Five Elements Theory and Traditional Chinese Medicine

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Five Elements theory, like Yin-Yang theory, is deeply rooted in traditional Chinese philosophy. Five Elements theory differentiates all things into the five major categories of Wood, Fire, Earth, Metal, and Water. The properties of the Five Elements and their mutually generative and inhibitory relationships are used to analyze and explain the world and its natural laws.

Five Elements theory evolved from the Chinese ancestors’ recognition that water, fire, metal, wood, and earth are the basic materials of human life and production. This concept was combined with that of the Five Directions(north, south, east, west, and center), which dates back to the Shang Dynasty(c.1600-1046BC) or even earlier, to create Five Elements theory.

Each of the Five Elements embodies a functional attribute. Water represents descending cold; Fire represents ascending heat; Wood represents exuberant vitality; Metal represents lethal devastation; Earth represents nurturing sustenance. The Five Elements interact in both a generative and inhibitory manner, creating the state of dynamic balance that gives rise to the material world. Five Elements theory holds that Wood, Fire, Earth, Metal, and Water are the basic building blocks of the universe, which is created and transformed through their interaction. Therefore, all things in the material world can be categorized in terms of the properties of the Five Elements.

The relationships among Wood, Fire, Earth, Metal, and Water are not isolated or static. Rather, their interaction follows rules of generation and inhibition, creating a state of dynamic balance and constant transformation within which all things have their being. This is the normal condition of the Five Elements.

In the generative cycle, each element gives rise to its adjacent element. Wood engenders Fire, Fire engenders Earth, Earth engenders Metal, Metal engenders Water, and Water engenders Wood. Every element both engenders and is engendered by another element. The ancients compared this relationship to that between mother and child. The engendering element is referred to as the Mother, and the engendered element as the Child. For instance, Wood is the Mother of Fire, and Fire is the Child of Wood. The generative relationship of the Five Elements is therefore also known as the Mother-Child relationship.

In the inhibitory cycle, each element inhibits the second element over. That is, the relationship skips a generation, so the Grandmother, rather than the Mother, inhibits the Child. Wood inhibits Earth, Earth inhibits Water, Water inhibits Fire, Fire inhibits Metal, and Metal inhibits Wood. Every element both inhibits and is inhibited by another element.

The generative and inhibitory relationships of the Five Elements are inseparable. Without generation, there would be no basis for growth; without inhibition, unchecked proliferation would cause disaster.

Both forces are essential to the harmonious existence and development of all things. For example, Wood inhibits Earth, Earth engenders Metal, and Metal in turn inhibits Wood. Wood is therefore neither excessive nor deficient, enabling it to engender Fire which in turn continues the cycle. The Five Elements inhibit as well as engender each other, interacting both directly and through intermediary elements to maintain a state of dynamic balance.

The Neijing’s application of Five Elements theory integrates philosophical theory and medical knowledge. TCM classifies the zangfu organ pairs and their functions according to the Five Elements. The zang and fu organs of each pair interact according to their interior and exterior function, and the pairs interact with each other according to the generative and inhibitory relationships of the Five Elements.

The organs and their functions thus form a complex, integrated system. Five Elements theory is also applied to the relationships among the various parts of the body, the interior and exterior of the body and the human body and the outside environment. Five Elements theory permeates every aspect of traditional Chinese medicine. It explains human physiology and pathology, and in clinical practice provides the guiding theory for determining diagnosis, identifying the progression of disease patterns, and determining treatment. Five Elements theory is a major theoretical component of traditional Chinese medicine.