What are the five elements in Chinese Medicine?

The Wu Xing, commonly known as the Five Elements of nature are phases of movement or change. The Five Elements theory is central to the practice of Traditional Chinese Medicine.

They describe stages of the constantly moving cycle between Yin and Yang. The five fundamental elements include Wood, Fire, Earth, Metal and Water.

Five Element Theory

Five Element theory arose from the ancient Chinese observation of the elements in nature around them.

Wu translates as five. Xing is translated most commonly as elements, though may also be translated as phases, forces, nature, transformations, walking or moving. Considering the range of translations guides us to a deeper understanding of the dynamic states that they describe.

The Five Elements are not static descriptions but described dynamic interactions. Each element is a description of one phase of constant movement, part of the observed natural cycles surrounding us. Each phase maintains a relative kinetic balance with the rest.

These phases of movement describe stages of the growth cycle from birth to death. They can be used to describe the phases of life that we pass through.

They are a manifestation of the ways in which the flow of Qi is guided. Within this is contained all the basic materials and movements within the universe.

The Five Elements can thus be used to describe everything in existence, and their relationships to everything else.

In the human body, all of the internal Zang-Fu organs have a Five Element association. There is also an aspect of our soul/spirit (the Five Shen Spirits of Chinese Medicine) that embodies each of the Five Elements.

Description of the Five Elements

Wood Element

The Wood Element describes a period of flourishing and growth. It is the Element of Spring and new life, being filled with vigour and vitality. The movement of energy at this time is outwards. It is a time full of promise, making plans and looking forward.

We come from an ultimate stillness in the womb, a place of Yin within Yin. Once we enter the world, drawing into ourselves the energies of heaven and earth with our first breath and first food, we begin the process of growth.

This is the time of our Yang energies increasing, the period of Yin within Yang. We are still small and Yin, however, are filled with the growth and vitality of Yang.

This is the Wood phase when we are infused with the upward movement of growth and development. Over the course of our lives, we equate this period to childhood through adolescence.

Fire Element

From Wood, we move into Fire, Yang within Yang. Fire is the Element of Summer, filled with warmth and activity. The movement of energy at this time is upwards, ascending. This is a time of being busy, connecting and laughter.

This is the period of maximum activity when we are highly productive in establishing our identities, careers, families, social networks etc. This is the time of young adulthood.

Earth Element

Earth follows and is the period of harvest, relating to late summer. This is when the fruits of summer are ripe for the picking. The movement of energy is central, stable, not dynamic. This is a period of receiving nourishment.

It is associated with balance and does not correlate to one of the four movements of Yin and Yang. It is central in nature, representing the changes between seasons and the axis around which the other phases are oriented.

This is when we reap the bounties from our actions of the Fire phase. Our careers advance, our families grow and we settle into our homes.

Metal Element

Metal is the phase where Yang energies remain, but we move into Yin. This is the cleansing period of Autumn when energy begins to move inwards.

We begin to internalise our energy, winding down our activities. We reduce our workload, retiring into a position of respect as is affiliated with the element of Metal. This is the time we become an elder.

This is the time we draw from our storehouse of wisdom and learning, a time of reflection for our soul and a time when dryness begins to take hold and make our bodies brittle.

Water Element

Water is the final phase of the cycle. It is the time of winter when energy moves downwards achieving stillness. Everything is cold and contracted.

Our activities slow down and we enter a period of rest, preparing to move onwards and close the cycle.

We return to the earth below us, providing the seed for new life to be reborn. We have reached Yin within Yin once more. From here the generation cycle can begin anew.

Five Element associations

(click to enlarge)

The relationships between the Five Elements

Generation (Sheng) cycle

The Generation, or Sheng creation cycle, describes how each element nourishes, or creates, another. This is commonly referred to as a Mother-Child relationship. Each element is Mother to one element and Child to another.

This cycle describes how the elements tend to support, feed and create each other. They work together in harmony to produce everything in this world

Therapeutically this means that an important method to strengthen an element is to nourish its mother.

This sequence is circular, ie it returns to its own beginning. From the stillness of Water is born Wood, giving birth to Fire and so on until we return to Water.

  • Wood generates (is the mother of) Fire
  • Fire generates (is the mother of) Earth
  • Earth generates (is the mother of) Metal
  • Metal generates (is the mother of) Water
  • Water generates (is the mother of) Wood

This process can be described as

  • Wood burns to create Fire
  • Fire creates ash (Earth)
  • From Earth we extract Metal
  • Metal can be heated to create liquid (Water)
  • Water poured on a seedling grows into Wood

Controlling (Ke) cycle

The Controlling, or Ke cycle, describes how each element keeps another in check, controlling its behaviour. This is commonly referred to as a Grandmother-Grandchild relationship.

Each element exerts control over another, restraining its growth. In turn, it is controlled by another.

