咽下胃之一物，在禽名曰嗉，在兽名曰肚，在人名曰胃。古人画胃图，上口在胃上，名
曰贲门。下口在胃下，名曰幽门。言胃上下两门，不知胃是三门。画胃竖长，不知胃是横长
，不但横长，在腹是平铺卧长。上口贲门向脊，下底向腹。下口幽门亦在胃上，偏右胁向脊
。幽门之左寸许，另有一门，名曰津门。津门上有一管，名曰津管，是由胃出精汁水液之道
路
正盖津门。总提下，前连气府接小肠，后接提大肠；在胃上，后连肝，肝连脊，此是膈膜以
下，总提连贯胃肝大小肠之体质。饮食入胃，食留于胃，精汁水液，先由津门流出入津管。
津管寸许，外分三杈。精汁清者，入髓府化髓。精汁浊者，由上杈卧则入血府，随血化血。
其水液，由下杈从肝之中间，穿过入脾。脾中间有一管，体相玲珑，名曰珑管。水液由珑管
分流两边，入出水道。出水道形如鱼网，俗名网油。水液由出水道渗出，沁入膀胱，化而为
尿。出水道出水一段，体查最难。自嘉庆二年看脏腑时，出水道有满水铃铛者，有无水铃铛
者，于理不甚透彻。以后诊病，查看久病寿终之人，临时有多饮水者，有少饮水者，有不饮
水者，故后其水仍然在腹。以此与前所看者参考，与出水道出水一节，虽然近理，仍不敢为
定准。后以畜较之，遂喂遂杀之畜，网油满水铃铛，三四日不喂之畜，杀之无水铃铛，则知
出水道出水无疑。前言饮食入胃，食留于胃，精汁水液，自津门流出。津门既孔如箸大，能
向外流精汁水液，稀粥岂不能流出？津门虽孔如箸大，其处胃体甚浓，四围靠挤缩小，所以
水能出而食不能出。况胃之内，津门之左一分远有一疙瘩，形如枣大，名曰遮食，乃挡食放
水之物，待精汁水液流尽，食方腐熟，渐入小肠，化而为粪。小肠何以化食为粪？小肠外有
气府，气府气抱小肠，小肠外、气府内，乃存元气之所，元气化食。此处与前气府参看。化
粪入大肠，自肛门出。此篇记精汁由胃出津门，生精生血；水液由珑管出水道，入膀胱为尿
；食由胃入小肠，元气蒸化为粪之原委也。
咽下进入胃中的食物，在鸟类中称为嗉囊，在兽类中称为肚，在人类中称为胃。古人绘制胃的解剖图时，将胃的上口画在上方，命名为贲门；将胃的下口画在下方，命名为幽门。他们只提到胃有上下两个门户，却不知道胃实际上有三个门户。古人将胃画成竖直细长的形状，却不知道胃实际上是横向长形的，而且不仅是横长，它在腹腔内是平铺卧着的。胃的上口贲门朝向脊柱，胃的底面朝向腹部。胃的下口幽门也位于胃的上部，偏向右侧胁肋并朝向脊柱。在幽门左侧约一寸处，另外有一个门户，名为津门。津门上方有一根管道，名为津管，这是从胃排出精汁和水液的通道。
总提（指连接各脏腑的组织结构）下方，前方连接气府并与小肠相接，后方连接大肠；它位于胃的上方，后方连接肝脏，肝脏连接脊柱，这是膈膜以下，总提连贯胃、肝、大小肠等器官实体的组织结构。饮食进入胃中，食物停留在胃里，其中的精汁和水液，首先通过津门流出进入津管。津管长约一寸多，向外分出三个分支。其中清稀的精汁，进入髓府转化为骨髓；浑浊的精汁，通过上方的分支，当人躺卧时进入血府，随着血液转化为血液。那些水液，通过下方的分支，从肝脏中间穿过进入脾脏。脾脏中间有一根管道，形态玲珑剔透，名为珑管。水液通过珑管分流到两侧，进入出水道。出水道的形状像鱼网，俗称网油。水液通过出水道渗出，浸润进入膀胱，转化为尿液。观察出水道排出的这一段过程，是最难查证的。自从嘉庆二年我开始观察人体脏腑以来，发现出水道有的像装满水的铃铛，有的像没有水的铃铛，对此原理理解尚不透彻。后来在诊治病人时，我查看那些久病去世的人，临终前有多喝水的，有少喝水的，也有不喝水的，因此死后腹中仍有积水。以此与之前所观察到的情况进行参考，虽然这与出水道排水一节的情况在道理上相近，但仍不敢将其作为确定的定论。后来通过与牲畜进行对比，随即喂养随即宰杀的牲畜，其网油部分充满像装满水的铃铛一样的液体；而三四天不喂养的牲畜，宰杀后则没有这种像没水的铃铛一样的现象，由此可知出水道排水是确凿无疑的。
前面说过饮食进入胃中，食物留在胃里，精汁和水液从津门流出。津门的孔径虽然只有筷子粗细，既然能向外流出精汁和水液，那么稀粥难道不能流出吗？津门虽然孔径如筷子粗，但该处的胃体组织非常厚实，四周挤压收缩使孔道变小，所以水能流出而固体食物不能流出。况且在胃内部，距离津门左边一分远的地方有一个疙瘩，形状像枣核一样大，名为遮食，它是阻挡食物、允许水流通过的物体。等到精汁和水液流尽之后，食物才开始腐熟，逐渐进入小肠，转化为粪便。小肠为什么能将食物转化为粪便呢？因为小肠外部有气府，气府的气包裹着小肠，在小肠外部、气府内部，是储存元气的地方，元气负责消化食物。此处需与前文提到的气府相互参照。食物转化为粪便进入大肠，最后从肛门排出。本篇记载了精汁由胃经津门流出，生成精气与血液；水液由珑管经出水道进入膀胱成为尿液；食物由胃进入小肠，由元气蒸化转化为粪便的完整过程。
The food swallowed and entering the stomach is called "su" (crop) in birds, "du" (stomach/abomasum) in beasts, and "wei" (stomach) in humans. In ancient anatomical drawings of the stomach, the upper opening was depicted at the top of the stomach and named *Benmen* (Cardia). The lower opening was depicted at the bottom and named *Youmen* (Pylorus). They spoke of two gates, upper and lower, in the stomach, unaware that the stomach actually has three gates. The stomach was drawn as vertically elongated, unaware that it is horizontally elongated; not only is it horizontal, but it lies flat within the abdominal cavity. The upper opening, Benmen, faces the spine, while the base of the stomach faces the abdomen. The lower opening, Youmen, is also located on the upper part of the stomach,偏 towards the right hypochondrium and facing the spine. Approximately one cun to the left of Youmen, there is another gate named *Jinmen* (Fluid Gate). Above Jinmen is a tube named *Jinguan* (Fluid Tube), which is the pathway for fluid essence and water to exit the stomach.
