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Capítulo 51 de 81
黄帝内经·灵枢
Overall Paraphrase
The Yellow Emperor asked Qi Bo: I wish to hear about the Shu points (specific acupoints that serve as reactive points on the body surface for the qi of the internal organs) where the qi of the five viscera is infused into the back. What is this about? Qi Bo replied: The Great Shu (i.e., Dazhu point, located lateral to the spinous process of the first thoracic vertebra) of the chest is at the tip of the zhu bone (the spinous process of the first thoracic vertebra); the Lung Shu is below the third vertebra, on both sides; the Heart Shu is below the fifth vertebra, on both sides; the Diaphragm Shu is below the seventh vertebra, on both sides; the Liver Shu is below the ninth vertebra, on both sides; the Spleen Shu is below the eleventh vertebra, on both sides; the Kidney Shu is below the fourteenth vertebra, on both sides. These points all flank the spine, approximately three cun (Chinese inches) lateral to the spinal column. To locate and verify them, press the corresponding area with the hand: if there is a sensation within the body and the original pain is relieved after pressing, that is where the Shu point lies. These Back Shu points can be regulated with moxibustion 🔥, but are not suitable for needling. When pathogenic qi is exuberant, the reducing method should be used; when righteous qi is deficient, the reinforcing method should be applied. When applying reinforcement with moxa fire, do not blow on the fire — let it extinguish naturally; when applying reduction with moxa fire, blow quickly to fan the fire, let the heat transmit through the moxa cone, and wait until the fire is extinguished.
Note: In the original text, characters such as "背跑" (adapted as "背腧" in the conventional version), "五藏之航" (for "五脏之腧"), "肺份" (for "肺腧"), "心脑" (for "心腧"), "隔份" (for "膈腧"), "肝翁" (for "肝腧"), "脾份" (for "脾腧"), and "肾胞" (for "肾腧") are errors from textual transmission, corrected here according to the standard edition of Ling Shu · Back Shu Points. "焦" is a phonetic loan for "椎" (vertebra), referring to the segment between spinal processes; thus "三焦之间" does not refer to the Triple Burner organ, but rather to the position between the third vertebrae.
Back Shu Point Theory
The qi of the five viscera each has a fixed infusion site on the back, located in the area traversed by the Foot-Taiyang Bladder Meridian. These Back Shu points correspond internally and externally with their respective viscera, forming a network of "viscera—back—meridian" connections. This is an important manifestation of the holistic view of viscera and meridians in the era of the Nei Jing (Inner Canon).
Diagnostic Thought of "Pressure Response and Pain Relief"
The original text proposes a simple method for locating and verifying acupoints: by pressing a specific back region, if there is a sensation within the body and the original pain or discomfort is relieved, that site can be identified as the corresponding Back Shu point. This reflects ancient observations of the body-surface—viscera reflex, and is a prototype of the ideas of "pain as acupoint" (yi tong wei shu) and "Ashi points."
Treatment Principle: "Moxibustion is Allowed; Needling is Not"
The Back Shu points are located close to the viscera. The ancients believed that the muscles in this area are shallow and that deep organs lie beneath, so they advocated moxibustion while being cautious with needling. This reflects the Ling Shu's preliminary awareness of needling risks at different body sites, and also indicates that Back Shu points were mainly used for warming and regulating in early times.
Reinforcing and Reducing Techniques in Moxibustion
The method of "do not blow on the fire; let it extinguish naturally" constitutes reinforcement, while "blow quickly on the fire; transmit the moxa heat" constitutes reduction. The distinction lies in the combustion speed and intensity of stimulation: slow, gentle heat tends toward warming and reinforcement; rapid, intense heat tends toward dispersing and reducing — embodying the traditional principle of "slow is reinforcing, rapid is reducing."
Modern Research on Back Shu Points
Back Shu points are mainly distributed on both sides of the spine, closely related to the segmental distribution of the dorsal rami of spinal nerves and the sympathetic chain. Modern medicine holds that stimulating specific back areas can regulate the function of corresponding internal organs through body-surface—viscera reflexes, echoing the ancient idea of "visceral qi communicating with the back." However, the positions described in ancient texts (three cun lateral to the spine) differ from modern common locations (1.5 cun lateral to the posterior midline), possibly due to differing acquisition standards of the time, proportional body inch (tong shen cun) conversions, or textual errors — these points should be viewed rationally.
Value and Limitations of Palpation as a Diagnostic Method
Using "pain relief upon pressure" to locate acupoints and judge related visceral responses is similar to modern clinical tenderness examination or the application of "Ashi points," and has some observational foundation. However, relying solely on palpation responses to diagnose visceral diseases lacks sufficient specificity and standardization, and cannot replace modern medical examinations.
Scientific Interpretation of Moxibustion Reinforcing and Reducing Methods
In moxibustion, whether or not one blows on the fire mainly affects the combustion temperature and the speed of heat penetration. In modern thermal terms: slow, gentle burning produces deeper, slower heat penetration; rapid blowing produces brief, intense heat with stronger stimulation. These different rates of temperature change may produce different physiological effects, but the traditional meanings of "reinforcement and reduction" are mostly empirical summaries and still require more evidence-based research.
Historical Limitations
The statement "moxibustion is allowed, needling is not" reflects the anatomical knowledge and acupuncture tool conditions of that era. In modern acupuncture clinical practice, needling the Back Shu points is already performed with safer, standardized depths and angles. Therefore, the acupuncture and moxibustion guidelines described in this text reflect only the understanding of the Nei Jing era and should not be directly applied to modern clinical operation.
Keep the Back Warm and Stretch It 🌿
Chinese medicine holds that "the back is the yang," and the qi of the five viscera pours into the back. In daily life, keep the back warm, and perform moderate chest-expanding, waist-twisting, and shoulder-and-back stretching movements to maintain the smooth flow of qi and blood in the back, reducing discomfort from prolonged sitting and fatigue.
Palpation for Awareness, Not Self-Diagnosis
When not in a disease state, one may gently press the back muscles with light force to note any abnormal tension or tender points, as a reference for everyday relaxation. However, avoid excessive force, and never use palpation sensations to self-diagnose illness or treat oneself.
Moxibustion Requires Professional Guidance
The moxibustion techniques described in this text belong to ancient external treatment principles and are only for understanding traditional thought. Actual moxibustion involves multiple factors such as acupoint selection, fire intensity, duration, and individual constitution, and must only be performed under the guidance of professionals, not on one's own.
Follow the Rhythms of the Viscera
The Back Shu points correspond to the five viscera. In daily life, one should adapt to the rhythms of the four seasons and the day–night cycle, avoiding overexertion and emotional imbalance that can harm the viscera, thereby indirectly affecting the smooth flow of qi in the back meridians.
Associated Concepts
Back Shu acupoints, Foot-Taiyang Bladder Meridian, correspondence between viscera and meridians, palpation of acupoints as a diagnostic method, moxibustion reinforcement and reduction, Dazhu point, proportional body inch, body-surface—viscera reflex.
Further Reading
This content is based on classical Chinese medical texts and is provided solely for the study of traditional culture and classical reading. It does not constitute any medical diagnosis, medication prescription, or treatment advice. If you experience any discomfort, please seek medical attention promptly.