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Coupled with the theory of yin-yang, the theory of the five elements was another part of the interpretation of natural phenomena that originated in ancient China. It reflected a primitive concept of materialism and dialectics and played an active role in promoting the development of natural science in China. Ancient physicians applied the theory to the field of medicine, greatly influencing the formation and development of the theoretical system of traditional Chinese medicine, and guiding clinical work up to the present time.

The five elements refer to five categories in the natural world, namely wood, fire, earth, metal and water. The theory of the five elements states that all phenomena in the universe correspond in nature either to wood, fire, earth, metal or water, and that these are in a state of constant motion and change. The theory of the five elements was first formed in China at about the time of the Yin and Zhou dynasties (16th century - 221 B.C.). Historically it derives from observations of the natural world made in early times by the Chinese people in the course of their lives and productive labour. Wood, fire, earth, metal and water were considered to be five indispensible materials for the maintenance of life and production, as well as representing five important states that initiated normal changes in the natural world. As said in A Collection of Ancient Works: "Food relies on water and fire, Production relies on metal and wood. Earth gives birth to everything. They are used by the people."

Although having different characteristics, the five materials depend on each other and are inseparable. Thus in ancient times, people took these five elements with their mutual relationships to explain all phenomena in the natural world. The primitive concept of the five elements was later developed into a more complex theory, which together with the theory of yin-yang, served as a conceptual method and a theoretical tool for understanding and analysing all phenomena, and ran through various academic classics in ancient times. In traditional Chinese medicine the theory of the five elements is applied to generalise and explain the nature of the zang-fu organs, the inter-relationships between them, and the relation between human beings and the natural world. It thus serves to guide clinical diagnosis and treatment.

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