Triple burner

三焦〔三焦〕 sān jiāo

The triple burner (三焦 sān jiāo) is a tripartite organ containing the bowels and viscera. The generally accepted view among scholars in China today is that it represents three segments of the abdominothoracic cavity, containing the bowels and viscera and including the pathways of original qì and the fluids. The upper burner is the segment above the diaphragm, containing the heart and lung; the center burner is the segment that lies between the diaphragm and the umbilicus, containing the liver, spleen, and stomach; and the lower burner is the segment that lies below the umbilicus containing the kidney, bladder, small intestine, large intestine, and genital organs.

The triple burner is responsible for ensuring the movement of original qì and for enabling water to flow through the waterways. Its associated channel is the hand lesser yáng (shào yáng) triple burner channel. The triple burner stands in external-internal relationship with the pericardium. It does not belong to any of the five phases.

The nature of the triple burner has been disputed. Some scholars of the past claimed that the triple burner possessed its own morphological structure distinct from the other bowels and viscera. Some argued that the burners include the head and limbs, as well as the trunk. The agreed modern view is that the triple burner has no anatomical structure of its own and that it represents the bowels and viscera with regard to the movement of original qì and water.

At the end of the 18th century, medical scholars of the warm disease school developed a new method of charting the penetration of external evil in the body that was based on their movement through the three burners.

The Triple Burner Ensures the Movement of Original Qì (通行元气 tōng xíng yuán qì)

Original qì is the fundamental qì of the body. It is rooted in the kidney and moves through the triple burner to reach all parts of the body. The triple burner thus influences the qì dynamic and qì transformation of the entire body.

The Triple Burner Ensures the Movement of Fluids (运行水液 yùn xíng shuǐ yè)

The Sù Wèn (Chapter 8) states, The triple burner is the official of the Ditches, the waterways arise from it (三焦者, 决渎之官, 水道出焉sān jiāo zhě, jué dú zhī guān, shuǐ dào chū yān). This means that the triple burner is like the official responsible for keeping irrigation and drainage ditches flowing smoothly. It ensures that water moves freely through the waterways. Water metabolism is closely associated with the lung in the upper burner, the spleen in the center burner, and the kidney in the lower burner. It is also reliant on the general regulatory effect of the triple burner. The triple burner’s action in the realm of water metabolism is referred to as triple burner qì transformation (三焦气化 sān jiāo qì huà).

Upper Burner

The upper burner is the upper part of the trunk above the diaphragm. It includes the heart and lung. According to some, it includes the head and even the upper limbs. It diffuses essential qì around the body and governs intake.

The upper burner’s action is likened to that of mist, gently diffusing upward and outward, spreading the essence of grain and water around the body. The Líng Shū (Chapter 30) states,.

The upper burner opens and effuses; it diffuses the five grain flavors (i.e., various nutrients contained in food), steams the flesh, fills the body, moistens the body hair, like the sprinkling of mist and dew (上焦开发，宣五谷味，熏肤、充身、泽毛，若雾露之溉 shàng jiāo kāi fā, xuān wǔ gǔ wèi, xūn fū, chōng shēn, zé máo, ruò wù lù zhī kāi fā).

Chapter 18 of the Líng Shū states that the upper burner is like a mist (上焦如雾 shàng jiāo rú wù). This means that the qì of the upper burner diffuses and spreads, nourishing and moistening the whole body. It has upward movement but no downward movement.

The functions of the upper burner correspond to the lung’s function of governing qì and the heart’s function of governing the blood.

The Nàn Jīng (31st Difficult Issue) states that the upper burner governs intake and does not put out, meaning that food and clear qì are taken in through the upper burner, but nothing leaves the body directly from there. For this reason, it is often said that the upper burner governs intake (上焦主纳 shàng jiāo zhǔ nà).

Center Burner

The center burner stretches from the diaphragm to the umbilicus. It includes the spleen and stomach and the liver.

It is responsible for rotting and ripening grain and water, extracting their essence, and producing qì and blood. The Líng Shū (Chapter 18) describes this as follows:

The center burner… is the recipient of qì (i.e., food), strains off waste, steams the fluids, and transforms the essence [of the qì received]. [The essence] pours it upward into the lung vessel and is transformed into blood, in order to provide nourishment for the whole body. (中焦… 受气者，泌糟粕，蒸津液，化其精微，上注于肺脉，乃化而为血，以奉生身 zhōng jiāo… shòu qì zhě, mì zāo pò, zhēng jīn yè, huà qí jīng wēi, shàng zhù yú fèi mài, nǎi huà ér wéi xuè, yǐ fèng shēng shēn).

