《灵枢·背 篇》帝日∶愿闻五脏之 出于背者。岐伯曰∶背中大 ，在杼骨之端；肺 ，在三焦之间；
心，在五焦之间；膈 ，在七焦之间；肝 ，在九焦之间；脾 ，在十一焦之间；肾 ，在十四焦之间，皆
挟脊相去三寸所。欲得而验之，按其处，应在中而痛解，乃其 也。灸之则可，刺之则不可。气盛则泻之，虚
则补之。以火补者，须自灭也；以火泻者，疾吹其火，传其艾，须其火灭也。
马注∶五脏之 皆在背。大 ，在杼骨端，大 者，大杼穴也，去中行督脉经大椎穴左右各开一寸半。其
肺以中行三椎为主，心 以五椎为主，膈 以七椎为主，肝 以九椎为主，脾 以十一椎为主，肾 以十四
椎为主，左右各开中行一寸半，挟中行脊骨而计之，则相去三寸所。故欲验诸穴者，乃按其处，其中必应之，
而内痛乃解，是五脏之各 穴也。楠按∶火即天地之阳气，待其自灭，则气入内为补；速吹之，则火引内气外
泄，故为泻也。
营卫经络者，合言之，即皮肉筋骨浅深之部位也。分言之，卫为阳，浅在表；营为阴，深在里。直者为经
如川，横者为络如渠。经深在营分，络浅在卫分。卫主气，卫护于表；营主血，营运于里。气主煦之，血主濡
之。然气血由阴阳生化，阴阳互根于太极，故气血必交互营运，不能分析。血中无气，则瘀结不行；气中无
血，则散漫不聚。血中之气，经气也；气中之血，络血也。故气血营运，而经络通贯，则营卫因之调和。而呈
露气血之形象可见者，则名脉，因其浅深而分营卫经络，故名经脉、络脉。然卫行经脉之外，故主气；营行
经脉之中，故主血。络脉在卫分，故络血为气中之血也；经脉在营分，故经气为血中之气也。所以必分营卫
经络，而各有所主者，要清其气血流行次序，以察受病浅深部位也。若其阴阳各经交接之处，皆由络脉贯通，
而气血始得周流一身。所以分手足三阴三阳十二经者，营血由经流行，无分昼夜，循环于一身表里，故为营行
脉中也；卫气漫溢于络脉肌腠间者，故为卫行脉外也。然其昼行于阳，分二十五度周于身；夜行于阴，分二
十五度周于身。平旦从阴出阳，随日而升；黄昏从阳入阴，随日而没；至夜半亥子之交，营卫之气血会合，如
日月合璧。是故卫同日为阳而主气，营同月为阴而主血。以各有所主，而流行不同，故分营卫；以脉路之横直
浅深不同，故分经络。如是周行一身表里，合而不可混，分而不可离，然后方可审知其病之所在而治之也。夫
气血由阴阳化生，阴阳互根于太极，为人身之命蒂，而通天地之气，故其升降流行，必应天地气候，丝毫不爽
者也。呜呼！非圣人垂慈，指示详悉，后世孰能明之，以救病苦哉。盖六气之邪伤人，各由门径而入，风寒湿
三气，由皮腠侵络，由络流经，由经入腑脏也；暑火燥三气，由口鼻吸入躯内膜外，随气血外走营卫，内侵腑
脏，是先从中道，分传表里，故诸病现证，各有不同也。又有内邪六气之病，是本脏自伤，非由外感者。如
肝伤则风邪内生，而眩晕、惊厥等病现矣；心劳则火邪内生，而烦恼、消渴等病现矣；脾伤则湿邪内生，而肿
胀、疲弱等病现矣；肾伤则寒邪内生，而阳痿、四逆等病现矣；肺伤则燥邪内生，而失音、干咳等病现矣。火
湿相合，即同暑邪，暑由火湿二气合化故也。为因人生天地之中，禀天地之全气，故外邪内邪，病状相同，而
内邪先伤本元为虚，外邪由浅入深为实，故经曰∶精气夺为虚，邪气盛为实，所以治法则迥异。此乃医经之
要旨，必先熟究洞明于心，庶免误治之失也。
《灵枢·背腧》篇中，黄帝问道：我想知道五脏的背俞穴是从背部哪里发出的。岐伯回答说：背部中间的大腧穴，位于脊柱骨的上端；肺俞穴，在第三胸椎之间；心俞穴，在第五胸椎之间；膈俞穴，在第七胸椎之间；肝俞穴，在第九胸椎之间；脾俞穴，在第十一胸椎之间；肾俞穴，在第十四胸椎之间，这些穴位都夹着脊柱，距离中线大约三寸。想要验证这些穴位的位置，可以按压该处，如果内部疼痛得以缓解，那就是正确的穴位。艾灸这些穴位是可以的，针刺则不可取。如果是实证（气盛），应当用泻法；如果是虚证，应当用补法。用火疗进行补法时，必须让艾火自然熄灭；用火疗进行泻法时，要快速吹旺艾火，移动艾条，直到艾火熄灭为止。
马莳注释道：五脏的背俞穴都在背部。大杼穴，位于脊柱骨的上端，所谓大杼穴，是指大杼穴，距离正中督脉经的大椎穴左右各开一寸半。肺俞以正中第三椎为主，心俞以第五椎为主，膈俞以第七椎为主，肝俞以第九椎为主，脾俞以第十一椎为主，肾俞以第十四椎为主，左右各距离正中线一寸半，夹着正中的脊骨计算，则相距约三寸。所以想要验证各个穴位，就按压该处，其中必然有反应，而体内的病痛就会解除，这就是五脏各自的背俞穴。楠按语：火就是天地的阳气，等待它自然熄灭，则气进入体内为补法；快速吹它，则火引导体内的气向外泄，所以称为泻法。
