THE TRIPLE BURNER (3)

In the last Clinical Tip (September 2011) we discussed the role of the Triple Burner as the avenues of fluids, a view deriving primarily from the Nei Jing. In the previous Clinical Tip (August 2011), we discussed that of the Triple Burner as the agent of the Yuan Qi, a view deriving primarily from the Nan Jing. We shall now discuss the view of the Triple Burner in relation to the movement of Qi.

3) The Triple Burner governing movement of Qi
Chapter 38 of the Nan Jing mentions the function of the Triple Burner in governing all Qi in the body. “The Triple Burner stems from the Yuan Qi; it governs all Qi in the body, it has a “name but no form”, it belongs to Hand Shao Yang, it is an external Fu.”1

This short passage summarizes most of the aspects of the Triple Burner:
1) It stems from the Yuan Qi (discussed in the August Clinical Tip).
2) It governs all Qi of the body (we shall see how below).
3) The Triple Burner has “a name but no form”, i.e. it is not an actual organ but a function.
4) It pertains to the Shao Yang with the Gall-Bladder.
5) It is a Fu.

Let us explore now the meaning of the Triple Burner governing the movement of Qi. The movement of Qi in general is called the “Qi Mechanism” (Qi Ji 气 机). This Qi Mechanism consists in the ascending/descending and entering/exiting of Qi in different places and different organs. Each organ has a particular direction of flow of Qi, e.g. Spleen-Qi ascends while Stomach-Qi descends. In each channel, Qi flows in an upward or downward direction. As acupuncturists, we are very familiar with the ascending/descending movement of Qi.

We use this movement every time we insert a distal and a local point to treat a particular problem along a channel. For example, when we use L.I.-1 Shangyang (for example) and L.I.-15 Jianyu to treat a pain in the area of the acromio-clavicular articulation of the shoulder, we are making use of the ascending/descending movement of Qi along the Large Intestine channel. By stimulating the ascending/descending movement of Qi in the channel, we are removing the obstruction and therefore the pain.



We are somewhat less familiar with the “horizontal” movement of Qi, i.e. entering and exiting of Qi. Qi enters and exits in and out of various structures and organs. For example, Qi enters and exits the space between skin and muscles, the Membranes, the joint capsules, and all other cavities. Moreover, Qi “enters and exits” in every part of the body among the Tai Yang, Shao Yang and Yang Ming and among the Tai Yin, Jue Yin and Shao Yin.



Take the shoulder as an example. On the scapula we have Tai Yang (Small Intestine channel), on the lateral side of the arm we have the Shao Yang (Triple Burner channel) and further forward the Yang Ming (Large Intestine channel). Within this zone of the body, the Tai Yang area is on the most Yang area (the scapula), the Yang Ming on the most Yin area (because it is near the Lung channel) and the Shao Yang in the middle: this ties in with the view that the Tai Yang “opens onto the Exterior”, the Yang Ming “opens onto the Interior” and the Shao Yang is “the hinge”. Exactly the same reationship exists in the Yin between Tai Yin (most exterior of the Yin), Jue Yin (the hinge) and Shao Yin (most interior of the Yin).



The “Avenues of Qi” (Qi Jie 气 街) described in chapter 52 of the Ling Shu are another example of the entering and exiting of Qi (“horizontal movement of Qi”): “In the chest Qi has streets; in the abdomen Qi has streets; in the head Qi has streets; in the lower legs Qi has streets. Therefore if [there is a problem with] Qi in the head, stop it at the brain; if [there is a problem with] Qi in the chest, stop it at the front of the chest and at the Back-Shu points; if [there is a problem with] Qi in the abdomen, stop it at the Back-Shu points and at the Chong Mai on the right and left of the umbilicus which is the Moving Qi [or Dong Qi]; if [there is a problem with] Qi in the lower legs, stop it at ST-30 Qichong [here called Qijie] and at BL-57 Chengshan.”2
Notice how it recommends the use of points in the front and the back for each area: in the chest, use the front of the chest and Back-Shu points; in the abdomen Back-Shu points and Chong Mai points; in the legs, ST-30 (front of leg) and BL-57 (back of leg). This suggests a “horizontal” movement of Qi within each area.

