Introduction: In Traditional Iranian Medicine (TIM), naturally affairs are seven principles which human health and existence are based on them and four elements are at the top of these principles. Although studying the philosophic and scientific subjects of these elements are parts of ancient philosophy knowledge, because of a long time interruption between fellows of Persian Medicine (PM) or TIM and basic science of traditional medicine and dramatically changes in concept and usage of these matters during centuries, surveying the meaning and practical use of such words is a primary step in order to understand PM.
 Materials and Methods: In this research, 11 traditional medical texts, 5 philosophic references, 4 dictionaries and some updated resources were surveyed.
Results and Conclusion: Upon the results of this research, although four elements (cosmic elements or primordial essences or first principles or elementary principles) are limited to the 4 familiar words Water, Fire, Air and Earth, their meaning and usage are totally different from the original concept of the modern elements (elements of periodic table) and contemporary meanings of water, fire, air and soil. Perhaps it is more accurate comparing the meaning and characteristics of these particles with fundamental and subatomic particles of modern knowledge