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See the section on Phlegm-Fluids (Tan Yin).

Academician Xu stated: Generally, to treat accumulations (Ji), one may either attack them with substances the patient dislikes or lure them out with substances the patient likes, which makes recovery easier. For example, Nao Sha (Sal Ammoniac) and Shui Yin (Mercury) are used for Rou Ji (Meat Accumulation); Shen Qu (Medicated Leaven) and Mai Ya (Germinated Hordeum) are used for Jiu Ji (Alcohol Accumulation); Shui Zhi (Leech) and Meng Chong (Blue Bottle Fly Larva) are used for Xue Ji (Blood Accumulation); Mu Xiang (Aucklandia Root) and Bing Lang (Areca Seed) are used for Qi Ji (Qi Accumulation); Qian Niu Zi (Pharbitis Seed) and Gan Sui (Kansui Root) are used for Shui Ji (Water Accumulation); Xiong Huang (Realgar) and Ni Fen (Calomel) are used for Xian Ji (Saliva/Phlegm Accumulation); Meng Shi (Lodestone) and Ba Dou (Croton Seed) are used for Shi Ji (Food Accumulation). This follows the principle of treating each according to its nature. If a large group of medicines is used, dispersing their therapeutic power, it will be difficult to achieve efficacy. One must clearly identify what kind of accumulation it is and what accompanying syndromes exist, then adjust and weigh the dosage accordingly. Otherwise, there will be damage. The key lies in flexible adaptation during clinical practice.

It is noted that some accumulations do not form due to the movement of Qi, such as those caused by occasional improper diet or accidentally swallowing coins and foreign objects. Others form due to the movement of Qi, such as those caused by Seven Emotions, improper diet and overwork, or transmission among the Five Zang Organs. Therefore, the accumulated materials vary, and the aggregation of Qi and Blood differs; some form complex conditions like Gu (Parasitic Disease/Tumor), Liu (Tumor), or Jia (Mass), which are hard to predict. Thus, one must clearly identify the type of accumulation, and medication should follow the nature of the accumulation. However, one must also assess the deficiency or excess of Yuan Qi (Primal Qi). One may use harsh purgative methods or gradually eliminate the accumulation by supporting Zheng Qi (Upright Qi). If not done this way, the harm would go beyond mere injury.

*Weisheng Baojian* records: Jiegu said, "Support the upright Qi, and the accumulation will naturally disappear." It is like having a room full of gentlemen; even if there is one villain, he will have no place to stay and will leave on his own. By making the True Qi substantial and the Stomach Qi strong, the accumulation will dissipate naturally. Would Jiegu’s words deceive us? *Neijing* states: "For large accumulations and aggregations, reduce them by more than half and stop." Even when there is Qi stagnation within fullness and excess, one must not excessively use highly toxic medicines, let alone when there is an accumulation within deficiency. This is but one aspect of treating accumulations. One must carefully examine the pathogenic factors, upright Qi, deficiency, and excess.

Commentary: Some say that accumulations must be treated with purgatives. Now it is said that after supporting the upright Qi, the accumulation is removed. Is this waiting for the restoration of upright Qi to remove it, or waiting for the medicinal power to remove it? However, any accumulation in the human body is pathogenic Qi. Just as a gentleman's seat contains a villain, only by regulating and tonifying the upright Qi can the True Qi operate normally, causing the accumulation to disappear naturally. If many gentlemen are upright and in position, the villains will naturally retreat. Otherwise, if the upright Qi is deficient and the True Qi is disordered, the accumulation will increase, the diaphragm will become chaotic, the true Qi will cease, and death will ensue. This is similar to when villains gain power, leading to chaotic governance and broken laws, where gentlemen cannot control the situation. Furthermore, "supporting the upright Qi" is not merely about adjusting diet and daily life. Since the accumulation has already formed and the physique has gradually emaciated, one must use nourishing methods to make Ying Wei (Nutritive and Defensive Qi) substantial, so that the accumulation disappears naturally. Only for those that remain hard and undissolved should one urgently apply purgation. This is "tonify first, purge later," aiming for the elimination of pathogenic factors and the restoration of upright Qi. If the removal of accumulation is not gradual, there will inevitably be catastrophic consequences. Consider Wu Zetian, who devastated the Tang dynasty and nearly changed the ruling house; she relied on the efforts of ministers like Di Renjie and Zhang Jianzhi to gradually eliminate her faction and restore the Tang throne. Unfortunately, Emperor Zhongzong did not learn from past mistakes, leaving behind figures like Zhang Yizhi and Zhang Changzong (referred to as "San Si" in context of treacherous favorites), which led to the disaster of Consort Wei. This is like residual accumulation remaining; if not urgently purged, and if one does not strictly observe dietary and lifestyle prohibitions, indulging in sensual desires, the disease will recur uncontrollably, leading inevitably to loss of life.