者，是因伤食得之，其状胁肋，心胸烦闷，饮食不下，吐逆恶心日久不治，渐
成结，又曰食结，其症属阴，阴主静，故 定于一处而不移。
瘕者，是因伤血得之，其状胸膈烦闷，痛引少腹，时或攻筑，上抢心胸，虽不阻
食，渐成瘕结，又曰血结，然此与 总以荣卫俱虚，风寒袭于外，饮食滞于中，久而
不化则邪并于阴，而为 ，邪并于阳则为瘕，瘕者假物象形，动而不息，去来无常或
两胁间有块如石，按之则痛，不按则轻，久而不已，而黄肌瘦，肚硬而胀，腹现青筋，
昼凉夜热。食减餐泥，成为疳积，治宜调脾养胃，磨积清疳，非一日一夕可愈也。
痞者，是因伤气得之，其候心腹膨胀，肚大胁满，痛引腹胁，住在左肋，面黄肌
瘦，倦怠无力，久而不治，渐成痞块，痞者
塞也，结者实也，凡热气蕴于胸膈之间，停饮聚于腹胁之内，于是荣卫不得流行，脏腑
不得宣通，而乃成结也，不可迅下，否则邪反坚结。《经》所谓着而不去，其病为实矣，
惟宜安胃理脾，佐以顺气化滞，若胸中气不通，痛而如痞者，乃正气不运所致，不可作
有形攻治，盖胸为受气之所，虚则受而不能行实，非物也，故曰痞者否也。
癖者，是因积得之，其症如肠癖之疾，便利无度，似痢非痢，似虫非虫，或下鲜
血，肚腹干痛，心胸满闷，久而不治，则顽结不散，有类痞状。盖由乳哺失调，停滞为
积，久则血膜并聚，胁傍结癖，时时作痛，或发潮热，又有食癖、乳癖、疳癖、惊癖、
虚癖、痰癖之分，其伤气血一也，若至面色紫黑，肚胀如鼓，凑心刺痛，忽泻鲜血，唇
舌皆黑，干呕气促，皮焦斑紫，吐泻出虫，肠鸣自利，体虚发搐，面青流涎，手足心
肿，面黑泻黑者，并皆不治。
癥，是由于饮食积滞引起的，其症状表现为胁肋部及心胸烦闷，饮食难以下咽，呕吐逆气、恶心日久不愈，逐渐形成结块，又称为食结。其病证属性属阴，阴主静，所以结块固定在一处而不移动。
瘕，是由于血分受损引起的，其症状表现为胸膈部烦闷，疼痛牵引至小腹，有时攻冲筑痛，向上冲击心胸，虽然不影响进食，但逐渐形成瘕结，又称为血结。然而这与癥总归是因为营卫俱虚，风寒侵袭于外，饮食停滞于中，日久不化则邪气并入阴分而成癥，邪气并入阳分则为瘕。瘕是假借物象来命名，其特点是动而不停息，去来无常。或者在两胁间有像石头一样的硬块，按压时疼痛，不按则感觉轻微。若久治不愈，会导致面色萎黄、肌肉消瘦，腹部坚硬而胀大，腹壁出现青筋，白天凉爽夜间发热。食欲减退甚至想吃泥土，形成疳积。治疗应当调理脾胃，消磨积滞，清除疳热，这不是一天一夕可以治愈的。
痞，是由于气机受伤引起的，其候症表现为心腹胀满，肚子大、胁肋胀满，疼痛牵引腹胁，病灶位于左肋，面色萎黄、肌肉消瘦，疲倦无力。若久治不愈，逐渐形成痞块。“痞”意为阻塞，“结”意为实邪。凡是热气蕴结在胸膈之间，停饮聚集在腹胁之内，于是营卫之气不能正常运行，脏腑之气不得宣通，从而形成结块。不可迅速使用攻下法，否则邪气反而坚固凝结。《内经》所谓“着而不去，其病为实”，只宜安胃理脾，辅以顺气化滞之法。如果胸中气机不通，疼痛感觉像痞块一样，这是正气不能运化的结果，不可当作有形之邪来攻治。因为胸是受气之所，虚则受而不能行实，并非实物，所以说“痞”就是“否”（闭塞不通之意）。
癖，是由于积滞引起的，其症状类似肠癖之疾，排便无度，似痢非痢，似虫非虫，有时排出鲜血，肚腹干痛，心胸满闷。若久治不愈，则顽结不散，有类似痞状的表现。这多由乳哺失调，食物停滞成为积滞，日久血膜并聚，在胁旁结成癖块，时时作痛，有时发潮热。又有食癖、乳癖、疳癖、惊癖、虚癖、痰癖之分，它们损伤气血的道理是一样的。如果发展到面色紫黑，肚子胀大如鼓，凑近心脏刺痛，忽然泻出鲜血，嘴唇和舌头都变黑，干呕气促，皮肤干枯且有紫色斑点，吐泻出虫，肠鸣自利，身体虚弱发生抽搐，面色青白流涎，手足心肿胀，面黑泻黑者，都属于不治之症。
Zheng (mass) arises from food stagnation. Its manifestations include distension and vexation in the hypochondrium and chest/epigastrium, difficulty in swallowing food, chronic vomiting, regurgitation, and nausea. If left untreated for a long time, it gradually forms a fixed mass, also known as "food knot" (Shi Jie). The pathogenesis belongs to Yin; since Yin is static, the mass remains fixed in one location and does not move.
