THE TRIPLE BURNER (2)

In the previous Clinical Tip (August 2011) we discussed the nature and functions of the Triple Burner as the activator of the Yuan Qi based primarily on the Nan Jing. In this Clinical Tip, I will discuss the second nature of the Triple Burner, i.e. as a system of waterways which is primarily from the Nei Jing.

2) The Triple Burner as a system of waterways
The view of the Triple Burner as a system of waterways is found primarily in the Su Wen but also in the Nan Jing. From this point of view, the Triple Burner is a Fu organ, i.e. it “has a form”. You will remember that the Triple Burner that is the activator of the Yuan Qi has “no form”, i.e. it is a set of functions and not a Fu organ.

Chapter 31 of the Nan Jing describes the Triple Burner as the “avenue of water and food”: “The Triple Burner is the avenue of water and food, and the beginning and end of Qi. The Upper Burner extends from below the heart and diaphragm up to the mouth of the stomach; it is charge of receiving and it does not discharge. It is treated via the Tan Zhong point [Ren-17]. The Middle Burner is located at the central duct of the stomach [Zhongwan]; it does not extend any further up or down; it controls the processing of water and food and it is treated at the sides of the umbilicus [ST-25?]. The Lower Burner starts above the upper opening of the bladder; it separates the clear from turbid; it controls discharge and it does not intake; it acts as a transmitter. It is treated one inch below the umbilicus [Ren-6 or Ren-5?]. Hence, one speaks of Three Burners. It collects at Streets of Qi [Qijie, ST-30]”

This chapter mentions three aspects of the Tripe Burner: first, the Triple Burner as the “avenue of water and food”; secondly, the Triple Burner as the “beginning and end of Qi”; thirdly, the Triple Burner as a three-fold division of the body.

This chapter of the Nan Jing clearly relates the Three Burners to a system of food and fluid digestion, transportation, transportation and excretion. Therefore this function of the Triple Burner would encompass that of the Stomach, Intestines and Bladder. Note that this function of the Triple Burner really has little to do with the Triple Burner channel in the arm: in other words we do not stimulate the transportation, transformation and excretion of food and fluids through the Triple Burner channel but mostly through Ren Mai points: Ren-17 Shanzhong for the Upper Burner, Ren-12 Zhongwan for the Middle Burner and Ren-5 for the Lower Burner. Of course, there are other points too that affect the digestion function of the Triple Burner, such as ST-25 Tianshu for example. These will be listed below.

From the point of view of the Triple Burner as the organ of transformation of fluids and food, there is therefore a convergence of views between the concept of Triple Burner in the Nei Jing and that in the Nan Jing, i.e. between the Triple Burner as an organ and the Triple Burner as a function, even though the starting point of these two classics is different. However, the Nei Jing emphasizes the role of the Triple Burner in its “letting out” function, seeing the three Burners as three avenues of excretion or “letting out”. The Nan Jing, on the contrary, places emphasis on the function of “receiving”, “rotting and ripening” and “excretion” of food and fluids, seeing digestion as a process of “Qi transformation” activated by the Yuan Qi through the intermediary action of the Triple Burner.

Chapter 8 of the “Su Wen” which describes the functions of all the Internal Organs comparing them to “officials”, says: “The Triple Burner is the official in charge of ditches”. This means, that just like the government official who is in charge of irrigation, the Triple Burner is responsible for the transformation, transportation and excretion of fluids. This is one of the most important functions of the Triple Burner. The terms used in Chinese in connection with the Triple Burner influence on the body fluids are often shu which means “free flow” and tong which means “free passage”. Therefore the Triple Burner is like a system of canals and waterways to channel irrigation water through the proper fields and then out: this ensures that body fluids are transformed, transported and excreted properly.

The Triple Burner function in relation to body fluids is closely dependent on its function of controlling the transportation and penetration of Qi (see point 3 below). As described below, the Triple Burner influences the ascending/descending and entering/exiting of Qi in the Qi Mechanism: it is the coordinated and harmonized ascending/descending and entering/exiting of Qi in all organs and structures that ensures that the body fluids also ascend/descend and enter/exit in the proper way in all places. Essentially, the transformation and movement of fluids depends on Qi.

