\r背俞部中行十三穴\pf-f11.bmp\r
大椎一穴。（一作 。）在第一椎上陷者宛宛中。针五分。留三呼。泻五吸。灸以年为壮
（明云∶日灸七壮至七七壮。）甲乙云、大椎下至尾 骨二十一椎。长三尺。折量取俞穴。
既曰大椎。又曰在第一椎上陷中。必是二穴。非二穴则不言在第一椎上矣。此大椎第一
以异也。但铜人云、大椎在第一椎上陷中。诸经皆同。惟明堂下经云在第一椎下。陶道穴既
在第一椎下。不应大椎亦在第一椎下。必是下经误写上字作下字也。考之下经。亦言陶道穴
在大椎节下。与铜人合。足见其误写上字作下无疑矣。
陶道在大椎节下间。俯而取之。灸五壮。针五分。
身柱在第三椎节下间。针五分。灸七七壮。明云、五壮。下云、三壮。
神道在五椎节下间。俯而取之。灸七七壮。止百壮。小儿风痫螈 。可灸七壮。明云
、针五分。灸三壮。下云、五壮。
灵台在六椎节下间。俯而取之。经阙疗病法。出素问。
至阳在七椎节下间。俯而取之。针五分。灸三壮。明下云、七壮。
筋缩在九椎节下间。俯而取之。针五分。灸三壮。明下云、七壮。
脊中一名神宗。在十一椎节下间。俯而取之。禁灸。灸令人腰背伛偻。针五分。得气即
明堂作脊俞。一名脊中。在十一椎中央。接脊在十二椎下节间。（下经治小儿疳脱肛。）
悬枢在十三椎节下间。伏而取之。针三分。灸三壮。明云、在十二椎下节间。下云、
十一椎下。
铜人云、悬枢在十三椎节下间，明堂上经作十二椎节间。下经作十一椎下。脊中穴既在
十一
椎下。不应悬枢又在十一椎下。固知其误矣。考之素问。亦与铜人同。当以铜人为正。明堂
上经亦误三字作二字也。要之、接脊穴在十二椎节下尔。
命门一名属累。在十四椎节下间。伏而取之。（明作俯而取之。）针五分。灸三壮。
阳关在十六椎下间。伏而取之。针五分。灸三壮。阙疗病法。出素问。
腰俞一名背解。一名髓孔。一名腰柱。一名腰户。在二十一椎节下间宛宛中。以挺腹地
舒身
。两手相重支额。纵四体后乃取其穴。针八分。留三呼。泻五吸。灸七壮至七七壮。忌房劳
举重强力。
甲乙云、针二寸。留七呼。灸七七壮。明云、三壮。下云、五壮。素注云、针一分。新
校正云、按甲乙经作二寸。水热穴注亦可二寸。气府论注、骨空论注作一分。一名髓空。
长强一名气之阴 。督脉络别。其穴跗地取之。甲乙云、在脊 端。针三分。转针以
大痛
为度。其穴跗地取之乃得。灸不及针。日三十壮。止二百。此痔根本是冷。忌冷食房劳。甲
乙云、针二寸。留七呼。明下云、五壮。
自大椎至腰俞。长同身寸三尺。折量取穴。（甲）
有里医言∶凡灸椎骨。当灸骨节突处方验。灸节下当骨无验。以鱼肉骨参之。其言为可
信。盍根据其言。当骨节灸之。
背俞部正中线上共十三个穴位
大椎穴一个。（另一种说法是“第一椎上”）。位于第一椎上方的凹陷处，宛宛然中。针刺深度五分。留针三呼的时间。行泻法时吸气五次。艾灸以年龄为壮数（即几岁灸几壮）。（王明堂说：每日灸七壮，直到七七四十九壮。）《甲乙经》说：从大椎到尾骨共有二十一节椎骨。全长三尺。通过折量法来取俞穴。
既然叫做大椎，又说在第一椎上方的凹陷中，必定是两个不同的穴位。如果不是两个穴位，就不会说在第一椎上方了。这就是大椎穴与其他穴位不同之处。但是《铜人腧穴针灸图经》说：大椎在第一椎上方的凹陷中，各经脉记载都相同。只有《明堂下经》说在第一椎下方。陶道穴既然在第一椎下方，那么大椎也不应在第一椎下方。必定是《下经》把“上”字误写成了“下”字。考证《下经》，也说陶道穴在大椎节段的下方，这与《铜人》相符。足见其将“上”字误写为“下”字无疑。
身柱穴在第三椎节段下方的间隙。针刺五分。灸七七四十九壮。王明堂说：五壮。下文说：三壮。
神道穴在五椎节段下方的间隙。俯身取穴。灸七七四十九壮，最多一百壮。小儿风痫抽搐，可灸七壮。王明堂说：针刺五分，灸三壮。下文说：五壮。
灵台穴在六椎节段下方的间隙。俯身取穴。经文缺失治疗病证的方法。出自《素问》。
至阳穴在七椎节段下方的间隙。俯身取穴。针刺五分。灸三壮。王明堂下文说：七壮。
筋缩穴在九椎节段下方的间隙。俯身取穴。针刺五分。灸三壮。王明堂下文说：七壮。
脊中穴又名神宗。在十一椎节段下方的间隙。俯身取穴。禁止艾灸，艾灸会让人腰背弯曲驼背。针刺五分。得气即可。（《明堂》作脊俞。又名脊中。位于十一椎中央。接脊穴在十二椎下方的节间。（《下经》主治小儿疳积脱肛。）
悬枢穴在十三椎节段下方的间隙。伏身取穴。针刺三分。灸三壮。王明堂说：在十二椎下方的节间。下文说：十一椎下方。
《铜人》说：悬枢在十三椎节段下方的间隙，《明堂上经》作十二椎节间。《下经》作十一椎下方。脊中穴既然在十一椎下方，那么悬枢穴不应又在十一椎下方。固然是知道这是错误的。考证《素问》，也与《铜人》相同。应当以《铜人》为正解。《明堂上经》也是将三字误写为二字。总之，接脊穴在十二椎节段下方罢了。
命门穴又名属累。在十四椎节段下方的间隙。伏身取穴。（王明堂作俯身取穴。）针刺五分。灸三壮。
阳关穴在十六椎下方的间隙。伏身取穴。针刺五分。灸三壮。缺失治疗病证的方法。出自《素问》。
腰俞穴又名背解、髓孔、腰柱、腰户。在二十一椎节段下方的凹陷处。用挺腹仰卧舒展身体。两手交叉支撑额头。四肢放松向后伸展，然后取穴。针刺八分。留针三呼。行泻法时吸气五次。灸七壮到七七四十九壮。忌房事劳累、举重和强力动作。
