Differentiation of Syndromes According to San Jiao Patterns

Differentiation of Syndromes According to San Jiao Patterns

Upper Jiao Damp Heat

Upper Jiao Damp Heat is the early stage of a Damp Evil invasion. In this stage the Damp Evil attacks both the Lungs and the Skin. Dampness can also affect the Stomach and Spleen at this stage. At this stage there is not much heat, mostly damp. However, if allowed to progress, heat symptoms will appear.

Symptoms of Upper Jiao Stage

  • Mucus discharge, inflammation.
  • Yellow nasal discharge.
  • Discharge and inflammation of the eyes.
  • Discharge and inflammation of the ears .
  • Lungs. Cough with thick yellow mucus.
  • Swollen lymph glands on the neck.
  • Fever. Slight fever, no fever, or afternoon fever. There may be chills and/or sensitivity to Cold.
  • Headache accompanied with a sensation of heaviness.
  • Nasal and sinus congestion.
  • Tongue: White coat.
  • Pulse: Fast

Treatment of Upper Jiao San Jiao

Formula: Huo Xiang Zheng Qi San

Function: Releases the exterior, transforms Dampness, regulates Qi and harmonizes the Middle Jiao.


  • Huo Xiang
  • Hou Po
  • Chen Pi
  • Zi Su Ye
  • Bai Zhi
  • Ban Xia
  • Da Fu Pi
  • Bai Zhu
  • Fu Ling
  • Jie Geng
  • Sheng Jiang

Middle Jiao Damp Heat

At this stage of San Jiao Damp Heat invasion, the Middle Jiao is attacked. The Spleen is easily weakened by Dampness and so at this stage the Spleen's function of Transformation and Transportation is injured. Because of the relationship between the Spleen and the Stomach, the Stomach's function of receiving food and water is is also impaired.

The Spleen is also responsible for keeping the muscles and limbs nourished, so there may be muscle tenderness and/or heaviness of the limbs at this stage.

Symptoms of Middle Jiao San Jiao Stage

  • Abdominal discomfort. Bloating, gas, indigestion, Loss of appetite.
  • Vomiting and nausea.
  • Diarrhea. With possible white mucus.
  • Jaundice. On skin and eyes, especially if Damp-Heat is strong. The facial complexion may be a "dirty" dark yellow.
  • Fever. May be slight, afternoon fever, or may be reduced after diaphoresis (sweating) but then increases again.
  • Heaviness of the limbs.
  • Dry mouth. With no desire drink. Decreased Shen. Fatigue or no energy.
  • Urination. Frequent with burning sensation
  • Tongue: gray,white and/or yellow coating.
  • Pulse: soft, slow and maybe slippery.

Treatment of Middle Jiao San Jiao Stage

Formula: San Ren Tang

Function: Remove Heat Evil and Resolve Dampness.


  • Xing Ren
  • Bai Dou Kou
  • Yi Yi Ren
  • Hou Po
  • Tong Cao
  • Hua Shi
  • Zhu Ye
  • Zi Ban Xia

If this stage of Damp-Heat is allowed to progress, the following may occur:

1. The Dampness may dry out and the disease becomes Warm Heat Qi Fen Stage (which is the same as the Four Stages Qi Fen Stage).
2. The Dampness may cool off and the disease becomes a Cold-Damp disease.
3. The disease may progress into Lower Jiao Damp Heat Disease.

Lower Jiao Damp Heat

This is the last stage of the San Jiao Differential Diagnosis. Chiefly, the Large Intestines and Urinary Bladder are affected so there will be problems with elimination.

Symptoms of Lower Jiao San Jiao Stage

  • Diarrhea with foul odor, possibly with a burning sensation, due to Large Intestine Damp Heat.
  • Urinary dysfunction. Similar to urinary tract infection. Burning sensation, scant dark-yellow urine. Yellow vaginal discharge with a bad odor.
  • Addition symptoms may include genital herpes, or pelvic inflammatory disease.
  • Lower abdominal distention.
  • Dizziness. The dampness may affect the clear Qi from ascending.
  • Tongue: Gray white and yellow greasy coating.
  • Pulse: Soft, rapid, slightly slippery

Treatment of Lower Jiao San Jiao Stage

Formula: Fu Ling Pi Tang

Function: Dispels dampness through diuresis.


  • Fu Ling Pi
  • Yi Yi Ren
  • Zhu Ling
  • Da Fu Pi
  • Bai Tong Cao
  • Dan Zhu Ye

References Used

The TCM information presented here has been referenced from numerous sources; including teachers, practitioners, class notes from Five Branches University, the following books, as well as other sources. If you have benefited from this information, please consider supporting the authors and their works by purchasing the books below.

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