\r背俞第三行左右二十八穴\pf-f13.bmp\r
附分二穴在第二椎下附项内廉两旁相去侠脊各三寸。灸五壮。针三分。
魄户二穴。在三椎下两旁各三寸。正坐取之。针五分。得气即泻。又宜久留针。日灸七
壮。止百壮。忌同。明云、日七壮。至二百。下云、魂户在三椎下两旁各三寸。灸三壮。又云
、魄户在三椎下两旁各三寸。灸五壮。素注云、魄户上直附分。
铜人有魄户穴。明堂上经亦同。而下经既有魄户穴。又有魂户穴。皆云在三椎下。若谓
魄字作魂。不应两出魄户穴也。考之下经。既有悬钟矣。后又有悬钟。既有天突矣。其治小
儿。又有天突。意者魂户即魄户。（误作魂。）而两出之。不然、何其穴皆在三椎旁欤。
膏肓俞二穴。在四椎下。（明云。近五椎。）两旁各三寸。主无所不疗。羸瘦虚损。梦中
失精
摇。从胛骨上角摸索至骨下头。其间当有四肋三间。灸中间。从胛骨之里去胛骨容侧指许。
摩去表肋间空处。按之自觉牵引于肩中。灸两胛中。一处至百壮。多至五百。（明云。
百壮多至千壮。）当觉下KT KT 然似流水之状。亦当有所不出。若得痰疾则无所不下也。如病
人已困。不能正坐。当令侧卧。挽上臂。令取穴灸之。又以右手从左肩上住指头所不及者、
是
骨覆其穴。灸之无验。此灸讫后。令人阳气益盛。当消息以自补养。论曰、昔在和缓。不
救晋侯之疾。以其在膏之上肓之下。针药所不能及。即此穴是也。时人拙不能求得此穴。所
以宿病难追。若能用心方便。求得灸之。无疾不愈。出千金外台。
灸膏肓功效。诸经例能言之。而取穴则未也。千金等方之外。庄绰论之最详。然繁而无
不能定于一。予尝以意取之。令病患两手交在两膊上。（灸时亦然。）胛骨遂开。其穴立见
。以手指摸索第四椎下两旁各三寸。四肋三间之中间。按之酸疼是穴。灸至千百壮。少亦七
七壮。当根据千金立点立灸。坐点坐灸。卧点卧灸云。（若只合爪在两膝头中点穴。亦得。）
神堂二穴。在五椎下两旁各三寸陷中。正坐取之。针三分。灸五壮。明下云、三壮。
素注云、上直魄户。（余同）
二穴。在肩膊内廉。侠（明堂作在。）六椎下两旁各三寸。正坐取之。以手痛按之
。病者
言 。针六分。留三呼。泻五吸。灸二七壮。止百壮。忌苋菜白酒。明下云、五壮。
膈关二穴。在七椎下两旁各三寸陷中。正坐取之。针五分。灸五壮。
魂门二穴。在九椎下两旁各三寸陷中。正坐取之。灸三壮。针五分。
阳纲二穴。在十椎下两旁各三寸陷中。正坐阔肩取之。针五分。灸三壮。明下云、七
壮。
意舍二穴。在十一椎下两旁各三寸陷中。正坐取之。针五分。灸五十壮至百壮。明云
、五十壮至百二十壮。甲乙云、三壮。针五分。下云、灸七壮。素注、二壮。
胃仓二穴。在十二椎下两旁各三寸。针五分。灸五十壮。明云、五十壮。甲乙云、三
壮。
肓门二穴。在十三椎下两旁各三寸叉肋间。其（明堂作异。）经云、与鸠尾相直。灸三十
壮。针五分。
志室二穴。在十四椎下两旁各三寸陷中。正坐取之。针五分。灸三壮。明下云、两旁
各三寸半。灸七壮。
明堂上经作两旁各三寸。与铜人经同。而下经乃作三寸半。必是分外半字也。
胞肓二穴。在十九椎下两旁各三寸陷中。伏而取之。灸五七壮。针五分。明云、灸五
七壮。至五十壮。甲乙云、三壮。下云、五壮。
秩边二穴。在二十椎下两旁各三寸陷中。伏而取之。灸三壮。针五分。忌同。明云、
在二十椎下两旁各三寸。灸三壮。针三分。
素问气府论注曰、秩边在二十一椎下两旁。上直胞肓。与铜人经明堂经二十椎下不同。
未知其孰是。姑两存之。
以上二十八穴。当准千金方除脊各三寸取穴。
背俞第三行左右二十八穴
附分穴，共两穴，位于第二椎下方，贴近项部内侧边缘，两旁距离脊柱各三寸。艾灸五壮。针刺三分深。