营卫经络，合起来说，就是指皮、肉、筋、骨的浅深部位。分开来说，卫气属阳，浅表在体表；营气属阴，深层在体内。直的经脉像河流，横的络脉像沟渠。经脉深在营分，络脉浅在卫分。卫气主司气的功能，护卫于体表；营气主司血的功能，运化于体内。气主要起温煦作用，血主要起濡润作用。然而气血由阴阳生化而来，阴阳互根于太极，所以气血必须交互运行，不能分离。血中没有气，就会瘀结而不行；气中没有血，就会散漫而不聚。血中的气，是经气；气中的血，是络血。所以气血运行，经络贯通，营卫因此调和。而显露出气血形象可见的，称为脉，根据其浅深分为营卫经络，所以称为经脉、络脉。然而卫气运行在经脉之外，所以主气；营气运行在经脉之中，所以主血。络脉在卫分，所以络血是气中之血；经脉在营分，所以经气是血中之气。之所以必须区分营卫经络，且各有主管，是为了理清气血流行的次序，以观察受病的浅深部位。如果在阴阳各经交接的地方，都由络脉贯通，气血才能周流全身。所以区分手足三阴三阳十二经脉，是因为营血由经脉流行，不分昼夜，循环于身体表里，所以叫“营行脉中”；卫气漫溢在络脉肌腠之间，所以叫“卫行脉外”。然而卫气白天运行于阳分，分二十五度周游全身；夜晚运行于阴分，也分二十五度周游全身。清晨从阴分出阳，随太阳升起；黄昏从阳分入阴，随太阳落下；到了半夜亥子之交，营卫的气血会合，如同日月合璧。因此卫气同日为阳而主气，营气同月为阴而主血。因为各自有所主管，且流行不同，所以分为营卫；因为脉路的横直浅深不同，所以分为经络。这样周行于身体表里，合起来不可混淆，分开来不可分离，然后才可以审察知道病所在的位置并治疗它。夫气血由阴阳化生，阴阳互根于太极，这是人体的生命根本，并与天地之气相通，所以其升降流行，必然顺应天地气候，丝毫不差。唉！如果不是圣人垂示慈爱，指示详尽，后世谁能明白它，以救治病人的痛苦呢？大概六气之邪伤人，各有门径而入，风寒湿三气，由皮腠侵入络脉，由络脉传入经脉，由经脉进入腑脏；暑火燥三气，由口鼻吸入躯内膜外，随气血外走营卫，内侵腑脏，是先从中道，分传表里，所以各种病症表现，各有不同。又有内邪六气引起的疾病，是本脏自我损伤，不是由外感引起的。如肝受伤则风邪内生，而出现眩晕、惊厥等疾病；心劳损则火邪内生，而出现烦躁、消渴等疾病；脾受伤则湿邪内生，而出现肿胀、疲弱等疾病；肾受伤则寒邪内生，而出现阳痿、四肢逆冷等疾病；肺受伤则燥邪内生，而出现失音、干咳等疾病。火与湿相合，就等同于暑邪，暑是由火和湿二气化合而成的。因为人生在天地之中，禀受天地的全气，所以外邪和内邪，病症表现相同，但内邪先伤本元导致虚证，外邪由浅入深导致实证，所以经文说：精气耗夺为虚，邪气亢盛为实，因此治法截然不同。这是医经的要旨，必须先熟究洞明于心，才避免误治的错误。
In the "Back Shu" chapter of *Ling Shu* (Spiritual Pivot), the Yellow Emperor asked: I wish to hear about where the Back-Shu points of the five Zang organs originate on the back. Qibo replied: The major Back-Shu point in the center of the back is located at the upper end of the vertebral bones; the Lung Back-Shu point is between the third thoracic vertebrae; the Heart Back-Shu point is between the fifth thoracic vertebrae; the Diaphragm Back-Shu point is between the seventh thoracic vertebrae; the Liver Back-Shu point is between the ninth thoracic vertebrae; the Spleen Back-Shu point is between the