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Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 65 The model of the Five Elements is one of the unchanging laws that brings order to the myriad manifestations of life,discovered through observing the workings of nature. For the ancient Chinese, the essence of the spiritual path was to live inharmony with the rhythms of the natural world, and the elementalrelationships have guided that pursuit over the centuries. Applied throughout Chinese culture, the elements are found in a cuisinethat balances five basic flavors, in paintings that incorporate the fiveassociated colors, and in a system of music built on a five-note scale.
There was a time in the history of China when these ideas wereused to govern, infusing the political process with wisdom. Sincethe energy within the human being is seen to follow these sameprinciples, an understanding of the Five Elements allows the med-ical practitioner to diagnose and treat the ch’i, which is the goal ofChinese medicine.
Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 66 Figure 4. The Creative and Control Cycles Essentially, the Law of the Five Elements describes a fundamen- tal interrelationship of nature’s elements. The circular arrangement,known as the sheng or creative-cycle, states simply that Wood createsFire, Fire creates Earth, Earth creates Metal, Metal creates Water,and Water creates Wood (Figure 4). We can see how Wood createsFire in the way a log serves as fuel for a flame; Fire, in turn, createsEarth as the ashes fall back to the soil; Earth creates Metal in theminerals found within the earth and in the mountains rising upfrom the plains; Metal then creates Water as seen in the rivers thatrun down from the mountains or in the rocks of the stream that holdthe water in its place; and finally Water, the source of life that allowsthe tree to grow, creates Wood. This cycle of the elements is alsoreferred to as the mother-child relationship.
In addition, the Five Element system includes another arrange- ment, the k’o or control-cycle, which is depicted by the arrows on theinside of the diagram. This pattern describes the observation thatWood controls Earth, Earth controls Water, Water controls Fire, Firecontrols Metal, and Metal controls Wood. Wood controls the Earthin that trees prevent a hillside from eroding; Earth controls Water asthe banks keep a river flowing in its course; Water controls Fire sinceit can put out a blaze; Fire controls Metal in that Fire can meltMetal; and Metal controls Wood in the way an axe can fell a tree.
Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 67 Chapter 4 . Model of the Five Elements Though some Chinese teachings refer to this elemental cycle asdestructive, it is more useful to understand the k’o cycle as essentialfor keeping the balance, reflecting the principle of yin/yang. Withoutthis controlling aspect, the sheng cycle would lead to an uncheckedbuild-up of energies that is likely to become excessive.
These relationships are wonderfully balanced and certainly reflect a sense of wholeness. However, in order to use this model inthe way the ancients did to describe the movement of life’s energies,we must move beyond a concrete interpretation and think of theseimages symbolically. Symbols have traditionally been utilized in allcultures to allow people to transcend the limits of rational thoughtand approach the realm of mystery. Since these laws were derivedfrom nature, especially from an awareness of the changes throughthe year and the alternations in the plant world, the qualities of theseasons can be used as a metaphor to uncover the true meaning ofthe elements. Because these patterns are inextricable from life, theyare able to reflect the transformations of ch’i. Through observing theshifts in the energy through the cycle of the seasons, we move froma static and finite view of the elements to a dynamic model forgrasping the infinite.
Wood symbolizes the energy of the springtime, a time of birth and growth. There is an upward movement of energy in nature, andwe observe a bursting forth of activity, as for example in the bambooshoot pushing up through the soil. In The Yellow Emperor’s Classicof Internal Medicine this season is described as the period of “begin-ning and development of life,” as living things unfold according tothe plan inherent in their seed. To get a sense of what the Wood ele-ment means, we need only reflect on the vitality and creativeexpression that is all around us in this season.
After the growth of spring, there is a transition into the heat of summer, into the Fire element. The rising aspect of nature’s cycle Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 68 has reached its zenith, as all things come to fullness in the light andwarmth of the sun. Everywhere there is “luxurious growth,” and thelife energy reaches maturity and finds its expression. To appreciateFire, we can notice, for example, how we feel on a warm summerday at a picnic with friends. Again, it is through a personal experi-ence of these elements that we can understand the meaning theyheld for the ancient Chinese.
