Formulas · Text · Donguibogam 東醫寶鑑

The Large Intestine

Daejangbu

한글 대장부 · Pinyin Da Chang Fu

The official of transmission — two jang one cheok coiled to the right of the navel, read from the nose and the skin, hating cold where the stomach hates heat, and treated by draining or firming

大腸腑

The fourth bowel chapter. The large intestine is the returning gut and the broad gut — two jang one cheok long, coiled sixteen times to the right of the navel, holding two mal of grain and seven and a half seung of water — and with it the Nanjing closes its accounts: the whole tract from mouth to anus is six jang four chon four pun, thirty-two bends, eight mal seven seung six and one-eighth hop. It receives the small intestine's residue and passes it to the anus; it is read from the nose and the skin, because it pairs with the lung and the lung rules both; and its disease is cutting pain and a bowel that rumbles like water, worse in winter, with cold making undigested diarrhoea and heat making stool like gruel. The Lingshu's dialogue on treatment is the chapter's centre: the stomach hates heat and the large intestine hates cold, and the two are reconciled not by medicine but by suiting food and clothing to the season. Then two formulas, one to drain the hot bowel and one to firm the cold. The signs of its end are diarrhoea without measure, and its twenty-four simples divide the same way — nine that hold the bowel and fifteen that open it.

10.1 The Form of the Large Intestine 大腸形象

10.1.1

Source원문

大腸, 一名廻腸, 又名廣腸. 長二丈一尺一作二尺, 廣八寸, 徑二寸寸之太半, 重二斤十二兩. 右廻疊積十六曲, 盛穀二斗, 水七升半. 《難經》

Translation영역

The large intestine is also called the returning gut and the broad gut. It is two jang one cheok long one version says two cheok, eight chon around and two and two-thirds chon across, and weighs two geun twelve nyang. It coils to the right of the navel in sixteen folds stacked on each other, and holds two mal of grain and seven and a half seung of water.

Clinical note임상 주석

Coiled to the right where the small intestine coiled to the left — the Lingshu's two guts divide the belly between them, and the tradition's palpation of the two sides follows.

Nangyeong 難經

10.1.2

Source원문

腸胃自所入至所出, 長六丈四寸四分, 廻曲環反三十二曲也. 凡腸胃合受水穀八斗七升六合八分合之一. 《難經》

Translation영역

From where food enters the intestines and stomach to where it leaves is six jang four chon four pun, with thirty-two bends turning back and forth. Together the intestines and stomach receive eight mal seven seung six and one-eighth hop of water and grain.

Clinical note임상 주석

The Nanjing's total — the Ojangyukbu chapter's 1.10 gave the Lingshu's, which differs by a few chon and a few hop. Two classics measuring the same gut and not quite agreeing, and the Bogam prints both.

Nangyeong 難經

10.2 The Position of the Large Intestine 大腸部位

10.2.1

Source원문

大腸後附脊, 以受小腸滓穢. 當臍右廻疊積, 上下抗大. 大腸下口, 連於肛門. 《入門》

Translation영역

The large intestine is attached behind to the spine, and receives the small intestine's residue. At the level of the navel it coils to the right in stacked folds, wide above and below; its lower mouth joins the anus.

Immun 入門

10.2.2

Source원문

天樞二穴, 大腸之募也, 在臍傍各三寸. 在背則大腸兪, 在脊第十六顀下兩傍, 此大腸部位也. 《銅人》

Translation영역

The two points Cheonchu (天樞, ST25) are the large intestine's alarm points, three chon to either side of the navel; on the back, Daejangsu (大腸兪, BL25) is on either side below the sixteenth vertebra. These are the large intestine's territory.

Clinical note임상 주석

Cheonchu, beside the navel — the point the Stomach chapter's 8.4 measured the stomach's length to, and the one the Stool chapter needles for both diarrhoea and constipation. The bowel's alarm point is on the stomach channel, because the stomach channel runs over it.

