积聚大小一辙，但人大气壮无积，人小气弱积多，故积论偏重哑科。
夫不言痢泻疳三者，而仅言积，治未病之源也。更不言六聚，而先言五积，从其难
者而言之也。聚与积总因食物不化，阴血凝聚，源同而名异。《经》曰∶积者五脏所生，
聚者六腑所成。气之所积名曰积，气之所聚名曰聚。聚者，阳气也，故阳浮而动其气，
运转不定，遇滞即止，发无本根，痛无常处，气旺渐消，不治自己。积者，阴气也，
故阴沉而伏，蓄积一处而不行，发有常处，其痛不离其邪，阴属里，治之为难，积有常
所，有形之血也。聚无定位，无形之气也，积块者，疾与食积，死血也，凡面黄浮肿，
腹胀虚鸣，小便如油，毛发焦黄，下痢赤白，目珠黄赤，遍体虚肿，当腹倍热，遇食
肚疼，昏困多睡者，皆是积候，宜急治之。若至面白喘急，或面黑眼直，干呕不食，泻
住又泻，腹急如鼓，项软口噤，手足俱细者，并为不治。然有五脏为积之名 瘕痞
癖，四症之别，食乳气三积之分，虚实惊诸积之异，先举五脏之积而详之。肝之积名曰
肥气，在左胁下，形如覆杯，有头有足，如龟鳖状。心之积名曰伏梁，起于脐上，大如
手臂，上至心下。脾之积名曰痞气，在于胃脘，覆大如盘。肺之积名曰息贲，在右胁
下，覆如大杯。肾之积名曰奔豚，发于少腹，上至心下，如豚奔走之状，或上或下，
亦无定时，此五积之候也。 者按之应手，亦如五积之不移。瘕者假物成形，如血鳖石
瘕之类。 者，皮浓也，在肌肉之间而可见者也。癖者，僻也，内结于隐僻，外不可见
也。乳积者吐泻兼作，气息酸臭，因乳哺失调所致也。食积者，腹坚热渴，或泻或呕，
肠鸣腹痛，因饮食过餐而得也。气积者，腹痛啼叫，痢如蟹渤，因物触忤儿，或食母气
乳而得也。虚积者，乳食不化，一身浮肿，虚中受积也。实积者，肚热粪硬，身热而
渴，嗜食善饥，实热蕴积也。惊积者，因惊时与食，口秽而黄当腹疼痛是也。治之之
法，寒者温之，热者清之，实者行之，虚者调之，惊者和之，治积惟有挨积、磨积、消
积、化积，而无迅下之理。丹溪云∶凡积不可用下药，徒损真气，病亦不去。况积之成
也，正气不足，而后邪气踞之。加小人在朝，由君子之衰也。正气与邪势不两立，一
胜则一负，邪气日昌，正气日削，不攻去之危亡从及。然攻之太急，正气转伤，国中末
之三法，不可不明也。初者，病邪初起，正气尚强，邪气尚浅，则任受攻。中者，受病
渐久，邪气较深，正气较弱，任受且攻且补。末者，病魔经久，邪气侵凌，正气消残，
则任受补。盖积之为义，匪伊芳朝夕，所以去之亦当行渐，攻之愈亟，则伤正气，正
伤则不能运化，而邪愈固矣，更宜审明何经
受病，受伤何物，从其因以治之。
昔张子和动辄言下，下之当也，仲景三承气审之详密，可下、不可下、急下，何积
何药，分毫不爽，寒积，巴豆感应丸，热积，大黄承气汤，血积，桃仁红花，下水牵
牛，甘遂，水中之血，虻虫，水蛭，虫积，槟榔、雷丸，今人畏而不敢下者，不明之
罪，无忌而妄用者，杀人之罪，稍虚者，当扶助正气，消息推荡之，慎勿孟浪戕人天年。
五积当从郁论，《难经》所谓∶因受胜已之邪，传于已之所胜，适当旺时，拒而不
受，因留为积，此皆抑郁不伸而受其邪，故五积六聚，治同郁断，伏梁者火之郁，肥气
者木之郁，痞气者土之郁，息贲者金之郁，奔豚者水之郁，郁者气不舒，而抑郁成积，
不独聚可以气言也。故治积之法，以理气为先，则津液流行，积聚何由而成？然更不可
不兼以补也。盖壮者气行则已，怯者着而成病，故积之为积，本于气并血弱之人，故
曰∶壮人无积，虚则有之。善治积者，不必问其何经何脏，必先调其中气，使能饮食，
气血既旺，积滞自消，即壮实而宜消者，亦当以补气补血之药兼服。《经》曰∶大积大
聚，其可犯也。衰其半而已，故消积及半，纯与甘温调养，使脾土健运，则余积不攻自
退，所谓养正则邪自除，犹满朝皆君子，则一二小人，自无容身之地。若欲积尽而后
止，胃气之存也无几矣。
积聚痞块之证，皆内为喜怒忧思悲恐惊七情所致，若以五脏传克成积，不亦求之太
过乎，盖气血荣卫，一身上下周流，无时少息，一旦七情感动五志之火，火性炎上，有
升无降，以致气液水谷，不能顺序，稽留而积也必矣。丹溪曰∶气不能成块成聚，夫块
乃有形之物，乃痰与食积，死血而成。凡在中为痰饮，在右为食积，在左为血块，何以
明之？夫左关肝胆之位，藏血液，右关脾胃之位，藏饮食、所以左边有积，在左为血
块，右边有积，则为食积，而其中间则为水谷出入之道路，五志之火，熏蒸水谷，而为
