Five Element Acupuncture – what it’s all about

Five Element Acupuncture – what it’s all about

Five element acupuncture – what it’s all about

22nd February 2023

From the British Acupuncture Council website insight by Susan Evans

Susan Evans has been an acupuncturist for many years and the first system of acupuncture studied was Five Element acupuncture at Leamington with Professor J.R.Worsley. The style learnt has more recently been commonly referred to as Worsley style acupuncture, as there was a mixture of different styles from over the East Asian area. The following is a brief explanation of how the elements play a part in our lives.

Five element acupuncture

Five element acupuncture is an ancient style of traditional acupuncture that relates back to a time when the whole Chinese empire and culture was informed and shaped by the 5- element cosmology. This powerful system of acupuncture works with the Body, Mind and Spirit of the individual. The elements are Wood, Fire, Earth, Metal and Water. Each element is necessary for the healthy function of the next.

Wood is the fuel for Fire, the ashes of a fire feed the Earth. The Earth houses the precious metals, Metals are present in water and the water is necessary for the trees to grow in Wood. This cycle is called the Shen cycle and is the creative or nourishing cycle maintaining our wellbeing. If any element is out of balance, then this will lead to an imbalance in the next element either side on the cycle etc. I see it like a family, who all have a part to play in the smooth running of family life. If for example, the family member who usually makes breakfast, is too depressed to get up on time and stays in bed, nobody gets breakfast, they all go out hungry or stressed and cannot work to their full potential. It is similar when one of the elements is out of balance, it has that knock- on effect. These elements are present in all of us and the aim in diagnosing from a 5- element perspective is to find the “Causative Factor” (CF) as we each have a predominant element which is out of balance. This imbalance begins either pre- birth or shortly after birth.

Five areas of investigation

The diagnosis relies on five areas of investigation: colour, sound, odour, emotion and the pulses.  Colour is like a hue, found in certain areas on the face. A sound is detected in the voice. An odour can be discerned from the individual and the individual will display a certain emotion that is out of context. These correlations can be either in dominance or lack.

There are 12 pulses that relate to the 12 officials or organ/functions. Each of the 12 organ/functions have a meridian or pathway where the qi flows through the body.

Picture: courtesy of TAA

The officials or organ/ functions

The officials or organ/ functions are as follows  Element    Colour    Sound        Odour         Emotion

I       Heart                                                                 Fire           Red        laughing        scorched            joy

II      Small intestine                                                 Fire           Red       laughing         scorched           joy

III     Bladder                                                             Water       Blue      groaning         putrid                fear

IV     Kidneys                                                            Water       Blue      groaning         putrid                fear

V      Pericardium/ heart protector                        Fire           Red        laughing        scorched            joy

VI     Triple heater                                                    Fire           Red        laughing        scorched            joy

VII    Gall bladder                                                    Wood       Green   shouting         rancid               anger

VIII   Liver                                                                 Wood       Green   shouting         rancid               anger

IX     Lung                                                                 Metal        White     weeping       rotten                grief

X      Large intestine                                                Metal        White      weeping      rotten               grief

XI     Stomach                                                          Earth         Yellow     singing         fragrant           empathy

XII    Spleen                                                              Earth         Yellow     singing         fragrant           empathy

The qi flows from one pathway to the next in this order, from I to XII and then back to I in a continuation. Qi can get stuck in one pathway and not be moving on to the next and we have specific Exit/Entry points on each meridian that we can treat when this blockage occurs.

The yin organs are deeper in the body, found on the inner circle of the diagram. Heart, heart protector, spleen, lungs, kidneys and liver. These are deeper in the body and more vital to life than the yang organs. The yang organs are small intestine, triple heater, stomach, large intestine/colon, bladder and gall bladder.

There are many associations with the elements. Each element has a peak time. For example, the peak time for the stomach is 7-9am and we all know that breakfast should be the most important meal of the day. Giving the stomach food when it is best able to digest it just makes sense.

The importance of the seasons

The seasons follow the cycle and are important to the working of the elements.

Wood is associated with Spring. The liver and gall bladder are the organ functions. Spring is a time of great energy when all life bursts forth after the quiet of winter. The gall bladder is associated with decision making and the liver with planning. If we lived by nature, these are the times the farmers are making plans for the seeds to be sown, looking forward to a healthy harvest. Having a healthy functioning Wood element allows us to make plans in our life, decide where we are going. The eyes are governed by Wood.

