THE FIVE ELEMENTS

1...for DIAGNOSIS

The 5 Elements, although often too rigid to accurately describe all physiological functions, are a very useful aid when determining a diagnosis based on TCM. The Element Correspondences can be utilized to assess the health of a patient. An example would be the appearance of bloodshot eyes along with an angry temperament reflecting an underlying Liver Excess or Stagnation of Liver Qi. Careful analysis of a patient's overall appearance and constitution is required to reach an accurate TCM diagnosis.

The following chart illustrates some of the Elemental Correspondences.

2...for TREATMENT

Specific points on each meridian, the Transporting Points, correspond to each of the 5 Elements.

LU LI ST SP HT SI BL KI PC TH GB LIV

WOOD 11 3 43 1 9 3 65 1 9 3 41 1

FIRE 10 5 41 2 8 5 60 2 8 6 38 2

EARTH 9 11 36 3 7 8 40 3 7 10 34 3

METAL 8 1 45 5 4 1 67 7 5 1 44 4

WATER 5 2 44 9 3 2 66 10 3 2 43 8

These very important, very useful, points are seen on the Bubble Chart...

I. TREATMENT using the SHENG (CREATION) CYCLE:

These points, the Transporting Points, are used clinically in the Sheng (Creation) Cycle according to the "Mother-Son Law". The Mother Point is before, and the Son Point after, the Horary Point.

The "Mother-Son Law" states:

In a Deficiency condition ->-> Tonify the Mother In an Excess condition ->-> Sedate the Son

II. TREATMENT using the KO (CONTROL) CYCLE:

The sedation/tonification principle of the Ko Cycle utilizes (goes back to) the Grandparent.

In a Deficiency condition ->-> Sedate the Grandparent In an Excess condition ->-> Tonify the Grandparent

III. TREATMENT using both the SHENG & KO CYCLES:

In a Deficiency condition->->Tonify the Mother & Sedate the Grandparent In an Excess Condition->-> Sedate the Son & Tonify the Grandparent

IV. TREATMENT using SHENG & KO CYCLES + the HORARY POINT:

This is also called the "4 NEEDLE TECHNIQUE".

The Horary Point is the point on a meridian that is the same Element as the meridian (ST 36 is an Earth Point on an Earth Meridian). Horary points have the ability to amplify the energy of the meridian, especially during the meridian's period of peak energy.

In a Deficiency:

(a)Activate the SHENG CYCLE

(i)Horary Point of Mother meridian

(ii)Mother Point on affected meridian (Tonification Point)

(b)Shut down the KO CYCLE

(iii)Horary Point of Grandparent

(iv)Grandparent Point on affected meridian

Example: KI Deficiency...

LU 8 Tonify

KI 7

SP 3 Sedate

KI 3

In an Excess:

(a)Activate the KO CYCLE

(i)Horary Point of Grandparent

(ii)Grandparent Point of affected meridian

(b)Shut down the SHENG CYCLE

(iii)Horary Point of Son

(iv)Son Point on affected meridian (Sedation Point)

Example: SP Excess

LIV 1 Tonify

SP 1

LU 8 Sedate

SP 5

V. TREATMENT using the 5 TRANSPORTING POINTS:

Each of the 5 Transporting Points on a meridian can be used to expel the correlated Pathogenic Factor. To expel a Pathogenic factor the appropriate point is sedated.

Points to Expel External Pathogenic Factors:

WATER Cold

WOOD Wind

FIRE Heat

EARTH Damp

METAL Dryness

THE EIGHT PRINCIPLES

The 8 Principles is a method of classifying disharmony/symptoms as a basis for diagnosis and treatment. Although different in approach from the 5 elements they are not exclusive of one another and the treatment points for each situation frequently overlap.

The basic patterns are based on the balances of:

Yin/Yang Hot/Cold Excess/Deficiency Interior/Exterior

This system is based on Yin and Yang as applied to the Location (Interior/Exterior), Quality (Hot/Cold) and Quantity (Excess/Deficiency) of the disease factor.

I: (A) YANG causes are due to Exogenous Pathogenic Factors (ExPF)

-6 "climatic factors"

Wind

Heat

Dryness

Dampness

Cold

Summer-Heat

-infective factors of rapid onset & high morbidity

-parasites bites..insect/animal

-bites..insect/animal

-traumatic injury

-poor posture

I: (B) YIN causes are due to Endogenous Pathogenic Factors (EnPF)

-7 "emotional extremes"

Joy

Anger

Melancholy/sadness

Meditation/Pensiveness

Grief/Sorrow

Fear

Fright

-inadequate diet &/or improper eating habits

-insufficient rest &/or overactivity

-insufficient exercise

-poor constitution

-pathological products such as:

endogenous Wind, damp or Fire

Qi Stasis

Blood Stasis

Fluid Accumulation

Food accumulation

II: LOCATION...Exterior/InteriorExterior/Interior...reveals the location or depth of the problem.

