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The San Jiao According to Traditional Chinese Medicine (TCM)

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This article is part of a series explaining the body’s organ systems from the perspective of Traditional Chinese Medicine (TCM) and Five Elements Theory.

The San Jiao, or Triple Burner, is one of the most conceptually complex and controversial systems in TCM.

Many TCM authorities debate whether the San Jiao consists of an actual “form” (organ), or if it is a conceptual framework to describe a function. The San Jiao is believed to be part of the six Yang organs and is paired (internal/external or Yin/Yang pair) with the Pericardium.

Division of the San Jiao

Note: An organ name with a capital letter, for example “Heart,” refers to the TCM concept and channel (or energetic pathway) of that name. The same organ named in the lowercase, as in “heart,” refers to the physiological organ or physiological structure.

Location in the BodyOrgans, structuresType of Functional Qi
Upper JiaoFrom the diaphragm upwardsHeart, Lungs, Pericardium, throat, headGathering Qi (Zong Qi)
Middle JiaoBetween the diaphragm and umbilicusSpleen, Stomach, GallbladderNutritive Qi (Ying Qi)
Lower JiaoBelow the umbilicusLiver, Kidneys, Intestines, BladderOriginal Qi (Yuan Qi)

Although the physiological liver resides in the Middle Jiao and Liver symptoms frequently include hypochondrial pain, epigastric pain, and belching, the Liver has complex functions and is a very long channel. Liver Channel location and patterns encompass gynecological disorders, which place it in the Lower Jiao.

Functions of the San Jiao

  • Mobilizes the Original Qi (Yuan Qi)
  • Controls the transportation and penetration of Qi
  • Controls the Water passages and the excretion of fluids

San Jiao mobilizes Original Qi (Yuan Qi)

As mentioned in our article on the Kidney and Bladder, Pre-Heaven Essence plus Post-Heaven Essence transforms into Original Qi.

Original Qi is responsible for the “action” form of Qi. It resides between the Kidneys and is closely related to the Ming Men (Fire of the Gate of Life).

“The Classic of Difficulties clarifies the relationship between the Original Qi and the San Jiao: Below the umbilicus between the Kidneys there is a Motive Force (Dong Qi) that is life-giving and is the root of the 12 channels: it is called Original Qi. The Triple Burner makes the Original Qi separate (into different functions) and it controls the movement and passage of the three Qi (of the Upper, Middle, and Lower burner) through the five Yin and six Yang.” 

(Nanjing College of Traditional Chinese Medicine, 1979, as cited in Maciocia, 2005, p. 210)

It is through the San Jiao that the Original Qi performs its functions. Because of the close relationship between the Original Qi and Ming Men it shares the responsibility of providing the heat necessary for all of the body’s functional activities.

Heat from the Original Qi is necessary for:

  • Spleen’s function of transforming and transporting food
  • Facilitation of the transformation of Gathering Qi (Zong Qi) into True Qi (Zhen Qi). The Upper burner transports Qi through the various passages of the chest.
  • Facilitates the transformation of Food Qi (Gu Qi) into the Blood in Heart

Imagine an orchestra. The individual talented musicians are the individual organ systems and the conductor is the San Jiao. The heat from the Original Qi is like the musical score animating the musicians with the guidance of the conductor.

San Jiao controls the transportation and penetration of Qi

“Qi Mechanism” is a term to describe the movement of Qi in carrying out various functions throughout the body. Qi ascends or descends and enters or exits different places and organs in the body. Each organ has a particular direction of Qi flow. For example, Spleen Qi rises and Stomach Qi descends. Qi also enters and exits the space between the skin and muscles, the joint capsules, and all other cavities. San Jiao controls the direction of Qi in the Qi Mechanism.  

TCM frequently will describe the San Jiao as “free passage, to pass through or penetrate.” This is another way to describe the Qi Mechanism performed by the San Jiao, ensuring that Qi passes correctly through all of the cavities and organs.

San Jiao not only controls the processes of the Qi Mechanism throughout the body, but also controls the transformation of Qi to generate Nutritive Qi (Ying Qi), Defensive Qi (Wei Qi), Blood, and Body Fluids.

"The Central Scripture Classic (Zhong Zang Jing, Han Dynasty) states: The Triple Burner is the three original Qi of the body, it is the Yang organ of clear [Qi], it controls the five Yin and six Yang organs, the Nutritive Qi and Defensive Qi, the channels and the Qi of the Interior and Exterior, left and right, above and below. When the Qi of the Triple Burner has free passage, Qi passes freely into the Interior, Exterior, left, right, above and below. The Triple Burner irrigates the body, harmonizes Interior and Exterior, benefits the left and nourishes the right, it conducts upwards and descends downwards."

