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The Twelve Officials and the Causative Factor of Disease

Five Elements Acupuncture

For thousands of years, the Chinese observed Nature’s rhythms and cycles through the model of the Five Elements: Wood, Fire, Earth, Metal, and Water. These elements are in everything, everyone, and observable in any process.

The Officials

Within human beings, each of twelve fundamental organs and functions is associated with a specific element. The Heart, Small Intestine, two functions known as the Heart Protector (AKA “Pericardium”), and Three Heater (AKA “Sanjiao”) are associated with the element Fire. The Stomach and Spleen are associated with Earth, Lungs and Colon with Metal, Urinary Bladder and Kidney with Water, and Gall Bladder and Liver with Wood. 

We call these organs and functions “Officials,” because they are more than physical entities, as understood in the Western medical model, with only physiological tasks to do, but as “beings” so to speak, with definitive physical, mental, and spiritual expressions. The early Chinese conceptualized these Officials as ministers of an imperial court, in service to the monarch and to the well-being of all. It is important to remember that the kingdom is, in reality, a metaphor for the totality of the body, mind, and spirit of a human being. As in the metaphor, the well-being of the whole kingdom depends on the healthy, smooth, and harmonious working of the Officials. If an element becomes imbalanced and falls sick, the functioning of its associated Officials will also be imbalanced, and will inevitably upset the functioning of every other Element and Official, as all are related like a family or team. 

The Causative Factor

Every human being is born with or develops early in life, an imbalance in the natural functioning of the Five Elements, with one element, and its associated Officials, being the primary source of the imbalance. This primary imbalanced element, called the Causative Factor (AKA “CF”), is the weak member of the team and is the root cause of a person’s illnesses of body, mind, and spirit. The concept is as old as Oriental medicine itself. The ancient Chinese medical text, the “Ling Shu”, the second half of the “Yellow Emperor’s Classic of Internal Medicine” and written some 2000 years ago, discussed (Ch. 64) the diagnostics of five main types of people corresponding to the Five Elements, including the concept of each element having, within itself, further expressions of all five. 

Throughout our lives, the CF does not change from one element to another, regardless of how symptoms change with time. The intensity of expression of the primary imbalance and the labelled symptoms may vary, according to the state of an individual’s health, but the underlying imbalance or predisposition is ours for life. Therefore, the thrust of the Five-Element treatment is to help, support, and restore the balance of the CF in the exact way needed by each unique and individual patient. In this way, symptoms, which are only the expression of the underlying imbalance, resolve naturally. When we properly treat the CF, all of the symptoms in every affected system and at every level must change for the better, provided the disease has not progressed beyond the reach of Nature to reverse. 

The Four Diagnostic Pillars

The moment an imbalance occurs in any of the elements, Nature gives us four clear and distinct signs. The odour emitted by the body will take on a characteristic smell. The color in certain areas of the face will change and certain colours will predominate. The sound of the voice will change and certain sounds will be inappropriately expressed or strangely absent. The emotions will change and, like the voice, will similarly over or under express. Each of the elements has a corresponding odor, color, sound, and emotion with which it is associated and which can be perceived when the particular element is the Causative Factor. With a Fire CF, the odor is scorched, the color red or lack of red (ashen gray), the sound laughing or lack of laughing, and the emotion joy or lack of joy. With Earth, the odor is fragrant, the color yellow, the sound singing, the emotion excess or lack of sympathy. With Metal, the odor is rotten, the color white, the sound weeping, and the emotion grief or lack of grief. With Water, the odor is putrid, the color blue, the sound groaning, and the emotion fear or lack of fear. With Wood, the odor is rancid, the color green, the sound shouting or lack of shouting, the emotion anger or lack of anger.

While it is relatively easy to memorize the associations, developing the skills to truly see, hear, feel, and smell these imbalances requires focused study, practice, and skilled guidance. Regardless of the presenting symptoms, it is only by odor, color, sound, and emotion that the Causative Factor is determined. When we perceive at least 3 of these 4 sensory indicators –the diagnostic pillars -pointing to one element, we know that element is the Causative Factor. 

Whether practicing Five-Element acupuncture or not, having a sense of a patient’s CF provides tremendous insight into a person’s process. It makes it more possible for us, as practitioners, to separate the disease process from the authentic, unique, and essential being who is experiencing the disease. It gives us answers as to “why” a patient behaves as he or she does. It increases our ability to feel genuine love and compassion. It gives us insight on how to “be” with each patient so that each feels truly heard and understood. Most importantly, these qualities of connection at the spirit level can be more healing than even the best of treatment by physical means alone.

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