All traditional Asian medical theories describe constitutional types, indicating possible predispositions toward physical and emotional states. One organizing principle for determining a type is the Five Elements, in which possible types include Fire, Earth, Metal, Water, and Wood. For example, a Fire-type person would be expected to have more problems involving the Fire element.

This method is called a "shorthand" approach because some Asian doctors observe the hands in order to perceive certain health problems. The idea is that a part of the body (usually the hands, nose, ears, or tongue) can represent a microcosm of the whole body. A Chinese herbalist may, for example, inspect your fingernails. They feel that a healthy pink color under the nails indicates adequate blood production and circulation. If the nail has crosswise grooves or ridges, the Chinese doctor may suspect you have weak nails from liver problems leading to poor absorption of calcium. Blood deficiency and poor calcium absorption indicate problems with the Wood element. With this information, the herbalist would continue to clarify the observations, using other methods of diagnosis, and finally make a prescription of herbs to correct the imbalance.

The Fire Person	The Metal Person	The Wood Person
Fire Hand: A long hand, with longer flexible fingers, small finger bent inward or hooked, convex, oval-shaped nails. Excess yang is red and warm. Excess yin is pale and cold. Passionate, sentimental Fire persons often wear red nail polish or talk with their hands. Read more	Metal Hand: A long hand, with long palm, knuckles like a knot in a tree, double-jointed or crooked fingers, rectangular nails with vertical lines. Often seen wearing many rings or elegantly lighting a cigarette. Read more	Wood Hand: An evenly proportioned size and shape, with many lines on palms and ventral fingers. Excess yang is reddish, dry, with thick grooves and nails. Excess yin is cold, clammy, pale, possibly tingling or numb. Fragile or horizontal indicate poor Nervous or emotional Wood persons often bite their nails. Read more...
The Water Person	The Earth Person	Combinations of Elements
		Our energy always involves more than one element. For that reason we are often made up of more than one type. It's fun to conjecture what certain combinations might produce. For example, a combination of Wood and Metal might read, "I'd rather do it perfectly myself!" Metal and Fire might produce the statement, "Things get emotional in my ivory tower!" Fire and Wood: "If I don't get my way, I'll scream!" or "I have to work out every last detail to the letter or I get upset." Read more
Water Hand: A short, fleshy hand. If you pinch loose skin on top of the hand or at the knuckles, it stays puckered. Nails are short, thin, or turn under with weakness; cuticle area is dark. Read more	Earth Hand: A short, pear-shaped hand, with square palm with thick base, sausage fingers, flat triangular nails. Often seen reaching into cookie jars. Read more

Another variation comes from the work of Dr. Yves Requena, a French endocrinologist, trained in traditional Chinese medicine and ancient palmistry.

According to this theory, physical tendencies and personality are given shape by each of the Five Elements. We can determine the constitutional type by observing the shape and markings of hands and fingernails. I modify that approach some-what, depending upon circumstances; for example, nail polish and false fingernails interfere with the interpretation.

The shape of the hand is its most outstanding feature. That determines its element.

Internal heat makes the hand feel warm and look dry, red, and scaly. Internal cold makes the hand cold and pale. Dampness makes the hand feel clammy. And stagnation makes the hand look purplish.

When reviewing the drawings, keep in mind that the person with a Fire hand would be expected to have more Fire-related symptoms, the Wood person to have Wood symptoms, and so on.

A person often comprises more than one constitutional type, according to the Five Elements. We might, for example, have a hand that shows both Earth and Metal elements. It takes some practice to become adept at this form of diagnosis, and it should be combined with other methods.