Published on 2025.10.24

How does TCM explain human constitution

(Part 2: The Five Elements Theory on Body Constitution)

The concept of body constitution in Traditional Chinese medicine began with the theory of yin and yang, and was developed and extended by the theory of the Five Elements, which gave a more detailed description of the morphological characteristics, physiological functions, environmental adaptability, and pathological symptoms of the human body. The Five Elements (wood, fire, earth, metal, and water) not only represent the basic elements of all things and the law of movement in the universe, but also form the theory of the Five Elements constitution.Through the relationship of promotion, restriction, subjugation and violation of the Five Elements, TCM doctors can analyze the different body constitution, disease development, and treatment instructions. The Five Elements Theory can be used to explain the human body constitutions originated from the ancient book of traditional Chinese medicine "The Yellow Emperor's Neijing Lingshu: Yin and Yang Twenty-five People黃帝內經 靈樞:陰陽二十五人", which divides people into five categories according to the Five Elements: wood, fire, earth, metal, and water, and then subdivides into 5 x 5 types according to the Five Tones (Jiao, Zheng, Gong, Shang, and Yu角徵宮商羽), with a total of 25 types of constitutions, and outline the details the body functions, personality, disease tendencies, and treatment methods of each constitution. "The Yellow Emperor's Inner Classic, Suwen: The Great Treatise on the Correspondences Between Yin-Yang and Phenomena 黃帝內經 素問:陰陽應象大論" corresponds the Five Elements (wood, fire, earth, metal, and water) to the Five Internal Organs (liver, heart, spleen, lungs, and kidneys), the Five Emotions (anger, joy, thinking, sadness, and fear), and the Five Body Structures (tendon, vein, muscle, skin, bone), etc., and establishes the physiological and pathological models of the five types of constitutions and the characteristics of the constitutions.

Wu Xing

wood

fire

earth

gold

water

Five Zang

liver

heart

spleen

lungs

kidney

Five Fu

gall bladder

small intestine

stomach

large intestine

urinary bladder

Five senses

eye

tongue

mouth

nose

ear

Five body-structure

sinew

vessel

muscle

skin

bone

Five flavors

sour

bitter

sweet

laborious

salty

Five colors

green

red

yellow

white

black

Five tones

Jiao

Zheng

Gong

Shang

Yu

Five emotions

anger

joy

think

sad

fear

Five seasons

spring

summer

Long summer

autumn

winter

2. The morphological characteristics, psychological characteristics, physiological functions, environmental adaptations and common pathological symptoms of the Five Elements constitution.

2.1 Wood-typed people (liver system).

Physical characteristics: tall and thin, pale complexion, pointed head and long face, broad shoulders and straight back, flexible joints

Psychological characteristics: quick thinking, mood swings, happy when liver is smooth, happy when liver is peaceful, and angry when liver is depressed

Physiological function: the liver is drained, the qi is unobstructed, the tendons and veins are strong, and the limbs are flexible

Pathological symptoms: liver depression and qi stagnation, liver fire inflammation, endogenous wind stirrind in the liver, liver blood deficiency

Environmental adaptation: like spring and hate autumn, afraid of wind and dryness

 

Wood-typed people (nourish the liver, eat green and sour food)

Dietary therapy (liver depression and qi stagnation, liver fire inflammation, endogenous wind stirrind in the liver, liver blood deficiency)  

  • The manifestations of liver depression and qi stagnation are distension, sighing, and depression, and you can use rose and tangerine peel tea, or depression relieving three-flower tea (roses, Albiziae flower, jasmine) to soothe liver and regulate liver qi.
  • The manifestations of liver fire inflammation are red eyes, bitter mouth, and headache. You can used gardenia and mung bean porridge or prunella vulgaris, chrysanthemun and mulberry leaves tea to clear the liver fire.
  • The manifestations of endogenous wind stirrind in the liver are dizziness, tremor, and convulsions. You can use gastrodia stew fish head with chrysanthemum and cassia seed tea to stop the liver wind.
  • The manifestation of liver blood deficiency are dry eyes, dry claws, and low menstrual flow in women. You can use pork liver porridge or angelica wolfberry chicken soup to replenish liver blood.
 

 

2.2 Fire-typed people (heart system).

Physical characteristics: sharp at the top and broad at the bottom, plump shoulders and back, rosy skin, flexible and strong hands and feet.

Psychological characteristics: enthusiastic and outgoing, impulsive and impatient, easy to feel happy and angry, and high creativity.