The Triple Burner controls the ascending/descending and entering/exiting of Qi in the Qi Mechanism. One of the words most frequently used in Chinese books to describe this function of the Triple Burner is tong 通 which means “free passage”, “to pass through”, “penetrate”: this describes the function of the Triple Burner in ensuring that Qi passes through in the Qi Mechanism, in all the cavities and in all organs. This whole process is called “Qi Transformation by the Triple Burner”: the result of the Qi transformation is the production of Nutritive-Qi (Ying Qi), Defensive-Qi (Wei Qi), Blood and Body Fluids. That is also why the Triple Burner is said to control “all kinds of Qi”.

The “Central Scripture Classic” (Zhong Zang Jing, Han dynasty) says: “The Triple Burner is the three original Qi of the body, it is the Yang organ of clear [Qi], it controls the 5 Zang and 6 Fu, Ying Qi and Wei 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 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.”3

As mentioned in the previous Clinical Tip, chapter 66 of the Nan Jing also confirms that the Triple Burner controls the movement of Qi in general: “The Triple Burner makes the Yuan Qi separate [into its different functions] and it controls the movement and passage of the 3 Qi [of the Upper, Middle and Lower Burner] through the 5 Zang and 6 Fu.”4 The “3 Qi” are the Qi of the Upper, Middle and Lower Burner: apart from referring generally to all the types of Qi in each Burner, this passage also refers specifically to the Gathering Qi (Zong Qi) in the Upper, Nutritive-Qi (Ying Qi) in the Middle and Defensive-Qi (Wei Qi) in the Lower Burner. Although the Defensive-Qi exerts its influence primarily in the Upper Burner and the superficial layers of the body (the space between skin and muscles), it originates in the Lower Burner from the Ming Men. Chapter 18 of the Ling Shu says: “Ying Qi originates from the Middle Burner; Wei Qi originates from the Lower Burner.”5

Chapter 38 of the Nan Jing also confirms that the Triple Burner exerts its influence on all types of Qi: “The Triple Burner stems from the Yuan Qi: it supports all of the Qi.”6 Chapter 31 confirms the influence of the Triple Burner on the movement of Qi in all parts of the body: “The Qi of the Triple Burner gathers in the avenues of Qi [Qi Jie]”.7 This means that the Triple Burner is responsible for the free passage of Qi in all channels but also all structures (such as cavities) of the body.

Thus, the Triple Burner’s function in governing the movement of Qi is quite similar to the Liver’s free flow of Qi and indeed, there are many similarities. With regard to the movement of Qi, it is useful to compare and contrast this function of the Triple Burner with those of Liver in ensuring the free flow of Qi.

The Liver ensures the free flow of Qi and this aids the ascending and descending of Qi in all organs, and especially in the Stomach, Spleen and Intestines: the Triple Burner's influence on the ascending/descending and entering/exiting of Qi extends to all organs. Moreover, the Triple Burner controls the entering and exiting of Qi in all parts of the body and especially the body cavities: the Liver has no such function in relation to the body cavities.

Clinical application
As the Triple Burner controls the movement of Qi in the Qi Mechanism. Its points may be used in a similar way to the Liver points to ensure the free flow of Qi. The main point I use to move Qi in the Triple Burner is TB-6 Zhigou.


1. 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, p. 94.
2. 1981 Spiritual Axis (Ling Shu Jing). People’s Health Publishing House, Beijing, first published c. 100 BC, p. 111.
3. Hua Tuo 1985 Classic of the Central Scripture (Zhong Zang Jing), Jiangsu Science Publishing House, Nanjing, p. 39. Written in Han dynasty.
4. Classic of Difficulties, p. 144.
5. Spiritual Axis, p. 52.
6. Classic of Difficulties., p. 94.
7. Ibid., p. 80.

The famous chapter 8 of the Ling Shu

Chapter 8 of the Ling Shu (entitled Ben Shen 本 神) is quoted very frequently, especially its famous opening sentence. I would like to comment briefly on that sentence and propose a different translation of it.

The opening sentence of chapter 8 of the Ling Shu is: Fan ci zhi fa, xian bi ben yu shen 凡 刺 之 法 先 必 本 于 神 and the words mean literally “every needling’s method first must be rooted in Shen”. This sentence is usually translated as: “All treatment must be based on the Spirit”. The implication of this sentence is that all treatment must be based on the Spirit (of the patient), whatever interpretation we give to the word “Spirit”.

