Integrating Five Elements & TCM Acupuncture

Five Elements

Five Element Acupuncture underpins most other styles of acupuncture. It is derived from an understanding of our place within Nature, and our ability to adapt to the changing seasons of the year as well as the demands of our modern environment.

The Chinese word Xing, usually translated as 'Elements', actually means 'Phases' or 'States of Change'. Five Element Acupuncture works with the five phases that unfold during the seasonal cycle of the year, during the cycle of each day, and in the relationships between the organs and systems of the body.

The organs are arranged in pairs, each attributed to a particular Element, whose qualities and characteristics they exhibit. Each Element has one solid (yin) vital organ and one hollow (yang) organ of digestion associated with it.


  • Heart and Small Intestines exhibit the life-creating qualities of Fire
  • Spleen / Pancreas and Stomach enable the absorption of nourishment from the Earth
  • Lungs and Large Intestine enable the rhythm of breathing in and breathing out, taking in and releasing the life-force (Qi) from the Air* that we breathe, and the minerals and trace elements (Metal) from the Earth
  • Kidneys and Bladder maintain balance and equilibrium (homeostasis) through the moistening, cleansing and purifying qualities of Water
  • Liver and Gall Bladder enable the nourishment and air that we have taken into our bodies to become a part of us, enabling us to grow and flourish through the transformative qualities of Wood
 * Metal corresponds with Air in the Western system of Elements. It is the haem (iron) molecule in the blood, which 'holds' the oxygen from the lungs, in the blood. The Large Intestine excretes waste and re-absorbs nutrients, trace elements and minerals (metal) that the body needs.

The diagram shows how each Element creates and sustain the next (moving clockwise); at the same time each Element controls the next but one, keeping its activity in check (following the five arrows).

Hence the Fire of the Heart and Small Intestines 'creates' the Earth of Spleen and Stomach; at the same time, Fire controls the Metal of the Lungs and Large Intestine, and so on.

The Causative Element or Causative Factor

Classical Five Element Acupuncture, according to Professor J R Worsley, teaches that each person has a fundamental constitutional 'weakness' in one of the Elements - the 'Causative Factor (CF). The CF gives rise to all other pathology and illnesses that can develop. The CF may be perceived negatively as a fundamental 'flaw', or more positively as the 'growing edge' that teaches us to develop new qualities, talents, abilities, and life-skills.

Identifying and supporting the CF Element with acupuncture treatment, diet, exercise and lifestyle changes, can help to restore and maintain balance in the whole system.

In some cases, treatment of the CF is all that is needed. However, the longer the CF imbalance persists, or is aggravated by illness or injury, then the more likely it is to give rise to other 'layers' and 'patterns' of imbalance. When these imbalances become lodged, or 'stuck' in the organs, tissues, blood, body fluids or meridians, then they can interfere with the ability of Five Element Acupuncture alone to restore balance. This is when it becomes necessary to integrate Five Element treatment with the healing techniques of TCM Acupuncture.



Traditional Chinese Medicine (TCM) Acupuncture, as is widely practised today, was formulated during the Cultural Revolution in the 1950's and 1960's; it became streamlined from out of a rich variety of different traditional methods, to formulate a system of medicine that conformed with, and could work alongside, the ideas of modern scientific medicine.

In essence, TCM works to restore and maintain balance between the 'Eight Principles' of Yin and Yang, Interior and Exterior, Heat and Cold, Fullness (congestion) and Emptiness (depletion).

A long term imbalance in the CF Element can eventually give rise to imbalances and pathology at more superficial or symptomatic levels, produced by chronic imbalances between the Eight Principles (see above). For example, too much heat in the interior will create a depletion of body fluids, which will eventually damage the solid (yin) organs.

In order to maximise the possibility for Five Element CF treatment to work, it is necessary to first deal with the imbalances that have arisen between the Eight Principles, and then support the CF Element. In practice, the aim is always to find the most simple and elegant way of integrating the requirements of TCM treatment within the context of the Five Elements and to support the CF Element. In this way, all levels of imbalance are addressed, from the most superficial and symptomatic, through to the underlying energetic, emotional, mental and spiritual levels.