Jia (shifting mass) arises from blood injury. Its manifestations include vexation in the chest and diaphragm, pain radiating to the lower abdomen, occasional attacking or pounding sensations, and upward rushing to the heart and chest. Although it does not obstruct food intake, it gradually forms a Jia knot, also known as "blood knot." Generally, both Zheng and Jia result from deficiency of Ying and Wei (Nutritive and Defensive Qi), external invasion of Wind-Cold, and internal stagnation of food. When these factors persist without transformation, pathogens merge into Yin to form Zheng, and merge into Yang to form Jia. Jia is named by analogy to objects; its characteristics are movement without cessation, unpredictability in location and timing. There may be stone-hard lumps between the hypochondria that are painful upon pressure but mild when untouched. If prolonged and unresolved, it leads to sallow complexion, emaciation, abdominal hardness and distension, visible subcutaneous veins on the abdomen, coolness during the day and fever at night. Appetite decreases, sometimes leading to pica (eating dirt), resulting in Gan accumulation (childhood malnutrition syndrome). Treatment should focus on regulating the Spleen and nourishing the Stomach, resolving accumulations, and clearing Gan heat. This condition cannot be cured in a single day or night.
Pi (fullness obstruction) arises from Qi injury. Its symptoms include fullness and distension in the heart and abdomen, enlarged abdomen with fullness in the hypochondria, pain radiating to the abdomen and hypochondria, typically located in the left hypochondrium. The patient presents with a sallow complexion, emaciation, fatigue, and weakness. If untreated for a long time, it gradually forms a Pi mass. "Pi" means blockage; "Jie" means solidity. When excessive heat accumulates in the chest and diaphragm, and retained fluids gather within the abdomen and hypochondria, Ying and Wei Qi fail to circulate freely, and Zang-Fu organs fail to communicate smoothly, resulting in formation of knots. Rapid purgation is contraindicated, as it may cause pathogens to become firmly entrenched. As stated in the *Classic* (*Huangdi Neijing*), "If it adheres and does not depart, the disease becomes excess." The appropriate treatment is to calm the Stomach and regulate the Spleen, assisted by methods to promote Qi flow and resolve stagnation. If there is Qi obstruction in the chest causing pain resembling Pi, this is due to the failure of Righteous Qi to transform and transport. It should not be treated as a tangible pathogen. Since the chest is the residence of Qi, deficiency prevents it from handling excess, meaning it is not a physical object. Therefore, "Pi" implies "Pi" (obstruction/stagnation).
Xi (hidden mass) arises from accumulation. Its symptoms resemble intestinal dysentery: uncontrolled bowel movements, resembling dysentery but not quite, resembling worms but not quite, sometimes passing fresh blood, dry and painful abdomen, and chest fullness. If untreated for a long time, stubborn accumulations do not disperse, presenting similarly to Pi. This is often caused by improper breastfeeding or feeding, leading to food stagnation and accumulation. Over time, blood membranes aggregate, forming Xi masses in the hypochondriac region with intermittent pain and tidal fevers. Variants include Food Xi, Milk Xi, Gan Xi, Shock Xi, Deficiency Xi, and Phlegm Xi. Although they differ in presentation, they all involve damage to Qi and Blood. If the condition progresses to a purple-black complexion, drum-like abdominal distension, stabbing pain near the heart, sudden passage of fresh blood, black lips and tongue, dry retching, shortness of breath, dry skin with purple spots, expulsion of worms in vomit or stool, borborygmus with spontaneous diarrhea, convulsions due to body weakness, bluish face with salivation, edema of the palms and soles, or black face with black stools, these are considered incurable.