五十五难曰∶病有积、有聚，何以别之？然∶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、六腑所成也。积者、阴气
也，其始发有常处，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。
五十六难曰∶五脏之积，各有名乎？以何月何日得之？
然∶肝之积名曰肥气，在左胁下，如覆杯，有头足。久不愈，令人发咳逆， 疟，连岁
不已。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。故知肥气以季夏戊己日得之。
心之积，名曰伏梁，起脐上，大如臂，上至心下。久不愈，令人病烦心。以秋庚辛日得之。
何以言之？肾病传心，心当传肺，肺以秋适王，王者不受邪，心欲复还肾，肾不肯受，故留结为
积。故知伏梁以秋庚辛日得之。
脾之积，名曰痞气，在胃脘，覆大如盘。久不愈，令人四肢不收，发黄胆，饮食不为肌肤。
以冬壬癸日得
之。何以言之？肝病传脾，脾当传肾，肾以冬适王，王者不受邪，脾复欲还肝，肝不肯受，故留结
为积。故知痞气以冬壬癸日得之。
肺之积，名曰息贲，在右胁下，覆大如杯。久不已，令人洒淅寒热，喘咳，发肺壅。以春甲乙
日得之。何以言之？心病传肺，肺当传肝，肝以春适王，王者不受邪，肺复欲还心，心不肯受，故留结
为积。故知息贲以春甲乙日得之。
肾之积，名曰贲豚，发于少腹，上至心下，若豚状，或上或下无时。久不已，令人喘逆，骨痿，
少气。以夏丙丁日得之。何以言之？脾病传肾，肾当传心，心以夏适王，王者不受邪，肾复欲还脾，
脾不肯受，故留结为积。故知贲豚以夏丙丁日得之。此五积之要法也。
Difficulty 55 states: In diseases, there are "Ji" (accumulation) and "Ju" (aggregation). How can they be distinguished? The answer is: "Ji" belongs to Yin Qi (Yin energy); "Ju" belongs to Yang Qi (Yang energy). Therefore, Yin is deep and latent, while Yang is floating and active. Where Qi accumulates, it is called "Ji"; where Qi gathers, it is called "Ju". Thus, "Ji" arises from the Zang organs (solid organs); "Ju" is formed by the Fu organs (hollow organs). "Ji" is of Yin nature; its onset has a fixed location, the pain does not leave its specific area, moving up and down with definite beginnings and endings, and left and right with limits; "Ju" is of Yang nature; its onset has no fixed root, moving up and down without staying in one place, and the pain occurs in various locations, which is termed "Ju". Therefore, one distinguishes between accumulation and aggregation based on these characteristics.
Difficulty 56 states: Do the accumulations of the five Zang organs have specific names? On what month and day do they form?
The answer is: The accumulation of the Liver is named Feiqi (Fatty Qi), located under the left hypochondrium, resembling an inverted cup with a head and feet. If not cured for a long time, it causes coughing and counterflow qi, malaria, persisting for years. It forms on Wu and Ji days during the late summer (the last month of summer). Why is this so? Because Lung disease transmits to the Liver, and the Liver should transmit to the Spleen. However, during late summer, the Spleen is prosperous and dominant. A dominant organ does not accept pathogenic factors. The Liver attempts to return the pathogen to the Lung, but the Lung refuses to accept it. Consequently, the pathogen remains and knots to form an accumulation. Thus, it is known that Feiqi forms on Wu and Ji days in late summer.
The accumulation of the Heart is named Fuliang (Hidden Beam), starting above the umbilicus, as large as an arm, extending upward to below the heart. If not cured for a long time, it causes mental restlessness and vexation. It forms on Geng and Xin days in autumn.
Why is this so? Because Kidney disease transmits to the Heart, and the Heart should transmit to the Lung. However, in autumn, the Lung is prosperous and dominant, refusing pathogens. The Heart attempts to return the pathogen to the Kidney, but the Kidney refuses. Thus, the pathogen remains and knots to form an accumulation. Hence, Fuliang forms on Geng and Xin days in autumn.
The accumulation of the Spleen is named Piqi (Stagnant Qi), located in the epigastrium, covering an area as large as a plate. If not cured for a long time, it causes weakness and inability to control the four limbs, jaundice, and failure of food intake to nourish the flesh. It forms on Ren and Gui days in winter.
Why is this so? Because Liver disease transmits to the Spleen, and the Spleen should transmit to the Kidney. However, in winter, the Kidney is prosperous and dominant, refusing pathogens. The Spleen attempts to return the pathogen to the Liver, but the Liver refuses. Thus, the pathogen remains and knots to form an accumulation. Hence, Piqi forms on Ren and Gui days in winter.
The accumulation of the Lung is named Xiben (Panting Accumulation), located under the right hypochondrium, covering an area as large as a cup. If not cured for a long time, it causes chills and fever, panting and coughing, and lung congestion. It forms on Jia and Yi days in spring.
Why is this so? Because Heart disease transmits to the Lung, and the Lung should transmit to the Liver. However, in spring, the Liver is prosperous and dominant, refusing pathogens. The Lung attempts to return the pathogen to the Heart, but the Heart refuses. Thus, the pathogen remains and knots to form an accumulation. Hence, Xiben forms on Jia and Yi days in spring.
The accumulation of the Kidney is named Benteng (Rushing Pig), originating in the lower abdomen and extending upward to below the heart, resembling the movement of a pig, rising or falling at irregular times. If not cured for a long time, it causes panting and counterflow qi, bone萎 (bone weakness/atrophy), and shortness of breath. It forms on Bing and Ding days in summer.
Why is this so? Because Spleen disease transmits to the Kidney, and the Kidney should transmit to the Heart. However, in summer, the Heart is prosperous and dominant, refusing pathogens. The Kidney attempts to return the pathogen to the Spleen, but the Spleen refuses. Thus, the pathogen remains and knots to form an accumulation. Hence, Benteng forms on Bing and Ding days in summer. These are the essential principles regarding the five accumulations.