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THE FIVE ELEMENTS AND YOUR CONSTITUTION

In addition to the qualities of yin and yang, the ancient Chinese recognized that energy could be classified further into the Five Elements. This philosophy dates back almost eight thousand years. Interestingly, you can find similar descriptions of energy in other cultures, as in Indian, Native American, Tibetan, and Mayan traditional medicine. These elements provide a language with which to describe the unique and dynamic energy of everything in our world.

FIRE ELEMENT	This literally refers to the element of fire, the sun, and that which creates heat.
EARTH ELEMENT	Earth refers to the soil that holds nutrients, plants, and trees in the ground.
METAL ELEMENT	Rocks, minerals, and compost are all considered part of the Metal element.
WATER ELEMENT	This refers to the water of our planet—oceans, rivers, lakes, precipitation, and so on.
WOOD ELEMENT	This refers not only to the wood found in trees but also to the sturdy, fibrous structure of all plant life.

All life on earth is dependent on the Five Elements. For instance, a seed attempting to grow must have access to Water to germinate; Wood so it grows a strong structure and roots for its coming leaves, flowers, and fruit; Fire so when it sprouts it will grow toward the sun; Earth so the soil can hold the roots and structure; and Metal so it is continuously nourished by the minerals in the compost.

The early Taoist philosophers observed that these elements described not only physical entities all around them but also something energetic. Upon deeper observation, they discovered that the elements are not fixed states of energy but rather are constantly changing and are more akin to phases than to fixed conditions. These phases can be seen in all life on earth. Using our plant metaphor, a plant would have a period of incubation (Water), growth (Wood), maturation (Fire), harvest (Earth), and death (Metal). This knowledge led to the discovery that nature’s way of moving through the elements matched the cycles and rhythms of the seasons. As a consequence, each element became associated with a season.

Additionally, it was observed that the seasons provided a similar experience for plants, animals, and humans alike. Granted, it’s important to note that these observations were recorded during a time when people lived close to the land and were dependent on the rhythms and cycles of the seasons. If they had tried to grow rice in winter or harvest fruit in spring, they would have risked their health and the survival of their community. This is what the ancients observed:

WINTER is a time for incubation.

SPRING is a time for birth and growth.

SUMMER is a time for maturation and celebration.

LATE SUMMER is a time for harvesting.

FALL is a time for letting go and returning to the earth.

Even though in the West most of us live indoors now, the seasons still impact us. Not only are we affected on the outside by bundling up in winter and wearing sunscreen in summer, but we are also affected on the inside. Seasons impact our emotions, organs, and systems too. Taoist philosophers found an example of this when they observed that the lungs, large intestine, and skin experienced health challenges during autumn that weren’t noticeable during the other seasons. One of the biggest differences was that it is often drier and cooler in autumn. The philosophers also noticed that in the natural world, autumn is a season of letting go, declining energy, and shedding what is no longer alive in us, the same way trees do. When this happens, the emotion that naturally arises in response to letting go is grief. Therefore, the lungs, large intestine, and skin became the organs and tissues associated with Autumn and the Metal element, and grief became the related emotion.

Since each organ is related to a particular season, we can target our support for certain emotional imbalances, organs, or systems to maximize our healing at certain times of the year. For instance, the emotion of anger and the liver and gallbladder are associated with the Wood element and the Spring season. When spring arrives, the body’s energy begins to move in a different way. Usually we are more active and more extroverted than we are in winter. As such, the liver and gallbladder begin to work harder to move the energy in our bodies to match the increased demand for energy. If we have any stuck energy, toxin buildup, or repressed emotions, this will be very noticeable during a season when we need more energy. This feeling of “stuckness,” whether physical or energetic, is what can lead to anger. Since the liver and gallbladder’s primary job is to move energy in the body, Spring would be the best time to support these organs and any emotional imbalances associated with the Wood element.

According to Chinese medicine, understanding what is happening in nature and knowing what to expect from each season provides an essential guide for how to stay healthy and get the most out of each day. According to this ancient system, if you look outside and see that it’s winter, you should also be experiencing Winter on the inside. If instead you find yourself with more Summer-type energy, you are likely to experience incongruence and, eventually, imbalance. Learning to live in accordance with the seasons is the second step toward health.

It is not just the seasons we need to consider when trying to improve our health and vitality. Practitioners of Chinese medicine observed many years ago that each organ also has a daily high point of energy as well as a low point. These points have been documented as a roughly two-hour window in each twenty-four-hour period. This information serves us well when it comes to supporting specific organs. If we know that heart time is between 11 A.M. and 1 P.M., would it be nice to know what we can do during that window to maximize support for our heart?