Exterior Patterns..when the disease factor is located at the depth of the Exterior structures. (Channels/Collaterals = Jingluo)

Caused by:

-invasion of the superficial body by one of the 6 ExPF

-trauma->Qi/Blood stagnation in the Jingluo

-Organ disorder ->Jingluo disorder

Interior Patterns...when the disease factor is located at the depth of the Interior structures. (Organs)

Caused by:

-transmission of an ExPF from the Exterior->Interior

-direct attack on an organ by an ExPF

-Organ disorder due to a Yin cause

III: QUALITY..Hot/Cold...reveals the quality or nature of the problem.

Hot -> Expand ..moves upward & outward.

It: -moves Qi & Blood rapidly

-consumes Yin fluids

-stirs up Wind

-consumes Yin Qi

-disturbs Yin functions of cooling, moistening, nourishing & providing rest

Due to: -invasion of a Yang ExPF (Wind,Heat,Dryness,Summer-Heat) or an Infective factor

-the transformation in the body of a Yin pathogenic factor

Cold->Heat

Damp->Damp-Heat

-internal disfunction of an Organ->->

-Yin insufficiency & realtive Yang excess OR

-endogenous production of heat or Damp-Heat

Cold -> Contract

It: -moves Qi & Blood slowly & tends to stagnate

-depresses the Yang functions of warming, moving, transforming, holding & protecting

Due to:

-invasion of a Yin ExPF (Cold or Damp)

-internal disfunction of an Organ->->

-Yang insufficiency & relatine Yin excess OR

-endogenous production of cold or Cold-Damp

IV: QUANTITY.. Excess/Deficiency..reveaals the quantity/strength of the disease or pathogenic factor relative to the antipathogenic factor.

Excess...

Due to: -a relatively strong antipathogenic factor (APF) battling a strong pathogenic factor (PF)

-an accumulation of Fundamental Substance (FS)..Qi Stasis, Blood Stasis, Phlegm

-Organ dysfunction->presence of Pathological Product (PP)..Fire, Damp, Food Accumul'n

-a hyperactive Organ

Deficiency...

Due to: -a weak antipathogenic factor (APF)(compromised)

-an insufficient amount of Fundamental Substance (FS)

-Qi Deficiency

-Blood Deficiency

-Body Fluid Deficiency

-Jing Deficiency

-Shen Deficiency

-Poor Shen

-a hypoactive Organ

SIGNS (SYMPTOMS) help depict the 8 PRINCIPLE PATTERNS

LOCATION:

EXTERIOR INTERIOR

-acute onset -chronic/recurrent onset

-mild symptoms -severe symptoms

-fever & chills -high fever

-aversion to cold or wind -no aversion to cold or wind

-head & body aches -changes in stool

-nasal congestion -changes in urine

Pulse: normal Pulse: deep

Tongue proper: no change Tongue proper: changes

Tongue coat: minimmal change Tongue coat: changes

QUALITY:

HOT COLD

-fever -chills & cold limbs

-aversion to heat -aversion to cold

-*perspiration -no perspiration

-discomfort increased with heat -discomfort increased by cold

-discomfort decreased by cold -discomfort decreased by heat

-dry mouth + thirst -*no thirst

-dry stools -watery stools

-scanty dark urine -lots of clear urine

Pulse: rapid Pulse: slow or tight

Tongue proper: red Tongue proper: pale

Tongue coat: dry yellow Tongue coat: moist white

QUANTITY:

EXCESS DEFICIENCY

-often acute -often chronic

-loud voice -weak voice

-heavy breathing -weak breathing

-heavy movement -weak/nonforceful movement

-*discomfort increased by pressure

-discomfort decreased by pressure

Pulse: forceful Pulse: weak

Tongue coat: thick Tongue coat: none or thin

COMBINATIONS:

