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Capítulo 32 de 81
黄帝内经·灵枢
Holistic Paraphrase
The Yellow Emperor asked: I wish to hear your explanation—if an ordinary person eats nothing, they will die within seven days. What is the reason for this?
Bo Gao replied: Allow me to explain the underlying cause.
The stomach (the organ that receives and initially decomposes food) has a circumference of one chi and five cun, a diameter of five cun, and a length of two chi and six cun. It is curved and coiled, and can hold three dou and five sheng of water and grain. Normally, it is full when it retains two dou of grain and one dou and five sheng of water. The upper burner (the region above the diaphragm, governing diffusion and distribution) transmits the fine vital essence of the water and grain outward; this essence is swift, agile, and moves rapidly. The lower burner (the region below the navel, governing excretion and permeation) irrigates and nourishes the various intestinal tracts downward.
The small intestine has a circumference of two cun and a half, a diameter of eight fen and one-third of a fen, and a length of three zhang and two chi. It can hold two dou and four sheng of grain, and six sheng and three he and two-thirds of a he of water. The hui intestine (the middle section of the large intestine) has a circumference of four cun, a diameter of one cun and one-third of a cun, and a length of two zhang and one chi. It can hold one dou of grain and seven sheng and a half of water. The guang intestine (the rectal portion) has a circumference of eight cun, a diameter of two cun and two-thirds of a cun, and a length of two chi and eight cun. It can hold nine sheng, three he, and one-eighth of a he of grain.
The total length of the stomach and intestines is five zhang, eight chi, and four cun, and together they can hold nine dou, two sheng, one he, and two-thirds of a he of water and grain. This is the total capacity of the stomach and intestines for holding water and grain.
However, the actual state of an ordinary person (a healthy person without illness) is not that the stomach and intestines are filled at the same time. When the stomach is full, the intestines are empty; when the intestines are full, the stomach is empty. Between the stomach and the intestines, there is a pattern of alternating emptiness and fullness—when one is full, the other is empty, alternating in succession. Because of this alternation between emptiness and fullness, the qi mechanism can flow upward and downward normally, the five viscera can remain settled, the blood vessels can be harmonious and unobstructed, and the spirit can remain anchored within. Therefore, it is said that the spirit (the vital vitality of a person) is materialized from the essential qi of water and grain.
Thus, the stomach and intestines should retain two dou of grain and one dou and five sheng of water. An ordinary person defecates twice a day, each time discharging two and a half sheng, for a total of five sheng per day. Over seven days, this accumulates to five times seven, or three dou and five sheng, which exactly exhausts all the water and grain retained in the stomach and intestines. Therefore, if an ordinary person neither eats nor drinks, they will die within seven days, because the essential qi and jin-ye (the collective term for normal body fluids) produced from water and grain have all been depleted.
The core medical principle of this chapter lies in elucidating a fundamental proposition: Human life activity depends on the continuous nourishment of the essential qi of water and grain, and the rhythm of "alternating emptiness and fullness" in the stomach and intestines is the driving mechanism that sustains this process.
Bo Gao first enumerates the dimensions and capacities of the stomach, small intestine, hui intestine, and guang intestine with anatomical data, then points out that "the ordinary person is not like this"—a healthy person does not have all digestive organs filled simultaneously, but rather when the stomach is full, the intestines are empty; when the intestines are full, the stomach is empty, alternating in succession. This rhythmic alternation of emptiness and fullness enables:
Finally, Bo Gao uses the calculation of defecation volume to demonstrate the reason for "death within seven days": discharging five sheng per day, over seven days this totals three dou and five sheng, exactly matching the amount normally retained in the stomach and intestines. When water and grain are exhausted, and the essential qi and jin-ye随之耗竭, life can no longer be sustained. Although this deduction is based on the weights and measures of that era, the underlying logic is a rigorous "matter–energy" conservation principle: what enters must come out, what comes out must be replenished; balance between entry and exit sustains life, while cessation of either leads to death.
From a modern physiological standpoint, this chapter reflects the ancient physicians' efforts to understand the digestive system through practical anatomical observation. The descriptions of intestinal segmentation (stomach, small intestine, hui intestine, guang intestine) correspond to the modern anatomical divisions of the stomach, small intestine, colon, and rectum, indicating that ancient medical practitioners were not purely speculative but had a basis in empirical observation.
However, the ancient measurements differ significantly from modern anatomical data. For example, the small intestine is recorded as "three zhang and two chi" (approximately over seven meters in modern conversion), whereas modern anatomy shows the adult small intestine to be about 5–7 meters in length—numerically roughly similar but still discrepant; the stomach capacity of "three dou and five sheng" converts to far more than the normal stomach capacity recognized today. These differences primarily stem from the different standards of ancient weights and measures, as well as observation methods, cadaveric states (such as dilation after muscle relaxation), and other multiple factors.
The assertion of "death within seven days" is an empirical conclusion drawn from ancient observations. Modern medicine holds that when a person completely fasts but continues to drink water, survival time may far exceed seven days, depending on body fat reserves, basal metabolic rate, environmental temperature, and other factors; if both food and water are completely withheld, survival time is much shorter. Therefore, "seven days" should be understood as an empirical conclusion based on conventional observations in ancient times, not as an absolutely precise physiological constant.
The idea of alternating emptiness and fullness has significant methodological value. Modern physiology similarly recognizes coordinated rhythmic activities among different segments of the digestive tract—when the stomach empties, the intestines may be undergoing digestion and absorption; when the intestines empty, the stomach begins to receive new food. This "orderly alternation" ensures the continuity and efficiency of the digestive process. Although the ancients lacked concepts such as "gastrointestinal peristaltic waves" or "migrating motor complex," they accurately captured this dynamic balance with the four characters "alternating emptiness and fullness," demonstrating a high degree of systems thinking.
Eat with moderation, avoid overeating: This chapter emphasizes the natural rhythm of "when the stomach is full, the intestines are empty; when the intestines are full, the stomach is empty." If one overeats at every meal and eats continuously, the stomach and intestines remain perpetually "full," disrupting this rhythm. Daily eating should be regular and moderate, leaving periods of "emptiness" for the stomach and intestines, allowing space for the qi mechanism to flow upward and downward.
Chew thoroughly and eat slowly, reducing the stomach's burden: The stomach's capacity and decomposing ability are limited. Thorough chewing and slowing down eating speed help the water and grain descend more smoothly and facilitate the full generation of fine essence.
Maintain regular bowel movements: Smooth defecation is an important link in sustaining the cycle of "alternating emptiness and fullness." If one feels the urge to defecate but does not do so promptly, the intestines remain in a prolonged state of "fullness," affecting the entire digestive rhythm and the ascending and descending of qi. Cultivating the habit of regular bowel movements is fundamental care for the stomach and intestines.
The spirit is grounded in water and grain: This chapter concludes by stating that "the spirit is the essential qi of water and grain." In modern life, many people experience mental fatigue, poor concentration, or low spirits due to dieting, picky eating, or irregular eating habits—manifestations of insufficient essential qi from water and grain. A reasonable diet is not only for nourishing the body but also serves as the foundation for nourishing the spirit.
Related Concepts:
Further Reading:
This content is based on classical Chinese medical texts and is provided solely for the study and research of traditional culture. It does not constitute any medical diagnosis, medication, or treatment advice; if you feel unwell, please seek medical attention promptly.