治心腹胀满，旦食不能暮食，由脾元虚弱，不能克制于水，水气上行，浸渍于土，土湿
不能运化水谷，气不宣流，上下痞塞，故令人中满。旦阳气方长，谷气易消，故能食；暮阴
气方进，谷不得化，故不能食。其脉沉实滑，病名谷胀。
上用鸡矢白半升，以好酒一斗渍七日，每服一盏，食后临卧时温服。
《针经》云∶夫积者，盖厥气生足， 生胫寒，胫寒则血脉凝涩，凝涩则寒气上入于
肠胃，入于肠胃则 胀， 胀则肠外之汁沫迫聚不得散，日以成积，卒然多饮食则肠满。起
居不节，用力过度，则络脉伤，阳络伤则血外溢，血外溢则衄血；阴络伤则血内溢，血内溢
则后血。肠胃之络伤。则血溢于肠外，有寒汁沫与血相搏，则并合凝聚不得散而成积矣。或
外中于寒，内伤于忧怒，则气上逆，则六输不通，温气不行，凝血蕴里不散，津液凝涩渗着
而不去，而成积矣。且如见于五脏者，各有名焉∶肝之积曰肥气，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，故谓之肥气，以季夏戊己日得之。心之积名曰伏梁，脾之积名曰痞气，肺之积名曰息
贲，肾之积名曰奔豚，此其五积之名。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。其始发者有常处，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。又有七症八瘕，又有石瘕肠覃。陈无择论症瘕属
肝部，积聚属肺部。夫症者证也，瘕者假也。假物而成形，然有七症八瘕之名，经论亦不详
出，虽有蛟蛇鳖肉发虱米等七证，初非定名，偶因食物相感而致患尔。若妇人症瘕，则由内
外不内外，因动伤五脏气血而成。古人谓为痼疾，以蛟蛇等为生瘕，然亦不必泥此，并属血
病。蛇发等事，皆出偶成，但饮食间误中之，留聚假血而成，自有活性。亦犹永徽中僧病噎
者，腹中有一物，其状如鱼，即生瘕也。又有石瘕，歧伯曰∶石瘕生于胞中，寒气客于子门
，子门闭塞，恶血当泻不泻，坏血留止，日以益大，状如怀子，月事不以时下，皆生于女子
，可导而下。《宝鉴》曰∶夫膀胱为津液之府，气化则能出矣。今寒客于子门，则必气塞不
通，血壅不流，而坏血以止之，结硬如石，是名石瘕也。此气先病而血后病，故月事不来，
则可宣导而下出者也。故《难经》云∶任之为病，其内苦结，男子为七疝，女子为瘕聚，此
之谓也。非大辛之药不能已。又有肠覃，歧伯曰∶此病寒气客于肠，外与胃相搏，不得荣养
，因有所系，瘕而内着，恶气乃起，息肉乃生。其始生者大如鸡卵，稍以益大，至其成如怀
子之状，久者离岁，按之则坚，推之则移，月事以时下，此其候也。夫肠者大肠也，覃者延
也。大肠以传道为事，乃肺之府，肺主卫，卫为气，气者炅则泄，寒则凝，令寒气客于大肠
，故卫气不荣，有所系止，而结瘕在内贴着，其延久不已，是名肠覃也。气散则清，气聚则
浊，结为瘕聚，所以恶气乃起，息肉乃生。小渐益大，至期而鼓，其腹则如怀子状也。此气
病而血未病，故月事不断以时下，此非妊娠，在乎脉辨。《原病式》曰∶症者腹中坚硬，按
之应手，谓之症也。《圣惠方》谓症犹证也。然水体柔顺，而今反坚硬如地者，亢则害承乃
制也。瘕者腹虽硬，而忽聚忽散，无有常准，故《圣惠方》云∶瘕犹假也，以其病瘕未及
症也。经曰∶血不流而寒薄，故血肉凝而成瘕也，腹内结痛也。经曰∶小肠移热于大肠，
为瘕，谓小肠热移入大肠，两热相搏，则血溢而为 瘕。血涩不利，则月事沉滞而不行，
故云 瘕为沉。 与伏同，若瘕为疝误矣。然则瘕病亦有热者，或阳气郁结，怫热壅滞，而
坚硬不消者，非寒症瘕也。以脉别之，王氏谓脉沉伏者症也，快坚者瘕也。故《难经》乃言
五积为病，且如肝之积曰肥气，在左胁下如覆杯，久不已令人发咳逆 疟，连岁不已；心之
积曰伏梁，起脐上，大如臂，上至心下，久不已令人病烦；心脾之积曰痞气，在胃脘覆大如
