by extension, apply these in the interpretation of disease.

The Five Elemental Energies (Wu Xing) represent the tangible activities of Yin and Yang as manifested in the cyclic changes of nature which regulate life on earth.

Where as Western thought developed the idea of elements as substances, Chinese philosophy conceived of the five elements, as dynamic states of change, for example:

1.Water is the elemental energy associated with winter, when a state of extreme Yin prevails.

Winter is the season of stillness and rest, during which energy is condensed, conserved, and stored

Water is a highly concentrated element containing great potential power awaiting release

In the human body, Water is associated with essential fluids such as hormones, lymph, marrow, and enzymes, all of which contain great potential energy. Its color is black, the color which contains all other colors

In concentrated form

In nature, Wateris dissipated by excess heat; in humans, Waterenergy is depleted by the heat of weather and the 'heat' stress fear and excess emotions.

The way to conserve the potential energy of Wateris to stay still (in winter time) and 'be cool' (in summer time).

2. The next phase of the seasonal cycle is spring, during which the Woodelement arises from the potential energy of water, just as plants sprout from the ground in spring rains.

This is the 'new yang' stage of the cycle. Woodenergy is expansive, exhilarant, explosive

It is the creative energy of 'spring fever', awakening the procreative drive of sexuality

It is associated with vigor and youth, growth and development

In the human body, Woodenergy is associated with the movement of muscles and the activity of tissues.

Its color is green, the vibrant color of spring growth.

Woodenergy demands free expression and space for open expansion.

Blocking it gives rise to feelings of frustration, anger, jealousy, and stagnation.

3. Just as spring develops naturally into summer, so the aggressive creative energy of Woodmatures into the flourishing 'full yang' energy of Fire.

This is the most overtly energetic phase of the cycle, during which the 'heat' of full yang energy is sustained.

All life forms flourish in summer owing to the warm, stable glow of Fireenergy

Fireis related to the heart, which is the seat of human emotions and the organ whose constant warmth and pulse keeps blood and energy moving

Its color is red, the warm color of fire and blood

It is associated with love and compassion, generosity and joy, openness and abundance

If blocked it results in hypertension and hysteria, heart problems and nervous disorders

4. Towards the end of summer comes an interlude of perfect balance during which Fireburns down and energy mellows, transforming itself into the elemental energy of Earth

Neither yin nor yang predominates during this period; instead they are in a state of optimum balance.

This is the pivot of the cycle, the fulcrum between the yang energies of springand summer and the yin energies of autumn and winter

The Five Elemental Energies hum in harmony at this time, providing a sense of ease, well-being, and completeness

The Earthenergy of late summer is the phase and the feeling celebrated in the song 'Summertime, and the living is easy...'

Its color is yellow, the color of sun and earth, and in human anatomy it is associated with the Stomach, Spleen, and Pancreas, which lie at the center of the body and nourish the entire system.

If Earthenergy is deficient, digestion is impaired and the entire organism is thrown off balance owing to insufficient nourishment and vitality.

5. As summer passes into autumn, the energy of Earthtransforms into Metal

During the Metalphase, energy once again begins to condense, contract, and draw inward for accumulation and storage, just as the crops of summer are harvested and stored in autumn for use in winter.

Wastes are eliminated, like winnowing chaff from wheat, and only the essence is kept in preparation for the nonproductive Waterphase of winter.

If the harvest fails or falls short, there may not be sufficient energy stored during Water/winter to generate a strong and healthy cycle in the following Wood/spring.

Metalenergy controls the Lungs, which extract and store essential energy from air and expel wastes from the blood, and the Large Intestine, which eliminates solid wastes while retaining and recycling water.

Its color is white, the color of purity and essence.

Autumn is the season of retrospection and meditative insight, for shedding old skin and dumping the excess baggage of external attachments and emotions accumulated in summer, just as trees shed their leaves and bees drive drones from the hive at this time of year.

Resisting this energy by clinging sentimentally to past attachments can cause feelings of melancholy, grief, and anxiety, which manifest themselves physiologically in breathing difficulties, chest pain, skin problems, and low resistance.

Flues, colds, and other respiratory ailments are common indicators of blocked Metal energy, which is associated with the lungs.

Just as Metal is a refined extract of Earth forged by Fire, so autumn is the season for extracting and refining essential lessons from the activities and experiences of summer, transforming them into the quiet wisdom of winter.

