Elementalism. Modern fantasy is as obsessed with the word as it is with any other fascinating idea that has its roots in ancient or medieval philosophy. It is a beautiful - if somewhat old-fashioned sentiment - to feel closer to the four original elements: earth, water, air and fire - and in some cultures a fifth - space. The 'elements' that all life seemed to be born out of to the primitive eye.
Stories, of course, are mostly narratives built around a simple core idea. And elementalism is a simple idea with much potential. At least, in the mythological sense of the term. The word 'element' is used for a large number of things today. Among others, it still conveys the idea of the basic building blocks of the existing world, but, as with all things, the building blocks of the existing world are no longer as simple and, more importantly, 'compact' as they once were.
If fantasy were to evolve with the sciences, the number four - or five, as the case may be - might well have to be replaced by a hundred and ten. That definitely complicates things.
But more than that, it creates a certain sense of hierarchy. The original elements were equals, if not to your staunch fire temple devotee - definitely from a quieter philosophical point of view. It would be quite difficult, however, to prepare an argument that would place, say, Bismuth, on the same footing as Oxygen. Even if I were to look at it quietly and philosophically - leaving quantity and abundance out of the equation - Bismuth, in turn, would definitely be superior to Unnilbium, fortunately - or unfortunately, depending on which way way you look at it - also named Nobelium.
Or would it? If the Ununtrium Tribe, blessed with and devoted to the worship and use of the element Ununtrium, were a so-called Uncontacted - or in this case - Undiscovered tribe in the deepest darkest caverns of the farthest reaches of our 'elemental' fantasy world (it would have to be quite a technologically superior tribe as it would be fantastically difficult, even in our fantasy world, for Ununtrium to occur naturally, since in our - also 'elemental' - world we haven't even discovered it yet), would they not consider their patron element to be above and beyond your petty hydrogen and nitrogen and what have you? Especially since they would have a much more appealing name for it - something that would probably be more pronounceable - or at least have a certain ring to it - if only in the Ununtrium - or whatever they'd call it - tongue.
Elementalism, after all, is its own religion - a way of life or whatyoumightcallit. And even a hundred and ten is a small number compared to the cultures and traditions of our world. Looking at it this way, perhaps, it's not such an insane idea for a fantasy story after all. A hundred and ten gods or a hundred an ten nations or even a hundred and ten planeteers is still less complicated than our 'elemental' world. Orbitalism - some strange kind of continentalism - would make things easier to categorize - as would your little political - or in this case, periodic - groups and associations. Historic world wars between the Metallic and Non-metallic factions(think that's a bit one-sided? well, think again) and haunting industrial disasters(okay, that really wouldn't be anything new) would be easy enough settings - but there's still one question that would need a little bit of thinking - and some lengthy justifications(often overlooked, omitted or added just as afterthoughts by the authors of many fantasy worlds).
What would the plant and animal life look like?