內外經絡心包三焦 // Inner and Outer Meridians [Protector of the Heart & the Three that Burn]
Sharing this paper written for a class at the beginning of 2020, a precursor to the next article relating to the Pericardium channel and our connections to the Heavens...
Chinese Medicine is a system of sublime cosmology and interconnectivity that precedes our understanding as humans, in form and formless. It is one of beauty and poetry, nature and harmony. In our modern studies, we are often disconnected from how far this medicine can take us and the story it has to tell. The story is told, not only through their names and meanings, but through their functions and how they exist within the workings of our physical and energetic bodies. We must remember the importance of the micro and macrocosmic existence... of each system, each channel, each point, their names, radicals, and what they represent individually and as a whole.
The Yin-Yang is commonly seen as a simple, two-dimensional sphere–a turning circle that rotates clock-wise or counter-clockwise. By observing the Yin-Yang in the third dimension, we can take this idea further and envision the circle becoming a sphere. When it is brought to the fourth dimension and beyond, it can translate to Newtonian mechanics of centrifugal force—seeing the expansion and contraction of the renowned symbol, it exists as a moving orb.
(Xing De, Five Immortals Temple)
With this idea in mind, we can apply these theories for each point that lives on each meridian. When a point is needled, it creates a whirlwind of recirculated Qi and that force is allowed to transmit and flow to the rest of the body as well as the universe. "In treating illness, it is necessary to examine the entire context, scrutinize the symptoms, observe the emotions and attitudes. If one insists on the presence of ghosts and spirits on cannot speak of therapeutics." (Inner Classic of the Yellow Emperor, pg. 78.) Each point serves as a collective meeting junction, that connects each and every one of us through these points. Each point can also be viewed as a portal or “black hole.”
Comparable to this idea of a “wormhole,” the channels do not necessarily begin or end, they are part of a continuum, have an incredible depth and can allow us to heal and travel. There is an importance to these ethereal concepts that help us grasp the limitless qualities that Chinese Medicine has to offer. By examining further into this wave of thought, we can look more specifically at the Zang Fu organs, the ethereal Sanjiao (三焦) and the visceral Pericardium (心包). These two meridians are integral in treating the body and its energetic field, they can only discussed as a pair—as their relationship is inherently, internally and externally, connected.
Being that the Pericardium is attached to the mediastinum, which feels like a metaphor for its roots and strength, and has been revered in history as the Heart Box, it helps protect the heart from external pathogens and emotional trauma and can serve as a gate–deciding what is allowed in and out; regulating blood vessels and circulation, assisting the Heart in housing the mind and shen (神). It is also a well-known in allopathic medicine as an anatomical structure and has a similar function in aiding and protecting the heart, as well as providing lubrication to pump oxygenated blood throughout the body. Alternatively, the San Jiao is a formless organ, one that does not exist in the physical and more in the spatial.
The San Jiao literally translates to the Triple Burner or “Three that Scorch,” which corresponds to each section of the Three Jiaos; the upper, middle and lower. Which is a concept ubiquitous throughout Daoist philosophy of "Heaven, Person, and Earth," the three levels that connect all three realms. The Triple Burner was “discovered” by Western medical science in the Spring of 2018, and is believed to live within the interstitium. In Chinese Medicine, it is deemed as a moving substance, one that is able to travel and treat the whole body:
"Since the 黄帝内经: Yellow Emperor's Inner Canon (c. 200 BCE), Traditional Chinese Medicine (TCM) has held that the san jiao system is the largest anatomical structure in the human body, and that it consists of a network comprising the large cavities in the body trunk and the small interstitial spaces between the tissues and cells throughout the body. More than 2000 years later, and according to recent scientific reports in America, this network of structures has been recognized by modern medicine. The two theories, TCM's San Jiao and its system of spaces (腠 còu), and the recent scientific discovery of an interstitial network in the human body, are quite similar in structure, distribution and function."
