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In early times, the Chinese people recognized that wood, fire, earth, metal and water were indispensible in their daily lives as well as having different natures. For instance, the character of wood is to grow and flourish, the character of fire is to be hot and flare up, the character of earth is to give birth to all things, the character of metal is to descend and be clear, and the character of water is to be cold and to flow downwards.

Early doctors applied the theory of the five elements in their extensive study of the physiology and pathology of the zang-fu organs and tissues of the human body, and indeed all phenomena in the natural world that were related to human life. Using analogy, they classified all these, according to their nature, function and form, into the five elements. They applied this theory to explain the complicated physiological and pathological relationships between the zang-fu organs, and between the human body and the external environment. This classification of phenomena was minutely described in the fourth and fifth chapters of Plain Questions. The classification of the meridians according to the five elements is based on the nature of the zang-fu organs:

As for the pericardium and sanjiao, the ancient Chinese considered that the pericardium is a protective membrane surrounding the heart, and prevents the heart from being invaded by pathogenic factors. Since the heart pertains to fire, the pericardium also pertains to fire.

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