四十难曰。经言肝主色。
虞曰。肝、木也。木之华萼。敷布五色。故主色也。
心主臭。
虞曰。心火也。火之化物。五臭出焉。是故五臭心独主之也。
脾主味。
虞曰。脾、土也。土甘。甘受味。故主味。礼云。甘受和味。此义也。
肺主声。
虞曰。肺金也。金击之有声。故五音皆出于肺也。
肾主液。
虞曰。肾、水也。水流湿。主液也。
鼻者肺之候。而反知香臭。耳者、肾之候。而反闻声。其意何也。然。肺者、西方金也。金生于巳。巳者、南方火
也。火者心。心主臭。故令鼻知香臭。肾者北方水也。水生于申。申者、西方金。金者肺。肺主声。故令耳闻声。
杨曰。五行有相因成事。有当体成事者。至如肺肾二脏。相因成也。其余三脏。自成之也。
四十一难曰。肝独有两叶。以何应也。然。肝者、东方木也。木者、春也。
虞曰。在五常木法春。应仁。故云木者春也。人之仁发用也。
万物始生。其尚幼小。
虞曰。肝、木足厥阴。配胆木足少阳。少阳之至。乍大乍小。乍短乍长。故云幼少。
意无所亲。
虞曰。木者、应春法仁。施恩无求报。不以亲而施化育。故曰意无所亲。
去太阴尚近。
虞曰。十二经相注。足厥阴还复注手太阴。故曰。去太阴尚近也。
离太阳不远。
虞曰。本经言足厥阴少阳木。生手太阳少阴火。故云离太阳不远。则此义也。
犹有两心。
虞曰。犹如也。如有两心者。谓注于太阴。有畏金之心。生于太阳。有生火之心。故云犹有两心。
故有两叶。亦应木叶也。
杨曰。肝者据大叶言之。则是两叶也。若据小叶言之。则多叶矣。解在后章。丁曰。经言肝者、东方木也。应春万
物之所生。其尚幼小。然始生者。非长生也。谓木初受气。是言幼少也。意无所亲者。谓以失其父未识其母。故曰意无
所亲也。去太阴尚近太阴是七月。木始受气。离太阳不远也。太阳是六月。故言离太阳不远也。犹有两心者。为离太阳
恋太阴。有此离恋。故言两心也。所以肝有两叶。以应木叶也。
四十二难曰。人肠胃长短。受水谷多少。各几何。然。胃大一尺五寸。径五寸。长二尺六寸。横屈受水谷三斗五升。
其中常留谷二斗。水一斗五升。
杨曰。凡人食入于口而聚于胃。故经云。胃者、水谷之海。胃中谷熟。则传入小肠也。
小肠大二寸半。径八分分之少半。长三丈二尺。受谷二斗四升。水六升三合合之太半。
杨曰。小肠受胃之谷。而传入于大肠。分谷三分有二为太半。有一为少半。
回肠大四寸。径一寸半。长二丈一尺。受谷一斗。水七升半。
杨曰。回肠者、大肠也。受小肠之谷。而传入于广肠焉。虞曰。水谷自胃有三斗五升。传入小肠。则谷剩四升。水
少八升六合合之少半。又传入大肠。水谷之数。比之在胃各减一半。至此则水分入膀胱。谷传入肛门也。
广肠大八寸。径二寸半。(按下文云。径二寸大半。以围三径一约之。其数正合。此处脱大字。)长二尺八寸。受谷
九升三合八分合之一。
杨曰。广肠者。 肠也。一名肛门。受大肠之谷而传出。
故肠胃凡长五丈八尺四寸。合受水谷八斗七升六合八分合之一(按此数误。根据上文计之。当云九斗二升一合又二十
四分合之十九。)此肠胃长短受水谷之数也。
杨曰。据甲乙经言。肠胃凡长六丈四寸四分。所以与此不同者。甲乙经从口至 肠而数之。故长。此经从胃至肠
而数之。故短。亦所以互相发明。非有谬也。
肝重四斤四两。(按别本并作二斤四两。惟史记正义引作四斤四两。与此合。)左三叶。右四叶。凡七叶。
虞曰。肝足厥阴。配足少阳。少阳之次数于七。故有七叶。
主藏魂。
虞曰。魂者、神气之辅弼也。杨曰。肝者、干也。于五行为木。故其体状有枝干也。(按原本。其下衍于字。根据史记
正义引此文删。)肝神七人。老子名曰明堂宫、兰台府。从官三千六百人。又云肝神。六童子。三女人。又肝神名盖蓝。
心重十二两。中有七孔三毛。盛精汁三合。主藏神。
杨曰。心、纤也。(按原本。纤误作识。根据史记正义引此文改。下同。)言所识纤微。(按原本所下衍以字。根据史记正
义引此文删。)无物不贯也。又云。心、任也。言能任物也。其神九人。太尉公名绛宫大始。南极老人元先之身。(按史
记正义引此文元先作员光。)其从官三千六百人。又曰心为帝王。身之主也。心神又名 。虞曰。神者、精气之化成也。
脾重二斤三两。扁广三寸。长五寸。有散膏半斤。主裹血。温五脏。主藏意。
杨曰。脾、裨也。(按原本裨误作俾。根据史记正义引此文改。下同。)在胃之下。裨助胃气。主化水谷也。其神五人。
玄光玉女子母。其从官三千六百人。其脾神又名俾俾。
肺重三斤三两。六叶两耳。凡八叶。
虞曰。肺者、金之稽。兑之气。位居于酉。酉是八门。八叶之应。法于此也。
主藏魄。
杨曰。肺、勃也。言其气勃郁。(按史记正义引此下有故短二字。)也。其神八人。大和君名曰玉堂宫、尚书府。其
从官三升六百人。又云。肺神十四。童子七。女子七。(按此字根据史记正义补。)肺神又名鸣鸠。虞曰。魄者、精气之匡
辅也。
肾有两枚。重一斤一两。主藏志。
杨曰。肾、引也。肾属水。主引水气灌注诸脉也。其神六人。司徒。司宫、司命(按史记正义。宫作空。又司命下
有司录。)司隶、校尉、廷尉卿。肾神又名 。虞曰。专意不移者志。
胆在肝之短叶间。重三两三铢。盛精汁三合。
杨曰。胆、敢也。言其人有胆气果敢也。(按史记正义引此句无其字。)其神五人。太一道君。居紫房宫中。其从官
三千六百人。胆神又名灌灌。虞曰。胆者、中正之官。决断出焉。
胃重二斤二两。(按史记正义引作二斤十四两。)纡曲屈伸。长二尺六寸。大一尺五寸。径五寸。盛谷二斗。水一斗
五升。
杨曰。胃、围也。言围受食物也。其神十二人。五元之气谏议大夫。其胃神名且且。虞曰。胃为仓廪之官也。
小肠重二斤十四两。长三丈二尺。广二寸半。径八分分之少半。左回叠积十六曲。盛谷二斗四升。水六升三合合之
太半。
杨曰。肠、畅也。言通畅胃气。去滓秽也。其神二人。元梁使者。小肠神又名洁洁。虞曰。小肠为受盛之官。化物
出焉。
大肠重二斤十二两。长二丈一尺。广四寸。径一寸半。(按原本脱半字。根据史记正义引此句补。与前文合。)当齐右
回十六曲。盛谷一斗。水七升半。
杨曰。大肠、即回肠也。以其回曲。因以名之。其神二人。元梁使者。其神名涸涸。虞曰。大肠为传导之官。变化
出焉。
膀胱重九两二铢。纵广九寸。盛溺九升九合。
杨曰。膀、横也。胱、广也。言其体短而横广。又名胞。胞、 也。 者、空也。以需承水液焉。(史记正义引此文
云。胞、虚空也。主以虚承水液。)今人多以两胁下及小腹两边为膀胱。深为谬也。虞曰。膀胱为州都之官。津液藏焉。
口广二寸半。唇至齿长九分。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。
杨曰。舌者、泄也。言可舒泄言语也。(按原本舒泄下有于字。根据史记正义删。)虞曰。唇者、声之扇。舌者、声之
机。
咽门重十两。广二寸半。至胃长一尺六寸。
杨曰。咽、 也。言可以 物也。又谓之嗌。言气之流通 要之处也。咽为胃之系也。故经曰。咽主地气。胃为土。
故云主地气也。
喉咙重十二两。广二寸。长一尺二寸。九节。
