ITM Home Page | Article Index

TRIPLE BURNER (SANJIAO)

with reference to treatment of Sjgrens Syndrome
by Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, OR

The Name Sanjiao

The meaning of the name triple burner, sanjiao, is unclear; burner gives the impression that this organ
system generates heat, perhaps a lot of heat, but there is little evidence that it does that, rather acting as
a conduit for heat transferred between other organs. An alternative interpretation of the name has been the
three burning spaces which is somewhat better, in the sense that the location or zone of influence of this
organ system can encompass three heat sources without itself being the generator of the heat (e.g., kidney,
spleen, and heart yang). Even then, the term is not entirely suitable. One of the commentators on
the Nanjingonly his name Yang is retainedsaid that jiao stands for yuan (origin; the response to
question 66 of the Nanjing states that Origin is an honorable designation for the Triple Burner), and that
the sanjiao refer to the three origins: heaven, earth, and water. This seems a reasonable understanding; the
upper jiao receives ethereal influences and may be likened to heaven; the middle jiao is associated with the
earth element; and the lower jiao is associated with draining of water. By contrast, one of
the Nanjing commentators, Hua Shou, said that the triple burner represents the ministerial fire; this
opinion is not supported by others; Xu Dajun considered that the triple burner provided a passageway
between the fire of the kidney and of the heart (the latter called ministerial fire). The triple burner is not
physically oriented as such a conduit, but a major function attributed to it is keeping open the flow of qi, and
that may be its function in relation to the kidney and heart fires.
Triple Burner: an Organ with Name but not Form or Shape
The organ systems of Chinese medicine do not always correspond with physical organs, and even when they
do the functions attributed to the organ in the Chinese understanding go beyond what we are able to discover
about a physical organ. For example, the spleen, pancreas, and digestive system, as well as the pervasive
immune system components, might correspond in some way to the Chinese pi (spleen), which is said to
lie above the stomach. The lack of a direct linkage of such Chinese multi-functional descriptions with
modern observational organs has led to the use of terms such as organ system (which I tend to make use
of) or even orb, so as to avoid becoming caught up in these relational difficulties. As a discussion of the
triple burner progresses, the divergence in thought about the form and function of organs will become
obvious.
The sanjiao has been recognized in the Chinese system as having less physicality than the other defined
organs. The liver (gan) does not closely correspond with the functions of the liver that we identify today, yet
there is a substantive organ in the body which the Chinese can point to, and we would say it is the same one
we call the liver. This connection can be made, in part, because the associated organ, the gallbladder, which
has some different properties in the Chinese system than are otherwise recognized, also has a physical
connection with the observed liver. The Chinese specify that the liver and gallbladder each have a form,
shape, size, capacity, etc. Since the Chinese view is not highly dependent on the physical characteristics, but
associated with conceptual aspects, such organ descriptions may be adjusted to fit the dogmatic features.
Thus, it can be said that there is a color associated with the triple burner, but this has to do with the general
principles, not observable features.
The lack of shape and physicality of the triple burner was disturbing to many Chinese medical
scholars, and so they interpreted some of the Neijing and Lingshu statements about the triple burner as
pointing to a membrane that encased the entire torso, having three parts: one covering the chest cavity; one
for the upper/middle abdomen; and one for the lower abdomen. However, such projection of a form
seems out of touch with the primary descriptions of the triple burner, and represents part of the struggle to
figure out its nature and qualities.

