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The Five Elements

The Five Elements of Traditional Chinese Medicine

Yin-Yang and the Five Elements were two ways of looking at nature in ancient China. These greatly influenced the formation and the development of  Traditional Chinese Medicine  and guide clinical work to this very day.

The Five Elements hold that wood, fire, earth, metal and water are the basic materials constituting the planet and the seasons, and are used to treat the body which is made from the planet’s materials. There exists among them an interdependence which determines their state of constant motion and change. Traditional Chinese medicine uses these five elements to classify natural phenomena, tissues and organs of the human body, the human emotions and interpreting the relationship between the physiology and pathology of the human body and the natural environment.

Man lives in the natural environment, such as weather changes and geographic conditions. Traditional Chinese medicine connects the physiology and pathology of the zang-fu organs and the tissues with many natural environmental factors using the five elements.


Zang organ – liver
Fu organ – gall bladder
Sense organ – eye
Tissue – tendon
Emotion – anger
Season – spring
Environmental factor – wind
Growth and development – germination
Colour – green
Taste – sour
Orientation – east


Zang organ – heart
Fu organ – small intestine
Sense organ – tongue
Tissue – vessel
Emotion – joy
Season – summer
Environmental factor – heat
Growth and development – growth
Colour – red
Taste – bitter
Orientation – south


Zang organ – spleen
Fu organ – stomach
Sense organ – mouth
Tissue – muscle
Emotion – meditation
Season – late summer
Environmental factor – dampness
Growth and development – transformation
Colour – yellow
Taste – sweet
Orientation – middle


Zang organ – lung
Fu organ – large intestine
Sense organ – nose
Tissue – skin and hair
Emotion – grief and melancholy
Season – autumn
Environmental factor – dryness
Growth and development – reaping
Colour – white
Taste – pungent
Orientation – west


Zang organ – kidney
Fu organ – urinary bladder
Sense organ – ear
Tissue – bone
Emotion – fright and fear
Season – winter
Environmental factor – cold
Growth and development – storing
Colour – black
Taste – salty
Orientation – north

The order of promoting is that wood promotes fire, fire promotes earth, earth promotes metal, metal promotes water, and water promotes wood. In this inter-promoting relationship of the five elements, each is in the position of “being promoted” and of “promoting”.

Acting refers to bringing under control and constraint. In the inter-acting relationship of the five elements, the order is wood acts on earth, earth acts on water, water acts on fire, fire acts on metal and metal acts on wood. Each of the five elements has a position of “being acted on” and “acting on”. For example, wood is acted upon by metal, while it acts on the earth.

Both promotion of growth and control are required for the five elements. Without promotion of growth, there would be no birth and development. But without control, there would be excessive growth. In the promotion of growth there is control, and in control there exists the promotion of growth. They are in opposition and also in co-operation, to maintain balance between promoting and acting, which ensures the normal growth and development of things.

In the case of excess or insufficiency in the five elements, there will appear abnormal inter-acting known as over-acting and counter-acting.
Over-acting takes the form of launching an attack when a counterpart is weak, and can be harmful under certain circumstances. The order of over-acting is the same as that of normal inter-acting, except that over-acting is not a normal inter-action, but a harmful one under certain conditions.
Counter-acting implies preying upon other elements. The order is just opposite to that of normal inter-acting.

The Five Elements

The phenomena of over-acting and counter-acting can occur simultaneously and is caused by the excess or the insufficiency of any one of the five elements. For example, when wood is in excess, it not only over-acts on earth; it also counter-acts on metal. Or, when wood is in insufficiency, it is over-acted on by metal and counter-acted on by earth at the same time.

This inter-dependence and inter-restraining of the five elements applies in the medical field. There is an inter-promoting, inter-acting, over-acting and counter-acting relationship between the zang-fu organs, sense organs and tissues, and between man and nature. This is mainly used to explain the changes, causation and mechanisms of the disease.
When an internal organ is inflicted, other organs may be affected, or the disease may spread or change into another kind of disease. There is over-acting and counter-acting. For instance, lung trouble may be due to a disorder of the lung itself. But the lung may be affected by a disorder of the spleen. Or it may be due to a disorder of the kidney. In some cases it may be caused by a cardiac disorder, with fire over-acting on metal. If it is due to impairment of the liver, this is explained as wood counter-acting on metal.

These five categories of the five elements and their inter-promoting, inter-acting, over-acting and counter-acting relationships are used for pathological conditions. Some examples. A greenish tinge in the complexion accompanied by a preference for sour food, suggests liver trouble. A red or flushed complexion accompanied by a bitter taste in the mouth suggests heart trouble. A disorder of the spleen accompanied by a greenish complexion implies wood (liver) over-acting on earth (spleen). Heart trouble with a dark complexion may be water (kindey) acting on fire (heart). These findings may be taken as a guide in treating the disease and preventing it from affecting another part of the body. It may be possible to control the transformation into other diseases, to shorten the treatment and cure the disease.

Yin-Yang and the Five Elements reflect the objective law of things. They are of practical significance in explaining physiological activities, explaining pathological changes and guiding medical practice. In clinical application, Yin-Yang and the Five Elements are usually related to each other, supplement one another, and cannot be separated.