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An Introduction to the Five Elements

by Richard Bertschinger

Ubiquitous to all classical Chinese Medicine are the Five Elements, or more correctly the ‘five forces’ (wu xing). In practical terms, when ‘doing classical Chinese medicine’ they provide five main diatheses whereby patients can be known, and their symptoms categorised. But actually they imply a great deal more. This first article will explore their deeper meaning. Later articles, it is hoped, will look at each element individually. Xing actually has the gloss ‘movers’, ‘walkers’ – it also means ‘to circulate’. As practitioners of an energy-medicine, such as acupuncture, this should all make perfect sense, because every day we are dealing with the circulation of ‘qi’. I would suggest that the most fundamental idea in classical Chinese medicine is qi-flow. And if you throw out qi – and this I know can be a bone of contention between traditional and medical acupuncturists – you throw out classical acupuncture.

When you link up the idea of qi to the wuxing, it is obvious that actually fire, water, wood, metals (minerals) and earth are not elements but stages of change, or becoming. Is it then any wonder then that the prime science book for the Taoist physician was, and still is the I Ching (or Book of Changes) ? (see end note 1)

We all have heard of the Five Elements: wood, fire, earth, metal and water, to list them. But let’s look at them in action. Beginning with the image of the tree (wood) we can visualise the growth of its leaves sprouting forth in the spring-time, the flowering and radiance of the plant in the summer and it’s dying back down in the fall – to return to the quiescence of the winter, before new growth returns in the spring. This was the agrarian cycle so close to the heart of all early civilisations. Quite simply, people were concerned with getting enough to eat. And the Chinese were more practical than most. In fact in Soil and Civilization, Edward Hyams catalogues our destructive relationship with the soil since the dawn of agricultural cultivation- early civilisations were dependent on the soil for their continued survival. And when the soil was destroyed, so were the peoples and their culture. It is no secret that the early Chinese were dependent on the repeated flooding of their rivers to bring fresh soil to their lands.

One later arrangement of the wuxing put soil/or earth at the centre of the five elements (see figure 1).
Figure 1. The Five Elements with Earth at its centre.

The earliest reference to the wuxing was in the Shu Jing, or Book of History (date variable, but pre-Han), a compilation of ancient records made around the time of the Qin unification. One section of this ancient book is entitled The Great Plan – and it discusses the model for the perfect government of a nation. There were, traditionally, nine divisions to the Great Plan, and the first discussed the Five Elements: “The first is water; the second is fire; the third, wood; the fourth, metal; and the fifth, earth. Water it is, which soaks and descends; fire it is, which blazes and ascends; wood it is, which is crooked or straight; metal it is, which follows form and changes; and the soil which supports seed-sowing and in-gathering. That which soaks and descends becomes salt; that which blazes and ascends becomes bitter; that which is crooked or straight becomes sour; that which follows form and changes becomes acrid; which from seed-sowing and in-gathering comes sweetness.” (trans. RB)

Of great interest here is that water is mentioned first in the elements; secondly that they are described by their actions, which derive from their natures; and thirdly that they are tied, distinctly, to their particular flavours, salty, bitter, sour, acrid or pungent and sweet. The Chinese were eminently practical in approach, not theoretical. They were most obviously, again, talking about food-production and the need to sustain a population.

Of course, much later, the wuxing became the bed-rock of Chinese science. Tsou Yen (or Zou Yan fl. 350-270 B.C.E.) has been credited with the development of Yin- yang theory, and wrote much on their interaction. This was during the great hiatus of scholarly activity which proceeded the establishment of the Qin and the unification of the country in 221 B.C.E.. Indeed Joseph Needham has said that Tsou Yen ‘may be considered the real founder of all Chinese scientific thought’. The simplicity of having Five Agents, as it were, under one’s control, acts as a spur to the imagination, and associations follow readily. The pictures of the elements become repositories for our own thoughts and feelings, leading to an understanding or processes, sometimes beyond our control, in the outside world. This is notwithstanding the fact that ‘in the real world’, i.e. nature, they underlay all creation and death, the life-force, qi itself.

The five elements underpin the passage of the seasons - spring, summer, late summer, autumn and winter; they each have a corresponding colour (green, red, yellow, white and black or dark blue); and also a corresponding direction (east, south, central, west and north), but note here that earth/central hovers, uneasily between following fire and preceding water, or being central. Thank heaven for a little uncertainty in this! this is more like true life. Somehow the Chinese mind was quite content to live with this – allowing a flexibility of thought unlike that of a mind schooled in Aristotelian logic.

Let us return now to the I Ching for a moment, The Book of Changes. It has something to say, on the true depths and complexities of the wuxing at work.
Anyone who studies the I Ching will soon be made aware that much is made of two sketches of the eight trigrams (ba gua), the before-heaven (or Fu Xi arrangement, figure 2) and the after-heaven (or King Wen arrangement, figure 3):

Figure 2. Fu Xi (inner world)

Figure 3. King Wen (outer world)

It is the after-heaven (King Wen, or Outer World) arrangement which interests us here, as the sequence of eight trigrams mimics the five element sheng (birth) order (see end note 2). The Fu Xi or before-heaven arrangement is literally ‘before-time’ – (what the circulating skies stand for, after all, is change and alteration) (see end note 3). The sheng order, which I described in the passage on the tree and the seasons above, describes how wood gives birth to fire, fire to earth (as it dies down), earth to metal (minerals) and metal to fluids (when smelted). What might seem to be several unrelated facts about the physical world are here starkly related. Let us be under no illusion – there is and was no one interpretation! The Chinese language and world-view is organic above all, allowing a multitude of explanations, full of layers and meaning. From the complexities of the living world, a simple elemental cycle gives us a handle, to deal with complex problems, including the progression of a patient’s medical condition!