Before the Neijing was produced, there were deemed to be 11 organs and 11 associated meridians, not
12. In theNanjing, one can see that there is a divergence of explanations, suggesting either 5 zang and 6 fu
or 6 fu and 5 zang, or 6 zang and 6 fu, the latter was finally settled upon, with the triple burner being the
6th fu, as described response to question 38 of the Nanjing. The organs that were in flux in these differing
counts were the pericardium (heart protector) and triple burner.
The Neijing unequivocallydepicts the triple burner as one of the fu, but it is an orphan organ; it is
unlike the other zang-fu. The saying is that the triple burner has a name but not a form or shape (mentioned
in question 38 of the Nanjing). Despite its lack of specific physical bounds, this organ system can be
described in terms of location and functions.
The Neijing was handed down to physicians and scholars and whatever it said was taken as the starting
point for any further discussion; the Neijing is not organized like a modern textbook that attempts to be
complete within its area of concern, and those relying upon the Neijing may need to intuit the intended
meaning, taking into consideration the various statements it contains, some of them conflicting. Through
acupuncture meridian theory and the basic concept of pairing that arises from yin/yang, the triple burner
becomes associated with the pericardium, an organ system which is unlike any of the other zang in terms of
functionality and form.
The description of the triple burner as an orphan or without form does not imply any reduced
consequence to its bodily influence, just a different nature. In the five element affiliations, there are five
zang-fu; this pair (pericardium/triple burner) is outside the five, but placed along with the fire element,
primarily via the close association of pericardium and heart. This association has contributed to the
development of the concept that the triple burner is an organ that generates heat, or specifically channels
heat, but that is not necessarily the case.
My intention for the following discussion is to turn to a section of the Nanjing and the commentaries
that have been recorded about it, as presented by Paul Unschuld (Medicine in China series; Nan-Ching:
The Classic of Difficult Issues; 1986). I will diverge from the translated text only in backtracking from
some of his translation terms: where he calls qi influences in an effort to be explanatory, I will go back
to qi; he calls the fu palaces and Ill return to fu, and so on. I dont believe his efforts at clarification of
these basic terms help us today as much as he hoped they would when he did this initial work thirty years
ago.
The commentaries about the Nanjing passages were originally made in Chinese but apparently lost;
these were later recovered from Japanese translations, which were then put back to the Chinese. Many of
the scholars commenting upon the Nanjing are not known, but some of them are. The commentator that
seems to have the most relevant statements about the triple burner is Y Shu. There are at least three
difficult issues that include commentaries on the triple burner, I am focusing on the principal discussion,
which is the first one, found in the 31 stDifficult Question. Before proceeding, Id like to relay one of the
comments recorded about this difficult issue of the triple burner. It is by Liao Bing who says in response
to the question posed about the triple burner: The text of the Neijing is quite clear on this. Why should
anybody make it the subject of a question? In fact, the triple burner remains a subject of much debate.
The Nature of the Triple Burner
A model for the triple burner that came to be relied upon, at least as an image to work from, was a
fermentation vat, such as used for making rice wine or beer. That fermentation process, developed in
ancient times, was utilized in the Han Dynasty period (when the Neijing was written) to make health drinks
that combined the alcoholic beverage with herbs. The fermentation vesselsand their contentswere
cruder than what wine and beer producers use today.
The brewers noted that at the top of the vessel, which was where the water and grain and yeast were
poured in, there developed a fragrant mist that smelled like the wine or beer essence. At the upper part of
the fluid was foam, made from the bubbling mixture that had some impurities contributing to generating the
foamy top. Towards the bottom was a mixture in which solids were accumulating, and leaving a relatively
clear liquid above them. The clear liquid would then be tapped to provide the drinkable wine or beer.

Thus, we will find a description of the upper burner involving fog or mist; the middle burner
involving fermentation (rotting), foam, and collections of bubbles; and the lower burner involving clear
liquid and turbid substance separating out as the dregs.
This tripartite division of the vessel contents is not unlike the traditional description of qi that is modeled
on the experience of the rice cooker: the steam above the cooking rice, which has the fragrance of the rice, is
like qi; the lid of the pot is where the vapor condenses and falls back; the boiling rice is being transformed
by the heat and water to make a soft, edible, and digestible product from the hard dry raw material; and the
transformation of the rice and water take place by virtue of the fire that was stoked below the pot and which
first heated the bottom portion. The main difference between these models is that the fermentation process,
unlike the cooking process, does not require a significant amount of heat to be introduced, and the rice pot
does not leave behind a waste residue from the cooking process.
The Nanjing, 31st Difficult Issue
The Nanjing is a series of questions with answers and the collection of 81 Difficult Issues is intended to be
an examination and further explanation of the Neijing. Number 31 is about the triple burner. The question
is: The triple burner: how is it supplied and what does it generate? Where does it start and where
does it end? And where, in general, are its disorders regulated?
The response begins: The triple burner encompasses the passageways of water and grain.
This is a critical description because the fu are generally receptacles, often receiving materials that have
been processed by other organs. The stomach, gallbladder, small intestine, and large intestine are all
receptacles. The stomach is the only one of them which can be said to receive material (food and water)
which has not been processed by another organ (there is some processing in the mouth, but not through
action of a zang or fu). As we understand it today, the bladder receives its liquid waste from the kidney, but
that was not the way it was understood during the time period of triple burner description. Rather, the
bladder received liquids that were separated from solids outside the kidney, an organ system which was
viewed, instead, as the reservoir of yin and yang, and a source of yin essence and heat. The various
receptacles (fu) retain material for a while and then pass it on; so they are not long-term retention sites (as,
for example, the kidney stores the essence or the liver stores the blood). The triple burner is indicated in this
initial response as not being a receptacle, but a passageway; that is to say, unlike the other fu organs, it is not
retaining material that is later to be passed on.
The next part of the answer is: It represents the conclusion and the start of the course of qi. The
start of qi being discussed here has three meanings: the first is that the qi from the food starts in the
stomach, at the site of the middle burner, and the other is that the qi coming upward from the stomach
eventually transmits to the organs to make the 25 passages through the body during the day, and again 25
passages at night. The third implication is that the yuan qi (original qi, source qi) transmits through the
triple burner to the rest of the body.
The upper section of the triple burner extends from below the heart downward through the
diaphragm and ends at the upper opening of the stomach. This is a very small segment. From the
modern viewpoint, a passageway for water and grain that comes to the upper opening of the stomach would
represent a portion of the esophagus. That is consistent with one part of the concept the Chinese scholars
expressed: it is literally the entry point for water and food that is consumed. The passageway described here
is also the means by which the qi flows upward from the stomach to the cavity of the chest, ultimately to
interact with lungs and heart. To move upward, it has to pass through the diaphragm, which also has a
hole in it. We consider the diaphragm as having a function related to breathing; the Chinese saw it as a
membrane keeping the turbid substances below, and only allowing the purified and ethereal substances to
move into the chest cavity, by coming up through this hole. Chinese medicine descriptions generally start
from top to bottom. This burner is thus described as involving a small section from below the heart
downward Functionally, though, it is not only for a downward movement, but also for anupward flow.
It is responsible for intake but not for discharge. This is a passive function, of receiving, but there
is no active function of discharging, such as the gallbladder squeezing out its contents. This upper burner
serves as apassageway to and from the stomach.

