Introduction to the Five Elements

7. Introduction to the Five Elements

Chapter contents


The first chapter – the Element and the resonances44

The second chapter – the functions of the Organs48

The third chapter – the behaviour typical of each Constitutional Factor48


The Five Elements lie at the heart of a Five Element Constitutional Acupuncturist’s diagnosis. This chapter gives an overview of Chapters 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22 and 23, which describe the Elements in detail. Each Element is described in three chapters:

• The first of the three chapters covers the Chinese character for the Element and the Element’s ‘resonances’. In many places we refer to the Chinese character and at the same time refer to a text where the character can be looked up. These references enable students to access some discussion of the various characters and thus broaden their understanding.

• The second of the three chapters explains the functions of the Organs associated with the Element.

• The third chapter of the three describes some aspects of the behaviour typical of the CFs of each Element.

Together, the three chapters about each Element provide the basis for diagnosing a patient’s CF.

The first chapter – the Element and the resonances

The Elements

Each chapter begins with a discussion about the Element itself. Earth, Water, Fire, Metal and Wood all evoke powerful images. Understanding the Elements allows practitioners to gain deeper insight into patients who have that Element as their constitutional weakness. The Chinese character is analysed and its connection with the life of a person is discussed. There is further comment about how the Element appears in nature and the relationship of one Element to another via the sheng and ke cycles.

The resonances

In most translations of Five Element texts the areas connected by an Element are called either ‘associations’ or ‘correspondences’. ‘Association’ suggests that the connection may be empirical or arbitrary. ‘Correspondence’, on the other hand, conveys something more about a relationship but does not suggest that the connection is energetic. Although ‘resonance’ departs from the usage of many writers, we prefer to use it because it suggests that there is an energetic link. For example, Wood, green, anger, wind and spring resonate together. Their qi has the same nature (see Chapter 2, this volume).

In the following chapters we describe two kinds of resonances:

• the ‘key’ or primary resonances

• the ‘secondary’ resonances.

Key or primary resonances

The key resonances used by a practitioner of Five Element Constitutional Acupuncture are colour, sound, emotion and odour. These are the primary resonances and provide the foundation of CF diagnosis. As Ling ShuChapter 47 states: ‘Examine the external resonances of the body to know the body’s inner viscera’ (Wu, 1993). These resonances can only be used in diagnosis if practitioners use their sensory acuity and intuition. Ideally the practitioner discerns all four of these resonances in order to make a diagnosis of a patient’s CF. Table 7.1 sets out the key resonances.

Table 7.1 Key resonances
Note that the translations from the Chinese vary slightly from one translator to another.

Wood Fire Earth Metal Water
Colour green red yellow white blue/black
Sound shout laugh sing weep groan
Emotion anger joy sympathy or worry grief fear
Odour rancid scorched fragrant rotten putrid

Assessing the resonances

Each resonance expresses imbalance somewhat differently. Colour, for example, is present on the face. To assess the emotion, on the other hand, requires a context in which a topic is discussed and its ‘appropriateness’ assessed. The following are some comments about how the different resonances express balance and imbalance (see Chapter 26, this volume, for more on diagnosis using the key resonances).


When an Element is in balance, the face does not manifest the Elemental colour. When a colour is apparent, the associated Element is out of balance. The colour resonant with the Element appears on the face beside or under the eyes, in the laugh lines or around the mouth. Unlike the emotion or the sound in the voice, the colour is relatively constant.

The colour may change over time, for example, as the balance of an Element improves. It can also change very quickly after a shock, during an acute illness or while an emotion is intensely felt. In general, however, colour is the most constant of the four key resonances.


A person’s voice normally manifests different and appropriate tones. Different voice tones occur because a person has a variety of emotions. When the emotion is felt the qi moves and this affects the voice tone. For example, a person shouts because anger makes the qi rise and this gives added force to the voice. The practitioner is listening for the sound that stands out as inappropriate or incongruent.

As the patient and practitioner talk, the content of the conversation and the rest of the patient’s expression determine appropriateness. For example, if patients are speaking about events that gave them great pleasure the emotion they express would naturally be joy. It is therefore normal if the voice tone is laughing, the sound resonant with the Fire Element. If patients are talking about their grief about a loved one’s death, then the fitting sound would be weeping, the sound resonant with the Metal Element. A sound that is not appropriate to the context, for example, laughing when the current context is painful, is a sign of an Elemental imbalance.

The voice tone is revealed during conversations between the patient and practitioner, so the practitioner must have skill and determination to ensure that several different contexts and emotions arise in those conversations.


Ideally patients do not have a particular odour. When they do, the Element resonating with the odour is imbalanced. Odour is less constant than colour, but more constant than sound. Odours can change during a treatment by lessening or increasing. They are also more fragile than colour. A practitioner can look away from a colour and then return to it expecting it to still be there; on the other hand, practitioners easily habituate or become desensitised to an odour. Acutely ill or elderly patients tend to emit one or other of the odours strongly.


An appropriately expressed emotion fits the context it is expressed in. During the practitioner–patient interaction the ‘context’ arises mainly from the content of the conversation. The practitioner must decide which of the five emotions is the least appropriately expressed. Like voice tone, appropriateness is measured by assessing whether the emotion is appropriate to the context in which it is used and the movement of the qi is smooth and of appropriate intensity. Emotions do not have a clear definition in modern psychology. The Rebers say ‘Historically this term has proven utterly refractory to definitional efforts; probably no other term in psychology shares its combination of nondefinability and frequency of use’ (see Reber and Reber, 1985, pp. 236–237). We would say that an emotion usually involves three things: 1, bodily sensations (to which people can become habituated and hardly feel); 2, some cognitive element, for example, interpretative perception based on memory; and 3, motivational properties in that the emotion tends to play a role in impelling activity.

The practitioner notices which emotion is the least fluent and least appropriate of the five. To use the previous example, if a patient is describing pain but has a laugh in the voice and appears to feel joyful, she or he is expressing an inappropriate emotion. By contrast, someone describing an upcoming and genuinely threatening situation would normally show some signs of fear, however mild.

Observing an emotion is somewhat different from observing a colour. From the practitioner’s point of view, emotions are perceived as patterns that can be discerned from what the patient says, the tone of voice, the facial expression, the gestures and bodily stance. The emotion is not simple, like a colour, but is more complex and changes from one moment to the next. According to Ekman and Friesen (2003, p. 7), ‘Our studies of the body, published in professional journals, have explored the differences in what the face and the body tell us. Emotions are shown particularly in the face, not in the body. The body instead shows how people are coping with emotions.’

Table 7.1 suggests that there are just five emotions. In the language of everyday life, this is not true. The concept, set out in the Nei Jing, of five key emotions posits that there are five emotional areas, each resonating with an Element. The resonance table labels the main emotion, but that emotion is really part of a continuum that has various extremes. For example, joy is a natural and normal emotion. But here its use spans both a complete absence of joy or misery on the one hand to euphoria on the other. Both are extreme and usually ‘inappropriate’ expressions.

Another issue about emotion is the language patients use to express what they feel. Practitioners cannot necessarily trust the patient’s own perception of their emotions because emotional language was not primarily designed to describe feelings. For example, many patients who are obviously anxious and fearful in temperament do not perceive themselves to be that way at all. Verbal descriptions have their use, but even novelists when attempting to convey emotions rely less on the language of emotions and more on context, thoughts and the telltale, non-verbal signs of emotions.

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Nov 30, 2016 | Posted by in PHYSICAL MEDICINE & REHABILITATION | Comments Off on Introduction to the Five Elements
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