Next, we move into the season of late summer, which accounts for the total of five seasons in this model. The energy has againshifted and transforms into the time of the Earth element. Herethere is a welcome decrease from the intensity of the summer heat,as the light energy begins to wane. Earth represents a time of harvestand “abundance,” as witnessed in the fruits ripening on the vine.
This energy is a symbol of nourishment, sustenance, and stability.
During the late summer (sometimes referred to as Indian summer),one may feel that all the seasons are present, an impression that isconsistent with the placement of Earth at the center in the YellowRiver Map of the elements, as discussed in the previous chapter.
Continuing our journey through the seasons, we come to autumn, the time of the Metal element, when the diminishing ofthe light energy continues. This is a time of letting go, as seen in theleaves falling from the trees. Walking in the woods during this sea-son provides a sense of peace; the active stages of the cycle are nowcomplete, and we can get in touch with the quality of life. Theautumn is a time of balance and is called the period of “tranquilityof one’s conduct.” In this quiet time, when nature is turning inward,we feel inspiration and a strength of spirit.
Finally, with the coming of winter, we have the Water energy, a time to go down into the depths and return to the source of the lifecycle. During this period of “closing and storing,” the reservoirs fillup and the energies are replenished through rest. There is a stark- Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 69 Chapter 4 . Model of the Five Elements ness around us, an impression of “emphasis” in the natural world, asseen in the bare branches of the trees. At this time, the life energy isnow underground; with the stillness of winter comes tremendouspotential, as the Water element contains the seed for the new birthin the spring.
To deepen our appreciation of the movement of the energy through the seasons, it is helpful to compare the associations of theelements that have just been presented. The chart below summa-rizes these aspects and adds some others: ASSOCIATIONS OF THE FIVE ELEMENTS IN NATURE Period of:
The Law of the Five Elements is so simple that it reminds us of a child’s game, but this simplicity is the key to its elegance andpower. The ancient Chinese lived close to the soil and had a keensense of life’s rhythms. They uncovered the principles of Five Ele-ment energetics in the most natural way, through tending theircrops through the seasons. The old farmer knew that if he didn’t Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 70 plant the seeds in the springtime, he would have missed themoment when the summer arrived. Without the growth of thespring (Wood), and the full maturity of summer (Fire), there wouldbe no harvest (Earth). Similarly, if the farmer failed to pick the cropsin the late summer and to turn the soil in the autumn, it would betoo late once the frost set in. It is the work of the Earth time thatallows for the letting go of autumn (Metal) and the rest of winter(Water). People who live an agrarian lifestyle are in intimate rela-tionship with the seasonal energies, and they have a genuine senseof what it means to be in harmony with them. Because the elementsare universal, as we study the Five Element model today we can,like the traditional farmer, draw upon our own connection withnature to build an awareness of the elements. This, in turn, allowsus to cultivate true wisdom within. Words can only provide adescription for energies that ultimately must be known through lifeexperience.
As we follow the progression through the seasons, we can observe the sheng cycle operating in the way that each element cre-ates the next one in the sequence. Since “the end of everything isjoined to a new beginning,”2 the movement is circular and self-per-petuating, resulting in the endless transformation of life’s energies.
The I Ching speaks of this rhythm in terms of “the appearance andwithdrawal of the vegetative life force.”3 We find an expansion of thelight energy (yang) through spring and summer and a contraction ofthe light (or a rising of the dark yin) through late summer andautumn, coming to a rest in winter. If we think of these changes as apattern of rising and falling energy, we have a model based on thenumber two, which provides an understanding in terms of yin/yang.