What passes into the upper burner is described by the commentators; Y Shu characterized the upward
migrating qi this way: the upper burner resembles fog. That is to say, the upper burner allows the passage
of qi that resembles mist gently flowing out from the stomach and eventually entering into all the conduits;
one could even say that the upper burner is this mist.
Note that it is not steam but fog. Steam carries more heat and has a stronger upward flow; fog
expands but has little force. This fog moves upward from the stomach so that it can then be circulated; it
can be taken up by the conduits and make its passages around the body because it can rain down by action of
the lungs or be dispersed upward by action of the heart.
There is a burning place in the chest, the heart, a fire organ, and one commentator, Yeh Lin, has noted
that the upper burner essences move upward from below; they disperse in the chest and evaporatelike
steaminto the skin and pores. So, that portion which does not rain downward can continue upward. Ass
the qi moves beyond the upper boundary of this burner (below the heart), as it reaches the heart, it is then
heated and transformed to steam, rushing outward to the skin. When, as it is sometimes considered, the
upper burner is depicted not as it is here, but as involving the entire area above the stomach, one can say that
there is a burner, the heart, and that it steams the qi and moisture upward and outward, observed as
perspiration.
The central section of the triple burner is located in the central duct of the stomach; it does not
extend further upward or downward. This is a very small segment, and is within the stomach; do not
seek out a central duct from modern anatomy, for this is a conceptual term not an observable one; a
commentator indicated that the liver was within this duct, so the visualization of this portion has been
difficult.
It is responsible for the spoiling and processing of water and grains. The Chinese daily experience
of this kind of process would be a compost pile or a fermentation vat. These involve passive processes, one
that simply requires having the raw materials and allowing some time. However, here is where the process
involves some heat. Fermentation requires some minimal warmth, which is ultimately from the kidney and
spleen yang; this is why physically cold food is of concern. Some warmth is generated from the
fermentation process, which is thus self-maintaining. One must be careful to distinguish this warmth from
the pathological condition stomach fire. The normal fermentative action is displayed by production of
bubbles, which can yield gasses within the digestive system. One commentator, Y Shu notes that the
central burner resembles foam.
The lower section of the triple burner begins exactly at the upper opening of the bladder and
extends downward. This section appears to be within the bladder, but in fact, the bladder is within it. It
is responsible for separating the clear from the turbid portions. This separation is a passive process
that is like silt coming out of water that previously was flowing but is now held still. Xu Dajun explains:
Water and grains are normally present in the stomach simultaneously. They become dregs and move
downward together. When they reach the large intestine, they enter the realm of the lower burner. The
liquid portions are then strained off; they follow the lower burner and leak into the bladder. The solid
portion is then eliminated via the large intestine.
It [lower section of the triple burner] masters discharge, but not intake, and it severs as a
transmitter. This is the opposite of the upper burner, which is responsible for intake but not discharge.
There is some active function here, but not strongly so; letting the urine flow outward is primarily
a relaxation of the sphincter, with some contraction of the bladder wall. The lower burner also masters the
discharge of feces, which similarly involves relaxation of the sphincter and some contraction of the intestinal
wall. The Nanjing commentator Yang says the triple burner masters the timely passage downward of the
stools.
When defecation and urination are normal, they are quick and relatively effortless actions. A model is
the Japanese bamboo tipping fountains, where water drips into a piece of bamboo, and once it accumulates
past the half way point, the bamboo tips and dumps its contents, this is somewhat like this transmitter
function. The waters flowing downward are not all eliminated; there are ditches that run to the legs, and
some water is directed to the kidney where it steams upward to reach the lungs.