盘，久不已令人四肢不收，发黄胆，饮食不为肌肤；肺之积曰息贲，在右胁下如覆杯，久不
已令人洒淅寒热，喘嗽发肺痈；肾之积曰奔豚，发于小腹，上至心下，若豚状，或上或下，
无时，久不已令人喘逆，骨痿少气。此五积之状，各随五脏之经发病，故不同也。东垣云∶
且积之为病，或因暴怒七情之气，或六淫之邪，其初甚微，导引去之可也。留而不去，遂成
五积。治当五郁之法，经言积之生于阴者，盖忧思伤心，重寒伤肺，忿怒伤肝，醉以入房，
汗出当风伤脾，用力过度，若入房汗出浴则伤肾。积之所成，由自来矣。有言积聚，有言症
瘕，有言 癖，虽名异而病同。东垣先生随经用药，制立五方，治五积，各有所主论，当察
其所痛，以知其应。有余不足，可补则补，可泻则泻，无逆天时，详脏腑高下，如寒者热之
，结者散之，客者除之，留者行之，坚者削之，消者安之，摩者咸而软以苦泻之。全真气，
节饮食，慎起居，和其中外，可使毕已。若以大毒之剂攻之，积不能除，反伤真气，终难治
矣。许学士解其要略，大抵治积以所恶者攻之，以所喜者诱之则愈。且如 砂阿魏治肉积，
葛根麦 治酒积，木香槟榔治气积，桃仁红花治血积，南星半夏治痰积，牵牛甘遂治水积，
三棱莪术治癖积，礞石巴豆治食积，雄黄腻粉治涎积，各从其类，而对证治之。若用群啄之
药分其势，则难取效。须是认得分明，是何积聚，兼见何证，然后增加佐使之药，不尔反有
所损，要在临时消息也。《脉经》曰∶脉来细而附骨者积也，寸口积在胸中，微出寸口，积
在喉中，关上积在脐旁上，关下积在心下，微下关积在少腹，尺中积在气街。脉出在右，积
在右，脉出在左，积在左，脉两出，积在中央，各以其部处之。脉来小沉而实者，胃中有积
聚，不食，食即吐；肺积脉浮而毛，按之辟易；心积脉沉而芤，上下无常处；肝积脉弦而细
；肾积脉沉而急。脉沉重而中散者，因寒食成症，脉左转而沉重者，气症在胃中，右转出不
至寸口者，肉有肉症也。洁古云∶养正积自除。譬如满座皆君子，纵有一小人，自无容地而
出。今其真气实，胃气强，积自消矣。洁古之言，岂欺我哉！《内经》曰∶大积大聚，衰其
大半而止。满实中有积气，大毒之剂尚不可过，况虚中有积者乎？此乃治积之一端也。邪正
虚实，宜详审焉。此皆古人论脉病证治，实后人之龟监，为医者能体古人之心为心，治证无
不效矣。
治疗心腹部胀满，早晨吃饭晚上却无法进食，这是由于脾元虚弱，不能制约水气，导致水气上行，浸渍于脾土，脾土因湿而无法正常运化水谷，气机不宣通流畅，上下痞塞不通，所以导致人体中焦胀满。早晨阳气正在生长，谷气容易消化，所以能进食；傍晚阴气开始进盛，谷物无法消化，所以不能进食。其脉象沉实滑，病名叫做谷胀。
上方使用鸡矢白（鸡粪中的白色部分）半升，用优质酒一斗浸泡七天，每次服用一盏，在饭后临睡前温服。
《针经》说：所谓积证，是由于厥逆之气产生于足部，进而导致小腿寒冷，小腿寒冷则血脉凝滞涩阻，凝滞涩阻则寒气向上进入肠胃，进入肠胃后导致腹胀，腹胀则肠外的津液泡沫被迫聚集而不能消散，日复一日形成积块。突然饮食过多则肠道充满。起居没有节制，用力过度，则络脉受损，阳络受损则血液外溢，血液外溢则出现鼻衄；阴络受损则血液内溢，血液内溢则出现便血。如果肠胃的络脉受损，血液溢出到肠外，有寒气和汁沫与血液相互搏结，则合并凝聚不能消散而形成积块。或者外感寒邪，内伤于忧怒，则气机上逆，导致六输不通，温煦之气不行，凝血蕴积在里不散，津液凝滞涩阻渗着而不离去，从而形成积块。至于表现在五脏的积证，各有名称：肝之积名叫肥气，是在季夏戊己日得的。为什么这样说呢？肺病传变给肝，肝应当传变给脾，但脾在季夏正值旺盛，旺盛的脏腑不受邪气侵袭，肝想再回传给肺，肺不肯接受，所以停留结聚成为积证，所以叫作肥气，是在季夏戊己日得的。心之积名叫伏梁，脾之积名叫痞气，肺之积名叫息贲，肾之积名叫奔豚，这就是五积的名称。积属于阴气，聚属于阳气。