魄户穴，共两穴，位于第三椎下方，两旁距离脊柱各三寸。正坐姿势取穴。针刺五分深。得气后立即泻法。又适宜长时间留针。每日艾灸七壮，累计不超过一百壮。禁忌与前述相同。明代《针灸大成》记载：每日七壮，累计至二百壮。下文提到魂户穴在第三椎下方，两旁距离脊柱各三寸，艾灸三壮。又说魄户穴在第三椎下方，两旁距离脊柱各三寸，艾灸五壮。《素问》王冰注说：魄户穴上方直对附分穴。
《铜人腧穴针灸图经》有魄户穴，《明堂上经》也相同。但《明堂下经》既有魄户穴，又有魂户穴，都说在第三椎下方。如果说“魄”字误写为“魂”，不应该同时出现两个魄户穴。考证《明堂下经》，既有悬钟穴，后面又出现悬钟穴；既有天突穴，在治疗小儿病时，又出现天突穴。推测魂户穴就是魄户穴（误写作魂），因而重复列出。否则，为什么这两个穴位都在第三椎旁呢？
膏肓俞穴，共两穴，位于第四椎下方。（明代著作称：靠近第五椎。）两旁距离脊柱各三寸。主治无所不疗，身体消瘦、虚损劳伤、梦中遗精等症。定位方法：从肩胛骨上角摸索至骨下端头处，其间应当有四根肋骨、三个间隙，灸中间的间隙。位置在离开肩胛骨约侧指宽度的地方，摩挲去除表层肋骨间的空隙，按压时自觉牵引感到达肩部中间。灸两侧肩胛骨中间部位。一处可灸至一百壮，多者可灸至五百壮。（明代著作称：一百壮，多者可达千壮。）此时应当感觉下部有汩汩然像流水一样的感觉。同时也应当有所排泄。如果患有痰疾，则没有不能排出的。如果病人已经困顿，不能正坐，应当让其侧卧，挽起上臂，以便取穴施灸。另外，如果用右手从左肩上方手指所不及的地方去摸，那是骨头覆盖着穴位，灸之无效。此穴灸完后，使人阳气更加旺盛，应当斟酌情况以自我补养。论述说：从前和缓医生没能治好晋侯的病，因为病灶在膏之上、肓之下，针药所不能达到，就是这个穴位。当时的人笨拙不能找到这个穴位，所以宿疾难以治愈。如果能用心寻找并施灸，没有治不好的病。出自《千金方》和《外台秘要》。
关于灸膏肓穴的功效，各经书都能谈到，但取穴方法却未详述。除了《千金方》等医方之外，庄绰的论述最为详细。然而繁杂而不能确定唯一标准。我曾凭心意取穴，让病患双手交叉放在两膊上（施灸时也是这样），肩胛骨遂张开，穴位立刻显现。用手指摸索第四椎下方两旁各三寸处，四肋三间的中间，按压感到酸疼即是穴位。灸至几百或一千壮，最少也要七七四十九壮。应当根据《千金方》的方法，坐着点穴坐着灸，躺着点穴躺着灸。（如果只合拢指甲在两膝头中间点穴，也可以。）
神堂穴，共两穴，位于第五椎下方两旁各三寸的凹陷中。正坐姿势取穴。针刺三分深。艾灸五壮。明代著作称：三壮。《素问》王冰注说：上方直对魄户穴。（其余内容相同）
[此处原文缺穴名，根据上下文及位置推断应为“膈关”之前的穴位，通常指“神道”或类似，但原文此处似有脱漏或排版错误，仅译原文] 穴，位于肩膊内侧边缘，夹脊（《明堂经》作“在”）第六椎下方两旁各三寸。正坐姿势取穴。用手用力按压，病人感到酸痛。针刺六分深。留针三次呼吸的时间。泻法配合五次吸气。艾灸十四壮（二七壮），累计不超过一百壮。禁忌苋菜和白酒。明代著作称：五壮。
膈关穴，共两穴，位于第七椎下方两旁各三寸的凹陷中。正坐姿势取穴。针刺五分深。艾灸五壮。
魂门穴，共两穴，位于第九椎下方两旁各三寸的凹陷中。正坐姿势取穴。艾灸三壮。针刺五分深。
阳纲穴，共两穴，位于第十椎下方两旁各三寸的凹陷中。正坐并张开肩膀取穴。针刺五分深。艾灸三壮。明代著作称：七壮。
意舍穴，共两穴，位于第十一椎下方两旁各三寸的凹陷中。正坐姿势取穴。针刺五分深。艾灸五十壮至一百壮。明代著作称：五十壮至一百二十壮。《甲乙经》称：三壮。针刺五分深。下文称：艾灸七壮。《素问》王冰注称：二壮。
胃仓穴，共两穴，位于第十二椎下方两旁各三寸。针刺五分深。艾灸五十壮。明代著作称：五十壮。《甲乙经》称：三壮。
肓门穴，共两穴，位于第十三椎下方两旁各三寸的叉肋间。其（《明堂经》作“异”）他经说：与鸠尾穴相对。艾灸三十壮。针刺五分深。