I propose an alternative translation with two important differences. Firstly, the text uses the word ci which means “to needle”, not “to treat”. If the text had meant to use the term “to treat”, it would have used the word zhi 治which does occur a lot in both the Su Wen and the Ling Shu. Thus, the first difference is that the first half of the sentence is “when needling” rather than “when treating”: this is an extremely important difference.

The second difference is that the “Shen” referred to here may be interpreted as the Shen of the practitioner, not of the patient. Therefore, the whole sentence would mean: “When needling, one must first concentrate one’s mind [Shen]”. If that “Shen” is the Shen of the practitioner, then “Mind” would be a better translation here.

There are other passages in the Nei Jing that would support this view. For example, chapter 4 of the Ling Shu uses the word “shen” to mean the doctor’s skill in palpation and needling. It says: “When pressing on a channel [the doctor is capable of] understanding the disease: this is called shen.”

This different interpretation of the opening sentence of chapter 8 of the Ling Shu is consistent with two factors. Firstly, the Ling Shu is very much an acupuncture text and therefore the reference to concentrating when needling makes sense. Secondly, the advice to concentrate and focus when needling is also found in many places in the Nei Jing. Indeed, the word “shen” is even used occasionally to mean “needling sensation”. Chapter 16 of the Su Wen says: “In Autumn needle the skin and the space between skin and muscles: stop when the needling sensation [shen] arrives.”

There are many passages in both the Ling Shu and Su Wen that stress the importance of concentrating one’s mind when needling. Indeed, chapter 25 of the Su Wen contains a sentence that is almost exactly the same as the opening sentence of the famous chapter 8 of the Ling Shu. In fact, chapter 25 of the Su Wen contains this sentence: “fan ci zhi zhen, bi xian zhi shen” [凡 刺 之 真， 必 先 治 神]. I would translate this so: “For reliable needling, one must first control one’s mind [shen].” Note the rhyming of “zhen” with “shen”.

The English translation of the Su Wen by Li Zhao Guo simply translates this sentence as “The key point for acupuncture is to pay full attention.”1 This interpretation is corroborated by the other paragraphs in that chapter which give advice as to how to practise needling. In fact, it says that the acupuncturist should not be distracted by people around or by any noise.

Unschuld, in his new translation of the Su Wen, translates this sentence as “For all piercing to be reliable, one must first regulate the spirit.”2 This translation would contradict mine but a footnote in the same book reports the interpretation of Wang Bing (the editor of the Nei Jing): “One must concentrate one’s mind and be calm without motion. This is the central point of piercing.”3

The central point that stems from an analysis of the famous opening sentence of chapter 8 of the Ling Shu is how to translate the word “Shen”: in my opinion, the word “Shen” can have many different meanings and only one of them is “Spirit”. Another translation of “Shen” is that of “Mind” which, in my opinion is appropriate in many contexts.

I have mentioned above two possible meanings of “shen” in the Nei Jing, one being the skill of the acupuncturist, the other being the needling sensation. In other passages, “Shen” is closely identified with the Vital Essences of the body: this makes sense given the close integration of body and mind (or spirit) in Chinese medicine. For example, chapter 26 of the Su Wen says: “Blood and Qi are the shen of a person.”4 Chapter 32 of the Ling Shu says: “Shen is the refined Qi of water and grains.”5 Chapter 1 of the Ling Shu says: “Shen is the Upright Qi [Zheng Qi].”6

The next step of this investigation would be to define the nature of “Shen” (Mind or Spirit) in Chinese medicine and how that relates to the ancient Greek or Christian concepts of “Spirit” but this would require a very long enquiry that is beyond the scope of this short piece.

1. Li Zhao Guo (translator) Yellow Emperor’s Canon of Medicine, Library of Chinese Classics, World Publishing Corporation, Xi’an, 2005, p. 335.
2. Unschuld P U and Tessenow H, Huang Di Nei Jing Su Wen – An Annotated Translation of the Huang Di’s Inner Classic – Basic Questions, Vol. I, University of California Press, Berkeley, 2011, p. 428.
3. Ibid., p. 428.
4. 1979 The Yellow Emperor’s Classic of Internal Medicine-Simple Questions (Huang Di Nei Jing Su Wen), People’s Health Publishing House, Beijing. First published c. 100 BC, p. 168.
5. Tian Dai Hua 2005 Spiritual Axis (Ling Shu Jing), People’s Health Publishing House, Beijing. First published c. 100 BC, p. 77.
6. Ibid., p. 3.