Dongin 銅人

10.3 The Connecting Cords of the Large and Small Intestines 大小腸連系

10.3.1

Source원문

大小腸之系, 自膈下與脊膂連, 心腎膀胱相系, 脂膜筋絡散布包裹, 然各分紋理, 羅絡大小腸與膀胱. 其細脈之中, 乃氣血津液流走之道也. 《入門》

Translation영역

The cords of the large and small intestines connect below the diaphragm with the spine, and are tied to the heart, kidney and bladder; fatty membranes and sinewy networks spread and wrap them, yet each has its own grain, netting round the large and small intestines and the bladder. Within their fine vessels is the road along which qi, blood and fluids flow.

Clinical note임상 주석

The mesentery — 脂膜筋絡, fatty membrane and sinewy net, wrapping the guts and tying them to the spine, with fine vessels running through it. The Immun's description is close to what an opened abdomen shows, and the Body chapter's 1.9 knew nothing of it.

Immun 入門

10.4 The Outer Signs of the Large Intestine 大腸外候

10.4.1

Source원문

鼻隧以長, 以候大腸.

Translation영역

A long nasal passage is the sign by which to judge the large intestine.

Clinical note임상 주석

The nose for the large intestine, as the lips were for the small — each bowel read at its viscus's orifice. The Lingshu's rule that the lung opens at the nose, lent to the lung's bowel.

Yeongchu 靈樞

10.4.2

Source원문

肺主皮. 皮厚者大腸厚, 皮薄者大腸薄. 皮緩腹裹大者, 大腸大而長. 皮急者, 大腸急而短. 皮滑者, 大腸直. 皮肉不相離者, 大腸結.

Translation영역

The lung governs the skin. Thick skin means a thick large intestine, thin skin a thin one. Slack skin with a big belly-fold means a large, long large intestine; tight skin, a tense, short one; smooth skin, a straight one. Where skin and flesh do not part from each other, the large intestine is knotted.

Clinical note임상 주석

Skin for the large intestine as skin-and-vessels was for the small at 9.4.2 — the lung rules the skin, and its bowel is read there. The Lingshu's whole outer diagnosis of the bowels is the five viscera's correspondences applied one organ down.

Yeongchu 靈樞

10.4.3

Source원문

天樞以下至橫骨, 長六寸半, 過則廻腸廣大, 不滿則狹短. 《靈樞》

Translation영역

From Cheonchu down to the pubic bone is six and a half chon; longer means the returning gut is broad and large, shorter means it is narrow and short.

Clinical note임상 주석

The Stomach chapter's 8.4 measured xiphoid to Cheonchu for the stomach; this measures Cheonchu to pubis for the bowel. The trunk divided at the navel, and each organ's size read from its half.

Yeongchu 靈樞

10.5 The Patterns of Large Intestine Disease 大腸病證

10.5.1

Source원문

大腸病者, 腸中切痛而鳴濯濯, 冬日重感于寒卽泄, 當臍而痛, 不能久立.

Translation영역

In large intestine disease there is cutting pain in the bowel with a rumbling like water; in winter, on a further contraction of cold, there is diarrhoea at once, pain at the navel, and inability to stand long.

Clinical note임상 주석

鳴濯濯 — rumbling like water being poured. The Lingshu's onomatopoeia for the bowel, and the whole pattern is the cold gut: worse in winter, worse with a chill, and too weak to stand.

Yeongchu 靈樞

10.5.2

Source원문

腹痛, 腸鳴, 氣上衝胸, 喘, 不能久立, 邪在大腸也.

Translation영역

Abdominal pain, rumbling of the bowel, qi surging up to the chest, panting and inability to stand long — the evil is in the large intestine.

Yeongchu 靈樞

10.5.3

Source원문

腸中寒, 則腸鳴飱泄. 腸中熱, 則出黃如糜. 《靈樞》

Translation영역

Where the bowel is cold there is rumbling and undigested diarrhoea; where it is hot the stool comes out yellow like gruel.

Clinical note임상 주석

Two stools: the cold one with food unchanged in it, the hot one yellow and soft as porridge. The Stool chapter sorts every diarrhoea by this line, and the two formulas of 10.6 are its two treatments.

Yeongchu 靈樞

10.5.4

Source원문

大腸小腸爲泄.

Translation영역

The large and small intestines make for diarrhoea.

