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Chapter 42 asks: What are the lengths of a person's stomach and intestines, and how much water and grain can they hold?

The answer is: The stomach has a circumference of one chi five cun, a diameter of five cun, and a length of two chi six cun. Its curved portion can hold three dou five sheng of water and grain, typically retaining two dou of grain and one dou five sheng of water. The small intestine has a circumference of two cun half, a diameter of eight fen plus a minor third part, and a length of three zhang two chi. It can hold two dou four sheng of grain and six sheng three he plus a major half he of water. The returning intestine (huichang) has a circumference of four cun, a diameter of one cun half, and a length of two zhang one chi. It can hold one dou of grain and seven sheng half of water. The broad intestine (guochang) has a circumference of eight cun, a diameter of two cun half, and a length of two chi eight cun. It can hold nine sheng three he plus one-eighth of a he of grain. Thus, the total length of the stomach and intestines is five zhang eight chi four cun, with a combined capacity for water and grain of eight dou seven sheng liu he plus one-eighth of a he. These are the measurements of the length and capacity of the stomach and intestines.

This discussion on the length and capacity of the stomach and intestines uses the method of "circumference three, diameter one" (assuming circumference is three times the diameter) for estimation, which does not match reality in many aspects, possibly due to simplification or error. However, these figures regarding length and capacity are merely approximate examples and should not be rigidly adhered to.

Commentary: Western medicine states that the stomach is curved like a bag, with a capacity of about three sheng. It lies horizontally below the diaphragm, connecting superiorly to the esophagus and inferiorly to the small intestine. Its wall consists of three layers. The outer layer has four vascular branches distributed above and below, with smaller vessels densely entangled within. Because the stomach receives more blood than other viscera, the middle muscular layer features intersecting longitudinal and transverse fibers, allowing it to contract and relax peristaltically to churn food evenly. The inner mucosal layer has small pores around its circumference to secrete gastric juices. Nerves (referred to as brain qi tendons) and fascial structures (white joint tendons) are scattered inside and outside the stomach body, linking it to all parts of the body. To the left of the stomach is the spleen, and to the right is the liver. The pancreas attaches behind the stomach. The inherent heat of the stomach is the same as other viscera but becomes stronger during digestion. Gastric juice is sour-tasting and resembles saliva; its primary function is digesting food.

The small intestine is approximately two zhang long. Its upper opening connects to the stomach, and its lower opening connects to the large intestine. The outer surface is smooth, while the inner surface is folded with dense textures. There are papillae on top, which are the openings of absorptive tubes (lymphatic/capillary vessels). These absorptive tubes absorb the essence from food. When food moves from the stomach to the head of the small intestine, it mixes with bile and pancreatic juice. As it descends, it is squeezed, extracting essences. These absorptive tubes branch extensively and spread between the mesenteric folds behind the intestine. They converge near the spine into a single main vessel called the main essence tube. This tube ascends along the spine from the waist to the neck, then turns downward to reach the heart to transform blood.

The large intestine is about five chi long, divided into upper, middle, and lower sections, each over one chi long. The junction where the upper section meets the small intestine is called the Lanmen (Appendiceal Gate). The middle section lies under the liver, crossing the bottom of the stomach. The lower section starts below the spleen, slanting down from the soft area of the left hypochondrium to the anus, forming the rectum. In the upper and middle sections, absorptive tubes still extract remaining fluids. By the time food reaches the lower section, the essences are exhausted, leaving only dregs.

The liver weighs four jin four liang. It has three lobes on the left and four on the right, totaling seven lobes. It houses the Hun (Ethereal Soul).

