The five elements describe what the body is made of. The sixth describes how it is lived in. Whatever name you give it — karma, conscience, consequence — the observation behind it is the same: our actions return to us, and health is not separable from conduct.
Diet, breathing and cleansing can all be managed with care and still leave a person unwell if the life around them is not in order. That is the part no regimen reaches, and in my experience it is the part that matters most.
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