Five different qualities of natural phenomena

water: liquidity, fluidity, solution
fire: heat, combustion
wood: solidity, workability
metal: solidity, congelation, mouldability, containment
earth: nutrition

Five movements:

water: represents downward movement
wood: expansive, outward movement in all directions
fire: blazes upwards
earth: is the centre, point of reference and represents neutrality or stability
metal: represents contractive, inward movement

The five movements find important applications in medicine, for example,

pathological fireclearly blazes upwards (causing a red face and feeling of heat and headaches)
wood (liver-qi) flows freely in every direction
metal controls the skin, which contains the body (contraction)
water (kidney-qi) has clearly a downward movement (excretion of impure fluids)
earthis in the centre and therefore the pivot of reference

Five phases in the cycle of seasons interrelationship among the Five Elements

water corresponds to winter and is associated with storage
wood corresponds to spring and is asso¬ciated with birth
fire corresponds to summer and is associated with growth
earth corresponds to the late season and is associated with transformation
metal corresponds to autumn and is associated with harvest

The Five Element interrelation and its application in medical practice

The relationship between the Five Elementscan be revealed via four main cycles/sequences:

When properly used, the symbols can provide a quick and effective model of the (energetic) functional interaction Internal Organsystem in medical practice and a guideline for diagnosis and treatment.

1. Harmonious cycles/sequences:

Promoting (or generating/nourishing) Sheng
Controlling (acting upon, balancing), Ke.

In the nourishing cycle, the motherelement nourishes her sonelement:

Water produces wood; when a tree is watered, it grows.
When Woodburns, fireis fed.
Fire reduces things to ashes which become part of the earth.
Earth is mined for metal.
Metalthen changes to liquid (water) under the heat of fire.
Finally, once again Waterprovides nourishment for trees to grow, producing wood.
Just as 'Wood generates Fire and is generated by Water', so we can say that the 'Liver is the mother of the Heart and the child of the Kidneys'.
The Liver is the mother of the Heart: the Liver stores blood and blood houses the mind (Shen, the spiritual aspect of Heart).
If Liver-Blood is insufficient, the Heart will suffer; Liver-Blood deficiency often induces Heart-Blood deficiency and they both affect sleep and dreaming.
The Heart is the mother of the Spleen: Heart-Qi pushes the blood and thus helps the spleen function of transportation.
The Spleen is the mother of the Lungs: the Spleen provides food-qi to the lungs where it interacts with air to form the Gathering Qi.
A deficiency of both Spleen- and Lung-Qi is common in clinical practice.
The Lungs are the mother of the Kidneys: Lung-Qi descends to meet Kidney-Qi. the Lungs also send fluids down to the Kidneys.
The Kidneys are the mother of the Liver: Kidney-Yin nourishes Liver-Blood. The Kidneys control the bones and the Liver the sinews; bones and sinews are inseparable.

The controlling cycleensures that a balance is maintained among the Five Elements, this way:

The Liver controls the Spleen, the Heart controls the Lungs, the Spleen controls the Kidneys, the Lungs control the Liver, the Kidneys control the Hearte.g., a Metal knife can cut Wood and shape or control it.

The Liver controls the Stomach and Spleen:

The Liver, with its free flow of Qi, helps the Stomach to rot and ripen food and the Spleen to transform and transport.

The Heart controls the Lungs:

Heart and Lungs are closely related as they are both situated in the Upper Burner. The Heart governs Blood and Lungs govern Qi; Qi and Blood mutually assist and nourish each other.

The Spleen controls the Kidneys:

Both Spleen and Kidneys transform Body Fluids. The Spleen activity in transforming and transporting fluids is essential to the Kidneys' transformation and excretion of fluids.

The Lungs control the Liver:

In this case, unlike the others, there is a certain element of 'control' of the Liver by the Lungs. The Lungs send Qi downwards, whereas the Liver spreads Qi upwards. If Lung-Qi is weak and cannot descend, Liver-Oi may tend to rise too much. This often happens in practice, when a deficiency of the Lungs leads to rising of Liver-Yang or stagnation of Liver-Qi.

The Kidneys control the Heart:

Kidneys and Heart actually assist and support each other. A proper communication and interaction between Kidneys and Heart is essential for health” (Maciocia).

