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The meridian system (simplified Chinese: 经络; traditional Chinese: 經絡; pinyin: jīngluò, also called channel network) is a concept in Traditional Chinese medicine (TCM) about a path through which the life-energy known as “qi” flows.1 The twelve standard meridians, also called principal meridians, are divided into Yin and Yang groups. The Yin meridians of the arm are Lung, Heart, and Pericardium. The Yang meridians of the arm are Large Intestine, Small Intestine, and Triple Burner. The Yin Meridians of the leg are Spleen, Kidney, and Liver. The Yang meridians of the leg are Stomach, Bladder, and Gall Bladder.2 The Sanjiao Meridian or Sanjiao Channel is one of the 12 principal meridians in TCM. It corresponds with the Jueyin Pericardium Meridian of the Hand. The Flow Hours of this meridian are 9:00 PM – 11:00 PM.3
CONTENTS
ORGAN AND FUNCTION
ACUPOINTS
FLOWING ROUTES
ORGAN AND FUNCTION
In TCM, the Sanjiao is a yang organ paired with the pericardium (Xin Bao), which is the yin organ associated with it. Yang (Fu) organs are typically hollow, whereas yin (Zang) organs are more solid. The triple burner, however, is said to be primarily energetic and does not have a physical component, unlike all the other organs in TCM. In dissecting a body, one would not be able to find a structure that could be called the Sanjiao. The Sanjiao’s Hand-Foot partner is Dan (Gall Bladder).4 It has the following principal functions:
It is said to be a metabolism mechanism similar to an old-fashioned water wheel, that is turned by incoming water and creates energy for accomplishing a task, such as grinding grain in the case of the water wheel, or for metabolising and digesting food in the case of the Sanjiao. The Sanjiao is closely associated with the spleen functions of transformation and transportation, particularly the metabolism of incoming food. It is also closely associated with the kidney’s function in TCM.5 The Sanjiao, however, is not limited to one metabolism function as the spleen or kidneys are, but is a general metaboliser which can be applied to a variety of metabolism needs.6
ACUPOINTS
This meridian contains 23 acupoints in one side, that is 46 acupoints in total.
TB-1
Location: On the lateral side of the ring finger, about 0.1 cun from the corner of the nail.
Indications: Headache, redness of the eyes, sore throat, stiffness of the tongue, febrile diseases, irritability.
Acupuncture Method: Puncture superficially 0.1 inch, or prick with a three-edged needle to cause bleeding. Moxibustion is applicable.
Vasculature: The arterial and venous network formed by the palmar digital proprial artery and vein.
Innervation: The palmar digital proprial nerve derived from the ulnar nerve.
TB-2
Location: When the fist is clenched, the point is located in the depression proximal to the margin of the web between the ring and small fingers, at the junction of the red and white skin.
Indications: Headache, redness of the eyes, sudden deafness, sore throat, malaria, pain in the arm.
Acupuncture Method: Puncture obliquely 0.3-0.5 inch towards the interspace of the metacarpal bones. Moxibustion is applicable.
Vasculature: The dorsal digital artery of the ulnar artery.
Innervation: The dorsal branch of the ulnar nerve.
TB-3
Location: When the fist is clenched, the point is on dorsum of the hand between the fourth and fifth metacarpal bones, in the depression proximal to the fourth metacarpophalangeal joint.
Indications: Headache, redness of the eyes, deafness, tinnitus, sore throat, febrile diseases, pain in the elbow and arm, motor impairment of fingers.
Acupuncture Method: Puncture perpendicularly 0.3-0.5 inch. Moxibustion is applicable.
Vasculature: The dorsal venous network of hand and the fourth dorsal metacarpal artery.
Innervation: The dorsal branch of the ulnar nerve.
TB-4
Location: On the transverse crease of the dorsum of wrist, in the depression lateral to the tendon of m. extensor digitorum communis.
Indications: Pain in the arm, shoulder and wrist, malaria, deafness, thirst.
