TCM vs Classical 5 Element

Yin Yang and Five Elements theory is the center thought of TCM, no matter acupunture or herbology all should inside these rules, five elements is connecting to 5 interal organs, and all herbs are connecting to the internal organs&#39 meridians, so they have very tight relationship.

As a Classical 5 Element practitioner, I hope I can clarify. When I refer to 5 element I mean Classical, as the contemporary 5 element has a different diagnostic procedure.

The 5 element theory underpins much of CM, as well as Chinese philosphy. It comes from the time(thousands of years ago) when observations of nature were applied to the human condition, i.e., seasonal changes and patterns in the environment mirror those in the body/mind/spirit. TCM is the result of more &#39modern&#39 observations of the human as an independent organism, and the patterns described are more particular to clinical conditions. Both recognise climatic conditions as causes of illness, and both are systematic and disciplined in their own format.

5 element practice emanates directly from 5 element theory with the diagnosis and treatment described in those terms. The presenting symptoms are not a major feature of the diagnosis, and treatment rarely links into them, although many symptoms can be understood as connected to the 5 element influence.

In practice you treat the patients Causative or Constitutional Factor(CF), the pivotal element that provides balance to the other 4 elements. The CF is the strength and the weakness.

My husband, who is both 5 element and TCM trained, and uses both in practice, describes it thus

5 element is like homeopathy in that it treats the constitutional type, whereas TCM analyses the symptoms using a differential daignostic method. In his experience a patient may have, for example, Liv qi Stagnation; treatment with Liv 3, 13, 14/GB 34 would improve their symptoms. However, the etiology may be frustration over a long period of time, with increasing resentment. If the CF is Wood, treating Liv would help short and long term outcomes. But if the CF is Fire, frustration and resentment comes from the vulnerablitiy of that element. By treating Fire, vulnerability would be replaced by ontological security, leading to resolution of resentment and frustration.

I only use 5 element, even where there are protocols to managing treatment (e.g. in IVF), as I treat on the CF as well as the protocol.

Classical/contemporary 5 element does not use herbs because they tend to correspond to TCM, although a good practitoner can do so. Mostly, this requires further training in patterns of disorders. Many practitioners are, like my husband, dual trained. I would say that TCM is great for addressing specific complaints and 5 element is great for embedded or chronic complaints. Both are wonderful systems of medicine. Neither is superior to the other. Both get great results.

Thanks for the positive feedback!

Well, one of the reasons I left nursing after 30 years of it was that I couldn&#39t get on with the reductionist approach to health and treatments. So, I am reluctant to go down that route now I am an acupuncturist! However, there are one or two principles that might answer some of your questions.

5 element treatment planning is, theoretically, very simple. Treat the CF and everything else will fix itself. And, honestly, in most cases I have found that to be true. The difficulty is in diagnosing the correct CF. It may sound easy - after all, there are only 5 possible options - but, in practice it is much harder. There is also the added complication of blocks between officials, and whether they are due to the nurturing cycle, or the controlling cycle. Additionally, elements can be in &#39distress&#39, or an element &#39within&#39 the CF...do you treat those first or stick to CF work and trust it will right itself? These are clinical calls that are made from taking pulses and constantly checking the patients colour, sound, odour, and emotion.

5 element theory also states that the root of dis-ease is emotional. It might claim that ALL ailments are emotional in origin, so it makes no difference what the biomedical, or TCM, diagnosis is, it will have an emotional origin. In many cases this is a very hard concept for patients to accept, as we tend to perceive that if we &#39allow&#39 our emotions to dominate then we are somehow weak, or that it is our &#39fault&#39. Not so, although understanding the complexity of emotions is crucial to helping patients manage their constitutional type and reducing dis-ease.

I work a lot with oncology patients, as well as IVF. I tend to view my practice as helping the patient tolerate such massively invasive procedures and do not go into the &#39cause&#39 of it - it&#39s not the right time nor is the patient in any fit state during those treatments to be challenged about the origins of their complaint. Again, just treating the CF, and working within the cyclical nature of the 5 elements is usually enough to give relief of distressing symptoms or acheive reasonable success.

