Formulas · Text · Donguibogam 東醫寶鑑

The Three Burners

Samchobu

한글 삼초부 · Pinyin San Jiao Fu

The official that dredges the channels — mist above, foam in the middle, drain below; a bowel with no form and a use, the road of water and grain and the beginning and end of the qi

三焦腑

The last of the six bowels, and the one that is not an organ. The three burners are the Lingshu's three images — the upper like mist, the middle like foam, the lower like a drain — and the chapter's first work is to say what each image means: the upper burner sends the yang qi out to warm the skin like a dew, the middle transforms grain into blood, the lower passes urine and stool. Where they are is disputed and the Bogam prints the dispute: the Nanjing puts them at the chest, the stomach and the lower belly, Wang Haogu divides the whole body at the heart and the navel, and Dongwon says they are one qi and no proper bowel at all — 無形而有用, without form and with a use. The middle of the chapter is the Lingshu's account of the construction and defence rising from the three burners, and Dongwon's summary that the upper burner is qi, the lower blood, and the middle the parting of the two. The disease section is Haizang's: mist that does not scatter is panting, foam that does not move is rheum, a drain that does not run is oedema. There are no signs of expiry, because what has no form cannot die; the treatment is to open both outlets, and the thirteen simples are sorted by which burner they feed.

12.1 The Form of the Three Burners 三焦形象

12.1.1

Source원문

上焦如霧, 中焦如漚, 下焦如瀆. 《靈樞》

Translation영역

The upper burner is like mist, the middle burner like foam, the lower burner like a drain.

Clinical note임상 주석

Twelve graphs, and the whole doctrine of the three burners is a commentary on them. Mist for what the lung and heart diffuse, foam for what the stomach churns, a drain for what the bladder and gut let out. 12.1.2 to 12.1.4 are the Immun's gloss on each.

Yeongchu 靈樞

12.1.2

Source원문

上焦主出陽氣, 溫於皮膚分肉之間, 若霧露之漑焉, 故曰上焦如霧.

Translation영역

The upper burner governs the sending out of the yang qi, warming the space between skin and flesh like the watering of mist and dew — hence the upper burner is like mist.

Immun 入門

12.1.3

Source원문

中焦主變化水穀之味, 其精微上注於肺, 化而爲血, 行於經隧, 以榮五藏周身, 故曰中焦如漚.

Translation영역

The middle burner governs the transforming of the flavours of water and grain; their essence rises and pours into the lung, is transformed into blood, and runs in the channel-tunnels to nourish the five viscera and the whole body — hence the middle burner is like foam.

Clinical note임상 주석

漚, foam — the froth on a fermenting vat, and the middle burner is the stomach's brew. The Blood chapter's 1.1 said blood is made from grain; this is the burner that makes it.

Immun 入門

12.1.4

Source원문

下焦主通利溲便, 以時傳下, 出而不納, 開通秘塞, 故曰下焦如瀆. 《入門》

Translation영역

The lower burner governs the free passage of urine and stool, sending them down in due time — letting out and not taking in, opening what is blocked — hence the lower burner is like a drain.

Immun 入門

12.1.5

Source원문

三焦, 指腔子而言, 包含乎腸胃之總司也. 胸中膈膜之上曰上焦, 肓膜之下臍之上曰中焦, 臍之下曰下焦, 總名曰三焦. 《正傳》

Translation영역

The three burners refer to the body's cavity — the overall governor that contains the intestines and stomach. Above the diaphragm in the chest is the upper burner; below the membrane of the vitals and above the navel is the middle burner; below the navel is the lower burner; together they are named the three burners.

Clinical note임상 주석

腔子 — the cavity. Yu Tuan's answer to what the three burners are: not an organ but the space the organs sit in, cut at the diaphragm and the navel. It is the most anatomical reading in the chapter, and the one the Bogam prints first among the positions.

Jeongjeon 正傳

12.2 The Position of the Three Burners 三焦部位

12.2.1

Source원문

上焦者, 在心下下膈, 在胃上口, 主內而不出. 其治在膻中, 玉堂穴名下一寸六分, 直兩乳間陷者是.