痰饮，所以中间有积而为痰饮也。治法因所因，从其类以治之。大抵积之初，多属寒，
而积之久则为热矣。宜知新久之异，以分辛温、辛平、辛凉三者之宜。然人之积块疝
气，心腹等痛，本多属热，而方中又多用桂附热药，却又不发药毒者，盖因诸积诸痛，
喜温而恶寒，热药病与情相和，况积久成郁，而火邪深矣。若见寒愈逆，见热愈喜，
两热相从，息即所谓亢则害，承乃制从治法也。世人见其投热不为热误，遂以是症为属
沉寒痼冷，恣投热剂，以致真气破蚀，阴血干枯，不可为矣。抑尝论之，医为病所困
者，惟阴虚之难补，久积之难除，故玉山自倒，阴虚之谓也。养虎遗患，久积之谓也。
人之罹此二者，须节欲以养性，内观以养神，淡泊自如，从容自得，然后委之于医，方能为尔保也。
积聚的大小规律是一致的，但人体正气壮盛的人不易产生积聚，而小儿正气虚弱，所以容易形成积聚，因此关于积聚的论述往往侧重于儿科（哑科）。
这里不提及痢疾、腹泻和疳证这三类疾病，而只谈论积聚，这是从预防疾病的源头入手。又不提及六聚，而先讲述五积，是因为从较难治疗的方面来论述。聚和积总归是因为食物消化不良，阴血凝聚而成，源头相同但名称不同。《黄帝内经》说：积是由五脏产生的，聚是由六腑形成的。气停留在某处称为积，气聚集在某处称为聚。聚属于阳气，所以阳气轻浮且流动，气机运转不定，遇到阻滞就停止，发作没有固定的根本，疼痛没有固定的位置，只要气机旺盛就会逐渐消散，即使不治疗也会自行痊愈。积属于阴气，所以阴气沉潜而潜伏，蓄积在一处而不运行，发作有固定的部位，疼痛不离其病邪所在，阴属里证，治疗起来比较困难，积有固定的位置，是有形的血瘀。聚没有固定的定位，是无形的氣；积块则是疾病与食积、死血（瘀血）有关。凡是面色黄而浮肿，腹胀且有虚鸣声，小便如油状，毛发焦黄干枯，下痢赤白相间，眼珠黄赤，全身虚肿，腹部特别发热，进食后肚子疼，昏沉困倦多睡的人，都是积聚的症状，应当紧急治疗。如果发展到面色苍白气喘急促，或者面色发黑眼睛直视，干呕不能进食，腹泻停止后又再次腹泻，腹部紧急胀大如鼓，颈部软弱无力口噤不开，手足都细瘦的人，都属于无法治愈的情况。
然而有五脏形成积的名称：瘕、痞、癖，以及四症的区别，乳积、气积、食积这三种积的分类，还有虚积、实积、惊积等不同类型。先列举五脏之积并详细阐述。肝的积名为肥气，位于左胁下，形状像倒扣的杯子，有头有足，像龟鳖的形状。心的积名为伏梁，起于脐上，大小如手臂，向上延伸至心下。脾的积名为痞气，位于胃脘部，覆盖面积大如盘子。肺的积名为息贲，位于右胁下，形状像倒扣的大杯。肾的积名为奔豚，发生于少腹，向上延伸至心下，像小猪奔跑的样子，或上或下，也没有固定的时间，这就是五积的症状。痞是按压时有应手感，也像五积一样位置固定不移。瘕是假借物象成形，如血鳖石瘕之类。寢是皮肉增厚，在肌肉之间且肉眼可见。癖是偏僻之意，内结于隐蔽偏僻之处，外表不可见。乳积表现为呕吐腹泻同时发生，气息酸臭，是由于哺乳失调所致。食积表现为腹部坚硬发热口渴，或者腹泻或者呕吐，肠鸣腹痛，是由于饮食过量造成的。气积表现为腹痛啼哭叫喊，痢疾状如蟹渤，是由于受惊吓触犯小儿，或者母亲情绪波动通过乳汁传给孩子所致。虚积表现为乳食不消化，全身浮肿，是体虚中积滞所致。实积表现为肚热粪便干硬，身体发热而口渴，贪吃容易饥饿，是实热蕴积所致。惊积表现为因受惊时进食，口臭且黄，腹部疼痛，就是这样。治疗的方法，寒性的用温法，热性的用清法，实性的用攻下消导法，虚性的用调理法，惊性的用安抚和解法，治疗积滞只有挨积、磨积、消积、化积的方法，而没有迅速攻下的道理。朱丹溪说：凡积聚不可用峻下药，只会损伤真气，病也不会去除。况且积聚的形成，是因为正气不足，然后邪气占据它。就像小人在朝廷当道，是因为君子的衰败。正气与邪势不两立，一方胜则另一方负，邪气日益昌盛，正气日益削弱，如果不攻除它，危亡随即到来。然而攻伐太急，正气反而受伤，所以初、中、末三法，不可不明白。初期，病邪刚起，正气尚强，邪气尚浅，则可以承受攻伐。中期，患病渐久，邪气较深，正气较弱，可以承受边攻边补。末期，病魔经久，邪气侵凌，正气消残，则可以承受补益。大概积聚的形成，不是朝夕之间的事，所以去除它也应当循序渐进，攻伐越急切，就越伤正气，正气受伤就不能运化，邪气就越牢固了，更应审明是哪条经络受病，受伤的是什么因素，顺着病因来治疗。
