San Jiao

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San Jiao
Traditional Chinese 三膲
Simplified Chinese 三焦

San Jiao is a term found in traditional Chinese medicine (TCM), as part of the modelling of the workings of the human body attempted by early Chinese medical writers. References to it can be found in the oldest Chinese medical texts available, including the Yellow Emperor's Huang Di Nei Jing.The identification of disease according to the Three Burners (三 焦) was first described in the Qing Dynasty by Wu Ju Tong (吳鞠通, 1758–1836) in his book A Systematic Identification of Febrile Diseases.[citation needed]. This system is used within the practice of Chinese herbal medicine, in conjunction with acupuncture and other Chinese medicine (TCM) modalities.[citation needed] Note that the San Jiao theory differs slightly from the San Jiao organ, or channel [(Shou Shao Yang, san jiao jing)]; referred to additionally as "Triple Heater", San Jiao, and "Triple Burner". Viewed by Chinese Medicine as the passage of heat and fluid throughout the body, Elementary Questions (su wen)' explains, "The Triple Burner holds the office of the sluices; it manifests as the waterways."[citation needed]


The system is often combined with Four Stages theory when diagnosing and treating an externally contracted disease caused by a wind-heat pathogen.[citation needed] The disease will be diagnosed and understood according to its location within the three burners.[citation needed]

San Jiao has been translated as "triple heater," triple warmer (or three warmers)," and "triple burner," the latter of which is probably favored because of the involvement of the San Jiao in metabolism. The current World Health Organisation standard term is "Triple Energizer" (TE), but many authors still prefer to use San Jiao.

Body model[edit]

There is no organ in Western medicine which corresponds to San Jiao, but The Triple-Burner is said to occupy the Thoracic and Abdomino-Pelvic cavities:

Triple Warmer
  • Upper Jiao (上焦)
  • Middle Jiao (中焦)
  • Lower Jiao (下焦)

Upper Jiao[edit]

The Upper Jiao refers to the upper part of the body, and includes the Heart, Lung, and Pericardium organs.[citation needed] The Pericardium is the corresponding internal organ of the Triple Burner (for the purpose of acupuncture only*).[citation needed] Patterns that affect the upper burner include:[citation needed]

  • Wind-heat invading the lungs — symptoms include fever, aversion to cold, headache, sore throat, red and swollen tonsils, red tip on tongue, floating-rapid pulse.
  • Heat in the lungs — symptoms include fever, sweating, cough, asthma, thirst, red tongue with yellow coat, rapid pulse.
  • Heat in the pericardium — symptoms include fever, delirium, aphasia, burning feeling in epigastrium, cold limbs, dark red tongue with no coat, fine-rapid pulse.

Middle Jiao[edit]

The middle jiao refers to the midsection of the body and includes the Spleen, Stomach, Gall Bladder and Liver organs.[citation needed]

  • Heat in Yang Ming — symptoms include high fever, profuse sweating, constipation, large thirst, irritability or delirium, red tongue with dry yellow coat, deep and full pulse. The yang ming pattern is often referred to as the Four Bigs – big fever, big sweat, big thirst, big pulse.[citation needed]
  • Damp-Heat invading the Spleen – symptoms include aversion to cold, low fever in the afternoon, feeling of heaviness, nausea, vomiting, red puffy tongue with a yellow-sticky coat,slippery and rapid pulse.[citation needed]

Lower Jiao[edit]

The lower jiao refers to the lower section of the body and includes the Small and Large Intestines, the Kidneys and the Urinary Bladder.[citation needed]

  • Lower jiao pattern — symptoms include low grade fever in the afternoon, hot palms and soles (also called "five palm heat"), dry mouth, convulsions, deep-red tongue with no coat, fine-rapid pulse.[citation needed]

Other Zang Fu organs were not included in the San Jiao model.

The Hand Channel of San Jiao Shao Yang is so called because of its generalized effects across the San Jiao. San Jiao is not an organ. In fact, many Zang Fu organ translations do not directly correspond with their defined Western organ. They more often refer to systems or functions within the body, and are useful to describe the flow of energy, which in turn helps prescribe therapy to disharmony.

The Shao Yang channel is the second shallowest channel in the six divisions of channel theory, and its hand division - San Jiao - starts at the fingernail of the ring finger, travels up the outside center of the hand and arm, encompasses the elbow, continues to the back of the Acromio-clavicular joint (part of the shoulder), meeting with the other Yang channels at the junction of the seventh cervical and first thoracic vertebrae (GV-14 "da zhui"), before travelling up the neck to behind the ear, encompassing the external ear and terminating at outer tip of the eyebrow. Aside from Wai Guan (TE-5), its points' most common clinical uses are for local problems.


In TCM theory, the San Jiao is a yang organ paired with the pericardium (Xin Bao) which is the yin organ associated with it. Yang (Fu) organs are typically hollow, whereas yin (Zang) organs are more solid. The triple burner, however, is said to be primarily energetic and does not have a physical component, unlike all the other organs in TCM. In dissecting a body, one would not be able to find a structure that could be called the San Jiao.

The San Jiao's Hand-Foot partner is Dan (Gall Bladder).


The San Jiao is also said to be a metabolism mechanism similar to an old-fashioned water wheel that is turned by incoming water and creates energy for accomplishing a task, such as grinding grain in the case of the water wheel, or for metabolising and digesting food in the case of the San Jiao. The San Jiao is closely associated with the spleen functions of transformation and transportation, particularly the metabolism of incoming food. The San Jiao is also closely associated with the kidney's function in TCM. The San Jiao, however, is not limited to one metabolism function as the spleen or kidneys are, but is a general metaboliser which can be applied to a variety of metabolism needs.

This dual usage of San Jiao to refer to a specific metabolic function and to refer to the areas of the body is a source of confusion, and care should be taken to make it explicit which is being referred to.

Wu Xing[edit]

San Jiao is related to the fire element of the Chinese Five Elements.


  • Kaptchuk, T.J. Chinese Medicine: The Web that has no Weaver. 2000. London: Rider.
  • Maciocia, G. The Foundations of Chinese Medicine. 2000. Churchill Livingstone.
  • Wiseman, N., Ye F. A Practical Dictionary of Chinese Medicine.1998. Paradigm Publications.

See also[edit]