Translation영역

The upper burner is below the heart and below the diaphragm, at the stomach's upper mouth, and governs taking in and not letting out. Its treatment is at Danjung, one chon six pun below Okdang a point name, in the hollow directly between the two nipples.

Nangyeong 難經

12.2.2

Source원문

中焦者, 在胃中脘穴名, 不上不下, 主腐熟水穀. 其治在臍傍.

Translation영역

The middle burner is at the stomach's middle cavity the point Jungwan, neither up nor down, and governs the rotting and ripening of water and grain. Its treatment is beside the navel.

Nangyeong 難經

12.2.3

Source원문

下焦者, 在臍下, 當膀胱上口, 主分別淸濁, 主出而不納, 以傳導也. 其治在臍下一寸. 《難經》

Translation영역

The lower burner is below the navel, at the bladder's upper mouth, and governs the parting of clear and turbid — letting out and not taking in, so as to transmit. Its treatment is one chon below the navel.

Clinical note임상 주석

The Nanjing's thirty-first difficulty, and each burner gets a verb — 內而不出, take in and not let out; 不上不下, neither up nor down; 出而不納, let out and not take in — and a point: Danjung, Jungwan, and one chon below the navel, which is Eumgyo. The three midline points are the three burners' alarm points in all but name.

Nangyeong 難經

12.2.4

Source원문

頭至心爲上焦, 心至臍爲中焦, 臍至足爲下焦. 《海藏》

Translation영역

From the head to the heart is the upper burner, from the heart to the navel the middle, from the navel to the feet the lower.

Clinical note임상 주석

Wang Haogu's division cuts the whole body, head to foot, where the Nanjing's cut only the trunk. Both survive in the tradition, and the Bogam prints both without choosing.

Haejang 海藏

12.2.5

Source원문

三焦之府, 在氣衝穴名. 氣衝乃陰陽道路, 足陽明之所發, 主腐熟水穀之氣. 三焦發用, 貫通十二經絡, 往來上下, 營運氣血. 是知氣衝爲三焦行氣之府也. 《入門》

Translation영역

The bowel of the three burners is at Gichung a point name. Gichung is the road of yin and yang, where the foot yang brightness issues, and governs the qi that rots and ripens water and grain. The three burners' working threads through the twelve channels and networks, comes and goes above and below, and moves the qi and blood; so one knows Gichung to be the bowel from which the three burners' qi moves.

Clinical note임상 주석

Gichung (氣衝, ST30), in the groin where the femoral pulse beats — the Immun's answer to where a formless bowel is: at the point where the qi surges. The Lingshu called the same point the origin of the sea of qi.

Immun 入門

12.2.6

Source원문

上中下三焦, 通爲一氣, 衛於身也. 三焦非正府也, 無形而有用. 《東垣》

Translation영역

Upper, middle and lower — the three burners are one qi throughout, guarding the body. The three burners are not a proper bowel: they have no form and have a use.

Clinical note임상 주석

無形而有用 — without form and with a use. Dongwon ends the dispute by stepping out of it: the three burners are a function, not a place, and the Kidney chapter's 6.2.2 said the same of the gate of life. The two formless organs are the fire and the water of the body's working.

Dongwon 東垣

12.3 What the Three Burners Pass and Receive 三焦傳受

12.3.1

Source원문

上焦出於胃上口, 幷咽以上, 貫膈而布胸中, 走腋, 循太陰之分而行, 還至陽明, 上至舌, 下足陽明. 常與榮俱行於陽二十五度, 行於陰亦二十五度, 爲一周, 而復大會於手太陰, 命曰衛氣也.

Translation영역

The upper burner issues from the stomach's upper mouth, runs alongside the gullet upward, threads through the diaphragm and spreads in the chest, goes to the armpit, follows the greater yin's territory, returns to the yang brightness, rises to the tongue and descends to the foot yang brightness. It always travels with the construction, twenty-five rounds in the yang and twenty-five in the yin, making one circuit, and then meets again at the hand greater yin. This is named the defence qi.

Clinical note임상 주석

The Lingshu's 營衛生會 — the defence qi rising from the upper burner and circling fifty times a day. The Qi chapter's 4.3.2 gave the same circuit from the qi's side; this is the burner it starts from.