Meridian Clock

Five Element Associations

	Water	Wood	Fire	Earth	Metal
SEASON	Winter	Spring	Summer	Late Summer	Autumn
EMOTION	Fear	Anger	Joy	Worry	Grief
YIN ORGAN	Kidneys	Liver	Heart, pericardium	Spleen	Lungs
YANG ORGAN	Bladder	Gallbladder	Small intestine, triple burner	Stomach	Large intestine
BODY PART	Bones	Tendons, ligaments	Blood, sexual fluids	Muscles, fat	Skin
SENSE/ORGAN	Hearing/Ears	Sight/Eyes	Speech/Tongue	Taste/Mouth	Smell/Nose
FLAVOR	Salty	Sour	Bitter	Sweet	Pungent

YOUR CONSTITUTION

We are made up of all five of the elements, and we cycle in and out of different elemental phases throughout our lives. That being said, according to Chinese medicine, each of us embodies a unique combination of the elements within us, which is called our constitution. The constitution is the energetic imprint we are born with. As we ebb and flow through life, our qualities of energy can also ebb and flow. However, the underlying current of our constitutional energy will, for the most part, always be the same.

It’s important to note that we need all of the elements present in our world to find balance in our bodies, minds, and spirits, as well as in our families and communities. Each person and his or her unique constitution bring something unique to the table that provides balance for and seeks balance from other constitutions.

The constitution can be viewed as our medicine offering to the world. Let’s look at plants for a moment, as they are very similar in this regard. There isn’t a single plant on earth that doesn’t carry within it the ability to heal something. For example, the bark from the cinchona tree heals malaria, turkey tail mushrooms (Coriolus versicolor) can shrink tumors, and even those little yellow dandelions that shoot up in every nook and cranny of your lawn can cool down a fever and help detoxify the blood. Every single plant has medicine, and humans are no different.

There is no other medicine, nor will there ever again be medicine, like what you have to offer our world. You are truly unique and a vital gift to the planet. You don’t come here with a unique energetic imprint just so you can hide away in your home all your life. You are born with a divine purpose that can be traced back to and manifests out of your constitution. (Sadly, length restrictions will not allow us to explore the process of uncovering your purpose in depth. You will have to stay tuned for my next book!)

There is great wisdom in learning about your constitution and patterns of imbalance before uncovering your purpose. A famous psychologist named Abraham Maslow created what we know as the “hierarchy of needs” in the early 1940s. His hierarchy depicts, in order of importance, the shared global human needs.

Maslow’s Hierarchy of Needs

Our most basic needs for survival live at the bottom of the hierarchy, and as we work our way up, we find the more complex needs. When we are sick or in pain, our very survival is challenged, and we often cannot possibly think of anything more complex than getting through the day. Fulfilling survival needs relates to the balancing of the Water element. As we heal, we can then work our way toward establishing feelings of safety in our minds, our bodies, and our lives. Working on our safety includes putting systems in place to prevent us from returning to survival mode by building personal, financial, and health resources. This stage relates to the Wood element.

As we enter the Fire stage, we can work toward fulfilling the need for love and belonging through family, friends, and intimate relationships. This provides us with a sense of being connected to the larger landscape of our lives. Feeling as though we belong is a need that is largely unmet in our culture and one that is absolutely vital. Beyond that, we can enter the stage of the Earth element, which is a key stage for individuation and taking ownership of who we are. At this stage we may feel inclined to take career risks that highlight our strengths and accomplishments. We may make bigger decisions about what we want to get out of life versus finding ourselves always at the other end, making do with others’ decisions about our lives. Our personal power grows in this stage.

Maslow’s final stage in the hierarchy relates to the Metal element and describes a state in which we want to become the best possible version of ourselves. He referred to this stage as that of self-actualization, and it represents the development of a personal connection with the divine, God, Goddess, you name it.

A few years before Maslow died, he realized he had made a mistake. He hadn’t completed the hierarchy, as one level was still missing. So in 1970, he added another need at the very top; he called this the need for transcendence. He was defining transcendence as the need all humans have at some point in their lives to live a life of purpose (and he acknowledged that purpose usually included service). He explained that this need does not typically come to the surface until we have met (even if only partially) most of our other needs lower in the hierarchy. This final stage of transcendence can also be likened to homing in on the unique balance of all the elements within us so that in some sense we can simply be present and no longer strive.

I’m sure after looking at this hierarchy of needs, you can see why it would be strange for me to give you information to guide you toward your purpose and offering to this world if you are waking with debilitating anxiety every day. You must work your way through your needs in an order that makes sense, that fills your cup along the way, and that gives you the tools to make your way to your own version of evolution. The book you hold in your hands contains these tools. If after some time spent with this material, you begin to feel the pings of “What is my purpose?” and “What am I doing with my life?” then you will probably be interested in the next book I’ll be writing, which will cover this very material: your constitution, your purpose, and how to manifest it into an offering for our world.

Knowing your constitution serves you in a number of ways, including:

1. Knowing how to support your body, mind, and spirit by supporting the elements that are most prominent in your constitution

2. Knowing how to prevent health imbalances by supporting the most challenged organs in your constitution

3. Having insight into your unique energetic imprint that will guide you toward your purpose and offering to the world

4. Developing compassion for yourself and others as you learn about critical elemental differences that make each of us important and unique

As a practitioner, I always want to know which elements are in each client’s constitution because that will set the foundation for the treatment plan as well as his or her health and life goals. One of the surefire ways to know the elements present in your constitution is to consult someone who has studied the Five Elements extensively, most notably a Five Element acupuncturist. This professional will listen to you, look at you, and even smell you to accurately diagnose your constitution. In the interest of discovery and supporting you in learning more about yourself, I have provided a quiz at the end of this section that will give you some insight into your constitution. However, I cannot guarantee that it will be 100 percent accurate. For this, you will need to see a qualified practitioner.

