治肝之积，在左胁下，如覆杯，有头足，如龟鳖状，久久不愈，发咳逆 疟，连岁不已。
青皮（去白，锉炒，一两） 川当归（去芦，洗，一两，焙） 蛇含石（火 ，醋淬七
次，三分） 苍术（削去皮，米泔浸一宿锉，炒一两） 莪术（切） 京三棱（切） 铁艳
粉（各一两半与三
上为细末，醋煮米糊为丸，如绿豆大，每服四十丸，当归浸酒，食前服。
治肺之积，在右胁下，大如覆杯，久久不愈，病洒洒寒热，气逆喘咳，发为肺痈。
半夏（汤泡七次） 吴茱萸（炒） 桂心（不见火。各七钱半） 人参 桑白皮（炙） 葶
苈（微炒）
上 咀，每服四钱，水一盏半，生姜七片，枣二枚，煎至七分，去滓，食前，温服。
夫积有五积，聚有六聚。积者生于五脏之阴气也；聚者成于六腑之阳气也。此由阴阳不
和，
有如忧、思、喜、怒之气，人之所不能无者，过则伤乎五脏，逆于四肢，传克不行，
乃留结而为五积。故在肝曰肥气，在心曰伏梁，在脾曰痞气，在肺曰息贲，在肾曰奔豚。其
名不同，其证亦异。肥气之状，在左胁下，大如覆杯，肥大而似有头足，是为肝积，诊其脉
弦而细，其色青，其病两胁下痛，牵引小腹，足寒转筋，男子为积疝，女子为瘕聚。伏梁之
状，起于脐下，其大如臂，上至心下，犹梁之横架于胸膈者，是为心积，诊其脉沉而芤，其
色赤，其病腹热面赤，咽干心烦，甚则吐血，令人食少，肌瘦。痞气之状，留于胃脘，大如
覆杯，痞塞不通，是为脾积，诊其脉浮大而长，其色黄，其病饥则减，饱则见，腹满呕泄，
足肿肉削，久不愈，令人四肢不收。息贲之状，在右胁下，大如覆杯，喘息奔溢，是为肺积，
诊其脉浮而毛，其色白，其病气逆背痛，少气喜忘，目瞑肤寒，皮中时痛，或如虱缘，或如
针刺。奔豚之状，发于小腹，上至心下，上下无时，有若豚走之状，是为肾积，诊其脉沉而
急，其色黑，其病饥则见，饱则减，小腹里急，腰痛口干，目昏骨冷，久不愈，令人骨痿少
气。又如六聚之成于六腑则异是矣，何者？六腑属于三阳，太阳利清气，阳明泄浊气，少阳
化精气，有如都会之腑，主转输以为常也。夫苟六腑失常，则邪气聚而不散，始发既无根本，
上下无所留止，其痛亦无常处，故在上则格，在下则胀，傍攻两胁，如有杯块，易于转动，
故非五积之比也。凡脉快而紧者，积聚也。脉来小沉重者，胃中有积聚也。大抵病各有证，
治各有方。如诊心腹积聚，其脉牢强急者生，虚弱急者死。又诸脉实强者生，沉小者死，此
又不可不察也。
又论∶夫积者伤滞也。伤滞之久，停留不化，则成积矣。且人之脏腑，皆因触冒以成疾
病，惟脾胃最易受触。盖日用饮食，稍或过多，停滞难化，或吐或呕，或泄或痢。当是之时，
法宜推荡，然后助养脾胃。所谓推荡者，更宜斟量人之虚实，伤滞之轻重而推荡之。停滞一
消，则不成积，克化失宜，久之必成积聚症瘕矣。所谓积者，有气积、肉积、酒积、茶积、
食积、痰积，更有妇室月经不通，遂成血积。凡治诸积之要，并载于后，倘于前证，参酌而
用之可也。
治疗肝脏的积证，部位在左侧胁下，形状像倒扣的杯子，有头有脚，如同龟鳖的形状，长久不愈，会引发咳嗽气逆、疟疾，连年不断。
青皮（去除白色内层，切碎炒制，一两） 川当归（去除芦头，洗净，一两，焙干） 蛇含石（火烧后，用醋淬炼七次，三分） 苍术（削去外皮，用米泔水浸泡一夜后切碎，炒制，一两） 莪术（切片） 京三棱（切片） 铁艳粉（以上各一两半）
将上述药物研成细末，用醋煮米糊作为粘合剂制成丸药，大小如绿豆，每次服用四十丸，用当归浸酒送服，饭前服用。
治疗肺脏的积证，部位在右侧胁下，大小如倒扣的杯子，长久不愈，会出现怕冷发热、气逆喘咳的症状，进而发展为肺痈。
半夏（用汤水泡七次） 吴茱萸（炒制） 桂心（避免火烤焦，各七钱半） 人参 桑白皮（炙烤） 葶苈子（微炒）
将上述药物切碎，每次取四钱，加水一盏半，生姜七片，大枣二枚，煎煮至七分水量，滤去药渣，饭前温服。
所谓“积”有五种，“聚”有六种。“积”产生于五脏的阴气；“聚”形成于六腑的阳气。这是由于阴阳不和，加上忧、思、喜、怒等情绪之气，这些是人之常情，但若过度则会损伤五脏，导致气机逆乱于四肢，传变受阻，从而留结成为五积。所以在肝称为肥气，在心称为伏梁，在脾称为痞气，在肺称为息贲，在肾称为奔豚。它们的名称不同，症状也各异。
肥气的症状，位于左胁下，大如倒扣的杯子，肥大且似乎有头有脚，这是肝积。诊察其脉象弦而细，面色青，病症为两胁下疼痛，牵引小腹，足部发冷转筋，男子表现为积疝，女子表现为瘕聚。
伏梁的症状，起于脐下，大如手臂，向上延伸至心下，就像横梁横架在胸膈之间，这是心积。诊察其脉象沉而芤，面色赤，病症为腹部发热、面红、咽干心烦，严重时吐血，使人食欲减退，肌肉消瘦。
痞气的症状，停留于胃脘部，大如倒扣的杯子，痞塞不通，这是脾积。诊察其脉象浮大而长，面色黄，病症为饥饿时减轻，饱食时显现，腹胀呕吐泄泻，足肿肌肉消损，长久不愈，使人四肢无力无法收持。
息贲的症状，位于右胁下，大如倒扣的杯子，喘息气急上溢，这是肺积。诊察其脉象浮而毛（轻虚），面色白，病症为气逆背痛，气短健忘，闭目皮肤寒冷，皮肤中时常疼痛，或如虫爬，或如针刺。
奔豚的症状，发作于小腹，向上至心下，上下无常，状如小猪奔跑，这是肾积。诊察其脉象沉而急，面色黑，病症为饥饿时显现，饱食时减轻，小腹里急，腰痛口干，目昏骨冷，长久不愈，使人骨痿气少。