If we choose to make five divisions in this alternation between lightand dark instead of two, we generate the Five Elements.4 Each ofthe elements can thus be understood as stages in the flow of life Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 71 Chapter 4 . Model of the Five Elements Figure 5. The Identity of the Five Element and Yin/Yang Models from most yin to most yang, symbols of five aspects in the endlessexpansion and contraction of the energies over time. This temporalprogression of the movement between yin and yang can be picturedas a continuous sine wave, with the elements created along the way(Figure 5). If the transformations of yin/yang give rise to the FiveElements, then these two models are really different ways todescribe the same natural process, based respectively on the num-bers two and five. At their core they are expressing the same truth.
Since humankind is seen in traditional cultures as an extension of nature, embodying the laws that are observed in the worldaround, it was an easy step for the sages of antiquity to apply thepatterns of the elements to the human condition. Once it is under-stood that we are a microcosm reflecting the same patterns as thelarger macrocosm, each of the elements holds a meaning for ourlives. The Five Element model then became the basis for a systemof medicine. Assessing the elements in a person could be a ratherabstract, intellectual endeavor, if not for the fact that there evolveda practical way to read these energies through the senses. Since ch’icannot be perceived directly, it is through the associations for eachof the elements that we come to know the state of the energy. In Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 72 Figure 6. Color, Sound, Emotion, and Odor particular, through observing the color, sound, emotion, and odorin a living human being, practitioners of Five Elementacupuncture can bring this ancient system alive in the presentmoment. The above diagram of the elements indicates these corre-spondences (Figure 6).
Wood is the energy of the springtime, a symbol of growth and development. To understand what the Wood element means in ahuman life, we can examine a person’s ability to grow. Does her lifecontain new births and creativity in much the same way as thisenergy exists in nature? Is there a plan, a vision of where she is Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 73 Chapter 4 . Model of the Five Elements headed? Can she make the decisions that allow growth to take place?The goal in Chinese medicine is a balance in the energies, and thehealthy expression of Wood is probably best considered to beassertiveness, like the upward-expanding bamboo shoot that pushesup through a crack in the pavement. When this activity goes to theextreme, or when growth does not occur in a person’s life, the ten-sion and frustration may be reflected in a shouting voice and theemotion of anger, expressions that can be understood as diagnostic ofa Wood element out of balance. The ideal of health in this system isseen to be the ability to express a range of emotions in the course ofthe day. This can be observed, for example, in the play of children,who are capable of getting fiercely angry, but then move on to otherfeelings in a relatively short time. In working with the Five Elements,when we find someone who is stuck in this emotion and is still angrylong after an event is over, we suspect that she may have difficulty inthe issues pertaining to Wood.
Conversely, an imbalance in this element may be associated with a lack of shouting and a lack of anger, as in the individual whois unable to assert herself to make things happen. Someone who isincapable of getting angry, who has her foot stepped on and says,“Pardon me for putting my foot under yours,” could also be suffer-ing from a Wood imbalance. It is likely this same person will nothave the creative energy required to make changes in other areas oflife, and as a result will most likely not be able to manifest growth.
Thus, we find that each of the elements may be out of balance ineither an excessive or deficient way (bipolar dysfunctions that reflectthe principle of yin and yang).
Through observing the world in the springtime, we know that Wood is associated with the color green. When this element does notfind a healthy expression in an individual, we can actually observe agreen hue on the side of her face. The phrase in our language “green Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 74 with envy” indicates an awareness of this phenomenon. If a personhas an imbalance in Wood, we may also smell a rancid odor, like thesmell of a gym locker room or rancid oils. It is important to under-stand these associations in their proper context as natural expressionsof their respective elements. The value of these correspondences liesin the way they reveal the energy of the moment: a person may denybeing angry in words, but if she expresses herself in a shouting voice,her true feelings are unmasked.
