Library

Ping An: This section from the beginning of the chapter to "thirty-two curves" is found in Volume 6, Chapter 31 "Gastrointestinal Tract" (Chang Wei) of the *Ling Shu* (Spiritual Pivot). From "The Yellow Emperor said, I wish to hear about people who do not eat" to the end, it is found in Volume 6, Chapter 32 "Normal People Fasting from Grain" (Ping Ren Jue Gu) of the *Ling Shu*. The *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion) arranges this similarly.

The Yellow Emperor asked Bo Gao: I wish to understand how the Six Fu Organs (Six Hollow Organs) transport grain. Specifically, what are the sizes, lengths, and capacities for receiving grain in the stomach and intestines? (The San Jiao (Triple Burner) transports grain qi; the Gallbladder receives grain essence; the Large Intestine, Small Intestine, Rectum, and Stomach transport grain dregs. Transporting dregs is the key process of moving grain through the system, hence the distinction among these six parts.)

Bo Gao replied: Please allow me to explain in detail. The measurements of depth, proximity, length, and shortness regarding the entry and exit of grain are as follows: (The Yellow Emperor asked about six aspects, and here four additional ones are explained, hence "explaining fully." Entry of grain into the mouth is called "entering"; exit from the anus is called "exiting"; from lips to teeth is "shallow"; from pharynx to intestines is "deep"; grain reaching the stomach is "near"; from stomach towards intestines is "far"; sixteen curves in the intestines constitute "long"; the pharynx at one chi six cun constitutes "short".)

From lips to teeth: length nine fen; mouth width two and a half cun; from behind teeth to epiglottis: depth three and a half cun; capacity five he. (The epiglottis is located above the throat behind the tongue, serving as the aperture for air entering the nose and mouth. A fleshy flap covers this aperture, controlling the entry and exit of air.)

Pharynx width: two and a half cun; from pharynx to stomach: length one chi six cun. (The pharynx is the food passage behind the epiglottis. From the pharynx down to the stomach, the length is one chi six cun. [Ping An]: The *Ling Shu* text includes eleven characters before "pharynx": "Tongue weighs ten liang, length seven cun, width two and a half cun," and four characters after "pharynx": "Gate weighs ten liang." The character "Da" (large) is written as "Guang" (broad) in the main text, consistent with the *Jia Yi Jing*. Two and a half cun is written as one and a half cun in the *Ling Shu*. In the original manuscript, the characters "Zhi Wei" (to stomach) were omitted before "Chang" (length), and "Yi Chi" (one chi) were omitted after "Chang". These have been supplemented based on the *Ling Shu* and *Jia Yi Jing*.)

Stomach: tortuous and curved; when straightened, length is two chi six cun; circumference one chi five cun; diameter five cun; capacity three dou. (The stomach is large in the center and small at both ends. Straightened measurement is two chi six cun. Circumference is one chi five cun. Diameter is five cun. Capacity for water and grain is three dou. [Ping An]: "Capacity three dou" is written as "two dou five sheng" in the *Ling Shu* and "three dou five sheng" in the *Jia Yi Jing*, with a note stating one version is two dou.)

Small Intestine: attached posteriorly to the spine, looping left with leaf-like accumulations; its connection to the ileum attaches externally above the umbilicus. The ileum loops and reverses sixteen times. Diameter two and a half cun; radius eight fen plus one-third of a fen (8.66 fen); length three zhang two chi. (Fu means attached. Dregs pass from the stomach to the small intestine, which attaches to the spine and externally connects to the ileum above the umbilicus. [Ping An]: "Fu" is written as "Fu" (attach) in both *Ling Shu* and *Jia Yi Jing*. "Ye Ji" is written as "Hui Zhou Die Ji" in the *Ling Shu* and "Hui Zhou Ye Ji" in the *Jia Yi Jing*.)

Ileum (Large Intestine): located at the umbilicus, looping left with leaf-like accumulations downwards, reversing sixteen times. Diameter four cun; radius one cun plus one-half cun; length two zhang one chi. (The ileum refers to the large intestine. The small intestine attaches to the spine posteriorly; the large intestine is anterior near the umbilicus. Thus, the output of the large intestine is superior, and that of the small intestine is inferior. [Ping An]: The *Ling Shu* and *Jia Yi Jing* include the characters "Cun Zhi" before "Shao Ban".)

