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The sages described the Five Accumulations (Wu Ji) and Six Gatherings (Liu Ju) very clearly, but their treatment methods were uniquely obscure. They stated regarding the Five Accumulations: The accumulation of the Liver is named Feiqi (Fatty Qi), located under the left hypochondrium, shaped like an inverted cup, with a head and feet; if not cured for a long time, it causes coughing, regurgitation, malaria, persisting for years; the accumulation of the Heart is named Fuliang (Hidden Beam), arising from the umbilicus, as large as an arm, extending upward to below the heart, and if not cured for a long time, causes irritability and heart distress; the accumulation of the Spleen is named Piqi (Stagnant Qi), located in the epigastrium, as large as a round plate, and if not cured for a long time, causes weakness of the four limbs, jaundice, and failure of diet to nourish muscles, commonly known as "Food-Labor Jaundice"; the accumulation of the Lung is named Xiben (Panting Burden), located under the right hypochondrium, as large as an inverted cup, and if not cured for a long time, causes chills and fever, panting and coughing, leading to lung abscess; the accumulation of the Kidney is named Bentun (Rushing Pig), originating in the lower abdomen, extending upward to below the heart, resembling a pig running, moving up or down without fixed timing, and if not cured for a long time, causes panting and counterflow, bone萎 (bone atrophy/weakness), and shortness of breath. These are the manifestations of the Five Accumulations, which the former sages explained clearly; is this not distinct? Visiting all medical circles, everyone can recite them.

However, when asked about treatment methods, they merely used herbs such as Sanleng (Rhizoma Sparganii), Guangzhu (Rhizoma Curcumae), Ganqi (Dry Resin of Toxicodendron vernicifluum), Naosha (Nuo Sha), Chenpi (Pericarpium Citri Reticulatae), Mengshi (Calamine), and Badou (Seed of Croton tiglium). Furthermore, those who did not understand the root and branch relationships would add tonifying treatments. How can one use tonification on a patient with excess pathogenic accumulations where major pathogens have not been expelled? As for the world's medicines for grinding and removing accumulations, I also used them when I first studied medicine, knowing they were ineffective, so I changed my approach. Thus, I consulted the *Neijing* (Yellow Emperor's Inner Canon) and suddenly had a great realization. The *Neijing* states: For Wood stagnation, promote its flow; for Fire stagnation, disperse it; for Earth stagnation, purge it; for Metal stagnation, drain it; for Water stagnation, restrain it. Wang Bing (Grand Master Wang) commented: "Promote" refers to emesis, "Disperse" refers to sweating, "Purge" refers to purgation, "Drain" refers to promoting urination, and "Restrain" refers to checking its counterflow and rebellion.

These five methods were established because the Five Movements (Wu Yun) were constrained by the Si Tian (Annual Climate) Qi, thus establishing these five methods. Although they seem dissimilar to the Five Accumulations, the principle is connected. The Five Accumulations occur because one receives the pathogen that overcomes oneself, transmits it to what one overcomes, and when that organ is at its peak, it refuses to accept it, returning it to the overcoming organ, which also refuses it, causing it to stay and knot into an accumulation. Therefore, the Liver accumulation is acquired on Wu and Ji days of late summer; the Heart accumulation on Geng and Xin days of autumn; the Spleen accumulation on Ren and Gui days of winter; the Lung accumulation on Jia and Yi days of spring; the Kidney accumulation on Bing and Ding days of summer. All these result from depression and lack of extension leading to pathogen reception. Why must one wait for the Si Tian to overcome the Yun (Movement) before calling it stagnation? Moreover, the formation of accumulations may be due to sudden anger, joy, sorrow, thought, or fear; injury from sour, bitter, sweet, pungent, or salty foods; retention of warm, cool, hot, or cold drinks; or exposure to wind, summer-heat, dryness, cold, fire, or dampness. Initially, the symptoms are slight and can be removed through breathing exercises and guidance within a square inch area. Unfortunately, encountering mediocre physicians who forcibly tonify and retain the pathogen, leaving it unresolved, leads to the formation of the Five Accumulations.

Feiqi involves not only excess Qi but also blood stasis, because the Liver stores blood. Fuliang is a stagnation of Fire; using hot herbs to scatter it will worsen it, and moxibustion will increase the aggregation. Furthermore, there are two types of Fuliang with the same name but different realities, which must be distinguished carefully. One type of Fuliang has roots above, below, left, and right, located outside the intestines and stomach, containing large amounts of pus and blood; this Fuliang is similar to intestinal abscess. The other type presents with swelling of the body, thighs, and legs, and pain around the umbilicus, known as Wind Root; it should not be disturbed, as disturbing it leads to difficult urination. Although the *Neijing* says these should not be disturbed, it means not to use severe purgation, not that purgation is completely forbidden, fearing that after the disease leaves, it might harm the body leading to Pi (stagnation). The world generally believes cold causes Pi, but the *Neijing* holds that dampness causes Pi. Although caused by drinking cold liquids, the Yang Qi is retained by dampness; attacking with heat will not disperse it, but attacking with cold will remove the dampness and retreat the cold.