EXTERIOR COLD INTERIOR COLD

-acute onset -chronic onset

-chills + slight fever -chills,cold limbs + no fever

-*no perspiration -spontaneous daytime sweating

-head & body aches -abdominal pain better with warmth

-stools normal -stools watery

-urine normal -urine copious & clear

Pulse: superficial & tight Pulse: deep, slow or tight

Tongue proper: normal Tongue proper: pale

Tongue coat: thin, white, moist Tongue coat: white moist

EXTERIOR HOT INTERIOR HOT

-fever + slight chills -high fever

-aversion to wind -no wind aversion

-*slight perspiration -*perspiration

-sore throat -restlessness

-slight thirst -*thirst

-urine normal -urine scant & dark

Pulse: superficial & tight Pulse: deep rapid

Tongue proper: normal Tongue proper: red

Tongue coat: thin, white, moist

Tongue coat: dry yellow

EXTERIOR EXCESS INTERIOR EXCESS

-as per Exterior Cold BUT..... -loud voice

-*no perspiration -heavy breathing

-discomfort worse with pressure

*Pulse: superficial & forceful Pulse: deep & forceful

Tongue coat: thin, white, moist Tongue coat: thick

EXTERIOR DEFICIENCY INTERIOR DEFICIENCY

-*mild perspiration -weak voice

-weak breathing

-discomfort better with pressure

*Pulse: superficial & relaxed Pulse: weak

Tongue proper: flaccid Tongue proper: flaccid

Tongue coat: none or thin Tongue coat: thin or none

HOT EXCESS *HOT DEFICIENCY = YIN DEFICIENCY

-high fever -afternoon fever

-entire body red & hot -malar flush

-discomfort better with cold -"5 hearts hot"..palms/soles hot

-discomfort worse with heat & pressure

-forceful, rapid movement -weak rapid movement

-restless, delerium -restlessness/insomnia

-*perspiration -*night-time perspiration

-urine dark & scanty -urine dark & scanty

-stools dry -stools dry

Pulse: rapid & forceful Pulse: rapid, weak, thin

Tongue proper: dark red Tongue proper: red

Tongue coat: thick yellow Tongue coat:thin yellow->none

COLD EXCESS *COLD DEFICIENCY = YANG DEFICIENCY

-chills & cold limbs -chills 7 cold limbs

-aversion to cold -aversion to cold

-discomfort better with warmth -discomfort better with warmth

-discomfort WORSE with pressure -discomfort BETTER with pressure

-forceful, slow movement -lassitude, sleeps a lot

-*no perspiration -*spontaneous perspiration in day

-urine copious & clear -urine dark & scanty

-stools watery -stools dry

Pulse: slow & forceful Pulse: slow weak

Tongue proper: pale Tongue proper: pale

Tongue coat: thick white Tongue coat: thin white

COLLAPSE of YIN COLLAPSE of YANG

-flushed face -pale face

-hot hands & feet -cold hands & feet

-aversion to heat -aversion to cold

-restless..no rest -listless

-*thirst + prefers cold drink -*thirst + prefers for warm drink

-perspiration sticky & warm -perspiration cold & profuse

-rapid respiration -slow respiration

Pulse: slow & forceful Pulse: thin slow

Tongue proper: pale Tongue proper: pale

Tongue coat: thick white Tongue coat: moist thin

EIGHT PRINCIPLES & TREATMENT

I: FUNDAMENTAL SUBSTANCES

Most YANG Most Yin

Shen Qi Body Fluids Jing Blood

YANG = function YIN = substance

Signs Special Theories Empirical Points Channel Theory

Qi Deficiency

-pale,lethargic,weak pulse,dizzy

Pts to benefit SP->make Qi ST 36

SP 6-3 Yin cross

-poor appetite SP 2-mother

-spontaneous sweating SP 3-Source CV 6

-frequent colds BL 20-Shu

-shortness of breath LIV 13-Mu

CV 17 CV 17- IP Qi

Qi Collapse

-dizzy/vertigo

Pts to benefit Qi

as above

GV 20 -abd. distention

-chronic diarr. Pts for specific symptoms

-visceral prolapse

Yang Deficiency

-Qi defic. signs+ Pts to benefit Qi GV 4

GV 14-6 Yang cross

-worse severity+ + MOXA

GV 14

-cold signs Pts to benefit KI:

KI 7

GV 20- head Yang cross KI 3

GV 20 BL 23

Yang Collapse -listless, cold, pale Pts to benefit Yang in

general CV4 MOXA

Pts on GV channel as it -profuse cold sweat

CV 6 MOXA

governs Yang QI

-weak

CV 8 MOXA

-cold aversion

-prefers warm drinks

Blood Deficiency

-pale, depressed, insomnia, dizzy

Pts to benefit Qi St 36

Pts to benefit SP -dry stool, skin, mouth, hair,stools

BL 17

Pts to benefit KI

-thin body, pulse BL 20 BL 17

Blood Exhaustion

-pale, faint, unconscious Pts to benefit Qi & Yang

ST 36 MOXA

-*very thirsty

Pts to benefit Blood GV 20 MOXA -thin,weak pulse

Body Fluid Deficiency

-dry, thirsty Pts to benefit Blood

-pale Pts to benefit Yin

-hot Pts to benefit ST(origin of Fluids)

