Difficulty 55

There are differences between accumulations (ji) and gatherings (ju) in disease. How are they to be distinguished?

Answer: Accumulations pertain to yin qi; gatherings pertain to yang qi. Therefore, yin qi is heavy and stagnant, tending to sink and hide, while yang qi is light and floating, tending to move about. What is formed by the stagnation of qi is called an accumulation; what is formed by the gathering of qi is called a gathering. Hence accumulations arise from the five viscera, and gatherings arise from the six bowels. Accumulations belong to yin qi; their initial site is fixed and unchanging, and pain does not leave this location. They have clear upper and lower boundaries and left and right margins. Gatherings belong to yang qi; their initial site has no fixed root, and they have no fixed location for stopping or staying above or below. Pain has no fixed place. This is what is called a gathering. Therefore, by these signs, accumulations and gatherings are distinguished.