杨曰。喉咙空虚也。言其中空虚。可以通气息焉。即肺之系也。呼吸之道路。故经云。喉主天气。肺应天。故云主
天气也。喉咙与咽并行。其实两异。而人多惑之。(按原本两作无。惑作感。并根据史记正义改正。)
肛门重十二两。大八寸。径二寸大半。长二尺八寸。受谷九升二合八分合之一。
杨曰。肛、 也。言其处似车 形。故曰肛门。即广肠也。又言 肠。丁曰。前肠胃径围。
一尺五寸径五寸者、即是围三径一也。小肠径八分。大二寸四分则是也。今言二寸半。即分之少半。回肠径一寸半。即
大四寸五分。今言大四寸。即少五分也。广肠径二寸半。即大七寸五分。今言八寸。即有剩五分也。其升斗寸尺者。先
立其尺。然后造其升斗秤两。皆以同身寸之为法。以尺造斗。斗面阔一尺。底阔七寸。高四寸。俱浓三分。可容十升。
凡以木此指节者。方一寸为两。十六两为斤。此制同身寸尺升斗之度。为人之肠胃斤重长短之法也。
四十三难曰。人不食饮。七日而死者。何也。然。人胃中常有留谷二斗。水一斗五升。故平人日再至圊。一行二升
半。日中五升。七日五七三斗五升。而水谷尽矣。故平人不食饮七日而死者。水谷津液俱尽。即死矣。
丁曰。人受气于谷以养其神。水谷尽即神去。故安谷者生。绝谷者死也。杨曰。胃中常留水谷三斗五升。人既不食
饮。而日别再圊。便一日五升。七日之中。五七三斗五升。胃中水谷俱尽。无气以生。故死焉。圊、厕也。虞曰。人受
气于谷。今不食饮七日。是知水谷气尽即死也。
四十四难曰。七冲门何在。然。唇为飞门。齿为户门。会厌为吸门。胃为贲门。太仓下口为幽门。大肠小肠会为阑
门。下极为魄门。故曰七冲门也。
丁曰。经言唇为飞门者、取动之义也。齿为户门者、为关键开合。五谷由此摧废出入也。会厌为吸门者、咽喉为水
谷下时厌按呼吸也。胃为贲门者、胃言若虎贲之士。围达之象。故曰贲门也。况胃者、围也。主仓廪、故别名太仓。其
下口者、即肠口是也。大肠小肠会为阑门。会者合也。大肠小肠合会之处。分阑水谷精血。各有所归。故曰阑门也。下
极为魄门。大肠者、肺之腑也。藏其魄。大肠下名肛门。又曰魄门也。杨曰。人有七窍。是五脏之门户。皆出于面。今
七冲门者。亦是脏腑之所。出而内外兼有证焉。飞门者、脾气之所出也。脾主于唇为飞门也。飞者动也。言唇受水谷。
动转入于内也。齿为户门者、口齿心气之所出也。在心为志。退场门为言。故齿为心之门户。亦取摧伏五谷传入于口也。
会厌为吸门者、会厌为五脏音声之门户。故云会厌为吸门也。胃为贲门。贲者、膈也。胃气之所出也。胃出谷气以传于
肺。肺在膈上。故以胃为贲门也。太仓下口为幽门者。肾气之所出也。太仓者、胃也。胃之下口。在齐上三寸。既幽隐
之处。故曰幽门。大肠小肠会为阑门。阑门者、遗失之义也。言大小二肠皆输泻于广肠。广肠既受传而出之。是遗失之
意也。故曰阑门。下极为魄门。魄门者、下极肛门也。肺气上通喉咙。下通于肛门。是肺气之所出也。肺藏魄。故曰魄
门焉。冲者、通也。出也。言脏腑之气通出之所也。
四十五难曰。经言八会者。何也。然。腑会太仓。
丁曰。腑会太仓者、胃也。其穴者、中脘是也。虞曰。太仓在心前鸠尾下四寸是也。足阳明胃脉、手太阳小肠脉、
手少阳三焦脉、任脉之会。本名中脘。此云太仓也。即胃之募也。胃化气养大腑。故云会。
脏会季胁。
丁曰。脏会季胁。软筋之名。其端有穴。直脐章门穴。是脾之募。足厥阴少阳所会。故曰脏会季胁也。虞曰。是章
门穴。乃脾之募也。直齐季胁端侧卧。屈上足。伸下足。齐臂取之。乃足厥阴少阳之会也。
筋会阳陵泉。
丁曰。阳陵泉、穴名也。在膝下一寸外廉是也。虞曰。阳陵泉穴。在膝下宛宛中。足少阳胆脉气所发也。
髓会绝骨。
丁曰。髓会绝骨、是骨名也。其穴在外踝上四寸。阳辅穴是也。虞曰。绝骨、乃阳辅穴也。亦足少阳之脉气所出也。
血会鬲俞。
丁曰。血会鬲俞、穴名也。在第七椎下两旁。同身寸各一寸五分是也。虞曰。鬲俞二穴。在脊骨第七椎下两旁各一
寸五分。足太阳膀胱脉气所发也。
骨会大杼。脉会太渊。
丁曰。骨会大杼、穴名也。在项后第一椎两旁相去同身寸一寸五分。脉会太渊穴。在右寸内鱼际下。虞曰。大杼亦
足太阳脉。气所发。在脊第一椎两旁各一寸五分。太渊在手鱼际间。应手动脉。则手太阴之脉气所发也。
气会三焦外一筋直两乳内也。热病在内者。取其会之气穴也。
丁曰。气会三焦外一筋直两乳内者、膻中穴是也。此者是成会之穴所在也。杨曰。人脏腑筋骨髓血脉气。此八者。
皆有会合之穴。若热病在于内。则于外取其所会之穴以去其疾也。季胁、章门穴也。三焦外一筋直两乳内者、膻中穴也。
余皆可知也。
四十六难曰。老人卧而不寐。少壮寐而不寤者。何也。然。经言少壮者。血气盛。肌肉滑。气道通。荣卫之行。不
失于常。故昼日精、夜不寤。(别本有也字。与下文一例。)老人血气衰。肌肉不滑。荣卫之道涩。故昼日不能精。夜不
得寐也。故知老人不得寐也。
第四十难说:医经上讲,肝主管颜色。
虞氏解释说:肝属木。木的花萼,铺展分布出青、赤、黄、白、黑五种颜色。所以肝主管颜色。
心主管气味。
虞氏解释说:心属火。火能化生万物,五臭(焦、香、腥、臊、腐)由此产生。因此,五臭由心单独主管。
脾主管味道。
虞氏解释说:脾属土。土味甘。甘味能够调和各种味道。所以脾主管味道。《礼记》说:“甘味能够调和五味。”说的就是这个道理。
肺主管声音。
虞氏解释说:肺属金。金属被敲击会发出声响。所以五音都出于肺。
肾主管津液。
虞氏解释说:肾属水。水往湿处流。所以肾主管津液。
鼻是肺的外候,却反而能辨别香臭;耳是肾的外候,却反而能听到声音。这是什么意思呢?回答说:肺属西方金。金生于巳时。巳时属南方火。火对应心。心主管气味。所以使鼻子能辨别香臭。肾属北方水。水生于申时。申时属西方金。金对应肺。肺主管声音。所以使耳朵能听到声音。
杨氏说:五行中有相互因应而成就事物的,有在本体自身就成就事物的。至于肺和肾两脏,是相互因应而成就的。其余三脏,是自身独立成就的。
第四十一难说:肝脏唯独有两叶,这是与什么相应呢?回答说:肝属东方木。木对应春季。
虞氏解释说:在五常中,木对应春季,顺应仁德。所以说木对应春季。这是人仁爱之心的发用表现。
万物刚开始生长,尚且幼小。
虞氏解释说:肝属足厥阴木,配胆属足少阳木。少阳之气,有时大有时小,有时短有时长。所以说是幼小。
意念没有亲疏之分。
虞氏解释说:木对应春季,效法仁德。施恩惠不求回报。不因亲近而施加化育之功。所以说是意念没有亲疏之分。
距离太阴经还近。
虞氏解释说:十二经脉气血流注,足厥阴肝经最后回流注入手太阴肺经。所以说距离太阴经还近。
距离太阳经不远。
虞氏解释说:本经讲足厥阴、足少阳木,生出手太阳、手少阴火。所以说距离太阳经不远。这就是这个意思。
就像有两颗心。
虞氏解释说:犹如的意思。好像有两颗心,是指注入太阴经时,有畏惧金的心理;生于太阳经时,有生火的心理。所以说是像有两颗心。
所以有两叶,也对应木叶的形状。
