三处乎。故下文云。其府在气街。所谓气街者。三焦之所行。诸十二经之俞原是也。灵枢卫气篇曰。知六腑之气街者。
能知解结契绍于门户。又曰。胸气有街。腹气有街。头气有街。胫气有街。又动输篇曰。四末阴阳之会者。此气之大络
也。四街者。气之径路也。滑注以足阳明经有气街穴。故疑为衍文。坐不深察故尔。其府在气街一句。非误非衍。所谓
府者。指气腑言。即气穴是也。素问有气府一篇。可以征已。明吴文炳辨真云。气街足阳明之气冲。是亦一义也。
（第四十旧三十七）难曰。五脏之气。于何发起。通于何许。可晓以不。然。五脏者。当（灵枢作常）上关（灵枢
作阅）于九（灵枢作七为是）窍也。故肺气通于鼻。鼻和（即肺气和）则知香臭（腥焦臊腐）矣。肝气通于目。目和（肝
和）则知黑白（赤黄青）矣。脾气通于口。口和（脾和）则知谷味（稻麦豆黍稷）矣。心气通于舌。舌和（心和）则知
五味（辛酸甘苦咸）矣。肾气通于耳。耳和（肾和）则知五音（宫商角征羽）矣。五脏不和。则九窍（各有所主之窍如
上所言）不通。六腑不和。则留结为痈。（统言形体所发诸肿）邪在六腑。则阳（经）脉不和。阳脉不和。则气（邪气）
留之。气留之。则阳脉（动）盛（实）矣。邪在五脏。则阴（经）脉不和。阴脉不和。则血（瘀血）留之。血留之。则
阴脉（动）盛（实）矣。阴（邪）气太盛。则阳（正）气不得相营也。故曰格。（灵枢作关）阳（邪）气太盛。则阴（正）
气不得相营也。故曰关。（灵枢作格）阴（邪）阳（邪）俱盛。不得相营也。故曰关（孤阴）格。（独阳）关格者。不得
尽其命而死矣。经言（脉度篇末说）气独行于五脏。不营于六腑者。何也。然。夫气之所行也。如水之流。不得息也。
故阴（经）脉营于五脏。阳（经）脉营于六腑。如环无端。莫知其纪。终而复始。其不复溢。人（疑血字误）气内温于
脏腑。外濡于腠理。
按此与脉度篇文。大同小异。五脏者。内藏神气。而外阅九窍。故多无形之病。六腑者。传谷物而外养肌肉。故多
有形之病。谓在脏九窍不通。在腑留结为痈。可见形之与神。病各有则焉。凡脏皆属阴。而其精上达为常。腑俱属阳。
而其气下行为常。若有所不和。则气血之分。偏虚偏实。至其太盛。则遂为关格之变。格是腑。将失常而反上逆。使所
受水谷。格拒噎塞。关是脏既废职。精气下坠。故二便闭而不通。盖下文复溢二字。即为死脉之名。则其所谓关格者。
孤阴独阳之病。殊无回旋之生意者必矣。读者莫以与灵枢文相颠倒为疑焉。
（第四十一旧四十）难曰。经言肝主（五）色。心主（五）臭。脾主（五）味。肺主（五）声。肾主（五）液。鼻
者肺之候。（肺气通臭）而反知香臭。（心所主）耳者肾之候。（肾气通耳）而反闻声。（肺所主）其意何也。然。肺者。
西方金也。金生（育）于巳（位）巳者南方火。火者心。心主臭。故令鼻知香臭。肾者。北方水也。水生（育）于申（位）
申者西方金。金者肺。肺主声。故令耳闻声。
按此承上引脉度篇文。而举脏气各有所通之窍。以发问难。所谓肝开窍于目。而其所主五色。亦通乎此。脾开窍于
口。而其所主五味。亦从此而入。唯肾与心肺。其所主不应于其窍。所以发疑焉。大氐五行之道。有生克之分。又有胎
化之理。此篇所述。即胎化之变也。何则。鼻知臭者相克。耳闻声者相生。故知非五行常例之谓。盖金胎于东方木。而
化于南方火。其气旺于西。自卯至酉。金得有气。水胎于南方阳中。而化于西方金。其气旺于北。自午至子。水得有气。
火。木之胎化亦然。越人之意。所以使学人知人身五行生克之外。别有胎化之理者。如此。六元正纪大论曰。春气西行。
夏气北行。秋气东行。冬气南行。淮南子天门训曰。金生丁巳。壮于酉。死于丑。三辰皆金也。水生丁申。壮于子。死
于辰。三辰皆水也。是亦与此篇之义相类。
（第四十二旧同）难曰。人肠胃长短。受水谷多少。各几何。然。胃大（围）一尺五寸。径五寸。（围三径一之法下
同）长二尺六寸。（古有纵横斜等黍尺不知是用何尺）横（横读如广）屈受水谷三斗五升。（此亦古量法未可知）其中常
留谷二斗。水一斗五升。小肠大二寸半。径八分分之小半。长三丈二尺。受谷二斗四升。水六升三合合之大半。回肠大
四寸。径一寸寸之少半。（旧本脱寸之少三字故补）长二丈一尺。受谷一斗。水七升半。广肠大八寸。径二寸寸之大半。
（脱寸之大三字故补）
长二尺八寸。受谷九升三合八分合之一。故肠胃凡长五丈八尺四寸。合受水谷八（灵枢作九）斗七（灵枢作二）升六（灵
枢作一）合八分合之一。（灵枢作合之大半○按每腑所受水谷多寡与灵枢同而本篇谓通计八斗七升六合八分合之一则见四
升五合之不足予私疑小肠二斗四升当是一斗九升强何则胃者腐熟水谷化生精液大小肠及广肠皆受其糟粕而次第减损转输
运逆则岂有增之理乎盖扁鹊见灵枢所书小肠谷量比诸胃量多四升强则直改以为会计者必矣然其所改遂乃漫灭后人再因灵
枢文而补之者乎姑且书此以俟识者）此肠胃长短。受水谷之数也。肝重二斤（十六两为斤）四两。（三钱弱为两下仿此）
左三叶。右四叶。凡七叶。主藏魂。心重十二两。中有七孔（窍同）三毛。盛精汁三合。主藏神。脾重二斤三两。扁广
三寸。长五寸。有散膏半斤。主裹血。温五脏。主藏意。肺重三斤三两。六叶两耳。凡八叶。主藏魄。肾有两枚重一斤
一两。主藏志。胆在肝之短叶间。重三两三铢。（两分二十四之一为铢下同）盛精汁三合。胃重二斤一两。纡曲屈伸。长
二尺六寸。大一尺五寸。径五寸。盛谷二斗。水一斗五升。小肠重二斤十四两。长三丈二尺。广二寸半。径八分分之小
半。左回叠积十六曲。盛谷二斗四升。水六升三合合之大半。大肠重二斤十二两。长二丈一尺。广四寸。径一寸寸之小