从前张子和动不动就言下法（泻下），认为下法是恰当的，张仲景在三承气汤的运用上审察得详密，可下、不可下、急下，针对何种积使用何种药，分毫不差。寒积用巴豆感应丸，热积用大黄承气汤，血积用桃仁红花，水饮用牵牛子、甘遂，水中的血瘀用虻虫、水蛭，虫积用槟榔、雷丸。今人畏惧而不敢用下法的，是不明白医理的罪过；无忌惮而妄用下法的，是杀人的罪过。稍微体虚的，应当扶助正气，斟酌推荡邪气，千万不要鲁莽地戕害人的寿命。
五积应当从郁证来论治，《难经》所谓：因为受到克制自己的邪气，传送到自己所能克制的脏腑，正当该脏腑旺盛之时，拒绝接受，因而停留成为积，这都是抑郁不伸而受邪，所以五积六聚，治疗同郁证断案，伏梁是火的郁结，肥气是木的郁结，痞气是土的郁结，息贲是金的郁结，奔豚是水的郁结。郁结是气机不舒展，而抑郁成积，不仅仅是聚可以用气来解释。所以治疗积的方法，以理气为先，那么津液流行，积聚怎么会形成呢？然而更不可不兼用补法。大概强壮的人气行则病愈，怯弱的人气滞着而成病，所以积的形成，本于气并血弱之人，所以说：强壮的人没有积，虚弱的人才有积。善于治疗积的人，不必问它是哪条经络哪脏的病，必须先调和中气，使他能饮食，气血既旺盛，积滞自然消除，即使是壮实而适宜消导的，也应当兼服补气补血的药物。《黄帝内经》说：大的积聚，是可以攻伐的，但要衰减到一半就停止，所以消积用到一半，纯用甘温调养，使脾土健运，那么剩余的积不攻自退，所谓养护正气则邪气自然除去，就像满朝都是君子，那么一两个小人，自然没有容身之地。如果想要积尽而后停止，胃气的存留就没有多少了。
积聚痞块的病症，都是内部由喜怒忧思悲恐惊七情所致，如果说是由五脏传克形成积，不是求之太过了吗？大概气血营卫，一身上下周流，无时稍停，一旦七情感动五志之火，火性炎上，有升无降，以致气液水谷，不能顺序，稽留而积也就必然形成了。朱丹溪说：气不能单独成块成聚，块乃是有形的物体，是由痰与食积、死血而成的。凡是在中间的是痰饮，在右边的是食积，在左边的是血块，怎么说明这一点呢？左关是肝胆之位，藏血液，右关是脾胃之位，藏饮食，所以左边有积，在左为血块，右边有积，则为食积，而其中间则为水谷出入的道路，五志之火，熏蒸水谷，而为痰饮，所以中间有积而为痰饮。治疗方法依据病因，顺从其类别来治疗。大致积的初期，多属寒，而积久了则为热。应当知道新积和久积的差异，以区分辛温、辛平、辛凉三者的适宜用法。然而人的积块、疝气、心腹等痛，本来多属热，而方剂中又多用桂枝、附子等热药，却不引发药毒的原因，大概因为诸积诸痛，喜温而恶寒，热药与病情相合，况且积久成郁，而火邪深重了。如果见到寒象就逆治，见到热象就顺治，两热相从，这也就是所谓的“亢则害，承乃制”的从治法。世人见到投用热药不为热所误，于是认为此症属于沉寒痼冷，肆意投用热剂，以致真气破蚀，阴血干枯，不可救治了。我曾论述过，医生被病情困扰的，只有阴虚难补，久积难除，所以玉山自倒是阴虚的比喻，养虎遗患是久积的比喻。人遭受这两种情况，必须节制欲望以养性，内观以养神，淡泊自如，从容自得，然后把病情委托给医生，才能保全性命。
The principles governing the size of *Ji* (accumulation) and *Ju* (aggregation) are identical; however, individuals with robust vital energy (*Zheng Qi*) rarely develop accumulations, whereas children with weak vital energy are prone to them. Therefore, discussions on accumulations often focus on pediatrics ("mute department").