The trigrams are best understood in pairs:


and Earth

Yin and Yang


and Mountain

move­ment and stillness


and Wetlands

penetration and dissipation


and Water

light and dark.

The order of the trigrams in the after-heaven sequence copies the sheng cycle of the wuxing: thunder, wind, fire, earth, wetlands, heaven, water and mountain. It is all much of a muchness.

There is no exact correspondence because there is rarely an exact parallel in nature. Is there a ‘perfect’ tree around? How often do we have a ‘perfect’ spring? Just as the so-called ‘mutation’ of the gene is the foundation of evolutionary change in the biological world and the ‘movement’ of the electron disallows us any chance to both measure and observe at the same time, so the world is full of complex events (which can seem to take us out of time). It is this very mutability which is encapsulated in the wuxing, and also in the King Wen after-heaven arrangement.

Thunder stands for wood, both arousing and stirring, ‘a flowing into form’; the gusts of wind which accompany the thunder, bring the Yin aspect of the wood, they are more penetrating; fire occupies the height of both the sheng and outer-world and after-heaven cycle; earth (or soil), follows in both; the wetlands, where the minerals (metal) are deposited, represent the lowest point on the earth, they represent the winding down of both Yin and Yang processes in nature and ‘a flowing out of form’; they are followed by heaven, the stern judgemental force of the Yang, where ‘the dry bones are left bleached by the sun’; before we descend to water, the lowest point in both the sheng and after-heaven cycles, the water which moves minerals back into solution, so the process can begin again. All life needs to return to water, or a fluid environment, to reproduce. In the mountain is the beginning and end of the cycle: the silent and still mountain represents the quietest days of winter, and ‘the dark before a new dawn’.

Put very blandly – tree becomes flame, which becomes flower, ripens in the fruit, which yields the stone, falls back to the seas and rivers, which deposit again…making the conditions for rebirth and renewal. This all needs careful pondering: and in doing so and, especially, seeing it in the mind’s eye, we can understand the importance of flow and form in all nature.

Renewal and regeneration are intrinsic to the wuxing, an idea too easily forgotten by Western minds but quite clearly represented in the turning Yin and Yang symbol (figure 4), as well as in the shifting lines of the gua (trigrams or three line figures).

Figure 4. Yin and Yang symbol

In conclusion ponder this diagram from Li Zhongzi’s Neijing Zhiyao (published 1642, The Essentials of Medicine - see end note 4) but copied from earlier texts (numbers identify the hexagrams in the Book of Changes:

Figure 5. From Li Zhongzi’s Neijing Zhiyao

The diagram above, a succession of hexagrams, in cycle, also demonstrates the intricate rise and fall of the wuxing, in symbolic, pictorial and poetic form. Specifically the gua (hexagram) sequence shows the Yang and Yin, rising and falling, flowering and declining. All of this is pertinent to thinking about personal health, patients and treatment.

Below is a simple chart of Yin and Yang, wuxing correspondences taken strictly from the text of the Hungdi Neijing Suwen (see end note 5)…. It is quite fun to see if you can follow the associations between the separate categories in your own mind. Good luck!




the eye



the heart

sickness present in all five zang

the goat




the tone ‘zheng’

sickness as in the vessels

a scorched odour





vegetation and trees


the eye



the liver

sickeness being frightened

the cockerel




the tone ‘mi’

a sickness in the sinews

a rank odour





the spleen

sickness at the root of the tongue


panicled millet



the tone ‘gong’

a sickness in the flesh

a fragrant odour

classed with metals


the nostrils



the lungs

sickness present in the back

the horse

rice grown in flooded fields



the tone ‘ray’

a sickness in the skin or hair

a rotten odour








two lower openings



the kidneys

sickness in the muscles

the swine

peas and beans



the tone ‘yu’

sickness as in the vessels

a stale odour (see end note 6)



End Notes

1. Note the famous Yiyi or Changes in Medicine by Zhang Jeibin (Ming physician), notwithstanding his later Yiyiyi or The Meaning of Changes in Medicine!
2. The earliest reference to this order seems to be around the 2nd Century BC (Needham: S &C VOl II, p.255).
3. Actually in a sense the King Wen diagram is the story of life and death, generation and degeneration. Of course it interests us most. But the fact is that returning to ‘before-heaven’, returning to before we were/are born was also the goal of the inner alchemists. More on this later.
4. Which formed the basis for my The Single Idea in the Mind of the Yellow Emperor, listed below.
5. Taken from my translation, with original Chinese text, of the larger part of the Neijing Zhiyao, by Li Zhongzi. The Neijing Zhiyao is a Ming primer to the Huangdi Neijing (cf. The Single Idea in the Mind of the Yellow Emperor).
6. The True Texts stored in his Golden Casket - Suwen 4 of the Neijing Suwen.


Needham, J. Science and Civilisation in China Vol.II, Cambridge (various dates).

Hyams, Edward S. Soil and Civilization (Paperback) Harpercollins (Nov 1976)

Bertschinger, R The Single Idea in the Mind of the Yellow Emperor Tao Booklets 2009 (ebook, on Chinesemedicinetimes website)

Bertschinger, R The Book of Changes: The Chinese Shamanic Teachings Tao Booklets 2009 (ebook, on Chinesemedicinetimes website)

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