Western medicine locates the liver in the right hypochondrium. It has five lobes, is purple-red in color, and weighs about thirty to forty liang. A long isthmus connects the two main lobes; the right lobe is larger than the left. Below the right lobe is a small square lobe where the gallbladder attaches. Posterior-inferior to the right lobe is another lobe, not very large, named the posterior lobe, with an especially small tail. Extending from the base of the posterior lobe to the end of the right lobe, this structure covers superiorly and cups inferiorly, rests against the stomach on the left, is bounded inferiorly by the cardia, and is wrapped superiorly by the Sanjiao membrane. Each of the left and right lobes emits a bile duct. These merge for about one cun, then split again: one penetrates the head of the small intestine, and the other penetrates the gallbladder. This channel transports bile to the small intestine to dissolve food. Inside the liver, there are venous return vessels to nourish the liver and connect with bile. Although the liver is not anatomically situated solely on the left, in Traditional Chinese Medicine, the Liver corresponds to Wind-Wood and the Xun trigram. Old theories stating the liver resides on the left refer to the ascending nature of Wind-Wood Qi, not anatomical position. If the Liver is obstructed by Heat, it may swell several times its normal size. If the vessels stagnate, blood and fluid leak into the mesenteric wraps, accumulating gradually and causing abdominal distension. Therefore, conditions like Gu Zhang (abdominal distension with masses) are often attributed to the Liver.

The heart weighs twelve liang. It has seven orifices and three hairs, holds three he of essence fluid, and houses the Shen (Spirit).

Western medicine describes the heart as bright red, weighing about ten liang, wide at the top and pointed at the bottom. It is surrounded by a membranous wrap, known as the Pericardium (Xin Bao Luo). It is covered by the lungs above, suspended in the chest, and shielded by the diaphragm below. The external surface is smooth, while the interior is hollow like a sac. Upon dissection, the walls appear rugged, concave, and convex. A septum divides it vertically, creating the Left Atrium and Right Atrium. A horizontal muscle separates the upper and lower halves, creating the Upper Chambers and Lower Chambers. The four chambers are roughly equal in size, separated by valves connected by fibrous strands that allow automatic opening and closing. The Right Upper Chamber has two venous returns, one ascending and one descending. The Right Lower Chamber has one large vessel, about one cun long, which splits into left and right branches entering the lungs. The Left Upper Chamber has venous returns also communicating with the lungs. The Left Lower Chamber has a main arterial trunk responsible for transporting red blood, following the Du Meridian, descending to the Sea of Blood, and dispersing through the meridians. Nerves and fascial structures are densely entangled within to perform functions. Thus, the Heart is the organ of blood circulation, governing all vessels, and is therefore the Ruler Organ.

The spleen weighs two jin three liang. It is flat, three cun wide, and five cun long. It contains half a jin of "scattered paste" (pancreas), envelopes the blood, warms the five Zang organs, and houses the Yi (Intellect).

Western medicine places the spleen beside the stomach. It is rectangular, flat, and soft, weighing about six to seven liang. It appears deep purple when blood-filled. Its size varies; it enlarges after overeating and shrinks when hungry. In cases of malaria or febrile diseases, it may enlarge tenfold. Located in the left hypochondrium, it connects to the gastric fat membrane. Venous return flows from the stomach posteriorly into the liver. When diseased, blood fails to circulate externally and accumulates in the spleen, causing enlargement. Stagnation of venous return in the spleen leads to leakage of blood and fluid downward, so edematous disorders often originate in the Spleen. The pancreas is attached to the spleen. It is rectangular, weighing about three to four liang, lying horizontally behind the stomach. Its head is large and faces right, while its tail is pointed and faces left. The right head borders the small intestine head, and the left tail connects to the spleen. A duct runs horizontally from left to right through the pancreas, obliquely entering the side of the small intestine's upper opening, sharing the path with bile. The secreted juice digests food; it is sweet-tasting and sometimes called "sweet flesh."

The lungs weigh three jin three liang. They have six lobes and two ears, totaling eight lobes, and house the Po (Corporeal Soul).

