Five-element theory was developed in acupuncture in China. It was then passed to Japan, Korea and then to the UK. After that, its concept and its application in the diagnosis and treatment of diseases have been changed dramatically. The UK's Five-element acupuncture system (hereafter known as Nora Five-element acupuncture) depends on a patient’s life story, voice, skin color and the smell/odor of the body in setting up a diagnosis for the dominant element of the body (e.g. one of the five elements: Wood, Fire, Soil, Metal and Water).

In treatment, the method emphasizes the personal relationship between the acupuncturist and the patient. The acupuncture is used as a complementary means of treatment and is used mostly to nourish the dominant element of the body, and to conduct the meridian energy from other meridians to the dominant element meridian, not caring for the various relationships among the elements (such as nourishing, restraining, reverse restraining, etc.).

Before a typical Five-element acupuncture treatment, some other clinical conditions have to be treated first, such as Attached body, Aggressive body energy, Blockage of energy flow between meridians, Unbalanced pulse (Left-right unbalance), scar tissue blockage, etc. The diagnosis and treatment of these conditions mostly has nothing to do with the Five-element theory. Therefore, we predict that the diagnosis of this acupuncture system is difficult to be accurate. It requires a very high personal ability from the acupuncturist (communication skills, the sense of body language, skin color and body odor, the willingness to come into patient’s emotional life, etc.). The placebo effect might take large part of the whole healing effect. The so-called Five-element is only a small part of the whole acupuncture treatment.  Furthermore, the treatment of various disease conditions, and the improvement of the symptoms after the treatment, could enhance the placebo effect and also tend to let the acupuncturist believe that the previous diagnosis of body-dominated element is correct.

During the so-called Five-element acupuncture course, the choice of many acupuncture points is not related to the Five-element theory. This acupuncture system is recommended mostly for the treatment of emotionally oriented issues, not for physically oriented or “out-oriented” diseases, so the favorite disease spectrum is narrow. Because there are so many differences between this UK Five-element acupuncture and the Traditional Five-element system in China, we recommend the launch of a clinical comparison study, to see if such modified acupuncture techniques could really contribute to the treatment of emotional issues, with or without the strongly recommended, very good personal relationship between acupuncturist and the patient, and with or without care of the mutual nourish-restrain relationship between the elements.