(Qu L. Structure and distribution of the San Jiao and You Li - Recognized Interstitium in Human Tissues. Chin Med Cult 2018; 1: 84-7)
At first glance, there are several obvious differences between the Pericardium and San Jiao channels. One is distinctly adhered to the chest and maintains qi flow within this space, the Pericardium distributes Qi down to the Stomach and Diaphragm and assists in Heart-Kidney communication. The other (Triple Burner) is more fluid and comparable to flowing water that integrates Qi throughout the body, head, neck, and sides of the body. It aids in metabolic and water functions of the Spleen, Lungs, and Kidneys, treats Shaoyang disease, manages the body temperature, and also assists in Heart-Kidney communication. The Pericardium has nine points, whereas the Sanjiao has twenty three. They are on opposing sides of the arm, the Pericardium (Jueyin 手厥陰) ends on the tip of the fourth metacarpal and the Sanjiao (Shaoyang (手少陽) begins on the ulnar aspect of the nail. The (formless) primary Pericardium channel hits all three burners, from the first point (天池 Tianchi (PC 1) Heavenly Pool — Meeting Point of Pericardium, Gall Bladder, Liver, San Jiao and a Window of Heaven Point), it goes to the Pericardium and down the upper, middle, and finally lower jiao. One format of the three Jiaos has three different processes; the upper governs respiration, middle governs digestion, and the lower governs reproduction and elimination. The more classical interpretations follow aspects of nature, “the Upper Burner is a mist,” (see cit. 14). A mist is pervasive, and traditionally this would correspond to the vaporized Water in the Lungs that is later disseminated throughout the body. “The Middle Burner is a foam.” (see cit. 13). This is traditionally interpreted as referring to the digestive churnings of the Stomach and Spleen. “The lower Burner is a swamp.” (see cit. 12). It is in charge of excreting impure substances. The reference here is primarily to the Kidneys, Large and Small Intestines, and the Bladder.
In modern medicine terminology, the San Jiao regulates the lymphatic and endocrine system and regulates the circulation of body fluid, which also deals with regulating the heartbeat and function via the autonomic nervous system. It is also known that the Triple Burner aids in balancing, harmonizing, and stabilizing both left and right sides of the brain and is keeping the body temperature regulated. “In the Nan Jing (“Difficulty 31”), the Triple Burner is called the “road for nutrition” and is referred to as “the beginning and end of Qi.” (Kaptchuk, pg.76) This is related to an excerpt from, Zhang Jie-bing’s Lei Jing: Classic of Categories, discussion on the Huang Di Nei Jing, “[The Triple Burner is] the commander-in-chief of all the Qi of the various Organs, the Protective Qi, Nutritive Qi, and the Meridian Qi of the Interior and Exterior, right and left, upper and lower regions...it is responsible for communication among the different parts of the body.” (Zhang Jie-bing, pg. 121). The Pericardium distributes Qi and regulates the vessels and blood circulation. It also regulates the stomach and diaphragm, in by doing so, the levels of control over breath and oxygen that is generated to the Lungs, influences the bloodstream through the four chambers of the heart. By using different body fluids to facilitate movement, both meridians have the function of allowing circulation and flow throughout.

After stating the tangible functions of the Pericardium and San Jiao, one can take a deeper look into where these actions originate. The Inner Classic Map (Nei Jing Tu 內經圖), shows the essential workings of life source that begin at the lifegate (命门 mingmen). Mingmen is where the ministerial fire burns and evaporates the water that rules the Kidneys, and is located in between them, level with L1 and L2 vertebrae. From here, the Sanjiao is able to disperse source qi, and is directly associated with the Kidneys and Liver as well as the Heart.
"The Nanjing commentaries described the lifegate and heart protector’s functional relationships. The sanjiao arises from the lifegate in the lower jiao. It disseminates the kidney-lifegate’s source qi and yin-fluids, and the lifegate fire powers their movement and transformations. In the upper jiao, the sanjiao connects with the qi structures enveloping the heart, the heart protector."
(Emotions, Desires, and Physiological Fire in Chinese Medicine, Part One: The Pericardium and Lifegate. Emotions, Desires and Physiological Fire in Chinese Medicine, Part One: The Pericardium and Lifegate. Mary Garvey PhD University of Technology Sydney, Australia. Australian Journal of Acupuncture and Chinese Medicine. VOLUME 7 ISSUE 1. 2012.)
