Let's look at the San Jiao Meridian and its 23 acupuncture points. Today, I'm going to discuss the San Jiao organ's function according to Chinese medicine because that can be really confusing at times. Then I'm going to look at the Meridian pathway, the function, location of each point, and I'm going to add in my clinical pearls. Welcome back to my channel! If it's your first time here, I'm Clara from AcuPro Academy, and I create Chinese medicine and acupuncture content for students and practitioners. I make it easy to grasp and fun to learn. Let's go! Let's face it, the San Jiao is a little bit of a weird entity within the Zang-Fu theory in Chinese medicine. First of all, nobody can agree on how to translate the San Jiao, so many books will have triple warmer, triple heater, burner, energizer, and that is so confusing to me that I prefer to keep it as the San Jiao and keep it the Chinese name because that way we're not confused about so many translations. And because in the Zang-Fu Theory, the San Jiao is the only one that doesn't connect to a physical, specific organ like the liver or the heart or the lung or the large intestine. This is why I'd rather keep it as the San Jiao instead of translating it. Does that make sense? Okay, so let's try to demystify this weird entity organ system San Jiao Meridian in Chinese medicine. First, the San Jiao is divided into three parts: the upper jiao, the middle jiao, and the lower jiao. The upper gel contains the lung, the heart, and the pericardium, which is in the chest area, which makes sense. The upper jiao connects to Zong Qi or gathering Qi which allows us to breathe and expand our chest area. The middle jiao contains the spleen, the stomach, and the gallbladder. I'm going to talk about the liver in a little bit, but right now let's think of those three organs, and the middle jiao connects to the Ying Qi or nutritive Qi which is in charge of digesting food, so it's also in charge of Yang Qi, which is the middle Qi for better digestion. The lower jiao contains the kidney and the bladder, the small intestine, the large intestine, and the liver. Now, let's talk about how the liver can be in the middle gel or in the lower gel depending on the text you're reading because TCM is never black or white, it is always 50 Shades of TCM. Oh, I had to go there, sorry. So when it comes to the liver, sometimes it's going to be put in the middle jiao, and when you look at the tongue, the liver is kind of like on the side, so it doesn't have a front, a middle, or a back because it does the whole side. However, on the tongue, we can see the front of the tongue is the lung and heart, the middle of the tongue is the spleen and stomach, middle gel, and the root of the tongue or the back of the tongue is the kidney, bladder, small intestine, and large intestine. The liver will be put in the middle jiao as an organ, but as a Meridian, it's often going to be in the lower jiao because the collateral of the liver goes and wraps around the external genitalia. So if we have anything happening in the lower jiao including external genitalia outbreak or a bladder infection after intercourse, this is going to be a liver collateral or L collateral issue, which now is affecting the lower jiao. See how that works? So, I like to use the Meridian as a lower jiao but the organ as a middle gel. You're going to have to decide what works best for you. I just wanted to give you that sidebar about the liver. Nobody agrees where it should be when it comes to San jiao. The low jiao connects to yuang qi or Source Chi which makes sense because the kidney is the root of who we are. It's also in charge of fluid transformation. I see the san jiao a little bit connecting to the lymphatic system of our bodies because it's in charge of detoxifying and getting rid of damp and heat specifically. So, if we have damp and heat in the upper jiao, it will affect the lung and heart, for example, if we have a cold or flu where we're coughing a lot of phlegm that is damp that is also going to be yellow that is heat. For example, in the middle jiao, we could have heat in the stomach and dampness in the spleen. So dampness in the spleen would have bloating, craving for sweet food, fatigue, and loose stools, and heat in the stomach would have acid reflux, bleeding gums, bad breath. So you could see how this damp heat can affect the middle gel. In the lower gel, we can have a bladder infection, we can have like I said, external genital outbreak, blisters that are really painful, that is damp and heat. Makes sense? So look at damp and heat affecting the San jiao. How do we apply this in clinical practice? Well, let's say you have a patient that has dampness in the spleen and heat in the stomach which are quite opposite, right? Dampness is excess fluid and heat dries fluid. So, what we want to do is we want to do points that are going to relieve the excess heat like large intestine 11 and if it's affecting the stomach probably Ren 12, maybe pericardium 6, maybe Ren 17. Right? We want to really address the heat in the stomach. Now, we also want to get rid of the dampness in the spleen like spleen 9 would be great and add spleen 3, maybe spleen 6 to allow better flow of the water in the middle jiao. And then we want to add up San jiao points that solidify that middle jiao issue. Does that make sense? So, we're going to look at all those points and see