The Five Elemental Phases are always in a delicate balance. The Yellow Emperor's Classic

Dear Qi Gong Practitioner,

Which of the Five Elements - Wood, Fire, Earth, Metal or Water - surges most strongly within you? The following questionnaire will help you determine the relative strengths and weaknesses of your affinities with the Five Elements. Answer with Yes if the statement describes your present-day condition or a predictable pattern you have experienced in the past.

Because an affinity to a particular element or an imbalance within that element may be expressed in a wide range or sometimes opposing symptoms.

After finishing the questionnaire, you will learn what your responses indicate about your affinities to Wood, Fire, Earth, Metal or Water.

Please schedule about 20 to 25 minutes to answer each of the 150 questions, in order to get the most accurate response.

Thank you for your patience!



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1. Muscular, athletic physique, well-proportioned body (arms, legs, head). Rough skin. Jaw and chin dominate the face, fingernails tend to split, peel and crack easily
2. Oily skin (especially around the face, nose and scalp). A subtle greenish color around the eyes and mouth
3. High-pitched ringing in the ears
4. Blurred vision. Dry, red, itchy or teary eyes
5. Difficulty swallowing (especially when tensed)
6. Chronic tension in the neck or shoulders
7. Menstrual problems (strong painful cramps, erratic cycles, PMS with mood swings)
8. Twitches in the muscles of the eyes, face, calves, or feet
9. Digestive disturbances (heartburn, constipation or ulcer), Abdominal pains
10. High blood pressure
11. I tend to feel confident about my abilities, I tend to do what I feel is right, I don’t care about what others might think
12. I enjoy competition. People say I am competitive, I feel I want to win at any cost
13. I am comfortable in conflict or under pressure
14. I can be stubborn, I can be impulsive
15. I like to take the lead
16. I like to think about creative solutions for difficult problems
17. I tend to make irrational decisions
18. I am willing to stick with the initial plan even if the odds are not in my favor
19. I am direct and straightforward in dealing with others, even if that means to be regarded as insensitive
20. I tend to be critical of others, especially when I don’t understand why they can’t keep up with me