黄帝问曰∶脉度言经脉之长短,何以立之?伯高对曰∶先度其骨节之大小广狭长短
,而脉度定矣。曰∶人长七尺五寸者,其骨节之大小长短知各几何?曰∶头(一作颈)之
骨围二尺六寸,胸围四尺五寸,腰围四尺二寸。发所覆者颅,至项一尺二寸,发以下至颐长
一尺,君子参(又作三,又作终)折。结喉以下至缺盆中长四寸,缺盆以下至 长
九寸,过则肺大,不满则肺小。 以下至天枢长八寸,过则胃大,不及则胃小
。天枢以下至横骨长六寸半,过则回肠广长,不满则狭短。横骨长六寸半,横骨上廉以下至
内辅之上廉长一尺八寸,内辅之上廉以下至下廉长三寸半,内辅下廉至内踝长一尺三寸,内
踝以下至地长三寸,膝 以下至跗属长一尺六寸,跗属以下至地长三寸,故骨围大则
太过,小则不及。角以下至柱骨长一尺(一作寸),行腋中不见者长四寸,腋以下至季胁长
一尺二寸,季胁以下至髀枢长六寸,髀枢以下至膝中长一尺九寸,膝以下至外踝长一尺六
寸,外踝以下至京骨长三寸,京骨以下至地长一寸。耳后当完骨者广九寸,耳前当耳
门者广一尺二寸。(一作三寸。)两颧之间广九寸半(《九墟》作七寸),两乳之间广九寸
半,两髀之间广六寸半。足长一尺二寸,广四寸半。肩至肘长一尺七寸,肘至腕长一尺
二寸半,腕至中指本节长四寸,本节至其末长四寸半。项发以下至脊骨长三寸半(一作
二寸),脊骨以下至尾 二十一节长三尺,上节长一寸四分分之七奇分之一,奇分在下
,故上七节下至膂骨,九寸八分分之七。此众人骨之度也。所以立经脉之长短也。是故视其
经脉之在于身也,其见浮而坚,其见明而大者多血,细而沉者多气,乃经之长短也。
曰∶愿闻六腑传谷者,肠胃之大小长短,受谷之多少奈何?曰∶谷之所从出入浅深远近
长短之度,唇至齿长九分,广二寸半。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。咽门重十两,广二寸半,至胃长一尺六寸。胃纡曲屈,伸之长二尺六寸,
大一尺五寸,径五寸,大容三(一作二)斗五升。小肠后附脊,左环回周叶(一作迭,下同)积
,其注于回肠者,外附于脐上回运环反十六曲,大二寸半,径八分分之少半,长三丈二尺
(一作三尺)。回肠当脐左环回周叶积而下,回运环反十六曲,大四寸,径一寸寸之少半,长
二丈一尺。广肠附(一作传)脊以受回肠,左环叶积(一作脊)上下僻,大八寸,径二寸
寸之大半,长二尺八寸。肠胃所入至所出,长六丈四寸四分,回曲环反三十二曲。
曰∶人不食七日而死者何也?曰∶胃大一尺五寸,径五寸,长二尺六寸,横屈受水谷
三斗五升。其中之谷常留者二斗,水一斗五升而满。上焦泄气,出其精微, 悍滑疾。下
焦下溉,泄诸小肠。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,胃满肠虚,肠
满则胃虚,更满更虚,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。故肠胃之中常留谷二斗四升,水一斗五升。故人一日再至后,后二升半,一日中五升。
五七三斗五升,而留水谷尽矣。故平人不饮不食七日而死者,水谷精气津液皆尽,故七日
死矣。
黄帝问道:《脉度》篇中论述了经脉的长短,依据什么来确定呢?伯高回答说:先测量人体骨节的大小、宽窄和长短,那么经脉的长度也就确定了。
黄帝说:身高七尺五寸的人,他的骨节大小长短各是多少呢?
