《褚氏遗书》曰∶“建平孝王妃、姬皆丽无子，择民家未笄女子入御，又无子。问曰∶求男有道乎？澄对
曰∶合男女必当其年，男虽十六而精通，必三十而娶；女虽十四而天癸至，必二十而嫁。皆欲阴阳完实，然后
交而孕，孕而育，育而子坚壮强寿。今未笄之女，天癸始至，已近男色，阴气早泄，未完而伤，未实而动，是
以交而不孕，孕而不育，育而子脆不寿。此王之所以无子也。然妇人有所产皆女者，有所产皆男者，大王诚能
访求多男妇人至宫府，有男之道也。王曰∶善！未再期，生六男。夫老阳遇少阴，老阴遇少阳，亦有子之道也。”
瘕之病，即积聚之别名。《内经》止有积聚疝瘕，并无 字之名，此后世之所增设者。盖 者，征也。
瘕者，假也。征者，成形而坚硬不移者是也；假者，无形而可聚可散者是也。成形者，或由血结，谓之血
；或由食结，谓之食 。无形者，瘕在气分，气滞则聚而见形，气行则散而无迹。此 瘕之辨也。然又有痛
者，有不痛者。痛者联于气血，所以知气血行则愈，故痛者易治。不痛者，不通气血，另结窠囊，药食难及，
故不痛者难治。此又治之有辨也。其他如肺之积曰息奔；心之积曰伏梁；脾之积曰痞气；肝之积曰肥气；肾
之积曰奔豚。以至后世有曰 癖、曰痞块之属，亦不过以形见之处有不同，故名亦因之而异耳。总之，非在气
分，则在血分，知斯二者，则 瘕二字已尽之矣。但血症气瘕各有虚实，而宜攻宜补，当审之真而用之确也。
诸经义另详积聚门，所当参阅。
《骨空论》曰∶“任脉为病，男子内结七疝，女子带下瘕聚。”张子和曰∶“遗溺、闭癃、阴痿、脬痹、
精滑、白淫，皆男子之疝也。若血涸月事不行，行后小腹有块，或时动移，前阴突出，后阴痔核；皆女子之疝
也。但女子不谓之疝，而谓之瘕。”
《褚氏遗书》中说：“建平孝王的妃子和姬妾都容貌美丽但没有生育，于是挑选民间未行笄礼的女子纳入后宫侍奉，依然没有子嗣。孝王问道：‘求取男婴有方法吗？’褚澄回答说：‘男女结合必须年龄相当，男子虽然十六岁精气已通，但一定要等到三十岁才娶妻；女子虽然十四岁天癸（月经）初至，但一定要等到二十岁才出嫁。这样都能使阴阳之气完备充实，然后交合才能受孕，受孕后能顺利孕育，出生后孩子才能坚固强壮、长寿。现在那些未行笄礼的女子，天癸刚刚到来，就接近男子，导致阴气过早泄漏，身体尚未发育成熟就已受损，元气尚未充实就已妄动，因此交合而不能受孕，即使受孕也不能顺利生产，即使生下孩子也体弱多病、短命。这就是孝王没有子嗣的原因。然而，有的妇人生的全是女孩，有的妇人生的全是男孩，大王如果能访求那些生了很多男孩的妇人到宫中府邸，就能得到生男孩的方法。’孝王说：‘好！’不到一年，就生了六个男孩。所谓老阳遇到少阴，老阴遇到少阳，也是得子的道理。”
瘕（jiǎ，腹内结块）这种病，就是积聚的别名。《内经》中只有积聚、疝瘕的说法，并没有“瘕”这个单独的字名，这是后世增设的概念。大概来说，“征”是指有形且坚硬不移的东西；“瘕”是指假象，无形而可以聚散的东西。有形的结块，有的是由血凝结而成，称为血瘕；有的是由食物积滞而成，称为食瘕。无形的结块，瘕位于气分，气机阻滞时就会聚集成形可见，气机运行通畅时就消散无影迹。这就是征与瘕的区别。然而，又有疼痛和不疼痛的区别。疼痛的结块与气血相连，所以知道气血运行通畅则病愈，因此疼痛的容易治疗。不疼痛的结块，不与气血相通，另外结成囊状巢穴，药物和食物难以到达，所以不疼痛的难治。这又是治疗上的区别。其他的如肺部的积块叫做息贲；心部的积块叫做伏梁；脾部的积块叫做痞气；肝部的积块叫做肥气；肾部的积块叫做奔豚。以至于后世所说的癖积、痞块之类，也不过是因为显现的部位不同，所以名称也因此而异罢了。总之，不是在气分，就是在血分，明白了这两点，那么“征”和“瘕”两个字的含义就全部概括了。但是血症和气瘕各有虚实之分，应当攻伐还是补益，必须仔细审察真实情况并准确运用。各经的相关义理另在积聚门中详细记载，应当参考阅读。
《骨空论》中说：“任脉发生病变，男子体内结聚成七种疝气，女子则出现带下病和瘕聚。”张子和说：“遗尿、小便不通、阳痿、膀胱痹阻、精液滑泄、白带异常，都是男子的疝病。如果血液枯竭导致月经不行，月经结束后小腹有肿块，有时移动，前阴突出，后阴痔核；这些都是女子的疝病。只是女子不称之为疝，而称之为瘕。”
The *Chu Shi Yi Shu* (Remnant Books of Master Chu) states: "The consorts and concubines of the King Xiaowang of Jianping were all beautiful but childless. He selected unmarried girls from common families to serve in his harem, yet still had no offspring. The King asked, 'Is there a method to conceive a male child?' Cheng replied, 'When men and women unite, their ages must be appropriate. Although a man's essence may become clear at sixteen, he should not marry until thirty; although a woman's Tian Gui (menstruation) may arrive at fourteen, she should not marry until twenty. This ensures that both Yin and Yang are complete and solid before intercourse, leading to conception, successful gestation, and offspring who are robust, strong, and long-lived. Now, for girls who have not yet undergone the capping ceremony, their Tian Gui has just begun. If they approach men prematurely, their Yin Qi leaks early, damaging them before they are fully developed and moving them before their vitality is solid. Thus, intercourse leads to infertility, pregnancy fails to sustain, and if a child is born, it is frail and short-lived. This is why the King had no children. However, some women give birth only to daughters, while others give birth only to sons. If Your Majesty could seek out women who have borne many sons and bring them to the palace, you would find the way to have sons.' The King said, 'Excellent!' Within a year, six sons were born. The principle is that Old Yang meets Young Yin, and Old Yin meets Young Yang, which is also a way to have children."
