The Five Elements in pathology include cases such as over acting and the insulting sequences, including the generating sequence that could induce an increase in pathological conditions. Disease spark when imbalance remains constant over a long period of time.

The Overacting Sequence

The organs overact each other because of the excessive irregularities that disorient the system. 

  • The Liver over-acts on the Stomach and Spleen: If Liver-Qi is in stagnation, the Stomach Qi can’t go down; it causes nausea and prevents the Spleen Qi from going up, causing diarrhea.
  • The Heart over-acts on the Lungs: the heart’s fire dries the fluids of the lung leading to Lung- Yin deficiency.
  • The Spleen over-acts on the Kidneys: the dampness in the spleen can stop the Kidney from transforming and excreting fluids
  • The Lungs over-act on the Liver: if the Lung Qi doesn’t go down, it can stop the physiological rise of the Liver Qi. 
  • The Kidneys over-act on the Heart: If the Kidney’s fluids are gathered pathologically, they “overflow” the heart causing abnormal function.
The Insulting Sequence

The controlling sequence is reversed when the insulting sequence starts.

  • The Liver insults the Lungs: Liver Qi doesn’t go up it blocks the chest and prevents breathing. Asthma could occur when the Liver-Fire obstructs the descending of Lung Qi.
  • The Heart insults the Kidneys: Heart- Fire can infuse downwards to the Kidneys and cause Kidney- Yin deficiency. 
  • The Spleen insults the Liver: the dampness in the Spleen can overflow and stop the free flow of Liver- Qi.
  • The Lungs insult the Heart: when the Lungs are blocked by Phlegm, they can stop the circulation of Heart-Qi.
  • The Kidneys insult the Spleen: If the Kidneys fall to transform fluids, the Spleen will suffer and become blocked by Dampness
The generating sequence

  In the generating sequence, sometimes the mother doesn’t nourish the child well or the child consumes so much from the mother; At times a deficient organ is insulted by another. 

The five elements in diagnosis


Each element is correlated to a color, where that could possibly determine the deficiency of the body. Sometimes the hybrid of two colors implicates an overacting or insulting sequence, but using the five element diagnosis is rather inaccurate without taking into account other symptoms.

– Red/ fire shows heart deficiency – White/metal shows Lung Qi deficiency – Green/wood is Liver Qi deficiency – Yellow/Earth is Spleen Qi deficiency – Dark colors/water shows Kidney deficiency. 

The Five Elements in Pathology

Similarly an imbalance is implicated depending on the prevailing sounds and emotions experienced. 

  • Wood: anger and shouting
  • Fire: Laughing and joy
  • Earth: pensiveness and singing
  • Metal: weeping and worrying
  • Water: groaning and fear


In diet and herbal therapy, taste would be changed according to the imbalance of the body. For instance, adding sour taste or reducing the excess of it. 

  • Wood: Rancid/sour, where the smell comes from the burning from the heart to the liver
  • Fire: scorched/bitter
  • Earth: Fragrant/sweet relating to spleen deficiency or dampness
  • Metal: Rotten/Pungent, 
  • Water: Putrid/ Salty
Tissues/ Sense Orifices

The tissue and five senses reflect the irregularities in the body with each element accordingly:

  • Wood: sinews/eyes – Fire: blood vessels/ tongue
  • Earth: muscles/ mouth and lips – Metal: skin/ nose
  • Water: bones/ ears

The climate affects the sensitivity one feels, disturbing the imbalance even further.

  • Wood: Wind – Fire: Heat – Earth: Dampness 
  • Metal: Dryness – Water: Cold

There are a few limitations to that of the five element model of correspondences because of the strict relationships between specific parts; leaving much space for assumptions. The Five Element Theory is useful in clinical practice as opposed to Chinese Medicine because medicine focuses on the patterns of signs and symptoms, rather than a one to one relationship.