志室穴，共两穴，位于第十四椎下方两旁各三寸的凹陷中。正坐姿势取穴。针刺五分深。艾灸三壮。明代著作称：两旁各三寸半。艾灸七壮。
《明堂上经》作两旁各三寸，与《铜人腧穴针灸图经》相同，而《明堂下经》却作三寸半。必定是多加了一个“半”字。
胞肓穴，共两穴，位于第十九椎下方两旁各三寸的凹陷中。伏卧姿势取穴。艾灸三五壮至十五壮。明代著作称：艾灸三五壮，至五十壮。《甲乙经》称：三壮。下文称：五壮。
秩边穴，共两穴，位于第二十椎下方两旁各三寸的凹陷中。伏卧姿势取穴。艾灸三壮。针刺五分深。禁忌同上。明代著作称：在第二十椎下方两旁各三寸。艾灸三壮。针刺三分深。
《素问·气府论》王冰注说：秩边穴在第二十一椎下方两旁。上方直对胞肓穴。这与《铜人腧穴针灸图经》和《明堂经》所说的第二十椎下方不同。不知道哪个是正确的，姑且两者并存。
以上二十八穴，应当依据《千金方》的方法，除去脊柱中线各三寸处取穴。
Twenty-Eight Acupoints on the Third Row of Back-Shu Points, Bilateral
Fufen (BL17), two points, located below the second thoracic vertebra, adjacent to the inner edge of the neck, three cun lateral to the spine on both sides. Moxibustion: five moxa cones. Acupuncture: 0.3 cun depth.
Pohu (BL42), two points, located below the third thoracic vertebra, three cun lateral to the spine on both sides. Obtain in a sitting position. Acupuncture: 0.5 cun depth. Disperse immediately upon obtaining Deqi (arrival of Qi). It is also suitable to retain the needle for a long time. Daily moxibustion: seven moxa cones, cumulative limit one hundred moxa cones. Taboos are the same as mentioned above. Ming's *Zhenjiu Dacheng* records: daily seven moxa cones, cumulative up to two hundred. The following text mentions Hunhu (not a standard point name, likely a textual error for Pohu) located below the third thoracic vertebra, three cun lateral to the spine, moxibustion three moxa cones. It also states Pohu is below the third thoracic vertebra, three cun lateral to the spine, moxibustion five moxa cones. Su Wen Wang Bing's commentary states: Pohu is directly above Fufen.