Acupuncture Method: Puncture perpendicularly 0.3-0.5 inch. Moxibustion is applicable.
Vasculature: The dorsal venous network of the wrist and the posterior carpal artery.
Innervation: The terminal branch of the posterior antebrachial cutaneous nerve and the dorsal branch of the ulnar nerve.
TB-5
Location: 2 cun proximal to the dorsal crease of the wrist, on the line connecting Yangchi (TB-4) and the tip of olecranon, between the radius and ulna.
Indications: Febrile diseases, headache, pain in the cheek, strained neck, deafness, tinnitus, pain in the hypochondriac region, motor impairment of the elbow and arm, pain of the fingers, hand tremor.
Acupuncture Method: Puncture perpendicularly 0.5-1.0 inch. Moxibustion is applicable.
Vasculature: Deeper, the posterior and anterior antebrachial interosseous arteries and veins.
Innervation: The posterior antebrachial cutaneous nerve; deeper, the posterior interosseous nerve and the anterior interosseous nerve.
TB-6
Location: 3 cun proximal to the dorsal crease of the wrist, on the line connecting Yangchi (TB-4) and the tip of olecranon, between the radius and ulna, on the radial side of m. extensor digitorum.
Indications: Tinnitus, deafness, pain in the hypochondriac region, vomiting, constipation, febrile diseases, aching and heavy sensation of the shoulder and back, sudden hoarseness of voice.
Acupuncture Method: Puncture perpendicularly 0.8-1.2 inches. Moxibustion is applicable.
Regional anatomy: See Waiguan (TB-5).
TB-7
Location: At the level with Zhigou (TB-6), on the ulnar side of Zhigou (TB-6), on the radial border of the ulna.
Indications: Deafness, pain in the ear, epilepsy, pain of the arm.
Acupuncture Method: Puncture perpendicularly 0.5-1.0 inch. Moxibustion is applicable.
Vasculature: The posterior antebrachial interosseous artery and vein.
Innervation: The posterior and medial antebrachial cutaneous nerves; deeper, the posterior and anterior interosseous nerves.
TB-8
Location: 4 cun proximal to the dorsal crease of the wrist, between the radius and ulna.
Indications: Deafness, sudden hoarseness of voice, pain in the chest and hypochondriac region, pain in the hand and arm, toothache.
Acupuncture Method: Puncture perpendicularly 0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy: See Huizong (TB-7).
TB-9
Location: On the lateral side of the forearm, 5 cun below the olecranon, between the radius and ulna.
Indications: Deafness, toothache, migraine, sudden hoarseness of voice, pain in the forearm.
Acupuncture Method: Puncture perpendicularly 0.5-1.0 inch. Moxibustion is applicable.
Regional anatomy: See Huizong (TB-7).
TB-10
Location: When the elbow is flexed, the point is in the depression about 1 cun superior to the olecranon.
Indications: Migraine, pain in the neck, shoulder and arm, epilepsy, scrofula, goiter.
Acupuncture Method: Puncture perpendicularly 0.3-0.5 inch. Moxibustion is applicable.
Vasculature: The arterial and venous network of the elbow.
Innervation: The posterior brachial cutaneous nerve and the muscular branch of the radial nerve.
TB-11
Location: 1 cun above Tianjing (TB-10) when the elbow is flexed.
Indications: Motor impairment and pain of the shoulder and arm, migraine.
Acupuncture Method: Puncture perpendicularly 0.3-0.5 inch. Moxibustion is applicable.
Vasculature: The terminal branches of the median collateral artery and vein.
Innervation: The posterior brachial cutaneous nerve and the muscular branch of the radial nerve.
TB-12
Location: On the line joining the olecranon and Jianliao (TB-14), midway between Qinglengyuan (TB-11) and Naohui (TB-13).
Indications: Headache, neck rigidity, motor impairment and pain of the arm.
Acupuncture Method: Puncture perpendicularly 0.5-0.7 inch. Moxibustion is applicable.