杨氏说:肝脏如果按大的叶片来说,就是两叶。如果按小的叶片来说,那就有很多叶了。解释在后面章节。丁氏说:医经讲肝属东方木,对应春天,是万物生长的地方。万物刚开始生长,尚且幼小。然而刚出生并不是长生,是说木刚刚接受元气,这就是所谓的幼小。“意念没有亲疏之分”,是说因为失去了父亲,不认识母亲,所以说是意念没有亲疏之分。“距离太阴经还近”,太阴是七月,木刚刚开始接受元气。“距离太阳经不远”,太阳是六月。所以说距离太阳经不远。“就像有两颗心”,是因为离开太阳经而依恋太阴经,有了这种离别的眷恋之情,所以说是两颗心。所以肝脏有两叶,以对应木叶的形状。
第四十二难说:人的肠胃长短,能容纳多少水谷,各是多少呢?回答说:胃大一尺五寸,直径五寸,长二尺六寸,弯曲部分能容纳水谷三斗五升。其中通常留有谷物二斗,水一斗五升。
杨氏说:凡人食物入口后聚集在胃里。所以医经说:胃是水谷的海洋。胃中的谷物煮熟后,就传入小肠。
小肠直径二寸半,半径八分又三分之一分,长三丈二尺,能容纳谷物二斗四升,水六升三合,加上大半合。
杨氏说:小肠接受胃里的谷物,然后传入大肠。将谷物分为三份,两份是大半,一份是少半。
回肠直径四寸,半径一寸半,长二丈一尺,能容纳谷物一斗,水七升半。
杨氏说:回肠就是大肠。接受小肠传来的谷物,然后传入广肠。虞氏说:水谷从胃出来有三斗五升,传入小肠后,谷物剩下四升,水减少八升六合,加上少半合。再传入大肠,水谷的数量,比在胃里时各减少一半。到了这里,水分渗入膀胱,谷物传入肛门。
广肠直径八寸,半径二寸半。(根据下文说,半径二寸大半,按照周长三倍于直径的比例计算,这个数值正好吻合。此处脱漏了一个“大”字。)长二尺八寸,能容纳谷物九升三合又八分之一合。
杨氏说:广肠就是直肠。又名肛门,接受大肠传来的谷物并排出体外。
所以肠胃总共长五丈八尺四寸,合计能容纳水谷八斗七升六合又八分之一合。(按此数字有误,根据上文计算,应当说是九斗二升一合又二十四分之十九合。)这就是肠胃长短及容纳水谷的数量。
杨氏说:根据《甲乙经》记载,肠胃总共长六丈四寸四分。所以与此不同的原因是,《甲乙经》是从口到直肠计算的,所以长。本经是从胃到直肠计算的,所以短。这也是互相阐明,并没有错误。
肝重四斤四两。(按其他版本都作二斤四两,只有《史记正义》引用作四斤四两,与此相合。)左边三叶,右边四叶,共七叶。
虞氏解释说:肝属足厥阴,配足少阳。少阳的序数在七。所以有七叶。
主藏魂。
虞氏解释说:魂是神气的辅佐。杨氏说:肝,即树干。在五行中属木,所以它的形体特征有枝干。(按原本多出一个“于”字,根据《史记正义》引用的此文删去。)肝神有七人,老子称为明堂宫、兰台府,随从官员三千六百人。又说肝神,有六个童子,三个女人。又说肝神名叫盖蓝。
心重十二两,中间有七个孔和三根毛,盛放精汁三合。主藏神。
杨氏说:心,即纤微。(按原本“纤”误作“识”,根据《史记正义》引用的此文改正,下同。)说的是所认识的细微之处。(按原本“所”下多出一个“以”字,根据《史记正义》引用的此文删去。)没有事物不能贯通。又说:心,即承担。说的是能承担万物。它的神有九人,太尉公名叫绛宫大始,南极老人元先之身。(按《史记正义》引用此文“元先”作“员光”。)他的随从官员三千六百人。又说心为帝王,身体的主宰。心神又名[缺字]。虞氏说:神是精气化生的成果。
脾重二斤三两,扁平宽三寸,长五寸,有散膏半斤。主包裹血液,温煦五脏。主藏意。
杨氏说:脾,即裨助。(按原本“裨”误作“俾”,根据《史记正义》引用的此文改正,下同。)在胃的下面,裨补助胃气,主要消化水谷。它的神有五人,玄光玉女子母,随从官员三千六百人。它的脾神又名俾俾。
肺重三斤三两,六叶两耳,共八叶。
虞氏解释说:肺是金的考核,兑卦的气,位居酉位。酉是八门,八叶的对应,效法于此。
主藏魄。
杨氏说:肺,即勃郁。说的是其气勃郁。(按《史记正义》引用此句下有“故短”二字。)它的神有八人,大和君名叫玉堂宫、尚书府,随从官员三千六百人。又说肺神十四人,童子七人,女子七人。(按此字根据《史记正义》补入。)肺神又名鸣鸠。虞氏说:魄是精气的匡正辅助。
肾有两个,重一斤一两。主藏志。
杨氏说:肾,即引导。肾属水,主引导水气灌注到各条经脉。它的神有六人,司徒、司宫、司命(按《史记正义》,“宫”作“空”。又在司命下有司录)、司隶、校尉、廷尉卿。肾神又名[缺字]。虞氏说:专心不移叫志。
胆在肝的短叶之间,重三两三铢,盛放精汁三合。
杨氏说:胆,即敢勇。说的是人有胆气果敢。(按《史记正义》引用此句没有“其”字。)它的神有五人,太一道君,居住在紫房宫中,随从官员三千六百人。胆神又名灌灌。虞氏说:胆是中正之官,决断由此产生。
胃重二斤二两。(按《史记正义》引用作二斤十四两。)迂曲屈伸,长二尺六寸,大一尺五寸,直径五寸,盛谷物二斗,水一斗五升。
杨氏说:胃,即围受。说的是环绕接受食物。它的神有十二人,五元之气谏议大夫。它的胃神名且且。虞氏说:胃是仓廪之官。
小肠重二斤十四两,长三丈二尺,宽二寸半,直径八分又三分之一分,向左回旋重叠积累十六个弯曲,盛谷物二斗四升,水六升三合,加上大半合。
杨氏说:肠,即通畅。说的是通畅胃气,去除渣滓污秽。它的神有二人,元梁使者。小肠神又名洁洁。虞氏说:小肠是受盛之官,化物由此产生。
大肠重二斤十二两,长二丈一尺,宽四寸,直径一寸半。(按原本脱漏“半”字,根据《史记正义》引用的此句补入,与前文相合。)正当脐部右侧回旋十六个弯曲,盛谷物一斗,水七升半。
杨氏说:大肠,即回肠。因为它回旋曲折,所以以此命名。它的神有二人,元梁使者。它的神名涸涸。虞氏说:大肠是传导之官,变化由此产生。
膀胱重九两二铢,纵广九寸,盛尿液九升九合。
杨氏说:膀,即横。胱,即广。说的是它的形体短而横广。又名胞。胞,即空虚。空者,空虚。用来承受水液。(《史记正义》引用此文说:胞,虚空也。主要用虚空来承受水液。)现在的人多把两胁下及小腹两边当作膀胱,这非常错误。虞氏说:膀胱是州都之官,津液藏在这里。
口宽二寸半,嘴唇到牙齿长九分,牙齿后面到会厌深三寸半,容量五合。舌头重十两,长七寸,宽二寸半。
杨氏说:舌,即泄。说的是可以舒展排泄言语。(按原本“舒泄”下有一个“于”字,根据《史记正义》删去。)虞氏说:唇是发声的扇子,舌是发声的机关。
咽门重十两,宽二寸半,到胃长一尺六寸。
杨氏说:咽,即吞咽。说的是可以吞咽食物。又叫嗌。说的是气流流通的关键之处。咽是胃的系带。所以医经说:咽主地气。胃属土。所以说主地气。
喉咙重十二两,宽二寸,长一尺二寸,有九个节。
杨氏说:喉咙空虚。说的是其中空虚,可以通气息。即肺的系带。呼吸的道路。所以医经说:喉主天气。肺应天。所以说主天气。喉咙与咽并行,其实两者不同,但很多人困惑它们。(按原本“两”作“无”,“惑”作“感”,并根据《史记正义》改正。)
肛门重十二两,宽八寸,直径二寸大半,长二尺八寸,容纳谷物九升二合又八分之一合。