伯高回答说:头骨的周长是二尺六寸,胸围四尺五寸,腰围四尺二寸。头发覆盖的头颅部分,从后项到发际线长一尺二寸,从发际线以下到下巴长一尺,这是中等身材者的标准尺寸。喉结以下至缺盆(锁骨上窝)长四寸,如果超过这个长度则肺大,不足则肺小。缺盆以下至鸠尾(剑突)长九寸,如果超过则胃大,不足则胃小。鸠尾以下至天枢穴(脐旁两寸)长八寸,如果超过则回肠宽大且长,不足则狭短。天枢以下至横骨(耻骨联合)长六寸半,如果超过则回肠宽大且长,不足则狭短。横骨长六寸半,从横骨上缘至内侧辅骨(胫骨内髁)上缘长一尺八寸,从内侧辅骨上缘至下缘长三寸半,从内侧辅骨下缘至内踝长一尺三寸,从内踝至地面长三寸,从膝腘窝下方至足背关节处长一尺六寸,从足背关节处至地面长三寸。所以骨围过大则太过,过小则不及。
从耳角(听宫穴附近)至柱骨(第七颈椎棘突)长一尺,沿腋中线不可见的部分长四寸,从腋下至季胁(第十二肋骨端)长一尺二寸,从季胁至髀枢(股骨大转子)长六寸,从髀枢至膝中长一尺九寸,从膝下至外踝长一尺六寸,从外踝至京骨(第五跖骨基底部)长三寸,从京骨至地面长一寸。
耳后当完骨(乳突)处的宽度为九寸,耳前当耳门处的宽度为一尺二寸。两颧骨之间的宽度为九寸半,两乳头之间的宽度为九寸半,两大腿内侧之间的距离为六寸半。脚长一尺二寸,宽四寸半。肩至肘长一尺七寸,肘至腕长一尺二寸半,腕至中指本节(掌指关节)长四寸,本节至指尖长四寸半。
颈后发际以下至脊骨长三寸半,脊骨以下至尾骶骨共二十一节,总长三尺。每一节长一寸又十四分之七,加上奇分在下,所以上面七节至膂骨(脊柱两旁肌肉)长九寸又十四分之七。这是普通人骨骼的尺寸,也是确立经脉长短的依据。因此观察身上的经脉,如果浮露而坚实,明亮而粗大的,多血;细小而沉隐的,多气,这就是经脉的长短情况。
黄帝说:我想听听六腑传导谷物的情况,肠胃的大小长短,以及容纳谷物的多少是怎样的?
伯高回答说:谷物出入的深浅远近长短的尺寸是:唇至齿长九分,宽二寸半。牙齿以后至会厌,深三寸半,容量可容纳五合。舌头重十两,长七寸,宽二寸半。咽门重十两,宽二寸半,至胃长一尺六寸。胃迂曲屈折,伸直后长二尺六寸,大一尺五寸,直径五寸,容量可容纳三斗五升。小肠后附于脊柱,向左环绕重叠堆积,注入回肠的部分,外附于脐上,回转环反十六曲,大一寸半,直径八分分之少半(约2.67分),长三丈二尺。回肠正当脐部左侧,环绕重叠堆积向下,回转环反十六曲,大四寸,直径一寸寸之少半(约1.33寸),长二丈一尺。广肠(大肠下部)附着于脊柱以接受回肠,向左环绕重叠堆积,上下偏斜,大四寸,直径二寸寸之大半(约2.67寸),长二尺八寸。肠胃从入口到出口,总长六丈四寸四分,回转环反三十二曲。
黄帝说:人七天不吃饭就会死,为什么呢?