半。（旧本脱寸之小今补）当脐右。（灵枢作左还为是）回十六曲。盛谷一斗。水七升半。膀胱重九两二铢。纵广（横同）
九寸。盛溺九升九合。口广二寸半。唇至齿。长九分。齿以后至会厌。深三寸半。大容五合。舌重十两。长七寸。广二
寸半。咽门重十二两。广二寸半。至胃长一尺六寸。喉咙重十二两。广二寸。长一尺二寸九节。肛门重十二两。大八寸。
径二寸寸之（旧本脱寸之二字今补）大半。长二尺八寸。受谷九升三合八分合之一。
按此与灵枢绝谷篇文同。而其所主专在胃中所受水谷三斗五升者。盖人平日承此食量。则足以荣养脏腑。苟有过不
及。则不徒害冲和之气。抑亦足以致病。至其大小肠及广肠。皆受其滓秽。以为泌别传导之用耳。此为后篇言绝谷七日
而死之起本。肝重云云以下一百九字。灵素无所见。此篇创出之。疑非扁鹊之言。何以言之。前既曰肝有两叶。此又曰
凡七叶。灵枢谓大小肠左环。此谓大肠右回。且一篇中肠胃度量。前后重复。其口广以下九十九字。剿取肠胃篇文。以
列膀胱之次。与灵枢所述之意。大失其旨。彼此所以发疑也。然历代名医。谓脏象皆以为据。则其所由来亦远。故姑书
以俟知者。
（第四十三旧同）难曰。人不食饮。七日而死者。何也。然。人胃中常有留谷二斗。水一斗五升。故平人日再至圊。
一行二升半。日中（终日）五升。七日五七三斗五升。而水（去则荣散）谷（消则卫亡）尽矣。故平人不食饮七日而死
者。水谷津液俱尽。即死矣。
按绝谷七日而死者。以其日再至圊。一行尽二升半。故为之限。虽然人心如面。肠胃传化亦异。盖人之更衣。一日
或一行二三行。二日或一行二三行。不可定度。故结之曰。水谷津液俱尽。即死矣。则此难主意。专在此一句耳。其所
谓七日。亦以一日二行之量言之。何必拘拘日数乎。读者思诸。与灵枢绝谷篇。辞有少异。而义全无差。
（第四十四旧同）难曰。七冲门（冲者冲突之冲往而不斥之意）何在。然。唇为飞门。（飞扬闭合之处经云口唇者音
声之扇也）齿为户门。（破坚碎硬之要专在此）会厌为吸门。（吞物出气之街）胃（上口）为贲门。（荣卫生发之关）太仓
（即胃腑）下口为幽门。（溲便受盛之境）大肠小肠会为阑门。（清浊分利之界）下极（即尻臀）为魄门。（糟粕转出之域）
故曰七冲门也。
按贲幽阑魄四门。散见内经诸篇。无有统系焉。其飞户吸三门。岂古文脱落。而存在此篇欤。所谓七衡者。水谷出
纳之门。而飞门至贲门。则主纳焉。幽门至魄门。则主出焉。上道四门失守。则噎隔翻胃呕吐吞酸诸病。随分而生。下
乡三门废职。则泄利秘结遗癃痔脱诸证逐次乃成。且胃者仓廪之腑。谷神之宫也。飞门包含之户门。齿决之吸门。 咽
之贲门。容纳之幽门。谷神既留。而糟粕成矣。受盛之阑门。分利之魄门。推辗之一门。不通则诸门为之生变。神欲安
稳。岂可得乎。又经有畜门。而此无见者。盖畜门者。鼻口之界。颃颡之关。不接水谷之路。故唯曰七冲门云。
（第四十五旧同）难曰。经言八会者。何也。然。腑会大仓。（任脉中脘穴）脏会季胁。（足厥阴章门穴）筋会阳陵
泉。（足少阳膝外穴）髓会绝骨。（陈氏以为枕骨足太阳头部穴）血会鬲俞。（足太阳背部第二行穴心肝二俞中间）骨会大
杼。（督脉大椎穴非背部第二行大杼穴杼古脊骨名故杼椎皆通用）脉会大渊。（手太阴寸口中穴）气会三焦。（即谓上焦古
三焦有专言偏言之分此乃偏言）外一筋（外有经而内无形故云）直两乳内（任脉膻中穴）也。热病在内者。取其（八）
会之气穴也。
按内经载热病五十九刺法。各处热邪。随分取之。此篇由是立八会法以适简约。盖此八会十三穴。诸热在身内者。
各随其部分而治之。虢太子尸 。取外三阳五会者。岂止百会一穴。疑兼取此会之五处者。可知矣。血海髓会骨会三说。
滑注所引四明陈氏之说为是。三焦之三作上字者。谢氏不达古。
（第四十六旧同）难曰。老人（夜）卧而不寐（睡不熟）少壮（夜）寐而不寤（睡熟）者。何也。然经言少壮者。
血气盛（满）肌肉滑（泽）气道通。（呼吸安静）荣卫之行。（周身）不失于常。（五十度）故昼日精（爽）夜不寤也。（眠
足）老人血气衰（少）肌肉不滑（润）荣卫之道涩。（失常度）故昼日不能精。（易眠）夜不得寐也。（难眠）故知老人不
得寐也。（醒眠）
按此虽论辨老壮昼夜寤寐之有异。然其实。则谓荣卫周身之度。老者有亏。而不应其数也。与灵枢生会篇义同。而
此重置问答者。盖壮者血气常盛。而至于老。则其平居血气既衰。况方得其病。则议药迥别。故老者之病。比诸少壮。
虽实犹尚挟虚。假令常寻内外病。有与少壮相似。然其攻补之际。最宜刻意。不可率以其病相似同治焉。扁鹊所以发难。
专在于斯乎。
（第四十七旧同）难曰。人面独能耐（忍）寒者。何也。然。人头者。诸阳（经）之会也。诸阴（经）脉皆至颈胸
中而还。（指正经言）独诸阳脉皆上至头耳。故令面耐寒也。
按与灵枢所载岐伯言。大同小异。彼谓十二经脉三百六十五络。其血气皆上于面者。历举经络本支。而示其血气纯
粹独聚于面耳。此篇乃谓首者诸阳所会。诸阴脉皆至颈胸而还。则独主经脉正行者言之。盖头面者。手足六阳之脉所会。
而其六阴脉之正者。皆终于胸中。其支别仅有贯颈系目上。至巅顶。然其阴之微。包含诸阳中。则虽有而犹无焉。故越
人断以诸阳会发其义。则于治病之事。有裨乎后世矣。盖首面支体骨属筋会。虽如同。然其血气清浊。自有分界。人身
虽为一气血。头面病多是浊阴犯上。支体病多是清阳滞下。是示用药施治之所以异也。
（第四十八旧同）难曰。人有三虚（脉病诊）三实。（同上）何谓也。然。有脉之虚实。有病之虚实。有诊之虚实也。
