Five Element Acupuncture

Acupuncture is a medical practice with over 2,000 years of written history. Orally, the traditions will likely have existed for much longer as they were handed down through the generations.

As a result, various styles of acupuncture have emerged over the years. These can include using the Five Elements, Stems and Branches, and more. Josh, who studied and now teaches at the International College of Oriental Medicine, is adept at understanding and treating using these diverse approaches.

Ultimately, all styles of acupuncture are based on the same classical sources, such as the Huang Di Neijing Su Wen and Ling Shu. These two books, each consisting of 81 chapters, are Josh's core texts in his study of classical acupuncture. Every style of acupuncture uses the same principles to treat. Still, it can help the practitioner to have multiple lenses to understand how health and illness affect the body.

The Five Elements, or Wu Xing (五行), can also be translated as the Five Phases or Five Movements. It is based on understanding the energies that drive the natural cycles of life. The movements were understood based on ancient Chinese cosmology and helped to describe the process of change in the universe (also known as Heaven in classical Chinese thought), the environment around us (Earth), and the human body. It is through understanding the world around us that we can understand the cycles and movements within us.

A man standing next to a woman lying on a treatment table in a clinic setting with a large window and wall clock in the background.

Everything that unfolds obeys the laws of yin and yang. This, in turn, creates the foundation of the Five Elements, or the Wu Xing (五行)—the movement of energy that gives birth to the ten thousand things. By meditating on and experiencing the Five Elements, we can describe both the world around us and the world within us. The dance of two polarities—a symbiosis—animates Heaven, Earth, and Man. It is the lens through which we understand health and restore harmony between people and nature.

The Correspondences of the Five Phases

The Five Phases, otherwise called the elements, consist of Wood, Fire, Earth, Metal, and Water. Each of these are words to describe a combination of ideas depending on the context in which they are used. For example, the Wood can describe the organs (the Liver and the Gall Bladder). There are various correspondences to each phase, which you can see to the right.

    • Zang Organ (Yin): Liver (肝)

    • Fu Organ (Yang): Gallbladder (胆)

    • Sense Organ: Eyes (目)

    • Tissue: Tendons (筋)

    • Emotion: Anger (怒)

    • Climate: Wind (风)

    • Season: Spring (春)

    • Color: Green (青)

    • Zang Organ (Yin): Heart (心)

    • Fu Organ (Yang): Small Intestine (小肠)

    • Sense Organ: Tongue (舌)

    • Tissue: Vessels (脉)

    • Emotion: Joy (喜)

    • Climate: Heat (热)

    • Season: Summer (夏)

    • Color: Red (赤)

    • Zang Organ (Yin): Spleen (脾)

    • Fu Organ (Yang): Stomach (胃)

    • Sense Organ: Mouth (口)

    • Tissue: Flesh/Muscles (肌)

    • Emotion: Reflection (思)

    • Climate: Dampness (湿)

    • Season: Late Summer (长夏)

    • Color: Yellow (黄)

    • Zang Organ (Yin): Lung (肺)

    • Fu Organ (Yang): Large Intestine (大肠)

    • Sense Organ: Nose (鼻)

    • Tissue: Skin/Hair (皮毛)

    • Emotion: Sadness (悲)

    • Climate: Dryness (燥)

    • Season: Autumn (秋)

    • Color: White (白)

    • Zang Organ (Yin): Kidney (肾)

    • Fu Organ (Yang): Bladder (膀胱)

    • Sense Organ: Ears (耳)

    • Tissue: Bones/Marrow (骨)

    • Emotion: Fear (恐)

    • Climate: Cold (寒)

    • Season: Winter (冬)

    • Color: Black (黑)

Two Cycles in Five Element Acupuncture

The classical sources describe two primary movement cycles between the Five Phases: the Generating and Controlling cycles.

1. The Generating/Sheng (生) Cycle

The Generating cycle describes how one element supports the growth of the next. Each phase requires its predecessor to feed it with energy for the cycle to flow harmoniously

  • Water nourishes Wood

  • Wood feeds Fire

  • Fire creates warmth for our digestion (digestion being associated with the Earth)

  • The Earth creates Metal (metals are found in the ground)

  • Metal generates Water

2. The Controlling/Ke (克) Cycle

This can also called the Destructive cycle. Each element also restrains another to ensure its energy does not grow too strong. Here are some examples:

  • Water controls Fire (as water can put out Fire)

  • Metal regulates Wood (an axe can cut down trees)

  • Fire balances Metal (as it can melt metal)

The Sheng and Ke cycles are interdependent processes that balance the energy in and around us. They work simultaneously to ensure balance and homeostasis so that illness does not emerge.

Diagram illustrating "The Five Elements": Wood, Fire, Earth, Metal, and Water, connected with arrows indicating their relationships. Each element is associated with specific organs.

Pathological Imbalances of the Five Phases

When an element fails to nourish its partner, following the Generating cycle, deficiency symptoms can develop:

  • Weak Kidney energy can lead to a lack of blood in the Liver. This could result in symptoms like blurred vision and dizziness.

  • A weak Spleen may struggle to transform fluids, partly as it fails to feed the lung, which can result in phlegm.

Alternatively, excess conditions may develop if an element over-nourishes its corresponding counterpart. For example, an overactive liver can overfeed the Heart, which may result in palpitations or insomnia.

  • Excess liver Qi can suppress the Spleen, resulting in bloating, diarrhoea and other IBS-type symptoms.

  • Weak Metal cannot manage Wood, which can cause the Qi to stagnate, and hence, headaches or irritability arise. 

These imbalances become a large part of how we diagnose and treat. 