杨氏说:肛,即车轴头。说的是那个地方像车轴头的形状。所以叫肛门。即广肠。又言直肠。丁氏说:前面的肠胃径围,一尺五寸直径五寸的,就是周长三倍于直径。小肠直径八分,大二寸四分正是如此。现在说直径二寸半,即半径八分又三分之一分。回肠直径一寸半,即大四寸五分。现在说直径四寸,即少五分。广肠直径二寸半,即大七寸五分。现在说直径八寸,即多出五分。那些升、斗、寸、尺,先确立尺的标准,然后制造升、斗、秤、两。都以同身寸为法则。用尺造斗,斗面阔一尺,底阔七寸,高四寸,壁厚三分,可容十升。凡是木头指节那样粗细,方一寸为一两,十六两为一斤。这种制度是同身寸、尺、升、斗的度量,作为人体肠胃重量、长短的方法。
第四十三难说:人不吃饭喝水,七天而死,为什么呢?回答说:人胃中通常留有谷物二斗,水一斗五升。所以普通人每天两次去厕所,一次排便二升半,一天五升。七天就是五乘以七等于三斗五升,水谷就排尽了。所以普通人不吃饭喝水七天而死,是因为水谷津液都耗尽了,人就死了。
丁氏说:人从谷物中接受气以滋养精神。水谷耗尽则精神离去。所以能安受谷气者生,断绝谷气者死。杨氏说:胃中通常留有水谷三斗五升。人既然不饮食,而每天两次去厕所,便一天五升。七天之中,五乘以七等于三斗五升,胃中的水谷都耗尽,没有气来生成生命。所以死亡。圊,即厕所。虞氏说:人从谷物中接受气。现在不饮食七天,就知道水谷气尽就会死。
第四十四难说:七冲门在哪里?回答说:唇为飞门,齿为户门,会厌为吸门,胃为贲门,太仓下口为幽门,大肠小肠交汇为阑门,下极为魄门。所以叫七冲门。
丁氏说:医经说唇为飞门,取动的意义。齿为户门,是关键开合,五谷由此摧折废弃出入。会厌为吸门,咽喉在水谷下行时,会厌按压呼吸。胃为贲门,胃言若虎贲之士,包围通达的景象。所以叫贲门。况且胃,即围受。主仓廪,所以别名太仓。其下口,即肠口。大肠小肠交汇为阑门,会即合。大肠小肠合会之处,分拦水谷精血,各有归属。所以叫阑门。下极为魄门,大肠是肺的腑。藏其魄。大肠下名肛门。又叫魄门。杨氏说:人有七窍,是五脏的门户,都出于面部。现在七冲门,也是脏腑所在,出内外兼有证候。飞门,是脾气所出。脾主于唇为飞门。飞即动。说的是唇受水谷,动转入内。齿为户门,是口齿心气所出。在心为志,退场门为言。所以齿为心之门户,也取摧伏五谷传入口的意思。会厌为吸门,会厌是五脏音声的门户。所以说会厌为吸门。胃为贲门,贲即膈。胃气所出。胃出谷气传给肺。肺在膈上。所以以胃为贲门。太仓下口为幽门,是肾气所出。太仓即胃。胃之下口,在脐上三寸。既幽隐之处。所以叫幽门。大肠小肠交汇为阑门,阑门即遗失的意义。说大小二肠都输泻于广肠。广肠既受传而出之,是遗失之意。所以叫阑门。下极为魄门,魄门即下极肛门。肺气上通喉咙,下通于肛门。是肺气所出。肺藏魄。所以叫魄门。冲即通。出。说的是脏腑之气通出的地方。
第四十五难说:医经说八会穴,是什么呢?回答说:腑会太仓。
丁氏说:腑会太仓,即胃。其穴位是中脘。虞氏说:太仓在心前鸠尾下四寸。是足阳明胃脉、手太阳小肠脉、手少阳三焦脉、任脉的交会。本名中脘。这里叫太仓。即胃的募穴。胃化气养大腑。所以叫会。
脏会季胁。
丁氏说:脏会季胁,软肋之名。其端有穴,直对脐章门穴,是脾的募穴。足厥阴少阳所会。所以叫脏会季胁。虞氏说:是章门穴,乃脾的募穴。直对脐季胁端侧卧,屈上足,伸下足,齐臂取之。乃足厥阴少阳之会。
筋会阳陵泉。
丁氏说:阳陵泉,穴名。在膝下一寸外廉。虞氏说:阳陵泉穴,在膝下宛宛中。足少阳胆脉气所发。
髓会绝骨。
丁氏说:髓会绝骨,是骨名。其穴在外踝上四寸。阳辅穴是。虞氏说:绝骨,乃阳辅穴。亦足少阳之脉气所出。
血会膈俞。
丁氏说:血会膈俞,穴名。在第七椎下两旁。同身寸各一寸五分。虞氏说:膈俞二穴,在脊骨第七椎下两旁各一寸五分。足太阳膀胱脉气所发。
骨会大杼。脉会太渊。
丁氏说:骨会大杼,穴名。在项后第一椎两旁相去同身寸一寸五分。脉会太渊穴,在右寸内鱼际下。虞氏说:大杼亦足太阳脉。气所发。在脊第一椎两旁各一寸五分。太渊在手鱼际间。应手动脉。则手太阴之脉气所发。
气会三焦外一筋直两乳内也。热病在内者,取其会之气穴。
丁氏说:气会三焦外一筋直两乳内,膻中穴是。此者是成会之穴所在。杨氏说:人脏腑筋骨髓血脉气,这八者,都有会合之穴。若热病在于内,则于外取其所会之穴以去其疾。季胁,章门穴。三焦外一筋直两乳内,膻中穴。余皆可知。
第四十六难说:老人躺下而不能入睡,少壮者睡着而不醒,为什么呢?回答说:医经说少壮者,血气旺盛,肌肉滑利,气道通畅,营卫的运行,不失常态。所以白天精神,夜晚不醒。(别本有“也”字,与下文一例。)老人血气衰弱,肌肉不滑利,营卫之道涩滞。所以白天不能精神,夜晚不能入睡。所以知道老人不得入睡。
Difficulty 40 states: The classic texts say that the Liver governs colors.
Yu explains: The Liver belongs to Wood. The calyx of wood spreads and distributes the five colors (green, red, yellow, white, black). Therefore, the Liver governs colors.
The Heart governs odors.
Yu explains: The Heart belongs to Fire. Fire transforms substances, and the five odors (scorched, fragrant, fishy, rank, putrid) arise from it. Thus, the five odors are uniquely governed by the Heart.
The Spleen governs tastes.
Yu explains: The Spleen belongs to Earth. Earth is sweet. Sweetness harmonizes various tastes. Therefore, the Spleen governs tastes. The *Book of Rites* says: "Sweetness can harmonize the five flavors." This refers to this principle.
The Lungs govern sounds.
Yu explains: The Lungs belong to Metal. Metal makes a sound when struck. Therefore, the five musical tones all originate from the Lungs.