Yeongchu 靈樞

12.3.2

Source원문

中焦亦幷胃中, 出上焦之後. 此所受氣者, 泌糟粕, 蒸津液, 化其精微, 上注於肺脈, 乃化而爲血, 以奉生身, 莫貴於此. 故獨得行於經隧, 命曰榮氣.

Translation영역

The middle burner is likewise alongside the stomach, issuing behind the upper burner. What it receives as qi it strains from the dregs, steams into fluid and transforms into essence, which rises and pours into the lung's vessels and there becomes blood to sustain the living body — nothing is more precious than this. So it alone runs in the channel-tunnels, and is named the construction qi.

Clinical note임상 주석

泌糟粕, 蒸津液, 化其精微 — strain, steam, refine. The middle burner's three verbs for making blood, and 莫貴於此, nothing is more precious. The construction is the burner's product and the defence is its exhalation.

Yeongchu 靈樞

12.3.3

Source원문

下焦者, 別廻腸, 注於膀胱而渗入焉. 故水穀者, 常幷居於胃中, 成糟粕, 而俱下於大腸, 而成下焦. 渗而俱下, 濟泌別汁, 循下焦而渗入膀胱焉. 《靈樞》

Translation영역

The lower burner parts off from the returning gut and pours into the bladder, seeping in there. So water and grain always dwell together in the stomach, become dregs, and go down together into the large intestine, forming the lower burner; seeping and going down together, the juice is strained and parted, and following the lower burner it seeps into the bladder.

Clinical note임상 주석

The Small Intestine chapter's 9.3 and the Bladder chapter's 11.3, from the burner's side. 濟泌別汁 — the juice parted and strained — is the lower burner's whole job, and the tradition put the kidney's water and the gut's waste under one office because they leave by neighbouring doors.

Yeongchu 靈樞

12.3.4

Source원문

上焦如霧者, 氣. 下焦如瀆者, 血也. 中焦者, 氣血之分也. 《東垣》

Translation영역

The upper burner like mist is the qi; the lower burner like a drain is the blood; the middle burner is where qi and blood part.

Clinical note임상 주석

Dongwon's reduction of 12.1.1 to the two things the Qi and Blood chapters are about: mist is qi, drain is blood, and the middle is where one becomes the other. Three burners in fifteen graphs.

Dongwon 東垣

12.3.5

Source원문

心肺若無上焦, 何以宗主榮衛. 脾胃若無中焦, 何以腐熟水穀. 肝腎若無下焦, 何以疎決津液. 無形而有用, 主持諸氣. 三焦者, 水穀之道路, 氣之所終始也. 《入門》

Translation영역

Without the upper burner, how would heart and lung preside over construction and defence? Without the middle burner, how would spleen and stomach rot and ripen water and grain? Without the lower burner, how would liver and kidney dredge and release the fluids? Without form and with a use, it holds and sustains all the qi. The three burners are the road of water and grain, and where the qi begins and ends.

Clinical note임상 주석

Three rhetorical questions that assign the six viscera to the three burners — heart and lung above, spleen and stomach in the middle, liver and kidney below — and the scheme the warm-disease school would later build its whole diagnosis on. 氣之所終始, where the qi begins and ends: the Immun's last word, and the chapter's.

Immun 入門

12.4 The Outer Signs of the Three Burners 三焦外候

12.4.1

Source원문

鼻柱中央起, 三焦乃約. 《靈樞》

Translation영역

Where the bridge of the nose rises at its centre, the three burners are constricted.

Clinical note임상 주석

A high-bridged nose for a constricted three burners — the third nose-reading in three bowel chapters, and the Lingshu's 本藏 gives the whole face out to the bowels one feature at a time.

Yeongchu 靈樞

12.4.2

Source원문

三焦外候, 詳見膀胱腑.

Translation영역

The outer signs of the three burners are treated in fuller detail in the Bladder chapter.

Clinical note임상 주석

The Bladder chapter's 11.4.2 read the two together from the skin, because the Lingshu treats them as one water system under the kidney.

Donguibogam · Samcho

12.5 The Patterns of Three Burner Disease 三焦病證

12.5.1

Source원문

三焦病者, 腹氣滿, 小腹尤堅, 不得小便, 窘急, 溢則水留, 卽爲脹.