The Fire element is the energy of the summer, and in evaluat- ing a person’s Fire we want to know if there is warmth in his life;quite literally we can ask, Does he have sunshine? The realm ofinterpersonal relationships is in many ways the province of Fire, andwe can see the health of this element reflected in the ability to com-municate, make connections, and develop true intimacy. On thedeepest level, Fire energy comes to us through love and it is here, inGod’s greatest gift, that we experience the spiritual power of this ele-ment. An imbalance may be observed in a red color, inappropriatelaughter in the voice, and excessive joy (or in a lack of these quali-ties). The odor of Fire is scorched, like the smell of a hot iron lefttoo long on clothes, or of a child with a high fever. These associa-tions can be derived quite easily from an awareness of our sensoryimpressions on a summer’s day. We probably have all encountered people who are deficient in Fire, who seem cold and distant and lack the spark that is theessence of life itself. An absence in the warmth this element pro-vides can be observed, in a very real way, through lack of laughingin the voice, lack of joy in the emotion, and a color that can bedescribed as lack of red. These people may crave connection, onlyto find that others avoid them once it becomes clear that those lack-ing in Fire are only interested in taking that element and are inca-pable of giving it back, in turn. Then there are those who are always Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 75 Chapter 4 . Model of the Five Elements laughing and socializing, who never seem happy unless they arepartying. Might the compulsion to constantly seek joy on the out-side be an indication that these people lack a genuinely sustainedFire on the inside? As we look beneath the surface we may indeedfind that the seemingly excessive joy of the person addicted to par-ties is actually compensating for a deficiency within.
The ancient Chinese understanding is that any extreme in the associations is an expression of an elemental disharmony, and oftenthere may be a mixture of excessive and deficient expressions.
When the Fire element is out of balance it is actually quite com-mon to observe an individual move suddenly from excess joy to atotal lack of joy (say, for example, when he experiences rejection ina relationship). According to the principle that yin and yang mutu-ally create each other, extremes turn into their opposite, as theyprove to be “two sides of the same coin.” The Earth energy brings stability and a sense of groundedness to the human condition. If a person is struggling in this element,she can experience tremendous insecurity. It is as if she literally hasno connection to the earth. Since the late summer is the time ofharvest, we can ask, in assessing an individual’s Earth, whether shefeels nurtured, can nurture others, and is capable of bringing forth aharvest in her life. A yellow color (like hay ready for the reaper) maybe observed along the side of the face when there is an imbalancehere. The sound of singing and the emotion of sympathy remind usof a mother caring for her child (Earth is indeed the great Mother).
Again, an excess in these signs may reflect a disharmony—for exam-ple, a person who is inclined to mother everyone. Someone who isalways feeling sorry for herself, who is constantly seeking sympathy,may also be expressing this same pattern; and, of course, a lack ofsympathy may be observed in someone who is out of touch with thiselement. The odor is fragrant, like the earth in late summer, and it Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 76 is an interesting correlation that people with uncontrolled diabetes(a disease of the pancreas, which is an organ associated with theEarth element) have a fruity smell of ketones on the breath that isindeed fragrant.
C A S E H I S TO RY: I once treated an older woman who lived in a mobile
home park. Having a long history of taking care of others, and happen- ing to own a car, she took on the task of running errands for other res- idents who lacked transportation. She found herself unable to set lim- its and would ignore her own needs in order to try to please everyone else. In time, she developed gastritis and was put on the medicine Prilosec to reduce stomach acid. Since the stomach organ is involved with bringing in food, problems here may be a manifestation of an imbalance in the Earth element. From a Five Element perspec- tive, her over involvement in which she attempted to fix every situa- tion (based on excess sympathy) was at the root of her dis-ease.The goal of treatment, through both counseling and acupuncture, was to restore a healthier balance to this emotion. A wholistic approach, in this case, allowed a deeper level to be addressed and provided far more lasting results than did symptomatic treatment. Eventually, she was able to discontinue the medication.
The Metal energy of autumn represents a time to find meaning and spirit. For humans, this element connects us to a greater pur-pose, imbuing life with a sense of quality, rather than quantity.