This text does not mention dysentery, diarrhea, or infantile malnutrition (*Gan*), but only discusses accumulations, addressing the root cause of disease prevention. It also omits the "Six Aggregations" (*Liu Ju*) in favor of discussing the "Five Accumulations" (*Wu Ji*), focusing on the more difficult aspects of treatment. Both *Ju* and *Ji* originate from undigested food and coagulated Yin blood; they share the same source but have different names. The *Classic* states: "Accumulations (*Ji*) arise from the Five Zang organs, while aggregations (*Ju*) are formed by the Six Fu organs." Where Qi stagnates, it is called *Ji*; where Qi gathers, it is called *Ju*. *Ju* belongs to Yang Qi; thus, Yang Qi is light, floating, and mobile. Its movement is irregular, stopping upon obstruction. It has no fixed root, pain occurs in varying locations, and as Qi becomes vigorous, it gradually dissipates, resolving spontaneously without treatment. *Ji* belongs to Yin Qi; thus, Yin Qi is heavy, sinking, and latent. It accumulates in one place and does not move. It has a fixed location, and pain remains localized to the pathogenic factor. Yin belongs to the Interior, making it difficult to treat. *Ji* has a fixed position and consists of tangible Blood stasis. *Ju* has no fixed position and consists of intangible Qi. *Ji* masses involve disease, food stagnation, and dead blood (blood stasis). Symptoms include yellowish and puffy complexion, abdominal distension with hollow sounds, urine resembling oil, scorched and yellow hair, dysentery with red and white discharge, yellow-red sclera, generalized edema, excessive heat in the abdomen, abdominal pain after eating, lethargy, and excessive sleepiness. These are all signs of accumulation requiring urgent treatment. If the condition progresses to pale complexion with rapid breathing, black complexion with staring eyes, dry heaving with inability to eat, cessation of diarrhea followed by its recurrence, drum-like abdominal tension, flaccid neck with locked jaw, and thin extremities, these are considered incurable.