伯高回答说:胃大一尺五寸,径五寸,长二尺六寸,弯曲容纳水谷三斗五升。其中常留存的谷物有二斗,水有一斗五升,这样就满了。上焦宣发气机,排出精微物质,其气剽悍滑疾。下焦向下灌溉,渗泄至各小肠。小肠大一寸半,径八分分之少半,长三丈二尺,受纳谷物二斗四升,水六升三合又大半合。回肠大四寸,径一寸寸之少半,长二丈一尺,受纳谷物一斗,水七升半。广肠大四寸,径二寸寸之大半,长二尺八寸,受纳谷物九升三合又八分之一合。肠胃的总长度为五丈八尺四寸,受纳水谷九斗二升一大半合,这是肠胃所能承受的水谷数量。
正常人的情况则不同,胃满时肠虚,肠满时胃虚,更替充满和排空,所以气机能上下运行,五脏安定,血脉调和通畅,精神才能安居,所以说神是水谷的精气。因此肠胃之中常留存谷物二斗四升,水一斗五升。所以人一天两次排便,每次排出二升半,一天共排出五升。七天就是三斗五升,这样留存的水谷就排尽了。所以正常人七天不饮不食就会死亡,因为水谷精气津液都耗尽了,所以七天就会死。
Huangdi asked, saying: The "Mai Du" (Measure of Vessels) chapter discusses the length and shortness of the meridians; on what basis are they established? Bogao replied: First measure the size, breadth, and length of the bone joints, and then the length of the vessels will be determined.
Huangdi said: For a person seven chi five cun in height, what are the respective sizes and lengths of their bone joints?
Bogao replied: The circumference of the skull is two chi six cun, the chest circumference is four chi five cun, and the waist circumference is four chi two cun. The hair-covered cranium extends from the nape to the hairline for one chi two cun, and from the hairline down to the chin is one chi; this is the standard measurement for an average adult. From the laryngeal prominence below to the Quepen (Supraclavicular Fossa) is four cun; if it exceeds this, the Lung is large; if less, the Lung is small. From Quepen below to the Jiuwei (Xiphoid Process) is nine cun; if it exceeds this, the Stomach is large; if less, the Stomach is small. From Jiuwei below to the Tianshu point (two cun lateral to the umbilicus) is eight cun; if it exceeds this, the Ileum is wide and long; if less, it is narrow and short. From Tianshu below to the Henggu (Pubic Symphysis) is six chi half cun; if it exceeds this, the Ileum is wide and long; if less, it is narrow and short. The Henggu is six chi half cun long. From the upper border of the Henggu to the upper border of the medial epicondyle of the tibia is one chi eight cun; from the upper border of the medial epicondyle to its lower border is three chi half cun; from the lower border of the medial epicondyle to the medial malleolus is one chi three cun; from the medial malleolus to the ground is three cun; from below the popliteal fossa to the dorsum of the foot joint is one chi six cun; from the dorsum of the foot joint to the ground is three cun. Therefore, if the bone circumference is too large, it is excessive; if too small, it is insufficient.
From the ear angle near Tinggong to the Zhu Gu (C7 Spinous Process) is one chi; the part running through the axilla that is not visible is four cun; from the axilla to the Ji Xie (end of the 12th rib) is one chi two cun; from the Ji Xie to the Bi Shu (Greater Trochanter) is six cun; from the Bi Shu to the middle of the knee is one chi nine cun; from below the knee to the lateral malleolus is one chi six cun; from the lateral malleolus to the Jing Gu (Base of the 5th Metatarsal) is three cun; from the Jing Gu to the ground is one cun.
The width behind the ear at the Wan Gu (Mastoid Process) is nine cun; the width in front of the ear at the Er Men is one chi two cun. The width between the two Zhen bones (Cheekbones) is nine chi half cun; the width between the two nipples is nine chi half cun; the width between the two thighs is six chi half cun. The foot is one chi two cun long and four chi half cun wide. From the shoulder to the elbow is one chi seven cun; from the elbow to the wrist is one chi two chi half cun; from the wrist to the base joint of the middle finger (Metacarpophalangeal Joint) is four cun; from this joint to the tip is four chi half cun.