The disease known as Jia (abdominal mass) is another name for Ji Ju (accumulations and masses). The *Nei Jing* (Inner Canon) only mentions Ji Ju, Shan, and Jia, but does not use the character 'Jia' as a standalone term; this was added by later generations. Generally speaking, 'Zheng' refers to something tangible, formed, hard, and immovable; 'Jia' refers to something illusory, formless, capable of gathering and dispersing. Formed masses may result from blood coagulation, called Xue Jia (Blood Jia); or from food stagnation, called Shi Jia (Food Jia). Formless masses reside in the Qi aspect; when Qi stagnates, they gather and become visible; when Qi moves, they disperse without a trace. This is the distinction between Zheng and Jia. Furthermore, there are those that are painful and those that are painless. Painful masses are connected to Qi and Blood, so healing occurs when Qi and Blood flow smoothly; thus, painful masses are easier to treat. Painless masses do not connect with Qi and Blood, forming separate sac-like structures where medicines and foods cannot reach easily; thus, painless masses are difficult to treat. This is another distinction in treatment. Others include: accumulation in the Lung called Xi Ben (Xi Fen); accumulation in the Heart called Fu Liang; accumulation in the Spleen called Pi Qi; accumulation in the Liver called Fei Qi; accumulation in the Kidney called Ben Tun. Later terms such as Pi Pi (partial accumulation) and Pi Kuai (lump) differ only in the location where they manifest, hence the different names. In summary, these are either in the Qi aspect or the Blood aspect. Understanding these two covers the meaning of Zheng and Jia completely. However, Blood disorders and Qi Jia each have deficiency and excess patterns, requiring careful assessment to determine whether to attack (purge) or tonify accurately. Relevant principles from various classics are detailed separately in the section on Accumulations and Masses and should be consulted.
The *Gu Kong Lun* (Treatise on Bone Emptiness) states: "Disease of the Ren Mai (Conception Vessel) manifests as seven types of Shan (hernias) internally in men, and Dai Xia (leukorrhea) and Jia Ju (masses) in women." Zhang Zihe said: "Enuresis, strangury, impotence, bladder bi (obstruction), seminal emission, and white discharge are all Shan diseases in men. If blood depletion causes amenorrhea, and after menstruation a lump appears in the lower abdomen, sometimes moving, with protrusion of the anterior yin and hemorrhoidal nodes at the posterior yin; these are all Shan diseases in women. However, they are not called Shan in women, but rather Jia."