黄帝曰。愿闻人之不食。七日而死。何也。伯高曰。臣请言其故。胃大一尺五寸。径五寸。长二尺六寸。横屈。受
水谷三斗五升。其中之谷。常留二斗。水一斗五升。而满上焦泄气出。其精微 悍滑疾下焦。下溉诸肠。小肠大二寸半。
径八分分之少半。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。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。长二尺八寸。受谷九升三合八分合之一。肠胃之长。凡五丈八尺四
寸。受水谷九斗二升一合合之大半。此肠胃所受水谷之数也。平人则不然。胃满则肠虚。肠满则胃虚。更虚更满。故气
得上下。五脏安定。血脉和利。精神乃居。故神者。水谷之精气也。故肠胃之中。当留谷二斗。水一斗五升。故平人日
再后。后二升半。一日中五升。七日。五七三斗五升。而留水谷尽矣。故平人不食饮。七日而死者。水谷精气津液皆尽
故也。
先叙事后发论。词旨洁净精微。
黄帝问于岐伯曰。余闻刺法于夫子。夫子之所言。不离于营卫血气。夫十二经脉者。内属于腑脏。外络于肢节。夫
子乃合之于四海乎。岐伯答曰。人亦有四海十二经水。经水者皆注于海。海有东西南北。命曰四海。黄帝曰。以人应之。
奈何。岐伯曰。人有髓海。有血海。有气海。有水谷之海。凡此四者。以应四海也。黄帝曰。远乎哉夫子之合人于天地
四海也。愿闻应之奈何。岐伯答曰。必先明知阴阳。表里荣输。所在四海定矣。黄帝曰。定之奈何。岐伯曰。胃者水谷
之海。其输。上在气街。下至三里。冲脉者为十二经之海其输。上在于大杼。下出于巨虚之上下廉。膻中者。为气之海。
其输。上在于柱骨之上下。前在于人迎。脑为髓之海其输。上在于其盖。下在风府。黄帝曰。凡此四海者。何利何害。
何生何败。岐伯曰。得顺者生。得逆者败。知调者利。不知调者害。黄帝曰。四海之逆顺奈何。岐伯曰。气海有余者。
气满。胸中 息。面赤。气海不足。则气少不足以言。血海有余。则常想其身大。怫然不知其所病。血海不足。亦常想
其身小。狭然不知其所病。水谷之海有余。则腹满。水谷之海不足。则饥不受谷食。髓海有余。则轻劲多力。自过其度。
髓海不足。则脑转。耳鸣。胫 。眩冒。目无所见。懈怠安卧。黄帝曰。余已闻逆顺。调之奈何。岐伯曰。审守其输。
而调其虚实。无犯其害。顺者得复。逆者必败。黄帝曰。善。
布局整暇运笔清挺。此与本神决气皆叙内伤证也。而此篇摹绘尤妙。
黄帝说：我想了解一下人如果不进食，七天就会死亡，这是为什么呢？伯高说：请允许我说明其中的原因。人的胃容量大一尺五寸，直径五寸，长二尺六寸，弯曲盘绕，能容纳水谷三斗五升。其中谷物通常留存二斗，水一斗五升，从而充满上焦并泄出气机；其精微、悍滑之气迅速下行至下焦，向下灌溉各个肠道。小肠大二寸半，直径八分又少半分，长三丈二尺，能容纳谷物二斗四升，水六升又大半合。回肠大四寸，直径一寸又少半分，长二丈一尺，能容纳谷物一斗，水七升半。广肠大八寸，直径二寸又大半分，长二尺八寸，能容纳谷物九升又八分之一合。肠胃的总长度，共五丈八尺四寸，能容纳水谷九斗二升又大半合。这就是肠胃所能容纳的水谷数量。
正常人不与此相同。胃充实时肠道就空虚，肠道充实时胃就空虚，虚实交替变化，因此气机能上下运行，五脏安定，血脉调和通畅，精神才能安居体内。所以神，是由水谷化生的精气。因此肠胃之中，应当留存谷物二斗，水一斗五升。所以正常人每天排便两次，每次排出二升半，一天共排出五升。七天下来，五七得三十五，即三斗五升，此时留存的水谷便排尽了。所以正常人如果不饮食，七天死后，是因为水谷的精气津液都耗尽的缘故。
先叙述事实再发表议论，文辞旨意洁净精微。
黄帝问岐伯说：我从夫子那里学习了针刺法则，夫子所说的话，不离于营卫血气。那十二经脉，内属于脏腑，外联络肢节。夫子将它们与四海相联系吗？岐伯回答说：人也有四海和十二条经水。经水都注入海中，海有东、西、南、北之分，称为四海。黄帝说：用人体来对应这种情况，是怎么回事呢？岐伯说：人有髓海、血海、气海、水谷之海。这四海，是用来对应自然界的海的。黄帝说：夫子将人与天地四海相类比，真是深远啊！我想听听是如何对应的。岐伯回答说：必须首先明确阴阳、表里、荣输（五输穴）的位置，四海也就确定了。黄帝说：如何确定它们呢？岐伯说：胃是水谷之海，其输注穴位，上部在气街，下部至足三里。冲脉是十二经脉之海，其输注穴位，上部在大杼，下部出于巨虚的上廉和下廉。膻中是气之海，其输注穴位，上部在柱骨之上下的定喘、身柱等处，前部在人迎。