Yin Deficiency

-night sweats Pts to benefit Yin Organs

BL 18 Sp 6 - 3 Yin SP 6 -dry body, scant urine BL 20

-"5 Hearts Hot" BL 23 CV 4 - 3

Yin+CV

Pts to benefit KI CV 4 -irritable, insomnia, restless Ht 6 -Yind Crevice -thin body

Yin Collapse

-malar flush Pts to resusscitate:

-rapid, thin pulse

KI 1

-restless..no rest

GV 26

-prefers cold drinks

PC 9

-warm sticky sweat

Jing Deficiency

CHILD:growth redtardation,slow maturity, poor dentition

Pts to benefit KI CV4

Pts to benefit SP

CV 6

ADULT:mental slowness, premature senility, infertility

GB 39-IP Marrow

GV 4 BL 11-IP Bone

Poor Shen

-unconsciousness

Pts to benefit the Heart

SP 6

BL 62-Qiao -psychosis

HT 7 -incoherent speech

SI 3-GV -sleep disturbances

PC 6 -muddled thought

Pseudo-Shen

*occurs during severe illness, patient suddenly becomes alert for a short time, "the last flicker of the candle"

II: PATHOGENIC FACTORS & PATHOLOGICAL PRODUCTS

I: WIND

characteristics: Sudden onset /Rapid changes upward & outward dispersion

Movement Special Theories

Empirical Points

Channel

Theory

*affects upper body

*affects LU

*affects the skin

External Wind +

-fever -facial paralysis

*LU points

as is the 1st Organ attacked by Wind

LU7, LU9, LI4, BL12, BL13, TH5, GB20, GV14,GV16

-wind/cold aversion

-sneeze/cough/runny nose

-migrating joint pain

-itchy throat

-itchy skin -stiffness

P:superficial

External Wind-Cold +

-basic Wind sypmtoms +

-facial paralysis

as above as above

-chills/slight fever

-no perspiration

-body aches

-stiff & painful joints -itchy *pale rash

P: superficial & tight

External Wind-Heat +

-basic Wind sypmtoms +

-joints

-stiff

*LU points

LU10, LU11, LI1, LI4, LI11, TH5, GB20, GV14

-painful

-fever/slight chills -red

-sore

-perspiration

-sore throat

-itchy *red rash

P:superficial & rapid

External Wind-Damp + -fever & chills -stiffness, pain & swelling -points for -points for

-body aches Wind & Damp Wind & Damp

-heavy sensation

-itchy/*weepy rash

P:superficial & slippery

Internal Wind +

-headache -facial paralysis

*LIV points

-endogenous Wind affects the Liver

BL18, GB20, LIV2, LIV3, GV20

-tremors

-vertigo -tics

-convulsions

II: DAMP

characteristics: stagnation/heaviness turbidity sitckiness Special Theories

Empirical Points

Channel Theory

External Damp

*sudden

onset

-head/body/limb heaviness

-cloudy urine

-sticky mouth *SP points

SP transforms damp

*Shu Stream points -> dispel/transform Damp

SP3, SP6, SP9, BL20, BL21, BL23, LIV13, CV6, CV12

-mucusy stools

-chest/abdomen fullness

-sticky discharges

-purulent leukorrhea

-oozing sores

-sticky *tongue coat

-joint pain & heavy sensation

-weeping rashes

Internal Damp

*gradual

onset -as above -as above -as above

for Internal Damp -> benefit Sp T&T

as above

III:HEAT

characteristics: Expansion Consumption of

YIN fluids

Rapid movement of QI & Blood

Special Theories

Empirical Points

Channel Theory

Upward & Outward Movement

Disturbance of YIN functions of cooling,

moistening, nourishing & providing rest

Sirring up of Wind

External Heat -perspiration -fever/slight chills

P:rapid & superficial

as Wind-Heat

as Wind-Heat

*sudden onset

-rash -slight thirst

like Wind-Heat

Internal Heat/Fire(Xs) -++perspiration

-++fever/no chills P: rapid

*Tx Organ affected by Fire

*Spring points -> dispel/clear Fire

-++thirst

-dry mouth -dizziness*

-dry stool

*gradual onset -red/purple rash with bleeding

-irritable -convulsions*

-insomnia

-delerium *due to Heat stirring up Wind

T: yellow coat

Damp Heat

-suppurating sores -afternoon fever

P: rapid & slippery

*Tx Organ affected by Damp-Heat

LI11, GV14, GV26

-irritated rashes

-thirst with no desire to drink

internal(gradual)

external(sudden)