脉之虚实者。濡（弱）者为虚。（诸脉象中皆见濡弱）紧（实）牢（强）者为实。（诸脉象中皆见紧牢）病之虚实者。出
者（内伤）为虚。入者（外邪）为实。言者（惺惺不妨于言）为虚。不言者（言语错乱混浊）为实。缓者（病以渐进非
一朝一夕之谓）为虚。急者（一时暴发生死在旦暮）为实。诊之虚实者。濡者（肌肉濡弱）为虚。牢者（肌肉牢坚）为
实。痒者（血气散涣）为虚。痛者（邪气盛满）为实。外痛（邪实在表）内快。（血气乏里）为外实内虚。内痛（邪盛在
里）外快（血气空表）为内实外虚。故曰虚实。
按灵枢分年之盛衰。月之虚满。时之和不和。以言三虚三实。然其义广远。而非至近之法。故此篇沿其名。而革其
法。所谓三虚三实者。脉病及诊是也。可谓至近矣。濡与紧牢者。假令虽脉有大小浮沉滑涩之异。大率濡弱而无力者。
Three places (referring to the Qi Streets) are here. Therefore, the following text says that its "Fu" (storehouse/origin) is at the Qi Street. What is meant by the Qi Street is the pathway of the Sanjiao (Triple Burner), and it is also the starting point for the Shu (Transporting) points of the twelve meridians. The *Ling Shu: Wei Qi* chapter states: "One who understands the Qi Streets of the six Fu organs can understand the key gates for untying knots and connecting collaterals." It further states: "There is a Qi Street in the chest, a Qi Street in the abdomen, a Qi Street in the head, and a Qi Street in the lower legs." Additionally, the *Dong Shu* chapter states: "The meeting points of Yin and Yang meridians at the four extremities are the great Luo (Collateral) vessels. The Four Streets are the direct pathways of Qi." Hua Shou's commentary notes that there is a Qichong (ST30) acupoint on the Foot-Yangming Stomach Meridian, so he suspected that the phrase "its Fu is at the Qi Street" was an interpolation (superfluous text), due to a lack of deep investigation. However, this phrase is neither erroneous nor superfluous. The term "Fu" here refers to the Qi Fu (Qi Storehouses), which are the Qi Acupoints. The *Su Wen: Qi Fu Lun* chapter can verify this. Wu Wenbing of the Ming Dynasty, in his *Bian Zhen*, stated that the Qi Street refers to the Qichong (ST30) acupoint of the Foot-Yangming Stomach Meridian; this is also one interpretation. (Difficulty 40, Old Edition Difficulty 37)
Question: From where does the Qi of the five Zang organs originate? Where does it connect? Can this be explained? Answer: The Qi of the five Zang organs should connect upwards to the nine orifices. Thus, Lung Qi connects to the nose; when nasal Qi is harmonious, one can distinguish odors (fishy, scorched, rancid, putrid). Liver Qi connects to the eyes; when eye Qi is harmonious, one can distinguish colors (red, yellow, green, black/white). Spleen Qi connects to the mouth; when oral Qi is harmonious, one can distinguish grain flavors (rice, wheat, beans, millet, broomcorn millet). Heart Qi connects to the tongue; when tongue Qi is harmonious, one can distinguish the five flavors (sour, pungent, sweet, bitter, salty). Kidney Qi connects to the ears; when ear Qi is harmonious, one can distinguish the five tones (Gong, Shang, Jue, Zhi, Yu). If the five Zang organs are not in harmony, the nine orifices will be blocked. If the six Fu organs are not in harmony, pathogenic factors will stagnate and condense, forming carbuncles/swellings (a general term for various swellings on the body). Pathogens in the six Fu organs cause disharmony in the Yang meridians; disharmony in the Yang meridians causes pathogenic Qi to stagnate; stagnation of pathogenic Qi leads to an excessive (Excess pattern) pulse in the Yang meridians. Pathogens in the five Zang organs cause disharmony in the Yin meridians; disharmony in the Yin meridians causes blood stasis to stagnate; stagnation of blood stasis leads to an excessive (Excess pattern) pulse in the Yin meridians. When Yin pathogens are excessively strong, Yang Zheng Qi (Righteous Qi) cannot interact harmoniously with them, hence it is called Ge (Rejection/Obstruction - *Ling Shu* calls it Guan). When Yang pathogens are excessively strong, Yin Zheng Qi cannot interact harmoniously with them, hence it is called Guan (Blocking/Closure - *Ling Shu* calls it Ge). When both Yin and Yang pathogens are excessively strong and cannot interact harmoniously, it is called Guan Ge (Isolated Yin and Solitary Yang). In Guan Ge disease, the patient dies before fulfilling their natural lifespan. The Classic states (end of *Mai Du* chapter): "Qi moves only within the five Zang organs and does not circulate to the six Fu organs." Why is this? Answer: The movement of Qi is like flowing water; it does not stop. Therefore, Yin meridians circulate to the five Zang organs, and Yang meridians circulate to the six Fu organs. Like a circle without beginning or end, unknown in origin, ending and restarting. It does not overflow; Human Qi warms the Zang and Fu internally and moistens the Couli (interstices/skin pores) externally.