Fire has four organ functions. The heart is seen as central to the integrity of a person in the wholistic sense as well as the vital pump that governs our blood circulation; a controller, physically it beats to pump out blood. Matters of the heart are to do with love in its widest sense.

The small intestine is involved in sorting the pure from the impure. Discerning true from false is a vital capacity in our lives as well as on a physical level in digestion.

The heart protector/pericardium and triple burner/heater are not associated with a physical organ. There are a few functions that the pericardium oversees. It is known as the heart protector, like a bodyguard for the heart, so the heart can carry on with its vital functioning. It is also responsible for healthy blood flow and healthy flow of the emotions, especially those related to matters of the heart.

The triple burner takes responsibility for body temperature. All the officials rely on this function. It is always important that our working temperature and our emotions do not blow hot and cold.

These two organ functions are very much associated with how we relate to others, our relationships, those close to us. Joy plays a big part in the working of the Fire element. A lack of joy can lead to depression. The season of fire is summer. This is a time when we naturally spend more time with others, having holidays and fun. Most of us are happier in the summer and joy is more abundant. The sun shares its warmth as we share our warmth, and the flowers grow. The colour red is associated with love, love hearts, red roses etc.

The Earth element houses the Stomach and Spleen. This is the element involved with digestion and nourishment. Are we able to nourish ourselves on an emotional and spiritual level? The stomach is where we take this nourishment, and the spleen is the transporter that spreads this nourishment throughout the body. The season here is Late Summer. This is when Mother nature is really showing her abundance, harvest is being gathered in. Within us we see our plans coming to fruition through the Earth element. Empathy comes from here. I often suspect the Earth element is out of sync with those patients who bring me presents or are always asking how I am. Always looking out for others before themselves.

Metal houses the lungs and the colon. We breathe in pure qi from the lungs and breathe out the spent air. The colon is responsible for clearing the rubbish from the body, mind, and spirit. Too much rubbish makes us toxic. Autumn, its season, is also a time for clearing. Nature gives us plenty of rain to wash away the dead leaves, allows them to be washed into the ground as nourishment for the soil. We too must let go of the past and not hold on, so we can make way for the new next year. If we get stuck in the past, we may have grief for what we have lost.

The bladder and kidneys are associated with the Water element. Water is vital to life. Each cell in our body relies on water for its existence. The water element is responsible for the flow in our lives. The bladder is the reservoir, and the kidneys control the flow. This fluidity is again on all levels – body, mind, and spirit. Ambition or will is housed in the kidney. The season of winter is when we see more water than at any other time. This is the season of rest. In nature, there is rest as the winter quietens life so reserves can be built for the coming spring. Stillness and movement can be tied up with the emotion of fear. If you cannot stop, cannot rest, anxiety and fear are often present. This is a quote from I do not know where, but it sums up winter for me,

“Plant life is at rest now, held in stillness in earth and wood. Yet, the cold of the deepest winter calls forth in seed and bud, the first signs of a new beginning”.

The seed of yang is present in the midst of deepest yin. I liken the still of winter to the stillness of meditation where we replenish ready to start again.


Making the correct diagnosis is important for our patients, whatever system we practice. When we rebalance the element that is primarily in distress, it can make the most amazing difference. The first time I was treated on my CF, which is Fire, I couldn’t stop laughing. It was embarrassing to say the least, but the Fire element was so grateful, it burst into life for me. I felt so amazing after that treatment, once the laughter stopped!!

This is truly an amazing system of medicine, taking all our idiosyncrasies into account. What we thought was “just how I am” can give great clues as to which element could be in distress. The elements play such a vital role in life and healthy elements will help us flow through our lives.

Susan Evans MBAcC
February 2023

Treatment at Southwell Acupuncture Clinic

Hannah Charles is also trained in Five Element Acupuncture in the Worsley tradition ‘This is truly an amazing system of medicine’.

To find out more about the Five Elements check out this page on my website;

For Information and Treatment contact Hannah on;

British Acupuncture Council

Hannah is also a member of the British Acupuncture Council (MBAcC)

The British Acupuncture Council (BAcC) – the UK’s largest, member-led, professional body for traditional acupuncturists.

With nearly 3,000 members. We’re governed by an elected Governing Board and driven by a specialist staff team.

Our members belong to an accredited register, regulated and approved by the Professional Standards Authority for Health & Social Care (PSA). The PSA protects the public by overseeing the regulation and registration of healthcare professionals – including statutorily regulated professions, such as the Nursing and Midwifery Council, and Accredited Registers like the BAcC. This offers a quality mark for high standards of training, safe practice and professional conduct.

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