积聚 瘕杂虫者。皆五脏六腑真气失。而邪气并遂乃生焉。久之不除也。或积。或聚。或 。或瘕。或变为虫。
其状各异。有能害人者。有不能害人者。有为病缓者。有为病速者。有疼者。有痒者。有生头足者。有如杯块
者。势类不同。盖因内外相感。真邪相犯。气血熏抟。交合而成也。积者系于脏也。聚者系于腑也。 者系于
气也。瘕者系于血也。虫者乃血气食物相感而化也。故积有五。聚有六。 有十二。瘕有八。虫有九。其名各
不同也。积有心肝脾肺肾也。聚有大肠。小肠。胆。胃。膀胱。三焦。之六名也。 有劳、气、冷、热、虚、实、风、
湿、食、药、思、忧之十二名也。瘕有青黄、燥、血、脂、狐、蛇、鳖之八名也。虫有伏、蛇、白、肉、肺、胃、赤、
弱、蛲、之九名也。为病之说出于诸论。治疗之法皆具于后。
劳者。劳于神气也。伤者。伤于形容也。饥饱无度则伤脾。思虑过度则伤心。色欲过度则伤肾。起居过常则
伤肝。喜怒悲愁过度则伤肺。又风寒暑湿则伤于外。饥饱劳役则败于内。昼感之则病荣。夜感之则病卫。
荣卫经行。内外交运。而各从其昼夜也。劳于一。一起为二。二传于三。三通于四。四干于五。五复犯一。一至
于五。邪乃深藏。真气自失。使人肌肉消。神气弱。饮食减。行步艰难。及其如此。虽司命亦不能生也。故调神
气论曰。调神气。慎酒色。节起居。省思虑。薄滋味者。长生之大端也。诊其脉甚数。（一作。数甚。余下仿此。）甚急。
甚细。甚弱。甚微。甚涩。甚滑。甚短。甚长。甚浮。甚沉。甚紧。甚弦。甚洪。甚实。皆生于劳伤。
积聚、瘕（腹内结块，聚散无常）及杂虫病，都是由于五脏六腑的真气亏损，导致邪气乘虚而入并逐渐形成。如果长期不治疗，就会形成积、聚、疰（指具有传染性或迁延难愈的疾病）、瘕、虫等病变。
这些病症的表现形态各不相同，有的会危害生命，有的则不会；有的发病缓慢，有的发病迅速；有的表现为疼痛，有的表现为瘙痒；有的形状像有头足的生物，有的像杯状的硬块。其势态类别不同，大概是因为内外因素相互感应，真气与邪气相互侵犯，气血熏蒸搏结，交织融合而形成的。
“积”是附着于脏的病变，“聚”是附着于腑的病变，“疰”是附着于气的病变，“瘕”是附着于血的病变，“虫”则是血、气、食物相互作用而化生的。所以，积有五种，聚有六种，疰有十二种，瘕有八种，虫有九种，它们的名字各不相同。
积包括心、肝、脾、肺、肾五脏的病变；聚包括大肠、小肠、胆、胃、膀胱、三焦这六个腑的名称；疰有劳、气、冷、热、虚、实、风、湿、食、药、思、忧这十二种名称；瘕有青、黄、燥、血、脂、狐、蛇、鳖这八种名称；虫有伏、蛇、白、肉、肺、胃、赤、弱、蛲这九种名称。关于这些病症的说法出自各种论述，治疗方法都在后面详细列出。
所谓“劳”，是指神气过度劳累；所谓“伤”，是指形体容貌受到损伤。饮食饥饱无度会损伤脾胃；思虑过度会损伤心脏；房事过度会损伤肾脏；起居作息失常会损伤肝脏；喜怒悲愁等情绪过度会损伤肺脏。此外，风寒暑湿等外邪会从外部侵袭人体，饥饱劳役等内因会从内部败坏身体。白天感受邪气则病在荣（营气），夜晚感受邪气则病在卫（卫气）。
荣气和卫气在经脉中运行，内外交互运转，各自顺应昼夜的变化。劳伤始于一种脏腑，进而发展为两种，再传变到三种，接着影响四种，然后干犯五种，五种又反过来侵害第一种，从一到五循环往复，邪气于是深深潜伏，真气自然丧失。这会导致人肌肉消瘦、神气虚弱、饮食减少、行走困难。等到出现这种情况，即使是掌管生死的司命之神也无法救活了。所以《调神气论》说：调养神气、谨慎对待酒色、节制起居、减少思虑、清淡饮食，这是长寿的根本大道。
诊察患者的脉象，如果脉象极快、极急、极细、极弱、极微、极涩、极滑、极短、极长、极浮、极沉、极紧、极弦、极洪、极实，这些都是由劳伤引起的。
Accumulation (Ji), Mass (Jia), and miscellaneous worm diseases all arise from the loss of true qi in the five zang organs and six fu organs, allowing pathogenic qi to combine and gradually form. If not treated for a long time, they may manifest as accumulation (Ji), gathering (Ju), persistent disease (Zhu), mass (Jia), or transformation into worms.
Their manifestations vary: some are harmful, others are not; some develop slowly, others rapidly; some cause pain, others itching; some resemble creatures with heads and feet, others resemble cup-shaped lumps. Their patterns differ, generally caused by the mutual interaction of internal and external factors, the conflict between true qi and pathogenic qi, the steaming and condensation of qi and blood, and their intermingling. Accumulation (Ji) is associated with the zang organs; gathering (Ju) is associated with the fu organs; persistent disease (Zhu) is associated with qi; mass (Jia) is associated with blood; and worms arise from the interaction of blood, qi, and food. Thus, there are five types of Ji, six types of Ju, twelve types of Zhu, eight types of Jia, and nine types of worms, each with distinct names.