所以阴气沉静而潜伏，阳气浮越而变动。气所积聚的地方叫作积，气所聚拢的地方叫作聚。所以积是五脏产生的，聚是六腑形成的。积证初发时有固定的部位，疼痛不离其部位，上下有始有终，左右有穷尽之处。聚证属于阳气，初发时没有根本，上下没有留止之处，疼痛没有固定位置，这叫作聚。因此通过这种方式来辨别积聚。又有七症八瘕，还有石瘕、肠覃。陈无择论述症瘕归属于肝部，积聚归属于肺部。夫“症”即“证”，“瘕”即“假”。借助物象而成形，虽然有七症八瘕的名称，经典论述中也不详细列出，虽然有蛟蛇、鳖肉、发、虱、米等七种证候，起初并非定名，只是偶然因为食物相感而致病罢了。如果是妇女的症瘕，则是由于内因、外因及不内外因，因动伤五脏气血而成。古人称之为痼疾，以蛟蛇等为生成瘕的理由，但也未必拘泥于此，都归属于血病。蛇发等事，都是偶然形成，只是在饮食间误食其中，留聚假血而成，自有活性。也如同永徽年间有个僧人患噎膈病，腹中有一物，形状像鱼，就是生瘕。又有石瘕，岐伯说：石瘕生于胞宫，寒气客居于子门，子门闭塞，恶血应当排出却排不出，坏血留止，日益增大，形状像怀孕，月经不能按时来潮，这些都发生于女子，可以用导引法使其下行排出。《宝鉴》说：膀胱是津液的府库，气化功能正常才能排出。现在寒气客居于子门，必然导致气塞不通，血液壅滞不流，而坏血停聚，结硬如石头，这名叫石瘕。这是气先病而后血病，所以月经不来，可以通过宣导的方法使其下行排出。所以《难经》说：任脉为病，内部苦于结聚，男子表现为七疝，女子表现为瘕聚，说的就是这个道理。不用大辛热的药物不能治愈。又有肠覃，岐伯说：这种病是寒气客居于肠外，与胃相搏结，不得荣养，因而有所系连，瘕结在内附着，恶气于是兴起，息肉于是生成。它初生时大如鸡蛋，逐渐增大，等到成熟时像怀孕的样子，病程长的超过一年，按压它则坚硬，推动它则移动，月经按时来潮，这是它的征候。夫“肠”指大肠，“覃”指延。大肠以传导为职司，是肺的府库，肺主卫气，卫气属于气，气遇热则泄散，遇寒则凝滞，现在寒气客居于大肠，所以卫气不能荣养，有所系连停止，而结瘕在内贴着，延长日久不止，这名叫肠覃。气散则清，气聚则浊，结聚为瘕聚，所以恶气兴起，息肉生成。逐渐增大，到期则腹部鼓胀，腹部像怀孕的样子。这是气病而血未病，所以月经不断按时来潮，这不是妊娠，在于通过脉象来辨别。《原病式》说：症是腹中坚硬，按压有应手之感，这叫症。《圣惠方》认为症犹言证。然而水性柔顺，而现在反而坚硬如地，这是亢盛则为害，承制乃能制约的道理。瘕是腹部虽然硬，但忽聚忽散，没有常规标准，所以《圣惠方》说：瘕犹言假，因为病在瘕阶段尚未达到症的程度。经文说：血不流动而寒气薄迫，所以血肉凝结而成瘕，腹内结痛。经文说：小肠移热于大肠，形成瘕，谓小肠热移入大肠，两热相搏，则血液溢出而为瘕。血液涩滞不利，则月经沉滞而不行，所以说瘕为沉。与伏同义，如果把瘕当作疝就错了。然而瘕病也有热证的，或者是阳气郁结，怫热壅滞，而坚硬不消的，不是寒性症瘕。通过脉象来区别，王氏认为脉沉伏的是症，快坚的是瘕。所以《难经》讲五积为病，且如肝之积名叫肥气，在左胁下像倒扣的杯子，久治不愈使人发生咳逆疟疾，连年不愈；心之积名叫伏梁，起于脐上，大如手臂，上至心下，久治不愈使人患病烦闷；脾之积名叫痞气，在胃脘处像倒扣的大盘子，久治不愈使人四肢无力不收，发黄疸，饮食不能化为肌肉；肺之积名叫息贲，在右胁下像倒扣的杯子，久治不愈使人洒淅寒热，喘嗽发作肺痈；肾之积名叫奔豚，发于小腹，上至心下，像猪跑的样子，或上或下，没有定时，久治不愈使人喘逆，骨痿少气。这五积的症状，各自随着五脏的经络发病，所以不同。李东垣说：且积之为病，或因暴怒七情之气，或六淫之邪，初起很轻微，用导引法去除是可以的。停留不去，遂成五积。治疗应当用五郁的方法，经文说积生于阴，大概是忧思伤心，重寒伤肺，忿怒伤肝，醉酒后行房事，汗出当风伤脾，用力过度，若入房汗出洗澡则伤肾。