Hence it is said, the center burner governs transformation (中焦主化 zhōng jiāo zhǔ huà). The same chapter also states, the center burner is like foam (中焦如沤 zhōng jiāo rǔ ōu). This image depicts stomach’s function of rotting and ripening grain and water. However, it has been contended that 沤 ōu is a mistranscription of 枢 shū, pivot, referring to the center burner’s role in moving essence and qì up and down the body.

Lower Burner

The lower burner stretches from the umbilicus downward. It includes the small intestine, large intestine, kidney and bladder, as well as the male and female genitals.

The lower burner is likened to a ditch or sluice, an image that describes the functions of the kidney, bladder, small intestine, and large intestine in draining off waste fluids from the body. Hence it is said, the lower burner is like ditches (下焦如渎 xià jiāo rú dú) and the lower burner governs exit (下焦主出 xià jiāo zhǔ chū).

The Triple Burner Channel (三焦经 sān jiāo jīng)

The triple burner channel is the hand lesser yáng (shào yáng) triple burner channel (TB).

Triple Burner: Mystery Organ?
Western students of Chinese medicine have difficulty in understanding the triple burner because it is an organ that has no correspondence in the modern anatomical model of the human body. In fact, the nature of the triple burner has been hotly disputed in China. The Nàn Jīng (25th Difficult Issue) states, The heart governor (i.e., pericardium) and the triple burner stand in exterior-interior relationship with each other; both have a name but no form. This view was adopted by many scholars over the centuries. By contrast, others have argued that the triple burner has both form and name, putting forward two main explanations: The triple burner is a large organ that lies inside the trunk and outside the other bowels and viscera, encompassing the latter completely. Adduced in favor of this argument is the fact that the Nèi Jīng calls the triple burner the solitary bowel (孤腑 gū fǔ). This epithet is understood to mean a singularly large organ, the implication being that if it is large, it must have extension, and therefore form. The triple burner is the fat and membranes surrounding the bowels and viscera. From the modern anatomical-physiological point of view, two problems attach to these explanations holding that the triple burner has its own substratum. The proposed notion of an abdominothoracic cavity sac only stands if the triple burner is confined to the abdominothoracic cavity. As pointed out in the text above, the triple burner is also said to include parts outside the abdominothoracic cavity (more about this further ahead). It is doubtful whether an abdominothoracic cavity sac or the fat and membranes surrounding the internal organs could possibly have the functions ascribed to the triple burner. Since traditional theories suggest that the functions of each of the burners are essentially syntheses of those of the bowels and viscera they each contain, the question arises as to whether the triple burner deserves to be accorded an existence as an independent organ. None of the traditional arguments broach this issue. The functions of the triple burner are to move fluids and original qì. The function of moving fluids would appear to correspond to the lung’s function of governing the waterways, while qì, capable of pervading matter, does not require an independent organ to explain its movement. Hence, the triple burner has no functions that cannot be otherwise explained and hence is arguably a redundant concept. The original inspiration for positing the existence of the triple burner may well have lain in the need to make the bowels, only five in number, conform to the yīn-yáng system as well as the five-phase system. The triple burner has not always been a universally accepted element of all healing arts in China. It is discussed in the Nèi Jīng , which is primarily concerned with the channel system and its related therapy, acupuncture. Toward the end of the 18th century, it was adopted in the medicinal-based warm disease theory as a system of levels through which external evils penetrated the body. However, before that time, the triple burner attracted little interest in the medicinal therapy tradition. of note is that very few medicinals are traditionally said to enter the triple burner channel. Only six of the 5,767 items of Zhōng Yào Dà Cí Diǎn include the triple burner under now generally accepted channel entries. Complete agreement is lacking with regard to what body parts are included in each of the burners. Some, but not all, modern textbooks include the head and face in the upper burner. In the past, some have included the upper arms too. The liver is anatomically located between the diaphragm and umbilicus, and hence is traditionally placed in the center burner. However, in the triple burner pattern identification system of the warm disease school, a series of liver disease patterns are included within the scope of the lower burner. Two final questions to be addressed are the naming of the sān jiāo in Chinese and the English translation of the term. Sān 三 means three and jiāo 焦 means burn, scorch, or parch. The most plausible explanation for the term is that it was originally based on an analogy to smelters or saltworks (Unschuld, Medicine in China, page 81); hence the English translation triple burner. In later literature a flesh radical was often added (膲) to denote a body part, in the same way as it was added to the characters 藏 zàng and 府 fǔ , viscera and bowels, even though in the earliest texts and in modern texts the standard form is the one without the additional radical. Some have argued that 膲 is the main form of the character, denoting a hollow organ, and that because of this there is no ideal translation, so the transliteration sanjiao should be used. The fact that the character jiāo has also appeared in some texts in the form 樵 (焦 with the addition of a wood/tree radical), meaning segment, has also been adduced to demonstrate the untranslatability of the term. However, these arguments neglect the fact that the original character was 焦, meaning burn or burner. The English term triple burner most clearly grasps the original conception of the internal workings of the body by analogy to a boiler that processes incoming fluid (center burner), producing steam that rises and spreads (upper burner), and has a system for draining off waste solids and liquids (lower burner). However, the Nèi Jīng descriptions of the triple burner can also be interpreted to reflect the rain cycle in nature (evaporation, precipitation, and downward flow through rivers).

