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。
五积和六聚的概念源自《难经》，七瘕和八瘕记载于《千金方》。肠覃（生长在肠外的肿块）和石瘕（生长在子宫内的肿块）需要通过月经情况来辨别，癖（指腹内结块，时隐时现的病症）的名称则用于区分病位的深浅。脏之积在发作时有固定的部位，腑之聚发作时忽散无根。类积、类瘕、类聚、类癖这些病症，多因肠胃充满、津液外溢并感受外寒所致。
【注】五积、六聚的名称，本源于《难经》。所谓五积，是指肥气、伏梁、痞气、息贲、奔豚这五种积聚。所谓六聚，是指积聚附着于孙络、缓筋、募原、膂筋、肠后、输脉这六个部位。七瘕、八瘕的名称，记载于《千金方》。七瘕包括蛟瘕、蛇瘕、鳖瘕、肉瘕、发瘕、虱瘕、米瘕。八瘕包括青瘕、黄瘕、燥瘕、血瘕、脂瘕、狐瘕、蛇瘕、鳖瘕。肠覃是积聚在肠外，形状像怀孕，但月经仍能按时来潮。石瘕是积聚在胞宫（子宫）中，形状也像怀孕，但月经不能按时来潮，所以说要通过辨别月经情况来区分。疰（此处原文似有缺字或通假，结合下文“不移”及“浅深”，通常指固定不移的积聚，注文中解释为“外结募原肌肉之间”，此处暂译为：疰，指在外侧结于募原肌肉之间）。癖，指在内侧结于隐蔽偏僻的膂脊肠胃之后，所以说通过名称来区别病位的深浅。然而，积属于脏，属阴，所以发作时有固定部位，不离开其所属区域。聚属于腑，属阳，所以发作没有根本，忽聚忽散。疰位置固定不移且可见，所以归类为积、类瘕。瘕可以移动，有时隐藏，所以归类为聚、类癖。积聚、疰瘕、肠覃、石瘕、癖这些疾病，都是因为喜怒不节制损伤了脏，饮食过饱损伤了腑，导致肠胃填满，汁液外溢，被外寒侵袭，与体内的气血、食物凝结相结合而形成的。
积聚如果牢坚且不软动，说明胃气虚弱且有溏泻症状，此时不可使用攻下法。奔豚发作时状如濒死，气从少腹上冲至咽喉，患者神情惊恐。
【注】积聚牢固不动，坚硬不软，说明病情已深入。如果胃弱食少、大便溏泻，则身体无法承受攻伐治疗。在五积之中，奔豚最为难治。如果再次发作，正气虚弱不能支撑，其症状表现为欲死之状，气从少腹升起，上冲咽喉，神色惊怖，这些都是恶候（预后不良的症状）。
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).