circulation of Blood, eventually leading to stasis of Blood. The "Spiritual Axis" in chapter 66
says: "Ji masses are due to Cold."4(396)

External Dampness may invade the channels of the legs and then creep up the legs to settle in the
lower abdomen where, in the long run, it transforms into Phlegm and may give rise to abdominal
masses.

As for pathology, abdominal masses are always characterized by either stagnation of Qi or stasis
of Blood, the former being non-substantial and the latter substantial masses. In addition to
stagnation, there may also be Phlegm. However, in all cases of abdominal masses there is always
an underlying deficiency of Qi. Deficient Qi fails to transport and transform and, leading to
stagnation of Qi and Blood, it allows masses to from.

Masses from stagnation of Qi come and go, are movable on palpation and change location. If
there is pain, the pain has no fixed location and is accompanied by a pronounced feeling of
distension.

Masses from stasis of Blood are fixed in location, they are not movable on palpation and feel
quite hard. If there is pain, the pain is fixed and stabbing in character.

Masses from Phlegm feel soft on palpation and have a fixed location. There is usually no pain.

Differentiation and Treatment

The treatment of abdominal masses is always based on moving Qi and Blood. However, there
are other factors to take into account depending on the stage of the disease. In the beginning
stages of the condition the pathogenic factor (stagnation of Qi or stasis of Blood) is relatively
weak and the body's Qi relatively strong. In the middle stage, the body's Qi is weakening and the
pathogenic factor becoming more prominent. In the late stages, the pathogenic factor is very
prominent and the masses very developed while the body's Qi is very weak. Thus, irrespective of
the pathogenic factor involved, the principle of treatment must be guided by the stage of the
condition:

• In the beginning stages primarily resolve the pathogenic factor, i.e. move Qi and Blood
  and resolve Phlegm


• In the middle stages resolve the pathogenic factor and tonify the body's Qi
  simultaneously


• In the late stages primarily tonify the body's Qi and secondarily resolve the pathogenic