夫微之显者，积也。人身皮里膜内必有津液滋润其间，乃气血之所生也。及
气血因感伤而停滞，则津液变涎沫以凝结，气血可以复通，凝结不能再解，潜孳
暗长，无减有增，此积之所由成也。若铜铁遇潮湿生锈，非括磨不能去，正如积
之非揉不消，同一理也。人生幼稚无积，积生则绝。少年气血旺，积不能生，壮
年气血更旺，嗜欲开，难免积，随长随消。中年并生并育，气血旺则伏，否则为患
。中年以后积渐大，占地阔。同是气血也，积有余而人反不足，宾夺主食矣。皮紧
、面鼓、项粗。腮缩，耳反、唇掀、结喉、露齿，此形之不足于外者也。再当要害
之地，手足则麻木、瘫痪；
颈项则瘰 、噎嗝；口舌则 哑、歪斜；耳目则聋 、糊涂，此急不待时者也。倘不甚重，尚可
苟延，逮至晚年，头尖、项壅、背驼、肩耸、腿胯直强、手足痿痹，四肢塞满，空隙毫无，生意隔
绝，而人积偕亡矣。此无他法，惟揉以去之，倘得消多长少，或者一条生路也。或者曰∶所言皆
病之内症，古有医案方药，安见所谓积？安见揉有效？自古无此治病法也。予应之曰∶子遵古而言
内症是也，独不见生于外之瘿瘤乎？附体成形，耗其气血，日长月大，竟以致命。虽有筋脂脓血
石肉之别，要皆气血凝结之积，古方皆以药内消，然历见消去者，十不获一。缘病在皮里膜内，药
力不能到也，在外揉之，竟可消散。今之所谓积者，即如瘿瘤使之反生于内，得不统谓气血之积乎
？独可专仗药力消之乎？总之，凡百病症，皆以气血为主，通则无积，不通则积，新则积小，久
则积大。不论大小内外病症，果能揉之，使经络气血通畅，则病无不愈者，不必先争此揉积之名分
今古也。再以浅近者申之，如头痛揉提太阳及眉心，立见轻爽，喉痛重提项前，亦见效验；小有肿痛
疮疖，揉之立时解散。揉之为法，有益无损，且可窒病之源，拔病之根，思患预防之道，无过是者，
岂反不及临渴掘井之医药耶？且也，病遇良医实是罕逢，而远乡僻野，更无所谓医药矣。况疳劳鼓嗝
，医效难期∶肓上膏下，药力不到，更有无力延医市药者，尤堪怜悯也。俗语云有病靠天，此无法如
何之词也。然则何如尽自己之心，竭自己之力，用日月之功，保百年之命，上可对天地，中可对父母，
下可对自身。今有揉晒二法，既不借人之力，又不费己之财，矢以诚，行以勤，用以和，守以恒，凡百
病症，概可立愈。健旺精神，延年益寿，此即所谓可以赞天地之化育也，请自身始。从古良医代不乏
人，真可起死回
生，实是出神入化，然垂名千古而心法无传，徒留医案方药，后人则效无从。今兹之道，
若大路然，人人能为，时时可行，惟患人之不求，不患法之不传也。集说既成，弁以揉
积论，愿先览焉。
所谓由微至显的，就是“积”。人体皮肤与筋膜之间必然有津液滋润其间，这是气血化生的基础。当气血因感受外邪或内伤而停滞时，津液就会转化为涎沫并凝结；此时若气血尚能重新通畅，则凝结尚可化解；若凝结无法再解，便会暗中滋生、逐渐增长，只增不减，这就是“积”形成的原因。这就好比铜铁遇到潮湿会生锈，不经过刮擦打磨就无法去除，正如“积”不通过揉按就不能消散，道理是一样的。
人在幼年时期没有“积”，一旦产生“积”就会断绝生机。少年时期气血旺盛，“积”难以生成；壮年时期气血更加旺盛，虽然欲望开启难免产生“积”，但也能随之生长、随之消散。中年时期既要生育又要劳作，若气血旺盛则“积”潜伏不发，否则就会成为祸患。中年以后，“积”逐渐变大，占据的空间也变宽。同样是气血，因为“积”有余而人体反而虚弱，这是宾客（病邪）夺取了主人（正气）的粮食。表现为皮肤紧绷、面部浮肿、颈部粗大、腮部收缩、耳朵后翻、嘴唇外翻、喉结突出、牙齿外露，这是形体在外部表现出的不足。
如果发生在要害部位，手足会出现麻木、瘫痪；颈项会出现瘰疬、噎膈；口舌会出现失语、歪斜；耳目会出现耳聋、神志糊涂，这些都是急迫且不能等待时机的病症。倘若病情不是特别严重，还可以勉强维持，等到晚年，出现头尖、颈部肿胀、背部驼曲、耸肩、腿胯僵硬笔直、手足痿软麻痹，四肢塞满，毫无空隙，生机隔绝，人与“积”一同消亡了。这没有其他办法，只有通过揉按来消除它，如果能消除得多、生长的少，或许还有一条生路。
有人问道：您所说的都是疾病的内部症状，古代虽然有医案和方药，哪里见过所谓的“积”？哪里见过揉按有效？自古以来就没有这种治病的方法。我回答说：你遵循古法谈论内部症状是对的，难道没看见生长在体外的瘿瘤吗？它们依附身体形成形状，消耗人的气血，一天天一月月长大，最终导致致命。虽然其中有筋、脂、脓、血、石、肉的区别，但总之都是气血凝结而成的“积”，古代方剂都用药物从内部消除，然而我历来看见消除成功的，十人中不到一个。原因在于病灶位于皮里膜内，药力达不到那里，而在体外揉按，竟然可以消散。现在所说的“积”，就像让瘿瘤反生在体内一样，怎能不统称为气血之“积”呢？难道只能专门依靠药力来消除它吗？
总之，所有的病症，都以气血为主，通畅就没有“积”，不通畅就会产生“积”，新产生的“积”小，久留的“积”大。不论大小内外病症，如果能揉按，使经络气血通畅，那么疾病没有不能治愈的，不必先争论这个“揉积”的名分是古是今。再用浅显的例子说明，比如头痛时揉提太阳穴及眉心，立刻感到轻松爽快；喉咙痛时重提项前部位，也能见效；小有肿痛的疮疖，揉按后立即解散。揉按这种方法，有益无损，而且可以堵塞病的源头，拔掉病的根子，思考预防灾患的道理，没有超过它的，难道反而不如临渴掘井式的医药吗？
