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Chen Wuyue stated: Jia (masses with shifting shape) belongs to the Liver department, while Ji (fixed masses) belongs to the Lung department. "Ji" implies hardness; "Jia" implies falsity or provisionality, taking shape by borrowing external substances. However, the names of the "Seven Jias" are not detailed in classic treatises. Although there are seven syndromes named after jiao (water dragon), snake, soft-shelled turtle, meat, hair, lice, and rice, these were not originally fixed names but rather accidental occurrences caused by the interaction of food items leading to illness. As for Jia in women, it is formed when internal, external, or neither-internal-nor-external causes injure the Qi and Blood of the Zang organs. The ancients called it a stubborn disease, regarding creatures like jiao and snakes as causes of "living Jia," yet one need not be rigid about this; all belong to blood diseases. Matters involving snakes or hair are merely coincidental; they remain and gather during eating, forming through borrowed blood, possessing their own vitality. It is similar to the monk in the Yonghui era who suffered from dysphagia, having an object in his abdomen shaped like a fish, which was a living Jia.

According to this theory, Ji and Jia belong to the Zang organs, roughly divided into Qi and Blood aspects, so one should not be overly constrained by this distinction. However, living Jia can also be caused by external factors, such as Xu Zhicai's treatment of a disease caused by consuming clam essence, which manifested on the foot. Why did Chen Wuyue omit this in his discussion of the Three Causes?

The *Shui Zhang* (Water Swelling) chapter asks: What is Shi Jia (Stone Jia)? Qibo replied: Shi Jia originates in the Baozhong (uterus). Cold pathogen lodges in the Zimen (os uteri), causing obstruction. Qi becomes blocked, and evil blood that should be discharged remains stagnant, accumulating day by day until the abdomen swells like pregnancy. Menstruation fails to arrive on time. This occurs only in women and can be treated by guiding the pathogenic factors downward. The *Baojian* states: The Bladder is the fu organ of body fluids; it functions through Qi transformation to excrete waste. Now, if cold lodges in the Zimen, Qi will surely become obstructed, and blood will stagnate and fail to flow, hardening like stone, hence named Shi Jia. Here, Qi pathology precedes Blood pathology; thus, since menstruation is absent, it can be guided out. Therefore, the *Nan Jing* states: When the Ren Mai is diseased, there is internal knottedness; in men, it manifests as Seven Hernias; in women, as Jia Ju (accumulations). This is what is meant. Unless potent acrid-hot medicines are used, the condition cannot be cured; Jian Dan may be taken.

What is Chang Qin (Intestinal Qin)? Qibo said: Cold pathogen lodges outside the intestines, contending with the Stomach, failing to receive nourishment. Due to adhesion, the Jia attaches internally, evil Qi arises, and polyps grow. Initially, it is the size of a chicken egg, gradually enlarging until it resembles pregnancy. If long-standing (over a year), it is hard upon pressure but movable upon pushing. Menstruation arrives on time. These are its signs. "Chang" refers to the Large Intestine; "Qin" means extension. The Large Intestine governs transmission and is the Fu organ of the Lung. The Lung governs Wei Qi (Defensive Qi). Wei Qi dissipates with heat and coagulates with cold. Now, cold lodges in the Large Intestine, so Wei Qi fails to nourish, adhering and stopping, forming Jia internally. This prolonged persistence is named Chang Qin. When Qi disperses, clear Qi gathers; when turbid Qi knots, pathological masses form. Thus, evil Qi arises, polyps grow, slowly increasing until the abdomen distends like pregnancy. Here, Qi is diseased but Blood is not, so menstruation continues regularly. It is not pregnancy, and this serves as the differentiation.

In analysis, Shi Jia is due to blood stagnation and obstruction, hence menstruation ceases; Chang Qin is due to the gathering of clear Qi and knotting of turbid Qi into Jia, hence Blood is unaffected and menstruation continues. From this, the difference between these two accumulations is known. However, other types of accumulations may cause similar presentations, or conditions like abscesses/pus may mimic these two syndromes; careful examination is indispensable.