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5-element/5-phases theory in Chinese Medicine

by Cyndi Norwitz
March 1997


I believe you should not use an acupuncturist who follows 5-element/5-phases theory. This is why:

I'm no expert on all of this but I will give a basic outline. There is a history of "Five Phases theory" in The Web That Has No Weaver: Understanding Chinese Medicine, by Ted Kaptchuk, Congdon & Weed, Inc., Chicago, 1983 (Appendix H). This, btw, is the book for an introduction to CM. I strongly recommend it. My descriptions of 5-elements is based on this appendix.

Yin-Yang theory, which TCM is based on, is many millenia old. 5-phases came out of a somewhat different philosophy in the 4th century B.C.E. They existed independently of each other and 5-phases did not enter into the realm of medicine until the Song dynasty (960-1279 C.E.). 5-phases theory had to be adapted and altered heavily to fit into medical practice and many correspondenes that never existed before have come up as part of these adaptations, partically in the use of the 5-elements (water, wood, fire, earth, metal).

According to Kaptchuk, "the Five Phases correspondence is at best a convenient way to organize significant clinical reality...it is an explanatory theory and is not meant as a binding doctrine." (p. 348). He also discusses how the theroy has been critized since its invention, and not just in its medical applications.

He also says, "Western practioners of acupunture and CM have special problems dealing with the 5-phases theory. The major difficulty is that much of the literature available in English decribes diagnosies and treatment exclusively in terms of 5-phases theory. Writings that refer to the theory as the 'Law of the 5 elements' betray a misunderstanding of Chinese science--natural laws such as those promulgated by Aristotle and Newton simply were not developed in traditional China. These writings also put undue emphasis on the importance of the 5-phases to the Chinese medical tradition; even respected defenders of the 5-phases theory readily admit that sometimes it is useful and sometimes it is not. Even so, it is unfortunate that many practioners simply consider 5-phases theory unscientific gibberish and do not try to understand it. It is actually an important secondary emblem system used to assess and discuss clinical reality (pp. 353-4).

Unfortunately, a lot of practioners trained in the US have learned that 5-element theory is the way to do Chinese Medicine. A lot of books about Chinese Medicine for the layperson also use 5-element theory to the exclusion of anything else. This is one reason I dont like Between Heaven and Earth: A Guide to Chinese Medicine or Dragon Rises, Red Bird Flies: Psychology in Chinese Medicine (the latter combines 5-elements with a strict adherence to Freudianism).

Any TCM doctor worth his or her salt will not use 5-elements in any primary way. As an additional system of explaination, or as a way to explain things in simple terms to their patients, it is fine. In my experience, relying on 5-elements and believing that you dont need to get chi with the needles tend to go together. It is bad training, period.

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Cyndi Norwitz / webmaster@immuneweb.org / Last Modified: 1/18/98