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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.