Sometimes, I recommend a TCM approach and refer on. Mostly it is a &#39gut&#39 feeling, although it can be where the 5 element approach is too slow for the patient - e.g., where there is a lot of damp or phlegm. In some cases, enlightened TCM practitioners refer a patient for 5 element.

There are some instances where only 5 element will do; husband/wife imbalance, and internal dragons. They are amazing treatments and effect enormous change both clinically and reported, paving the way for any other interventions to be much more successful. There is no substitute.

When all is said and done, much depends on the patient and not the practitioner. 5 element is more systemic and more gentle, but can be too subtle or soft for some. TCM may be too brutal or short-term for others. It&#39s ultimately up to the patient and practitioner to work together and decide. That&#39s why I think it&#39s very important not to take an either/or, better/worse approach. It is good practice to be au fait with other modalities, as we can then best serve our patients and feel sure of our professional integrity.

Thank you for such a full comment. I would like to add my understanding to your comments and perhaps gain some clarification.

Firstly, I know what I studied in my course. I also know that, like TCM, the 5 element canon has a number of variables. The LicAc I studied was based on daoist teachings, essentially the Nei Jing and all that emanates from it (3 treasures, 8 extra channels, and so on). Root and branch theory was very much at the heart of it, and we were also told again and again that while there is no &#39superior&#39 kind of acupuncture &#39superior&#39 practitioners were possible - mainly ones that understood the concept of humility.

I think I made it clear in my comments that there is no gain in being territorial, although preserving the integrity of a practice tradition is worthy. I am married to a TCM/herbal practitioner, and we learn much from each other. He is also a practising Christian, and I am aetheist; again, we learn much from each other.

Good practitioners are found in all fields of medicine, regardless of the discipline. Respectful practitioners - respectful of the patients as well as other practitioners as well as the self - tend to be good practitioners. The hall mark of a professional, however, is one who knows what they cannot do, and a good professional practitioner will also have an awareness of who would be able to &#39do it&#39.

Using Western terminology to translate and define Chinese terminology does, as you rightly point out, cause significant problems in gaining common ground and understandings. Part of this is because the conceptual frameworks are so different, and this leads to ontologies and epistemologies that are not always compatible. Clearly this impacts on training and studying, especially when an institution of education requires courses to comply with the wider teaching models, which appears to be one of the disadvantages of Chinese Medicine being taught in the West. Indeed, here in the UK there is a faction of so-called academic scientists who are hell-bent on closing courses that contain (in their words) voodoo and mumbo-jumbo, on the premise that they are not proper subjects. Students and teachers operating that that kind of environment are bound to become defensive and protective. Similarly, MDs/physiotherapists et al doing weekend courses in sticking needles in and calling it acupuncture are an outrage, yet a recent study claims that 48% of all &#39acupuncture&#39 consultations in the UK are of this sort. The net result may be that a proportion of LicAc practitioners feel they must hold on to their expertise at all costs and not embrace any other way of working.

Whatever the influences, my stance is to welcome input from experienced, knowledgeable people, so I can deepen my understanding and, hopefully, improve my service to patients. To that end, anyone who is a practitioner of Chinese Medicine is welcome in my world.

It appears you have had some less-than-helpful interactions with individuals who have in common the local 5 element teaching. I am sorry about that, as hostility is rarely a pleasant experience. Clearly, you assume this is an identifying feature of the 5 element system of Chinese medicine. I am sorry about that, too.

J R Worsley had long left the college in the UK when I studied there and I can assure you, arrogance and entitlement were not part of the curriculum. As he has been dead for 10 years, I am confident that if those aspects are being taught now they are nothing to do with him as a person, and certainly not part of the 5 element system as I know it after 12 years practice.

Reading through all the posts following the original query, it seems that nobody has suggested TCM is akin to allopathic/modern medicine, neither has it been suggested that TCM is somehow inferior to any other system of medicine (Chinese or modern biomedicine). I can only surmise that&#39s because most of us here don&#39t believe either to be true.

I am familiar with Jeffrey Yuen&#39s work but, thank you anyway for the reference. Perhaps you might like Elisabeth Rochat de la Valle and Claude Larre for their excellent explanations of 5 element medicine.

Om Shanti Shanti SHanti