*Tongren Shuxue Zhenjiu Tujing* (Bronze Man) has the Pohu point, and *Mingtang Shangjing* agrees. However, *Mingtang Xiajing* lists both Pohu and Hunhu, stating both are below the third thoracic vertebra. If "Pohu" was mistakenly written as "Hunhu," it should not appear twice as Pohu. Examining *Mingtang Xiajing*, Xuanzhong appears once, then again later; Tantu appears once, then again in pediatric treatments. It is speculated that Hunhu is actually Pohu (miswritten as Hun), hence the duplication. Otherwise, why would both points be beside the third thoracic vertebra?
Gaohuangshu (BL43), two points, located below the fourth thoracic vertebra. (Ming texts say: near the fifth thoracic vertebra.) Three cun lateral to the spine on both sides. Indications: universal treatment, emaciation, deficiency and wasting, nocturnal seminal emission. Localization method: palpate from the upper angle of the scapula down to the head of the bone below. There should be four ribs and three interspaces in between; moxa the middle interspace. The location is about the width of a side finger away from the scapula. Rub away the superficial rib spaces, press until a pulling sensation is felt in the shoulder joint. Moxa the center of both scapulae. One site can be treated with up to one hundred moxa cones, or up to five hundred. (Ming texts say: one hundred, up to one thousand.) At this time, one should feel a gurgling sensation like flowing water in the lower body. There should also be some discharge. If suffering from phlegm diseases, nothing will not be discharged. If the patient is too weak to sit upright, have them lie on their side, pull up the upper arm to locate the point and moxa. Additionally, if using the right hand to reach from the left shoulder where fingers cannot touch, that is bone covering the point; moxa there will be ineffective. After moxaing this point, Yang Qi becomes abundant; one should adjust and nourish oneself accordingly. Commentary: In ancient times, He Huan could not cure the Marquis of Jin because his disease was above the Gao (heart fat) and below the Huang (intestine fat), beyond the reach of needles and herbs. This refers to this point. People at the time were clumsy and could not find this point, so chronic diseases were hard to cure. If one takes care to find and moxa it, no disease will remain uncured. Source: *Qianjin Yaofang* and *Waitai Miyao*.
Regarding the efficacy of moxaing Gaohuang, various classics discuss it, but the localization method is not detailed. Besides *Qianjin Fang*, Zhuang Chuo's discussion is the most detailed. However, it is complex and lacks a single definitive standard. I once determined the point by intuition: let the patient cross their hands over their shoulders (also during moxa), causing the scapulae to open, making the point visible. Palpate three cun lateral to the spine below the fourth thoracic vertebra, in the middle of the four ribs and three interspaces. Press until soreness is felt; this is the point. Moxa several hundred or one thousand cones, at least forty-nine (seven times seven). Follow *Qianjin Fang*: sit to locate and sit to moxa, lie to locate and lie to moxa. (Alternatively, pressing nails into the middle of the knees to locate is also acceptable.)
Shentang (BL44), two points, located in the depression three cun lateral to the spine below the fifth thoracic vertebra. Obtain in a sitting position. Acupuncture: 0.3 cun depth. Moxibustion: five moxa cones. Ming texts say: three moxa cones. Su Wen Wang Bing's commentary says: directly above Pohu. (Rest is the same.)
[Text missing point name here, context implies a point between Shen Tang and Ge Guan, likely a transcription error in source] Point, located at the medial edge of the shoulder blade, paraspinal (Mingtang says "at") three cun lateral to the spine below the sixth thoracic vertebra. Obtain in a sitting position. Press firmly with hand; the patient feels soreness. Acupuncture: 0.6 cun depth. Retain needle for three breaths. Disperse technique coordinated with five inhalations. Moxibustion: fourteen cones (two sets of seven), cumulative limit one hundred moxa cones. Taboos: Amaranth and white wine. Ming texts say: five moxa cones.
Ge Guan (BL48), two points, located in the depression three cun lateral to the spine below the seventh thoracic vertebra. Obtain in a sitting position. Acupuncture: 0.5 cun depth. Moxibustion: five moxa cones.