《甲乙经》说：针刺二寸。留针七呼。灸七七四十九壮。王明堂说：三壮。下文说：五壮。《素问》注说：针刺一分。新校正说：按《甲乙经》作二寸。水热穴注也可作二寸。《气府论》注、《骨空论》注作一分。又名髓空。
长强穴又名气之阴。督脉别络。此穴需俯卧取穴。《甲乙经》说：在脊柱末端。针刺三分。转动针具，以大痛为度。此穴必须俯卧取穴才能准确。艾灸不如针刺有效。每日灸三十壮，最多二百壮。此穴是痔疮的根本原因，属于寒证。忌冷食和房事劳累。《甲乙经》说：针刺二寸。留针七呼。王明堂下文说：五壮。
有一位内科医生说：凡是灸治椎骨，应当灸在骨节突起处方有效。灸在节段下方骨头处没有疗效。拿鱼肉和骨头做比喻，他的话是可以相信的。何不依据他的话，当在骨节处施灸。
Thirteen Acupoints on the Midline of the Back-Shu Region
Dazhui (GV14, Great Vertebra) is one acupoint. (Another reading is "on the first vertebra"). It is located in the depression above the first vertebra, feeling rounded and full. Needle depth: 5 fen. Retain needle for three breaths (hu). For reducing method, inhale five times. Moxibustion dosage is based on age in years (i.e., number of moxa cones equal to age). (Wang Mingtang states: Moxa seven cones daily up to 7x7=49 cones.) *Jia Yi Jing* (Systematic Classic of Acupuncture and Moxibustion) states: From Dazhui to the coccyx, there are twenty-one vertebral segments. The total length is three chi. Use proportional measurement to locate Shu points.
Since it is called Dazhui, yet described as being in the depression above the first vertebra, they must be two different acupoints. If not two points, it would not say "above the first vertebra." This distinguishes Dazhui from others. However, *Tong Ren Shu Xue Zhen Jiu Tu Jing* (Bronze Man Manual of Acupuncture and Moxibustion) states: Dazhui is in the depression above the first vertebra; all meridians agree. Only *Ming Tang Xia Jing* (Ming Hall Lower Classic) states it is below the first vertebra. Since Taodao is below the first vertebra, Dazhui should not also be below the first vertebra. It must be that *Xia Jing* erroneously wrote "below" instead of "above." Examining *Xia Jing*, it also states Taodao is below the segment of Dazhui, which agrees with *Tong Ren*. This confirms the error of writing "below" for "above" without doubt.
Taodao (GV13, Pathway of Breath) is located in the interspace below the segment of Dazhui. Locate while bending forward. Moxa 5 cones. Needle 5 fen.
Shenzhu (GV12, Pillar of Spirit) is located in the interspace below the segment of the third vertebra. Needle 5 fen. Moxa 7x7=49 cones. Wang Mingtang states: 5 cones. The text below states: 3 cones.