积的形成由来已久。有说积聚，有说症瘕，有说癖，虽然名称不同但病症相同。东垣先生遵循经文用药，制定五个方剂，治疗五积，各有所主论，应当观察其疼痛所在，以知道其对应关系。有余不足，可补则补，可泻则泻，不要违背天时，详细考察脏腑高下，如寒者用热药，结者用散药，客者用除药，留者用行药，坚者用削药，消者用安药，摩者用咸味软化并用苦味泻下。保全真气，节制饮食，谨慎起居，调和内外，可以使疾病痊愈。如果用大毒的药物攻伐，积不能除去，反而损伤真气，最终难以治愈。许学士解释其要领，大抵治疗积证用其所厌恶的药物攻伐它，用其所喜欢的药物诱导它就能痊愈。且如砂仁、阿魏治疗肉积，葛根、麦芽治疗酒积，木香、槟榔治疗气积，桃仁、红花治疗血积，南星、半夏治疗痰积，牵牛、甘遂治疗水积，三棱、莪术治疗癖积，礞石、巴豆治疗食积，雄黄、腻粉治疗涎积，各自从其类，而对证治疗。如果用群啄般的猛药分散其势力，则难以取效。必须认得分明，是何种积聚，兼见何种证候，然后增加佐使之药，否则反而有所损害，关键在于临时斟酌。《脉经》说：脉来细而附骨者是积证，寸口脉积在胸中，微出寸口，积在喉中，关上脉积在脐旁上，关下脉积在心下，微下关脉积在少腹，尺中脉积在气街。脉出现在右边，积在右边，脉出现在左边，积在左边，脉两边都出现，积在中央，各自根据部位判断。脉来小沉而实者，胃中有积聚，不吃东西，吃了就吐；肺积脉浮而毛，按之辟易；心积脉沉而芤，上下无常处；肝积脉弦而细；肾积脉沉而急。脉沉重而中散者，因寒食成症，脉左转而沉重者，气症在胃中，右转出不至寸口者，肉有肉症也。洁古说：养正积自除。譬如满座都是君子，纵然有一个小人，自然没有容身之地而出走。现在如果真气充实，胃气强盛，积自然消除。洁古的话，难道骗我吗！《内经》说：大积大聚，衰减大半就停止。满实中有积气，大毒的药物尚且不可过量，何况虚中有积者呢？这是治疗积证的一个方面。邪正虚实，应当详细审察。这些都是古人论述脉病证治，确实是后人的借鉴，作为医者能体悟古人的心意作为自己的心意，治疗证候没有不有效的。
Treats distension and fullness in the heart and abdomen, where one can eat in the morning but not in the evening. This is caused by the deficiency of Spleen Yuan (Spleen's primordial qi), which fails to control Water Qi (Water-related pathogenic factors). Consequently, Water Qi ascends and infiltrates the Earth/Spleen. The dampness of the Earth prevents the proper transformation and transportation of food and fluids. Qi fails to circulate freely, causing obstruction and blockage above and below, leading to central fullness. In the morning, Yang Qi is growing, and grain Qi digests easily, so one can eat; in the evening, Yin Qi advances, and grain cannot be transformed, so one cannot eat. The pulse is deep, solid, and slippery. The disease is named Grain Distension (Gu Zhang).
