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2. Accumulation and mass disorders present with firm, hard masses that do not move upon palpation. If the patient has weak stomach qi and loose stools or diarrhea, purgative methods should not be used. In the onset of Ben Tun (Rushing Pig) disease, the patient suffers to the point of feeling like dying, with Qi rushing up from the lower abdomen to the throat, accompanied by a frightened and terrified spirit.
[Note] When accumulation and mass disorders are firm and immobile, hard and unyielding, it indicates that the pathogen is deep-seated. If the stomach qi is weak, food intake is scanty, and there are loose stools or diarrhea, the body cannot withstand purgative treatment. Among the Five Accumulations, Ben Tun (Rushing Pig) is the most difficult to treat. If it recurs, the healthy Qi is too deficient to sustain itself. The symptoms include suffering to the point of feeling like dying, Qi rushing up from the lower abdomen to the throat, and a frightened, terrified expression; these are all ominous signs.

3. If the patient with accumulation and mass disorders has strong stomach qi and can eat, purgative methods may be used. When treating deficiency patients with purgatives, tonifying herbs must be combined to achieve harmony between the elimination of pathogens and the preservation of healthy Qi. For Qi stagnation, food retention, and癖块 (masses), Huazhi Wan (Eliminate Stagnation Pill) should be used to resolve stagnation. For accumulations, Wenbai Wan (Warm White Pill) or Taoren Jian (Peach Kernel Decoction) may be used. For Phlegm accumulation, Kongxian Dan (Control Fluids Pill) is appropriate.
[Note] Accumulation and mass disorders are suitable for purgative treatment, but only when the patient's stomach qi is strong and they can eat. If purging a debilitated person, tonifying medicines must be combined, employing strategies such as "one purge followed by three tonifications" or "five tonifications followed by one purge," ensuring that pathogens are eliminated without damaging healthy Qi, and healthy Qi is nourished without aiding pathogens, thus achieving balance between pathogen and healthy Qi. For treating Qi accumulation, food retention, and masses, the secret formula Huazhi Wan (Eliminate Stagnation Pill) is suitable, recorded in the Internal Injury section. For treating accumulations and Zheng Jia (symptomatic masses), Wenbai Wan (Warm White Pill), also known as Wanbing Ziwan Wan (Ten Thousand Disease Astera Pill) with doubled Chuanwu (Aconiti Radix Preparata), is suitable. For treating Blood accumulation and Xue Jia (blood masses), Taoren Jian (Peach Kernel Decoction) is suitable, composed of Tao Ren (Persicae Semen, 1 liang), Da Huang (Rhei Radix et Rhizoma, 1 liang), Meng Chong (Blattidae, stir-fried, 5 qian), and Po Xiao (Natrii Sulfas, 1 liang), ground into powder. First, boil 1 jin of pure vinegar slowly in a clay pot until reduced to slightly more than half a zhong. Add the powder and stir for a long time, then form small pills. Do not eat dinner the night before. At dawn (Wu Geng), take 1 qian with warm wine to expel foul matter resembling bean juice or chicken liver. If not fully expelled, take again the next day; stop medication when fresh blood appears. If Meng Chong (Blattidae) is unavailable, Shui Zhi (Hirudo, leech) may be substituted, though Meng Chong is superior. For treating Phlegm accumulation, Kongxian Dan (Control Fluids Pill) is suitable, recorded in the Phlegm-Fluids section.

1. The Classics state: Disorders of the Ren Mai (Conception Vessel) can lead to Seven Hernias (Qi Shan). Zhang Hezi attributes the Seven Hernias primarily to the Liver. The Liver Meridian passes through the abdomen and circles the genitalia, while the Ren Mai circulates within the abdominal interior. Symptoms of Shan diseases include pain in the lower abdomen radiating to the genitals, Qi rushing up to the heart, difficulty in urination and defecation, Jue (cold extremities) and vomiting, Zheng Jia (masses), Hu Shan (Fox Hernia) with intermittent protrusion, ulceration with pus discharge, Long Bi (difficulty in urination), and hard, swollen scrotum.
[Note] The Classics say: Disorders of the Ren Mai result in Seven Hernias in men and Dai Xia (leukorrhea) and Zheng Ju (accumulations) in women. Zheng Ju refers to hernias in women. The reason Seven Hernias are governed by the Ren Mai is that the Ren Mai originates at Zhongji (CV3) and circulates within the abdomen. The reason Seven Hernias are governed by the Liver is that the Liver Meridian passes through the abdominal interior and circles the genitalia. Therefore, all Shan diseases arise from these two meridians and are thus governed by them. Regarding the syndromes of Shan diseases: Lower abdominal pain radiating to the testicles, Qi rushing up to the heart, and inability to pass urine or stool constitute Chong Shan (Surging Hernia). Lower abdominal pain radiating to the testicles, with rebellious Liver Qi rushing to the Stomach causing vomiting, constitutes Jue Shan (Rebellious Hernia). Qi stagnation in the lower abdomen causing painful masses on either side constitutes Xia Shan (Mass Hernia). A mass that enters the abdomen when lying down and protrudes into the scrotum when standing, resembling a fox that urinates out of its hole during the day and stays in at night, constitutes Hu Shan (Fox Hernia). Lower abdominal pain radiating to the testicles, with a cucumber-shaped swelling at both ends of the Henggu bone containing pus and blood, constitutes Cui Shan (Cui Hernia). Lower abdominal pain radiating to the testicles with urinary obstruction constitutes Long Shan (Long Hernia). Absence of lower abdominal pain but with a large, hard, swollen scrotum constitutes Cixin (Cixin condition).