病胁下素有痞连在脐旁痛引少腹入阴筋者此名脏结死
肝脉行于两胁素有痞者肝气之郁结也脐当脾胃之交中气所在胁下之痞连在脐旁土败木郁肝邪之乘脾也肝主筋自少腹
而结阴器前阴者宗筋之聚肝气郁结则痛引少腹而入阴筋土木郁迫痞塞不开此名脏结久而木贼土崩必主死矣
脏结无阳证不往来寒热其人反静舌上苔滑者不可攻也
脏结之证阴胜则寒阳复则热寒为死机热则生兆阴阳相争多见烦躁复之过者邪热如焚亦有下证若绝无阳证不往来寒热
其人反静舌上苔滑者是为绝阴不可攻也肝胆同气寒热往来而生烦者胆木之阳复也寒热不作而反静者肝木之阴胜也
太阳病下之其脉促不结胸者此为欲解也脉浮者必结胸也脉紧者必咽痛脉弦者必两胁拘急脉细数者头痛未止脉沉紧者
必欲呕脉沉滑者协热利脉浮滑者必下血
太阳病下之里邪既去经热不得内传而表邪未解经热不能外达表里迫束故脉见促象而不结胸者则表阳未陷经气郁勃必
当外发为汗此为欲解也若寸脉浮者阴邪逆冲膈热郁迫必作结胸脉紧者表热被束邪火上燔必苦咽痛肝胆之经旁循胁肋其脉
象为弦脉弦者木气不舒必两胁拘急脉细数者阳虚不能下秘为浊阴冲逼升浮无根头痛发作必当未止脉沉紧者胃气郁迫容纳
失职必作呕吐脉沉滑者脾阳郁陷肝木疏泄必协热下利脉浮滑者乙木升发而生气不畅郁而生风疏泄失藏必病下血也
病人在胁下素有痞块，疼痛牵连到脐旁，并放射至小腹及阴筋，这称为“脏结”，属于死证。
肝经的脉气运行于两侧胁肋部，素有痞块，是肝气郁结所致。脐部位于脾胃交接之处，是中气所在之地。胁下的痞块连及脐旁，说明脾土衰败、肝木郁滞，导致肝邪乘袭脾土。肝主筋，阴器（生殖器）为宗筋汇聚之处。肝气郁结，则疼痛牵引少腹并进入阴筋。由于土木之气郁迫，痞塞不通，这称为“脏结”。久而久之，木气贼害土气，导致土崩瓦解，必然导致死亡。
脏结证没有阳证表现，不出现往来寒热，病人反而神志安静，舌苔滑润，这种情况不可使用攻下法。
脏结之证，若阴盛则表现为寒，阳气恢复则表现为热。寒是死亡的征兆，热则是生存的兆头。阴阳相争时，多见烦躁不安；若阳气回复过度，邪热如焚，也可能出现可下之证。但如果完全没有阳证，不出现往来寒热，病人反而安静，且舌苔滑润，这是绝阴之象，绝对不可攻下。肝胆同属一气，寒热往来并伴有烦躁，是胆木阳气恢复的表现；若无寒热往来而反见安静，则是肝木阴气胜出的表现。
太阳病经过误用泻下法后，如果脉搏急促但未形成结胸，这是病情即将解除的迹象。如果脉搏浮，必然会形成结胸。如果脉搏紧，必然会咽喉痛。如果脉搏弦，必然两胁拘急。如果脉搏细数，头痛不会停止。如果脉搏沉紧，必然想要呕吐。如果脉搏沉滑，必然伴有热利的腹泻。如果脉搏浮滑，必然出现便血。
太阳病误用泻下法后，里部的邪气已去，经中的热邪不能内传，而表部的邪气仍未解除，经热也不能外达，表里之气相互迫束，所以脉搏呈现促象。若不形成结胸，说明表阳未陷入体内，经气郁勃旺盛，必然应当通过发汗来解除，这是病情即将解除的迹象。如果寸脉浮，说明阴邪逆冲，膈间热邪郁迫，必然发生结胸。如果脉紧，说明表热被束缚，邪火上炎，必然痛苦于咽喉痛。肝胆的经脉旁循胁肋，其脉象为弦。脉弦表示木气不舒，必然导致两胁拘急。脉细数表示阳虚不能固秘于下，浊阴上冲逼迫，升浮无根，头痛发作必然不会停止。脉沉紧表示胃气郁迫，容纳失职，必然发生呕吐。脉沉滑表示脾阳郁陷，肝木疏泄功能失常，必然伴随热利而下利。脉浮滑表示乙木（肝木）升发而生气不畅，郁而生风，疏泄失藏，必然病发便血。
The patient has a chronic mass (痞块, localized swelling or hardness) under the hypochondrium, with pain radiating to the side of the umbilicus, extending into the lower abdomen and entering the Yin sinews (阴筋, referring to the genitalia). This is named Zang Jie (脏结, Organ Knotting), which is a fatal condition.
