Five Element Theory – Conditions & Relationships in Chinese Medicine

Five Element Theory in Chinese Traditional Medicine (TCM) is regarded as one of the most complex, yet comprehensive systems of understanding health and well being in human beings. It is the core teaching of TCM and teaches root causality and connection to illnesses.

In this article, we outline various concepts of Five Element Theory, examples of this theory interacting with the human body, and also explore the various elements in depth in connection to physiological change, illness and remedy. The goal is to expose the nature of Five Element Theory to our readers and reveal how TCM explains this theory with detailed relationship and causality in the body.

Mutual Invasion and Reverse Restriction of the Five Elements

Mutual invasion and reverse restriction constitute an abnormal phenomenon generated under the impact of certain factors in the Five-Element relationship. Invasion means raiding a weak element. Restriction means a powerful element utilizing its strength to overpower a weak element. Mutual invasion means an overkill of the inter-inhibition, which goes so much over the normal restrictive strength that the normal coordination in the Five-Element systematic structure is lost. Such an abnormal phenomenon usually occurs in two scenarios: One, the invaded element is weak itself, so the strong element takes the advantage to bully and attack the weak element. Two, the raiding element, which is so hyperactive that it is free from restriction of the other elements, utilizes its strength to bully the element supposed to restrict it.

It should be pointed out that “reciprocal restraint” differs from “mutual invasion” in that reciprocal restraint is a restrictive relationship under normal condition; mutual invasion, which is an overkill when the normal restrictive relationship is damaged, is an abnormal phenomenon. Inside the human body, the former represents a physiological status while the latter is a pathological state.

Reverse restriction means the opposite direction of reciprocal restrain and are also called reverse restraint, which is a representation for the lost normal coordination in the Five-Element systematic structure relationship. This representation also boasts two scenarios: One, the restrained element becomes so hyperactive that it is beyond restriction and bullies the restraining element. For example, Gold is supposed to restrain Wood; if Qi of Wood gets hyperactive, Wood starts extricating the restriction from Gold and bullying Gold, and this scenario is called Wood bullying Gold. Two, the restraining elements gets weak and the restrained element takes the advantage to bully the restraining element. In other words, under regular conditions Gold is supposed to restrain Wood, but when Qi of Gold is sapped, Wood takes the advantage of Gold.

Therefore, it can be said: “When an organ possesses sufficient Qi, it is an easy matter to restrain the organ supposed to be restrained by itself and to bully the organ supposed to restrain itself; when an organ possesses insufficient Qi, it is no easy matter to restrain the organ supposed to be restrained by itself and to trigger mutual invasion, and the organ which is supposed to be restrained by itself can easily bully itself.” In other words, if Qi of one element gets overly strongly, then mutual invasion transpires when the restrained element (restrained by me) is overly restrained. Reverse restraint transpires when the restraining element (restraining me) is bullied. If Qi of one element is insufficient, then the restraining element will surely have an overkill to trigger mutual invasion. If an element is weak, then the restrained element will take advantage of that weak element to bring about reverse restraint. Take clinical bronchitis dilation for an example. The illness lies in the lung; every time when liver-Qi stagnation appears, it will rapidly and reversely go up and turn into fire to burn the lung; blood will be coughed up, which means fire from Wood torturing Gold (i.e. thriving Wood bullies Gold); Qi stagnation caused by liver depression will affect the digesting and absorbing ability of spleen and stomach, which means a depressed Wood invading Soil. In the case of damp-heat hypertension, damp-heat suppresses spleen organ to trigger liver dysfunction and liver-Yang hyperactivity, which means Soil bullying Wood. With regard to the case of Gold raiding weak Wood, it is rarely seen clinically.

Mutual generation and mutual restraint of the Five Elements

The connection law of mutual generation and mutual restraint exists in the Five Elements; the so-called mutual generation means mutual nurturing, promotion and growing assistance; the so-called mutual restraint means mutual restriction, overcoming and suppression. Mutual generation and restraint represents the basic viewpoint for the Five Elements Theory to highlight and describe internal relations and developing changes of all things.

The mutual generation law of the Five Elements is that Wood generates Fire, Fire generate Earth, Earth generates Gold, Gold generates Water, and Water generates Wood; the mutual restraint law is that Wood restrains Earth, Earth restrains Water, Water restrains Fire, Fire restrains Gold, and Gold restrains Wood. The following diagram illustrate such a relationship:

In the mutual generation relationship, each element boasts a dual relationship of “somebody generating me” and “me generating somebody else;” somebody generating me is the mother, and somebody else generated by me is my child; so, the mutual generation relationship is also called the “mother-child relationship.”

