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The Five Elements in TCM

by Tony Reid


Ancient Chinese Philosophies

Through observation and reflection upon the processes of change that occur in Nature, the ancient Chinese philosophers developed a system whereby the orderly cycles of growth, renewal and decay may be analysed and understood. While the Yin-Yang paradigm provided a means to observe and understand the broad movements of Nature and the relationships involved, it was found to be insufficient for the complexities of physiology, pathology, diagnosis and treatment. The Five Elements, which is based on the Yin-Yang theory, is a more elaborate paradigm wherein phenomena are grouped into five categories.


In terms of Yin-Yang, a further differentiation gives: Yang within Yin (emerging or young Yang); Yang within Yang (mature or full Yang); Yin within Yang (emerging or young Yin); Yin within Yin (full or mature Yin). In addition to these four stages we have the point of balance, or the ground on which the others manifest. Thus, we have Wood (as emerging Yang); Fire (as mature Yang); Metal as (emerging Yin) and Water (as mature Yin) and Earth (as Yin and Yang equally balanced, with only the potential for activity).


Five stages in a repeating cycle

According to the Five Elements theory, Qi (the universal energy of life) undergoes five stages of transformation – wood, fire, earth, metal, and water – denoting five different types of activity that occur within a repetitive cycle.


‘The universal yin and yang transform into the five earthly transformative energies, also known as the five Elements that consist of wood, fire, earth metal and water.’ (Yellow Emperor’s Classic of Internal Medicine, Ch. 3)


Every observable phenomenon is seen as an expression of these transformations. A prime example is the cycle of growth that occurs during the seasons of the year, specifically related to food crops. Spring is the time of germination and new growth. This is the emerging Yang and is related to Wood. Summer is the period of active growth and is the mature Yang, related to Fire. In autumn the harvest occurs and this is the emerging Yin, related to the Metal. Finally, winter is the time for storage and dormancy, which is the mature Yin, related to Water. In addition, there is a period of ripening and maturing of the crops, which occurs in late summer. In this period the activities of growth and decline are momentarily balanced. This period is the fifth season and belongs to Earth.


Different aspects of the five Elements

Another, perhaps more static, example is seen in a description of the four cardinal directions: North, South, East and West – a simple division into four. However, a system of co-ordinates must have a reference point. Thus, the initial fourfold division receives a fifth when we include the center or reference point. In the northern hemisphere, the qualities that relate to the North are the colder climate from which arise cold winds; in the South there is a warmer climate, sending hot winds; the sun rises in the East and sets in the West. Thus, East relates to Wood, South to Fire, West to Metal and North to Water, while the center is Earth.


Another helpful way to understand the dynamic nature of the Five Elements is to analyze the progress from ‘potentiality’ to ‘actuality’, where a specific result is derived from a particular activity (or sequence of activities).


  1. The initial plans and decisions are made, the necessary performers and materials are gathered together in an organized way.
  2. The specific activities are carried out.
  3. The final result is achieved.


Wood is the state of preparation to act, in which all the components are gathered together, organized and made ready, in order to provide the preconditions for the stage of actual activity. Fire represents the stage of actual activity directed towards a goal, or end result. Immediately preceding the completed action, when the processes involved in Fire (the active stage) are about to produce the result, the potential for producing this specific result is at its greatest and, in fact, the result is now inevitable. This is Metal, when the momentum of the activity needs to be restrained, controlled and guided towards the finishing point. The specific result is Water. Thus, we have:


  • Wood – potential activity
  • Fire – actual activity
  • Metal – potential result
  • Water – actual result


Let us take the act of driving a car to a specific destination as an example:


  • Wood – making the decision to go to this destination, determining the route to follow, the gathering together of driver, car, road-map etc., making sure that there is adequate fuel, oil, water, etc., and then inserting the key into the ignition, i.e. preparing to move.
  • Fire – starting the engine and driving safely to the destination, i.e. moving.
  • Metal – the destination comes into view, the brakes are applied and the car slows down, i.e. preparing to stop
  • Water – The destination is safely reached, i.e. stopping and arriving.