how we utilize them in clinical practice, but this is how we use the San jiao as a Meridian much more than as an organ in the Zang Fu Theory. So, let's look at the San jiao Meridian. It is a hand Meridian because it starts at the hand. Anything that starts and finishes at the hands or hand Meridian and it is a yang meridian. So, this is a Shaoyang Meridian. The opposite is a foot Shaoyang, which is a gallbladder Shaoyang. Sha means less yang because it doesn't have as much yang as, for example, the Yangming Meridian, which are the large intestine and the stomach. It is really activated or peaking between 9:00 p.m. and 11:00 p.m. because it's in charge of all our organs, right? Upper, middle, and lower jiao. Think of this as 9 to 11:00 p.m, the time to put all our organs to sleep. So, in summer, we can go all the way up to 11:00, and in winter, we go of the seasons, we go closer to 9:00, 9:30. Right? We want to really be sleeping between 9:00 and 11:00 p.m. The organ before that is the pericardium from 7:00 to 9:00 p.m., which is its counterpart, Yin and yang, right? And the pericardium is in charge of protecting the heart. So, from 7:00 to 9:00 p.m., this is when we get ready for bed, we calm down, maybe we do some stretching exercise, we read something good for the soul, we are calming our mind. It's not time to watch some gory movie on Netflix, right? So, we prepare for bed and then at the San jiao time, we go to bed and we go to sleep. Yes? Okay. Now, let's look at the pathway of the Meridian. The previous Meridian in the cyclical flow of chi was the pericardium, so the pericardium finishes at the middle finger, and so it is going to connect to the San jiao. The San jiao starts at the fourth finger, as you can see in my beautiful drawing, which I know most people laugh when they see this. My husband was laughing this morning, literally on the floor. He's like, "This is the worst thing I've seen." But it makes my point, right? It doesn't matter that I'm not a good drawing person. So, we start with S1 at the fourth fingertip, and we're going to ascend along the dorsum or the back of the hand between the fourth and fifth metacarpal and we're going to go through the wrist again all on the posterior back of the hand and the wrist all the way up to the elbow, and we're going to go right through the back of the elbow, the posterior part, and along the triceps all the way to the shoulders specifically the back of the shoulder, the posterior deltoid going through the trapezius right here at San jiao 15. And then from there, the meridian is going to go into the front and enter the body at the supraclavicular FSA or stomach 12 is located. It will go into the body and connects to the pericardium, its related organ. Then it will go down to the middle jiao and the lower jiao, so it connects with all three jiaos. There is a branch starting from the upper jiao, and it's going to come out at the Supraclavicular FSA and emerge to go along the neck where it connects to San jiao 16, going to the back of the ear, go around the ear, and will go up to the top of the corner of the head where stomach 8 is located, go back down along the cheek, and finish at the inner canthus. The second branch starts behind the ear, enters the ear, emerges in front of the ear at San jiao 21, and will end up at San jiao 23 at the lateral end of the eyebrow, connecting to the next Meridian, the gallbladder. The San jiao Meridian function as a whole is to address anything affecting the ear, the cheeks, the temple area, the neck, the throat, and of course, anything along the Meridian as well as addressing the issue of the San jiao as part of the Zang Fu Oregon Theory. San jiao 1 is located at the lateral side or on the side of the ring finger at the base of the nail, point 1 cun from the base or the corner of the nail. Easy one, right? San jiao 2 is located between the fourth and fifth finger at the web margin. San jiao 3 is located between the fourth and fifth metacarpal, proximal to the metacarpophalangeal joint on the dorsum of the hand. San jiao 4 is located on the on-side of the extensor digitorum comminus, which is on the dorsum of the wrist. San jiao 5 is one we use a lot in clinical practice, and it is two tunes above the dorsum part of the wrist between the ulnar and the radius. San jiao 6 is located three cuns above the wrist between the radius and the ulna. San jiao 7 is also three tunes above the wrist, but it is on the radial border of the ulna, so a little bit more towards the ulna area, so more lateral. S8 is four tunes above the wrist on the dorsal part of the forearm, between again the radius and the ulna, and San 9 is seven tunes above the wrist again between the radius and the ulna. And remember that from the wrist to the elbow is 12 cuns, so it's a little bit more than halfway on San jiao 9.San jiao 1 expels external pathogen for sore throat, red eyes, or fever. It is a Jing well point, so most Jing well points are used for fever but also for fainting. Also, San jiao 1 is great to clear heat specifically for temple headaches, stiff tongue, and irritability. San jiao 2 and San jiao 3 are the Ying spring and Shu Stream Point, out of the Shu transporting point. And if you haven't watched my video on the five Shu transporting points and how to utilize them in clinical practice with the mother-son relationship, I'll have the link for you below because it's