Glossary

The Back-Shu Points are located 1.5 and 3 cun from the level of transverse processes of the spine and are each associated with an organ that is usually at approximately the same level. 俞 Shu means to transport and so they are seen as an access route to affect the Zangfu directly and can be used to treat any disorder, whether Excess or Deficient, Hot or Cold.

They are:

Theory

Ling Shu ch. 51 lists the Back-Shu points associated with the five Zang and the Su Wen ch. 59 lists the Back-Shu points of the five Fu. Huangfu Mi then added the Diaphragm, San Jiao, Spine Centre, White Ring and Outer Shu points in his Systematic Classic of Acupuncture (282 C.E.) and Sun Simiao first mentions the Jueyin Shu (Pericardium) in 1000 Ducat Formulas (652 C.E.). Other Shu have been added by later authors to make the present list.

Nan Jing ch. 67 says: "Yin diseases move to the Yang [area]; Yang diseases move to the Yin [area]. The Front-Mu points are situated on the Yin surface [and therefore treat Yang diseases]; the Back-Shu points are situated on the Yang surface [and therefore treat Yin diseases]." This has given rise to a practice that the Front-Mu points should be used to clear Excesses in acute (Yang) diseases, while the Back-Shu should be used in chronic (Yin) diseases. One explanation for this that Yang passes through the Du Mai in the spine and branches out to supply each Organ with Qi, while issuing the governing (督 Du) commands for correct functioning at these points. Chronic malfunctioning of the Zangfu eventually leads to Qi disorder, rebellion and eventual deficiency which can all be treated at these points by re-establishing their connection with the Governing Yang principle.

The "Outer Shu" are generally used for clearing Heat from their associated Zangfu. The name of the Outer Shu all contain the aspect of the Shen associated with that Zang which may suggest that they had a more spiritual or psychological purpose in the past, although few maintain this function. Only Pohu Bl-42 contains an indication for Three Corpse Possession Disorder and Five Corpse Disorder which has any relevance to spiritual disorders.

Modern medical acupuncture styles have interpreted these points as relating to the segments of spinal innervation where nerves leave the spine to supply associated organs. There is overlap between the segmental innervation of organs and the Zangfu which that Shu point is said to connect to.

Practical Uses

The Nei Jing is inconsistent about how to treat these points. Ling Shu ch. 51 says that these points should only be palpated diagnostically or given moxa but never needled, while chs. 20 & 22 describe needling these points, as does Su Wen ch. 55. Huangfu Mi (282 C.E.) also presented contradictory advice citing the same prohibition to needling from the Ling Shu, followed by descriptions of each of the points and saying they can be needled to a depth of 3 (inner) or 5 (outer) fen.

Today this has led to differing interpretations. Some understand Ling Shu ch. 51 as a caution against needling them deeply, but are safe when using the right technique. This is valid as there is a risk of pneumothorax from deep needling at these points and matches Huangfu Mi's advice to go no deeper than 3-5 fen. Others impose limitations on retention time, while others avoid needling these points entirely. Some, like Tung acupuncture, often bleed these points, especially the upper and lower Shu points, which could be a safer practice than retained needles since bleeding lancets do not penetrate deeply and are not retained at all so will not move while in. Finally, these are common areas for cupping.

A simple way of using them is to palpate the points to find out which organs are imbalanced, then palpate the corresponding channel. Wherever a corresponding sensation is felt along the channel, it can be treated and the Shu point re-palpated to determine its effectiveness and confirm the point selection.

Alchemical Perspectives

In conventional medical thinking the Kidneys are the source of Yin and Yang and provide their Essence and Original Qi to ascend the Ren and Du Mai to nourish the body through the chest and back Shu. This model only applies when dealing with standard Post-natal physiology. When working alchemically, these come from their cosmic sources:

The Original Essence (原精 Yuan Jing) of Heaven (乾 Qian, ☰) forms the 陽神 Yang Shen of the Sun (Taiyang), which descends through the head and spine and flow into the organs through the back Shu, enabling us to perceive the Governing (督 Du) of the Will of Heaven.

The Original Breath (原氣 Yuan Qi) of Earth (坤 Kun, ☷) forms the 陰神 Yin Shen of the Moon (Taiyin) which is drawn up through the soles where it ascends the Chong Mai to enter the organs through the chest Shu, giving the receptivity and a sense of responsibility (任 Ren) to follow the Will of Heaven.

The successful mingling of this descending Yang and ascending Yin makes the Hexagram ䷊ (泰 Tai, "Peace"). Furthermore, the mingling of ☰ and ☷ causes them to exchange their inner lines and form Fire ☲ and Water ☵ which govern the east and west, the directions associated with Wood and Metal and the 魂 Hun and 魄 Po souls.

Connecting with these primal forces brings us in line with our destiny (性命 Xingming). Therefore the flow of energy in the Du Mai and back Shu can be seen as flowing upwards, drawing from the Ming Men to nourish the post-natal body leading to eventual exhaustion and death, or reversed to flow downwards from Heaven to meet with the rising Yin of Earth to add Fire ☲ to the Gate of Life (命門 Ming Men) and facilitating the process of becoming Immortal (仙 Xian).