问曰∶病有积、有聚、有系气（系一作谷，下同），何谓也？师曰∶积者，脏病也，终不移；聚者，腑病也，发作有
时，展转痛移，为可治；系气者，胁下痛，按之则愈，愈复发为系气。夫病已愈，不得复发，今病复发，即为系气也。
诸积大法，脉来细而附骨者，乃积也（细，一作结）。寸口，积在胸中。微出寸口，积在喉中。关上，积在脐旁。上关上，
积在心下。微下关，积在少腹。尺，积在气街。脉出在左，积在左，脉出在右，积在右，脉两出，积在中央。各以其部
处之。
诊得肺积，脉浮而毛，按之辟易，胁下气逆，背相引痛，少气，善忘，目瞑，皮肤寒，秋瘥夏剧，主皮中时痛，如
虱缘之状，甚者如针刺，时痒，其色白。
诊得心积，脉沉而芤，上下无常处，病胸满悸，腹中热，面赤嗌干，心烦，掌中热，甚即唾血，主身螈 ，主血厥，
夏瘥冬剧，其色赤。
诊得脾积，脉浮大而长，饥则减，饱则见， 起与谷争减，心下累累如桃李，起见于外，腹满呕泄，肠鸣，四肢重，
足胫肿，厥不能卧是，主肌肉损，其色黄。
诊得肝积，脉弦而细，两胁下痛，邪走心下，足肿寒，胁痛引少腹，男子积疝，女子瘕淋，身无膏泽，喜转筋，爪
甲枯黑，春瘥秋剧，其色青。
诊得肾积，脉沉而急，苦脊与腰相引痛，饥则见，饱则减，少腹里急，口干，咽肿伤烂，目KT KT ，骨中寒，
主髓厥，善忘，其色黑。
寸口脉沉而横者，胁下及腹中有横积痛，其脉弦，腹急痛，腰背痛相引，腹中有寒，疝瘕。脉弦紧而微细， 也。
夫寒痹、 瘕、积聚之脉，皆弦紧。若在心下，即寸弦紧；在胃脘，即关弦紧；在脐下，即尺弦紧。（一曰∶关脉弦长，
有积在脐左右上下也）又脉 法，左手脉横， 在左，右手脉横， 在右；脉头大者在上，头小者在下。
又法∶横脉见左，积在右，见右积在左。偏得洪实而滑，亦为积。弦紧亦为积，为寒痹，为疝痛。内有积不见脉，
难治，见一脉（一作胁）相应，为易治，诸不相应，为不治。左手脉大，右手脉小，上病在左胁，下病在左足。右手脉
大，左手脉小，上病在右胁，下病在右足。
脉弦而伏者，腹中有 ，不可转也。必死不治。
脉来细而沉，时直者，身有痈肿，若腹中有伏梁。
脉来小沉而实者，胃中有积聚，不下食，食即吐。
问：疾病有积、聚、系气（“系”一作“谷”，以下同），这是什么意思？老师说：积，是脏的病，位置固定不移；聚，是腑的病，发作有定时，疼痛辗转移动，是可以治疗的；系气，是胁下疼痛，按压后缓解，但好了之后又复发。既然病已经痊愈，就不应该再复发，现在病情复发，这就是系气。
关于各种积病的诊断大法：脉象细弱且按之直达骨部的，就是积病（“细”一作“结”）。脉见于寸口部，积在胸中；脉象略微超出寸口，积在喉中；脉见于关上部，积在脐旁；脉象略微高于关上，积在心下；脉象略微低于关部，积在少腹；脉见于尺部，积在气街。脉象显现于左手，积在身体左侧；脉象显现于右手，积在身体右侧；脉象左右手都显现，积在身体中央。根据脉象出现的部位来判断积病的位置。
诊察到肺积：脉象浮而如毛，重按则感觉空豁无力，胁下气逆，背部牵引作痛，气短，健忘，眼睛昏花，皮肤发冷，秋季症状减轻夏季加重，主要症状是皮肤有时疼痛，像有虱子爬行的感觉，严重的像针刺一样，偶尔发痒，面色白。
诊察到心积：脉象沉而芤（中空），位置上下不定，病症表现为胸部胀满、心悸，腹部发热，面红，咽喉干燥，心烦，手心发热，严重时咳血，主要症状是身体抽搐，主病为血厥，夏季症状减轻冬季加重，面色赤。
诊察到脾积：脉象浮大而长，饥饿时脉象减弱，饱食时脉象显现，起身活动时脉搏与进食后的变化相争减，心下累累然像桃李大小，突起可见于体表，腹部胀满，呕吐泄泻，肠鸣，四肢沉重，足胫浮肿，厥逆不能卧倒，主要症状是肌肉受损，面色黄。
诊察到肝积：脉象弦而细，两胁下疼痛，邪气走窜至心下，足部肿胀发冷，胁痛牵引少腹，男子患疝气，女子患瘕淋，身体没有光泽，喜欢转筋，指甲枯黑，春季症状减轻秋季加重，面色青。
诊察到肾积：脉象沉而急，痛苦于脊柱与腰部相互牵引作痛，饥饿时症状显现，饱食后减轻，少腹里急，口干，咽喉肿痛溃烂，眼睛视物模糊不清，骨髓寒冷，主病为髓厥，健忘，面色黑。
寸口脉沉而横的，胁下及腹中有横向的积块疼痛，如果脉象弦，则是腹部急痛，腰背疼痛相互牵引，腹中有寒，疝气瘕块。脉象弦紧而微细的，是疝气。
寒痹、瘕块、积聚的脉象，都是弦紧脉。如果在心下，就是寸脉弦紧；在胃脘，就是关脉弦紧；在脐下，就是尺脉弦紧。（另一种说法：关脉弦长，表示脐的左右上下有积块）又有脉法说：左手脉横，积在左侧；右手脉横，积在右侧；脉头大的在上部，脉头小的在下部。
又一种方法：横脉出现在左手，积在右侧；出现在右手，积在左侧。偏于洪大、实而滑的脉，也是积病。弦紧脉也是积病，或者是寒痹，或者是疝痛。体内有积块但脉象不见相应变化，难治；见到一脉（或一胁）相应，容易治疗；所有脉象都不相应，是不治之症。左手脉大，右手脉小，上部病在左胁，下部病在左足。右手脉大，左手脉小，上部病在右胁，下部病在右足。
Question: Diseases include Ji (accumulation), Ju (gathering), and Xi Qi (tied qi). What do these terms mean? The Master said: Ji refers to diseases of the Zang organs, which remain fixed in location and do not move; Ju refers to diseases of the Fu organs, which occur at specific times, with pain that shifts and moves around, and is treatable; Xi Qi refers to pain under the hypochondrium that alleviates upon pressure but recurs after relief. Since a cured disease should not recur, its recurrence indicates Xi Qi.