Physiological function: the heart governs the blood vessels, blood circulation is vigorously. Sweat is the fluid of the heart, which is sensitive to heat and metabolism is fast, and is easy to discharge.

Pathological symptoms: heart yang deficiency, insufficient heart blood, hyperactivity of heart fire, phlegm and fire disturbing the heart, and heart blood stasis.  

Environmental adaptation: like summer and hate winter, afraid of heat and dislike cold.

Fire-typed people (nourish the heart, eat red and bitter food)

Dietary therapy (heart yang deficiency, insufficient heart blood, hyperactivity of heart fire, phlegm and fire disturbing the heart, and heart blood stasis)

  • The manifestations of heart yang deficiency and insufficient heart blood are palpitations, forgetfulness, insomnia, chills and cold limbs, and pale complexion. You can use red dates and longan porridge, dried ginger, cinnamon and mutton soup, and astragalus beef soup to warm and replenish the heart yang, nourish the heart blood, in order to relieve palpitations, insomnia and chills.  
  • The manifestations of hyperactivity of heart fire are mouth and tongue sores, restlessness and insomnia, red face and yellow urine. You can use lotus seed core, bamboo leaf core, mung bean soup to detoxify and reduce heart fire.
  • The manifestations of phlegm fire disturbing the heart are irritability, phlegm yellow and sticky. You can use kelp, winter melon soup, light bamboo soup, pear and lily juice, etc. to dissolve phlegm and reduce fire. 

 

2.3 Earth-type people (spleen system).

Physical characteristics: large head and round face, yellowish skin, thick body, plump muscles, small hands and feet.

Psychological characteristics: gentle and introverted, not fond of change, stable thinking, down to earth, patience and perseverance.

Physiological function: the spleen is responsible for transportation and transformation, digestion and absorption of food, plumps muscles, and coordination of limb functions, which directly affects physical fitness.

Pathological symptoms: spleen qi deficiency, spleen yang deficiency, cold and dampness trapped in the spleen, damp and heat accumulating in the spleen.

Environmental adaptation: like long summer and hate spring, fear dampness blocking spleen.

Earth-typed people (nourish the spleen, eat yellow and sweet food) 

Diet therapy (spleen qi deficiency, spleen yang deficiency, cold and dampness trapped in the spleen, damp and heat accumulating in the spleen)

  • The manifestations of spleen qi deficiency are loss of appetite, abdominal distension and loose stools, fatigue, and yellowish complexion. You can use yam, lotus seed and rice porridge to replenish qi and strengthen the spleen.
  • The manifestations of spleen and yang deficiency are cold pain in the abdomen, prefer warmth and massage, avoid cold and cold limbs , and indigestion. You can use dried ginger, red dates, brown sugar drink or cinnamon and mutton stew to strengthen the spleen and warm yang.
  • The manifestations of cold and dampness blocking the spleen are abdominal distension, bland mouth and no thirst, heaviness in head and body, nausea and vomiting, and sticky stool. You can use coix seed, poria, rice and ginger porridge to dispel cold and dampness.
  • The manifestations of damp heat and spleen are nausea, bitter and sticky taste in the mouth, and sticky stools. You can use red bean, winter melon and coix seed soup to cool heat and remove dampness.

bitter and sticky mouth, and sticky stool.


 

2.4 Metal-typed people (lung system).

Physical characteristics: square and pale face, broad and flat shoulders and back, fine and soft hair, obvious skeleton, square hands and feet.

Psychological characteristics: principle-oriented, slightly rigid, sensitive to things, self-disciplined and well-organized.

Physiological functions: The lungs controls qi, and the respiratory function, protects of the body, resists external pathorens, and moisturizes the skin and hair.

Pathological symptoms: lung qi deficiency, lung yin deficiency, wind-cold restraining the lung, wind-heat attacking the lung, phlegm dampness obstruction of the lung.

Environmental adaptation: like autumn and hate summer, fear dampness and and love coolness.