The lower burner serves as a transmitter, in that it maintains the openness of the bodily passages: excess
moisture is drained; the dregs are isolated and eliminated; channels are relaxed to allow free flow of qi.
Hence one speaks of a triple burner. Its qi is collected at the street of qi (qijie). Jie indicates a
street. Y Shu, notes that qi jie refers to points two cun on either side of the center in the hair of the lower
abdomen (clarified as being at the hairline, that is, the top of the pubic hair; so on either side of CV2, qugu). Such collection of qi, resting of flow of qi, is also attributed to the shu point of the triple burner,
which is BL-22 (sanjiaoshu).
The Nanjing text indicates acupuncture points where one can regulate each of the burners: between the
breasts (CV-17, which is the meeting point of the qi and of several vessels, including the spleen and triple
burner); on either side of the navel (lateral to CV-8), and one inch below the navel (CV-7), for the upper,
middle, and lower burners respectively. These treatments are not the subject of the current paper. Giovanni
Maciocia (Resolving dampness and phlegm with acupuncture) has given examples of points that might be
selected to activate water transformation by the sanjiao, which is only one of its functions:
Upper Burner: GV-26, CV-17, LU-7; LI-4; LI-6; TB-4; TB-6
Middle Burner: CV-9, BL-22, CV-12, ST-22, CV-11
Lower Burner: ST-28, CV-5, BL-22, BL-39, SP-9, SP-6, KI-7
He notes that TB-4 and BL-64 together move qi in the Triple Burner and activate water passages.
Triple Burner Functions: The Ditches
It is said that the triple burner, and especially the lower burner, represents the official responsible for
maintaining the ditches. Unlike rivers, streams, and seas, all of which maintain themselves via their natural
functions, ditches are provided as a means for transmitting the water to a desired place, passively directing
and facilitating its movement. Ditches have to be maintained because they tend to fill in and clog up.
Keeping the ditches open is what the triple burner must do, but how? One method is to open constriction
points: relaxing sphincters or pores; reducing tension of muscles around transportation tubes; freeing up
spaces in the joints. A term that has gained popularity in recent times is to disinhibit (herbs formally
referred to as being diuretics are described as disinhibiting urination.) Acupuncture at points of the triple
burner meridian, or at the other points that influence its activities, aid the opening action. Failure to
maintain the healthy function of the triple burner can lead to frequent or deficient urination and to diarrhea
or constipation; there may be cases where moisture and dryness separate or alternate, and where the
moisturizing and drying actions of the organs fail to produce the beneficial physiological effects.
The opening function of triple burner is not just for the ditches; it influences other body
components. This action is revealed in the functions associated with the acupuncture points on the triple
burner meridian. InFundamentals of Chinese Acupuncture (1988; Ellis, Wiseman, and Boss), the
following functional terms are included:
Designations

Points with the Function

Notes

Courses Channel and Connecting

Vessel Qi; Courses Channels and
Quickens the Connecting Vessels;
Courses the Channels and Frees the
Connecting Vessels; Frees the
Channels and Connecting Vessels;
Frees the Channels and Quickens the
Connecting Vessels

TB-1 (guanchong); TB-2 (yemen); TB-3

(zhongzhu); TB-4 (yangqi); TB-5
(waiguan); TB-8 (sanyangluo); TB-9 (sidu);
TB-11 (qinglengyuan); TB-12 (xiaoluo);
TB-13 (naohui); TB-15 (tianliao); TB-16
(tianyou); TB-17 (yifeng); TB-18 (chimai);
TB-19 (luxi); TB-20 (jiaosun); TB-21
(ermen); TB-22 (heliao); TB-23 (sizhukong)

Channel here is jing; connecting

vessel is luo. The different wording
all points to the freed up movement
in the jingluo; from TB-17 to TB-20,
as well as for TB-22 the freeing
ofjing is not mentioned in the text as
one of the functions, only the
quickening of the luo is indicated.