The prescription uses half a sheng of Ji Shi Bai (white part of chicken manure), soaked in one dou of fine wine for seven days. Take one zhan (cup) per dose, warmed and taken after meals before retiring.
The *Zhen Jing* (Classic of Acupuncture) states: Regarding "Ji" (accumulations), they arise from Jue Qi (rebellious/counterflow qi) originating in the feet, causing cold in the calves. Cold in the calves leads to coagulation and stagnation of blood vessels. Stagnation allows Cold Qi to ascend into the stomach and intestines. Once in the stomach and intestines, it causes abdominal distension. Distension forces the juices and foam outside the intestines to gather and condense, unable to disperse, forming an accumulation day by day. Sudden overeating causes intestinal fullness. Irregular living habits and excessive physical strain damage the collaterals. Damage to Yang collaterals causes external bleeding (e.g., epistaxis); damage to Yin collaterals causes internal bleeding (e.g., hematochezia). If the collaterals of the stomach and intestines are damaged, blood spills outside the intestines. Cold and juices mix with the blood, combining and condensing without dispersing, thus forming an accumulation. Alternatively, external invasion of Cold and internal injury from sorrow and anger cause Qi to rebel upward, blocking the six transport points. Warm Qi fails to move, coagulated blood remains trapped inside without dispersing, and body fluids become stagnant and adhere, failing to leave, resulting in an accumulation.