The general principle for diagnosing various accumulations: A pulse that is fine and adheres closely to the bone indicates an accumulation. If the pulse is located at the Cun Kou (inch position), the accumulation is in the chest. If it slightly extends beyond the Cun Kou, the accumulation is in the throat. If it is at the Guan position, the accumulation is beside the umbilicus. If it is slightly above the Guan position, the accumulation is below the heart (epigastrium). If it is slightly below the Guan position, the accumulation is in the lower abdomen. If it is at the Chi position, the accumulation is at the Qi Jie (groin area). If the pulse appears on the left hand, the accumulation is on the left side of the body; if on the right hand, on the right side; if on both hands, in the center. Diagnosis should be made according to the specific pulse location.
Diagnosing Lung Accumulation: The pulse is floating and superficial like hair, feeling empty when pressed deeply. Symptoms include rebellious Qi under the hypochondrium, pulling pain in the back, shortness of breath, forgetfulness, blurred vision, cold skin, worsening in summer and improving in autumn. Main symptoms include intermittent skin pain resembling the crawling of lice, severe cases feeling like needle pricks with occasional itching, and a white complexion.
Diagnosing Heart Accumulation: The pulse is deep and Kou (cleft-like/empty), with no fixed location. Symptoms include chest fullness, palpitations, heat in the abdomen, red face, dry throat, mental restlessness, heat in the palms, and hemoptysis in severe cases. Main symptoms include muscle twitching and Blood Jue (syncope due to blood disorder). It worsens in winter and improves in summer, with a red complexion.
Diagnosing Spleen Accumulation: The pulse is floating, large, and long. It weakens when hungry and becomes apparent when full. Rising from bed causes the pulse to fluctuate against the effect of food. There is a lump under the heart resembling peaches or plums, visible externally. Symptoms include abdominal fullness, vomiting, diarrhea, borborygmus, heavy limbs, edema of the legs, and inability to lie down due to reversal of Qi. Main symptoms involve damage to muscles, with a yellow complexion.
Diagnosing Liver Accumulation: The pulse is wiry and fine. Symptoms include pain in both hypochondria, evil Qi moving to the epigastrium, swollen and cold feet, hypochondriac pain radiating to the lower abdomen. In men, it presents as hernia; in women, as mass and strangury. The body lacks luster, there is a tendency for muscle cramps, and nails are dry and black. It worsens in autumn and improves in spring, with a green complexion.
Diagnosing Kidney Accumulation: The pulse is deep and rapid. The patient suffers from pulling pain between the spine and waist. Symptoms appear when hungry and subside when full. There is urgency in the lower abdomen, dry mouth, swollen and ulcerated throat, blurred vision, and coldness in the bones. Main symptoms include Marrow Jue and forgetfulness, with a black complexion.
If the Cun Kou pulse is deep and transverse, it indicates horizontal accumulation and pain in the hypochondrium and abdomen. If the pulse is wiry, it indicates acute abdominal pain, pulling pain between the waist and back, cold in the abdomen, and hernia/mass. A wiry, tight, and slightly fine pulse indicates hernia.
The pulses for Cold Bi, Mass, and Accumulation are all wiry and tight. If located at the epigastrium (below heart), the Cun pulse is wiry and tight; if in the stomach region, the Guan pulse is wiry and tight; if below the umbilicus, the Chi pulse is wiry and tight. (Another view: A long wiry Guan pulse indicates accumulation around the umbilicus.) Another pulse method states: Transverse pulse on the left hand indicates accumulation on the left; on the right hand, on the right. A pulse head that is large indicates upper accumulation; small indicates lower.
Another method: Transverse pulse on the left indicates accumulation on the right; on the right, accumulation on the left. A pulse that is predominantly surging, solid, and slippery also indicates accumulation. Wiry and tight pulses indicate accumulation, Cold Bi, or hernia pain. If there is internal accumulation but no corresponding pulse change, it is difficult to treat. If one pulse corresponds, it is easy to treat. If none correspond, it is untreatable. If the left hand pulse is large and the right is small, the upper disease is in the left hypochondrium, and the lower disease is in the left foot. If the right hand pulse is large and the left is small, the upper disease is in the right hypochondrium, and the lower disease is in the right foot.
A wiry and hidden pulse indicates an immobile mass in the abdomen. This is fatal and untreatable.
A pulse that is fine, deep, and occasionally straight/stiff indicates abscesses in the body or Ful Liang (a type of abdominal mass) in the abdomen.
A pulse that is small, deep, and solid indicates accumulation in the stomach, inability to eat, and vomiting immediately after eating.