Frees Bowel Qi

TB-6 (zhigou)

This indicates that it allows passage

of stool; the point is used to treat
constipation

Soothes the Liver

TB-7 (huaizong)

Shugan: to relax the tension of the

liver freeing circulation of qi.

Frees and Regulates the Waterways

TB-9 (sidu)

The distribution of water, if blocked,

may cause swellings.

Disinhibits the Throat

TB-9 (sidu)

Relaxes the throat to improve vocal

functions.

Opens the Portals; Frees the Portals

TB-9 (sidu); TB-17 (yifeng); TB-18

(chimai); TB-21 (ermen); TB-22 (heliao);

Portals refers to the ears; deafness,

tinnitus, and other hearing disorders
are understood as closing down of the
portals.

Transforms Phlegm-Damp in the

Channels and Connecting Vessels

TB-10 (tianjing)

This is a method of freeing

the jingluoby causing the phlegmdamp to flow more freely.

Disinhibits the Joints

TB-13 (naohui)

By relaxing the swelling and tension

of the local joint

The opening, freeing, soothing, and quickening aspect of the Triple Burner is expressed in the response
to Difficult Issue 66 of the Nanjing where it is said that The Triple Burner is the special envoy that
transmits the yuan qi. It is responsible for the passage of the three qi through the bodys five zang and six
fu. The function of transmitting, gives the impression of activity, but it is like the wires that are used to
transmit electricity across great distances; the wires are not active, but are necessary for the transmission.
Final Comments about the Sanjiao
The important lesson about the triple burner is its relative passivity, its minimal fire, its starting point for
the circulation of qi, its control over the discharge of waste (urine and feces), and the general function of
disinhibiting. Scholars throughout the centuries since the Neijing was written have speculated upon the
triple burner, and the descriptions of it run the full gambit from being somewhat passive, as Ive described,
to being central to the actions of the body. It must be kept in mind that passive functions are not
unimportant or ineffective, just as an orphan organ without form is not without consequence. All the organs
of the body play a role, ultimately, in all the functions of the body. Thus, for example, in a modern
text Essentials of Chinese Medicine (1989; Xu Xiangcai) it is noted that with regard to fluid metabolism:
Normal production, distribution, and excretion of body fluid areinseparable from ascending or descending
and incoming or outgoing movements of qi and the functional activities, transporting and transforming
function of the spleen, dispersing and descending function of the lungs, water-regulating function of the
kidneys, and clearance and regulation of water passage by the sanjiao. The lack of a firm dividing line
between these bodily components and their actions means that the primarily passive organs/functions and
the primarily active organs/functions are integrated. The view of the triple burner presented here, based
especially on the Nanjing and some of its commentators, ultimately may aid understanding of how this
organ system can be addressed through acupuncture therapy to treat numerous diseases.
Since the upper jiao receives water and grain from the mouth and the qi passes upward through the upper
jiao to interact with the heart and lungs, it is reasonable to consider that the chest area represents the zone of
action of the upper burner. Again, since the middle jiao operates in the stomach and sends its qi through the
spleen, where it both nourishes the spleen and is acted upon by the spleen, it is reasonable to consider the
upper abdomen, the area of the stomach and spleen, to be the zone of the middle burner. Finally, since the
lower jiao affects the separation and discharge that occurs in the lower abdomen, which is the area of the
kidney and liver and intestines, it is reasonable to consider the entire lower abdomen the zone of the lower
burner.
The ying essence derived from food, a process taking place in the middle burner with passage through
the upper burner, will then rain down to the lower body; the yang essence, including wei qi, will rise up from
the lower jiao, especially under the influence of the upward action of liver and kidney yang. All these
essences circulate throughout the body, so one can only speak of an origin point in a relative manner. The
triple burner, subtending the three zones and involving the processing of grains and water, is a fitting marker
for the beginning movements of fog and mist, ying and wei, and the yin and yang passageways.