Commentary: This passage is largely similar to the *Ling Shu: Mai Du* chapter. The five Zang organs store Shen Qi internally and open to the nine orifices externally, thus they often manifest as formless diseases. The six Fu organs transport grains and nourish muscles externally, thus they often manifest as formed diseases. Saying that in Zang organs the nine orifices block, and in Fu organs stagnation forms carbuncles, shows that Form and Spirit have their respective pathological rules. All Zang organs belong to Yin, and their essence ascending is the norm; all Fu organs belong to Yang, and their Qi descending is the norm. If there is disharmony, Qi and Blood become either deficient or excess. When extremely strong, it becomes the pathology of Guan Ge. Ge refers to the Fu organs losing their normal function and reversing upward, causing food and drink to be rejected and blocked. Guan refers to the Zang organs failing in their duties, causing essence and Qi to sink downward, resulting in constipation and urinary retention. The term "overflow" (Fuyi) mentioned later refers to a death pulse. Thus, Guan Ge is a disease of isolated Yin and solitary Yang, with absolutely no vitality for recovery. Readers should not doubt the text because its order differs from the *Ling Shu*.
(Difficulty 41, Old Edition Difficulty 40)
Question: The Classic states that the Liver governs the five colors, the Heart governs the five odors, the Spleen governs the five flavors, the Lungs govern the five sounds, and the Kidneys govern the five fluids. The nose is the manifestation of the Lungs (Lung Qi connects to smell), yet it perceives odors (which the Heart governs). The ears are the manifestation of the Kidneys (Kidney Qi connects to hearing), yet they perceive sound (which the Lungs govern). What is the meaning of this? Answer: The Lungs correspond to Metal of the West. Metal is born/nurtured in Si (the position of South Fire). Fire corresponds to the Heart, and the Heart governs odors; therefore, the nose can perceive odors. The Kidneys correspond to Water of the North. Water is born/nurtured in Shen (the position of West Metal). Metal corresponds to the Lungs, and the Lungs govern sound; therefore, the ears can perceive sound.
Commentary: This follows the previous citation of the *Mai Du* chapter, listing the orifices connected to each Zang organ's Qi to raise questions. It is said that the Liver opens into the eyes, and its governed five colors also connect through this. The Spleen opens into the mouth, and its governed five flavors enter through this. Only the Kidneys and Heart/Lungs have governed functions that do not match their orifices, hence the doubt. Generally, the Way of the Five Elements includes generation and restriction, but also the principle of Conception and Transformation (Taihua). This chapter describes the changes of Conception and Transformation. Why? Perceiving odors via the nose involves restriction (Metal restricts Wood? No, Smell is Heart/Fire, Nose is Lung/Metal; Fire melts Metal, a restrictive relationship in some contexts, or rather the text implies a cross-relation). Hearing sound via the ears involves generation (Water generates Metal). Thus, it is known that this is not the standard example of the Five Elements. Generally, Metal is conceived in East Wood and transforms in South Fire; its Qi is prosperous in the West, from Mao to You, Metal gains Qi. Water is conceived in South Yang and transforms in West Metal; its Qi is prosperous in the North, from Wu to Zi, Water gains Qi. The conception and transformation of Fire and Wood are similar. Yue Ren's (Bian Que's) intent is to make students understand that beyond the generation and restriction of the Five Elements in the human body, there is another principle of Conception and Transformation. As stated in the *Liu Yuan Zheng Ji Da Lun*: Spring Qi moves West, Summer Qi moves North, Autumn Qi moves East, Winter Qi moves South. The *Huainanzi: Tianwen Xun* states: Metal is born at Ding-Si, prospers at You, dies at Chou; these three branches are Metal. Water is born at Ding-Shen, prospers at Zi, dies at Chen; these three branches are Water. This is also consistent with the meaning of this chapter.