The Kidneys govern fluids.
Yu explains: The Kidneys belong to Water. Water flows toward dampness. Therefore, the Kidneys govern fluids.
The nose is the external manifestation of the Lungs, yet it perceives odors; the ears are the external manifestation of the Kidneys, yet they hear sounds. What is the meaning of this? The answer is: The Lungs belong to Metal of the West. Metal is born in the Si hour. The Si hour belongs to Fire of the South. Fire corresponds to the Heart. The Heart governs odors. Thus, it enables the nose to perceive odors. The Kidneys belong to Water of the North. Water is born in the Shen hour. The Shen hour belongs to Metal of the West. Metal corresponds to the Lungs. The Lungs govern sounds. Thus, it enables the ears to hear sounds.
Yang states: Among the Five Elements, some achieve their functions through mutual interaction, while others achieve them within their own nature. As for the Lungs and Kidneys, they achieve their functions through mutual interaction. The other three organs achieve their functions independently.
Difficulty 41 states: Why does the Liver alone have two lobes, and what does this correspond to? The answer is: The Liver belongs to Wood of the East. Wood corresponds to Spring.
Yu explains: In the Five Constants, Wood corresponds to Spring and aligns with Benevolence (Ren). Hence, it is said that Wood corresponds to Spring. This represents the expression of human benevolence.
When all things first begin to grow, they are still young and small.
Yu explains: The Liver belongs to Foot Jueyin Wood and pairs with the Gallbladder, which belongs to Foot Shaoyang Wood. The Qi of Shaoyang fluctuates, sometimes large and sometimes small, sometimes short and sometimes long. Hence, it is described as young and small.
Its thoughts have no preference or intimacy.
Yu explains: Wood corresponds to Spring and follows the principle of Benevolence. It bestows grace without seeking return. It does not apply its transformative power based on closeness. Hence, it is said that its thoughts have no preference.
It is still close to the Taiyin (Lung) channel.
Yu explains: In the circulation of Qi and Blood through the Twelve Meridians, the Foot Jueyin Liver channel finally flows back into the Hand Taiyin Lung channel. Hence, it is said to be still close to the Taiyin.
It is not far from the Taiyang (Small Intestine) channel.
Yu explains: The text states that Foot Jueyin and Foot Shaoyang Wood generate Hand Taiyang and Hand Shaoyin Fire. Hence, it is said to be not far from the Taiyang. This is the meaning here.
It is like having two hearts.
Yu explains: "Like" means resembling. Having two hearts implies that when flowing into the Taiyin, there is a heart fearing Metal; when generating the Taiyang, there is a heart generating Fire. Hence, it is said to be like having two hearts.