Naegyeong 內經

10.5.5

Source원문

腸痺者, 數飮而出不得, 中氣喘爭, 時發飱泄. 《內經》

Translation영역

In intestinal impediment one drinks often but it will not come out, the centre qi pants and strains, and at times undigested diarrhoea breaks out.

Naegyeong 內經

10.5.6

Source원문

大腸有寒者, 多鶩溏. 有熱者, 便腸垢. 《仲景》

Translation영역

Where the large intestine has cold, there is much duck-dropping stool; where it has heat, the stool carries bowel grime.

Clinical note임상 주석

鶩溏, duck droppings — thin, watery, greenish stool — and 腸垢, the mucous slime of the hot bowel. Zhongjing's two stools for two temperatures, and the pair the Stool chapter uses to tell cold dysentery from hot.

Junggyeong 仲景

10.5.7

Source원문

腸虛則鳴. 又寒氣相搏, 則爲腸鳴. 《入門》

Translation영역

Where the bowel is vacuous it rumbles; and where cold qi strikes against it, that too makes rumbling.

Immun 入門

10.6 The Treatment of Large Intestine Disease 大腸病治法

10.6.1

Source원문

黃帝問曰, 胃惡熱而喜淸冷, 大腸惡淸冷而喜熱, 兩者不和, 何以調之. 岐伯對曰, 調此者, 飮食衣服, 亦欲適寒溫. 寒無凄滄, 暑無出汗. 飮食, 熱無灼灼, 寒無滄滄. 寒溫中適, 故氣將持, 乃不致邪僻也. 《靈樞》

Translation영역

The Yellow Emperor asked: the stomach hates heat and likes cool, the large intestine hates cool and likes heat; when the two are not in harmony, how is it regulated? Qi Bo answered: to regulate this, food, drink and clothing should likewise be suited to cold and warmth. In cold, no shivering; in heat, no sweating. Food and drink neither scalding hot nor chilling cold. With cold and warmth suited to the middle, the qi will hold, and evil and deviance will not arise.

Clinical note임상 주석

The stomach and its bowel want opposite temperatures, and the Lingshu's answer is not a formula but a rule for the table and the wardrobe: nothing scalding, nothing chilling, neither shivering nor sweating. The Stomach chapter's 8.9.3 was Dongwon's version of the same answer.

Yeongchu 靈樞

10.6.2

Source원문

大腸熱, 宜瀉白湯. 大腸寒, 宜實腸散.

Translation영역

For large intestine heat, Drain the White Decoction is appropriate; for large intestine cold, Firm the Intestines Powder.

Clinical note임상 주석

Two formulas for 10.5.3's two stools, both registered. Mirabilite to drain the hot bowel and nutmeg to firm the cold one — and 瀉白 is the Lung chapter's name, because the bowel is the lung's.

Donguibogam · Daejang

10.7 The Signs of the Large Intestine Expiring 大腸絶候

10.7.1

Source원문

大腸絶不治, 何以知之. 泄利無度, 利絶則死. 《脈經》

Translation영역

The large intestine expiring is not to be treated — how is it known? Diarrhoea without measure; when the flux stops, death.

Clinical note임상 주석

利絶則死 — when the diarrhoea stops, death. The Maekgyeong's grimmest line: the bowel that has emptied itself past measure dies when there is nothing left to pass, and the stopping is not recovery.

Maekgyeong 脉經

10.8 Simple Medicinals 單方

10.8.1

Source원문

凡二十四種.

Translation영역

Twenty-four kinds in all.

Clinical note임상 주석

Twenty-four simples, and they sort by 10.6.2. Nine that hold the bowel — chebula rind, dog skull, gallnut, pomegranate rind, old rice, a millet product, mume, acorn and oyster shell — and fifteen that open it — bushcherry kernel, rhubarb, caper spurge, mulberry root bark, gardenia, peach blossom, sesame oil, hemp seed, water dropwort, loofah, scallion, wax gourd, a vegetable, milk and child's urine. The peach-blossom entry is Zhang Zihe's: gather the fallen petals, knead them into flour, and bake a cake. **Caper spurge seed (續隨子) is a violent purgative and is toxic.**

Donguibogam · Daejang

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Inner Landscape, Volume 3, The Large Intestine chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.