The Sanjiao is able to reach many parts of the body, including some of the extraordinary organs, These connections show how water is heated by the Mingmen fire, creating steam and permeating throughout. The parallels in how our biological life evolved is palpable, the first hints of organisms were birthed from the heating of primordial fluid, the purest water. Similarly to how we have developed in modern society, we disperse and are our own organisms that can reach all corners of the body and the universe via this interstitial fluid (“dark matter”), eventually nourishing and treating all.

"The sanjiao and channel system arising from the lifegate extends its influences to the brain and bone marrow, to the limbs and the body surface, warming the skin and the tissue spaces and textures (腠理 couli), steaming the three jiao, guiding and maintaining correct qi physiology. (see cit. 5 & 7) The shaoyin (heart-kidney), the sanjiao-pericardium-lifegate associations, and the uterine network channels help transmit kidney jing-essence (water), and minister and sovereign (fire) influences between the upper and lower body. These connections ensure communication of the physiological fire of the sovereign and minister, and the mixing of water and fire in the sanjiao allows life to develop." (see cit. 9 & 10)
It seems that the Pericardium is rooted in physicality, an organ that lives in this reality, processing emotions–whereas the Triple Burner filters sensory experience, from eyes and ears, aiding the Pericardium to only encounter the simplified version of our experiences. It keeps us warm and gives way to speak one’s truth by way of the tongue, the manifestation of the Heart.
The connections to the sensory orifices are furthered by the arm yang channels, the Triple Burner going to the eyes and ears and contributing to reducing inflammation and clearing the portals of consciousness. Additionally, this sinew channel, as a fire element, impacts temperature and regulation and autonomic functions related to the thyroid gland… (Heart fire symptoms) can be addressed due to its connection to the Heart. It has a large impact on the throat as well as the tongue, enabling speech and articulation of one’s voice and Heart.
(see cit. 4., Rosen, pg. 134)
The following points on each respective channel, epitomized the Yin-yang theory; Neiguan 內關 (PC 6) Inner Pass/Gate to Internal Well-Being and Waiguan (外關 SJ 5) Outer Pass, both points are Confluent Point of the Yin-Yang Wei and Luo Connecting points. Not only do they share a character within their name, corresponding to the inner (Jueyin 厥陰) and outer (Shaoyang 少陽) aspects of the arm, they also have a harmonious objective.
The Pericardium provides solutions and prioritizes options (directs our qi in ways that fulfill the Heart) to address the problems that we are experiencing. It helps us to manage stress and assists in generating empathy. As Jeffrey Yuen says, while the Heart offers hope, the Pericardium offers help; help is always available, hope less so. The Pericardium is problem management, biding its time until the Heart can be restored and hope reignited.
(see cit. 4., Rosen, pg. 171)
The Confluent of the Yin Wei, Neiguan (內關 PC 6) , helps carve one’s life path, purpose, and destiny by seeing life through a lens of compassion and enabling our past and future to come closer to the present. Although Neiguan is on the Pericardium channel, one of its functions, aids in the treatment and communication of the Sanjiao, gauging how emotions affect the body’s function. One of the energetic expressions in the Six Division Energetic paradigms (liu jing bian zheng 六经辨证), shows how this point can treat emotions and a stagnant Liver. “As the Heart Protector, and a jueyin channel, it assists in mediating the relationship between the Liver and Heart when traumatic experiences cause a closing of the Heart as a protective measure to insulate one from emotional pain.” Since the Liver is the organ that is tied to our emotions, it is paramount in this way:
Neiguan is inextricably bound with the liver, at the Jue Yin level. This energetic, coupled with Luo point usage and its internal pathway, allows Neiguan to relieve stagnant Liver Qi. In the author's opinion, Neiguan is the most clinically effective point for dredging stagnant Liver Qi. It is probably lack of appreciation of this energetic that makes Neiguan so undervalued as a point for adjusting Liver Qi stagnation.
(CLINICAL PERSPECTIVES: Assessing and Treating Pericardium-6 (Neiguan): Gate to Internal Well-Being. http://www.acupuncturejournal.com/AJASple1.html Skya Gardner-Abbat. Department of Clinical Medicine, Southwest Acupuncture College. American Journal of Acupuncture. Vol. 23, No.2, 1995.)

