The Five-Element Model for 12 Meridians—the Imbalance in Balance
Eric M. Hao, MSAOM, LAc
Editor's Note: Part 1 of this series appeared in the April issue (2019).
The Five-Element model is one of the core theories/concepts of traditional Chinese medicine (TCM) and acupuncture that describes how the Zang-Fu organs function and interact with each other; how disease happens and changes; and how the symptoms transmit among meridians.
TCM views all disorders as the result of an "imbalanced" state or "disharmony" between yin and yang and among the Five Elements. All of the treatment modalities and protocols are not only targeted at internal organs, but also restoring a dynamic balance in the body to maintain health.
Since the concept of "balance" is critically fundamental to TCM theory and practice, it is rational to question whether 12 meridians fit into Five Elements. One element has 4 meridians, and therefore is not as balanced as TCM has claimed to be for centuries. Like lacking the concept of a "Father" in TCM theory, this principle conflict and imperfection has been presented throughout Chinese medicine, and has guided acupuncture treatments from ancient China to academic research in today's contemporary society.
For the 12 meridians with the exterior-interior pairing relationship, the logical state of balance is a six-element model instead of the Five-Element model for even distribution. Unlike the pentagon, the hexagon is one of the most stable geometric structures in nature, in addition to the triangle and the square. The new model demonstrates both the generating and controlling relationship in a circular yet opposite direction for better understanding the interaction between/among the six elements.
An Imbalance in the Model?
The discoveries of the imbalance in the Five-Element model; the transformation made to it from five- to six-elements; together with the modification described in part 1 of this article, complete the theoretical and practical basis of the new six-element model. It is the principal guideline for the successful management of intractable disorders (and numbness) that TCM practitioners seem to be baffled at when trying to obtain the fast and reliable clinical therapeutic outcomes.
As shown in the six-element model, two adjacent elements (the solid arrows, Father and Mother) generate the next element (Child/Children) clockwise, which is more rational and realistic regarding the natural laws of reproduction. An element controls (dotted arrow) the next element counterclockwise, which stands for the "controlling relationship" in the six-element model. Table 1 (in part 1) describes in detail the generating relationships in the six-element model. For example, with water (Bladder/Kidney, BL/KI) and earth (Stomach/Spleen, ST/SP), plants (Gallbladder/Liver, GB/LR) grow, which represents the parents-children relationship.
To be clear, just as Yin is to Yang, "Mother" is to a "Father" in the new model. The "Father" or "Mother" is more of a conceptual idea than an actual gender, or a specific element. By that, each element can be the Father or Mother or both, and the "role" is determined by the location of the disease or the organ/meridian to be treated.
The six-element model reflects and duplicates most reproductive patterns more honestly than that of a female and a male model - required to produce the next generation. In clinical application, the six-element model is a practical tool for treatment, whereas the "corrected" Five-Element model, described in part 3 of this series, is for diagnosis; identifying the course of symptoms transmission (CST) among meridians; and providing correct procedures for successful management of neck and shoulder issues such as whiplash-associated disorders (WAD).
The patient's complaints regarding the CST after neck injuries, comprehensive history intake, and judicious physical examination performed by practitioners are the three primary sources to confirm the CST's reliability.
Editor's Note: Part 3, the final in the series, will discuss the Five-Element model.
As modern medical standardization continues, the field of traditional Chinese medicine has the advantage of comprehensive personalization. For rare or complex cases, deeper consideration of constitution is invaluable. Proper constitutional assessment, especially with first-time clients, can guide desirable and predictable outcomes. This leads to a higher rate of return, and greater trust between you and your patient.
Though the creation of a financially sustainable, health-promoting model feels far away today, we are casting a vision for a full return on health, believing that this compels us to keep one foot firmly rooted in caring for the sick and the other foot firmly founded in maintaining health. Shifting from a fee-for-service model to value-based care using a phased approach is paramount.
Traditional Chinese medicine and the Vedic traditions both offer rich frameworks for understanding human health, emphasizing the balance of physical, mental, and spiritual aspects. The concept of "souls" or spiritual components in TCM, namely Hun, Po, Shen, Yi, and Zhi, bears significant similarities to the yogic concept of koshas. Their similarities and differences provide insights into how these systems contribute to holistic health practices.