Regarding accumulations manifesting in the five Zang organs, each has a specific name: The accumulation of the Liver is called Fei Qi (Fat Qi), acquired on Wu/Ji days of late summer. Why? Lung disease transmits to the Liver. The Liver should transmit to the Spleen. However, the Spleen is prosperous in late summer; a prosperous organ does not accept pathogenic factors. The Liver attempts to return the pathogen to the Lung, but the Lung refuses to accept it. Thus, it stays and knots to form an accumulation, hence named Fei Qi, acquired on Wu/Ji days of late summer. The accumulation of the Heart is named Fu Liang (Hidden Beam); the Spleen's accumulation is named Pi Qi (Stagnant Qi); the Lung's accumulation is named Xi Ben (Panting Accumulation); the Kidney's accumulation is named Ben Tun (Running Piglet). These are the names of the Five Accumulations. Accumulations belong to Yin Qi, while Gatherings (Ju) belong to Yang Qi. Therefore, Yin is quiet and latent, while Yang floats and moves. Where Qi accumulates, it is called Ji; where Qi gathers, it is called Ju. Thus, Ji arises from the five Zang organs, and Ju forms in the six Fu organs. Ji has a fixed starting point; pain remains in its region, with definite upper/lower limits and left/right boundaries. Ju belongs to Yang Qi; it has no root, no fixed location for movement, and pain occurs in varying places, hence called Ju. This distinguishes Ji from Ju. There are also Seven Zheng and Eight Xia, as well as Shi Xia (Stone Xia) and Chang Tan (Intestinal Polyp). Chen Wuyue discusses that Zheng/Xia belong to the Liver sector, while Ji/Ju belong to the Lung sector. "Zheng" means evidence/symptom; "Xia" means false/provisional. It takes shape by borrowing objects. Although there are names for Seven Zheng and Eight Xia, classics do not detail them. Conditions like those caused by dragon snakes, turtle meat, hair, lice, or rice grains were not fixed names but accidental illnesses due to food interactions. In women, Zheng/Xia result from internal, external, or non-internal/external factors injuring the Qi and Blood of the five Zang organs. Ancients called these chronic diseases. Using dragon snakes etc. as causes for Xia is not rigidly adhered to; all belong to Blood diseases. Snake/hair issues arise accidentally from mistaken ingestion, gathering false blood, possessing vitality. For example, during the Yonghui era, a monk with dysphagia had a fish-like object in his abdomen, constituting a Sheng Xia.
Shi Xia (Stone Xia): Qibo states it originates in the Bao Zhong (uterus). Cold invades the Zi Men (cervical os). Zi Men closes, preventing the discharge of evil blood. Retained bad blood enlarges daily, resembling pregnancy, with menstrual irregularities. This occurs only in women and can be treated by guiding it downward. *Bao Jian* states: The Bladder is the mansion of body fluids; Qi transformation allows excretion. Cold at Zi Men blocks Qi, causing blood stasis. Bad blood stops and hardens like stone, named Shi Xia. Qi disease precedes Blood disease, causing amenorrhea, treatable by guiding downward. *Nan Jing* states: Ren Mai disease causes internal knotting; men present as Seven Hernias, women as Xia Ju. This refers to this condition. Only large acrid-hot medicines can cure it.
Chang Tan (Intestinal Polyp): Qibo states: Cold invades outside the intestines, battling the Stomach, lacking nourishment, attaching internally. Evil Qi rises, polyps grow. Initially egg-sized, gradually enlarging to resemble pregnancy. Duration may exceed a year. Pressing makes it hard; pushing moves it. Menstruation continues normally. "Chang" is Large Intestine; "Tan" is extension. Large Intestine governs transmission, is the mansion of the Lung, which governs Wei Qi (Defensive Qi). Wei Qi dissipates with heat but coagulates with cold. Cold in the Large Intestine prevents Wei Qi from nourishing, causing attachment and knotting. Prolonged extension is named Chang Tan. Dispersed Qi is clear; gathered Qi is turbid. Knotting forms Xia/Ju, raising evil Qi and polyps. Gradual enlargement leads to drum-like abdominal distension resembling pregnancy. This is Qi disease without Blood disease, so menstruation is normal. Not pregnancy; distinguish by pulse. *Yuan Bing Shi* states: Zheng is hard in the abdomen, tender to pressure. *Sheng Hui Fang* equates Zheng with evidence. Water is soft; hardness resembles Earth, indicating excess overcoming control. Xia is hard but fluctuates, gathering and scattering without constancy. *Sheng Hui Fang* says Xia means false, as it hasn't reached Zheng stage. Classics state: Blood stagnation with thin cold causes flesh/blood coagulation into Xia, causing abdominal pain. Small Intestine transferring heat to Large Intestine forms Xia. Two heats battle, causing blood spillage into Xia. Blood stagnation causes delayed menstruation, hence Xia is "chen" (sunken/deep). Same as "fu". Confusing Xia with Shan (hernia) is wrong. However, Xia can have heat patterns: Yang Qi constraint, stifling heat stagnation causing hardness not resolving by cold. Distinguish by pulse: Wang Shi says deep/floating pulse indicates Zheng, rapid/firm indicates Xia. *Nan Jing* describes Five Accumulations: Liver Fei Qi under left hypochondrium like an inverted cup; long-term causes cough/wheeze/malaria. Heart Fu Liang starts above navel, arm-sized, up to heart; long-term causes irritability. Spleen Pi Qi in epigastrium like a plate; long-term causes limb weakness, jaundice, poor muscle formation. Lung Xi Ben under right hypochondrium like inverted cup; long-term causes chills/fever, cough/pneumonia abscess. Kidney Ben Tun starts in lower abdomen, up to heart, pig-like movement; long-term causes panting, bone萎 (withering), shortness of breath. These vary by meridian involvement.