况且，病人遇到良医确实是罕逢，而在偏远乡村，更没有什么医药可言。何况疳积、劳损、鼓胀、噎膈等病，医疗效果难以期待；病位在肓之上、膏之下，药力达不到，更有无力请医生买药的人，尤其令人怜悯。俗语说“有病靠天”，这是无可奈何的话。既然如此，如何尽自己的心，竭自己的力量，用日月的功夫，保全百年的寿命，对上可以对得起天地，对中可以对得起父母，对下可以对得起自身。现在有揉法和晒法两种，既不借别人的力，又不费自己的财，以诚心立志，以勤奋行动，以平和运用，以恒心坚守，所有的病症，大概都可以立即痊愈。精神健旺，延年益寿，这就是所谓可以赞助天地化育万物的道理，请从自身开始实践。从古以来良医代代不乏其人，真正能让死人复活，确实出神入化，然而流传千古却心法未传，只留下医案方药，后人效仿无从下手。现在的这门道术，像大路一样平坦，人人能做，时时可行，只怕人不去追求，不怕方法不流传。集说既已写成，加上《揉积论》，希望先阅读它。
What manifests from the subtle is "accumulation" (Ji, 积). Within the human body, between the skin and the fascia, there must be Jin Ye (Body Fluids) to moisten the space, which is generated by Qi and Blood. When Qi and Blood stagnate due to pathogenic invasion or internal injury, Jin Ye transforms into phlegm and foam, condensing together. If Qi and Blood can resume their flow, the condensation can still be resolved; but if the condensation cannot be further resolved, it secretly proliferates and grows, increasing without decreasing. This is how "accumulation" comes into being. It is like copper or iron rusting when exposed to dampness; it cannot be removed without scraping and polishing. Similarly, "accumulation" cannot be dissipated without kneading and rubbing, following the same principle.
In infancy and childhood, there is no "accumulation"; once "accumulation" arises, vitality is severed. In youth, Qi and Blood are vigorous, so "accumulation" cannot form. In early adulthood, Qi and Blood are even more vigorous; although desires open up and "accumulation" is inevitable, it grows and dissipates simultaneously. During middle age, one engages in both reproduction and labor. If Qi and Blood are vigorous, "accumulation" lies dormant; otherwise, it becomes a hazard. After middle age, "accumulation" gradually enlarges and occupies a wider area. Although it involves the same Qi and Blood, because "accumulation" is excessive, the person becomes deficient; this is the guest (pathogen) seizing the food of the host (healthy Qi). Manifestations include tight skin, swollen face, thick neck, retracted cheeks, backward-turned ears, everted lips, protruding Adam's apple, and exposed teeth. These are signs of physical deficiency on the exterior.