Rectum (Broad Intestine): attaches to the spine to receive the ileum, looping left with leaf-like accumulations opening and closing上下. Diameter eight cun; radius two cun plus one-half cun; length two chi eight cun. (The rectum, also called Bai Chang, attaches to the spine to receive dregs from the large intestine. Bi means adhering to the spine. It refers to the middle part being eight cun wide, with the upper reception point and lower expulsion point having a diameter of two and a half cun, totaling a length of two chi eight cun. [Ping An]: "Ye Ji" is written as "Ye Ji" in the *Ling Shu*. The *Ling Shu* and *Jia Yi Jing* include "Cun Zhi" before "Da Ban".)

Total length from entry to exit of the gastrointestinal tract: six zhang four cun four fen. (The upper opening of the pharynx is the entry; the lower end of the rectum is the exit. Distance from lips to teeth is nine fen; teeth to epiglottis is three and a half cun; epiglottis to stomach pharynx is one chi six cun; stomach start to end is two chi six cun; small intestine start to end is three zhang two chi; rectum start to end is two chi eight cun. Summing these gives six zhang four cun four fen. [Ping An]: In the commentary under "Small Intestine Start to End," the original manuscript reads "Length two zhang one chi." Checking the main text, the small intestine is three zhang two chi, and the ileum is two zhang one chi. Nine characters "Length three zhang two chi, Ileum Start to End" should be added after "Small Intestine Start to End" to match the total of six zhang four cun four fen. These nine characters were likely lost during transcription.)

Total number of loops and reversals: thirty-two. (One loop in the stomach, sixteen in the small intestine, sixteen in the large intestine, totaling thirty-three. However, the large loop of the stomach is short and excluded from the count, resulting in thirty-two loops. This is standardized for a person seven chi five cun tall.)

The Yellow Emperor said: I wish to know why a person who does not eat dies after seven days. What is the reason? (Having learned the size of the gastrointestinal tract, I still do not know how long it takes for the contained water and grain to be exhausted, leading to death on the seventh day.)

Bo Gao said: Allow me to explain the reason. The stomach has a circumference of one chi five cun, diameter five cun, and length two chi six cun. Horizontally curved, it holds three dou. Typically, it retains two dou of grain and one dou of water, filling it up. (This explains the origin: water and grain total three dou, filling the stomach. [Ping An]: "Horizontally curved holding three dou" is written as "Horizontally curved holding water and grain three dou five sheng" in the *Ling Shu* and *Jia Yi Jing*. "Water one dou fills it" is written as "Water one dou five sheng fills it" in both texts.)

The Upper Jiao (Upper Burner) vents qi, releasing fine essences; it is vigorous, rapid, and slippery. (Qi of the Upper Jiao exits from the upper orifice of the stomach. Its essence is fine, vigorous, rapid, and slippery. It circulates through the body fifty times day and night, which is the Wei Qi (Defensive Qi). [Ping An]: One character is missing after "Upper Jiao" in the original. Based on the *Ling Shu* and *Jia Yi Jing*, it is supplemented as "Xie" (vent). Yuan edition writes "Zhong Jiao" (Middle Jiao). Also, the note writes "Er Jiao" instead of "Shang Jiao", inconsistent with the original manuscript.)

The Lower Jiao (Lower Burner) irrigates downward to all intestines. (The Lower Jiao separates from the ileum, pouring into the bladder, like a ditch, irrigating downward to all intestines. The bladder is the Black Intestine, along with the Broad Intestine, etc. [Ping An]: "Zhu Chang" (all intestines) is written as "Xie Zhu Xiao Chang" (drain to small intestines) in the *Jia Yi Jing*.)

Small Intestine: diameter two and a half cun; radius eight fen plus one-third of a fen; length three zhang two chi. Capacity: one dou three he plus two-thirds of a he. Grain: four sheng; Water: six sheng three he plus two-thirds of a he. (One-third is Shao Ban (minor half), two-thirds is Da Ban (major half). [Ping An]: The twelve characters "Receiving one dou three he plus major half, grain four sheng" are summarized as "Receiving grain two dou four sheng" in the *Ling Shu* and *Jia Yi Jing*.)

Ileum: diameter four cun; radius one cun plus one-half cun; length two zhang one chi. Capacity: one dou seven sheng plus one-half sheng. Grain: one dou; Water: seven sheng plus one-half sheng. (Half sheng means 0.5 sheng. [Ping An]: The seventeen characters "Receiving one dou seven sheng plus half sheng, grain one dou, water seven sheng plus half sheng" are summarized as "Receiving grain one dou, water seven sheng half" in the *Ling Shu* and *Jia Yi Jing*.)