Once you know your constitution (whether through seeing a practitioner or through your own studies), a part of your healing strategy should always include the foods, herbs, and practices that best support that primary element and season. For example, if you discover you are primarily a Wood constitution, I recommend that you include nourishing your liver and gallbladder in regimens throughout your whole life and especially in spring. While it is enticing to flip straight to the chapter on your constitutional element, I invite you to follow along through all the chapters to better understand how to use this information in your day-to-day life. As a rule, practitioners always seek to find balance in the individual and his or her true nature first, followed by attuning the person to the corresponding season. Working in this order ensures that we don’t undermine the nature of a patient. I recommend you follow a similar path as you work your way through this book.

Quiz

For each question, select one answer out of the five options. Remember that since we are assessing your constitution and not just a sudden uprising of symptoms, you need to read these statements as though you are looking at a lifetime of patterns. For instance, one of the questions reads, “When it comes to a large social gathering…_____.” The options include “No thanks,” “Bring it on,” and so forth. When you answer, choose the response that reflects something that you have noticed for most of your life as opposed to something you have felt on occasion. For example, we have all had times when we feel antisocial and want to reject an invitation, but is that your usual reaction to large social gatherings? Or would that be rare for you? You will want to give it the highest score if it is your primary reaction.

After you have taken the quiz, tally up the numbers in each column. You will end up with five columns of numbers. Take the highest number and note the element that it is associated with. This element will be considered your primary element and therefore, your constitution. If you have a tie between two elements, then consider it a wonderful opportunity to learn about both of the elements that show up strongly in your constitution. Regardless of having a tie, it’s important to learn about all of the elements, since you are made up of all of them, and they each play a pivotal role in your life.

Five Element Quiz

	1	2	3	4	5
My dominant emotion is:	Fear	Anger	Joy	Worry	Grief
I identify as:	An extreme introvert	Mostly extroverted	An extreme extrovert	Half introvert/half extrovert	Mostly introverted
I prefer company to be:	Minimal and quiet	Focused on a task	One on one	An intimate gathering of lots of close-knit family and friends	A gathering of people that have room to do things on their own and together
When it comes to a large social gathering:	No, thanks.	What’s our goal?	Bring it on!	Wait, who will be there?	I can take it or leave it
I am mostly afraid of:	Death	Not meeting my life’s goals	Not being loved	Not belonging	Not being connected
My Achilles’ heel is:	Dogmatism	Feelings of being stuck/held back	Impulsiveness	Worry and self-doubt	The need to be right
I know I’m stressed out when I:	Get extremely tired and can’t get enough sleep	Feel angry and exhibit addictive behavior, even with work addicition	Feel anxiety, have heart palpitations, and experience insomnia	Do not digest food properly (Every meal is an obstacle.)	Get frequent colds and sinus infections, asthma
What’s most important to me and my work:	Truth	Justice	Connection	Sharing	Fairness
I’m really good at:	Using my imagination, creating art	Problem solving	Communicating	Anticipating others’ needs, establishing routines	Seeing the big picture
I’m not so good at:	Being frivolous	Not fixating on a goal/plan	Being serious	Setting/reading boundaries, handling change	Making mistakes
My family and friends come to me for:	Serious talks, words of wisdom	Decision making, planning	Love, play, adventures	Nurturing, compassion, listening ear	Inspiration, spiritual guidance
I consider myself:	Articulate and deep (I just want to know.)	Highly creative and intuitive (I just want to create.)	A people person with no shortage of passions (I love life.)	A natural caretaker (I just want to help.)	Self-disciplined and organized (I just want to serve the greater good.)
On a Friday night, I prefer:	To stay home with a book	To work late and get ahead for next week	To go out and socialize	To have people over for a community dinner	To attend a ceremony or ritual to commemorate someone or something
I wish all beings:	Would just listen to their own truth	Would just do something for the world	Could be happy	Could have their needs met	Could feel connected, not alone
My leadership style is:	Within the comforts of my home or office	Front line, alone if necessary	I prefer to have one good friend by my side	Collaborative, or equal leadership in a group	Quiet and with integrity, but I’ll get big and loud if I need to
I am at my best when:	I’m given full creative license and space	I’m in charge	I get to follow my bliss	I get to be of service to others	My life mimics my core values
I love my:	Alone time	Work	Spontaneity	Routines	Guiding principles
My natural pacing for life is:	Slowest—it’s more important to focus on quality	Fast—let’s get it done so we can move on	Quick—how much can we fit into one lifetime?	Average—I’m no faster or slower than those around me	Slow—it’s more important that we not miss anything
I have an aversion to:	Chaos	Pushy people	Attention stealers	Clinginess or neediness	Authority and misuse of power
Physically I feel:	I am not as adept as others, and I don’t care.	I’m really strong and have lots of stamina.	Great! I can do anything!	I have to work hard to keep fit.	I’m okay. I can get stronger if I put my mind to it.
My body type is:	Average. Weight goes to my belly but doesn’t touch my legs.	Athletic, sinewy. My weight is evenly distributed.	Sexy/good-looking. I like to dress to show my body.	Fluctuating. I have challenges with my weight, which typically settles in my belly, hips, and thighs.	Tall and lean with a long neck. I can gain weight mostly in my hips.
Totals
KEY	1 = Water	2 = Wood	3 = Fire	4 = Earth	5 = Metal