If located in critical areas, the limbs may experience numbness or paralysis; the neck and throat may develop scrofula (Luo Li, 瘰疬) or dysphagia (Ye Ge, 噎膈); the mouth and tongue may suffer from aphasia or deviation; the ears and eyes may suffer from deafness or confusion. These are urgent conditions that cannot wait. If not too severe, life can be barely prolonged. By late years, however, the head becomes pointed, the neck swollen, the back hunched, shoulders shrugged, legs and hips stiff and straight, and limbs withered and paralyzed. The four limbs are filled, leaving no gaps, vitality is cut off, and the person perishes along with the "accumulation." There is no other method except to remove it through kneading. If one can reduce more than what grows, perhaps there is a path to survival.
Someone might ask: What you describe are all internal symptoms of disease. Ancient medical cases and prescriptions exist, but where is this so-called "accumulation"? Where is the efficacy of kneading? Such a treatment method has never existed since ancient times. I reply: You are correct to follow ancient texts regarding internal symptoms, but have you not seen goiters and tumors (Ying Liu, 瘿瘤) growing on the exterior? They attach to the body, take shape, consume Qi and Blood, and grow day by day and month by month until they become fatal. Although they differ in nature—such as tendon, fat, pus, blood, stone, or flesh—they are essentially "accumulations" formed by the condensation of Qi and Blood. Ancient formulas use herbs to dissolve them internally, yet I have observed that fewer than one in ten cases succeed. This is because the pathology lies within the skin and fascia, where medicinal power cannot reach. However, external kneading can actually dissipate them. The "accumulation" discussed today is akin to having goiters and tumors grow internally. How can we not uniformly call them "accumulations" of Qi and Blood? Can we rely solely on herbal medicine to dissolve them?
In summary, all diseases are primarily governed by Qi and Blood. If unobstructed, there is no "accumulation"; if obstructed, "accumulation" forms. New "accumulations" are small; old ones are large. Regardless of whether the disease is minor or major, internal or external, if kneading is applied to make the meridians and Qi-Blood flow smoothly, then no disease will fail to heal. One need not first debate whether the title "Kneading Accumulation" is ancient or modern. Let me illustrate with simple examples: for headache, kneading and lifting the Taiyang acupoint and the glabella brings immediate relief; for sore throat, firmly lifting the front of the neck yields results; for minor swelling, pain, sores, or boils, kneading disperses them instantly. The method of kneading is beneficial without harm. It can block the source of disease and pull out its root. Regarding preventive care against potential illness, nothing surpasses this. Is it not superior to the reactive approach of "digging a well only when thirsty," i.e., seeking medical treatment only after illness strikes?
Moreover, encountering a skilled physician is rare, and in remote villages, medical care is virtually non-existent. Furthermore, for conditions such as infantile malnutrition (Gan Lao, 疳劳), abdominal distension (Gu Zhang, 鼓胀), and dysphagia (Ye Ge, 噎膈), therapeutic effects are hard to expect. When the disease is located above the diaphragm and below the heart (Huang Shang Gao Xia, 肓上膏下), medicinal power cannot reach. There are also those who lack the means to hire doctors or buy medicines, which is truly pitiable. The common saying "rely on Heaven when sick" reflects a sense of helplessness. Therefore, how can one exert one's own heart, exhaust one's own strength, apply the effort of days and months, and preserve a hundred-year lifespan? This allows one to answer to Heaven and Earth above, parents in the middle, and oneself below. Currently, there are two methods: kneading and sunbathing. They require neither others' labor nor one's wealth. With sincerity as the vow, diligence as the action, harmony as the application, and perseverance as the guard, all diseases can theoretically be cured immediately. Spirit becomes robust, extending life and health. This is what is meant by assisting the transformation and nourishment of Heaven and Earth. Please begin with yourself. Since ancient times, skilled physicians have been numerous, capable of reviving the dead and achieving miraculous results. However, while their fame lasts for millennia, their core techniques were not transmitted, leaving only medical cases and prescriptions, making it impossible for later generations to emulate. The present Dao is like a broad road; everyone can practice it, at any time. The only issue is whether people seek it, not whether the method is transmitted. Having compiled these discussions, I add the "Treatise on Kneading Accumulation," hoping it will be read first.