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For practitioners or Traditional Chinese Medicine, the theory may be used to help form a
diagnosis when there is conflicting signs and symptoms. Additionally, elements of the
theory are useful for assisting patients with nutritional balancing and/or working through
emotional issues. The theory is used extensively by Japanese acupuncturists within the
five phase treatment protocols and by Classical five element practitioners, such as those
who follow the teachings of the late J.R. Worsley. The information below discusses the
Five Element theory and clinical applications in detail.
Primary Correspondences Within Five Element Theory
The Five Element theory is based on the observation of the natural cycles and
interrelationships in both our environment and within ourselves. The foundation of the
theory rests in the correspondences of each element to a variety of phenomena. The most
common correspondences are listed in the chart below:
Within five element theory there are four main relationships or ways in which the
elements interact. The first of these is the generating (sheng, mother-child) cycle. This
cycle describes the ways in which each element, serving as a mother, promotes the
growth and development of the following child element.
Examples of this cycle are the Wood element providing the generative force for Fire, Fire
providing the generative force for Earth, etc. This relationship provides the foundation for
understanding five element theory and, consequently, where imbalances may arise within
the cycle. If Earth, for example, is weakened from a poor diet and overwork you will see
that more nourishment is requested from the Fire element to nourish Earth. Additionally,
if Earth is weakened the Metal element may also be effected.
From a clinical perspective you may see people develop digestive issues from irregular
eating, excessive worry and overwork which leads to a proliferation of dampness which
then effects the Metal element. Within this case you may see a combination of bloating,
gas and poor energy with the development of Metal (Lung) symptoms such as sinusitis or
phlegm-type asthma.
The controlling (ke, grandparent-grandchild) cycle provides for a check and balance
system among all of the elements. Within this cycle Earth, for example, provides a
control for Water and is controlled by Wood. An example of this relationship within the
body is in cases of anxiety (Fire) which are related to LV Qi Stagnation (Wood) where,
over time, you begin to see more Kidney (Water) related signs as the Water element
attempts to control the overactive Fire.
The overacting cycle (cheng) is an imbalance within the controlling cycle where the
grandmother element provides too much control over the grandchild and weakens the
element. Within nature you may see Water putting out Fire, Earth soaking up Water and
so on.
A clinical example of this relationship would be Liver (Wood) overacting on the Spleen
(Earth). In this case you have an overactive Wood element overcontrolling Earth leading
to distruptions in the digestive system.
The insulting cycle (wu) is also an imbalance within the controlling cycle where the
grandchild insults or returns the controlling force generated by the grandmother. Using
examples from nature you can see Fire burning up Water and Water washing away Earth
and so on.
Clinically you may see this in cases where people have long-term psychological problems
(Fire) which eventually effect the Kidneys (Water) as seen in the development of more
Yin (Water) deficiency signs.
This section describes the basic ways in which a practitioner of traditional chinese
medicine applies the theory in a clinical setting. The Five Shu (transporting) Points, listed
below, represent the relationship of the theory to individual acupuncture points. Our
understanding of these points is based largely on the information within the Nan-Ching:
The Classic of Difficult Issues.
The major point categories (i.e. jing well, etc.) described above are discussed in more
detail here. For the purposes of this discussion an extract from the chart above showing
only the Mother and Child points provides a good starting point to understand the
application of the theory to acupuncture.
The Mother and Child points for each meridian are derived from the chart above using
the following logic. According to the generating cycle the mother of Earth is Fire and the
child of Earth is Metal. Using this information for the Yin Earth Meridian (Spleen) the
mother point is the Fire point on the Spleen meridian SP 2 and the child point is the Metal
point on the Spleen meridian SP 5.
A clinical example of this theory would be dispersing the child point of the Wood
meridian (Liver) - LV 2 - in the case of LV Fire Rising where a patient is experiencing
LV signs such as anger and irritability along with HT related signs such as disturbed
sleep and agitation.
Another example would be tonifying the mother point of the Earth meridian (Spleen) - SP
2 - in the case of SP Qi Deficiency where a patient is experiencing poor appetite and low
energy.
The example above brings up an interesting point from the perspective of a TCM
practitioner. While the five element theory is a useful tool in many cases, there are times
where the theory indicates a point which clinical experience has proven to be less
effective than another point. In the case above, SP 2 is indicated by the theory whereas
SP 3 is more commonly used for this condition. Some of the points which have varying
degrees of correspondence with the theory are: