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Application of the Five Elements Theory to Traditional Chinese Medicine

The Five Elements theory is applied to the physiology and pathology of the human body by using the relationships of generation and subjugation to guide clinical diagnosis and treatment.

The Physiological Functions and Interrelationships of the Five Zang Organs

Physiologically the Five Elements theory explains the unity of the mutual relationships between the zang-fu organs and body tissues as well as between the human body and nature. The physiological activities of the five zang organs can be classified according to the different characteristics of the five elements. For example, the liver is said to preside over the vigorous flow of qi and also has the function of ensuring free qi circulation. Since these characteristics are similar to the properties of wood, the liver is categorized as wood in the scheme of the five elements. Heart yang has a warming action so it belongs to the category of the fire element. The spleen is the source of transformation of essential substances and is associated with the earth element's characteristics of growth and transformation. The lung has clearing and descending properties and is associated with the metal element's characteristics of clearing and astringency. The kidney has the function of controlling water metabolism and storing essence and is associated with the water element's characteristics of moistening and flowing downward.

The Five Elements theory is also used to describe the correlations of physiological functions between zang-fu organs and body tissues. There are both generating and subjugating relationships among the five zang organs. The generating relationships are: the essence of kidney (represented by the water element) nourishes the liver; the liver (represented by the wood element) stores the blood in order to support the heart; the heat of the heart (represented by the fire element) warms the spleen; the spleen (represented by the earth element) transforms and transports the essential nutrients to replenish the lung; and the clearing and descending functions of the lung (represented by the metal element) assist the flowing of kidney water.

The subjugating relationships among the same organs are as follows: the clearing and descending functions of the lung (metal element) can restrict the hyperactivity of liver yang; the unobstructed flowing of liver (wood element) qi is capable of removing the stagnation of the spleen (earth element); the transportation and transformation of spleen is able to subdue the overflowing of kidney water; and the nourishing and moistening function of kidney (water element) can prevent the strong flaring up of heart fire. The yang heat of the heart (fire element) can control the hyperactivity of the lung's clearing and descending functions.

Furthermore, the Five Elements theory is employed to express the mutual relationships between the human body with the seasons, climates, and flavors. For example, while the wood element is associated with East, spring, wind, sour, etc., it is also connected with the liver, tendons, and eyes of the human body. In this way the Five Elements theory gives expression to a holistic view of the relationship between the human body and its natural environment.

Five Elements Theory and Pathological Influences on the Zang-Fu Organs

Five Elements theory is not only used to correlate the functions of the sang-fu organs, but also to demonstrate their mutual pathological influence. To denote the mutual influence of the sang-fu organs in pathological changes the concepts of extreme subjugation and counter subjugation are used. For example, liver disease may affect the spleen because wood over-subjugates earth, while spleen illness may affect the liver as earth counter subjugates wood. Diseases of the liver and spleen interact with each other. Liver disease may also influence the heart, this is a "mother affecting son" illness. If the liver disease is transmitted to the lung, this is categorized as wood counter subjugating metal. If it is transmitted to the kidney, then it is considered a "son affecting mother" illness. The other zang organs follow suit. Thus the application of the Five Elements theory in explaining the complicated interaction between the zang organs can be summed up by these four relationships: extreme subjugation, counter subjugation, mother affecting son illness, and son affecting mother illness.

Use of the Five Elements Theory in the Diagnosis and Treatment of Disease

Abnormal changes of the internal organ's functions and interrelationships can be detected by external appearances. Thus changes in a a patient's complexion, voice, sense of taste, pulse, etc. can be used to diagnose disease. According to the Five Elements theory the five zang organs have certain connections with the "five colors," "five tones," and "five tastes" as well as changes in the pulse. Therefore, in the clinical diagnosis of a disease, the data collected by the four diagnostic methods (inspection, auscultation and olfaction, inquiring, and palpation) should be analyzed according to the properties and changing laws of mutual generation and subjugation, extreme subjugation, and counter subjugation of the Five Elements theory. For example, a blue complexion accompanied with a preference for food of a sour taste and a wiry pulse, suggests liver disease. A flushed face accompanied by a bitter taste in the mouth and a forceful pulse suggests heart disease with the symptom-complex of hear-fire flaring up. A patient with insufficient spleen qi may have a blue complexion implying wood's (i.e. liver) extreme subjugation of earth (i.e. spleen). If a patient is suffering from heart trouble and has a dark complexion, it may be explained as water (i.e. kidney) subjugating fire.

The occurrence and development of a disease is sometimes related to the abnormality of the mutual generation and subjugation relationships. Therefore, clinical treatment should not only concentrate on the diseased zang organ, but also be concerned with readjusting the relationships between the particular zang or fu organs in accordance with Five Elements theory. For example, the Nanjing says, "When the liver is diseased, the liver will transmit to the spleen, and so one should replenish the qi of the spleen." This reflects the clinical application of five element's extreme subjugation theory. The laws of mutual generation and subjugation and extreme subjugation and counter subjugation have been applied by subsequent generations of traditional Chinese medicine practitioners to create more methods of treatment such as "cultivating the earth in order to generate metal," "nourishing the water to conserve wood," "supporting the earth to restrict wood," etc.

The yin-yang and Five Elements theories represent the world outlook and methodology of the ancient Chinese for their understanding and explanation of nature. The application of these two theories to Chinese medicine consists of viewing the phenomena and laws of nature and applying them to the study of the physiological activities and pathological changes of the human body and its interrelationships. The theory of Yin-Yang explains the dynamics of physical objects through a consideration of their contrary, mutual depending, consuming-increasing and transforming relationships. Normal human physiological activities are understood as the relative balance and harmonization between yin and yang. When yin and yang lose their relative balance and coordination, disease occurs. The theories of Yin-Yang and the Five Elements are used together as a guide to clinical diagnosis and treatment.

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