Abdominal masses is a general term in traditional Chinese medicine （TCM） that encompasses various intractable conditions such as tumors and abdominal lumps. Clinically， it often presents with a mixture of deficiency and excess， as well as a complex interplay of cold and heat. The therapeutic principle emphasizes both purgation and supplementation， with treatment strategies tailored to syndrome differentiation. Representing the "School of Attacking Pathogens"， ZHANG Congzheng， and the "School of Strengthening the Spleen and Stomach"， Li Gao， systematically differed in their understanding of the etiology and pathogenesis of abdominal masses， as well as in their therapeutic approaches and medication strategies. ZHANG advocated "attacking through purgation" and "replacing supplementation with attack"， while LI emphasized "supplementing through purgation" and "prioritizing strengthening healthy

qi

". Their diagnostic and therapeutic thinking thus differed in the balance of "embedding supplementation within attack" versus "embedding attack within supplementat

ion". Further analysis reveals that the divergence in their academic propositions and clinical practices was closely related to their respective lineages， historical contexts， and patient populations.