5.

Five Element Acupuncture Theory and Clinical Applications TCM Theory

Five element theory is one of the major systems of thought within Chinese medicine. From a
historical perspective it is an important underpinning of medical theory and serves as one of
the major diagnostic and treatment protocols. In modern clinical practice the five element
theory is used in varying degrees depending on the practitioner and style of acupuncture that
they practice.

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:

FIRE EARTH METAL WATER WOOD

Heart &
Yin Organs Spleen Lungs Kidneys Liver
Pericardium
Small
Urinary Gall
Yang Organs Intestine & Stomach Large Intestine
Bladder Bladder
Triple Heater
Sense Organs Tongue Mouth Nose Ears Eyes
Tissues Vessels Muscles Skin Bone Tendons
Tastes Bitter Sweet Pungent Salty Sour
Colors red yellow white blue/black green
Sounds Laughing Singing Crying Groaning Shouting
Odor scorched fragrant rotten putrid rancid
Emotions Joy Worry/Pensiveness Grief/Sadness Fear Anger
Seasons Summer Late Summer Autumn Winter Spring
Environment Heat Dampness Dryness Cold Wind
Developmental
Growth Transformation Harvest Storage Birth
Stages
Direction south center west north east
round tall slender
pointed triangular
features strong
features large features features
strong bones and
Body Types small hands strong legs strong voice
digestion joints
quick calm generous meticulous,
loyal, enjoy hard
energetic strong willed
movement workers

Five Element Cyles, Relationships and Interactions

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.

Five Element Pathology and Clinical Applications

As described in the introduction there are a variety of ways in which the theory is used
clinically. Our Japanese section describes the five phase treatments in detail and our classical
five element (worsley style) page describes the ways in which a pure five element practitioner
would utilize the theory.

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.

Five Shu Points

Jing-well Ying-spring Shu-stream Jing-river He-Sea

Yin Meridians
(Wood) (Fire) (Earth) (Metal) (Water)
LU LU 11 LU 10 LU 9 LU 8 LU 5
PC PC 9 PC 8 PC 7 PC 5 PC 3
HT HT 9 HT 8 HT 7 HT 4 HT 3
SP SP 1 SP 2 SP 3 SP 5 SP 9
LV LV 1 LV 2 LV 3 LV 4 LV 8
KD KD 1 KD 2 KD 3 KD 7 KD 10
Jing-well Ying-spring Shu-stream Jing-river He-Sea
Yang Meridians
(Metal) (Water) (Wood) (Fire) (Earth)
LI LI 1 LI 2 LI 3 LI 5 LI 11
TH TH 1 TH 2 TH 3 TH 6 TH 10
SI SI 1 SI 2 SI 3 SI 5 SI 8
ST ST 45 ST 44 ST 43 ST 41 ST 36
GB GB 44 GB 43 GB 41 GB 38 GB 34
UB UB 67 UB 66 UB 65 UB 60 UB 40

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.

Mother & Child Five Element Points

Mother Child
Lung (Metal) LU 9 LU 5
Large Intestine (Metal) LI 11 LI 2
Stomach (Earth) ST 41 ST 45
Spleen (Earth) SP 2 SP 5
Heart (Fire) HT 9 HT 7
Small Intestine (Fire) SI 3 SI 8
Urinary Bladder (Water) UB 67 UB 65
Kidney (Water) KD 7 KD 1
Pericardium (Fire) PC 9 PC 7
Triple Heater (Fire) TH 3 TH 10
Gall Bladder (Wood) GB 43 GB 38
Liver (Wood) LV 8 LV 2

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:

 HT 9 & PC 9 - are most often used to clear heat.

 SI 3 & SI 8 - reduce heat, pain and stagnation but provide no tonifying effect.
 LI 11 - is typically dispersed to clear heat.
 TH 3 - has no tonification effects.
 ST 41 - is typically used to disperse fever a/or reduce abdominal distention, although it
can be as a local point in a tonifying manner to increase energy flow to the foot.
 SP 2 - is not the most tonifying point on the SP meridian - SP 3 is a better choice.
 UB 67 - dispersive point for acute conditions.
 GB 43 & GB 38 - are both used to clear heat.