Shendao (GV11, Pathway of Spirit) is located in the interspace below the segment of the fifth vertebra. Locate while bending forward. Moxa 7x7=49 cones, up to 100 cones. For pediatric wind-phlegm epilepsy and convulsions, moxa 7 cones. Wang Mingtang states: Needle 5 fen, moxa 3 cones. The text below states: 5 cones.
Lingtai (GV10, Spirit Platform) is located in the interspace below the segment of the sixth vertebra. Locate while bending forward. The classic lacks treatment indications. Originates from *Su Wen* (Basic Questions).
Zhiyang (GV9, Supreme Yang) is located in the interspace below the segment of the seventh vertebra. Locate while bending forward. Needle 5 fen. Moxa 3 cones. Wang Mingtang's text below states: 7 cones.
Jinsuo (GV8, Tendon Contraction) is located in the interspace below the segment of the ninth vertebra. Locate while bending forward. Needle 5 fen. Moxa 3 cones. Wang Mingtang's text below states: 7 cones.
Jizhong (GV7, Spine Center), also known as Shenzong, is located in the interspace below the segment of the eleventh vertebra. Locate while bending forward. Moxibustion is contraindicated; moxibustion may cause kyphosis (hunchback) of the waist and back. Needle 5 fen. Obtain Deqi (arrival of qi). (*Ming Tang* writes Jishu. Also known as Jizhong. Located in the center of the eleventh vertebra. Jieji (GV6, Connecting Vertebra) is in the interspace below the twelfth vertebra. (*Xia Jing* treats pediatric malnutrition with rectal prolapse.)
Xianshu (GV5, Hanging Pivot) is located in the interspace below the segment of the thirteenth vertebra. Locate while lying prone. Needle 3 fen. Moxa 3 cones. Wang Mingtang states: In the interspace below the twelfth vertebra. The text below states: Below the eleventh vertebra.
*Tong Ren* states: Xianshu is in the interspace below the thirteenth vertebra. *Ming Tang Shang Jing* (Ming Hall Upper Classic) places it in the interspace below the twelfth vertebra. *Xia Jing* places it below the eleventh vertebra. Since Jizhong is below the eleventh vertebra, Xianshu should not also be below the eleventh vertebra. It is certain this is an error. Examining *Su Wen*, it agrees with *Tong Ren*. *Tong Ren* should be considered correct. *Ming Tang Shang Jing* also erroneously wrote three characters as two. In summary, Jieji is simply below the segment of the twelfth vertebra.
Mingmen (GV4, Gate of Life), also known as Shulei, is located in the interspace below the segment of the fourteenth vertebra. Locate while lying prone. (Wang Mingtang writes: Locate while bending forward.) Needle 5 fen. Moxa 3 cones.
Yangguan (GV3, Yang Pass) is located in the interspace below the sixteenth vertebra. Locate while lying prone. Needle 5 fen. Moxa 3 cones. Treatment indications are missing. Originates from *Su Wen*.
Yaoshu (GV2, Waist Shu), also known as Beijie, Sukong, Yaozhu, and Yaohu, is located in the depression below the segment of the twenty-first vertebra. Extend the abdomen, lie supine, and stretch the body. Cross hands to support the forehead. Relax limbs backward, then locate the point. Needle 8 fen. Retain needle for three breaths. For reducing method, inhale five times. Moxa 7 cones up to 7x7=49 cones. Avoid sexual fatigue, lifting heavy weights, and strenuous exertion.
*Jia Yi Jing* states: Needle 2 cun. Retain needle for seven breaths. Moxa 7x7=49 cones. Wang Mingtang states: 3 cones. The text below states: 5 cones. *Su Wen* annotation states: Needle 1 fen. New Correction states: According to *Jia Yi Jing*, it is 2 cun. Annotation for Shuire point also allows 2 cun. Annotations for *Qifu Lun* and *Gukong Lun* state 1 fen. Also known as Sukong.
Changqiang (GV1, Long Strength), also known as Qi Zhi Yin, is the divergent collateral of the Du Meridian. Locate the point while the patient is prone (feet touching the ground). *Jia Yi Jing* states: At the end of the spine. Needle 3 fen. Rotate the needle until severe pain is felt. The point must be located while prone to be accurate. Moxibustion is inferior to needling. Moxa 30 cones daily, up to 200 cones. This point is the root of hemorrhoids, caused by cold. Avoid cold food and sexual fatigue. *Jia Yi Jing* states: Needle 2 cun. Retain needle for seven breaths. Wang Mingtang's text below states: 5 cones.
From Dazhui to Yaoshu, the length is equivalent to 3 chi of Cun-bian (body-inch measurement). Use proportional measurement to locate points. (Jia)
An internal medicine physician stated: Whenever moxibusting vertebral bones, one should moxa at the bony prominence of the joint for efficacy. Moxa below the joint on the bone shaft has no effect. Comparing meat/fish with bone, his words are credible. Why not follow his advice and moxa at the bony joints?