Western medicine locates the lungs above the diaphragm, shaped like a hanging bell, attached to the trachea. They are white like silk with a reddish hue, pointed at the apex and round elsewhere. There are two lobes on the left and three on the right, hanging loosely. The right lobe is larger because the cardiac apex deviates slightly to the left. The left lobe is longer because the liver meridian passes on the right, and the lung sits slightly higher than the spleen. Posteriorly attached to the spine, anteriorly connected to the chest, the lungs have tubular openings communicating with the throat to exhale turbid Qi and inhale clear Qi, thereby exchanging purple blood for red blood in the heart. They draw Heart Qi downward to the uterus/womb. Lung tissue is light and porous, moistened externally by membranous foam to assist respiration.

There are two kidneys, weighing one jin one liang, housing the Zhi (Willpower).

Western medicine locates the kidneys between the twelfth thoracic vertebrae. They resemble pig kidneys, weighing about three to four liang each. They are wrapped in Sanjiao fat membranes and lie opposite each other. The upper left is covered by the stomach, spleen, and lower large intestine; the upper right is covered by the liver and upper large intestine. An oily membrane runs through the spine from the kidney, known as the Kidney Cord, connecting inferiorly to the root of the Sanjiao. Another tube attaches to the spinal cord via the Kidney Cord and ascends to connect with the Heart and Lungs. The two Kidneys belong to Water, while the central Kidney Cord belongs to Fire, which is the Mingmen (Gate of Life). Mingmen is the source of the Sanjiao. Thus, the Sanjiao governs Ministerial Fire and stands in exterior-interior relationship with the Pericardium. The Qi of the Sanjiao circulates through the Upper, Middle, and Lower Jiao, representing the circulation of Ministerial Fire.

The gallbladder is located between the short lobes of the liver, weighs three liang three zhu, and holds three he of essence fluid.

Western medicine describes the gallbladder as pear-shaped, attached to the small square lobe on the right side of the liver. It stores green bile, formed when venous blood enters the liver and undergoes transformation via Wood Qi. After eating, the full small intestine compresses the gallbladder, forcing bile into the intestine to dissolve food and facilitate the passage of dregs. Insufficient bile results in undigested food, white stool, and lack of yellow color. Excess bile causes vomiting of bitter saliva or green diarrhea. Biliary obstruction allows bile to enter the blood, causing Jaundice (Dan Huang).

The stomach weighs two jin two liang, is curved and flexible, two chi six cun long, one chi five cun in circumference, five cun in diameter, holding two dou of grain and one dou five sheng of water. The small intestine weighs two jin fourteen liang, is three zhang two chi long, two cun half wide, eight fen plus a minor third part in diameter, with sixteen curves in the left loop, holding two dou four sheng of grain and six sheng three he plus a major half he of water. The large intestine weighs two jin twelve liang, is two zhang one chi long, four cun wide, one cun in diameter. At the navel, the right loop has sixteen curves, holding one dou of grain and seven sheng half of water.

The bladder weighs nine liang two zhu, is nine cun long and wide, and holds nine sheng nine he of urine. The mouth is two cun half wide; lips to teeth are nine fen long; teeth to epiglottis are three cun half deep, with a capacity of five he. The tongue weighs ten liang, is seven cun long and two cun half wide. The pharynx gate weighs ten liang, is two cun half wide, and extends one chi six cun to the stomach. The larynx weighs twelve liang, is two cun wide, one chi two cun long, and has nine segments. The anus weighs twelve liang, is eight cun wide, two cun half in diameter, two chi eight cun long, and holds nine sheng three he plus one-eighth of a he of grain.

This aligns with the meanings found in *Ling Shu: Chang Gu Pian* and *Ping Ren Jue Gu Pian*. Additional data on the weight, content, and storage of the Five Zang organs are included. Although repetitive, this serves as careful emphasis. Western physicians describe visceral anatomy in greater detail, so their views are frequently cited in annotations. However, human bodies vary in size and robustness, and ancient and modern standards of measurement differ. Therefore, specific dimensions and capacities should not be rigidly applied; understanding the general principles is sufficient.