The five types of Ji involve the heart, liver, spleen, lungs, and kidneys. The six types of Ju involve the large intestine, small intestine, gallbladder, stomach, bladder, and sanjiao (Triple Burner). The twelve types of Zhu include labor, qi, cold, heat, deficiency, excess, wind, dampness, food, medicine, thought, and worry. The eight types of Jia include green, yellow, dry, blood, fat, fox, snake, and turtle. The nine types of worms include hidden, snake, white, meat, lung, stomach, red, weak, and pinworm. The descriptions of these diseases are found in various treatises, and treatment methods are detailed below.
"Labor" refers to the overexertion of spirit and qi; "injury" refers to damage to the physical form. Indiscriminate eating and drinking injures the spleen; excessive thinking injures the heart; excessive sexual activity injures the kidneys; irregular daily routines injure the liver; and excessive emotions such as anger, joy, sorrow, and anxiety injure the lungs. Furthermore, wind, cold, summer-heat, and dampness invade from the exterior, while improper diet and overwork damage from within. Contracting pathogens during the day affects ying (nutritive) qi; contracting them at night affects wei (defensive) qi. Ying and wei qi circulate through the meridians, interacting internally and externally, following the rhythms of day and night.
Labor begins in one organ, spreads to two, then three, then four, then five, and finally circles back to affect the first. From one to five, the cycle repeats, causing pathogenic qi to hide deeply and true qi to be lost. This leads to emaciation, weakness of spirit and qi, reduced appetite, and difficulty walking. When the condition reaches this stage, even Si Ming (the deity of life and death) cannot save the patient. Therefore, the *Treatise on Regulating Spirit and Qi* states: regulating spirit and qi, being cautious with alcohol and sex, moderating daily routines, reducing mental exertion, and eating bland food are the major principles of longevity.
In pulse diagnosis, if the pulse is extremely rapid, urgent, thin, weak, minute, choppy, slippery, short, long, floating, deep, tight, wiry, flooding, or full, these are all generated by labor and injury.