PATTERNS OF IMBALANCE

Once you have discovered your elemental constitution, you will have an idea of how best to use this book to support yourself throughout the many phases of your life. But that’s not all you will need to find balance in your world. In addition to your constitution, you also need to know which patterns of imbalance you are experiencing. While patterns may reflect some aspect of your constitution, often they reveal something completely different about you, like your Achilles’ heel. Patterns are best understood as a collection of symptoms that often end up with a Western medical diagnosis such as pain, depression, anxiety, or high blood pressure. However, if you look at these patterns through the lens of chi and the Five Elements, you can begin to understand them in a different light. Instead of “pain,” you can see where chi is stuck and learn how to get it moving. Instead of “chronic fatigue syndrome,” you can see where chi is depleted and learn how to replenish it.

Learning about the most common patterns of imbalance will guide you to a direct understanding of how your chi is impacted by your diet, lifestyle, environment, genetics, and so on. Guiding principles that address the pattern of imbalance presenting in your life include recommendations for specific dietary, lifestyle, and environmental changes. While there is a total of sixty-two patterns of imbalance in Chinese medicine, there are only about twenty that I see frequently. If you find that you have multiple patterns of imbalance, or you can’t differentiate your pattern of imbalance based on the information that follows, then I recommend working with a qualified practitioner before proceeding with treatment principles.

Understanding the Language of Chinese Medicine

The language used to describe patterns of imbalance can help us to understand how elements, organs, and systems can lose their natural balance. The common terms Chinese medicine practitioners use to describe the state of chi in a person, an organ, or a system are yin, yang, deficiency, dampness, and stagnation.

GENERAL CHI DEFICIENCY: When our chi is abundant, we feel abundance in body, mind, and spirit. We awake looking forward to the day; we feel aligned physically, mentally, and spiritually; and we have enough energy to do the things that are important to us. It’s just like a river that is full and wide and flowing downstream. When we experience a loss of chi, the river goes down and the banks are exposed. We feel this deficiency on all levels and may develop symptoms that include fatigue, shortness of breath, spontaneous sweating, a swollen tongue with teeth marks on the sides, and a weak pulse. General chi deficiency does not happen overnight but is a condition that develops over a long period of time. Any organ can experience chi deficiency.

In addition to general chi deficiency, there are more specific types: yin chi deficiency, yang chi deficiency, and blood deficiency.

YIN CHI DEFICIENCY: Also a chronic pattern, yin chi deficiency usually presents after long-term exposure to high-output activities, stressors, and lifestyles, without the appropriate yin to keep us balanced. This is where we may find ourselves feeling “tired but wired.” When yin is deficient, yang gets to take over. Thus, yin deficiency often produces yang symptoms such as dry skin and hair, night sweats, excessive thirst, dry mouth or throat, poor memory, weakness (especially in the lower back and knees), restlessness, sleep disturbances, irritability, anxiety, and muscle aches.

YANG CHI DEFICIENCY: As with all chi deficiency patterns, yang chi deficiency takes a long time to develop. Often, though not always, it is preceded by yin deficiency. Burning the candle at both ends is most often what leads us to developing these patterns. Instead of the tired-but-wired feeling we get with yin deficiency, yang deficiency leaves us feeling just plain tired. When yang is deficient, yin gets to take over. This leads to symptoms such as low energy and stamina, low libido, afternoon crashes in energy, cold hands and feet, a desire for warmth, feelings of all-over weakness, fears, phobias, and panic attacks.

BLOOD DEFICIENCY: Water that flows through a healthy river is teeming with life and abundant in minerals. Can you imagine water that is empty of life and minerals? That would be akin to the pattern we call blood deficiency in Chinese medicine. Not only can blood deficiency reflect a low level of blood (as in cases of anemia), but it can also reflect a deficiency in nutrients typically found in the blood. When we have plenty of nutrient-rich blood flowing through our veins, every organ is nourished, and the mind and spirit flourish also. We feel at home in ourselves and look vibrant, from rosy cheeks to shiny hair, moist skin, and healthy nails. When the blood is deficient, anxiety is one of the first symptoms we notice. Additionally we may experience heart palpitations; brittle and dry hair, nails, and skin; sleep disturbed by active dreams or nightmares or a lack of REM sleep; exhaustion; a pale complexion; and sadness.