(Hua Tuo,1985, as cited in Maciocia, 2005, p. 211)

Some comments about the “three original Qi” mentioned in the above quotation:

Refers to the Upper, Middle, and Lower Jiao, and to all types of Qi in each Jiao (burner), but specifically to:

  • Gathering Qi (Zong Qi) – located in the Upper Burner
  • Nutritive Qi (Ying Qi) – located in the Middle Burner
  • Defensive Qi (Wei Qi) – located in the Lower Burner

Although Defensive Qi exerts its influence on the Upper Burner and the “superficial layers of the body,” i.e. the space between the muscles and skin, it originates from the Lower Burner, from the “Gates of Life” (Ming Men).

San Jiao functions compared with Liver and Lung functions

San Jiao FunctionsLiver Functions
Influences the ascending-descending and entering-exiting of Qi in all the organsEnsures Free Flow of Qi, which aids the ascending and descending of Qi, especially in Spleen, Stomach, Intestines
Controls the entering-exiting of Qi in ALL parts of the body and especially the body cavitiesThe Liver has no function in relation to the body cavities
San Jiao FunctionsLung Functions
Has no action Governing QiGoverns Qi, specifically controlling the intake of air, breathing, and the production of Gathering Qi (Zong Qi) from Food Qi (Gu Qi)
The function of transporting Qi exerts its influence on all organs and all three BurnersInfluences the ascending-descending and entering-exiting movements of Qi, but mostly in the Upper Burner.

San Jiao controls the water passages and the excretion of fluids

This is one of the most important roles of the San Jiao.

"In ‘The Simple Questions’ it describes the internal organs as “official;” The Triple Burner is the official in charge of irrigation and it controls the Water passages."

(The Yellow Emperor's Classic of Internal Medicine: Simple Questions [Huang Ti Nei Jing Su Wen], 1979, as cited in Maciocia, 2005, p. 212)  

Like an “official” in charge of irrigation, the San Jiao is responsible for the transformation, transportation and excretion of fluids

Think of the San Jiao’s function of ensuring that the Body Fluids are transformed, transported and excreted properly as a system of canals and waterways to channel irrigation water through the proper fields and then out. 

Inhibition of the San Jiao’s function of movement and penetration of Qi will have an effect on the Body Fluids. It is the coordination and harmonization of the ascending-descending and entering-exiting of the Qi in all the organs and structures that ensures that the Body Fluids also follow that same path. The transformation and movement of fluid is dependent on the proper flow of Qi. 

Body Fluids are formed as the result of the successful processes of transformation, transportation, and excretion of fluids in each of the three Jiao.

The fluids of the Upper, Middle and Lower Jiao

  • Upper Jiao forms sweat; which flows in the space between the skin and muscles
  • Middle Jiao forms the fluids produced by the Stomach which moisten the body and integrate the blood
  • Lower Jiao forms urine and the small amount of fluid in stool

As mentioned before, there is a lot of controversy as to whether the San Jiao is considered to be one of the six Yang organs. The belief that it is the “official” in charge of irrigation suggests that the San Jiao has form, like the rest of the organs. All of the Yang organs share similar functions (actions) of receiving food/drink, digesting/ transforming food, transporting the nourishment, and excreting waste.

Another school of thought is that the San Jiao does NOT have form. In other words, it is nothing more than a collection of functions.

Mental aspects of the San Jiao

The San Jiao is related to both Fire and Wood in Five Element Theory. It is related to Fire through its relationship to the Pericardium (Interior-Exterior) and to Wood through its relationship with the Gallbladder (Lesser Yang Channels). 

The relationship to Fire means that it assists the Mind (Shen) and Ethereal Soul (Hun) in forming and maintaining relationships.

San Jiao as a pivot point

It is illuminating to think of the San Jiao as the main pivot point between Exterior pathology, and a deepening into an Interior pathology. This can be seen by the position of San Jiao in the Clinical Manifestations of the Six Stages, below.

The San Jiao also acts as a pivot point of sorts on an emotional level, maintaining the emotional balance between outgoing movements towards other people and relationships, and the inward movements towards oneself.

"An exterior pathology or the Tai Yang present as stiffness and pain in the head and neck, stiff lumbar spine, aversion to cold, feelings of heat within the system. 

Examples of symptoms from Jue Yin are thirst, Qi surging up to the Heart, pain and heat in the chest, hunger with no desire to eat, vomiting after eating (vomiting of roundworms), severe constant diarrhea."

(Mitchel et al., 1999, p. 6)

Clinical Manifestations of the Six Stages

The Clinical Manifestations of the Six Stages were formulated by Zhang Zhong Jing (AD 150-219) in the Shang Han Lun (Mitchel et al., 1999). The book is a discussion on the treatment and severity of exterior pathogenic factors and the herbal formulas to address them. 