one of my most popular videos to understand the Shu transporting point using the five elements. Now, those two points are great when it comes to tis having external pathogen invasion on the face with fever, red eyes, or sore throat. San jiao 4 is the yuan source point of the Sinew, so we can use it, first of all, for anything happening on the wrist or pain along the Meridian as a distal point. We can also use it for the common cold and specifically for that Shaoyang syndrome which is alternating chills and fever because it helps expel pathogen also for red swollen eyes as well. And because the Meridian goes around the ear, any acute hearing loss maybe due to an accident, this is really good to use as well as part of the protocol. The closer to the accident, the easier it is to hopefully get the hearing back. When I grew up, one of my neighbors had a trampoline, and her daughter was playing on the trampoline and she fell on the side hitting the rings or the side of the trampoline and her head and ear hit that. She was unconscious for a while, she was in a coma for a while. When she came out, she had lost her hearing on the side where it hit the trampoline bar. So, this is something that can happen with traumatic injury, accident, and if we do acupuncture as soon as possible, we may be able to restore some of the hearing. It's not always for sure, but that's the strength of acupuncture, to apply it ASAP after injury. San jiao 5, I think we use this point, I do anyway, in clinical practice a lot. First of all, it's the Luo Connecting Point, connecting the San jiao to the pericardium. Pericardium 6 is the opposite of that. I had a teacher who used to say we can needle all the way through, don't ever do that. Oh my gosh, I'm never doing that, that is crazy. Anyway, when it comes to San jiao 5, we can use it for anything that's happening on the cheeks, on the ear like tis on the side of the face, temple headaches, because the Meridian is all around the temple area, so it makes sense, right? And because it goes through the neck, it's also really good to use Sanjiao 5 when there's some issue or tight sternal mastoid muscle around the neck area. San jiao 5 is the confluent point of the yang wei vessel, making it a great point to combine with the confluent point, which is gallbladder 41. And gallbladder is a shaoyang Meridian, both really work well together. So, SJ 5, which is the confluent point of the yin wei vessel and GB41, which is the confluent point of the dai vessel, work really well. Remember, the dai vessel is the vessel that goes around the hip area, it's the belt. So, those two together work really well to open the hip, to relax the hip. So, great for pelvic inflammatory disease, great for relaxing the hip when there is an issue with the IT band or anything, hip flexors really, really tight. And I love to use those two points in pregnancy to relax the hips when there is so much pain at the end of pregnancy because of the weight of the baby, and for labor to relax the whole pelvic floor in order to get a better labor outcome. Isn't that fantastic, great combo that I love to use in clinical practice. Are you enjoying my graphics so far? Well, they are all part of my acupoint made easy book. As you can see, it is really colorful and it's so visual, people love that because it's easier to retain the information, right? Now, the digital version comes with a lot of video links to complement it and the book, if you're like me, you like a real book, ships all over the world. I'll have the link below this video for you if you haven't got your copy yet. SJ6 is a jing river point, but one of the best ways to use it in clinical practice is for constipation due to excess pattern. You can use this during pregnancy because you can't use belly points or large intestine 4, but SJ6 is super good, specifically combined with the lower he-Sea point of the large intestine, which is stomach 37 and stomach 36 to allow better flow and better digestion. So, if the person is not pregnant, of course you can also use stomach 25, which is the front mu point of the large intestine, that is a perfect thing to do. And I actually show my patients to acupressure this point when they're at home because it works really, really well when they are pregnant and it's safe compared to large intestine 4. Now, we can combine it with large intestine 4 if there is no pregnancy, does that make sense? And if it's due to excess. Another thing that SJ6 is great for is to clear excess wind-heat affecting the skin like skin rashes that are acute and specifically combined with spleen 10, that is a fantastic combo. SJ7 is a she cleft point, and remember, she cleft point of any yang Meridian is going to be connected to pain, while in Meridian, it connects to blood. So, the she point of the yang Meridian, in this instance, is going to be great for pain all along the Meridian, ear pain, shoulder pain, arm, anywhere along the Meridian, you've got to put SJ7. It is also used as part of a protocol to prevent epileptic attack. Now, there are many points for epilepsy, this is one of them that works quite well combined with d points like DU9. S8 opens the orifices for better hearing. S8 can help with deafness or sore throat, but really, it is a local point, really good for pain around the extensors. S9 is a great point for pain along the Meridian, specifically around the arm area, but