Waiguan (外關 SJ 5) Outer Pass, is also a Luo Connecting and Confluent Yang Wei point, it is also connected to the Dai Channel. The Yang Wei helps us shed patterns that no longer serve us, giving us a chance to move forward. Energetically, many terminal ailments relate to how we hold onto versions of ourselves that have no bearing in our present. They manifest into illness from an inability to release the past and rise up from emotional and karmic experiences that has inflicted us over lifetimes, which brings us to its alliance with the Dai Mai Meridian (帶脈). The Dai Mai is located horizontally along the lower jiao, holding all the watery components we cannot transform (along with the enteric system, which has the second highest amount of neurons inside the body). Since water holds memory, the Dai Mai meridian keeps our most suppressed and undecided emotions in the tributaries of the belt around the waist.
If our intuitive creativity becomes blocked, disregarded, or discouraged by others or our own failures, the Triple Burner luo can become full, with symptoms such as rigidity (Physical and mental) and stubborn fixed attitudes—people who live for the sake of survival with a hardened attitude and austere personality with unwavering opinions... Emotionally, the person becomes indifferent, numb, and unwilling to react or take sides/express opinions on anything. They have become a shell, hardened on the outside and hollow within. This indifference is distinguishable from the Stomach luo where the person cannot take on any more feelings (the ability has been compromised). With the Triple Burner, the person has been hurt with past experiences and has become depressed uninterested and ultimately suicidal.
(see cit. 4, Rosen, pg. 172)
It can be argued that because of the intensity of these unresolved traumas, Waiguan is cardinal is treating these psycho-spiritual-emotional and terminal diseases that surface from a dam that has become over-flooded with the dark waters of the emotionally unexpressed.
The allure and complexity of how these two particular meridians coalesce is vast and something of great magnificence and can be explored eternally. It is clear the broad spectrum of treatments that can be administered through just these two channels alone, while keeping in mind that each point has its own immense power. By holding the importance of the unseen and unknown, we can navigate the mystery of the Sanjiao and the sensitive nature of the Pericardium. They need one another to survive, to live, to simply exist––internally and externally.
Please visit the following websites for more information on teachings, schools, and publications from Daoist Abbott, LiShifu + his students:
https://purplecloudinstitute.com
Here is a comprehensive list of the points on each channel to see their relationship:
San Jiao:
關衝 Guang Chong (SJ 1) Rushing Pass
Jing Well
Metal
液門 Yemen (SJ 2) Fluid Gate
Ying Spring
Water
中渚 Zhongzhu (SJ 3) Central Islet
Shu Stream
Wood
陽池 Yangchi (SJ 4) Yang Pool
Yuan Source
外關 Waiguan (SJ 5) Outer Pass
Luo-Connecting
Confluent Point of Yang Linking Vessel/Master point of the Yangwei channel
Coupled point of the Dai Channel
支溝 Zhigou (SJ 6) Branch Ditch
Jing River
Fire
會宗 Huizhong (SJ 7) Ancestral Meeting
Xi-Cleft
三陽絡 Sanyangluo (SJ 8) Three Yang Luo
四瀆 Sidu (SJ 9) Four Rivers
天井 Tianjing (SJ 10) Heavenly Well
He-Sea
Earth Point
清冷淵 Qinglengyuan (SJ 11) Clear Cold Abyss
肩髎 Xiaoluo (SJ 12) Dispersing Luo River
臑會 Naohui (SJ 13) Upper Arm Meeting
Meeting point of SJ and Yang Linking Vessel
肩髎 Jianluo (SJ 14) Shoulder Crevice
天髎 Tianliao (SJ 15) Heavenly Crevice
Meeting point of SJ, GB, and Yang Linking Vessel
天牖 Tianyou (SJ 16) Heavenly Window
Window of Heaven Point
翳風 Yifeng (SJ 17) Wind Screen
Meeting point of SJ and GB
契脈 Qimai (SJ 18) Spasm Vessel
顱息 Luxi (SJ 19) Skull’s Rest
角孫 Jiaosun (SJ 20) Minute Angle
Meeting point of the SJ, SI, GB
耳門 Ermen (SJ 21) Ear Gate
耳和髎 Erheliao (SJ 22) Ear Harmony Crevice
Meeting point of the SJ, GB, SI
絲竹空 Sizhukong (SJ 23) Silken Bamboo Hollow
Pericardium:
天池 Tianchi (PC 1) Heavenly Pool
Meeting Point of PC, GB, LV, SJ
Window of Heaven Point
天泉 Tianquan (PC 2) Heavenly Spring
曲澤 Quze (PC 3) Marsh at the Crook
He-Sea
Water
郄門 Ximen (PC 4) Xi-Cleft Gate
Xi-Cleft
間使 Jianshi (PC 5) Intermediate Messenger
Jing River
Metal
內關 Neiguan (PC 6) Inner Pass/Gate to Internal Well-Being
Luo Connecting
Confluent point of Yin Linking Vessel
大陵 Daling (PC 7) Great Mound
Shu-Stream
Yuan Source
Earth
Sun Si-Miao Ghost Point
勞宮 Laogong (PC 8) Palace of Toil
Ying-Spring
Fire
Sun-Si Miao Ghost Point
中衝 Zhongchong (PC 9) Middle Rushing
Jing Well
Wood
Bibliography:
Inner Classic of the Yellow Emperor: Simple Questions.