(Difficulty 42, Old Edition Same)
Question: What are the lengths of a person's intestines and stomach, and how much water and grain can they hold? Answer: The stomach is large (circumference) 1 chi 5 cun, diameter 5 cun (method of circumference three times diameter, same below), length 2 chi 6 cun (ancient measures varied, unknown which chi is used), curved to hold 3 dou 5 sheng of water and grain (also ancient measurement, unknowable). It usually retains 2 dou of grain and 1 dou 5 sheng of water. The small intestine is large 2 cun 5 fen, diameter 8 fen plus one-third of a fen, length 3 zhang 2 chi, holding 2 dou 4 sheng of grain and 6 sheng 3 he (two-thirds of a he) of water. The returning intestine is large 4 cun, diameter 1 cun minus one-quarter of a cun, length 2 zhang 1 chi, holding 1 dou of grain and 7 sheng 5 sheng of water. The broad intestine is large 8 cun, diameter 2 cun plus three-quarters of a cun, length 2 chi 8 cun, holding 9 sheng 3 he and one-eighth of a he of grain. Thus, the total length of the stomach and intestines is 5 zhang 8 chi 4 cun, collectively holding 8 dou 7 sheng 6 he and one-eighth of a he of water and grain (*Ling Shu* says 9 dou 2 sheng 6 he and two-thirds of a he. Note: The amount held by each organ is the same as in *Ling Shu*, but this text says the total is 8 dou 7 sheng 6 he 1/8 he, leaving a deficit of 4 sheng 5 he. I privately suspect the small intestine's 2 dou 4 sheng should actually be nearly 1 dou 9 sheng. Why? The stomach roasts and ripens water and grain to produce essence and fluid; the small and large intestines receive the dregs and sequentially reduce and transport them. If transport is reversed, how could the amount increase? Probably Bian Que saw that *Ling Shu* recorded the small intestine's grain volume as 4 sheng more than the stomach's, so he directly corrected it for calculation, but this correction was later erased, and descendants supplemented it again based on *Ling Shu*. I write this here to await experts.) These are the lengths of the stomach and intestines and the quantity of water and grain they hold. The liver weighs 2 jin 4 liang (16 liang = 1 jin, approx 3 qian weak = 1 liang, following below), left lobe has 3 leaves, right lobe has 4 leaves, totaling 7 leaves, governing the storage of Hun (Ethereal Soul). The heart weighs 12 liang, has seven apertures (orifices) and three hairs, holds 3 he of essence fluid, governing the storage of Shen (Spirit). The spleen weighs 2 jin 3 liang, flat width 3 cun, length 5 cun, has half a jin of scattered pancreas, governing the envelopment of blood, warming the five Zang organs, and storing Yi (Intellect). The lungs weigh 3 jin 3 liang, six lobes and two ears, totaling eight lobes, governing the storage of Po (Corporeal Soul). The kidneys are two pieces, weighing 1 jin 1 liang, governing the storage of Zhi (Willpower). The gallbladder is between the short lobes of the liver, weighing 3 liang 3 zhu (1 zhu is 1/24 of a liang, same below), holding 3 he of essence fluid. The stomach weighs 2 jin 1 liang, winding and curving, length 2 chi 6 cun, large circumference 1 chi 5 cun, diameter 5 cun, holding 2 dou of grain and 1 dou 5 sheng of water. The small intestine weighs 2 jin 14 liang, length 3 zhang 2 chi, width 2 cun 5 fen, diameter 8 fen plus one-third of a fen, coiling back and stacking sixteen curves, holding 2 dou 4 sheng of grain and 6 sheng 3 he (two-thirds of a he) of water. The large intestine weighs 2 jin 12 liang, length 2 zhang 1 chi, width 4 cun, diameter 1 cun minus one-quarter of a cun (Old edition missing "minus one-quarter", now supplemented), opposite the umbilicus on the right (*Ling Shu* says left is correct), coiling sixteen curves, holding 1 dou of grain and 7 sheng 5 sheng of water. The bladder weighs 9 liang 2 zhu, vertical and horizontal dimensions 9 cun, holding 9 sheng 9 he of urine. The mouth is wide 2 cun 5 fen, lips to teeth length 9 fen, from behind teeth to epiglottis depth 3 cun 5 fen, capacity 5 he. The tongue weighs 10 liang, length 7 cun, width 2 cun 5 fen. The pharynx gate weighs 12 liang, width 2 cun 5 fen, length to stomach 1 chi 6 cun. The trachea/larynx weighs 12 liang, width 2 cun, length 1 chi 2 cun with nine joints. The anus weighs 12 liang, large opening 8 cun, diameter 2 cun plus three-quarters of a cun (Old edition missing "plus three-quarters", now supplemented), length 2 chi 8 cun, holding 9 sheng 3 he and one-eighth of a he of grain.
Commentary: This is identical to the *Ling Shu: Jue Gu* chapter, but focuses specifically on the 3 dou 5 sheng of water and grain received by the stomach. Presumably, if a person maintains this dietary intake daily, it is sufficient to nourish the Zang and Fu organs. If there is excess or deficiency, it not only harms the Harmonious Qi but also causes disease. The small and large intestines and the broad intestine all receive the waste for separation and transportation. This serves as the basis for the later chapter stating that death occurs after seven days of fasting. The following 199 characters regarding liver weight etc. are not found in *Ling Shu* or *Su Wen* and were created in this chapter; it is suspected that these are not words of Bian Que. Why? Previously it stated the liver has two lobes, here it states seven lobes total; *Ling Shu* says small and large intestines coil to the left, here it says the large intestine coils to the right; moreover, the measurements of the stomach and intestines in this chapter are repetitive; the 99 characters from "mouth width" onwards are plagiarized from the *Chang Wei* chapter and placed after the bladder, greatly deviating from the intent of *Ling Shu*, causing mutual doubt. However, famous doctors of successive generations have used these visceral images as evidence, so their origin is distant. Thus, I record this here to await those who know.
(Difficulty 43, Old Edition Same)
Question: Why does a person die after seven days without eating or drinking? Answer: The human stomach usually retains 2 dou of grain and 1 dou 5 sheng of water. Therefore, a normal person goes to the toilet twice a day, passing 2 sheng 5 sheng each time, totaling 5 sheng per day. Over seven days, 5 x 7 = 3 dou 5 sheng. Thus, the water (when gone, Ying disperses) and grain (when consumed, Wei perishes) are exhausted. Therefore, a normal person dies after seven days without eating or drinking because the Jingye (Essence Fluids) of water and grain are completely exhausted, leading to death.
