Romantic, rejuvenating, cathartic, relaxing, energizing, empowering: music has touched these emotional chords in human beings for thousands of years. In ancient China, physicians developed a systematic approach of incorporating musical notes into the healing process.
The use of music as therapy is documented in China’s first medical text, The Yellow Emperor’s Classic of Medicine, written 2,300 years ago. Music therapy is an aspect of Five-Element theory, which is foundational to traditional Chinese medicine. All things in nature are composed of the elements of earth, water, fire, metal and wood. Each of these elements has many corresponding aspects, such as season of the year, internal organ, color, musical note, etc. Classical Chinese music was composed from five notes or sounds — jiao, zhi, gong, shang, and yu — and was performed on classical Chinese musical instruments such as drum, gong, flute and zither. Chinese medicine uses the relationship between internal organs and five-element correspondences, such as musical notes, to achieve different healing purposes.
According to this theory, the “jiao” note (corresponding to E in Western musical notation) belongs to the wood element, is the sound of spring, and influences the Liver. It promotes the smooth functioning of Liver Qi, helping to relieve depression. The “zhi” note (corresponding to G) belongs to the fire element, is the sound of summer, and influences the Heart. It helps to nourish the Heart and invigorate blood flow. The “gong” note (corresponding to C) belongs to the earth element, is the sound of late summer, and strengthens the Spleen. The “shang” note (corresponding to D) belongs to the metal element, is the sound of autumn, and protects and nourishes Lung yin. The “yu” note (corresponding to A) belongs to the water element, is the sound of winter, and helps to nourish Kidney yin, protect Kidney essence, and reduce Lung fire.
Recently, three clinical studies in China tested the healing power of classical Chinese five-element music. A study conducted in Taiwan and reported in the International Journal of Nursing Practice (March 2014) was designed to evaluate the effects of Chinese five-element music therapy on nursing students who reported suffering from depression. Seventy-one nursing students with depression were randomly assigned to either a “music group” using five-element musical therapy, or a control group. Otherwise, both groups followed their routine lifestyles. They were assessed by the Depression Mood Self-Report Inventory for Adolescence, and their salivary cortisol levels were measured. The study found that, over time, there was a significant reduction in levels of depression in the music group, based on pre- and post-therapy test scores and salivary cortisol levels.
The second study explored the effects of five-element music therapy on elderly patients with seasonal affective disorder. Fifty patients in a Beijing nursing home were randomly assigned to either a musical treatment group or a control group, with 25 participants in each group. The music group heard five-element music for one to two hours per week over an eight-week period. The self-rating depression scale (SDS) and Hamilton depression scale (HAMD) were used to assess the patients before and after treatment.
No significant difference in SDS and HAMD scores was found between the two groups before the treatment. After eight weeks of music therapy, the SDS and HAMD scores of the music-treatment group were significantly lower than those for the control group (Journal of Traditional Chinese Medicine, April 2014).
The objective of the third study was to evaluate the effects of five-element music on the quality of life for patients with advanced cancer. Advanced-stage cancer patients were randomly assigned to one of three groups: the five-element music group (68 patients); the Western-music therapy group (68 patients); and a group that received no music therapy (34 patients). Both the five-element and the Western-music groups listened to music 30 minutes each day, five days a week, for three weeks. Patients were assessed with the Hospice Quality of Life Index-Revised (HQOLI-R) and Karnofsky Performance Score (KPS) before and after treatment.
Results showed that there were significant differences in the HQOLI-R and KPS scores after treatment between the five-element music group and the other two groups. This study concluded that five-element music therapy could improve the quality of life and KPS for advanced cancer patients (Chinese Journal of Integrative Medicine, October 2013) .
Studies have shown that music can affect brain waves, brain circulation, and stress hormones. Music therapy seems to be especially effective in reducing the physiological effects of stress: it can slow the heart rate, reduce blood pressure, decrease breathing rate, and strengthen the immune system. Music also can expand the mind. A study (Nature, April 1998) suggested that the area of the brain used to analyze the pitch of a musical note can be enlarged through practice and experience of music by 25 percent.
The studies cited above do not specifically prove five-element theory that the “zhi” note calms the Heart, or the “shang” note nourishes the Lung. But they certainly give scientific validation to the wise Chinese doctors who invented a form of music therapy more than 2,000 years ago!