Qu L. Structure and distribution of the San Jiao and Cou Li – Recognized interstitium in human tissues. Chin Med Cult 2018;1:84-7
The Web That Has No Weaver: Understanding Chinese Medicine. Ted J. Kaptchuk O.M.D. Congdon & Weed, Inc. 1983.
HEART SHOCK: Diagnosis and Treatment of Trauma with Shen-Hammer and Classical Chinese Medicine. Ross Rosen. Singing Dragon. 2018
Chace C, Zhang TL. A Qin Bowei Anthology: Clinical Essays By Master Physician Qin Bowei. Brookline: Paradigm Publications; 1997.
Unschuld PU. Huang Di Nei Jing Su Wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text. Berkeley: University of California Press; 2003.
Qu LF, Garvey M. The Location and Function of Sanjiao. Journal of Chinese Medicine. 2001 February (65):26–32.
Ma Ruo-shui. Theoretical Foundations of Traditional Chinese Medicine (Zhong-yi Ji-chu Li-lun Zhi-shi 中医基础理论知识). Guiyang: Guizhou People’s Press, 1977.
Rossi E. Shen: Psycho-Emotional Aspects of Chinese Medicine. London: Churchill Livingstone; 2007.
Larre C, Rochat de la Vallee E. Heart Master, Triple Heater. revised edition, 1998 ed. London: Monkey Press; 1992.
Zhang Jie-bing’s Lei Jing: Classic of Categories. Zhang, Illustrated Wing [30]. sec. 3, chap. 23, p. 121
Qin Bo-wei et al. Traditional Chinese Medical References for Clinical Patterns (Zhong-yi Ling/Lin-chuang/zheng Bei-yao 中医临证备要). Beijing: People’s Press, 1973.
Qin Bo-wei. Medical Lecture Notes of Qian Zhai (Qian Zhai Yi-xue Jiang-gao 谦寨医学讲稿). Shanghai: Science and Technology Press, 1964.
Qin Bo-wei. Elementary Traditional Chinese Medicine (Zhong-yi Ru/ren-men 中医人门). Hong Kong: Taiping Book Publishers, 1971.
Emotions, Desires, and Physiological Fire in Chinese Medicine, Part One: The Pericardium and Lifegate. Emotions, Desires and Physiological Fire in Chinese Medicine, Part One: The Pericardium and Lifegate. Mary Garvey PhD University of Technology Sydney, Australia. Australian Journal of Acupuncture and Chinese Medicine. VOLUME 7 ISSUE 1. 2012.
CLINICAL PERSPECTIVES: Assessing and Treating Pericardium-6 (Neiguan): Gate to Internal Well-Being. http://www.acupuncturejournal.com/AJASple1.html Skya Gardner-Abbat. Department of Clinical Medicine, Southwest Acupuncture College. American Journal of Acupuncture. Vol. 23, No.2, 1995.
Dr. Masaru Emoto. https://thewellnessenterprise.com/emoto/