Vasculature: The median collateral artery and vein.
Innervation: The posterior brachial cutaneous nerve and the muscular branch of the radial nerve.
TB-13
Location: On the line joining Jianliao (TB-14) and the olecranon, on the posterior border of m. deltoideus.
Indications: Goiter, pain in the shoulder and arm.
Acupuncture Method: Puncture perpendicularly 0.5-0.8 inch. Moxibustion is applicable.
Vasculature: The median collateral artery and vein.
Innervation: The posterior brachial cutaneous nerve, the muscular branch of the radial nerve; deeper, the radial nerve.
TB-14
Location: On the shoulder, posterior to Jianyu (LI-15), in the depression inferior and posterior to the acromion when the arm is abducted.
Indications: Pain and motor impairment of the shoulder and upper arm.
Acupuncture Method: Puncture perpendicularly 0.7-1.0 inch. Moxibustion is applicable.
Vasculature: The muscular branch of the posterior circumflex humeral artery.
Innervation: The muscular branch of the axillary nerve.
TB-15
Location: Midway between Jianjing (GB-21) and Quyuan (SI-13), on the superior angle of the scapula.
Indications: Pain in the shoulder and elbow, stiffness of the neck.
Acupuncture Method: Puncture perpendicularly 0.3-0.5 inch. Moxibustion is applicable.
Vasculature: The descending branch of the transverse cervical artery; deeper, the muscular branch of the suprascapular artery.
Innervation: The accessory nerve and the branch of the suprascapular nerve.
TB-16
Location: On the lateral side of the neck, directly below the posterior border of mastoid process, on the level of the mandibular angle, and on the posterior border of sternocleido mastoid muscle.
Indications: Headache, neck rigidity, facial swelling, blurring of vision, sudden deafness.
Acupuncture Method: Puncture perpendicularly 0.3-0.5 inch. Moxibustion is applicable.
Vasculature: The posterior auricular artery.
Innervation: The lesser occipital nerve.
TB-17
Location: Posterior to the lobule of the ear, in the depression between the mandible and mastoid process.
Indications: Tinnitus, deafness, otorrhea, facial paralysis, toothache, swelling of the cheek, scrofula, trismus.
Acupuncture Method: Puncture perpendicularly 0.5-1.0 inch. Moxibustion is applicable.
Vasculature: The posterior auricular artery and vein, the external jugular vein.
Innervation: The great auricular nerve; deeper, the site where the facial nerve perforates out of the stylomastoid foramen.
TB-18
Location: In the centre of the mastoid process, at the junction of the middle and lower third of the curve formed by Yifeng (TB-17) and Jiaosun (TB-20) posterior to the helix.
Indications: Headache, tinnitus, deafness, infantile convulsion.
Acupuncture Method: Puncture subcutaneously 0.3-0.5 inch or prick with a three-edged needle to cause bleeding. Moxibustion is applicable.
Vasculature: The posterior auricular artery and vein.
Innervation: The posterior auricular branch of the great auricular nerve.
TB-19
Location: Posterior to the ear, at the junction of the upper and middle third of the curve formed by Yifeng (TB-17) and Jiaosun (TB-20) behind the helix.
Indications: Headache, tinnitus, deafness, pain in the ear, infantile convulsion.
Acupuncture Method: Puncture obliquely 0.3-0.5 inch. Moxibustion is applicable.
Vasculature: The posterior auricular artery and vein.
Innervation: The anastomotic branch of the great auricular nerve and the lesser occipital nerve.
TB-20
Location: Directly above the ear apex, within the hair line.
Indications: Tinnitus, redness, pain and swelling of the eye, swelling of gum, toothache, parotitis.
Acupuncture Method: Puncture subcutaneously 0.3-0.5 inch. Moxibustion is applicable.
Vasculature: The branches of the superficial temporal artery and vein. Innervation: The branches of the auriculotemporal nerve.
TB-21
Location: In the depression anterior to the supratragic notch and behind the posterior border of the condyloid process of the mandible. The point is located with the mouth open.
