经曰∶寸口脉沉而横，曰胁下有积，腹中有横积痛。
又曰∶太阴脉涩则病积，心腹时满，厥阴涩则病小腹积气，少阴涩则病积溲血，阳明涩则病
积，时善惊。太阳涩则病积，时善颠疾，少阳涩则病积，筋急目痛。
又曰∶推而内之，内而不外，有心腹积也。
巢氏曰∶脉细沉附骨者，积也。脉出在左，积在左；脉出在右，积在右；脉两出，积在
中央，各以部处之。
脉 而紧，积聚也。脉浮而牢，积聚也。
脉弦紧而细， 也，出寸口， 在心；出关上， 在胃脘；出足中， 在脐。
脉横者，胁下有积聚。脉来小沉实者，胃中有积聚，食不下，或食吐出。
肺积，脉浮而毛，按之辟易；心积，脉沉而芤，上下无常处；肝积，脉弦而细；肾积，脉沉
而急；脾积；脉浮大而长。
脉沉而中散者，寒食 也。
积聚脉牢强者生，虚弱沉者死。
大积大聚，其可犯也，衰其大半而已。
坚者削之，留者攻之，结者散之，客者除之，上之下之，摩之浴之，搏之劫之，开之发之，
适事为故。
洁古云∶壮人无积，虚人则有之。脾胃怯弱，气血两衰，四时有感皆成积。若遽以磨坚破
结之药治之，疾虽去而人已衰矣。干漆、 砂、三棱、大黄、牵牛之类则暂快，药过则依然，
气愈消，疾愈大，竟何益哉？故治积者当先养正，则疾自除。譬如满座皆君子，纵有一小人，
自无容地而出。令其真气实，胃气强，积自消矣。
实中有积，大毒之剂治之尚不可过，况虚而有积者乎？此治积之一端也。邪正盛衰，固宜
详审。（甫谓养正积除，此积之微者也。如脾胃失于健运而气积食积之不疏导者，惟养脾胃之正
气，而滞积自疏矣。若夫大积大聚，如五积之久而成 病坚固不移者，若非攻击悍利之剂，
岂能推逐之乎？惟虚弱之人必用攻补兼施之法也。）
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: If the Cun Kou pulse (pulse at the radial artery, representing the Lung and Large Intestine channels) is deep and horizontal, it indicates accumulation in the hypochondrium and painful transverse accumulation in the abdomen.
It further states: A choppy pulse in the Taiyin channel indicates accumulation disease, with occasional fullness in the heart and abdomen; a choppy pulse in the Jueyin channel indicates accumulation of Qi in the lower abdomen; a choppy pulse in the Shaoyin channel indicates accumulation accompanied by hematuria; a choppy pulse in the Yangming channel indicates accumulation with frequent fright; a choppy pulse in the Taiyang channel indicates accumulation with frequent epilepsy; a choppy pulse in the Shaoyang channel indicates accumulation with tendon stiffness and eye pain.
It also states: When pushing the pulse inward, if the pulse energy remains internalized and does not reach the exterior, it signifies accumulation in the heart and abdomen.
Chao Yuanfang stated: A pulse that is fine, deep, and only palpable when pressed to the bone indicates accumulation. If the pulse manifestation appears on the left hand, the accumulation is on the left side; if it appears on the right hand, the accumulation is on the right side; if it appears on both hands, the accumulation is in the center. The location should be determined according to the specific pulse position.
A wiry and tight pulse indicates accumulation. A floating and firm pulse also indicates accumulation.
A wiry, tight, and thin pulse indicates accumulation. If manifested at the Cun Kou (inch position), the accumulation is in the Heart; if manifested at the Guan position, the accumulation is in the stomach region; if manifested at the Chi position (foot position), the accumulation is at the umbilicus.
A horizontal pulse indicates accumulation in the hypochondrium. A small, deep, and solid pulse indicates accumulation in the stomach, with inability to eat or vomiting after eating.
Lung accumulation presents with a floating and hair-like pulse, which feels scattered and easily displaced upon pressure. Heart accumulation presents with a deep and hollow pulse, with no fixed upper or lower location. Liver accumulation presents with a wiry and thin pulse. Kidney accumulation presents with a deep and rapid pulse. Spleen accumulation presents with a floating, large, and long pulse.
A deep pulse with a scattered middle indicates cold and food retention.
If the pulse of an accumulation disease is firm and strong, survival is likely; if it is weak and deep, death is indicated.
For major accumulations and聚结s, attacking treatment may be used, but one should cease once more than half of the pathogen has been eliminated.
Hard masses are reduced by削法 (scraping/reducing method); lingering pathogens are attacked; knotted pathogens are dispersed; external invaders are removed; pathogens above are treated with emesis or downward-draining methods; massage and bathing are applied; forceful binding is addressed with劫法 (plundering/seizing method); obstruction is opened and released; treatment follows the principle of appropriateness to the condition.
Li Dongyuan (Jiegu) said: Robust individuals do not have accumulations; only deficient individuals develop them. Due to weak spleen and stomach and dual deficiency of Qi and Blood, seasonal exogenous pathogens can all lead to accumulation. If one immediately uses drugs that grind hardness and break knots, although the disease may be removed, the patient will be depleted. Drugs such as Drynaria rhizome processed with lacquer (Ganqi), Nao Sha (Nitratum), Sanleng (Sparganii Rhizoma), Dahuang (Rhei Radix et Rhizoma), and Qianniu (Pharbitidis Semen) may provide temporary relief, but after the drug effect wears off, the condition remains unchanged, Qi is further consumed, and the disease grows larger. What benefit is there? Therefore, treating accumulation requires first nourishing righteousness (Zheng Qi), so the disease will naturally eliminate itself. It is like having a room full of gentlemen; even if there is one villain, he will naturally have no place to stay and must leave. Let true Qi become substantial and Stomach Qi become strong, and the accumulation will dissipate on its own.
Even for excess patterns with accumulation, using highly toxic agents should not be excessive; how much less should this be done for deficiency patterns with accumulation? This is one aspect of treating accumulation. The balance between pathogenic factors and healthy Qi must indeed be carefully examined. (Xu Chunfu comments: Nourishing righteousness to remove accumulation applies to mild cases. For example, Qi stagnation and food retention caused by the spleen and stomach losing their transportation function, if not unblocked, can be resolved solely by nurturing the righteous Qi of the spleen and stomach, allowing the stagnant accumulation to naturally disperse. However, for major accumulations, such as those formed from the five types of accumulation over a long period, which are firm and immovable, unless fierce and potent attacking agents are used, how can they be driven out? Only for weak patients must a combined method of attacking and tonifying be employed.)