至于六聚的形成，由于六腑而异，为什么呢？六腑属于三阳经，太阳经利导清气，阳明经排泄浊气，少阳经化生精气，犹如都会之腑，主要功能是转输运化以维持常态。如果六腑功能失常，则邪气聚集而不散，起初没有根本，上下无处停留，疼痛也没有固定位置，所以在上则格拒，在下则胀满，旁攻两胁，如有杯块，易于转动，所以不同于五积。凡是脉象快而紧的，是积聚病。脉来小且沉重的，是胃中有积聚。大抵疾病各有证候，治疗各有方药。如诊察心腹积聚，脉象牢强急者预后良好，虚弱急者预后不良。又诸脉实强者预后良好，沉小者预后不良，这又是不可不仔细考察的。
又论述：所谓积，是伤滞所致。伤滞日久，停留不化，就形成了积。人的脏腑，都因触犯外邪而成疾病，其中脾胃最容易受触。因为日常饮食，稍微过多，停滞难化，就会发生呕吐或腹泻痢疾。在这个时候，治法应当推荡积滞，然后辅助调养脾胃。所谓的推荡，更应斟酌病人的虚实情况和伤滞的轻重程度来进行推荡。一旦停滞消除，就不会形成积证；若克化失宜，久而久之必成积聚症瘕。所谓积，有气积、肉积、酒积、茶积、食积、痰积，更有妇女室女月经不通，遂成血积。凡治疗各种积证的要点，都记载在后面，如果在前面所述证候中，参考斟酌而使用即可。
Treatment for the accumulation in the Liver: The lesion is located under the left hypochondrium, resembling an inverted cup with distinct head and tail, similar to the shape of a turtle or tortoise. If untreated for a long time, it may induce coughing with reverse flow of Qi (cough and belching), malaria, persisting year after year.
Qingpi (Pericarpium Citri Reticulatae, remove white pith, chop and stir-fry, 1 liang) Chuan Danggui (Radix Angelicae Sinensis, remove radicle, wash, 1 liang, dry-bake) Shehanshi (Hematites, fire-calcine, quench in vinegar seven times, 3 fen) Cangzhu (Rhizoma Atractylodis Macrocephalae, peel off skin, soak in rice washing water overnight, chop and stir-fry, 1 liang) Ezhu (Rhizoma Curcumae Zedoariae, slice) Jingsanleng (Rhizoma Sparganii, slice) Tieyanfen (Limonitum, 1.5 liang each).
Grind the above ingredients into fine powder. Use vinegar-boiled rice paste as a binder to form pills the size of mung beans. Take 40 pills per dose, administered with wine infused with Danggui, before meals.
Treatment for the accumulation in the Lung: The lesion is located under the right hypochondrium, large as an inverted cup. If untreated for a long time, it causes chills and fever (shivering cold and heat), reverse flow of Qi with wheezing and coughing, developing into Lung Abscess (Fei Yong).
Banxia (Rhizoma Pinelliae Preparatum, soak in hot water seven times) Wuzhuyu (Fructus Evodiae, stir-fry) Guixin (Cortex Cinnamomi, avoid excessive heating, 7.5 qian each) Renshen (Radix Ginseng) Sangbaipi (Cortex Mori, honey-fried) Tinglizi (Semen Lepidii et Descurainiae, lightly stir-fry).