Therapeutically this means that to control an excess of an element’s behaviour, one can strengthen or empower its grandmother.

Being an intertwined system, a means a dynamic balance is maintained between all Five Elements.

  • Wood controls Earth
  • Earth controls Water
  • Water controls Fire
  • Fire controls Metal
  • Metal controls Wood

This process can be described as

  • Wood can grow through / covers Earth
  • Earth can Absorb / dams Water
  • Water puts out Fire
  • Fire can melt Metal
  • Metal tools cut through Wood

Imbalances of the Control (Ke) cycle

When we observe imbalances in the Control cycle, then health conditions manifest as a result of the disruption of balance affecting the internal organs.

Overacting (Cheng) cycle

In this circumstance, the Grandmother element overacts on its Child element. This means that it exerts too much control, stifling the natural growth and expression of the child.

This results in an abnormal condition where the Child Element is deficient in its expression.

Counteracting (Wu) cycle

Here the will of the Child Element is too strong, and it counteracts (rebels) against its Grandmother Element. This is also known as the insulting sequence.

  • Earth insults Wood
  • Wood insults Metal
  • Metal insults Fire
  • Fire insults Water
  • Water insults Earth

This is an adverse condition as the direction of control is against the natural flow.

  • Earth smothers the growing shoots (Wood)
  • Wood is too hard and breaks the axe (Metal)
  • Metal absorbs the heat, putting out the Fire
  • Fire flares, drying up the Water
  • Water washes away the banks of the river (Earth)

How to balance the Five Elements

Deficiency or excess of any element tends to disrupt the dynamic balance. This, in turn, influences the other elements due to their dynamic, intertwined relationship.

Illness can be corrected by restoring the dynamic of the Element that is too strong/weak. The way to balance the Five Elements is by:

  • Treating the Element directly
  • Treating the Mother / Child Element
  • Treating the Controlling (Grandmother) Element

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Constitutional (Causative) Factor

In Constitutional Five Element acupuncture, also known as Worsley acupuncture, it is viewed that one dominant element is at the core of all dysfunction in a person. Somewhere early in life, whether in birth or early childhood, we develop a constitutional weakness in an imbalanced element.

This arose from our physical and emotional experiences that led to our habituations and patterns. Ultimately it becomes the weak link in the dynamic balance of our elements. This constitution may manifest in our body type, personality type, health issues and in our approach to life.

Earth may become the Constitutional Element for someone that was raised in an environment of being over parented or conversely abandoned. Their relationship with nourishment is affected, manifesting in their relationship with food or neediness in their life.

Water may become the Constitutional Element for someone that was raised in an environment where fear was used as a tool of control. They feel unsure that they are doing the right thing and try to accomplish everything, displaying determination and persistence. This often covers a deep sense of fear

Metal may become the Constitutional Element for someone that was raised in an environment where they were not honoured or respected. They may hold high standards for themselves, striving to earn that respect and honour. This may sit above a deep sense of grief.

Wood may become the Constitutional Element for someone that was raised in an environment where excessive rules and disciplinary actions were the norms. They may have issues with their boundaries, and the ability to set limits.

Fire may become the Constitutional Element for someone that was raised in an environment where there was a lot of hurt and lack of connection. Relationships become of utmost importance, a craving for connection existing. Sadness or a lack of joy may sit with them internally.

The result of this is poor health which may manifest physically or emotionally, preventing us from truly living our full potential.


The Five Element Theory is a comprehensive system for understanding the fundamental elements of life and their interconnections. This theory provides a framework to explain how all living things are related and how they interact with each other. It is based on the notion that different forces combine in nature to create balance and harmony.

The five elements are wood, fire, earth, metal, and water and they are connected in a cycle of creation, destruction, and transformation. This theory is used as an approach to health understanding in Chinese Medicine to understand how natural phenomena manifests in the body when in health or illness. This can then inform an acupuncture treatment plan to restore balance to an individual.

The Constitutional Element is the element that has been weakened by our experiences earlier on in life. The symptoms of this element can be physical or emotional, manifesting as pain or fatigue in the body or feelings of sadness or lack of joy in the mind. Recognising and addressing this element is essential to restoring balance and health in the body.

Some of my favourite books that delve deeper into Five Element theory include

What else would you like to know?

Thanks for reading this far. Have I missed your question? Was something unclear? Let me know in the comments below, I read and respond to everyone!

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Dr Jason Chong (Traditional East Asian Medicine Physician)

Traditional East Asian Medicine Physician. Educator.

Jason is the owner and principal practitioner at Dantian Health, providing consultations for Classical Chinese Herbal Medicine and Japanese Acupuncture in Melbourne, Australia.

He is a qualified acupuncture physician, Classical Chinese herbal medicine clinician, shiatsu practitioner and tuina therapist, Oriental therapies educator and director at the Australian Shiatsu College.

Jason's qualifications include:

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