Thus, we have our basic system of four stages; all on one plane, as it were – goal directed activity with tangible results. From the Yin-Yang perspective, we can infer that there should also exist a complementary factor that gave birth to these various activities. This complementary factor is the background of the many possibilities, against which this whole process occurs, and out of which one particular pathway is chosen. This is also the realm in which the tendency to activity and the tendency towards latency are in a state of balance, with neither predominating. This is Earth. In addition, after the end result of this sequence has been reached, there is also a return to Earth, which represents the period in which there exists the undefined potential for further activities, from which a single pathway is chosen and a new sequence of events arises to create another result.


This background of possible activities is an undifferentiated state (i.e. Yin), from which arises the differentiated state of one specific sequence of events leading to a particular result (i.e. Yang). In the example given above, the stage pertaining to Earth exists in the period before the decision has been made to go to this particular destination, where there are very many other possible destinations. Earth is also reached again on arrival at the destination, in the period of time before the next sequence of activities, when there are any number of possibilities for further action. Thus, Earth represents the period between completed activity and potential activity, where Yin and Yang are momentarily in balance.


Five Elements in traditional Chinese medical science

In TCM all of the structures and functions of the human body are classified according to this system. All of the things listed within each Element correspond with one another, i.e. they have a very close relationship, which is not necessarily of a causal nature, but definitely a synchronous one.


Five Elements Correspondences



DYNAMIC Potential activity Actual activity Undifferentiated world of possibility Potential result Completion of activity
YIN-YANG Young Yang Mature Yang Balance Young Yin Mature Yin
DEVELOPMENT Germination Growth Ripening Harvest Storage, Seed
SEASON Spring Summer Late Summer, Monsoon Autumn Winter
CLIMATE/PATHOGEN Wind Heat Damp Dryness Cold
VISCUS (SOLID ORGAN) Liver Heart Spleen Lung Kidney
BOWEL (HOLLOW ORGAN) Gallbladder Small Intestine Stomach Large Intestine Urinary Bladder
EMOTIONAL QUALITY Self-assertion, Righteous indignation Joy, Enthusiasm Orderliness Instincts, Drive towards survival Will, Drive
PATHOLOGICAL EMOTION Anger Over-excitement Obsession, Worry Sadness, Grief Fear, Timidity
HUMAN QUALITY Planning, Decision making Clarity of Consciousness Ideas, Inspiration, Understand, Focus of attention, Working memory Taking in, Holding on & Letting go Long term memory, Concentration
TISSUE Tendons and Nail Blood and Blood vessels Muscle, Fat Skin and Body hair Bones and Marrow
SENSE ORGAN Eyes, Vision Tongue, Speech Mouth, Taste Nose, Smell, Touch Ears, Hearing
FLUID Tears Sweat Watery saliva Nasal mucus Mucoid saliva
SOUND (OR TONE OF VOICE) Shouting Laughing Singing Crying Groaning
COLOUR Green Red Yellow White Blue, Black
INJURED BY EXCESSIVE Walking Staring Sitting Lying Standing
FLAVOUR Sour Bitter Sweet Pungent (Spicy) Salt
WESTERN MEDICAL CORRESPONDENCE Hepatobiliary system, Emotion and Stress-related disorders Cardiovascular system, Brian and Psyche Digestive system including Pancreas Respiratory system HPA axis, HPG axis, Urogenital system, Congential disorders

An important application of Five Elements theory is in the classification of the internal organs, which are regarded as both functional systems and physical structures within the body. The major bodily organs are divided into Yin-Yang pairs; and each pair is allocated to one of the Five Elements. The Yin component of each pair, referred to as ‘zang’, or ‘zang-organs’, are the relatively more solid viscera (i.e. Liver, Heart, Lung, Spleen and Kidney). On the other hand, the Yang organs, referred to as ‘fu’, or ‘fu-organs’, are the hollow bowels, such as stomach, small intestine, large intestine, etc. These are discussed in the section on the Internal Organs.