五积六聚本难经，七 八瘕载千金，肠覃石瘕辨月事， 癖之名别浅深，脏积发时
有常处，腑聚忽散无本根， 类积 瘕聚癖，肠满汁溢外寒因。
【注】五积、六聚之名，本乎《难经》。五积者，肥气、伏梁、痞气、息贲、奔豚也。六
聚者，积之着于孙络、缓筋、募原、膂筋、肠后、输脉也。七 、八瘕之名，载《千金方》。
七者，蛟、蛇、鳖、肉、发、虱、米也。八瘕者，青、黄、燥、血、脂、狐、蛇、
鳖也。肠覃者，积在肠外，状如怀子，月事以时而下。石瘕者，积在胞中，状如怀子，月
事不以时下，故曰辨月事也， 者，外结募原肌肉之间。癖者，内结隐僻膂脊肠胃之后，
故曰别浅深也。然积者属脏，阴也，故发有常处，不离其部。聚者属腑，阳也，故发无
根本，忽聚忽散。 不移，而可见，故类积、类 也。瘕能移，有时隐，故类聚、类癖也。
积聚、 瘕、肠覃、石瘕、 癖之疾，皆得之于喜怒不节则伤脏，饮食过饱则伤腑，肠
胃填满，汁液外溢，为外寒所袭，与内气血、食物凝结相成也。
积聚牢坚不软动，胃弱溏泻不堪攻，奔豚发作状欲死，气上冲喉神怖惊。
【注】积聚牢固不动，坚硬不软，则病深矣。胃弱食少、大便溏泻，不堪攻矣。五积
之中，奔豚最为难治，若更发作，正气虚不能支，其状欲死，从少腹起，气上冲喉，神
色惊怖，皆恶候也。
The concepts of Five Accumulations (Wu Ji) and Six Gatherings (Liu Ju) originate from the *Nan Jing* (Classic of Difficult Issues), while Seven Stasis (Qi Xia) and Eight Masses (Ba Xia) are recorded in the *Qian Jin Fang* (Prescriptions Worth a Thousand Gold). Changtan (Mass outside the Intestines) and Shixia (Stone Stasis in the Uterus) are distinguished by menstrual conditions, and the term Pi (Parasitic Mass) is used to differentiate the depth of the disease location. Accumulations in Zang organs have fixed locations upon onset, whereas Gatherings in Fu organs scatter suddenly without a root. These conditions—those resembling Accumulation, Stasis, Gathering, and Parasitic Mass—are generally caused by fullness in the intestines and stomach, overflow of fluids, and invasion by external cold.
[Note] The names of Five Accumulations and Six Gatherings stem from the *Nan Jing*. The Five Accumulations refer to Feiqi (Fatty Qi), Fuliang (Hidden Beam), Piqi (Obstructed Qi), Xiben (Breath Retention), and Bentun (Rushing Pig). The Six Gatherings refer to accumulations attaching to Sunluo (Branch Collaterals), Huanjin (Relaxed Sinews), Muyuan (Sea of Origin), Lijin (Back Sinews), Changhou (Behind the Intestines), and Shumai (Transporting Vessels). The names of Seven Stasis and Eight Masses are recorded in the *Qian Jin Fang*. The Seven Stasis include Jiaoxia (Dragon Stasis), Shexia (Snake Stasis), Bixia (Turtle Stasis), Rouxia (Flesh Stasis), Faxia (Hair Stasis), Shixia (Louse Stasis), and Mixia (Rice Stasis). The Eight Massa include Qingxia (Green Mass), Huangxia (Yellow Mass), Zaoxia (Dry Mass), Xuexia (Blood Mass), Zhixia (Fat Mass), Huxia (Fox Mass), Shexia (Snake Mass), and Bixia (Turtle Mass). Changtan refers to an accumulation outside the intestines, resembling pregnancy, but menstruation occurs on time. Shixia refers to an accumulation within the Baogong (Uterus), also resembling pregnancy, but menstruation does not occur on time; hence, it is said that they are distinguished by menstrual status. Zhu (here referring to fixed masses described in the note as binding externally at the Muyuan and muscles) binds externally between the Sea of Origin and muscles. Pi binds internally in hidden and remote areas behind the back sinews and intestines; thus, it distinguishes the depth of the disease. However, Accumulations belong to Zang organs and are Yin, so their onset has a fixed location and does not leave its region. Gatherings belong to Fu organs and are Yang, so their onset has no root, appearing and disappearing suddenly. Zhu is fixed and visible, so it is classified with Accumulation and Stasis. Xia can move and sometimes hides, so it is classified with Gathering and Pi. Diseases such as Accumulation, Gathering, Zhu-Xia, Changtan, Shixia, and Pi all arise from unregulated anger and joy damaging the Zang organs, and overeating damaging the Fu organs. This leads to fullness in the intestines and stomach, overflow of juices, invasion by external cold, and coagulation with internal Qi, Blood, and food residues.
If Accumulation and Gathering are firm, hard, and immobile, and accompanied by weak Spleen/Stomach function and loose stools, aggressive purgative treatment is contraindicated. When Bentun (Rushing Pig) attacks, the patient feels as if dying, with Qi rushing up to the throat, accompanied by mental fear and alarm.
[Note] If Accumulation and Gathering are firm, immobile, and hard, the disease is deep. If the Stomach is weak, appetite is poor, and stools are loose, the body cannot withstand attack/purgation. Among the Five Accumulations, Bentun is the most difficult to treat. If it recurs, the Healthy Qi is too deficient to support the body. The symptoms include a sensation of impending death, Qi rising from the lower abdomen to the throat, and expressions of terror. These are all ominous signs (E Hou).