The functions of the internal organs and the abnormal changes in their mutual relationships are manifested in the patient's complexion, voice, taste preference, and pulse conditions. The Classic of Questions (originally named Eighty-One Medical Problems of the Yellow Emperor, it is a book of questions and answers explaining traditional Chinese medical problems) points out: "To acquire information through visual inspection means to pinpoint the nature of the disease by observing the `five colors' of the patient. To acquire information through listening means to differentiate the disease by listening to the 'five tones' of the patient. To acquire information through inquiry refers to the possibility of determining the cause and location of the disease by asking about `five tastes' the patient prefers. To acquire information through the taking of pulse is in-tended to differentiate the conditions of deficiency and excess and determine in which organ the disease is located."
Traditional Chinese medicine uses the theory of the five element to interpret information acquired through the observation, auscultation, interrogation and pulse taking. For example, a green tinge in the facial complexion, a preference for sour food and a taut pulse indicate liver trouble. Or, a florid complexion, a bitter taste in the mouth and a bounding pulse suggest hyperactivity of heart fire. An apparent deficiency of the spleen, accompanied by a bluish facial complexion, indicates that the liver (wood) is overacting upon the spleen (earth). A patient with heart disorder has a dark facial complexion, indicating that the water (kidney) is overacting upon the fire (heart).
The development of a disease is often related to the relation ship of mutual promotion and restriction between the internal organs.In treatment, therefore, in order to prevent the spread of the disorder, not only should the diseased organ be attended to, but also the related organ. The Classic of Questions points out: "Liver disease may spread to the spleen, so the strategy to forestall transmission is to tone the spleen." This approach accords with the theory of the five elements. Practitioners of later generations have formulated a number of particularly detailed therapeutic methods, such as those to strengthen earth (spleen) to promote metal (lung), replenish water (kidney) to benefit wood (liver), sustain earth (spleen) to check wood (liver), and strengthen water (kidney) to inhibit fire (heart).
In summary, the theories of yin-yang and the five elements form the philosophical foundation and methodology of traditional Chinese medicine. The theory of yin-yang describes the change and development of matters by studying their two mutually opposite yet complementary aspects. The theory of the five elements studies the nature of matters and phenomena, as well as their interrelations, proceeding from the categorization of their attributes in line with the law of mutual promotion and restriction, as well as subjugation and reverse restriction between the five elements.
In clinical practice, the theories of yin-yang and the five elements are inseparable, i.e. when one talks about yin and yang, one cannot neglect the five elements, or vice versa. For instance, when the functions of zang-fu organs are discussed, the zang organs are attributed to yang, while the fu organs are attributed to yin. However, when the function of each organ is analyzed, the changes of yin and yang of the given organ are bound to affect the changes of yin and yang of the related organs, because the organs, corresponding to the five elements separately, have the relationships of mutual promotion and restriction. For example, hyperactivity of liver yang is often caused by the deficiency of kidney yin.
The combination of the theories of yin-yang and the five element serves not only to explain the relationships between the two conflicting aspects of yin and yang within all matters, but also illustrate the more complicated interdependent and mutual restraining relationships between matters, and in this way helping explain the sophisticated life phenomena and pathological processes.
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