Water is Groan

Water is the sound of "groan" - the determination of the river moving on to the sea. Nothing really gets in its way and nothing can really stop it, it moves steadily on to its destination.  It can move from a very excited to slightly boring energy but always constant.  Sometimes it drops like a waterfall and continues on it way again.  As thought they are trying to stay calm in a dangerous situation.
In Five Element Acupuncture the way to diagnose a persons Causative Factor is by their Colour, their Sound, Odour and Emotion.  As the Causative Factor element is weakest this will effect they way sound in created by the person. Each of the Elements presents with a different sound..
Diagnosis by Sound
Wood is Shout

We think of the assertion of Wood, the energy that pushes forward, bringing and creating new things.  Shout has a lot of energy at the beginning of a word and at the end the word it dies out.  Wood people will always have this quality of Shout in their voice even when they are speaking quietly or gently. When they are excited it can sounds as though they are actually shouting at you. There is also Lack of Shout where there is not enough energy for the word to leave the persons mouth.
Fire is Laugh

Fire holds the emotions of sadness and joy, so the sound of Fire is a lack or excess of this energy.  A Fire person may sound excited or that they are about to get to the punch line of a joke. The sound a Fire will encourage you to have is a smile in your voice or be on the edge of laughter yourself.  Lack of Fire is a sad drone, nearly a "lack of laugh" in the voice.
Earth is Sing

Earth is the sound of sympathy or understanding that is classically called "sing" It is the rise and fall in the voice as the person says the word.  It is like the person is telling you a story; it can be a soothing sound like a mother's lullaby.
Metal is Weep

Metal is the sound of grief. It is a descending sound. It is classically called a "weep" - like the sound of someone on the edge of tears, that slight catch in the throat at the middle of the word.