However, there are names for accumulations formed by the five Zang organs: *Xia*, *Pi*, and *Pi*. There are distinctions among four types of syndromes and classifications into three types of accumulations: milk accumulation, Qi accumulation, and food accumulation. There are also differences between deficiency-type, excess-type, and fright-induced accumulations. We first detail the five Zang accumulations. The liver's accumulation is named *Fei Qi* (Fat Qi), located under the left hypochondrium, shaped like an inverted cup with heads and feet, resembling a turtle or tortoise. The heart's accumulation is named *Fu Liang* (Hidden Beam), starting above the umbilicus, as large as an arm, extending upward to below the heart. The spleen's accumulation is named *Pi Qi* (Stagnant Qi), located in the epigastrium, covering an area as large as a plate. The lung's accumulation is named *Xi Ben* (Gasping Accumulation), located under the right hypochondrium, shaped like a large inverted cup. The kidney's accumulation is named *Ben Tun* (Rushing Pig), originating in the lower abdomen and extending upward to below the heart, resembling a running pig, moving up and down without a fixed schedule. These are the manifestations of the five accumulations. *Pi* feels responsive to pressure and, like the five accumulations, does not shift position. *Xia* takes shape provisionally, such as blood-related or stone *Xia*. *Qin* refers to thickened skin/flesh, visible between the muscles. *Pi* implies seclusion; it forms internally in hidden places and is invisible externally. Milk accumulation presents with simultaneous vomiting and diarrhea, sour-smelling breath, caused by improper feeding. Food accumulation presents with hard, hot, thirsty abdomen, diarrhea or vomiting, borborygmus, and abdominal pain, caused by overeating. Qi accumulation presents with abdominal pain, crying, and dysentery-like stools resembling crab roe, caused by fright offending the child or maternal emotional fluctuations transmitted via breast milk. Deficiency-type accumulation presents with indigestion of milk/food and generalized edema, resulting from accumulation within a deficient state. Excess-type accumulation presents with hot abdomen, hard stool, fever, thirst, gluttony, and hunger, resulting from internal heat accumulation. Fright-induced accumulation results from feeding during fright, foul mouth odor, yellowing, and abdominal pain.
Treatment methods include warming for cold patterns, clearing for heat patterns, purging/draining for excess patterns, regulating for deficiency patterns, and harmonizing/calming for fright patterns. Treating accumulations involves methods of approaching, grinding, dissolving, and transforming accumulations, rather than rapid purgation. Zhu Danxi stated: "Accumulations must not be treated with harsh purgatives, as this merely damages true Qi without removing the disease." Moreover, accumulations form because of insufficient Zheng Qi, allowing pathogenic factors to occupy the space. This is akin to petty officials dominating the court due to the decline of virtuous ministers. Zheng Qi and pathogenic forces are mutually exclusive; when one wins, the other loses. As pathogens flourish daily and Zheng Qi declines daily, failure to attack them leads to imminent danger. However, overly aggressive attack damages Zheng Qi further. Thus, the initial, middle, and late-stage treatments must be understood. In the initial stage, pathogens are new, Zheng Qi is strong, and pathogens are shallow; aggressive treatment is tolerated. In the middle stage, illness persists, pathogens are deeper, and Zheng Qi is weaker; combined attacking and tonifying is tolerated. In the late stage, illness is chronic, pathogens invade deeply, and Zheng Qi is depleted; tonification is tolerated. Accumulations do not form overnight; thus, their removal must be gradual. Overly aggressive attack damages Zheng Qi, impairing transformation and transportation, causing pathogens to become entrenched. One must ascertain which meridian is affected and the nature of the injury, treating according to the etiology.
Zhang Zihe frequently advocated purgation, considering it appropriate. Zhang Zhongjing’s detailed analysis of the Three Chengqi Decoctions clarified indications for purgation, urgency, specific accumulations, and corresponding herbs with precision. For cold accumulation, use *Badou Yingwan* (Croton Seed Responsive Pill); for heat accumulation, use *Dahuang Chengqi Tang* (Rhubarb and Magnolia Bark Decoction); for blood accumulation, use *Taoren Honghua* (Peach Kernel and Safflower); for water retention, use *Qianniu* (Morning Glory Seed) and *Gansui* (Kansui Root); for blood in water, use *Machong* (Leech) and *Shengzhi* (Hirudo); for worm accumulation, use *Binglang* (Areca Nut) and *Leiwuan* (Vermifuge). Today, those who fear purgation commit the sin of ignorance; those who use it recklessly commit the sin of murder. For slightly deficient patients, support Zheng Qi and carefully push out pathogens. Do not rashly harm natural lifespan.