The end result of the complex process of transformation, transportation and excretion of fluids leads to the formation of various body fluids in each of the three Burners. The fluids of the Upper Burner are primarily sweat which flows in the space between skin and muscles; those of the Middle Burner are the fluids produced by the Stomach which moisten the body and integrate Blood; those of the Lower Burner are primarily urine and the small amount of fluids in the stools.
I. The Upper Burner is like a mist
The main physiological process of the Upper Burner is that of distribution of fluids all over the body in the space between skin and muscles by the Lungs in the form of fine vapour. This is an aspect of the Lung diffusing function. For this reason the Upper Burner is compared to a “mist”.
The Ling Shu in chapter 30 says: “The Upper Burner opens outwards, spreads the 5 flavours of the food essences, pervades the skin, fills the body, moistens the skin and it is like mist”.

ii. The Middle Burner is like a maceration chamber
The main physiological processes in the Middle Burner are those of digestion and transportation of food and drink (described as “rotting and ripening”) and the transportation of the nourishment extracted from food to all parts of the body. For this reason the Middle Burner is compared to a “maceration chamber” or a “bubbling cauldron”.

The Ling Shu in chapter 18 says: “The Middle Burner is situated in the Stomach . . . it receives Qi, expels the wastes, steams the body fluids, transforms the refined essences of food and connects upwards with the Lungs”.

iii. The Lower Burner is like a ditch
The main physiological process in the Lower Burner is that of separation of the essences of food into a clean and dirty part, with the excretion of the dirty part. In particular, the Lower Burner directs the separation of the clean from the dirty part of the fluids and facilitates the excretion of urine. For this reason the Lower Burner is compared to a “drainage ditch”.

The Ling Shu in chapter 18 says: “Food and drink first enter the stomach, the waste products go to the large intestine in the Lower Burner which oozes downwards, secretes the fluids and transmits them to the bladder”.

Clinical application
There are many points that stimulate the Triple Burner’s transformation and excretion of fluids. I will list them according to each Burner:

- Upper Burner: Ren-17 Shanzhong, LU-7 Lieque, L.I.-6 Pianli, L.I.-4 Hegu, Du-26 Renzhong (also called Shuigou, i.e. “Water ditch”).
- Middle Burner: Ren-12 Zhongwan, ST-21 Liangmen, Ren-9 Shuifen, Ren-11 Jianli, ST-22 Guanmen, BL-20 Pishu.
- Lower Burner: Ren-5 Shimen, BL-22 Sanjiaoshu, ST-28 Shuidao, BL-23 Shenshu, Ren-6 Qihai, SP-9 Yinlingquan, SP-6 Sanyinjiao, KI-7 Fuliu, BL-39 Weiyang.

When fluids stagnate, Dampness, Phlegm or oedema may arise. In order to activate the Triple Burner to move fluids, I activate each Burner using some of the points above, using more points from the Burner where the fluids stagnate. For example, if there is Dampness in the Lower Burner, I would use several points from those of the Lower Burner plus one or two from the Upper and Middle Burner. This usually means that when I stimulate the transformation, transportation and excretion of fluids, I do not hesitate in using more points than I would normally.

For example, if there is Dampness in the Lower Burner causing a urinary problem I would use these points:
- Lower Burner: Ren-3, Ren-5, BL-22, BL-28, SP-9, BL-39.
- Middle Burner: Ren-9.
- Upper Burner: LU-7.

To give an example from the Middle Burner, if there was Phlegm in the Stomach, I would use these points:
- Middle Burner: Ren-12, Ren-9, ST-21, BL-20, Ren-11.
- Upper Burner: L.I.-4.
- Lower Burner: ST-40, SP-9.

END NOTES
1. 1979 The Yellow Emperor’s Classic of Internal Medicine-Simple Questions (Huang Ti Nei Jing Su Wen). People’s Health Publishing House, Beijing, first published c. 100 BC, p. 59.
2. Medicine Treasure cited in Wang Xin Hua 1983 Selected Historical Theories of Chinese Medicine (Zhong Yi Li Dai Yi Lun Xuan). Jiangsu Scientific Publishing House, p. 2.
3. 1981 Spiritual Axis (Ling Shu Jing). People’s Health Publishing House, Beijing, first published c. 100 BC, p.71.
4. Selected Historical Theories of Chinese Medicine, p. 2.
5. Spiritual Axis, p. 52
6. Selected Historical Theories of Chinese Medicine, p. 2.
7. Spiritual Axis, p. 52