The foundations of Five Element Constitutional Acupuncture were laid down over 2000 years ago. The values and beliefs of the physicians of the time continue to shape the practice of the system of medicine today.

Two major texts constitute the main theoretical foundations of Five Element Constitutional Acupuncture. The first is the Nei Jing (approximately −200), which comprises Su Wen (Simple Questions) and the Ling Shu (Spiritual Pivot). This applies the concepts of yin/yang and the Five Elements to medicine. The second text is the Nan Jing (Classic of Difficulties, approximately +200). This further develops the application of ideas put forward in the Nei Jing.

The era in which these texts were written was the Han dynasty (−202 to +220). During this time a complex system of medicine was developed from a diverse range of ideas concerning health, illness, treatment and the causes of disease (see Unschuld, 1992, for a discussion of the transformation in Chinese medicine during the Han dynasty). At that time, little distinction was made between religion, philosophy, science and medicine, and the classics of Chinese medicine are permeated with ideas arising from Daoism, Naturalism, Confucianism and other branches of religious and philosophical thought (a good introduction to these ideas and their influence on Chinese science can be found in Ronan and Needham, 1993, pp. 78–84, 85–113 and 127–190).

Naturalism and Daoism maintain that humans are an integral part of Nature and the Dao, not the creation of a divine supernatural being. Both schools of thought emphasise the unity of all phenomena in the universe. What unites everything is qi. Qi is the insubstantial matter that underlies everything that is manifest.

The character for qi (Weiger, 1965, lesson 98A) shows the ‘vapour’ or ‘gas’ given off during the cooking of rice. It defies adequate translation into English, but is usually translated as ‘energy’ (for example, Porkert, 1982), ‘influences’ (Unschuld, 1992) or ‘breaths’ (Larre and Rochat de la Vallée, 1995). In Chinese and Daoist thinking, qi has many contexts and meanings. Ever present, however, is the idea that, in any situation, what is ultimately significant is the nature of the qi present. For example, an illness may manifest, but the way to understand and transform it is to understand the underlying imbalance in the qi.

Qi pervades the entire universe. Naturalists and Daoists thought that all phenomena in nature were ‘immersed’ in qi, whether they were inanimate objects or whether they were alive and more obviously full of life-force. In approximately −400 Wen Tian Xiang sang:

Daoism and Naturalism were concerned with how humans can best conform to the laws of nature. In fact, nature provided the root metaphors for the most fundamental concepts of Chinese philosophy. Dao (the way), de (virtue), wu wei (non-action), xin (mind/ heart), qi, yin/yang, wu xing (Five Elements) and other ideas were all described by referring to different aspects of the natural world (Allan, 1977). The Dao was seen as being the ‘the way the universe works’ (Waley, 1965, p. 30) or ‘the Order of Nature’ (Ronan and Needham, 1993, p. 85). Han dynasty Daoists drew on their observations of nature in order to further understand the Dao. Lao Tse stated that, ‘the Dao follows the way of nature’ (Zhang and Rose, 2000, Chapter 25).