2. Conflicting cycles:

2.1 Overacting, Cheng
Also called attacking cycle, is a disruption of a balancing cycle, Ke

2.2 counteracting, Wu
Is a disruption of apromoting cycle, Sheng
Involve sinsulting and affecting activity of an Element, e.g.mother affects the son or vice versa

The conflicting cycles inthe Five-Element model provide an important and clinically useful pattern of pathological relationships among the Internal Organs

Each Element (and its pertaining Internal Organ) can manifest disharmonyin four ways:

1. Element is in excess and over-acts on another element (over actingcycle (pathological Ke cycle).
2. Element is in excess and 'draws' excessively from its Mother Element (pathological Sheng cycle or affecting cycle).
3. Element is deficient and fails to nourish its Child (pathological Sheng cycle or affecting cycle).
4. Element is deficient and is insulted by another Element (insulting cycle or anti Ke cycle).

2.1 over-acting cycle, Cheng

The Element which is in pathology exhibits over controlling action instead of controlling/balancing one

This occurs when a particular element become sexces¬sivedue to various causes internal (e.g. lifestyle, negative emotions, etc.) and-orexternal (e.g. harming weather conditions,etc.)

The Liver over-acts on the Stomach and Spleen:

If Liver-Qi stagnates (e.g. due to stress, anger, excessive fatty food consumption) it 'invades' both the Stomach, impairing its function of rotting and ripening, and the Spleen, impairing its function of transforming and transporting.

In particular, when Liver-Qi invades the Stomach, it prevents Stomach-Qi from descending, which can causenausea, distension in the hypochondrium/chest/epigastrium and it prevents Spleen-Qi from ascending. Qi descends, instead, which causes diarrhea (e.g. IBS).

The Heart over-acts on the Lungs:

Heart-Fire (e.g. due to Liver Fire(Liver is mother of Heart) prolonged anger, restrained emotions) can dry up the Lung fluids and cause Lung-Yin deficiency (dry cough/throat, tickly throat, weak-hoarse voice, night sweating, etc.).

The Spleen over-acts on the Kidneys:

When the Spleen holds Dampness (e.g. due to excess consumption of cold, raw foods, protein-deficient diet,excessive or too little eating, pensiveness, worry, etc.).

This can obstruct the Kidneys' function of transformation and excretion of fluids → edema.

The Lungs over-act on the Liver:

Pathology of Lungs can be transmitted to the Liver
Lung-Heat or Phlegm-Heat may be transmitted to the Liver

The Kidneys over-act on the Heart:

If Kidney-Yin is deficient, Empty-Heat forms and this can be transmitted to the Heart

2.2 Counteracting cycle (or anti Ke cycle)

The Element which is in pathology (in excess) “jumps counterclockwise”and prevents normal function of the preceding element

The insulting cycle Wu:

The Liver insults the Lungs:

Liver-Qi can stagnate upwards and obstruct the chest and breathing, thus insulting the Lungs
one of the most important interactions between Metal (lungs) and Wood (liver) is thorough breathing (or oxygenation).

This way the Lungs control the Liver, in other words, in practice, breathing controls the anger (emotion pertaining to the Wood element).

In the case of deficiency of Metal Qi (due to poor breathing, lung disease) or hyperactivity of Wood Qi (due to anger, stress), the Wood may counteract on Metal, causing hyperventilation, breathlessness, coughing, asthma (i.e. weak Lung Qi cannot descend).

Another aspect of oxygenation is stresscontrol.

In TCM the Liver is the most vulnerable organ to this modern life occurrence.

As we stress(pent up anger, frustration, emotionally and physically strenuous situations), the smooth flow of Qi becomes disrupted, hence Liver Qi stagnates and/or Liver-Yang rises, thus, becoming excessive this, in turn, makes the Wood insult the Metal.

As a result, we seize to breathe deeply and rhythmically, in other words we hyperventilate, which causes general deprivation of all the organs of the oxygen(a condition when invaded Lung cannot descend its Qi).
* Aalthough air flowing in and out of the lungs per minute increases this, however, does not promote the oxygenation process, to the contrary, it evokes a chain of pathological reactions.
* In hyperventilation, the air flowing out of the lungs increases, as a result CO2 level in the blooddecreases Lung deficiency and there is a slight shift towards alkalinity.
* This is turn increase in the amount of calcium entering the muscles controlled by Liver and nerves
* Excess calcium in muscles and nerves makes them hyperactive Liver overactive: they willcontract more readily, more strongly andfor a greater duration than they normally would, this is called titanic contraction or in simple words muscle cramping or in milder casesmuscle tension. In TCM this insulting cycle could be illustrated as vicious circle:
* Stress Liver (wood) overactive → hyperventilation Lung (metal) deficient →
* Muscle strain wood overactive + diaphragm (which is a muscle) strain → deep breathing is obstructed →
* Oxygenation further obstruction further metal deficiency → even more severe muscle strain wood even more overactive.

