Functional dyspepsia and accumulation (積) in classical medical texts share expressions such as epigastric discomfort, nausea, belching, and fullness. Rome IV, however, defines its diagnostic scope through four core symptoms, frequency and duration thresholds, and exclusion of structural disease, whereas selected passages in Jingui Gouxuan, Zabing Guangyao, and Donguibogam also record pulse findings, palpable form and movement, location, diarrhea, and changes after defecation. Shared symptom terms therefore do not establish diagnostic, mechanistic, or causal equivalence. No material reviewed here applies Rome IV and contemporary damjeok criteria to the same people, and the classical sources lack adequate edition, facsimile, character-variant, and translation controls. The article sets out these limits and proposes conditions for a future study that records the two sets of observations independently in the same participants at the same time. Another diagnostic vocabulary cannot replace clinical evaluation for structural disease.