Rectum: diameter eight cun; radius two cun plus one-half cun; length two chi eight cun. Capacity: nine sheng three he plus one-eighth of a he. (This is the quantity of water and grain received by the rectum. [Ping An]: The *Ling Shu* includes "Cun Zhi" before "Da Ban" and "Gu" (grain) after "Shou" (receive). The *Jia Yi Jing* is the same.)

Total length of stomach and intestines: six zhang four cun four fen. Total capacity for water and grain: six dou six sheng liu he plus one-eighth of a he. This is the total amount of water and grain received by the gastrointestinal tract. (Calculating the total received, considering fractions of sheng and he. [Ping An]: "Six zhang four cun four fen" is written as "Five zhang eight chi four cun" in the *Ling Shu* and *Jia Yi Jing*. "Receiving water and grain six dou six sheng liu he plus one-eighth of a he" is written as "Receiving water and grain nine dou two sheng one he plus major half" (thirteen characters). In the note, "Chui" is written as "Cheng" by Yuan edition; the meaning is unclear.)

A normal person is different. When the stomach is full, the intestines are empty; when the intestines are full, the stomach is empty. They alternate between full and empty, allowing Qi to move up and down. (The previous discussion was based on the static capacity of the gastrointestinal tract. For a living person, fullness and emptiness alternate within the stomach and intestines, so they do not simultaneously hold the maximum amounts described earlier. When food fills the stomach, the stomach is solid and intestines empty; emptiness in intestines allows Qi to descend. When dregs enter the intestines, the stomach becomes empty and intestines solid; emptiness in stomach allows Qi to ascend. Due to this alternation of fullness and emptiness, Qi moves up and down. [Ping An]: The missing character after "Liang" (measure/capacity) in the note is conjectured to be "Rong" (contain).)

The Five Zang Organs (Five Solid Organs) remain stable, desiring to nourish themselves with the flavor of water and grain, thus requiring fullness. (To receive the Qi of water and grain, emptiness is required. Internal harmony of flavors ensures stability of the Five Zang Organs.)

Blood vessels are harmonious and unobstructed. (Flavors circulate up and down, ensuring harmonious vessels.)

Spirit (Shen) resides therein. (With stable organs and harmonious vessels, the Five Spirits and Five Essences reside in their respective organs.)

Thus, Spirit is the refined essence of water and grain. (Refined essence of water and grain nourishes the Five Spirits. Therefore, when water and grain are exhausted, Spirit perishes.)

Therefore, within the stomach and intestines, there is typically retained grain: two dou four sheng; water: one dou one sheng. (Calculating the total received six dou six sheng liu he plus one-eighth, considering fullness and emptiness, a normal person requires three dou five sheng. [Ping An]: "Grain two dou four sheng" is "two dou" in the *Ling Shu*. "Water one dou one sheng" is "one dou five sheng" in the *Ling Shu*. The *Jia Yi Jing* states "Grain two dou four sheng, Water one dou five sheng".)

Thus, a normal person defecates twice a day, each time two and a half sheng, totaling five sheng per day. Over seven days, this amounts to five times seven, three dou five sheng, exhausting the retained water and grain. (Two bowel movements equal five sheng, needing replenishment from diet, totaling three dou five sheng. If one does not eat for a day but excretes five sheng, five sheng are lacking. If one continues to excrete for seven days without eating, the five sheng and three dou five sheng are all exhausted.)

Therefore, a normal person who does not eat or drink will die after seven days because the essence of water and grain, Jin Ye (Body Fluids), are all exhausted. Hence, death occurs after seven days. (What is stored in the Gate of Life is called Jing (Essence). The Upper Jiao disseminates the flavors of grain, warming the skin, filling the body, and moistening hair, like mist and dew irrigating, thus called Qi. Sweat released from pores is called Jin. Grain essence moistens bones, aiding flexion and extension, nourishing marrow and brain, and moistening skin, thus called Ye. Once water and grain are exhausted, the four substances—Jing, Qi, Jin, and Ye—are all depleted, hence death after seven days. [Ping An]: The missing character after "Si Wu" (four substances) in the note is supplemented as "Jie" (all) based on the main text.)