In the mutual restraint relationship, each element boasts a dual relationship of “somebody restraining me” and “me restrained by somebody else;” somebody I restrain is “one overpowered by me,” and somebody restrains me is one who “I cannot overpower;” so, the mutual restraint relationship is also called the mutual overpowering relationship in which “I overpower somebody and somebody overpowers me.”

The mutual generation and mutual restraint relationship in the five aspects of structural systems of the things constitutes the cyclic movement of the things in normal conditions, therefore, such a relationship is in eternal motion and development, and it is not balanced. Take the Five-Elements as a holistic structure; however, we can see that mutual generation and mutual restraint manifest a relative dynamic state of equilibrium in the sum total. Each of the five elements generates other element and is generated by another element; each element restrains other element and is restrained by another element, so overall each element is also in dynamic equilibrium. It thus can be seen that the state of balance reached by the Five Elements is not a state of absolute tranquility, but a state of dynamic equilibrium established on the motion basis.

Restrictive generation and resistance of the Five Elements

The reason why the Five-Elements systematic structure can sustain dynamic equilibrium and cyclic movement mainly lies in the fact that the two automatic regulation mechanisms and channels inhabit in the Five Elements. One is the “restrictive generation” regulation in normal condition; the other the “resistance” regulation in abnormal condition.

Restrictive generation means restriction and growth. The so-called restrictive generation regulation mainly refers to, in normal condition in the Five-Element systematic structure, the regulation function created by the interaction of mutual generation and mutual restraint, which is also called “restrictive generation of the Five Elements.”

Firstly, it can be seen from the holistic function of the Five Elements that the relationship between any two elements is not unidirectional but reciprocal. Each element possesses the quadruple relations of me generated, generated by me, me restrained and restrained by me, which ensures the normalcy of “restrictive generation” relationship.

That is to say, Wood can restrain Soil, Soil can generate Gold and Gold can also restrain Wood, so that Wood does not become hyperactive or weak; so, on one hand, Wood can nurture Fire, and on the other hand, Wood can sustain normal growth of Fire.

Fire can restrain Gold, Gold can generate Water, and Water can also restrain Fire, so that Fire does not become hyperactive or weak; so, on one hand, Fire can nurture Soil, and on the other hand, Fire can sustain normal growth of Earth.

Earth can restrain Water, Water can generate Wood, and Wood can also restrain Earth, so that Earth does not become hyperactive or weak; so, on one hand, Earth can nurture Gold, and on the other hand, Earth can sustain normal growth of Gold.

Gold can restrain Wood, Wood can generate Fire, and Fire can also restrain Gold, so that Gold does not become hyperactive or weak; so, on one hand, Gold can nurture Water, and on the other hand, Gold can sustain normal growth of Water.

Water can restrain Fire, Fire can generate Earth, and Earth can also restrain Water, so that Water does not become hyperactive or weak; so, on one hand, Water can nurture Wood, and on the other hand, Water can sustain normal growth of Wood.

It is obvious that it is just such a mutual generation and restriction system with both opposite and complementary characteristics that adjusts and sustains the relative structural coordination and balance of things. The course of mutual generation and restriction is also the course of the growth and decline of things, in which imbalanced growth and decline situations occur and which is another round of regulation of mutual generation and restriction, thus the repeated occurrence of coordinated equilibrium is observed. It is just such a cyclical motion in which balance is obtained from imbalance and balance is again superseded by new imbalance that drives incessant changes and development of things.

The so-called regulation by resistance of the oppressed elements mainly refers to the regulation of a big cyclic motion through mutual restriction relationship under abnormal conditions of the Five-Element systematic structure, i.e., under the condition of big local imbalance. The resistance regulation can restore balance from imbalance by means of regulation in the Five-Element systematic structure, in which temporary excessive exuberance or debilitation transpires.