eleventh thoracic vertebrae; and the Kidney Back-Shu point is between the fourteenth thoracic vertebrae. All these points are flanking the spine, approximately three Cun away from the midline. To verify their locations, one should press the area; if internal pain is relieved upon pressing, then it is the correct Back-Shu point. Moxibustion is permissible for these points, but acupuncture is not recommended. If the condition is excess (Qi Sheng), one should apply the reducing method; if it is deficiency, one should apply the tonifying method. For tonification using fire therapy, the moxa must be allowed to extinguish naturally; for reduction using fire therapy, one should quickly blow up the fire, move the moxa stick, until the fire extinguishes.
Ma Shi commented: The Back-Shu points of the five Zang organs are all on the back. Da Zhu (Great Bamboo) is at the upper end of the vertebral bone. Da Zhu refers to the Da Zhu acupoint, which is 1.5 Cun lateral to the Da Zhui acupoint on the Governor Vessel (Du Mai) at the midline. The Lung Back-Shu centers on the third thoracic vertebra, the Heart Back-Shu on the fifth, the Diaphragm Back-Shu on the seventh, the Liver Back-Shu on the ninth, the Spleen Back-Shu on the eleventh, and the Kidney Back-Shu on the fourteenth. Laterally, each is 1.5 Cun from the midline. Measured from the central spinal column, they are approximately three Cun apart. Thus, to verify these acupoints, one presses the location; there will be a response, and internal pain will resolve. These are the respective Back-Shu points of the five Zang organs. Nan added: Fire represents the Yang Qi of Heaven and Earth. Waiting for it to extinguish naturally allows Qi to enter the interior, constituting tonification. Quickly blowing it causes the fire to draw internal Qi outward, constituting reduction.