Li Dongyuan states: Accumulations arise from sudden anger/emotions or Six Evils. Early stages can be removed by Daoyin. If retained, they become Five Accumulations. Treat using methods for Five Stagnations. Classics say accumulations arise from Yin: Worry hurts Heart, heavy cold hurts Lung, anger hurts Liver, drunken sex with sweating wind hurts Spleen, excessive strain or sex with sweat/bathing hurts Kidney. Accumulations have long origins. Terms include Ji/Ju, Zheng/Xia, Pi. Names differ, pathology same. Dongyuan created five formulas for Five Accumulations based on classics. Observe pain location to identify correspondence. Tonify deficiency, drain excess, respect seasons, assess organ position. Cold treated with heat, knots with dispersion, invaders with removal, retention with movement, hardness with reduction, collapse with calming, masses with softening/acrid-bitter draining. Preserve True Qi, regulate diet, careful routine, harmonize interior/exterior for cure. Violent toxic drugs fail to remove accumulation, damage True Qi, making treatment difficult. Xu Xueshi summarizes: Attack what the accumulation dislikes, lure with what it likes. Sandar/Awei for Meat Accumulation, Gegen/Maiya for Wine Accumulation, Muxiang/Binglang for Qi Accumulation, Taoren/Honghua for Blood Accumulation, Nansing/Banxia for Phlegm Accumulation, Qiannian/Gansui for Water Accumulation, Sanleng/Ezhu for Pi Accumulation, Mengshi/Badou for Food Accumulation, Xionghuang/Nifen for Saliva Accumulation. Match category to syndrome. Using indiscriminate harsh drugs disperses power ineffectively. Identify specific accumulation and accompanying symptoms, then add assistants. Otherwise, harm ensues. Requires clinical discretion.
*Mai Jing* states: Fine pulse attached to bone indicates accumulation. Cun position: chest/throat. Guan position: umbilicus/epigastrium. Chi position: lower abdomen/Qi Street. Right/left pulse indicates right/left accumulation. Bilateral indicates central. Small/deep/solid pulse: gastric accumulation, anorexia, vomiting after eating. Lung accumulation: floating/hairy pulse, deflects on pressure. Heart accumulation: deep/hollow pulse, variable location. Liver accumulation: string-taut/thin pulse. Kidney accumulation: deep/rapid pulse. Heavy/dispersed pulse: cold-food Zheng. Left-turning heavy pulse: Qi Zheng in stomach. Right-turning not reaching Cun: Flesh Zheng. Jinggu states: Nourish righteousness, accumulation removes itself. Like a room full of gentlemen, a villain has no place to stay. Strong True Qi and Stomach Qi eliminate accumulation naturally. Jinggu's words are trustworthy. *Nei Jing* states: For major accumulations, stop when half reduced. Even with full/excess accumulation, avoid excessive toxic drugs, especially in deficiency-with-accumulation cases. This is one aspect of treating accumulation. Carefully examine pathogenic vs. righteous, excess vs. deficiency. Ancient discussions on pulse/pathology/treatment are mirrors for posterity. Physicians who emulate ancient wisdom will achieve efficacy.