The five accumulations should be discussed in terms of Stagnation (*Yu*). As stated in the *Nan Jing*: When a person receives a pathogen that overcomes them, transmitting it to the organ they normally control, just as that organ is at its peak strength, it rejects the pathogen, which then stays and forms an accumulation. This is due to depression and failure to extend, leading to pathogenic invasion. Thus, the treatment for the five accumulations and six aggregations is similar to treating stagnation. *Fu Liang* is Fire stagnation; *Fei Qi* is Wood stagnation; *Pi Qi* is Earth stagnation; *Xi Ben* is Metal stagnation; *Ben Tun* is Water stagnation. Stagnation is Qi not flowing freely, leading to accumulation through depression. Not only aggregations can be explained by Qi. Therefore, the primary method for treating accumulations is regulating Qi, allowing fluids to circulate, preventing accumulation formation. However, tonification must not be omitted. Generally, robust individuals recover as Qi moves; frail individuals develop disease as Qi stagnates. Accumulations stem from Qi binding and Blood weakness. Hence, "Robust people have no accumulations; deficient people do." Skilled practitioners need not ask which meridian or Zang organ is affected; they must first regulate Middle Jiao Qi to restore appetite. Once Qi and Blood are robust, stagnation resolves naturally. Even for robust individuals suitable for draining, tonifying Qi and Blood herbs should be taken concurrently. The *Classic* states: "For major accumulations and aggregations, attack may be used, but cease when half is reduced." Thus, when reducing accumulation by half, use purely sweet-warm tonics to strengthen Spleen Earth. Remaining accumulations will recede without direct attack. Nourishing Zheng Qi eliminates pathogens, just as if the court were full of virtuous men, petty officials would have no place. If one waits until accumulations are completely gone before stopping, little Stomach Qi will remain.
Syndromes of accumulation, stagnation, and masses are caused internally by the seven emotions: joy, anger, worry, thought, sadness, fear, and fright. Attributing them solely to Zang organ transmission and overcoming is excessive. Qi, Blood, Ying, and Wei circulate throughout the body without pause. Once the seven emotions stir the fire of the five wills, Fire nature rises, ascending without descending. Consequently, Qi, fluids, and grain cannot follow order, leading to retention and inevitable accumulation. Zhu Danxi said: "Qi alone cannot form masses or aggregations." Masses are tangible objects formed by Phlegm, food stagnation, and dead blood. Those in the center are Phlegm-fluids; on the right, food stagnation; on the left, blood masses. Why? The left Guan position corresponds to Liver/Gallbladder, storing Blood. The right Guan position corresponds to Spleen/Stomach, storing food. Thus, left-sided accumulations are blood masses; right-sided are food stagnation. The center is the pathway for grain entry/exit. Fire from the five wills steams grain, creating Phlegm-fluids. Hence, central accumulations are Phlegm-fluids. Treatment follows the etiology, treating according to category. Generally, early accumulations are mostly Cold, while long-standing accumulations become Heat. One must distinguish new from old to select appropriate acrid-warm, acrid-neutral, or acrid-cool methods. However, accumulations, hernias, and heart/abdominal pains are often Heat-based, yet formulas often use warm/hot herbs like Cinnamon Twig (*Guizhi*) and Aconite (*Fuzi*) without causing toxicity. This is because various accumulations and pains prefer warmth and dislike cold. Hot herbs harmonize with the condition. Moreover, long-standing accumulations lead to stagnation and deep Fire pathogens. If cold symptoms appear, reverse treatment is needed; if heat symptoms appear, follow treatment is used. This mutual adherence of heat aligns with the principle "Excess causes harm, succession brings regulation," known as following-treatment (*Cong Zhi*). Laypeople see hot herbs working without error and assume the syndrome is deep-cold stubborn-cold, indiscriminately using hot agents, destroying Zheng Qi and drying Yin Blood, rendering it incurable. I have argued that physicians are troubled mainly by the difficulty of tonifying Yin deficiency and removing long-standing accumulations. "Jade mountain collapsing itself" refers to Yin deficiency; "Raising a tiger leaves trouble" refers to long-standing accumulation. Those suffering from these two must restrain desires to nourish nature, practice introspection to nourish spirit, remain indifferent and calm, and then entrust themselves to medical care to ensure preservation.