Ying (Nutrient) and Wei (Defensive) Jingluo (Meridians and Collaterals), when discussed collectively, refer to the superficial and deep levels of skin, flesh, sinews, and bones. When discussed separately, Wei Qi is Yang, residing superficially on the exterior; Ying Qi is Yin, residing deeply within the interior. Straight pathways are Jing Luo (Meridians), like rivers; horizontal pathways are Luo Luo (Collaterals), like canals. Jing Luo are deep within the Ying level, while Luo Luo are superficial within the Wei level. Wei Qi governs Qi functions, protecting the exterior; Ying Qi governs Blood functions, circulating within the interior. Qi primarily provides warmth, and Blood primarily provides nourishment. However, Qi and Blood are generated by Yin and Yang, which are mutually rooted in the Taiji (Supreme Ultimate). Therefore, Qi and Blood must interact and circulate together and cannot be separated. Without Qi in Blood, stasis occurs and circulation stops; without Blood in Qi, dispersion occurs and gathering fails. The Qi within Blood is Jing Qi (Meridian Qi); the Blood within Qi is Luo Xue (Collateral Blood). Thus, when Qi and Blood circulate and Jing Luo are connected, Ying and Wei become harmonious. What manifests visibly as the image of Qi and Blood is named Mai (Vessels/Pulse). Based on their depth, they are divided into Ying/Wei and Jing/Luo, hence termed Jing Mai (Meridians) and Luo Mai (Collaterals). Since Wei Qi circulates outside the Jing Mai, it governs Qi; since Ying Qi circulates inside the Jing Mai, it governs Blood. Luo Mai are in the Wei level, so Luo Xue is Blood within Qi; Jing Mai are in the Ying level, so Jing Qi is Qi within Blood. The necessity of distinguishing Ying, Wei, Jing, and Luo, each with its specific governance, is to clarify the sequence of Qi and Blood circulation to observe the depth of disease involvement. At the junctions of the Yin and Yang meridians, Luo Luo connect them, allowing Qi and Blood to flow throughout the body. This is why the Twelve Meridians of Hand and Foot Three Yin and Three Yang are distinguished: Ying Blood flows through the Jing Mai, day and night, circulating through the interior and exterior of the body, hence "Ying circulates within the vessels"; Wei Qi overflows into the Luo Luo and muscle-cavity spaces, hence "Wei circulates outside the vessels." However, Wei Qi travels in the Yang during the day, completing twenty-five circuits around the body; it travels in the Yin at night, also completing twenty-five circuits. At dawn, it emerges from Yin to Yang, rising with the sun; at dusk, it enters Yin from Yang, setting with the sun. At midnight, during the transition of Hai and Zi hours, the Qi and Blood of Ying and Wei converge, like the conjunction of the sun and moon. Therefore, Wei Qi corresponds to the Sun, is Yang, and governs Qi; Ying Qi corresponds to the Moon, is Yin, and governs Blood. Because they have different governors and circulation patterns, they are divided into Ying and Wei; because the vessel paths differ in direction, straightness, and depth, they are divided into Jing and Luo. By circulating throughout the body's interior and exterior, they are inseparable yet distinct, allowing one to ascertain the location of disease and treat it accordingly. Qi and Blood are generated by Yin and Yang, which are mutually rooted in the Taiji. They are the life root of the human body and communicate with the Qi of Heaven and Earth. Thus, their ascending and descending circulation must correspond to the climate of Heaven and Earth without error. Alas! If not for the sages' benevolence in providing detailed guidance, how could later generations understand this to alleviate the suffering of the sick? Generally, pathogens of the Six Qi injure humans through specific entry points. Wind, Cold, and Dampness invade via the skin and pores into the Luo Luo, then into the Jing Luo, and finally into the Fu and Zang organs. Summer-Heat, Fire, and Dryness are inhaled through the mouth and nose into the interior membranes and exterior, moving outward with Qi and Blood to Ying and Wei, and inward to invade Fu and Zang organs. They first affect the middle pathway and distribute to the interior and exterior, resulting in various clinical manifestations. There are also diseases caused by internal pathogens of the Six Qi, which result from self-injury of the Zang organs rather than external invasion. For example, injury to the Liver generates internal Wind, leading to dizziness and convulsions; exhaustion of the Heart generates internal Fire, leading to irritability and Xiao Ke (Wasting-Thirst); injury to the Spleen generates internal Dampness, leading to edema and weakness; injury to the Kidney generates internal Cold, leading to impotence and cold extremities (Si Ni); injury to the Lungs generates internal Dryness, leading to aphonia and dry cough. Fire combined with Dampness equals Summer-Heat, as Summer-Heat is formed by the combination of Fire and Dampness. Humans live within Heaven and Earth and inherit the complete Qi of Heaven and Earth. Therefore, although external and internal pathogens present similar symptoms, internal pathogens first damage the Yuan Qi (Original Qi), causing Deficiency (Xu), while external pathogens enter from shallow to deep, causing Excess (Shi). Hence, the classic states: "Depletion of Essence and Qi is Deficiency; Exuberance of Pathogenic Qi is Excess." Consequently, treatment principles are vastly different. This is the core principle of medical classics, which must be thoroughly understood to avoid therapeutic errors.