-stool/urine foul smelling

-painful/red/stiff joints T: sticky yellow coat

IVa:QI STASIS

characteristics: pain lumps/masses other signs Special Theories

Empirical Points

Channel Theory

-soreness/distentions -soft,mobile, poorly-defined

-depression

*Tx LIV points to maintain flow of Qi

LIV2, LIV3, GB34, LIV14, BL18

-local & distal points on affected channel

-moodiness

-*sighing

come & go and shift location -often in breast/abdomen

P: wiry

T: purple

IVb:BLOOD STASIS Special Theories

Empirical Points

Channel Theory

progression of Qi Stasis (more severe)

-sharp/stabbing pain -hard,well defined immobile, fixed masses

-purple face & lips *Tx LIV

points->move Qi->move Blood

*Tx HT points -> benefit Ht controlling Blood

BL17, SP10, SP8

-local & distal points on affected channel

-purple rash

-bleeding w/dark purple clots

-constant & fixed location -including Organ enlargement

P: choppy

T: dark purple w/ dark spots

V:COLD BLOOD

pain other signs Special Theories

Empirical Points

Channel Theory

Cold "contracts" & "stagnates" Blood

-pain: sharp/stabbing, constant, fixed

-*amenorrehea

*Tx points to disperse Blood Stasis

none local points with MOXA

-pale face

-chills/cold skin

Uterus is often affected -severe dysmenorhea

-better w/ warmth

P: slow or tight

T:pale/pale purple

VI:HOT BLOOD Special Theories

Empirical Points

Channel Theory

Hot "moves Qi & Blood rapidly"

-red/dark red bleeding & rashes

*Tx points to dispel/clear Heat

Spring points

SP10, BL40, PC3, PC9

Hot disturbs YIN function of cooling, moistening, nourishing & providing rest.

-abnormal uterine bleeding

-red face

-fever/warm skin

-restlessness

-hematemesis

-heamaturia

P: rapid

T: red/dry

VII:FOOD ACCUMULATION

-leads to disturbance of ST function disturbs ST descending function

disturbs ST/SP T&T function

other signs Special Theories

Empirical Points

Channel Theory

-nausea -sudden loss of appetite

P: slippery

*ST points to benefit descending & T&T

ST21, ST25, ST37, ST44, LIV13, LIV14, CV12

local points over abdomen & epigastrum

-vomiting

-distending abdominal/epigastric pain

-belching/burping

-pain less with belching, vomiting, bowel movement T:

thick/sticky coat

-hiccups

-awful smelling flatulence

-acid regurgitation

VIII:FLUID ACCUMULATION

Special Theories Empirical Points

Channel Theory

LU:Facial & upper extremity edema

none local points

SP/ST: abdominaledema/ascites,boborygmi, watery stool, *vomiting watery fluid after drinking

*Lu/SP/KI points -> benefit Body Fluid metabolism

KI: lower extremity edema

IX:PHLEGM Special Theories

Empirical Points

Channel Theory

Similar to Damp.

It stagnates & is characterized by: Substantial Phlegm *(visible) Insubstantial

Phlegm *(invisible) *Tx SP points->benefit T&T of Body Fluids

*Tx HT points -> benefit housing of Shen (re insubstantial Phlegm)

ST40 all Phlegm

LU9, CV22 for substantial Phlegm

PC5 for insubstantial Phlegm

-heaviness

-turbidity/stickiness

P: slippery

T: sticky coat

LU Phlegm-Cold -cough w/ watery phlegm -stuffy chest

-other Cold signs -dypsnea

LU Phlegm-Heat -cough w/ yellow sticky phlegm -stuffy chest

-other Heat signs -dypsnea

LU Phlegm-Damp

-cough with profuse white watery phlegm

-stuffy chest

-no Cold signs -dypsnea

Subcutaneous Phlegm -soft, well defined, mobile lumps

Joint Phlegm

-bony deformations w/ chronic arthritis

-Qi Stasis->Fluid Accumulation->Phlegm & bony deformation.

Phlegm in Channels

-limb numbness

-hemiplegia

-facial paralysis

HT Phlegm-Cold -rattling sound in throat

-mental confusion

-letargy/stupor

-muttering

-unconsciousness

HT Phlegm-Heat -rattling sound in throat

-mental confusion

-restlessness

-violent behavior

uncontrolled laughter/crying

-muttering

-insomnia

Qi Phlem (Plum-pit)

-feeling of "lump in throat"

-trouble swallowing