Metal is required for self-esteem and, in extreme cases, if a person iscut off from this element, there can be the most profound depres-sion and despair. When out of balance, we can observe the whitecolor (like a metallic sheen), a weeping voice, the emotion of grief,and a rotten odor (which reminds us of the smell of a decayingpumpkin in the autumn). These were the diagnostic clues in the Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 77 Chapter 4 . Model of the Five Elements first Five Element patient I ever observed, as described in the “Intro-duction.” It is not surprising that our modern world, having lost contact with traditions and meaningful rituals, suffers from a lack of spirit.
Though the essence of Metal has little to do with material posses-sions, people typically attempt to compensate for a deficiencythrough acquiring money and jewels (physical manifestations ofthis element). Those who endlessly search for spiritual truths, whorepeatedly travel across the globe to be with a guru, may be seekingon the outside what they are missing (and can in the end only find)on the inside. One of the healthiest expressions of the Metal ele-ment I’ve come across was the statement by an impoverished butvery spiritual Hispanic woman who, when asked whether her lifehad meaning, replied simply, “God does not make junk.” Water, the energy of winter, symbolizes a time of stillness and rest that allows for the building up of reserves. When the reservoirsare dry there can be no potential for coming forth into life, andthose with a deficiency in this element may experience a severedepletion of energy. Since the winter rains bring fluidity and fresh-ness, Water brings the ability to flow; when there is a lack of thisenergy, a person may become rigid. An imbalance in this elementmay be reflected in a blue color, which can appear under the eyesor as a darkening on the side of the face that makes it seem that theperson needs a shave. A groaning sound in the voice and the emo-tion of fear are also associated with the Water element, which isunderstandable when one considers the fear of drowning or the feel-ing that would be engendered by a scarcity in the storehouse duringthe wintertime. Once again, the ideal is to achieve balance, and weneed to realize there is appropriate fear that prevents a person frombeing unduly reckless. Thus, the daredevil who is constantly riskinghis life may also be expressing an imbalance in Water. The odor for Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 78 this element is putrid, the smell of stagnant water or of urinals. Ihave found the best place to experience this smell to be hospitalwards, where the overwhelming putrid odor stems from the combi-nation of bed pans plus the devastating fear that is typically present.
C A S E H I S TO RY : I recall the case of a carpenter who, despite extensive
bodywork therapy, suffered from chronic back pain. Of interest was the fact that his symptoms were especially severe in the winter months. His fear at not being able to earn a living was quite apparent and, since the meridians of the Water element run through the back, the pattern underlying his situation could be readily understood through the Five Element model. He failed to respond to treatments on the physical level essentially because the problem did not have a structural cause. Rather, it was an energetic disturbance of depleted reserves and held the underlying message that he needed to rest during the wintertime. Like so many in the modern world, he ignored the signals from his body as he was swept into a frenzy of activity during the Christmas season—behavior that was clearly not in har- mony with nature.The advice found in the Yellow Emperor’s Classic of Internal Medicine for staying healthy in the winter would apply here: go to bed early and rise late, after the sun is well up in the sky.
Once he integrated this counsel into his life, the back pain began to Though there are a great many expressions in human life, it is the color, sound, emotion, and odor, along with the twelve pulses,that are primarily used to assess the state of the elements in FiveElement acupuncture. As they come closest to reflecting the true Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 79 Chapter 4 . Model of the Five Elements energy of the individual, these associations form the foundation fordiagnosis in a system of medicine concerned with addressing thech’i. Each of us needs to express all of the elements in our lives and,in a similar way, we tend to manifest a spectrum of colors, sounds,emotions, and odors in the course of a day. In order to discover theelement that is most out of balance, the key is to recognize the cor-respondences that stand out as being inappropriate, whether exces-sive or strikingly absent. If a person fails to show any sorrow oneweek after the death of a parent, we would call that an inappropriatelack of grief. On the other hand, if years later the individual is stillimmobilized by the loss, that may represent an excess grief. Both sit-uations point to an imbalance in the Metal element.
