五十五难曰∶病有积、有聚，何以别之？然∶积者、阴气也；聚者、阳气也。故阴沉而伏，
阳浮而动。气之所积名曰积，气之所聚名曰聚。故积者，五脏所生；聚者、六腑所成也。积者、阴气
也，其始发有常处，其痛不离其部，上下有所终始，左右有所穷处；聚者、阳气也，其始发无根本，
上下无所留止，其痛无常处，谓之聚。故以是别知积聚也。
五十六难曰∶五脏之积，各有名乎？以何月何日得之？
然∶肝之积名曰肥气，在左胁下，如覆杯，有头足。久不愈，令人发咳逆， 疟，连岁
不已。以季夏戊己日得之。何以言之？肺病传于肝，肝当传脾，脾季夏适王。王者不受邪，肝复欲还肺，
肺不肯受，故留结为积。故知肥气以季夏戊己日得之。
心之积，名曰伏梁，起脐上，大如臂，上至心下。久不愈，令人病烦心。以秋庚辛日得之。
何以言之？肾病传心，心当传肺，肺以秋适王，王者不受邪，心欲复还肾，肾不肯受，故留结为
积。故知伏梁以秋庚辛日得之。
脾之积，名曰痞气，在胃脘，覆大如盘。久不愈，令人四肢不收，发黄胆，饮食不为肌肤。
以冬壬癸日得
之。何以言之？肝病传脾，脾当传肾，肾以冬适王，王者不受邪，脾复欲还肝，肝不肯受，故留结
为积。故知痞气以冬壬癸日得之。
肺之积，名曰息贲，在右胁下，覆大如杯。久不已，令人洒淅寒热，喘咳，发肺壅。以春甲乙
日得之。何以言之？心病传肺，肺当传肝，肝以春适王，王者不受邪，肺复欲还心，心不肯受，故留结
为积。故知息贲以春甲乙日得之。
肾之积，名曰贲豚，发于少腹，上至心下，若豚状，或上或下无时。久不已，令人喘逆，骨痿，
少气。以夏丙丁日得之。何以言之？脾病传肾，肾当传心，心以夏适王，王者不受邪，肾复欲还脾，
脾不肯受，故留结为积。故知贲豚以夏丙丁日得之。此五积之要法也。
第五十五难问道：疾病中有“积”和“聚”，如何区分它们？回答说：“积”属于阴气；“聚”属于阳气。所以阴气沉潜而潜伏，阳气轻浮而变动。气机积聚的地方称为“积”，气机聚集的地方称为“聚”。因此，“积”是由五脏产生的；“聚”是由六腑形成的。“积”属于阴气，它发作时有固定的部位，疼痛不离开其所在的区域，上下有起止点，左右有尽头处；“聚”属于阳气，它发作时没有根本固定的位置，上下没有停留止息之处，疼痛没有固定的地方，这就叫做“聚”。所以根据这些特征来辨别“积”和“聚”。
第五十六难问道：五脏的“积”，各有名称吗？是在哪个月、哪一天形成的？
回答说：肝的积名叫“肥气”，位于左胁下，形状像倒扣的杯子，有头有足。如果久治不愈，会导致人咳嗽气逆，患疟疾，多年不停止。这是在季夏（夏季的最后一个月）戊己日形成的。为什么这样说呢？因为肺病传变给肝，肝本应再传变给脾，但正值季夏，脾土当令旺盛。当令之脏不受邪气侵袭，肝想将邪气返还给肺，肺不肯接受，所以邪气留结形成积块。因此知道“肥气”是在季夏戊己日形成的。
心的积，名叫“伏梁”，起于脐上，大小如手臂，向上延伸至心下。如果久治不愈，会导致人心烦不安。这是在秋季庚辛日形成的。
为什么这样说呢？因为肾病传变给心，心本应再传变给肺，但正值秋季，肺金当令旺盛，当令之脏不受邪气侵袭，心想将邪气返还给肾，肾不肯接受，所以邪气留结形成积块。因此知道“伏梁”是在秋季庚辛日形成的。
脾的积，名叫“痞气”，位于胃脘部，覆盖面积大如盘子。如果久治不愈，会导致人四肢无力不能收持，出现黄疸，饮食无法转化为肌肤营养。这是在冬季壬癸日形成的。
为什么这样说呢？因为肝病传变给脾，脾本应再传变给肾，但正值冬季，肾水当令旺盛，当令之脏不受邪气侵袭，脾想将邪气返还给肝，肝不肯接受，所以邪气留结形成积块。因此知道“痞气”是在冬季壬癸日形成的。
肺的积，名叫“息贲”，位于右胁下，覆盖面积大如杯子。如果久治不愈，会导致人寒战发热，气喘咳嗽，引发肺壅塞。这是在春季甲乙日形成的。
为什么这样说呢？因为心病传变给肺，肺本应再传变给肝，但正值春季，肝木当令旺盛，当令之脏不受邪气侵袭，肺想将邪气返还给心，心不肯接受，所以邪气留结形成积块。因此知道“息贲”是在春季甲乙日形成的。
肾的积，名叫“贲豚”（奔豚），发作于少腹，向上延伸至心下，形状像小猪奔跑的样子，有时上行有时下行，没有固定时间。如果久治不愈，会导致人气喘逆乱，骨骼痿弱，气息短少。这是在夏季丙丁日形成的。
为什么这样说呢？因为脾病传变给肾，肾本应再传变给心，但正值夏季，心火当令旺盛，当令之脏不受邪气侵袭，肾想将邪气返还给脾，脾不肯接受，所以邪气留结形成积块。因此知道“贲豚”是在夏季丙丁日形成的。这是关于五种积证的关键法则。
Difficulty 55 states: In diseases, there are "Ji" (accumulation) and "Ju" (aggregation). How can they be distinguished? The answer is: "Ji" belongs to Yin Qi (Yin energy); "Ju" belongs to Yang Qi (Yang energy). Therefore, Yin is deep and latent, while Yang is floating and active. Where Qi accumulates, it is called "Ji"; where Qi gathers, it is called "Ju". Thus, "Ji" arises from the Zang organs (solid organs); "Ju" is formed by the Fu organs (hollow organs). "Ji" is of Yin nature; its onset has a fixed location, the pain does not leave its specific area, moving up and down with definite beginnings and endings, and left and right with limits; "Ju" is of Yang nature; its onset has no fixed root, moving up and down without staying in one place, and the pain occurs in various locations, which is termed "Ju". Therefore, one distinguishes between accumulation and aggregation based on these characteristics.
Difficulty 56 states: Do the accumulations of the five Zang organs have specific names? On what month and day do they form?