From the back of the neck hairline to the spinal bone is three chi half cun; from the spinal bone to the coccyx, consisting of twenty-one segments, is three chi. Each segment is one chi plus seven-fourteenths, with the fractional part below; thus, the upper seven segments down to the Lv Gu (Muscles alongside the spine) are nine chi plus seven-fourteenths. These are the measurements of the bones of ordinary people, which serve as the basis for establishing the lengths of the meridians. Therefore, observing the meridians in the body, those that appear floating and firm, bright and large, contain much blood; those that are thin and deep contain much Qi; these are the lengths of the meridians.
Huangdi said: I wish to hear about the transmission of grain by the Six Fu Organs; what are the sizes and lengths of the stomach and intestines, and how much grain can they hold?
Bogao replied: The dimensions of the entry and exit of grain, including depth, distance, and length, are as follows: From the lips to the teeth is nine fen, and two chi half cun wide. From the teeth to the Epiglottis, the depth is three chi half cun, with a capacity of five he. The tongue weighs ten liang, is seven cun long, and two chi half cun wide. The pharynx gate weighs ten liang, is two chi half cun wide, and one chi six cun long to the Stomach. The Stomach is tortuous; when straightened, it is two chi six cun long, one chi five cun wide, five cun in diameter, and has a capacity of three dou five sheng. The Small Intestine attaches posteriorly to the spine, looping left and overlapping; the part entering the Ileum attaches externally above the umbilicus, looping back sixteen times, one chi half cun wide, with a diameter of slightly less than one-third of a fen (approx. 2.67 fen), and three zhang two chi long. The Ileum loops around the left side of the umbilicus, overlapping downward, looping back sixteen times, four cun wide, with a diameter of slightly less than one-third of a cun (approx. 1.33 cun), and two zhang one chi long. The Large Intestine (Guang Chang) attaches to the spine to receive the Ileum, looping left and overlapping, slanting up and down, eight cun wide, with a diameter of slightly more than two-thirds of a cun (approx. 2.67 cun), and two chi eight cun long. The total length of the gastrointestinal tract from entry to exit is six zhang four chi four cun, with thirty-two curves.
Huangdi said: Why does a person die after seven days without food?
Bogao replied: The Stomach is one chi five cun wide, five cun in diameter, and two chi six cun long, curving to hold three dou five sheng of water and grain. Normally, it retains two dou of grain and one dou five sheng of water, which fills it. The Upper Jiao disperses Qi, releasing essence and subtle nutrients; its Qi is vigorous, slippery, and rapid. The Lower Jiao irrigates downward, draining into the various Small Intestines. The Small Intestine is one chi half cun wide, with a diameter of slightly less than one-third of a fen, and three zhang two chi long; it receives two dou four sheng of grain and six sheng three he plus half-he of water. The Ileum is four cun wide, with a diameter of slightly less than one-third of a cun, and two zhang one chi long; it receives one dou of grain and seven sheng half of water. The Large Intestine is eight cun wide, with a diameter of slightly more than two-thirds of a cun, and two chi eight cun long; it receives nine sheng three he plus one-eighth-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 plus half-he of water and grain; this is the quantity of water and grain the gastrointestinal tract can hold.
However, a healthy person is different: when the Stomach is full, the Intestines are empty; when the Intestines are full, the Stomach is empty. They alternate in filling and emptying, allowing Qi to circulate up and down, keeping the Five Zang Organs stable, the Blood Vessels harmonious and smooth, and allowing Spirit to reside. Thus, Spirit is the essence-qi of water and grain. Therefore, the stomach and intestines normally retain two dou four sheng of grain and one dou five sheng of water. A person defecates twice a day, expelling two chi half sheng each time, totaling five sheng per day. Over seven days, this amounts to three dou five sheng, exhausting the retained water and grain. Thus, a healthy person who does not drink or eat for seven days dies because the essence-qi and fluids of water and grain are exhausted; hence, death occurs after seven days.