The Liver meridian runs through both hypochondria. The presence of a chronic mass indicates stagnation and knotting of Liver Qi. The umbilicus is at the junction of the Spleen and Stomach, where the Middle Qi resides. The mass under the hypochondrium connecting to the side of the umbilicus indicates the failure of Earth (Spleen/Stomach) and stagnation of Wood (Liver), leading to Liver pathogenic factors attacking the Spleen. The Liver governs the sinews, and the external genitalia are the gathering point of the Zong Jin (宗筋, major sinews). When Liver Qi stagnates, pain radiates from the lower abdomen into the Yin sinews. Due to the oppression between Wood and Earth, blockage fails to open, hence this is called Zang Jie (脏结, Organ Knotting). Over time, Wood rots Earth, leading to the collapse of Earth, which inevitably results in death.
Zang Jie (脏结, Organ Knotting) presents without Yang syndromes, without alternating chills and fever, and the person appears unusually calm. If the tongue coating is slippery, it cannot be treated with purgation.
In Zang Jie (脏结, Organ Knotting), if Yin prevails, there is cold; if Yang recovers, there is heat. Cold is an omen of death, while heat is an omen of life. When Yin and Yang contend, irritability is common. If Yang recovery is excessive, pathogenic heat may burn fiercely, potentially presenting indications for purgation. However, if there are absolutely no Yang syndromes, no alternating chills and fever, the person remains calm, and the tongue coating is slippery, this indicates absolute Yin deficiency/failure, and purgation is strictly contraindicated. The Liver and Gallbladder share the same Qi. Alternating chills and fever with irritability indicate the recovery of Gallbladder Yang. The absence of alternating chills and fever with a state of calmness indicates the predominance of Liver Yin.
After a Sun Taiyang disease (太阳病, Taiyang Disease) is incorrectly treated with purgation, if the pulse is rapid (促, Cu) but does not form Jie Xiong (结胸, Chest Binding/Knotting), this indicates the condition is about to resolve. If the pulse is floating (浮, Fu), Jie Xiong (结胸, Chest Binding/Knotting) will definitely occur. If the pulse is tight (紧, Jin), throat pain will definitely occur. If the pulse is wiry (弦, Xian), bilateral hypochondriac stiffness and spasm will definitely occur. If the pulse is fine and rapid (细数, Xi Shu), headache will not cease. If the pulse is deep and tight (沉紧, Chen Jin), vomiting will definitely occur. If the pulse is deep and slippery (沉滑, Chen Hua), diarrhea with heat (协热利, Xie Re Li) will definitely occur. If the pulse is floating and slippery (浮滑, Fu Hua), hematochezia (下血, Xia Xue) will definitely occur.
After Sun Taiyang disease (太阳病, Taiyang Disease) is incorrectly treated with purgation, the interior pathogens have departed, so the heat in the meridians cannot transmit inward, while the exterior pathogens remain unresolved, preventing the meridian heat from reaching the exterior. The exterior and interior constrain each other, resulting in a rapid (促, Cu) pulse. If Jie Xiong (结胸, Chest Binding/Knotting) does not form, it means the Exterior Yang has not sunk into the interior, and the meridian Qi is stagnant and vigorous, likely to be released via sweating, indicating the condition is about to resolve. If the Cun position pulse is floating, it indicates Yin pathogens counter-attacking and heat in the diaphragm being constrained, leading to Jie Xiong (结胸, Chest Binding/Knotting). If the pulse is tight, it indicates exterior heat being constrained and pathogenic fire flaring upward, causing severe throat pain. The Liver and Gallbladder meridians run alongside the hypochondrium; their pulse image is wiry (弦, Xian). A wiry pulse indicates unsmooth Wood Qi, leading to bilateral hypochondriac stiffness and spasm. A fine and rapid (细数, Xi Shu) pulse indicates Yang deficiency failing to secure the lower jiao, allowing turbid Yin to rush upward and rise rootlessly, causing persistent headache. A deep and tight (沉紧, Chen Jin) pulse indicates Stomach Qi stagnation and oppression, with loss of its function of containment, leading to vomiting. A deep and slippery (沉滑, Chen Hua) pulse indicates Spleen Yang sinking due to stagnation and Liver Wood losing its draining function, leading to diarrhea with heat. A floating and slippery (浮滑, Fu Hua) pulse indicates Yi Wood (Liver Wood) failing to ascend smoothly, causing stagnant Sheng Qi, generating wind due to stagnation, and losing control over drainage, leading to hematochezia.