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Five Elements Acupuncture - Which Element are You?

Updated: Oct 16, 2019

By: Dr. Halina O'Neill

A Five Elements Acupuncture Diagram.

While Chinese Medicine, Feng Shui, and Chinese Astrology have sent ripples of interest to the West in recent decades, the Five Elements aspect is still relatively unknown.

The Five Elements is a comprehensive template that organizes all natural phenomena into five master groups or patterns in nature: wood, fire, earth, metal and water. They are described in the book, Essentials of Chinese Acupuncture, as the basic materials of the world. The elements alchemically transform into each other in a continuous movement of waxing and waning while visibly manifesting into cycles of day and night, the season of the year and in human life: (birth, growth, decline and death). Those patterns, observable in nature, govern all life, including our bodies, emotions and aspects of the soul.

Within the structure of the Five Elements are two dynamic relationships: generation and control which describe an intricate system of nurture and control that lies at the core of balance and harmony in nature.

As all things in nature, this cycle applies to human beings as well. In the generation cycle, the Liver, (organ of Wood), stores the blood that nurtures the spirit that resides in the Heart, (organ of Fire). The Heart nourishes the Spleen, (organ of Earth), by transmitting the energy and blood that are needed. The Spleen nurtures the Lungs, (organ of Metal); the Lungs nurture the Kidneys, (organ of Water), and the Kidneys nurture the Liver (organ of Wood).

In the control cycle, Wood (the Liver) controls Earth (the Spleen); Fire (the Heart) controls Metal (the Lungs); Earth (the Spleen) controls Water (the Kidneys); Metal (the Lungs) controls Wood (the Liver); and Water (the Kidneys) controls Fire (the Heart).

In the Five Elements diagnostic system, one must examine the state of the elements within the patient with special attention on the primary element of imbalance, (also called the Causative Factor (CF)). Then they will assess the interaction of elements in the generation and control cycle to pin point imbalances and disharmonies in the patient’s energetic system.

The Five Elements diagnostic system goes beyond examining the medical history, patient complaints and physical aspects of the patient, although those are all important and necessary steps in the process.

The main focus is on sensory diagnostics which includes color, sound, odor, and emotion, (CSOE), and are all different for each element. For example: the Earth element color is yellow, the sound of the voice is singing, the odor is fragrant and the emotion is worry. The predominant presence of those aspects of the Earth element will indicate the Earth element as the primary imbalance element.

CSOE: Color, Sound, Odor, Emotion

Color: The hue that radiates from the temples or the coloration of the creases around the eyes and mouth.

Sound: The voice may have a singing nature, groaning nature or a weeping quality.

Odor: An elemental scent can be detected in the back of the neck or around the belly button. (Note: it is not the smell of sweat on the body).

Emotion: Observe what the person’s guiding emotion is. Is there an angry undertone or a fearful undertone?

The Five Element acupuncture treatment is focused on correcting the weakness in the primary element, (the CF element), and restoring balance in the flow of the elemental energy within the cycles. This approach profoundly affects the person’s health by healing the root cause of the weakness and imbalance and engendering healing and recovery from pain, discomfort, and diseases on all levels of the body, mind and spirit.

So, what is your Primary Element?

Diagnosing the Primary Element using CSOE (color, sound, odor and emotion) requires skill and practice. There are no two of the same fragrant odors or two identical shades of yellow that clearly indicate Earth as the Causative Factor. As in nature, Earth can be dry, sandy, swampy, rocky, or clay-like, yet it is still Earth. Such endless variations can be found in nature, therefore, in individuals as well. No two people are the same, regardless of the similarities of their symptoms or of their underlying elemental imbalance (the CF).

The description below can be a guide to help you find what your elemental imbalance is and hopefully encourage you to seek more information about Five Elements acupuncture or find a Five Elements practitioner in your area to start your journey to health and wellness.


Bamboo trees representing the Wood Element.

Meridians: Liver, Gallbladder

CSOE: Color – Green, Sound – Shouting, Odor – Rancid, Emotion - Anger

People who have a strong energy of the Wood element have clear visions and goals, knowing how to bring them into being. They excel at planning and decision making. They can be forceful in disagreements and can strongly argue their opinions. Their piercing, penetrating eyes may attract you, but avoid their wrath.

Wood out of Balance

When the wood Qi is weak, people can be indecisive, without strong direction in life, and stuck. They may be constrained emotionally and unable to express anger. When the Liver Qi is congested or stagnant, people can be arrogant, over controlling, and have angry dispositions. They may have a tendency to be workaholics or have addictive personalities, including the possibility of abusing drugs and alcohol. They may have digestive problems like bloating, gas, alternating constipation and diarrhea.

The organs associated with the Wood Element are the Liver and Gallbladder. Common signs of the Liver meridian stress include dry, brittle, thickened nails and pain just below the ribs. Common illnesses include migraines, eye problems, and sinus problems. The Liver meridian circles the genitals. Rashes and discharges are associated with its imbalance as well as hernias. For women, menstrual problems are common including PMS, painful periods, and heavy bleeding. Uterine fibroids may be related to the imbalance of the Liver meridian as well. The Liver and Gallbladder meridian pathways traverse the top and sides of the head, the most common sites for migraine headaches.

Balancing Wood Element

To balance the Wood Element, find a healthy stress relieving activity such as tai chi and meditation. Drink lots of water and stretch often throughout the day. Limit consumption of alcohol and include sour foods in your diet to stimulate the liver.


Fire representing the Fire Element.

Meridians: Heart, Small Intestines, Pericardium, Triple Warmer

CSOE: Color - Red, Sound - Laughter, Odor - Scorched, Emotion - Luck of joy

People with strong Fire energy may be quite charismatic. They excel at commanding others to action. They are the social “butterfly” with plenty of friends and places to go.