Xiben refers to panting rising angrily. This is the old theory. I believe Ben refers to the cardiac orifice (Benmen). The sinews of the Hand-Taiyin Lung Meridian knot inside the chest and penetrate the Benmen, entering it and descending to the costal margin; their disease involves twisting spasms, and severe pain forms Xiben. The sinews of the Hand-Jueyin Pericardium Meridian knot in the arm; their disease involves chest pain and Xiben. It is also said: When the Lung is low, it resides near the Benmen; the Liver easily causes hypochondriac pain; when the Liver is high, it supports the Benmen upward, causing distension in both hypochondria known as Xiben. If spoken of this way, it is Qi accumulating in the Benmen and not dispersing.

This explanation of "Ben" appears frequently in the *Lingshu* (Spiritual Pivot) discussions on the locations of the Five Zang organs, so I elucidated it. Bentun means Ben is synonymous with Ben (running). The *Tongren* (Bronze Man) states it may be caused by excessive reading, but this is not always the case. The Kidney governs bones; this accumulation is deep and difficult to treat. Emesis is strictly contraindicated because the pathology is in the lower part; only purgation is suitable. Thus, I once used Dusheng San to induce vomiting for Feiqi, and regulated it with fire-descending herbs. I once treated Piqi with complete success: first using Genti San to vomit out three or two sheng of sour, bitter, yellow, gelatinous, fishy, and foul substances; then using Daoshui Wan and Yugong San to purge twenty or thirty times; finally regulating with Wuling San and other mild diuretic herbs. I once treated Xiben using Genti San, regardless of the season, placing the patient in a warm room, adding a stove to assist sweating, performing emesis and sweating simultaneously. This disease must not be delayed, as prolongation harms the person. I once treated Bentun using Daoshui Wan and Tongjing San, purging every three days, ten times in a month, totaling over a hundred purgations, then regulating with herbs for treating blood, transforming Qi, and grinding accumulations. Although this accumulation does not kill, it accompanies the person until old age.

As for the Six Gatherings, being in the Fu organs, they belong to Yang and have no fixed form, nor fixed methods. Therefore, applying this logic, what difficulty is there? Some say my treatment of accumulations is too harsh. I say: Not so. An accumulation in the Zang organs is like dead branches in a river. Accumulations in the Zang often adhere to fatty membranes and tortuous places, like areas in a mortar; dead branches in rivers are not in the midstream but mostly in shallow backwaters. When the river floods, they are washed away. The principle for accumulations in the Zang is similar. Thus, I first use pill medicines to drive out newly ingested food stagnation to prevent blockage. The fragmented adhering accumulations have loosened but not passed. Then I use powder medicines to fill the stomach and induce downward movement. Like a raft across a river, once blocked, it is all swept away. If any remains, I regulate with medicine. Only hard accumulations cannot use this method; they should be gradually eliminated. The *Neijing* states: Harden things must be pared down. This is what people call Kuaipi (masses and癖). Therefore, I describe the Nine Accumulations diagram, attached at the end of the chapter, awaiting future wise men to know that my efforts have been arduous for a long time, yet unknown to the world.

Food Stagnation: Sour taste in the heart, abdominal fullness. Use Dahuang (Radix et Rhizoma Rhei), Qianniu (Semen Pharbitidis); severe cases use Mengshi (Calamine), Badou (Seed of Croton tiglium).
Wine Stagnation: Yellow eyes, dry mouth. Use Gegen (Radix Puerariae Lobatae), Maiya (Fructus Hordei Germinatus); severe cases use Gansui (Radix Euphorbiae Kansui), Qianniu.
Qi Stagnation: Belching, obstruction. Use Muxiang (Radix Aucklandiae), Binglang (Semen Arecae); severe cases use Zhike (Fructus Aurantii), Qianniu.
Saliva Stagnation: Throat feeling like being sawed. Use Zhusha (Cinnabar), Nifen (Mercurius Sublimatus Corrosivus); severe cases use Gadi (Fructus Gardeniae Jasminoidis - note: usually Genti San uses Gadi fruit, here likely referring to the herb itself or preparation), Gansui.
Phlegm Stagnation: Thick and sticky sputum. Use Banxia (Rhizoma Pinelliae), Nanxing (Rhizoma Arisaematis Cum Bile); severe cases use Gadi, Lilü (Radix Veratri).
Pi Stagnation: Piercing pain in both hypochondria. Use Sanleng (Rhizoma Sparganii), Guangzhu (Rhizoma Curcumae); severe cases use Gansui, Xieshao (Cauda Scorpii).
Water Stagnation: Swelling and fullness of calves. Use Yuziren (Semen Pruni Armeniacae), Shanglu (Radix Phytolaccae); severe cases use Gansui, Yuanhua (Flos Genkwa).
Blood Stagnation: Bruising from falls, postpartum amenorrhea. Taoren (Semen Persicae), Diyu (Radix Sanguisorbae); severe cases use Mengchong (Hirudo), Shuizhi (Whitmania pigra).
Meat Stagnation: Tumors and nodules. Use Nifen, Baidingxiang (Avis Excrementum); scarification to bleed; severe cases use... [Text implies strong agents, but original text cuts off or merges].

All nine accumulations are primarily governed by Qi, and each is treated according to its specific manifestations. Today's physicians mix all these herbs into one prescription, claiming it treats all accumulations; this is a great error! If I do not have this disease, why use this medicine? If I do not have that disease, why use that medicine? With ten sheep and nine shepherds, whom should one follow? It is not only useless but harmful.