The answer is: The accumulation of the Liver is named Feiqi (Fatty Qi), located under the left hypochondrium, resembling an inverted cup with a head and feet. If not cured for a long time, it causes coughing and counterflow qi, malaria, persisting for years. It forms on Wu and Ji days during the late summer (the last month of summer). Why is this so? Because Lung disease transmits to the Liver, and the Liver should transmit to the Spleen. However, during late summer, the Spleen is prosperous and dominant. A dominant organ does not accept pathogenic factors. The Liver attempts to return the pathogen to the Lung, but the Lung refuses to accept it. Consequently, the pathogen remains and knots to form an accumulation. Thus, it is known that Feiqi forms on Wu and Ji days in late summer.
The accumulation of the Heart is named Fuliang (Hidden Beam), starting above the umbilicus, as large as an arm, extending upward to below the heart. If not cured for a long time, it causes mental restlessness and vexation. It forms on Geng and Xin days in autumn.
Why is this so? Because Kidney disease transmits to the Heart, and the Heart should transmit to the Lung. However, in autumn, the Lung is prosperous and dominant, refusing pathogens. The Heart attempts to return the pathogen to the Kidney, but the Kidney refuses. Thus, the pathogen remains and knots to form an accumulation. Hence, Fuliang forms on Geng and Xin days in autumn.
The accumulation of the Spleen is named Piqi (Stagnant Qi), located in the epigastrium, covering an area as large as a plate. If not cured for a long time, it causes weakness and inability to control the four limbs, jaundice, and failure of food intake to nourish the flesh. It forms on Ren and Gui days in winter.
Why is this so? Because Liver disease transmits to the Spleen, and the Spleen should transmit to the Kidney. However, in winter, the Kidney is prosperous and dominant, refusing pathogens. The Spleen attempts to return the pathogen to the Liver, but the Liver refuses. Thus, the pathogen remains and knots to form an accumulation. Hence, Piqi forms on Ren and Gui days in winter.
The accumulation of the Lung is named Xiben (Panting Accumulation), located under the right hypochondrium, covering an area as large as a cup. If not cured for a long time, it causes chills and fever, panting and coughing, and lung congestion. It forms on Jia and Yi days in spring.
Why is this so? Because Heart disease transmits to the Lung, and the Lung should transmit to the Liver. However, in spring, the Liver is prosperous and dominant, refusing pathogens. The Lung attempts to return the pathogen to the Heart, but the Heart refuses. Thus, the pathogen remains and knots to form an accumulation. Hence, Xiben forms on Jia and Yi days in spring.
The accumulation of the Kidney is named Benteng (Rushing Pig), originating in the lower abdomen and extending upward to below the heart, resembling the movement of a pig, rising or falling at irregular times. If not cured for a long time, it causes panting and counterflow qi, bone萎 (bone weakness/atrophy), and shortness of breath. It forms on Bing and Ding days in summer.
Why is this so? Because Spleen disease transmits to the Kidney, and the Kidney should transmit to the Heart. However, in summer, the Heart is prosperous and dominant, refusing pathogens. The Kidney attempts to return the pathogen to the Spleen, but the Spleen refuses. Thus, the pathogen remains and knots to form an accumulation. Hence, Benteng forms on Bing and Ding days in summer. These are the essential principles regarding the five accumulations.