Below the *Zongti* (General Connector, referring to the connective tissue linking organs), anteriorly it connects with the *Qifu* (Qi Mansion) and joins the small intestine; posteriorly it connects with the large intestine. Located above the stomach, it posteriorly connects with the liver, and the liver connects to the spine. This constitutes the physical structure below the diaphragm, where the Zongti links the solid tissues of the stomach, liver, and intestines. When food and drink enter the stomach, the food remains in the stomach, while the fluid essence and water first flow out through Jinmen into Jinguan. Jinguan is about one cun long and divides externally into three branches. The clear portion of the fluid essence enters the *Sui Fu* (Marrow Mansion) to transform into marrow. The turbid portion of the fluid essence, via the upper branch, enters the *Xue Fu* (Blood Mansion) when lying down, transforming into blood along with the blood. The water portion passes through the middle of the liver via the lower branch and enters the spleen. Within the center of the spleen is a tube with a delicate, intricate structure, named *Longguan* (Exquisite Tube). The water flows from Longguan, dividing to both sides, and enters the *Chushuidao* (Water Outlet Channel). Chushuidao resembles a fish net, commonly known as "Wangyou" (Net Oil). Water渗ates through Chushuidao, infiltrates into the bladder, and transforms into urine. Examining this section of water discharge from Chushuidao is the most difficult. Since observing human viscera in the second year of the Jiaqing era, I have seen Chushuidao appearing like a bell full of water or empty of water, yet the principle remained unclear. Later, in diagnosing patients, I examined individuals who died of chronic illness; some drank heavily before death, some little, and some not at all, yet water remained in the abdomen afterward. Comparing this with previous observations, although this aligns closely with the theory of water discharge from Chushuidao, I dared not accept it as an absolute certainty. Subsequently, by comparing with livestock, animals slaughtered immediately after feeding had nets filled with watery bells, whereas animals not fed for three to four days had no such empty bells upon slaughter. Thus, the water discharge from Chushuidao was confirmed.
As stated previously, food enters the stomach and stays there, while fluid essence and water flow out from Jinmen. Although the aperture of Jinmen is only as wide as a chopstick, if it can expel fluid essence and water, why could it not expel thin porridge? Although the aperture is chopstick-wide, the gastric tissue at this site is very thick, and the surrounding walls compress to narrow the passage, allowing water to exit but preventing solid food from passing. Furthermore, inside the stomach, one fen to the left of Jinmen, there is a lump shaped like a date pit, named *Zheshi* (Food Blocker), which serves to block food while allowing water to pass. Only after the fluid essence and water have flowed out does the food begin to rot and ripen, gradually entering the small intestine to transform into feces. Why does the small intestine transform food into feces? Because outside the small intestine is the Qifu; the Qi of Qifu envelops the small intestine. Between the exterior of the small intestine and the interior of Qifu lies the reservoir of Yuan Qi (Original Qi), which digests the food. Refer to the earlier mention of Qifu here. The transformed feces enter the large intestine and are expelled from the anus. This chapter records the complete process: fluid essence exits the stomach via Jinmen to generate essence and blood; water flows via Longguan and Chushuidao into the bladder to become urine; and food enters the small intestine from the stomach, where Original Qi steams and transforms it into feces.