Metal-typed people (nourishing lungs, eat white and spicy food)

Dietary therapy (lung qi deficiency, lung yin deficiency, wind-cold restraining the lung, wind-heat attacking the lung, phlegm dampness obstruction of the lung)

  • The manifestations of lung qi deficiency are shortness of breath and low voice, self-sweating and fear of wind, pale complexion, and susceptibility to colds. You can eat astragalus, yam, and rice porridge to strengthen lung qi.   
  • The manifestations of lung yin deficiency are dry cough with little phlegm, dry throat and mouth, hot flashes and night sweats. You can use lily, ophiopogon and tremella soup to nourish yin and reduce deficiency heat.   
  • The manifestations of wind-cold bundle lungs are cough with white phlegm, nasal congestion and runny nose, averrsion to cold and no sweating. You can use ginger, red dates and scallion soup to relieve the symptoms and dispel the cold. 
  • The manifestations of wind-heat attacking the lungs are cough with yellow phlegm, sore throat, thirst, fever, and aversion to wind. You can drink mulberry leaf, chrysanthemum and mint tea to relieve the symptoms and clear away heat.
  • The manifestation of phlegm and dampness obstruction of the lung are cough with a lot of phlegm, chest tightness and shortness of breath. You can drink tangerine peel, poria and rice porridge to eliminate phlegm and dry dampness.
 

2.5 Water-typed people (kidney system).

Physical characteristics: dark complexion, round face and wide chin, fat body with large skeleton, plump waist and hips, large hands and feet, and thick hair.

Psychological characteristics: resourceful, good at thinking and observing, gentle personality, adaptable, secretive, and focused on self-cultivation.

Physiological functions: kidney store essence, control body water, bones and marrow, growth and development, reproduction and those functions are related to kidney qi.

Pathological symptoms: kidney yang deficiency, kidney yin insufficiency, and kidney essence insufficiency and kidney qi is not solid.

Environmental adaptation: like winter and hate spring, fear dampness and and love coolness.  

Water-shaped people (nourish kidney, eat black and sour food)

Dietary Therapy (kidney yang deficiency, kidney yin insufficiency, kidney essence insufficiency, and kidney qi is not solid)

  • The manifestations of kidney yang deficiency are cold pain in the waist and knees, fear of cold extremities, frequent urination at night, and decreased sexual function. You can eat mutton, cinnamon, ginger soup and fried shrimp with walnut kernels to warm up the kidney yang. 
  • The manifestations of kidney yin deficiency are soreness in the waist and knees, hot flashes and night sweats, five heart irritability, dry throat and red tongue. You can eat black sesame glutinous rice paste or yam and turtle shell soup to nourish kidney yin and reduce deficiency heat.
  • The manifestations of kidney essence deficiency are stunting, premature aging, forgetfulness, hair loss, tooth shaking, and infertility. You can eat black chicken stewed with placenta and black beans to nourish and replenish the kidney essence.
  • The manifestations of kidney qi instability are spermatorrhea, frequent urination and incontinence, thin vaginal discharge, and easy fetal movement. You can eat euryale ferox and lotus seed porridge to consolidate kidney qi.
3. Summary

The yin-yang theory of TCM believes that the balance of the physiological and functional states of the human body determines whether the body is healthy or not. The Five Elements Doctrine (Wood, Fire, Earth, Metal, Water) is a TCM explanation of the composition of the human body and its interactions. Through the mutual generation and mutual restraint of the Five Elements, we can systematically analyze the tendency of physical constitution, the direction of disease occurrence and conditioning, and give corresponding suggestions on health care, diet and drug treatment, so as to promote the goal of health.

Dr. CHENG Lee Chuen

Education: PhD Guangzhou University of Chinese Medicine, PhD Shanghai University of Finance and Economics, Master of Traditional Chinese Medicine from the Chinese University of Hong Kong, Master of Business Administration from York University in Toronto Canada, Bachelor's degree from York University in Toronto Canada, and Higher Diploma in Tradition Chinese Medicine from the University of Hong Kong.
Professional qualification: Registered Chinese medicine practitioner in Hong Kong.
Work experience: Served as editor-in-chief of the Great China Chinese Medicine Website, lecturer of Chinese medicine courses in university educational institutions, lecturer of business administration courses in university, and registered Chinese medicine practitioner in clinics.
Research projects: Participated in university's market research on traditional Chinese medicine and health care products, and traditional Chinese medicine online model VR/AR teaching material development projects.
Publications/Books: Contents include articles such as “a literature discussion on Jingui Shenqi Pills〈金匱腎氣丸論述〉”, “research on consumer value and brand strategy of traditional Chinese medicine health products”, and “research on the impact of brand sensitivity of traditional Chinese medicine health products on consumers purchasing decisions” etc.


All articles/videos are prohibited from reproducing without the permission of the copyright holder.

Welcome to leave a message:
Please Sign In/Sign Up as a member and leave a message