DAMPNESS AND PHLEGM: While dampness may be unfamiliar in Western medical terminology, Chinese medicine refers to it as the root of many imbalances, such as high cholesterol, metabolic disorders, chronic fatigue syndrome, fibromyalgia, allergies, and even cancer. Dampness refers to a level of internal humidity that develops when the spleen does not function well. Dampness then accumulates in the digestive system and lungs. It can cause mucus, phlegm, a wet cough, diarrhea, and generally low energy. If left unaddressed for a long time, dampness can become what is referred to as phlegm in Chinese medicine. Phlegm is the progression of dampness into congealed fluid that can further disrupt the function of other organs and systems.

STAGNATION: Stagnation occurs in a river that is low or has areas of debris where the flow is blocked. Patterns that fall under this category are indicative of chi or blood that is no longer flowing as well as it could be and is therefore stagnating in either the meridians or the organs. Most often this results in pain, emotional instability, feeling stuck, frustration, and/or depression. For women who have menstrual cycles, this can show up as the classic symptoms of PMS. The organ most susceptible to stagnation is the liver, which is responsible for the smooth flow of all chi in the body.

Tongue Diagnosis

Much information can be gleaned from looking at your tongue: from the quality of your blood to the strength of your liver to the challenges of your digestive system. It is one of the key tools in understanding all of these patterns. Tongue diagnosis is often the differentiating factor between two similar patterns.

Practitioners diagnose your patterns of imbalance by not only hearing what symptoms brought you in, but also by looking at your body, skin, hair, and nails, listening to the sound of your voice, listening to your pulses, palpating your organs and meridians, and looking at your tongue. Since you aren’t able to listen to your own pulses (it would take many years of practice before you could), the best way to self-diagnose patterns of imbalance is to make a list of the symptoms you are experiencing, categorize them based on the most common patterns presented in the following pages, and having a look at your tongue to match it to the pattern. The tongue diagnosis diagram is reflective of the most common patterns practitioners see. All of the information you gain from your symptoms and your tongue will mostly fit a single pattern but sometimes more than one.

The best way to begin diagnosing your tongue is to start having a regular look at it in the mirror. It’s best to do this in the morning before you have eaten and brushed your teeth or tongue. Notice your tongue’s general appearance, its shape and colors, and any coating it may have. Notice if there are cracks in the surface and, if so, where they are located. If you look at the underside of your tongue, there are two blood vessels, which should be full, blueish, and about an inch in length. Once you have gotten an idea of the general state of your tongue, check it once every week or two as you begin to apply changes to your diet and lifestyle and most certainly if/when you begin working with a Chinese medicine practitioner (changes to your tongue don’t happen rapidly).

Tongue diagnosis often includes descriptions such as light red, pink, pale, red, purplish, wet, dry, swollen, thin, teeth marks, red tip, white coating, yellow coating, cracked, or peeling. Each of these descriptions gives you information that guides you toward a pattern of imbalance diagnosis. A chart of the most common tongue patterns is provided for your reference.

Tongue Diagnosis: Which Tongue Are You?

The tongue is considered to be a map of the body’s major organs, from its base relating to the kidneys to its tip relating to the lungs and heart. Therefore, in addition to the descriptions of your tongue, a practitioner is also interested to see if there are changes to the tongue’s appearance in specific places. Notice that when the tongue map provided is flipped upside down, it follows the way the organs are situated in your body.

Tongue Map

Together, symptoms, tongue diagnosis, and a pulse picture (obtained from a practitioner) will guide you to the pattern of imbalance you are likely experiencing. The most common patterns of imbalance I see in my practice are listed in the tables by element.

Water Element Patterns
ORGANS	Kidney (Yin Organ)
PATTERNS	Yang Deficiency	Yin Deficiency
SYMPTOMS	Chills and aversion to cold; cold limbs; feelings of fear; bright pale complexion; asthma; apathy; lethargy; cold and sore lumbar region; cold and weak knees; loose stools, especially early morning (“cock’s crow diarrhea”); copious, clear urine; frequent urination; incontinence; edema; memory issues; ear and/or hearing challenges; spermatorrhea	Tired but wired, five palm heat (hands, feet, and face all hot), malar flush or red cheeks, night sweats, afternoon fever, constipation, dark urine, thirst, soreness in knees and lumbar region, low-pitched tinnitus, poor memory, dizziness, feelings of fear, sexual dysfunction (premature ejaculation and/or nocturnal emission), tendency toward addiction, chronic urinary tract infections (UTIs), ear and/or hearing challenges
TONGUE	Pale, flabby, with thin white coating	Red with little or no coating, likely cracked
HOW WE GOT HERE	Burned the candle at both ends. Began depleting kidney chi (milder experience of symptoms) and then kept going until cold signs began to appear. Kidney chi deficiency led to kidney yang deficiency.	Burned the candle at both ends. Overwork, overstimulation, stress, and even too much sex can lead to kidney yin deficiency. Often too much yang activity and not enough yin activity. Without the rest and restoration to balance yang, the body begins to burn up fluids and signs of heat increase.
WESTERN MEDICAL DIAGNOSES	Low sex drive, infertility, adrenal fatigue, chronic fatigue syndrome, hypothyroidism, polycystic ovary symptom (PCOS), menopausal symptoms, obsessive-compulsive disorder (OCD), tendency toward addiction, autoimmune conditions	PMS, low libido, attention-deficit disorder (ADD) or attention-deficit/hyperactivity (ADHD), autoimmune conditions, adrenal fatigue, chronic fatigue syndrome, insomnia, hyperthyroidism, menopausal symptoms, fibroids, infertility
NUTRITIONAL PRINCIPLES	Bitter Pungent Warming Tonifying Slightly astringent Avoid salty and cooling	Salty Neutral Slightly cooling Calming Moistening Avoid warming and astringent