脑为髓之海，其输注穴位，上部在头顶的百会（盖），下部在风府。黄帝说：这四海，有什么益处，什么害处？什么导致生，什么导致败？岐伯说：顺应则生，逆乱则败，懂得调治则有利，不懂调治则有危害。黄帝说：四海的逆乱情况是怎样的呢？岐伯说：气海有余，则气满胸中，喘息，面红；气海不足，则气短不足以说话。血海有余，则常觉得自己身体庞大，郁结不知病在哪里；血海不足，也常觉得自己身体狭小，局促不知病在哪里。水谷之海有余，则腹部胀满；水谷之海不足，则虽觉饥饿却无法接受食物。髓海有余，则身体轻健有力，超过正常限度；髓海不足，则头晕耳鸣，小腿酸软，眩晕昏花，视物不清，倦怠嗜卧。黄帝说：我已经知道了逆顺的情况，如何调治呢？岐伯说：仔细审察并守住其输注穴位，以调补其虚实，不要犯禁忌伤害正气。顺者得以恢复，逆者必然败坏。黄帝说：好。
Huangdi said: I wish to hear why a person who does not eat will die after seven days. Bo Gao replied: Allow me to explain the reason. The stomach is one chi five cun in circumference, five cun in diameter, and two chi six cun in length. It is coiled and curved, capable of holding three dou five sheng of water and grain. Of this, grain usually remains two dou, and water one dou five sheng, filling the Upper Jiao (Upper Burner) and allowing Qi to escape; its subtle, vigorous, and slippery essence rapidly descends to the Lower Jiao (Lower Burner), irrigating the various intestines downwards. The small intestine is two cun and a half in circumference, eight fen and a fraction less than a fen in diameter, and three zhang two chi in length, capable of holding two dou four sheng of grain and six sheng and more than half a he of water. The returning intestine is four cun in circumference, one cun and a fraction less than a cun in diameter, and two zhang one chi in length, capable of holding one dou of grain and seven sheng and a half of water. The broad intestine is eight cun in circumference, two cun and more than half a cun in diameter, and two chi eight cun in length, capable of holding nine sheng and one-eighth of a he of grain. The total length of the stomach and intestines is five zhang eight chi four cun, capable of holding nine dou two sheng and more than half a he of water and grain. This is the quantity of water and grain that the stomach and intestines can hold.