The Six Stages in descending order are: 

  • Greater Yang/ Supreme Yang (Tai Yang: Small Intestine and Bladder channels)
  • Bright Yang/ Yang Brightness (Yang Ming: Large Intestine and Stomach channels)
  • Lesser Yang (Shao Yang: San Jiao and Gallbladder channels)
  • Greater Yin/Supreme Yin (Tai Yin: Lung and Spleen channels)
  • Lesser Yin (Shao Yin: Heart and Kidney channels)
  • Terminal Yin/ Absolute Yin (Jue Yin: Pericardium and Liver channels)

Each stage indicates a worsening of the severity of symptoms.

Note: Different texts translate the names of the channel pairs differently. The translation variations have been included to assist in future articles and your own research.

The San Jiao Channel of Hand ShaoYang

San Jiao Channel
Image with the kind permission of www.amanualofacupuncture.com (Deadman et al., 2005)

The Primary Channel

  • Begins at the ulnar aspect of the tip of the ring finger and runs between the fourth and fifth metacarpal bones along the dorsum of the hand
  • Travels up the posterior aspect of the forearm between the radius and the ulna and between the Large Intestine and Small Intestine channels
  • Transverses the olecranon of the ulna at SJ 10 and continues up the postero-lateral aspect of the upper arm to the shoulder where it intersects the Small Intestine channel at SI 12
  • Travels towards the spine via BL 11 where it intersects the Governing vessel (Du) at Du 14
  • Ascends laterally to the highest point of the shoulder where it intersects GB 21
  • Descends anteriorly into the supraclavicular fossa at St 12, then disperses midway between the breasts at Ren 17 (Conception Vessel 17)
  • Connects with the Pericardium then descends through the diaphragm to the abdomen via Ren 12, linking along its pathway with the upper, middle and lower jiao

Branch 1

  • Separates in the region of Ren 17
  • Ascends to emerge from the supraclavicular fossa
  • Rises along the neck to the posterior aspect of the ear
  • Circles behind the ear via GB 11 to the temples where it intersects the Gallbladder channel at GB 6, GB 5, GB 4, and GB 14
  • Winds down across the cheek, intersecting the Small Intestines channel at SI 18
  • Ascends to the inferior aspect of the eye

Branch 2

  • Separates behind the ear and enters the ear
  • Emerges in front of the ear to intersect the Small Intestines and Gallbladder channels at SI 19 and GB 3
  • Crosses the previous branch on the cheek to terminate at the outer canthus of the eye at GB 1

Some texts reference another branch of the SJ primary channel that descends to BL 39 (its “back shu point”).

(Deadman et al., 2005, pp. 387-388)

References

  • Deadman, P., Al-Khafaji, M., & Baker. K. (2005). A Manual of Acupuncture. East Sussex: Journal of Chinese Medicine Publications.
  • Hua Tuo (1985). Classic of the Central Scripture (Zhong Zang Jing), Jiangsu Science Publishing House, Nanjing p. 39. Written in Han dynasty.
  • Hyunbae,K. (2007). Handbook of Oriental Medicine (3rd ed.). Harmony & Balance Press.
  • Kastner, J. (2004). Chinese Nutritional Therapy. Jeorg Thieme Verlag.
  • Maciocia, G., & Xin Ming, S. (2005). The Foundations of Chinese Medicine: A Comprehensive Text for Acupuncturists and Herbalists. London: Churchill Livingstone.
  • Mitchel, C., Ye, F., & Wiseman, N. (1999). Shang Han Lun on Cold Damage. Paradigm Publication, Brookline Massachusetts.
  • Nanjing College of Traditional Chinese Medicine (1979). A Revised Explanation of the Classic of Difficulties (Nan Jing Jiao Shi). People’s Health Publishing House, Beijing, first published c. AD 100.
  • Pitchford, P. (2002). Healing with Whole Foods (3rd ed.). Berkeley, CA: North Atlantic Books.
  • Spiritual Axis (Ling Shu Jing) (1981). People’s Health Publishing House, Beijing, first published c. 100 BCE.
  • Wang Xin Hua (1983). Selected Historical Theories of Chinese Medicine (Zhong Yi Li Dai Yi Lun Xuan). Jiangsu Scientific Publishing House, Jiangsu.
  • Wiseman, N. (ed., trans.), & Ellis, A. (trans.) (1996). Fundamentals of Chinese Medicine. (Rev. ed.) Brookline, MA: Paradigm Publications.
  • The Yellow Emperor’s Classic of Internal Medicine: Simple Questions (Huang Ti Nei Jing Su Wen) (1979). People’s Health Publishing House, Beijing, first published c. 100 BCE.

About the author

Teri Calandra

Teri Calandra Dipl.Acu, MSTOM, L.Ac., LMT, RMT

Teri began her studies in energy medicine as part of her own personal development journey, and continues to to learn and integrate that knowledge into her practice. Teri is the founding practitioner of Calandra Center for Health & Wellness in Schaumburg, Illinois. She is licensed by the State of Illinois in acupuncture (L.Ac.), and board certified through the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).

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