On the following page is an extended list of the Five Element associations. It is traditional for students of this system to inquireinto a range of manifestations as a way to evaluate the state of thech’i. As we continue our exploration of the elements, we will havethe opportunity to examine these relationships in greater depth.
The universal applicability of the Five Element model can be appreciated in the way it can be applied to anatomy and physiology,as understood by modern biology. The vital organs fall nicely into aFive Element pattern, indicative of a plan for the organization of thebody that is entirely consistent with traditional wisdom (Figure 7).5On the level of cellular physiology, metabolism can be categorizedaccording to the Five Elements, as the basic food groups and life-sustaining molecules also follow this framework.6 Fats can be associ-ated with Wood, since they are digested with the aid of the gall blad-der and are processed by the liver. Proteins, the spark of life, may berelated to the Fire element. Carbohydrates are considered to be anexpression of Earth, as they provide the sweet taste, while the pan-creas produces the insulin needed for sugar to enter the cells. Both Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 80 ASSOCIATIONS OF THE FIVE ELEMENTS IN PEOPLE Emotion:
Metabolites: Fats

Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 81 Chapter 4 . Model of the Five Elements FIRE
(Heart Protector)
Figure 7. A Lay-out of the Organs of the Body According to Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 82 the minerals needed for healthy function, as well as the oxygenrequired for respiration, correspond to Metal. Lastly, water, whichcomprises two-thirds of our bodies, belongs with the Water element.
Historically rooted in ancient China, the practical use of the Law of the Five Elements based on observable associations is, to agreat extent, the work of Professor J. R. Worsley, with whom I hadthe good fortune to study in England. Drawing upon diverse healingmethods, as well as his own experience in Asia, he revitalized classi-cal practices, placing a strong emphasis on sensory perception. Thegenius of this approach is that it is able to cut through words andsymptoms in order to read the energy of the moment. As a system ofmedicine, it is transmitted largely through oral teaching and, whenasked for a textbook, Dr. Worsley never failed to remind his studentsthat nature is the real teacher of the elements. Practitioners areencouraged to develop themselves as instruments in order to effec-tively apply these principles in the treatment room, and non-acupuncturists can certainly use these same tools to assess energyand act in harmony with the demands of the time.
It is said that “the map is not the territory,” and it is indeed important to not become so focused on the methodology that weforget the real person who is the reason for the inquiry. Yet, toaddress the full range of life’s expressions, we need a vehicle capableof expressing a deep level of experience. Based on enduring patternsof nature, the Five Element model is a form that encapsulates agreater wisdom. Since it is built on images that are inherently partof the human condition, it has survived the test of time and remainsas applicable today as it was in China, thousands of years ago.
1. I Ching, Bollingen Series, trans. Richard Wilhelm (Princeton: Prince- ton University Press, 1950), Hexagram 30, The Clinging, p. 119.
Dolowich 04 p2.3.qxd 6/7/04 1:08 PM Page 83 Chapter 4 . Model of the Five Elements 2. I Ching, “Discussion of the Trigrams,” p. 271.
3. I Ching, “The Great Treatise,” p. 294.
4. For those who prefer fewer categories, the “lumpers” among us, the yin/yang model offers a way to describe the movement of life energywith just two distinctions. The “splitters,” who enjoy breaking thingsdown further, would naturally gravitate to a system based on five (ormore) possibilities.
5. Susan Mankowski first brought this East-West connection to my awareness, during conversations we had while working together atJade Mountain Health Centre.
6. I am indebted to Darlena L’Orange, fellow Taoist and co-author, for pointing out this relationship to me. For a more in-depth explorationof metabolism and nutrition in a format consistent with Five Elementtheory, please see the book we have written together: Ancient Roots,Many Branches: Energetics of Healing across Cultures and throughTime (Twin Lakes, Wisc.: Lotus Press, 2002).



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