Indications: Tinnitus, deafness, otorrhea, toothache, stiffness of the lip.
Acupuncture Method; Puncture perpendicularly 0.3-0.5 inch. Moxibustion is applicable.
Vasculature: The superficial temporal artery and vein.
Innervation: The branches of the auriculotemporal nerve and facial nerve.
TB-22
Location: Anterior and superior to Ermen (TB-21), at the level with the root of the auricle, on the posterior border of the hairline of the temple where the superficial temporal artery passes.
Indications: Migraine, tinnitus, lockjaw.
Acupuncture Method: Avoid puncturing the artery, puncture obliquely 0.1-0.3 inch. Moxibustion is applicable.
Vasculature: The superficial temporal artery and vein.
Innervation: The branch of the auriculotemporal nerve, on the course of the temporal branch of the facial nerve.
TB-23
Location: In the depression at the lateral end of the eyebrow
Indications: Headache, redness and pain of the eye, blurring of vision, twitching of the eyelid, toothache, facial paralysis.
Acupuncture Method: Puncture subcutaneously 0.3-0.5 inch.
Vasculature: The frontal branches of the superficial temporal artery and vein.
Innervation: The zygomatic branch of the facial nerve and the branch of the auriculotemporal nerve.
FLOWING ROUTES
This meridian originates from the ulnar side of the tip of the ring finger (Guanchong, TB-1) and runs upwards along the dorsum of the wrist to Yangchi (TB-4). Running upwards between the ulna and the radius, it passes through the olecranon and runs along the lateral side of the upper arm to the shoulder region where it moves forward into the supraclavicular fossa (Quepen, ST-12) and spreads in the chest to link with the pericardium. Then, it descends through the diaphragm to successively distribute in the upper, middle and lower energizer. One branch from Danzhong (CV-17) runs upwards and emerges from the supraclavicular fossa (Quepen, ST-12). Then, it reaches the shoulder and the back of the neck (Dazhui, GV-14) where it crosses and meets its opposite branch. From there, it ascends to the neck and runs along the posterior border of the ear (Yifeng, TB-17), reaching the region superior to the apex of the ear. Further, it turns downward to the cheek and terminates in the infraorbital region. Another branch separating from retroauricular region enters the ear. Then emerging along the anterior aspect of the ear in front of Shangguan (GB-3), it crosses the previous branch at the cheek and reaches the outer canthus (Tongziliao, GB-1) to connect with shaoyang gallbladder meridian of foot.7
Footnotes
- What Is Traditional Chinese Medicine – sciencebasedmedicine.org – 2012, https://sciencebasedmedicine.org/what-is-traditional-chinese-medicine/
- Advanced Pressure Point Fighting of Ryukyu Kempo – A Dillman Karate International Book – 1994, https://www.amazon.com/Advanced-Pressure-Point-Fighting-Ryukyu/dp/0963199633/
- Acupuncture points of the Sanjiao meridian of the hand – cnacupuncture.com – 2017, http://www.cnacupuncture.com/points-of-triple-energizer-meridian-of-hand-shaoyang.html
- Chinese natural cures – Black Dog & Leventhal Publishing – 1994, https://www.abebooks.com/book-search/isbn/1579120563/
- The foundations of chinese medicine: a comprehensive text for acupuncturists and herbalists – Black Dog & Elsevier Churchill Livingstone – 2005, https://www.amazon.com/Foundations-Chinese-Medicine-Comprehensive-Acupuncturists/dp/0443074895
- Chinese acupuncture and moxibustion – Foreign Languages Press – 1987, https://www.amazon.com/Chinese-Acupuncture-Moxibustion-Seventeenth-Printing/dp/7119059947/ref=sr_1_1?s=books&ie=UTF8&qid=1493125663&sr=1-1
- Sanjiao meridian of the hand – tcmwiki.com – 2017, https://tcmwiki.com/wiki/shaoyang-sanjiao-meridian-of-hand