Triple Burner: Mystery Organ?

Western students of Chinese medicine have difficulty in understanding the triple burner because it is an organ that has no correspondence in the modern anatomical model of the human body. In fact, the nature of the triple burner has been hotly disputed in China.

The Nàn Jīng (25th Difficult Issue) states, The heart governor (i.e., pericardium) and the triple burner stand in exterior-interior relationship with each other; both have a name but no form. This view was adopted by many scholars over the centuries.

By contrast, others have argued that the triple burner has both form and name, putting forward two main explanations:

The triple burner is a large organ that lies inside the trunk and outside the other bowels and viscera, encompassing the latter completely. Adduced in favor of this argument is the fact that the Nèi Jīng calls the triple burner the solitary bowel (孤腑 gū fǔ). This epithet is understood to mean a singularly large organ, the implication being that if it is large, it must have extension, and therefore form.
The triple burner is the fat and membranes surrounding the bowels and viscera.

From the modern anatomical-physiological point of view, two problems attach to these explanations holding that the triple burner has its own substratum.

The proposed notion of an abdominothoracic cavity sac only stands if the triple burner is confined to the abdominothoracic cavity. As pointed out in the text above, the triple burner is also said to include parts outside the abdominothoracic cavity (more about this further ahead).
It is doubtful whether an abdominothoracic cavity sac or the fat and membranes surrounding the internal organs could possibly have the functions ascribed to the triple burner.

Since traditional theories suggest that the functions of each of the burners are essentially syntheses of those of the bowels and viscera they each contain, the question arises as to whether the triple burner deserves to be accorded an existence as an independent organ. None of the traditional arguments broach this issue. The functions of the triple burner are to move fluids and original qì. The function of moving fluids would appear to correspond to the lung’s function of governing the waterways, while qì, capable of pervading matter, does not require an independent organ to explain its movement. Hence, the triple burner has no functions that cannot be otherwise explained and hence is arguably a redundant concept.

The original inspiration for positing the existence of the triple burner may well have lain in the need to make the bowels, only five in number, conform to the yīn-yáng system as well as the five-phase system.

The triple burner has not always been a universally accepted element of all healing arts in China. It is discussed in the Nèi Jīng , which is primarily concerned with the channel system and its related therapy, acupuncture. Toward the end of the 18th century, it was adopted in the medicinal-based warm disease theory as a system of levels through which external evils penetrated the body. However, before that time, the triple burner attracted little interest in the medicinal therapy tradition. of note is that very few medicinals are traditionally said to enter the triple burner channel. Only six of the 5,767 items of Zhōng Yào Dà Cí Diǎn include the triple burner under now generally accepted channel entries.

Complete agreement is lacking with regard to what body parts are included in each of the burners. Some, but not all, modern textbooks include the head and face in the upper burner. In the past, some have included the upper arms too. The liver is anatomically located between the diaphragm and umbilicus, and hence is traditionally placed in the center burner. However, in the triple burner pattern identification system of the warm disease school, a series of liver disease patterns are included within the scope of the lower burner.

Two final questions to be addressed are the naming of the sān jiāo in Chinese and the English translation of the term. Sān 三 means three and jiāo 焦 means burn, scorch, or parch. The most plausible explanation for the term is that it was originally based on an analogy to smelters or saltworks (Unschuld, Medicine in China, page 81); hence the English translation triple burner. In later literature a flesh radical was often added (膲) to denote a body part, in the same way as it was added to the characters 藏 zàng and 府 fǔ , viscera and bowels, even though in the earliest texts and in modern texts the standard form is the one without the additional radical. Some have argued that 膲 is the main form of the character, denoting a hollow organ, and that because of this there is no ideal translation, so the transliteration sanjiao should be used. The fact that the character jiāo has also appeared in some texts in the form 樵 (焦 with the addition of a wood/tree radical), meaning segment, has also been adduced to demonstrate the untranslatability of the term. However, these arguments neglect the fact that the original character was 焦, meaning burn or burner. The English term triple burner most clearly grasps the original conception of the internal workings of the body by analogy to a boiler that processes incoming fluid (center burner), producing steam that rises and spreads (upper burner), and has a system for draining off waste solids and liquids (lower burner). However, the Nèi Jīng descriptions of the triple burner can also be interpreted to reflect the rain cycle in nature (evaporation, precipitation, and downward flow through rivers).

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