Commentary: Death after seven days of fasting is limited because the person passes stool twice a day, completely emptying 2 sheng 5 sheng each time. Although individual hearts are like faces, gastrointestinal transit varies. Generally, bowel movements may occur once or 2-3 times a day, or once or 2-3 times every two days; it cannot be fixed. Thus, the conclusion is: "When water and grain Jingye are exhausted, death occurs." The main point of this difficulty lies in this sentence. The "seven days" is calculated based on the volume of two movements per day. Why be so rigid about the number of days? Readers should ponder this. The wording differs slightly from *Ling Shu: Jue Gu*, but the meaning is identical.
(Difficulty 44, Old Edition Same)
Question: Where are the Seven Rush Gates (Chong Men)? Answer: The lips are the Fei Men (Flying Gate, place of opening and closing; Classic says lips are fans for voice). The teeth are the Hu Men (Door Gate, key for breaking hardness). The epiglottis is the Xi Men (Suction Gate, street for swallowing and breathing). The upper opening of the stomach is the Ben Men (Rising Gate, pass for Ying and Wei generation). The lower opening of the Tai Cang (Stomach) is the You Men (Secluded Gate, realm for receiving urine and feces). The junction of the large and small intestines is the Lan Men (Screen Gate, boundary for separating clear and turbid). The lower extreme (buttocks/coccyx) is the Po Men (Corporeal Soul Gate, domain for expelling dregs). Hence, they are called the Seven Rush Gates.
Commentary: The Ben, You, Lan, and Po gates are scattered throughout various chapters of the *Nei Jing* without a systematic arrangement. Did the Fei, Hu, and Xi gates fall out of the ancient text and survive only in this chapter? The so-called Seven Heng (Chong) are the gates for the entry and exit of water and grain. Fei Men to Ben Men govern ingestion; You Men to Po Men govern excretion. If the upper four gates fail, diseases such as dysphagia, regurgitation, vomiting, and acid reflux arise according to the specific gate. If the lower three gates fail, conditions such as diarrhea, constipation, enuresis, strangury, hemorrhoids, and prolapse develop successively. Moreover, the stomach is the granary and the palace of the Grain Spirit. The Fei Men contains, the Hu Men chews, the Xi Men swallows, the Ben Men receives, and the You Men stores. Once the Grain Spirit remains, dregs are formed. The Lan Men separates, and the Po Men pushes. If this one gate is blocked, all other gates undergo changes. How can the Spirit remain stable? The Classic mentions the Xu Men (Storage Gate), but it is not seen here. The Xu Men is the boundary between nose and mouth, the pass of the hangsang (nasopharynx), not a path for water and grain, hence only the Seven Rush Gates are named.
(Difficulty 45, Old Edition Same)
Question: The Classic speaks of the Eight Hui (Assemblage) Points. What are they? Answer: The Hui Point of the Fu organs is Tai Cang (Zhongwan, CV12 on the Ren Meridian). The Hui Point of the Zang organs is Ji Xie (Zhangmen, LR13 on the Foot-Jueyin Meridian). The Hui Point of the tendons is Yanglingquan (GB34, lateral knee, Foot-Shaoyang Meridian). The Hui Point of the marrow is Juegu (Xuanzhong, GB39, Chen Shi considers it the occipital bone/head point of Foot-Taiyang Meridian). The Hui Point of the blood is Geshu (BL17, second row of Foot-Taiyang Back, between Heart and Liver Shu points). The Hui Point of the bones is Dazhu (BL11, Dujia/Dazhui GV14 is not BL11; Zhu means spine, so Zhu and Zhui are interchangeable). The Hui Point of the vessels is Dazyuan (Taiyuan, LU9, center of the寸 Kou/Wrist). The Hui Point of the Qi is Sanjiao (meaning Upper Jiao here; ancient texts distinguish between specific and general use of Sanjiao, this is general). Plus one tendon (external meridian, internal formless) straight between the two breasts (Shanzhong, CV17 on the Ren Meridian). For heat diseases inside the body, select the Qi Acupoints of these (Eight) Hui Points.
Commentary: The *Nei Jing* records the Fifty-Nine Needles for Heat Diseases, selecting points according to the location of heat pathogens. This chapter establishes the Eight Hui method for simplicity. These eight Hui points comprise thirteen acupoints; for internal heat, treat according to the respective region. When Guo Taizi suffered corpse-like coma, selecting the Wuhui (Five Meetings) of the External Three Yangs—was it only Baihui (GV20)? It is suspected that the five locations of this Hui were also selected, which can be known. Regarding the Blood Sea, Marrow Hui, and Bone Hui theories, Hua Shou's commentary citing Chen Shi of Siming is correct. Regarding "Sanjiao" being written as "Upper Jiao," Xie Shi did not understand ancient usage.
