Guiding clinical diagnosis
Since the five zang-organs pair with the five elements, the five colors, the five flavors and the five pulses respectively, and because the disorders of the internal organs can manifest on the surface of the body, clinically the theory of the five elements can be used to analyze the changes of complexion, taste and pulse in order to decide which viscus and meridian are involved.
Diagnosis according to complexion, taste and pulse
The five colors, the five flavors and the five pulses correspond to the liver, the heart, the spleen, the lung and the kidney respectively. So they can be directly used to diagnose disease. For example, bluish complexion, preference for sour flavor or sour taste in the mouth and taut pulse indicate liver disease; reddish complexion, bitter taste in the mouth and full pulse indicate heart disease; yellowish complexion, sweet taste in the mouth and slow pulse indicate spleen disease; whitish complexion, acrid taste in the mouth and floating pulse indicate lung disease; and blackish complexion, salty taste in the mouth and deep pulse indicate kidney disease.
Deciding the transmission of disease according to complexion, taste and pulse
If the complexion, taste and pulse of the patient do not agree with the nature of visceral disorder, it shows that the disorder is already changed among the five zang-organs. Then the theory of the five elements must be used to analyze the transmission. Take spleen deficiency for example. Instead of displaying the manifestations of yellowish complexion, sweet taste in the mouth and slow pulse, there are signs of bluish complexion, sour taste in the mouth and, taut pulse which are normally the manifestations of liver disorder. It shows that liver disease has been transmitted to the spleen, i.e. wood over restraining earth. Take lung disease for another example. Instead of displaying the manifestations of whitish complexion, acrid taste in the mouth and floating pulse, there are signs of reddish complexion, bitter taste in the mouth and full pulse which are normally the manifestations of heart disease. It shows that heart disease has been transmitted to the lung, i.e. fire over restraining metal.
Of course, using the theory of the five elements to diagnose disease is only one of the methods used in clinical diagnosis. In order to reveal the nature of disease and make correct diagnosis, this method should be used together with other methods for differentiation of syndrome, such as yin and yang, zangxiang (visceral and their manifestations), qi, blood and body fluid.
Guiding the treatment of disease
In the treatment of disease, the theory of the five elements is mainly used to control the transmission of disease and decide therapeutic principles.
Controlling the transmission of disease
The pathological changes of the five zang-organs, according to the phenomena of over restraint, reverse restraint and mutual involvement of the mother-element and the child-element among the five elements, can affect and transmit to each other. Thus in clinical treatment of the affected viscus, other viscera to be possibly involved must be taken into consideration by taking preventive measures in advance to control the transmission of disease. However, the following two points have to be borne in mind. One is to select the viscera that are subject to transmission for treatment. For example, liver disease, according to the theory of five elements, tends to transmit to the heart, the lung, the spleen and the kidney. However, clinically the organ that is more frequently to be affected by liver disease is the spleen. So preventive measures should be taken in advance to protect the spleen in the treatment of liver disease. The other is that the treatment should be done according to the functional state of the viscera. Though liver disease tends to transmit to the spleen, the transmission usually results from the abnormal changes of spleen function. If the spleen is sufficient in qi, healthy in function and powerful in resistance, liver disease is difficult to transmit to the spleen and no measures need to be taken to deal with the spleen. If the spleen is too weak to resist attack of liver disease, it will be invaded by liver disease. In this case measures must be taken to prevent further transmission in treating the spleen.
Deciding therapeutic principles
Visceral diseases, according to the inter-promotion and inter-restraint relationships among the five elements, may affect each other. Clinically the theory of the five elements can be used to readjust the relationships among the five zang-organs to realize the aim of treatment. Usually the therapeutic principles are decided in the light of inter-promotion and inter-restraint relationships.
The therapeutic principle decided according to inter-promotion relationship is termed "tonifying the mother-organ and purging the child-organ".
Tonifying the mother-organ is a therapeutic principle used to treat deficiency syndrome. It is also known as "tonifying the mother-organ in the treatment of deficiency syndrome". This principle is mainly used to treat deficiency syndrome due to failure of the mother-organ to promote the child-organ. The aim of this principle is to strengthen the weakened child-organ by tonifying the mother-organ. Take insufficiency of liver-yin for example. Since it results from malnutrition of liver-wood due to insufficiency of kidney-yin, it can be treated by nourishing kidney-yin. Since the kidney is the mother-organ of the liver, tonifying kidney-water can promote liver-wood. That is why this therapy is called "enriching water to nourish wood."
Purging the child-organ is a therapeutic principle used to treat excess syndrome, also known as "purging the child-organ in treating excess syndrome". This principle is mainly used to treat excess syndrome resulting from disorder of the mother-organ by reducing exuberant pathogenic, factors through purging the child-organ. For example, superabundance of heart-fire due to hyperactivity of liver-fire can be treated by purging the heart because the heart is the child-organ of the liver. That is why liver-fire can be reduced by purging heart-fire.
The principle decided according to inter-restraint relationship is called "inhibiting the strong organ and supporting the weak organ".
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