Therefore, it has two lobes, corresponding also to the shape of leaf blades.
Yang states: If referring to the liver by its large lobes, there are two. If referring to the small lobes, there are many. The explanation is in later chapters. Ding states: The classic texts say the Liver belongs to Wood of the East and corresponds to Spring, the time when all things are born. When things first begin to grow, they are young. However, being newly born is not equivalent to longevity; it means Wood has just received its vital Qi, which is referred to as young. "Thoughts have no preference" means having lost the father and not knowing the mother, hence thoughts have no preference. "Close to Taiyin": Taiyin is the seventh month, when Wood begins to receive its Qi. "Not far from Taiyang": Taiyang is the sixth month. Hence, it is said to be not far from Taiyang. "Like two hearts" refers to leaving Taiyang and clinging to Taiyin; due to this separation and attachment, it is called two hearts. Thus, the Liver has two lobes to correspond to the shape of leaves.
Difficulty 42 states: What are the lengths of the human intestines and stomach, and how much water and grain can they hold? The answer is: The stomach is one chi five cun wide, five cun in diameter, and two chi six cun long. Its curved portion can hold three dou five sheng of water and grain. It usually retains two dou of grain and one dou five sheng of water.
Yang states: When food enters the mouth, it gathers in the stomach. Hence, the classic texts say: The stomach is the sea of water and grain. Once the grain in the stomach is cooked, it is transmitted to the small intestine.
The small intestine is two cun and a half wide, eight fen and one-third fen in radius, three zhang two chi long, and can hold two dou four sheng of grain and six sheng three he plus more than half a he.
Yang states: The small intestine receives grain from the stomach and transmits it to the large intestine. Two-thirds of the grain constitutes "more than half," and one-third constitutes "less than half."
The Hui Chang (returning intestine) is four cun wide, one cun and a half in radius, two zhang one chi long, and can hold one dou of grain and seven sheng half of water.
Yang states: The Hui Chang is the large intestine. It receives grain from the small intestine and transmits it to the Guang Chang (broad intestine). Yu states: There are three dou five sheng of water and grain coming from the stomach. After transmission to the small intestine, four sheng of grain remain, and water decreases by eight sheng six he plus less than half a he. Upon further transmission to the large intestine, the amount of water and grain is halved compared to when it was in the stomach. At this point, water seeps into the Bladder, and grain enters the anus.
The Guang Chang is eight cun wide, two cun and a half in radius. (According to the following text, the radius is two cun and a half major; calculating circumference as three times the diameter, the numbers match exactly. The character "major" is missing here.) It is two chi eight cun long and can hold nine sheng three he plus one-eighth of a he of grain.
Yang states: The Guang Chang is the rectum. Also known as the anus, it receives grain from the large intestine and expels it.
Thus, the total length of the stomach and intestines is five zhang eight chi four cun, capable of holding a total of eight dou seven sheng six he plus one-eighth of a he of water and grain. (Note: This number is incorrect; based on the previous text, it should be nine dou two sheng one he plus nineteen twenty-fourths of a he.) These are the dimensions and capacities of the stomach and intestines.
Yang states: According to the *Jia Yi Jing*, the total length of the stomach and intestines is six zhang four cun four fen. The reason for the difference is that the *Jia Yi Jing* measures from the mouth to the rectum, hence it is longer. This classic measures from the stomach to the rectum, hence it is shorter. They illuminate each other and are not erroneous.
The Liver weighs four jin four liang. (Other versions read two jin four liang, but only the *Zhengyi* commentary on the *Shiji* cites four jin four liang, matching this text.) The left side has three lobes, and the right side has four lobes, totaling seven lobes.
Yu explains: The Liver belongs to Foot Jueyin and pairs with Foot Shaoyang. The sequence number of Shaoyang is seven. Hence, it has seven lobes.
It stores the Hun (Ethereal Soul).
Yu explains: The Hun is the assistant to the Shen (Spirit). Yang states: Gan (Liver) sounds like Gan (trunk). In the Five Elements, it belongs to Wood, so its physical form has branches and trunks. (Originally, the character "yu" was erroneously added; deleted according to the *Shiji Zhengyi* citation.) The Liver Spirit consists of seven persons, named by Laozi as Mingtang Palace and Lantai Mansion, with 3,600 attendant officials. It is also said that the Liver Spirit includes six boys and three women. Another name for the Liver Spirit is Gailan.
The Heart weighs twelve liang, has seven holes and three hairs inside, and holds three he of essence juice. It stores the Shen (Spirit).
Yang states: Xin (Heart) sounds like Xian (fine/delicate). It refers to recognizing the subtle. (Originally, "Xian" was miswritten as "Shi"; corrected according to *Shiji Zhengyi*. Similarly below.) Nothing is not penetrated. It is also said: Xin means Ren (to bear/undertake), indicating its ability to bear all things. Its spirit consists of nine persons; the Grand Commandant is named Jiangong Dashi, the body of the Old Man of the South Pole Yuanxian. (In *Shiji Zhengyi*, "Yuanxian" is written as "Yuanguang".) His attendant officials number 3,600. It is also said that the Heart is the Emperor and the master of the body. The Heart Spirit is also named [missing character]. Yu states: Shen is the transformation and production of essence and Qi.
The Spleen weighs two jin three liang, is flat and three cun wide, five cun long, and has half a jin of loose pancreas. It wraps blood and warms the five Zang organs. It stores the Yi (Intellect).
Yang states: Pi (Spleen) sounds like Bi (assist). Located below the stomach, it assists Stomach Qi and primarily digests water and grain. Its spirit consists of five persons: Xuanguang Yu Nü Zi Mu, with 3,600 attendant officials. Its Spleen Spirit is also named Bibi.
The Lungs weigh three jin three liang, have six lobes and two ears, totaling eight lobes.
Yu explains: The Lungs are the examination of Metal, the Qi of Dui, located at You. You is the eighth gate, corresponding to the eight lobes. This follows that pattern.
It stores the Po (Corporeal Soul).
Yang states: Fei (Lung) sounds like Bo (surging/oppressive). It refers to its Qi being surging. (The *Shiji Zhengyi* adds "gu duan" [thus short] after this sentence.) Its spirit consists of eight persons; Dahe Jun is named Yutang Palace and Shangshu Mansion, with 3,600 attendant officials. It is also said that the Lung Spirit has fourteen persons: seven boys and seven girls. (This character is supplemented according to *Shiji Zhengyi*). The Lung Spirit is also named Mingjiu. Yu states: Po is the correction and assistance of essence and Qi.
There are two Kidneys, weighing one jin one liang. They store the Zhi (Will).
Yang states: Shen (Kidney) sounds like Yin (guide). The Kidneys belong to Water and guide Water Qi to irrigate the meridians. Its spirit consists of six persons: Situ, Sigong, Siming (In *Shiji Zhengyi*, "Gong" is written as "Kong". Below Siming is Silu), Silü, Xiaowei, and Tingwei Qing. The Kidney Spirit is also named [missing character]. Yu states: Unwavering concentration is called Zhi.