Wood Element Patterns
ORGANS	Liver (Yin Organ)
PATTERNS	Liver Chi Stagnation	Liver Fire Blazing	Liver Blood Deficiency
SYMPTOMS	Emotionally backed up; irritability; constant sighing; moodiness; tendency toward addiction; constipation, diarrhea, or switching between the two; irritable bowel syndrome (IBS); allergies; pain; headaches/migraines (especially on the sides of the head and around the eyes); distention and pain in the chest and hypochondriacal region	Irritability; red face and eyes; angry outbursts; high-pitched tinnitus; dizziness; temporal headaches/migraines (especially on the sides of the head and around the eyes); thirst; bitter taste in the mouth; constipation; dream-disturbed sleep; dark, yellow urine	Blurry vision, floaters in the eyes, pale complexion, dizziness, pale lips, tight tendons, weak muscles, muscle spasms and cramps, brittle nails
TONGUE	Can be normal	Red body, redder sides, with a dry yellow coating	Pale, especially on the sides
HOW WE GOT HERE	Liver chi stagnation is due to holding on to the past, not forgiving, not expressing real feelings, and not moving on. These emotional symptoms begin to affect the physical body as the two cannot be separated. With liver chi stagnation, patients often complain and/or are negative much of the time because whatever happened to them in the past has been left unaddressed and now colors their world. Instead of expressing how angry/scared/sad they are about something, they complain (and sigh) a little each day to slowly release the pressure they have built up inside. Stress will exacerbate this pattern.	As a consequence of unresolved liver chi stagnation, significant heat signs and the pattern of liver fire blazing can develop. This pattern is unmistakable in its presentation of heat as it is a truly excessive pattern, and the heat signs are everywhere. There tends to be a lot of irritability and impulsiveness with this pattern.	Deficiency of protein in the diet and/or poor overall diet, sluggish or weak digestive system, blood loss due to hemorrhage, and long-standing kidney chi deficiency can all cause blood deficiency in the liver.
WESTERN MEDICAL DIAGNOSES	PMS, post-traumatic stress disorder (PTSD), depression, IBS, allergies, fibromyalgia, chronic fatigue syndrome, insomnia, low libido, infertility, PCOS, endometriosis, eating disorders, bipolar disorder	Irritability, bipolar disorder, acute trauma, PTSD, cold sores/herpes, constipation, insomnia	PMS, amenorrhea, anemia, dysmenorrhea
NUTRITIONAL PRINCIPLES	Sour Neutral Pungent Sweet Avoid warming	Cooling Bitter Moistening Calming Avoid warming and astringent	Blood-building Warming Tonifying Salty