Translation영역

In three burner disease the abdomen is full of qi and the lower abdomen especially hard, one cannot urinate and feels urgent pressure; where it overflows the water is retained, and that is distension.

Yeongchu 靈樞

12.5.2

Source원문

小腹痛腫, 不得小便, 邪在三焦約也. 《靈樞》

Translation영역

Where the lower abdomen is painful and swollen and one cannot urinate, the evil is in the constricted three burners.

Clinical note임상 주석

三焦約, the three burners constricted — the Lingshu's diagnosis for retention with a hard lower belly, and Jigak-hwan at 12.6.2 is written for it. The drain is shut.

Yeongchu 靈樞

12.5.3

Source원문

上焦如霧, 霧不散則爲喘滿, 此出而不納也. 中焦如漚, 漚不利則爲留飮, 留飮不散, 久爲中滿, 此上不能納, 下不能出也. 下焦如瀆, 瀆不利則爲腫滿, 此上納而下不出也. 《海藏》

Translation영역

The upper burner is like mist: where the mist does not scatter there is panting and fullness — this is letting out without taking in. The middle burner is like foam: where the foam does not move there is retained rheum, and retained rheum that does not scatter becomes in time fullness of the centre — this is neither taking in above nor letting out below. The lower burner is like a drain: where the drain does not run there is swelling and fullness — this is taking in above without letting out below.

Clinical note임상 주석

12.1.1's three images turned into three diseases: mist that will not lift is the Cough chapter's panting, foam that will not move is the Phlegm chapter's rheum, a drain that will not run is the Oedema chapter. Wang Haogu's three lines are an index to three later chapters.

Haejang 海藏

12.5.4

Source원문

下焦溢爲水. 《內經》

Translation영역

The lower burner overflowing becomes water.

Naegyeong 內經

12.5.5

Source원문

三焦爲丙火之府, 故其發也, 爲無根之相火. 《入門》

Translation영역

The three burners are the bowel of the byeong fire, and so when it breaks out it is the rootless ministerial fire.

Clinical note임상 주석

The three burners are the pericardium's bowel, and the pericardium carries the ministerial fire — so the three burners' fire has no organ to root in, and when it flares it is the Fire chapter's 無根之火, the fire that has left its place. The Kidney chapter's 6.3.5 tied the same cord from the gate of life.

Immun 入門

12.6 The Treatment of Three Burner Disease 三焦病治法

12.6.1

Source원문

內經曰, 三焦者, 決瀆之官, 水道出焉. 盖三焦爲上中下水穀之道路, 其病宜通利大小便.

Translation영역

The Neijing says: the three burners are the official that dredges the channels, from which the waterways issue. The three burners are the road of water and grain through upper, middle and lower, and their disease should be treated by opening the passage of stool and urine.

Clinical note임상 주석

The Body chapter's 1.8.2 gave the title; the Bogam draws the rule. A bowel that is a road is treated by clearing the road, and both formulas that follow open the two outlets at once.

Donguibogam · Samcho

12.6.2

Source원문

宜用枳殼丸ㆍ木香檳榔丸ㆍ三和散方見氣門.

Translation영역

Bitter Orange Pill, Costus and Areca Pill and Three Harmonies Powder formula in the Qi chapter are appropriate.

Clinical note임상 주석

Three formulas, all registered — the first here, the second in the Distension chapter where the Bogam printed it in full, the third in the Qi chapter. All three move the qi downward and open the bowel, and Mokhyangbinrang-hwan's own first words are 疏導三焦, dredge the three burners.

Donguibogam · Samcho

12.7 Simple Medicinals 單方

12.7.1

Source원문

凡十三種.

Translation영역

Thirteen kinds in all.

Clinical note임상 주석

Thirteen simples sorted by burner. For all three: astragalus — 上中下內外三焦之藥, the medicine of the whole three burners, inside and out — akebia fruit, ox marrow, alpinia, sesame oil and muskmelon. For the upper: ginseng, 補上焦元氣, supplementing the upper burner's origin qi. For the lower: a meat fried in butter, green tangerine, lotus root, pig's intestine and loofah. The lower burner is fed with the heaviest things in the list, because a drain is filled from the bottom.

Donguibogam · Samcho

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Inner Landscape, Volume 3, The Three Burners chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.