The Gallbladder is located between the short lobes of the Liver, weighs three liang three zhu, and holds three he of essence juice.
Yang states: Dan (Gallbladder) sounds like Gan (dare). It indicates that people possess the courage of the Gallbladder. (The *Shiji Zhengyi* omits the character "qi" in this sentence.) Its spirit consists of five persons: Taidao Yijun, residing in the Purple Chamber Palace, with 3,600 attendant officials. The Gallbladder Spirit is also named Guanguan. Yu states: The Gallbladder is the official of uprightness, and decision-making arises from it.
The Stomach weighs two jin two liang. (Cited as two jin fourteen liang in *Shiji Zhengyi*). It is convoluted and flexible, two chi six cun long, one chi five cun wide, five cun in diameter, holding two dou of grain and one dou five sheng of water.
Yang states: Wei (Stomach) sounds like Wei (encircle/receive). It refers to encircling and receiving food. Its spirit consists of twelve persons: Wuyuan Zhi Qi Jianyi Dafu. Its Stomach Spirit is named Qieqie. Yu states: The Stomach is the official of the granary.
The Small Intestine weighs two jin fourteen liang, is three zhang two chi long, two cun and a half wide, eight fen and one-third fen in radius, loops back and accumulates sixteen curves to the left, holds two dou four sheng of grain and six sheng three he plus more than half a he of water.
Yang states: Chang (Intestine) sounds like Chang (smooth/unobstructed). It refers to smoothing Stomach Qi and removing dregs and filth. Its spirit consists of two persons: Yuanliang Shizhe. The Small Intestine Spirit is also named Jiejie. Yu states: The Small Intestine is the official of reception and transformation, and transformation arises from it.
The Large Intestine weighs two jin twelve liang, is two zhang one chi long, four cun wide, and one cun and a half in radius. (The character "half" is missing in the original; supplemented according to *Shiji Zhengyi*, matching the earlier text.) It loops back sixteen curves to the right of the navel, holds one dou of grain and seven sheng half of water.
Yang states: The Large Intestine is the Hui Chang. It is named so because of its looping curves. Its spirit consists of two persons: Yuanliang Shizhe. Its spirit is named Hehe. Yu states: The Large Intestine is the official of conduction, and change arises from it.
The Bladder weighs nine liang two zhu, is nine cun long and wide, and holds nine sheng nine he of urine.
Yang states: Pang means horizontal; Guang means broad. It refers to its short and broad shape. It is also named Bao (Bladder/Womb). Bao means empty. Empty means void, used to receive and hold fluids. (*Shiji Zhengyi* cites: Bao is void, primarily using emptiness to receive fluids.) Nowadays, many people mistakenly identify the areas under both hypochondria and the sides of the lower abdomen as the Bladder, which is deeply erroneous. Yu states: The Bladder is the official of the capital, where fluids are stored.
The mouth is two cun and a half wide. From lips to teeth is nine fen. From behind the teeth to the epiglottis is three cun and a half deep, with a capacity of five he. The tongue weighs ten liang, is seven cun long, and two cun and a half wide.
Yang states: She (Tongue) sounds like Xie (discharge/excrete). It refers to the ability to articulate speech. (The character "yu" after "shuxie" is deleted according to *Shiji Zhengyi*). Yu states: The lips are the fan of sound; the tongue is the mechanism of sound.
The pharynx gate weighs ten liang, is two cun and a half wide, and one chi six cun long to the stomach.
Yang states: Yan (Pharynx) sounds like Yan (swallow). It refers to swallowing food. It is also called Ai. It refers to the critical passage for airflow. The pharynx is the connection of the Stomach. Hence, the classic texts say: The pharynx governs Earth Qi. The Stomach belongs to Earth. Hence, it is said to govern Earth Qi.
The larynx/trachea weighs twelve liang, is two cun wide, one chi two cun long, and has nine segments.
Yang states: Houlong is hollow. It refers to its internal hollowness, allowing breath to pass. It is the connection of the Lungs and the pathway of respiration. Hence, the classic texts say: The throat governs Heaven Qi. The Lungs correspond to Heaven. Hence, it is said to govern Heaven Qi. The throat and pharynx run parallel but are actually different, yet many people confuse them. (Originally, "liang" was written as "wu" and "huo" as "gan"; corrected according to *Shiji Zhengyi*).
The anus weighs twelve liang, is eight cun wide, two cun and a half major in radius, two chi eight cun long, and holds nine sheng two he plus one-eighth of a he of grain.
Yang states: Gang (Anus) sounds like [vehicle axle head]. It refers to the place resembling the shape of a vehicle axle head. Hence, it is called the Anus. It is the Guang Chang. Ding states: Regarding the diameters mentioned earlier: One chi five cun wide with five cun diameter follows the rule of circumference being three times the diameter. Small intestine radius eight fen, width two cun four fen is correct. Now it says diameter two cun and a half, which is radius eight fen and one-third fen. Hui Chang radius one cun and a half, width four cun five fen. Now it says width four cun, which is five fen less. Guang Chang radius two cun and a half, width seven cun five fen. Now it says width eight cun, which is five fen excess. The units of sheng, dou, cun, and chi were established by first setting the standard for the chi, then creating the sheng, dou, scale, and liang. All use Tong Shen Cun (body-inch) as the method. To create a dou from a chi: the top width is one chi, bottom width seven cun, height four cun, wall thickness three fen, holding ten sheng. For wood finger joints, one square cun equals one liang; sixteen liang equal one jin. This system of Tong Shen Cun, chi, sheng, and dou serves as the method for the weight, length, and dimensions of human stomach and intestines.
Difficulty 43 states: Why do people die after seven days without eating or drinking? The answer is: The stomach usually retains two dou of grain and one dou five sheng of water. Therefore, an average person goes to the toilet twice a day, passing two sheng five he each time, totaling five sheng per day. Over seven days, five times seven equals three dou five sheng, and the water and grain are exhausted. Thus, an average person dies after seven days without food or drink because the water, grain, and Jin-Ye (fluids) are completely depleted, leading to death.
Ding states: Humans receive Qi from grain to nourish the Shen. When water and grain are exhausted, the Shen departs. Hence, those who can retain grain live; those cut off from grain die. Yang states: The stomach usually retains three dou five sheng of water and grain. Since the person does not eat or drink, and goes to the toilet twice a day, passing five sheng daily, over seven days, five times seven equals three dou five sheng, exhausting the water and grain in the stomach. Without Qi to sustain life, death occurs. Qing means toilet. Yu states: Humans receive Qi from grain. Not eating or drinking for seven days shows that when the Qi of water and grain is exhausted, death ensues.
Difficulty 44 states: Where are the Seven Rush Gates? The answer is: The lips are the Flying Gate; the teeth are the Household Gate; the epiglottis is the Inhaling Gate; the stomach is the Ben Gate; the lower opening of the Tai Cang is the Hidden Gate; the junction of the large and small intestines is the Fence Gate; and the lower extreme is the Po Gate. Hence, they are called the Seven Rush Gates.