(Difficulty 46, Old Edition Same)
Question: Why do the elderly sleep lightly (do not achieve deep sleep) at night, while the young and vigorous sleep deeply (do not wake) at night? Answer: The Classic states that the young and vigorous have abundant and full Qi and Blood, smooth and lustrous muscles, and unobstructed Qi channels (quiet respiration). The circulation of Ying and Wei around the body does not deviate from the norm (50 cycles). Therefore, they are alert during the day and sleep soundly at night. The elderly have declining Qi and Blood, non-lustrous muscles, and sluggish Ying and Wei pathways (deviating from the norm). Therefore, they are easily sleepy during the day and have difficulty sleeping at night. Thus, we know the elderly have difficulty achieving proper sleep.
Commentary: Although this discusses the differences in day/night sleep-wake cycles between the elderly and the young, the essence is that the degree of Ying and Wei circulation in the elderly is deficient and does not meet the required number. This aligns with the *Ling Shu: Sheng Hui* chapter. The re-statement of Q&A here emphasizes that while the young have constant abundance, the elderly have decline even in health. If they fall ill, the prescription strategy is entirely different. Elderly diseases, compared to the young, although appearing Excess, still harbor Deficiency. Even if external/internal symptoms resemble those of the young, the timing of tonification and purging requires careful attention; one must not treat them identically just because symptoms are similar. This is likely why Bian Que raised this difficulty.
(Difficulty 47, Old Edition Same)
Question: Why is the human face uniquely able to endure cold? Answer: The human head is the convergence of all Yang meridians. All Yin meridians reach the neck and chest and then return (referring to the regular meridians). Only all Yang meridians ascend to the head and ears. Therefore, the face can endure cold.
Commentary: This is largely similar to the statement by Qibo in the *Ling Shu*. That text lists the twelve meridians and 365 collaterals, showing that all Qi and Blood ascend to the face, indicating that pure Qi and Blood gather exclusively there. This chapter states that the head is the meeting of all Yang, and Yin meridians return at the neck/chest, focusing solely on the regular meridians. Generally, the head and face are the meeting of the six Yang meridians of the hands and feet, while the regular paths of the six Yin meridians terminate in the chest. Their branch collaterals merely pass through the neck, connect to the eyes, and reach the vertex. However, the subtle Yin is contained within the Yang; thus, although present, it is negligible. Therefore, Yue Ren concluded with the meeting of Yang to elucidate the principle, which benefits future treatments. Generally, the head, face, limbs, bones, and tendons have similar structures, but the clarity and turbidity of their Qi and Blood have distinct boundaries. Although the human body is one Qi and Blood system, diseases of the head and face are mostly caused by turbid Yin attacking upwards, while diseases of the limbs are mostly caused by clear Yang stagnating downwards. This indicates the difference in medication and treatment.
(Difficulty 48, Old Edition Same)
Question: Humans have Three Deficiencies (Xu) and Three Excesses (Shi) in pulse, disease, and diagnosis. What are they? Answer: There is Pulse Xu/Shi, Disease Xu/Shi, and Diagnosis Xu/ShI. Pulse Xu/ShI: Weak (Ru) is Deficiency (seen in all pulse images as weak); Tight (Jin) and Firm (Lao) are Excess (seen in all pulse images as tight/firm). Disease Xu/ShI: Outward (internal injury) is Deficiency; Inward (external pathogen) is Excess. Speaking (alert and able to speak) is Deficiency; Not speaking (confused/delirious speech) is Excess. Slow (gradual onset, not sudden) is Deficiency; Rapid/Urgent (sudden onset, life/death imminent) is Excess. Diagnosis Xu/ShI: Soft muscles (Ru) is Deficiency; Firm/Hard muscles (Lao) is Excess. Itching (scattered Qi and Blood) is Deficiency; Pain (excessive pathogen) is Excess. External pain (pathogen Excess in exterior) with internal comfort (Qi/Blood Deficiency in interior) is Exterior Excess Interior Deficiency. Internal pain (pathogen Excess in interior) with external comfort (Qi/Blood Empty in exterior) is Interior Excess Exterior Deficiency. Hence, it is called Xu and Shi.
Commentary: The *Ling Shu* discusses Three Xu and Three Shi based on the decline of age, the waxing and waning of the moon, and the harmony of seasons. However, its meaning is broad and not a practical, immediate method. Therefore, this chapter retains the name but changes the method. The so-called Three Xu and Three Shi refer to Pulse, Disease, and Diagnosis. This can be considered very immediate/practical. Regarding Ru (Weak) and Jin/Lao (Tight/Firm), even if pulses vary in size, floating, sinking, slippery, or choppy, generally, those that are weak and powerless are...