Fire Element Patterns
ORGANS	Heart (Yin Organ)
PATTERNS	Heart Chi Deficiency	Heart Blood Deficiency	Heart Yin Deficiency	Heart Fire Blazing	Heart Phlegm Fire	Blood Deficiency	Blood Stagnation/Stasis
SYMPTOMS	Heart palpitations, fatigue, shortness of breath, spontaneous sweating, pale complexion, feelings of cold, a desire for warmth	Heart palpitations (more pronounced in the evening); poor memory; dream-disturbed sleep; feelings of being easily startled; dull, pale complexion; pale lips; dizziness	Heart palpitations, mental restlessness, feelings of being easily startled, poor memory, fever, hot flashes (more pronounced in the evening), night sweats, and five palm heat, dry mouth and throat	Heart palpitations, mouth and tongue ulcers, mental restlessness, agitation, impulsiveness, dream-disturbed sleep, bitter taste in the mouth, thirst, fever	Severe mental health imbalance, heart palpitations, restlessness, thirst, feelings of oppression in the chest, dream-disturbed sleep, agitation, confusion, red face	Dizziness, anemia, restless leg syndrome, problems with focus and concentration, musculoskeletal pain	Body aches (general or local), fixed pain, chest pain. For women’s health imbalances: fixed pain in the lower abdomen relieved by warmth; dark, clotted menstrual discharge; aversion to cold; late or absent period; back pain; diarrhea; vomiting; nausea; loss of appetite
TONGUE	Normal to slightly pale	Pale and slightly dry	Red with no coating, possible red tip or red spots	Red with a very red tip, possibly swollen with red spots, possible yellow coating and midline crack	Red with redder tip, swollen tip, thick yellow coating, often with a deep heart crack	Pale, otherwise normal (The blood vessels on the underside of the tongue may appear empty or be difficult to see.)	Purplish, dark or purple spots, possible swelling or distension of the blood vessels on the underside of the tongue
HOW WE GOT HERE	Often occurs after a period of chronic sadness or excessive negative emotions. Since the heart is the home of shen (spirit), emotions can significantly disrupt the heart’s function. If left unaddressed, this can turn into heart yang deficiency (more extreme coldness, more sweating, cold limbs).	Too much mental activity, overthinking, and worry combined with an insufficient diet turns the pattern of spleen chi deficiency to heart blood deficiency. Chronic worry and anxiety disturbs shen, which depresses the heart’s function and leads to a deficiency in the blood that moves through it. Severe hemorrhaging (such as in childbirth) can also cause heart blood deficiency.	Chronic anxiety, worry, and a busy lifestyle can damage the yin, dry up the body’s fluids, and eventually cause yin deficiency.	Trauma, chronic anxiety, constant worry, being in a state of fight-or-flight for a long time, and chronic depression can all lead to heart fire. The emotional aspect to this pattern leads to chi stagnation, and chronic stagnation leads to fire. Liver fire can often turn into or include heart fire signs. Therefore, any of the causes of liver fire (anger, resentment, or frustration) can also cause heart fire.	Trauma, especially emotional trauma (excessive and chronic worry, fear, shame, or guilt) along with a diet with excessive amounts of phlegm-inducing foods (dairy, sugar, greasy foods, alcohol) and/or overeating in general are usually responsible.	Since blood is formed out of food, an insufficient diet and chronic stress can often lead to blood deficiency. Most at risk are vegetarians or vegans, those on a restrictive or low-fat diet, and nursing mothers. Spleen chi deficiency can lead to blood deficiency via worry, overthinking, and anxiety. Liver chi stagnation can also lead to blood deficiency, especially when emotions go unexpressed.	Blood stagnation is a thickening or clotting of the blood in the body. A general achy feeling can arise from the area of stagnation, often from chronic inflammation of the body, usually from poor diet, stress, or an unhealthy lifestyle (like excessive alcohol or drugs). If left unaddressed, this can become blood stasis, which has fixed, stabbing pain.
WESTERN MEDICAL DIAGNOSES	Anxiety, blood pressure issues (mostly high, but sometimes low), tendency toward addiction, depression	Anxiety; depression, PTSD; blood pressure issues (mostly high but sometimes low); insomnia	Anxiety, high blood pressure, tendency toward addiction, insomnia	Anxiety, bipolar disorder, tendency toward addiction, high blood pressure, insomnia, cold sores	Anxiety, bipolar disorder, high blood pressure, insomnia	Insomnia, depression, anxiety, skin conditions (especially dryness), headaches/migraines, chronic fatigue syndrome, infertility, chronic pain, arthritis, women’s health imbalances (such as fibroids, PMS, midcycle spotting, amenorrhea, PCOS, and cycles longer than 35 days)	Pain, arthritis, fibromyalgia, endometriosis, PCOS, fibroids, acute trauma, mania, cancer, congestive heart failure
NUTRITIONAL PRINCIPLES	Warming Pungent Calming Avoid cooling and salty	Blood-building Calming Sweet	Bitter Neutral Moistening Calming Avoid salty and warming	Cooling Bitter Calming Moistening Avoid salty, sour, and warming	Cooling Bitter Astringent Calming Avoid moistening	Blood-building Tonifying Salty Sweet Avoid sour and pungent	Cooling Sour Bitter Avoid warming and astringent

