On the Five Elements' Generation and Control in Traditional Health Preservation
The Dream of the Red Chamber, Chapter 45, describes how Lin Daiyu suffers from coughing every spring and autumn. One day, while ill in bed, Xue Baochai visits her and discusses "those who eat grains live." She says: "Yesterday I glanced at your prescription—ginseng and cinnamon seem excessive. Although they benefit qi and nourish spirit, they are too warming. In my view, first prioritize calming the liver and strengthening the stomach. Once the liver fire is subdued, it cannot overact on earth (spleen), so the stomach will remain healthy, and diet can then nourish the body." With just three sentences, Baochai reveals the essence of traditional health preservation based on the Five Elements’ generation and control.
“Five Elements” refer to metal, wood, water, fire, and earth. Ancient people believed these five elements were the fundamental components of all things in the universe. The Guoyu states: “Thus, ancient kings mixed earth, metal, wood, water, and fire to create myriad things.”
The basic principles of the Five Elements are mutual generation and mutual control. “Mutual generation” means metal generates water, water generates wood, wood generates fire, fire generates earth, and earth generates metal; each has a “source” and a “produced” aspect. “Mutual control” means metal controls wood, wood controls earth, earth controls water, water controls fire, and fire controls metal; each has a “controlled” and “controller” relationship. Generation contains control, and control contains generation—opposites complement each other, perpetually circulating.
Beyond normal generation and control, the Five Elements may also exhibit abnormal phenomena such as overacting (xiang cheng) and counteracting (xiang wu). “Overacting” refers to excessive control according to the sequence of mutual control, implying taking advantage of weakness. “Counteracting” refers to abnormal control contrary to the sequence, implying dominance over the weak. For example, if wood energy is excessive and metal cannot restrain it, wood will overact on earth and even counteract metal. Conversely, if wood energy is deficient, metal will overact on wood, and earth will counteract wood.
Thus, the balance of generation and control requires moderation—neither deficiency nor excess. This is precisely what TCM’s “diagnosis by differentiation” aims to achieve.
Based on this philosophy, ancient medicine combined clinical practice to explain the relationships between the Five Elements and internal bodily functions as well as external environmental factors, offering clear guidance for self-care:
For instance, the liver belongs to wood; anger harms the liver, which should be overcome by sorrow and relieved by fear. Anger causes qi to surge, leading to an overactive liver. Sorrow relates to the lungs, which belong to metal—metal restrains wood. Fear relates to the kidneys, which belong to water—water nourishes wood. This applies to internal environment; others follow similarly.
Regarding external environment, the key to spring health preservation lies in protecting the liver and strictly preventing wind invasion. The rationale behind “wearing more clothes in spring” stems from this principle. Others follow similarly.
Returning to Baochai’s words: “Once the liver qi is calmed, it cannot overact on earth.” The liver belongs to wood, and the spleen and stomach belong to earth. Wood and earth mutually control each other. Wood generates fire; excessive liver fire harms the spleen and stomach. Once liver fire is calmed, it no longer overacts on the spleen and stomach, allowing them to properly absorb nutrients. How vivid and apt! It is impossible not to be convinced.
Ancient people believed that the generation, control, overacting, and counteracting of the Five Elements represent the fundamental patterns of cosmic composition, birth, death, cycles, and evolution—and also the foundation of health preservation. Zhang Jingyue, an ancient medical master, said wisely: “The mechanism of creation cannot lack generation, nor can it lack control (restraint); without generation, development would have no basis; without control, excess would cause harm.” Therefore, when pursuing health preservation, we must follow the laws of the Five Elements; following these laws demands balanced, dialectical moderation.
That said, due to limitations of their era, ancient people could not develop a fully rigorous scientific system. Human health is an extremely complex engineering system. Thus, when applying the Five Elements concept to health care, we must avoid dogmatism and forced interpretations.