The Five Elements

Wood, earth, metal, water and fire are stars of Chinese medicine
A combination of herbs used to create "Rambling Powder" is used in Chinese medicine to harmone and relax the body. The powder is made of, clockwise from top left, licorice root, bai zhu, chi fuling, white tree peony root, dang gui and radix bupleri. 11/2011 Denise Baratta

The Five Elements could be the name of a musical band. But in the realm of Chinese medicine, the five elements — wood, earth, metal, water, fire — are veritable rock stars. The elements are used to diagnose patients and to set up treatments that can include diet, herbs, acupuncture and changes in lifestyle.

The five elements — also called the "five phases" or "movements" — provide a very different framework than Western medicine and are "based on the observation of nature," says Dr. Steve Rotter of Grants Pass.

"For instance, with wood, it has the quality of wanting to thrust upward with strength," says Rotter, both a medical doctor and Chinese-medicine practitioner.

The system is very metaphorical, sensory and intuitive, with the doctor looking at the color of a patient's face, odor and emotional state, he says. A person can have either too much or too little of the energy associated with each element, and doctors such as Rotter will work to bring them back into balance with the other elements. Acupuncture needles, for instance, can be placed along meridians that correspond to each element.

Everyone has all of the five elements, but one will predominate at any given time, and these will change throughout a person's lifetime. Wood, for instance, may prevail in childhood, fire during young adulthood, earth in busy midlife, metal in old age and water in all stages, says Ashland acupuncturist and Chinese-medicine practitioner Isabeau Vollhardt, who teaches a course on the five elements at Southern Oregon University.

Vollhardt takes the 12 pulses (not just one as in Western medicine), does a "tongue reading," noting chronic imbalances by its color and shape, and prescribes herbs to bring the elements back into balance.

For example, notes Vollhardt, insomnia usually is a problem with fire while indigestion can be an indication that earth and wood are out of harmony — and these can be going on in the same person.

If you're wondering why the Chinese system doesn't have an air element, which we see in the ancient Greek system, it's covered by metal, which rules the lungs (all the elements have their associated organs).

Each element also has associated emotions, which the practitioner discerns by observation and what the patient says. If there's something amiss with the lungs, for instance, that's metal, which governs grief and depression, says Vollhardt — and that insight can direct her to the appropriate herbs, acupuncture points and lifestyle changes, including diet, exercise and sleep.

Working with the five elements will definitely bring some prescriptions you wouldn't hear in a typical physician's office, Rotter notes.

"If your primary element is wood, you might not be able to tolerate alcohol and marijuana. If you're earth, you might need to start the day with a good breakfast."

The five elements, called Wu Xing, are rooted in the ancient Chinese philosophy of Taoism, which guides life by focusing on the balance of yin and yang, says Vollhardt.

Chinese-medicine practitioners may find themselves balancing opposing principles such as excess-deficient, hot-cold and outside or inside the body. For instance, a practitioner might diagnose symptoms of stress headache and lower-back pain as "excess above, deficient below" and treat accordingly to bring them in balance.

"In Western medicine, we don't see the connection," says Vollhardt. "In Chinese medicine, we know there is a connection, and we come up with a treatment using acupuncture and lifestyle changes, mainly."

It's an extremely complex and esoteric body of knowledge that doctors must spend their lives learning — with thick tomes of herbal recipes using many nearly unpronounceable ingredients.

Ashland acupuncturist and Chinese-medicine practitioner Ann Fielder calls the five elements "the spiritual side of Chinese medicine, a very elegant framework for helping people by evaluating their psychology and emotions."

It's very effective, she adds, for posttraumatic stress disorder.

The five elements are useful in visually evaluating patients, says Fielder. Sciatica, for instance, can come with a pale look and soft, low voice, meaning lack of fire — thus leading her needles to the meridians and organs governed by that element. On the other extreme, someone coming into the office with a booming voice, red face and short temper needs sedation of his excess fire.

"Each person is a system, a microclimate, and you look at their weather," says Fielder. "So if a patient is deficient in lung chi, they're deficient in metal and will catch colds, have phlegm and get bronchitis. Too much worry and sympathy indicates too much earth, which can show up as damage to the digestive system."

Each element has its seasons and asserts its emotional qualities, affecting certain organs, but can be counterbalanced by nutritional choices, says Fielder. Fall is metal — the lungs — bringing colds and flu with grief and crying, so make soups and increase protein to "tonify lung chi."

The Internet is a source of many tables and five-pointed star charts showing the seasons, five elements and how one causes or overcomes the other. Vollhardt recommends the ones on Wikipedia as a visual aid.

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