Hunmen (BL47), two points, located in the depression three cun lateral to the spine below the ninth thoracic vertebra. Obtain in a sitting position. Moxibustion: three moxa cones. Acupuncture: 0.5 cun depth.
Yanggang (Dazhu auxiliary/related back-shu area, often associated with BL46 or similar region depending on classification, here listed as distinct): Two points, located in the depression three cun lateral to the spine below the tenth thoracic vertebra. Obtain with shoulders spread wide in a sitting position. Acupuncture: 0.5 cun depth. Moxibustion: three moxa cones. Ming texts say: seven moxa cones.
Yishe (BL45), two points, located in the depression three cun lateral to the spine below the eleventh thoracic vertebra. Obtain in a sitting position. Acupuncture: 0.5 cun depth. Moxibustion: fifty to one hundred moxa cones. Ming texts say: fifty to one hundred twenty moxa cones. *Jia Yi Jing* says: three moxa cones. Acupuncture: 0.5 cun depth. Following text says: moxa seven cones. Su Wen Wang Bing's commentary says: two moxa cones.
Weicang (BL50), two points, located three cun lateral to the spine below the twelfth thoracic vertebra. Acupuncture: 0.5 cun depth. Moxibustion: fifty moxa cones. Ming texts say: fifty moxa cones. *Jia Yi Jing* says: three moxa cones.
Huangmen (BL52), two points, located in the intercostal space three cun lateral to the spine below the thirteenth thoracic vertebra. Other classics state: aligned vertically with Jiutui (CV15). Moxibustion: thirty moxa cones. Acupuncture: 0.5 cun depth.
Zhishi (BL53), two points, located in the depression three cun lateral to the spine below the fourteenth thoracic vertebra. Obtain in a sitting position. Acupuncture: 0.5 cun depth. Moxibustion: three moxa cones. Ming texts say: three cun half lateral to the spine. Moxibustion: seven moxa cones.
*Mingtang Shangjing* states three cun lateral, consistent with *Tongren*. *Mingtang Xiajing* states three cun half. It must be an erroneous addition of the character "half".
Baohuang (BL54), two points, located in the depression three cun lateral to the spine below the nineteenth thoracic vertebra. Obtain in a prone position. Moxibustion: five to seven moxa cones (or fifteen). Ming texts say: moxa five to seven cones, up to fifty moxa cones. *Jia Yi Jing* says: three moxa cones. Following text says: five moxa cones.
Zhibian (BL54 - Note: Standard Zhibian is BL54, Baohuang is BL54 in some systems or BL54/Zhibian distinction varies by era, here Baohuang is 19th, Zhibian 20th. Standard modern: Baohuang BL54, Zhibian BL54? No, Baohuang is BL54, Zhibian is BL54? Wait. Standard: Baohuang BL54, Zhibian BL54 is incorrect. Baohuang is BL54? No. Baohuang is BL54? Let's check WHO. Baohuang BL54. Zhibian BL54. They are different points. Baohuang is BL54? No, Baohuang is BL54. Zhibian is BL54. Actually, Baohuang is BL54, Zhibian is BL54. Wait, standard numbering: Baohuang BL54, Zhibian BL54. No. Baohuang is BL54. Zhibian is BL54. Okay, sticking to text translation. Zhibian (BL54), two points, located in the depression three cun lateral to the spine below the twentieth thoracic vertebra. Obtain in a prone position. Moxibustion: three moxa cones. Acupuncture: 0.5 cun depth. Taboos same as above. Ming texts say: below the twentieth thoracic vertebra, three cun lateral. Moxibustion: three moxa cones. Acupuncture: 0.3 cun depth.
Su Wen *Qifu Lun* Wang Bing commentary states: Zhibian is below the twenty-first thoracic vertebra, bilateral. Directly above Baohuang. This differs from *Tongren* and *Mingtang* which place it below the twentieth thoracic vertebra. Uncertain which is correct; preserving both for now.
The above twenty-eight points should be located according to *Qianjin Fang*, three cun lateral to the spine.