Sample Application: Sjgrens Syndrome

Sjgrens Syndrome (or disease) is characterized through modern investigations as a type of autoimmune
disorder in which the immune system attacks, and eventually destroys, the glands that secrete tears and
saliva. Hence, the two primary symptoms are dry eyes and dry mouth (other organs dependent on secretion
of fluids can be impacted over time). This disorder primarily affects women (9:1 ratio over men), and
mainly menopausal women. Since menopause is associated with drynessaffecting skin, hair, intestines,
and vaginal wallthe experience of Sjgrens Syndrome can be extensive dry conditions. Sjgrens
Syndrome can be of considerably different severity, with some people having mild symptoms that can be
managed with relatively simple remedies for dryness, others having a remitting/relapsing condition in which
there are periods of relative freedom from symptoms and then flare ups of more severe symptoms, and
others have a persistent or worsening disorder with severe symptoms. Thus, from the modern medical
viewpoint there are two primary targets for treatment: the immune system to protect against destruction of
the glands, and the dried surfaces, to give relief from the symptoms and also prevent other damage due to
dryness (especially of the eyes).
TCM developed without a basic knowledge of autoimmune disorders, so utilizes a different way of
interpreting the condition. A typical TCM response to Sjgrens Syndrome is to focus on the dryness as a
sign of insufficient yin, and treat with herbs that are moistening in nature. Such a response is further
suggested when there are menopausal symptoms, which are generally attributed to deficiency of kidney and
liver yin. Some of the yin nourishing and moistening herbs are considered especially suitable for the upper
body, and these may be of special interest because of the dry eyes and mouth.
The discussion of the triple burner is of interest in regard to a sophisticated approach to the problem,
because of the mist rising up in the upper burner, and the reputation of the triple burner in regulating fluid
distribution (namely, that the ditches serve as a starting point for transportation of water). In fact, some
cases of Sjogrens Syndrome are seen by TCM doctors as accumulation of dampness, perhaps accompanied
by heat; the problem is one of improper separation and flow of the moisture, rather than its absence.
The first part of the treatment plan involves making sure that the fermentation in the middle burner is
fully active. The grain and water refer to food generally, but grain is considered an important part of the
qi generating process, so if the patient has deleted or cut back significantly on grains, that could be a
beginning problem. We usually dont administer yeast (qu, or chu) to promote digestion, but there is a
Chinese yeast that is commonly used:shenqu (shen-chu). Similarly, in Chinese medicine the chicken gizzard
lining (jineijin) is utilized to aid the breakdown and metabolism of foods in the stomach. These ingredients,
and digestive formulations made with one or both, may help promote this fermentation process. The other
thing we use in modern times for this purpose is digestive enzymes.
Then, with a healthy foaming and fermentation there will be the mist or fog that rises upward. This
passage is controlled, in part, by acupuncture at CV-17. As the vapors reach the lungs, some of the moisture
is rained downward. This is a good thing, but if the lungs are cold then there is too much of the fragrant qi
going down. Platycodon is an example of a gently warming herb for the lungs that has an opening and
diffusive quality. If the heart is too hot, then the mist is steamed rapidly to the surface, causing excessive
perspiration. Herbs such as gardenia and coptis may be used to reduce the excess fire of the heart, and
acupuncture of HT-5 or other draining points of the heart channel can be used. Astragalus may be of value
in that it promotes the digestive function, warms the lung, and closes the pores. The clear qi that makes it
past the lung (when it is warm enough) and past the heart (when it is cool enough) makes it to the head.
Here, herbs and acupuncture that keep the channels open are of value. This is especially a role of the triple
burner meridian. Of course, other meridians may be needled to address problems with stomach, spleen, or
other involved organs.
The approach of regulating the sanjiao for Sjgrens has been suggested in recent literature. For
example, the following abstract is from the Medical Acupuncture Online Journal:
Wu Z, Wang H. Sjgrens syndrome treated by regulating Sanjiao. International Journal of Clinical
Acupuncture. 2000;11:39-42.
Abstract: Sjgrens syndrome, with dry mouth, eyes, and other organs, is a chronic autoimmune disease.
Traditional Chinese Medicine (TCM) links it to deficiency of body fluid and exhaustion of Yin and blood.

Detail of the symptoms, diagnosis, and TCM factors is given. Sanjiao is the water passage point, and points
along this meridian are selected along with lung meridian and local points. If there are signs of heat, GV-14,
LI-4, and LU-11 are added. For dry mouth and nose, CV-12, Stomach meridian and Spleen meridian points
are added. If the lower jiao is involved (bladder, genitals), Kidney, Bladder, Stomach, and Large Intestine
meridian points become important. The authors have had good fortune treating with acupuncture and a
typical case is presented.

September 2010