How Five Element Acupuncture Works

 Five Element Acupuncture is so much more than treating symptoms. It's about identifying which element is out of balance, the root of the problem, and seeking to restore harmony. This highly personalised approach addresses physical, emotional, and spiritual wellbeing.

The Five Phases are the foundation for many acupuncture, herbal medicine, and food treatments. So, how do we treat them? One tenant is by understanding Chapter 69 of the Nan Jing: "To tonify, nourish the mother; to reduce, drain the child."

This principle directs acupuncture. For example:

  • With a Kidney deficiency, we might tonify the Metal with points like Lung 9 (Taiyuan, 太渊) to support the Water.

  • To drain Fire, we may use points like Liver 2 (Xingjian, 行间) to reduce excess Liver heat.

There are other ways of thinking about treatments. For example, according to Chapter 74 of the Suwen, seasonal adaptations include nourishing the Liver in the spring. We can also use seasonal treatments, such as pericardium and liver points, to help patients adjust to changing climates when transitioning between seasons.

The Five Phases in Nature

The Five Phases encompass much more than just what occurs inside the body. They are about understanding the motions of all that exists within Heaven, Earth, and Man. Chapter 5 of the Suwen discusses this, asserting that "heaven has five energies, earth has five elements, and mankind follows these cycles."

Each phase can be associated with a season or a climate, in addition to all we have already explored. Each movement or phase educates us on how energy changes throughout the year impact the world around us and human health. Let's explore the seasons.

  • Spring

    The Spring is associated with the Wood (木). It symbolises an upward expansion of yang, enabling rebirth and regrowth whilst encouraging movement. It's seen in how the plants begin to sprout, the animals and inspects awaken, and our energy levels rise. It's an expansion, a renewal, of life as we come back from the hibernation of winter. It's associated with the Liver (肝) and the climatic influence of wind.

  • Summer represents Fire (火) and the pinnacle of Yang. The movement is a rushing upward growth, bringing warmth and brightness. The summer celebrates hot weather, ripening crops, and increased activity. It's when we can socialise more, be out in the open, and enjoy life to its fullest. As we explored before, the Fire is associated with the Heart (心), which regulates blood circulation and houses our spirit (Shen 神).  

  • Late summer is characterised by Earth (土). It is a period of transition and stability. The Suwen says, "Earth is the centre of balance, where all things return to transform and nourish." In nature, this is the harvest season, when fruits and grains are collected. Earth is connected to the Spleen (脾), which regulates digestion and nutrition.

  • Autumn is synonymous with the Metal (金) phase. This is the harvest season when energy is beginning to be focused inward. It's a period which symbolises release, purification, and preservation. According to the Suwen, this is the time to stockpile and prepare for winter. In nature, autumn provides dryness, cold weather, and falling leaves. Metal is related to the lungs (肺), which regulate breathing and helps us to deal with sorrow. This is a time to conserve and contemplate.

  • Winter is controlled by Water (水). It's a period for withdrawal and storage.  Water energy flows downhill, representing depth, knowledge, and possibility. According to the  Suwen, winter is when Yang is at its lowest strength, and everything returns to its origins. It is a time of silence and preparation for regeneration. The Kidneys (肾), an organ of Water, store Essence (Jing, 精), which holds our blueprint and destiny. This is a time to preserve energy in preparation for the next growth stage.

The Stages of Life through the Five Elements

Human existence, like the seasons, is organised into five phases. Classical acupuncture texts describe the natural course of life in terms of these stages.

Water (Infancy and our Potential)

Newborns are regulated by the Essence (Jing 精) from the Kidneys and need sustenance and care. This is their prenatal energy; it forms their life's blueprint, including holding their destiny.

Wood (Youth Growth and Expansion)

Children and teenagers undergo tremendous development and mobility, similar to how plants sprout in spring. The Liver is associated with the Wood, so it can be associated with learning, ambition, and exploration.

Fire (Adulthood and Maturity)

This is the stage of life when we have more Yang energy and the courage to express ourselves more freely. It's the stage when we can enjoy life with all its high activity. At its peak, Heart Fire influences social relationships, professions, and creativity.

Earth (Middle Age of Transformation and Stability)

This stage signifies responsibility. We have found who we are, often settled down, and begun to think about families. This is the period where we have come to enjoy stability and started to have children. Our role here is to nurture life in a way comparable to how the Earth nourishes us.

Metal (Old Age: Reflection and Let Go)

Metal is associated with refinement, and we feel comfortable letting go of what no longer serves us. It's the period of our lives when we get older, start to let go of anything that's holding us back, and begin to enjoy a more peaceful life. It's typically the period where we come towards the end of our first cycle and start to think of what is next.

Water (Return to the Source)

Once one cycle completes, another begins. The Metal is often about death, but the Water holds this as the most yin of all the elements. When no yang is left, and there is no vital force, we pass for the cycle to start again.

Five Element Acupuncture For You

The Five Phases help us understand the external world and the deep organisation of our internal world. They help us begin to appreciate the patterns of Heaven, Earth, and Man in all of their glory. Ultimately, the Five Phases can describe the movement of life through the expansion and decline of yin and yang. They help us understand the seasons, the cycles of life, and the movements of energy within us.  

The Huangdi Neijing, our classical texts within Chinese medicine, encourage us to see how understanding these cycles can help us to align with the Dao and sustain good health.

Aligning oneself with these cycles promotes balance, longevity, and harmony with nature. Whether via seasonal adjustments, lifestyle modifications, or medicinal treatments, the Five Phases' wisdom continues to influence traditional Chinese medicine and holistic living today.