Fire out of Balance

When the Fire Qi is weak, a person may be lackluster or bland or overly hot and overwhelming. They may suffer from anxiety, restlessness, and insomnia. They may stutter, talk too much and too rapidly, or laugh nervously. They may be too excitable, easily stimulated to excesses, or they may be emotionally cold and unfeeling. They can be prone to engage in impulsive and frequent sexual activities or can be cold and frigid.

Common illnesses include circulatory problems, palpitations, hypertension, heart problems, and sores in the mouth and tongue.

Balancing Fire Element

Balance your social activities by moderating the excess or lack of it. Start journaling to give yourself time to reflect and balance tendencies towards hyperactivity and hastiness. Learn to plan and prioritize important aspects of your life.

Avoid foods that are too spicy and over-heating and include bitter foods into your diet such as leafy greens as well as cooling foods such as pears, cucumber and yogurt.


Sand Dunes representing the Earth Element.

Meridians: Spleen, Stomach

CSOE: Color - Yellow, Sound - Singing, Odor - Fragrant, Emotion - Worry

People with strong Earth Qi are well grounded, nurturing, and compassionate.  Earth people are peacemakers and reliable friends. They often enjoy both preparing food and eating. You may be attracted by their generous mouth and full, sensual lips. 

Earth out of Balance

When people have a weak Earth Qi, they can be worriers and meddlers. They are prone to pensiveness. They may overwork, especially in studying or in other intellectual work. They are vulnerable to digestive problems and diarrhea. They may gain weight easily and lose it with difficulty. Their bodies have a tendency to make excessive mucus, and they may suffer from cloudy thinking, muzzy-headedness, and lack of clarity.

Common illnesses include: fatigue, diarrhea, gas & bloating, food allergies & sensitivities, eating disorders, heartburn, and canker sores.  Excessive mucus may collect in the lungs or in the sinuses. In women, menstrual problems may include either excessively light or heavy periods.

Balancing Earth Element

Develop healthy boundaries in your relationships and learn how to say “no”. Make time to be in nature because this will refuel you. Don’t indulge in spending too much time in the past or future, practice staying in the present moment.

Avoid sweets and replace them with sweet vegetables such as yams or carrots.


Clear crystals representing the Metal Element.

Meridians: Lungs, Colon

CSOE: Color - White, Sound - Weep, Odor - Rotten, Emotion - Grief

Metal Element types are intellectually sharp and have a tendency for self-discipline which can make them very successful people. They are respectful of virtue and authority and in reverence of beauty and refinement. Balanced Metal is methodical, discerning, scrupulous, accepting, neat, calm, disciplined, and honorable. Balanced Metal types are highly creative, detail orientated, and good at solving problems. They make good lawyers, teachers or counselors.

Metal Out of Balance

The Metal Element is associated with the lungs and skin, so when these types are out of balance they are prone to respiratory problems such as asthma and skin problems such as eczema, psoriasis and constipation. Excess Metal can become the stereotypical “anal-retentive” personality which becomes too restrictive, dogmatic and overly concerned with rules and preserving purity. Deficient Metal types can fall into sloppiness and hypocrisy. Out of balance Metal can become self-righteous, autocratic, strict, and meticulous with a tendency for obsessive compulsive disorders. They are either devoted spiritual seekers or can be focused just on the material aspects of life. The Metal type can be consumed excessively by grief and past hurts that may damage their present relationships. This can make it hard for them to form bonds with other people and they may end up replacing intimacy with material things.

Balancing Metal Element

Regular aerobic exercise will strengthen your lungs and benefit the Metal Type.

Practice meditative techniques that involve focusing on the breath and letting go of the past.

Include in your diet foods that are high in minerals, especially leafy greens and vegetables.


Water drop representing the Water Element.

Meridians: Kidney, Bladder

CSOE: Color - Blue, Sound – Groaning, Odor - Putrid, Emotion - Fear

The Water element is difficult to grasp because it seems to change its form based on the perceptions of the observer. Water maintains its substance while effortlessly changing its form and appearance to suit the situation. Water is adaptable. When balanced, Water types are candid, introspective, modest, watchful, objective, curious, ingenious, careful, particular, thrifty, sensible, and lucid. They are known for their determination and are often described as self-contained or self-sufficient. Unlike the Wood Types, who get things done by force, the Water Types are more adaptable and achieve their aims by determining the best path through a situation. Water Types may seem somewhat enigmatic and enjoy their anonymity, solitude and tranquility. Water type people may seem to be wise beyond their year.

Water out of Balance

The organs associated with the Water type are the Kidney and Bladder. These types are prone to urinary tract infections and water metabolism issues leading to swelling and edema. The Water element also governs the bones so Water types can have sore joints and back problems. The emotion associated with water is fear and when out of balance, the water type can be fearful, timid and indecisive. When in excess, Water types can become "demanding and covetous”, and when deficient can completely withdraw from the world. The major issue for Water is fear or complete lack of fear which can lead to life endangering activities.

Balancing Water Element

Drink plenty of fluids. Avoid cold foods and salads, especially in the winter. Seaweed, seafood, asparagus, walnuts are particularly nourishing for the Water Type and should be included in the diet whenever possible. Guard against becoming too isolated by consciously prioritizing your social life. Develop hobbies, like theater or karaoke to overcome fear and timidity.



Beijing College of Traditional Chinese Medicine, Shanghai College et al. (1980). Essentials of Chinese Acupuncture. Beijing, China: Foreign Languages Press.

Kaptchuk, Ted. (1983). The Web That Has No Weaver. New York: Congton and Weed.

Worsley, Professor J.R. (1998). Classical Five Element Acupuncture, Volume III, The Five Elements and The Officials. Published by J.R. & J.B.Worsley

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