Earth Element Patterns
ORGANS	Spleen (Yin Organ)
PATTERNS	Spleen Chi Deficiency	Spleen Yang Deficiency	Stomach Yin Deficiency	Rebellious Stomach Chi
SYMPTOMS	Little or no appetite, abdominal distention after eating, weakness and heaviness in limbs, sallow complexion, loose stools, nausea, stuffiness in chest and epigastrium	Lack of appetite, abdominal distention after eating, bright white or sallow complexion, weakness in the four limbs, loose stools (often with undigested food), aversion to and feelings of cold, edema	Stomachaches; little or no appetite; fullness after eating; slight fever or feelings of warmth, especially in the evening; dry mouth	Nausea, belching, hiccupping, lack of appetite, stomachaches, spontaneous sweating
TONGUE	Normal or pale with swollen sides; teeth marks; and a thin, white, sticky, greasy coating	Pale, swollen and wet with significant teeth marks, sometimes with a white coating	Red, peeling in the center	Possibly normal (This condition is often an acute experience or the progression of another pattern and may not affect the tongue.)
HOW WE GOT HERE	Excessive cold and raw foods, irregular and excessive eating, or eating lots of carbs and not a lot of protein combined with excessive mental activity and worry, overwork, and eating on-the-go (or while stressed) all deplete spleen chi. This is common in students and very active businesspeople. If left untreated, this deficiency can create dampness that leads to lumps, cysts, nodules, and in some cases, cancer.	When spleen chi deficiency is unaddressed, spleen yang energy is compromised, leading to an excess of yin symptoms (hence the edema, coldness, and so on).	Eating at irregular times, especially late at night before bed, or eating too quickly or while worrying can deplete stomach chi, over time burning up the stomach fluids and creating a yin deficiency.	Often this pattern develops due to overwork, stress, pregnancy, eating foods that are difficult to digest, a digestive system lacking in good bacteria (not enough probiotics), or as a response to stomach yin deficiency that has turned into stomach fire. A diet with foods that irritate you (but are not necessarily allergic to) also creates heat that burns up fluids. If left unaddressed, this deficiency can turn into stomach fire and blood stagnation in the stomach.
WESTERN MEDICAL DIAGNOSES	Anxiety, ADD/ADHD, IBS, leaky gut syndrome, gas and bloating, diarrhea, asthma, fatigue, chronic fatigue syndrome, fibroids, infertility, PCOS, OCD, yeast/Candida infections, cancer	Anxiety, eating disorders, leaky gut syndrome, diarrhea, yeast/Candida infections, fatigue	Anxiety, constipation, heartburn, stomach ulcers	Nausea/vomiting, heartburn, anxiety
NUTRITIONAL PRINCIPLES	Sweet Neutral Warming Slightly astringent Avoid moistening and cooling	Warming Bitter Pungent Slightly astringent Avoid cooling and salty	Slightly cooling Moistening Neutral Sweet Avoid sour and warming	Sweet Neutral Salty Calming Avoid pungent and sour

Metal Element Patterns
ORGANS	Lung (Yin Organ)
PATTERNS	Lung Qi Deficiency	Lung Yin Deficiency	Damp Heat in the Large Intestine	Heat and Dryness in the Large Intestine
SYMPTOMS	Grief; shortness of breath upon exertion; weak cough; thin, watery sputum; weak voice; lack of desire for speaking; spontaneous sweating; aversion to cold; bright white complexion; smoking addiction	Dry cough or cough with sticky sputum, dry mouth and throat, grief, hoarse voice, low-grade fever or heat sensation in the evening, malar flush, night sweats, five palm heat	Stomachaches; intestinal cramps; urgent diarrhea; mucus and/or blood in the stool; foul-smelling stools; burning anal sensation (especially after a bowel movement); scanty and dark urine; long-standing grief; fever; spontaneous sweating; thirst (not necessarily a desire to drink); heavy sensation in the body and limbs	Long-standing grief, constipation, dry stools, emotional “backup,” slight fever, scanty and dark urine
TONGUE	Pale or normal	Red, peeling with cracks in the lung area (late stage)	Red body, sticky yellow coating	Thick yellow coating (possibly dark)
HOW WE GOT HERE	Unresolved grief, especially carried down through the family, can lead to lung chi deficiency. Children who grew up in a smoking household often wind up with this pattern. Chronic use of antibiotics, especially at a young age, depletes the lung chi and wei qi.	If left unaddressed, lung chi deficiency and stomach yin deficiency can develop into lung yin deficiency. Additionally, due to the relationship between the lungs and kidneys in Chinese medicine, chronic overwork and adrenal fatigue (kidney yin deficiency) can lead to this pattern.	Consuming too many hot and greasy foods or foods with bacteria the body doesn’t know how to handle can lead to this pattern. Unprocessed grief, relentless worry, and anxiety can also lead to damp heat in the large intestine. When there is an emotional component (almost always), there may be liver chi stagnation as well.	Unprocessed grief and other emotions can lead to this pattern. Children and adults who had difficult childhoods often wind up with constipation due to heat and/or dryness in the bowels. Constant stress burns up the fluids in the body, and the inability to express feelings constricts the bowels. This can also happen from overconsumption of hot and astringent foods.
WESTERN MEDICAL DIAGNOSES	Allergies, asthma, skin conditions, chronic or recurrent colds and flu	Allergies, asthma, skin conditions, chronic or recurrent colds and flu, chronic fatigue syndrome, insomnia, tendency toward addiction (especially to smoking)	Diarrhea, IBS	Constipation
NUTRITIONAL PRINCIPLES	Pungent Tonifying Moistening Warming Avoid cooling	Slightly cooling Moistening Sweet Neutral Avoid warming and astringent	Sour Astringent Cooling Avoid moistening and sweet	Moistening Slightly cooling Pungent Sweet Salty Avoid astringent and warming

As you can see, there are many overlapping patterns. For instance, allergies are listed under multiple patterns. This is why Chinese medicine is so unique: no two people are ever treated exactly the same, even if they have the same Western medical diagnosis. Someone with allergy symptoms could likely be diagnosed with either lung chi deficiency or liver chi stagnation as the pattern behind the symptoms, and the treatment strategies will be entirely different. Even two people who both present with lung chi deficiency will be treated differently. One person may have asthma, whereas the other may have a cough and eczema. These two people will be treated and given dietary feedback and practices that are radically different from one another.