Ding states: The classic texts say the lips are the Flying Gate, taking the meaning of movement. The teeth are the Household Gate, acting as the key for opening and closing, through which grains enter and exit after being broken down. The epiglottis is the Inhaling Gate; when water and grain descend through the throat, the epiglottis presses down to regulate breathing. The stomach is the Ben Gate; "Ben" resembles the image of Hu Ben soldiers surrounding and reaching everywhere. Hence, it is called the Ben Gate. Moreover, Wei (Stomach) sounds like Wei (encircle), governing the granary, hence also named Tai Cang (Grand Granary). Its lower opening is the intestinal mouth. The junction of the large and small intestines is the Fence Gate; "Hui" means meeting. At the meeting point of the large and small intestines, water, grain, essence, and blood are separated and directed to their respective destinations. Hence, it is called the Fence Gate. The lower extreme is the Po Gate; the Large Intestine is the Fu organ of the Lungs and stores the Po. The lower part of the Large Intestine is named the anus, also called the Po Gate. Yang states: Humans have seven orifices, which are the portals of the five Zang organs, all emerging from the face. The Seven Rush Gates are also locations of the Zang and Fu organs, manifesting symptoms internally and externally. The Flying Gate is where Spleen Qi emerges. The Spleen governs the lips as the Flying Gate. "Fei" means moving, indicating that the lips receive water and grain and move them inward. The teeth are the Household Gate, where mouth/tooth and Heart Qi emerge. In the Heart, it is Zhi (Will); exiting the field/gate is Yan (speech). Hence, the teeth are the portal of the Heart, also taking the meaning of crushing grains entering the mouth. The epiglottis is the Inhaling Gate, the portal of the voice of the five Zang organs. Hence, it is called the Inhaling Gate. The stomach is the Ben Gate; "Ben" means diaphragm. It is where Stomach Qi emerges. Stomach Qi transmits grain Qi to the Lungs. The Lungs are above the diaphragm. Hence, the stomach is called the Ben Gate. The lower opening of Tai Cang is the Hidden Gate, where Kidney Qi emerges. Tai Cang is the Stomach. The lower opening of the Stomach is three cun above the navel, a secluded and hidden place. Hence, it is called the Hidden Gate. The junction of the large and small intestines is the Fence Gate; "Lan" implies loss or letting go. It means the large and small intestines both discharge into the Guang Chang. Once the Guang Chang receives and transmits it out, it is a matter of letting go. Hence, it is called the Fence Gate. The lower extreme is the Po Gate, which is the lower extreme anus. Lung Qi connects upward to the throat and downward to the anus. It is where Lung Qi emerges. The Lungs store the Po. Hence, it is called the Po Gate. "Chong" means open/pass through. It refers to the places where Zang and Fu organ Qi passes through and emerges.
Difficulty 45 states: The classic texts mention the Eight Hui Points. What are they? The answer is: The Hui Point of the Fu organs is Tai Cang.
Ding states: The Hui Point of the Fu organs is Tai Cang, which is the Stomach. The acupoint is Zhongwan. Yu states: Tai Cang is four cun below Jiutai in front of the Heart. It is the convergence of the Foot Yangming Stomach Meridian, Hand Taiyang Small Intestine Meridian, Hand Shaoyang Sanjiao Meridian, and Ren Mai. Originally named Zhongwan, here called Tai Cang. It is the Mu point of the Stomach. The Stomach transforms Qi to nourish the greater Fu organs. Hence, it is called the Hui.
The Hui Point of the Zang organs is the Hypochondrium (Ji Xie).
Ding states: The Hui Point of the Zang organs is the Hypochondrium, referring to the soft ribs. At its end is an acupoint, directly opposite the Zhangmen point at the navel, which is the Mu point of the Spleen. It is the convergence of Foot Jueyin and Foot Shaoyang. Hence, it is called the Hui Point of the Zang organs. Yu states: This is the Zhangmen point, the Mu point of the Spleen. Lie on the side with the upper leg bent and lower leg extended, directly opposite the navel at the end of the hypochondrium, measuring with the arm. It is the convergence of Foot Jueyin and Foot Shaoyang.
The Hui Point of the Tendons is Yanglingquan.
Ding states: Yanglingquan is an acupoint name, located one cun below the knee on the lateral margin. Yu states: The Yanglingquan acupoint is in the depression below the knee, where the Qi of the Foot Shaoyang Gallbladder Meridian emerges.
The Hui Point of the Marrow is Juegu.
Ding states: The Hui Point of the Marrow is Juegu, a bone name. The acupoint is four cun above the lateral malleolus, which is the Yangfu point. Yu states: Juegu is the Yangfu point, also where the Qi of the Foot Shaoyang Meridian emerges.
The Hui Point of the Blood is Ge Shu.
Ding states: The Hui Point of the Blood is Ge Shu, an acupoint name, located on both sides one cun and a half lateral to the spinous process of the seventh thoracic vertebra, using Tong Shen Cun. Yu states: The two Ge Shu acupoints are one cun and a half lateral to the spinous processes of the seventh thoracic vertebra, where the Qi of the Foot Taiyang Bladder Meridian emerges.
The Hui Point of the Bones is Dazhu. The Hui Point of the Vessels is Taiyuan.
Ding states: The Hui Point of the Bones is Dazhu, an acupoint name, located one cun and a half lateral to the spinous process of the first cervical vertebra in the neck. The Hui Point of the Vessels is the Taiyuan acupoint, located below the Thenar eminence on the radial pulse of the right wrist. Yu states: Dazhu is also where the Qi of the Foot Taiyang Meridian emerges, one cun and a half lateral to the spinous process of the first thoracic vertebra. Taiyuan is between the Thenar eminence of the hand, where the artery pulses, indicating the emergence of the Qi of the Hand Taiyin Meridian.
The Hui Point of the Qi is outside the Sanjiao, one tendon straight between the two breasts. For heat diseases located internally, one should select the Qi acupoints of these Hui points.
Ding states: The Hui Point of the Qi, outside the Sanjiao, one tendon straight between the two breasts, is the Tanzhong acupoint. This is the location of the formed Hui points. Yang states: The Zang organs, Fu organs, tendons, bones, marrow, blood, vessels, and Qi—these eight categories—all have converging acupoints. If heat disease is internal, one should select the external converging acupoints to remove the pathology. The Hypochondrium is the Zhangmen point. Outside the Sanjiao, one tendon straight between the two breasts is the Tanzhong point. The rest can be understood similarly.
Difficulty 46 states: Why do elderly people lie down but cannot sleep, while the young and vigorous sleep but do not wake? The answer is: The classic texts state that the young and vigorous have abundant Qi and Blood, smooth muscles, unobstructed Qi pathways, and normal circulation of Ying and Wei. Therefore, they are alert during the day and sleep soundly at night. (Some versions add the character "ye" here, consistent with the following text.) Elderly people have declining Qi and Blood, non-smooth muscles, and sluggish Ying and Wei pathways. Therefore, they cannot be alert during the day and cannot sleep at night. Hence, it is known that the elderly suffer from insomnia.