The so-called “Sheng” (victory) or the prevailing Qi refers to intemperate and overpowering restriction by a certain restraining element. On the other hand, once a prevailing Qi appears, it will definitely draw an opposite strength to suppress it, the so-called recovery Qi. The booklet of Su Wen (part of the Yellow Emperor’s Canon of Internal Medicine) also states: “A prevailing Qi will certainly attract a resisting Qi.” In addition, the stronger the prevailing Qi is, the more powerful the resisting Qi becomes. The less strong the prevailing Qi is, the less powerful the resisting Qi becomes.

If Fire-Qi gets intemperate, for example, it will exert excessive restriction on Gold, resulting in the following circling effect: Gold-Qi gets very much debilitated that it is unable to restrain Wood, and the prevailing Wood-Qi exerts excessive restraint over Soil; overly restrained Soil-Qi is so debilitated that it is unable to restrain Water, and Water becomes quite exuberant to suppress Fire-Qi to restore its normalcy. If Fire-Qi is insufficient, then it will get overly restrained by Water, and the debilitated Fire is unable to restrain Gold, making Gold-Qi excessively exuberant; the exuberant Gold-Qi enhances its restraint over Wood so that Wood get so debilitated that it is unable to restrain Earth; then Earth-Qi will become exuberant to put more restrain over Water so that Water gets weak and exerts weak restraint over Fire, so that the strength of Fire gradually recuperates to its normal status.

If there is only prevailing Qi without resisting Qi, in other words, any element in the Five Elements appears to be excessively exuberant without another element restraining it, then the coordination relationship in the Five-Element systematic structure will be damaged, an abnormal state of disorder will transpire and the case of serious illness will occur.

Based on the aforesaid description, we can see the Five-Element relationship as the logical representation and the replenishment of Yin-Yang relationship. The affected element, via some middle link, brings about counter effect onto the affecting element, producing a feedback and the regulating effect so as to sustain the relative equilibrium in the systematic structure.

The mother-child correlation in the Five-Element structure

The mother-child correlation comprises two categories, that is, the mother’s illness affects the child and the child’s illness affects the mother; these two categories represent the disorderly changes caused by irregularities in the Five-Element mutual generation relationship.

A mother’s illness affecting the child

The scenario in which a mother’s illness is affecting the child refers to the disorder of one element, which impacts the child element and brings about irregular changes for both the mother and child elements. The general pattern of the mother’s illness affecting the child is: ① the mother element becomes debilitated and weakens the child element, resulting in the debilitation of the mother and the child elements. This is the so-called the “mother making the child week.” If Water is a frail, it cannot generate Wood and causes Wood frail as well, as a result the exhaustion of Water causes the exhaustion of Water, making both the mother and child frail. Clinical cases of depletion of vital kidney energy to trigger insufficient supply of liver energy and blood are often observed; or cases in which kidney deficiency and Yin debilitation touches off pathological changes into Yin-energy insufficiency and Yang energy exuberance in the hepatic system all fall into this category. ② The mother element becomes hyperactive and gives rise to the exuberance of the child element, making both the mother and child element hyperactive. If the element of Wood becomes hyperactive, it can set off excessive exuberance of the element of Fire, making both Wood and Fire elements hyperactive. Clinical cases of excessive liver fire touching off heart and liver disorder due to fire exuberance in the cardiac system and hepatic system are subsumed to this category.

A child’s illness affecting the mother

The scenario in which a child’s illness is affecting the mother refers to the disorder of one element, which impacts the mother element and brings about irregular changes for both the mother and the child elements. The general pattern of the child’s illness affecting the mother is: ① The child element becomes vigorous and causes the mother element to be exuberant, making both the child and the mother elements hyperactive. This is the so-called the “child makes the mother energy excessive,” which is generally called the “mother taking up the child’s illness.” For example, clinical cases have it that exuberant heart fire brings about liver fire exuberance, touching off pathological changes due to exuberant heart and liver fire. ② The child element becomes hyperactive and hijacks the mother element, debilitating the mother element; such disorder can be called the “child stealing the mother-Qi.” For example, clinical cases of excessive liver fire hijacking kidney-Yin downward are observed, in which physiological changes occur due to deficiency and depletion of both liver-Yin and kidney-Yin, touching

off heart and liver disorders due to fire exuberance in the cardiac system and hepatic system; such cases are subsumed to this category. ③ The child element gets weak and upwardly affects the mother element, which is debilitated; such scenario is usually called the “child stealing the mother-Qi.” For example, clinical cases of cardiac blood insufficiency deplete hepatic blood supply, causing pathological changes in the cardiac system and the hepatic system as well.

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