When CO2 decreases Lung deficiency there is also constriction of the arteries in the head, there by reducing blood flow, and oxygen availability to the brain (hypoxia)
Many researchers have emphasized the role of lowoxygen in migraine Liver overactive: Liver-Yang rising or Live-Fire
Liver-Fire may also obstruct the descending of Lung-Qi and cause asthma

The Heart insults the Kidneys:

Heart-Fire can infuse downwards to the Kidneys and cause Kidney-Yin deficiency feeling of heat in the evening, night sweating, dizziness, tinnitus, vertigo, dry mouth/throat at night, poor memory

The Spleen insults the Liver:

If the Spleen retains Dampness, this can overflow and impair the free flow of Liver-Qi (which manifest as irritability, anger, sighing, feeling of lump in the throat, PMS, etc.)

The Lungs insult the Heart:

If the Lungs are obstructed by Phlegm they can impair the circulation of Heart-Q i(palpitations, chest distension/oppression, weak /cold limbs)

The Kidneys in sult the Spleen:

If the Kidneys fail to transform fluids, the Spleen will suffer and become obstructed by Dampness (nausea, feeling of heaviness, tiredness, sticky tongue coating etc.)

This occurs when a particular element (s) becomes (s) deficient due to various internal and-or external causes.

The affecting sequence, is a pathological Sheng cycle and involves two mechanisms:

The Mother Elementis not nourishing the ChildElement.
The Child Element taking too much (draining) from the Mother Element.

The Liver (mother) fails to nourish the Heart
When Liver-Blood is deficient, it often affects Heart-Blood, which becomes deficient, and palpitations and insomnia ensue.

The Heart (child) affecting the Liver:
If Heart-Blood is deficient, it can lead to general deficiency of Blood, which will affect theLiver’s function of storing of Blood.
This causes scanty periods or amenorrhoea.

The Heart (mother) fails to nourish the Spleen:
The Mind (Shen) of the Heart needs to support the mental faculties and capacity of concentration, which belong to the Spleen.
Another aspect of this relationship is in Heart-Fire deficency being unable to warm Spleen-Yang and leading to cold feeling, diarrhea,…

The Spleen (child) drainingthe Heart:
The Spleen makes Qi and Blood and the Heart needs asuficient supply of Blood.
If the Spleen does not make enough Blood, the Heart will suffer and palpitations, insomnia, poor memory and slight depression will.

The Spleen (child) draining the Heart:
The Spleen makes Qi and Blood and the Heart needs asuficient supply of Blood.
If the Spleen does not make enough Blood, the Heart will suffer and palpitations, insomnia, poor memory and slight depression will ensue.

The Spleen (mother) fails to nourish the Lungs:
If the Spleen's function of transformation and transporta¬tion of fluids is impaired, Phlegmwill be formed.
Phlegmoften settles in the Lungs and causes breathlessness and asthma.

The Lungs (child) drainingthe Spleen:
The Lungs govern Qi and, if Lung-Qi is deficient, Spleen- Qi will be affected causing tiredness, no appetite and loose stools.
In practice, Spleen-Qi and Lung-Qi deficiency often occur together.

The Lungs (mother) fails to nourish the Kidneys:
Lung-Qi normally descends towards the Kidneys, which 'hold' Qi down
Also, the Lungs send fluids down to the Kidneys.
Thus, if Lung-Qi is deficient, Qi and Body Fluidscannot descend to the Kidneys, causing breathlessness (Kidney unable to receive Qi) and dryness of the Kidneys.

The Kidneys (child) drainingthe Lungs:
If Kidney-Qiis deficient it will fail to hold Qi down.
Qi will rebel upwards and obstruct the Lungs causing breathlessness.

The Kidneys (mother) fails to nourish the Liver:
Kidney-Yin nourishes Liver-Yin and Liver-Blood.
If Kidney-Yin is deficient, Liver-Yin or Liver-Blood, or both, will become deficient and give rise to tinnitus, dizziness, headaches and irritability.
This particular relationship is one of the most important and common in clinical practice.

The Liver (child) drainingthe Kidneys (mother):
Liver-Blood nourishes and replenishes the Kidney-Essence.
If Liver-Blood is deficient over a long period of time, it can contribute to deficiency of Kidney-Essence, causing dizziness, tinnitus, poor bone development and sexual weakness.