Chop the above ingredients. Take 4 qian per dose, add 1.5 sheng of water, 7 slices of fresh ginger, and 2 jujubes. Decoct until reduced to 0.7 sheng, strain, and take warm before meals.
There are five types of Accumulation (Ji) and six types of Gathering (Ju). Accumulations arise from the Yin Qi of the Five Zang Organs; Gatherings form from the Yang Qi of the Six Fu Organs. This results from disharmony of Yin and Yang. Emotions such as worry, thought, joy, and anger are inherent to humans, but excess damages the Five Zang Organs and causes Qi rebellion in the four limbs. When transmission and overcoming cycles fail, pathogenic factors remain and knot together to form the Five Accumulations. Thus, in the Liver it is called Feiqi (Fat Qi); in the Heart, Fuliang (Hidden Beam); in the Spleen, Piqi (Stagnant Qi); in the Lung, Xiben (Gathering Breath); in the Kidney, Bentun (Running Piglet). Although their names differ, their symptoms vary.
The manifestation of Feiqi is under the left hypochondrium, large as an inverted cup, enlarged with apparent head and tail; this is Liver Accumulation. Palpation reveals a string-taut and thin pulse (Xuan and Xi), bluish complexion, pain in both hypochondria radiating to the lower abdomen, cold feet with tetany, hernia masses in men, and abdominal masses in women.
The manifestation of Fuliang starts below the umbilicus, as large as an arm, extending up to the epigastrium, resembling a beam横跨 across the chest and diaphragm; this is Heart Accumulation. Palpation reveals a deep and hollow pulse (Chen and Kou), reddish complexion, heat in the abdomen, facial flushing, dry throat, irritability, severe cases may involve hematemesis, loss of appetite, and emaciation.
The manifestation of Piqi remains in the epigastrium, large as an inverted cup, causing stagnation and obstruction; this is Spleen Accumulation. Palpation reveals a floating, large, and long pulse (Fu, Da, Chang), yellowish complexion, symptoms that diminish when hungry and appear when full, abdominal distension, vomiting, diarrhea, swollen feet, muscle wasting, and prolonged illness leading to inability to control the four limbs.
The manifestation of Xiben is under the right hypochondrium, large as an inverted cup, with wheezing and surging Qi; this is Lung Accumulation. Palpation reveals a floating and superficial/hairy pulse (Fu and Mao), whitish complexion, reverse flow of Qi with back pain, shortness of breath, forgetfulness, drowsiness with cold skin, intermittent skin pain feeling like insect crawling or needle pricks.
The manifestation of Bentun originates in the lower abdomen, rising to the epigastrium, occurring irregularly, resembling a running piglet; this is Kidney Accumulation. Palpation reveals a deep and rapid pulse (Chen and Ji), blackish complexion, symptoms appearing when hungry and diminishing when full, urgency in the lower abdomen, lower back pain, dry mouth, blurred vision, cold bones, prolonged illness leading to bone atrophy and shortness of breath.
Regarding the formation of the Six Gatherings in the Six Fu Organs, it differs. Why? The Six Fu Organs belong to the Three Yang channels. Taiyang facilitates clear Qi, Yangming drains turbid Qi, Shaoyang transforms essence and Qi. They act like capitals, primarily responsible for transportation and transformation. If the Six Fu Organs lose normal function, pathogenic Qi gathers and does not disperse. Initially lacking a root, they move up and down without staying in one place, and pain has no fixed location. Upper manifestations cause blockage; lower manifestations cause distension. Lateral attack on the hypochondria creates movable masses like cups. Thus, they differ from the Five Accumulations. Generally, a fast and tight pulse indicates accumulation. A small and heavy pulse suggests gastric accumulation. Diseases have specific syndromes, and treatments have specific formulas. In diagnosing heart/abdominal accumulations, a firm, strong, and urgent pulse indicates survival, while a weak and urgent pulse indicates death. Real and strong pulses indicate survival; deep and small pulses indicate death. These must be carefully observed.
Furthermore: Accumulations result from injury and stagnation. Prolonged stagnation fails to transform, forming accumulations. Viscera suffer diseases from external pathogens, with the Spleen and Stomach being most susceptible. Daily diet, if excessive, leads to stagnation and difficult digestion, causing vomiting or diarrhea/dysentery. At this stage, the method should be to purge and sweep away stagnation, then assist in nourishing the Spleen and Stomach. Purging requires assessing the patient's deficiency/excess and the severity of stagnation. Once stagnation clears, accumulation does not form; improper digestion over time leads to accumulation, mass, and tumor syndromes. Accumulations include Qi accumulation, flesh accumulation, wine accumulation, tea accumulation, food accumulation, phlegm accumulation, and blood accumulation (in women due to amenorrhea). The key principles for treating various accumulations are listed below; refer to them and apply appropriately to the aforementioned syndromes.