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 emptiness and fullness, thus allowing Qi to move up and down, keeping the Five Zang Organs stable, blood vessels harmonious and smooth, so that Spirit can reside. Therefore, Spirit is the refined essence derived from water and grain. Thus, within the stomach and intestines, there should remain two dou of grain and one dou five sheng of water. Hence, a normal person defecates twice a day, each time expelling two sheng and a half, totaling five sheng per day. Over seven days, five times seven equals thirty-five, i.e., three dou five sheng, at which point the retained water and grain are exhausted. Therefore, if a normal person does not eat or drink for seven days and dies, it is because the refined essence, Jing, Qi, Jin, and Ye (body fluids) from water and grain have all been exhausted.
The narrative first states the facts and then presents the theory; the wording is clean and precise.
Huangdi asked Qibo: I have learned acupuncture methods from the Master. What the Master says never departs from Ying-Wei (Nutrient and Defensive Qi) and Blood-Qi. The Twelve Primary Meridians belong internally to the Fu Organs and connect externally to the limbs and joints. Does the Master correlate them with the Four Seas? Qibo answered: Humans also have Four Seas and Twelve Meridian Waters. The Meridian Waters all flow into the Seas. The Seas have directions of East, West, South, and North, hence called the Four Seas. Huangdi said: How does the human body correspond to this? Qibo said: Humans have a Sea of Marrow, a Sea of Blood, a Sea of Qi, and a Sea of Water and Grain. These four seas correspond to the four natural seas. Huangdi said: The Master’s correlation of humans with the Four Seas of Heaven and Earth is profound. I wish to hear how they correspond. Qibo replied: One must first clearly understand Yin-Yang, Interior-Exterior, and Ying-Shu (Five Shu points). Once these are known, the Four Seas are determined. Huangdi said: How are they determined? Qibo said: The Stomach is the Sea of Water and Grain; its Shu points are located above at Qichong (ST30) and below at Zusanli (ST35). The Chong Mai (Penetrating Vessel) is the Sea of the Twelve Meridians; its Shu points are located above at Dazhu (BL11) and below at Shangjuxu (ST37) and Xiaguxu (ST39). Danzhong (CV17) is the Sea of Qi; its Shu points are located above at the upper and lower parts of the vertebral column (Dingchuan BL15/Shenzhu BL12 area) and anteriorly at Renying (ST9). The Brain is the Sea of Marrow; its Shu points are located above at Baihui (GV20, the crown) and below at Fengfu (GV16). Huangdi said: Regarding these Four Seas, what brings benefit and what brings harm? What leads to life and what to failure? Qibo said: Following the natural order leads to life; opposing it leads to failure. Knowing how to regulate brings benefit; not knowing how to regulate brings harm. Huangdi said: What are the patterns of reversal in the Four Seas? Qibo said: If the Sea of Qi has excess, there is Qi fullness in the chest, panting, and redness of the face. If the Sea of Qi is deficient, there is shortness of breath and inability to speak. If the Sea of Blood has excess, one often feels their body is large, feeling stifled without knowing where the illness lies. If the Sea of Blood is deficient, one often feels their body is small, feeling confined without knowing where the illness lies. If the Sea of Water and Grain has excess, there is abdominal fullness. If the Sea of Water and Grain is deficient, there is hunger but an inability to accept food. If the Sea of Marrow has excess, the body feels light and energetic, exceeding normal limits. If the Sea of Marrow is deficient, there is dizziness, tinnitus, soreness of the calves, vertigo, blindness, lassitude, and a desire to lie still. Huangdi said: I have heard of the patterns of reversal and compliance. How should they be regulated? Qibo said: Carefully observe and treat their Shu points to tonify deficiency and reduce excess, without causing harm. Those who follow the order will recover; those who oppose it will fail. Huangdi said: Excellent.
The layout is orderly and leisurely, and the brushwork is clear and elegant. Like the chapters *Ben Shen* and *Jue Qi*, this chapter describes internal injury syndromes. However, its depiction here is particularly exquisite.