also any pain affecting the ear, the cheeks, or the gum like a toothache and the temporal area of the head like a migraine, specifically if you combine with LU7, which is the command point of the head and neck, it works really well. There's a lot of combination we can do for headaches, this is a good pair. S10 is one soon above the oint and S11 is one soon above S10. S12 is halfway between S11 and S13. S13 is twelve soon below S14 on the posterior border of the deltoid. S14 is in the depression inferior and posterior to the acromion when the arm is abducted. And then we can see large intestine 15 as the blue dot, which is anterior and S14 which is posterior. Make sense? Those are really next to each other and they really work well together. S10 is underutilized in clinical practice, maybe because of its location, but it's a fantastic he-Sea point, and yes, it clears heat and relieves pain all along the Meridian, but what it does is it transforms phlegm, physical phlegm-like nodules, ovarian cyst, or excess body fat. Remember, the San jiao is in charge of the lymphatic drainage, this is a very good point to allow this to occur and to relieve all this excess water, excess phlegm that we have in the body, and all the toxins that are trapped into excess fatty cells. Now, that's a fantastic point, right? San jiao 11 all the way to 15 all address issues with the shoulder, the back of the arm, basically, musculoskeletal issues. Now, often we want to press, see where the pain is, and pick the best point for this. What I love is like a frozen shoulder protocol, which is one of my favorite ones, which would be large intestine 15, San jiao 14, large intestine 14, San jiao 13, LI4, very important for the pain, large intestine 11, and Jin, which is an extra point that is located between large intestine 15 and the anterior axillary fold. Now, that's if the frozen shoulder is really more painful in the front. But if it's happening more in the back of the shoulder, we want to add up small intestine 9, 10, and 11, maybe even small intestine 13 to the whole protocol, and it works so well if you add up tuina and cupping and you do this consistently because for on shoulder, it's very difficult for patients to get rid of and it takes a long time. Acupuncture rocks when it comes to frozen shoulder. SJ15 is halfway between gallbladder 21 and small intestine 13 on the superior angle of the scapula. Sj16 is on the lateral side of the neck on the posterior border of the sternal cleidomastoid. It is at the level of the mandible and on the posterior border of the midprocess. As you can see, the low green dot is between gallbladder 12 and San jiao 17, which is below the ear to give you a little bit of a reference point. I have located also the gallbladder points that are at the same area of the Sanow, so you can see the difference. I think it helps to have a perspective. So, San 17 is posterior to the ear between the midprocess and the mandible angle, as you can see in the lower part. Sanle 18 is behind the earlobe between the upper and middle part of the helix. And I don't use this point a lot, but when I have to, I use it for issues along the jaw, which is also because it's the area where the sinew goes through. So, if there's any issue along the Meridian in that area, this is the best point to use. SJ19 is on the side of the neck below the root of the ear at the superior border of the hyoid bone. SJ20 is located on the side of the neck below the lower border of the ear, in the depression between the ramus of the mandible and the sternocleidomastoid. SJ21 is located at the top of the shoulder on the scapula or San jiao 20 is located on the side of the neck below the lower border of the ear, in the depression between the ramus of the mandible and the sternocleidomastoid. San jiao 21 is located at the top of the shoulder on the scapula at the highest point of the medial border, San jiao 22 is in the hollow below the spinous process of the seventh cervical vertebra. It is a really good point for stiff neck and shoulder pain, specifically if you combine with DU 14, which is the point between the shoulder blade or the Jiaji point, the du point for the shoulder blade, it really helps with that upper back tension. San jiao 23 is on the lateral end of the eyebrow, 0.5 cm above the eyebrow. Now, the best way to find it is to locate large intestine 4 and one soon directly above it, that's it. If you see it's exactly in the line of large intestine 4, which is a fantastic point to use for tics, drooling, eye twitching, dizziness, and add up to large intestine 4 for wind. And because this is a yang Meridian, combining it with a yin Meridian like liver 3 or spleen 6 works really well, especially if it's chronic or more of a pattern, or even gallbladder 20. Remember gallbladder 20 is the meeting point of yang meridians. So, I would use gallbladder 20 when I'm dealing with the upper part of the Meridian and Sanle 23 when I'm dealing with the lower part of the Meridian, just to balance yin and yang, it works really well. A lot of points of similar function but we always want to look at the best and differences between all of them and this is how we utilize them in clinical practice. Wow that was amazing. Click here for the playlist of all the other meridians function just like the San jiao if you haven't seen the other meridians and no matter what keep rocking it using TCM