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Pain in various parts of the body is classified into its respective categories; for example, gouty pain (Tongfeng) is categorized under Bi syndrome (Obstruction Syndrome), and eye pain is categorized under Eye diseases. This merely outlines the general principles of pain.

In the *Suwen* (Basic Questions): The Yellow Emperor asked: I have heard that those who are skilled in discussing the Heavenly Dao must find verification in human beings; those skilled in discussing ancient times must find harmony with the present; and those skilled in discussing others must be able to apply it to themselves. If one can achieve this, the Dao will not be confused, and the essential numbers/laws will be fully grasped, which is called "Clarity" (Ming). Now I ask you, Master, hoping to hear things that can be known through words, seen through observation, and felt through touch, so that I may verify them on myself, dispel my ignorance, and resolve my doubts. May I hear about this? Qibo bowed twice and kowtowed, replying: What kind of Dao do you ask about? The Emperor said: I wish to hear why sudden pain occurs in the five Zang organs, and what Qi causes it. Qibo replied: The flow of Qi and Blood in the meridians never ceases, circulating around the body without rest. When Cold pathogen enters the meridians, its flow becomes sluggish and stagnant. If Cold lodges outside the vessels, Blood volume decreases; if it lodges inside the vessels, Qi mechanism becomes obstructed. Therefore, sudden pain occurs. The Emperor said: Regarding pain that starts suddenly and stops suddenly, or pain that is severe and unceasing, or pain that is severe and cannot be pressed, or pain that is relieved by pressing, or pain that is unaffected by pressing, or pain where the pulse beats against the fingers, or pain radiating between the heart and back, or pain radiating between the hypochondrium/ribs and lower abdomen, or abdominal pain radiating to the inner thigh, or pain that has existed for a long time forming an accumulation, or sudden severe pain leading to unconsciousness followed by recovery, or pain accompanied by vomiting, or abdominal pain followed by diarrhea, or pain accompanied by constipation—since these pains differ in form, how should they be distinguished? Qibo said: When Cold lodges outside the vessels, the vessels become cold. Cold vessels contract and curl up, becoming taut and cramped. This tension pulls on the small collaterals externally, causing sudden pain. Upon exposure to Heat (Jiong), the pain stops immediately. However, if repeatedly attacked by Cold, the pain persists.

(Jiong means heat.) When Cold lodges within the meridians and combats with Heat Qi, the vessels become full. Fullness causes pain that cannot be pressed. If Cold lingers and Heat rises from above, the vessels swell and become large, disrupting Qi and Blood, resulting in severe pain that cannot be pressed. When Cold lodges between the stomach and intestines, below the membrane source, Blood cannot disperse, and small collaterals contract tightly, causing pain. Pressing disperses Qi and Blood, thus relieving pain. When Cold lodges in the vessels alongside the spine, deep pressure cannot reach the disease site, so pressing is ineffective. When Cold lodges in the Chong Mai (Penetrating Vessel), which originates at Guanyuan (CV4) and ascends straight up the abdomen, Cold obstruction prevents vessel patency. Obstruction causes Qi to surge, making the pulse beat visibly against the hand. When Cold lodges in the Back-Shu vessels, Blood stasis occurs. Stasis leads to Blood deficiency, which causes pain. Since these Shu points connect to the Heart, pain radiates between the chest and back. Pressing brings Warmth to the area, and upon arrival of Warmth, pain ceases. (Treatment see Heart Pain.) When Cold lodges in the Jueyin Meridian, which connects to the genitalia and attaches to the Liver, Cold inside the vessels causes Blood stagnation and vessel cramping, leading to radiating pain between the hypochondrium and lower abdomen. (Treatment see Hypochondriac Pain.) When Jue Yin Qi lodges in the inner thighs, and Cold ascends to the lower abdomen, Blood stagnates below and pulls inward, causing abdominal pain radiating to the inner thighs. (Treatment see Abdominal Pain.) When Cold lodges in the blood of the collaterals between the membrane source of the Small Intestine, Blood stagnates and cannot flow into the main meridians. Qi and Blood stagnate and fail to circulate, leading to accumulations over time. (Treatment see Accumulation.) When Cold lodges in the Five Zang organs, causing rebellious Qi to ascend and leak, Yin Qi is exhausted while Yang Qi fails to enter. This causes sudden severe pain and unconsciousness. Life returns if Qi reverses and recovers. When Cold lodges in the stomach and intestines, rebellious Qi surges upward, causing pain and vomiting. (Treatment see Vomiting Methods.) When Cold lodges in the Small Intestine, it fails to properly gather and transform, causing diarrhea and abdominal pain. (Treatment see Dysentery.) When Hot Qi remains in the Small Intestine, it causes pain. Severe heat and thirst lead to dry, hard stool that cannot pass, resulting in pain and constipation. (Treatment see Constipation.) The Emperor said: You mentioned knowing through words; how is seeing possible? Qibo said: The Five Zang and Six Fu organs each have their specific areas. Observing the five colors: yellow and red indicate Heat; white indicates Cold; green and black indicate Pain. This is what is meant by "visible." The Emperor said: How is touching possible? Qibo said: By observing the pulse of the primary disease: if it is firm/hard with blood stasis, or sunken/depressed, these can be detected by palpation. (All from Chapter "Discourse on Sudden Pain")

From the *Yin Yang Ying Xiang Lun*: Qi injury causes pain; Form injury causes swelling. Therefore, pain preceding swelling indicates Qi injuring Form; swelling preceding pain indicates Form injuring Qi.

From the *Lingshu*: Having form but no pain belongs to the category of Yang; having no form but pain belongs to the category of Yin. No form but pain means Yang is intact but Yin is injured; urgently treat Yin, do not attack Yang. Form with pain means Yin is intact but Yang is injured; urgently treat Yang, do not attack Yin. If both Yin and Yang are affected, alternating between formless and formed states, accompanied by vexation, it is named "Yin overcoming Yang." This is neither exterior nor interior, and the condition is critical, threatening life.

Li Dongyuan stated: Unobstructed means no pain; painful means obstructed. He also said: Pain diminishes with purgation/unblocking. One should follow the meridians to unblock them, thereby removing pain. For example, light herbs can remove excess, such as Ephedrae Herba (Mahuang) and Puerariae Radix (Gegen). For headache, use Ligusticum Chuanxiong Rhizoma (Chuanxiong) and Asari Radix et Rhizoma (Xixin) to unblock stagnation, so pain diminishes with unblocking.

Wang Haigu stated: All pain is Excess; pain diminishes with unblocking. Many people interpret "unblocking" (Li) as purgation (downward draining). Suppose pain is in the Exterior, it is Excess; pain in the Interior, it is Excess; pain in Qi and Blood, it is also Excess. Therefore, pain in the Exterior is cured by sweating; pain in the Interior is cured by purging; pain in Qi and Blood is cured by dispersing and moving. How can "Li" only mean purgation! If we interpret "Li" as "Unblocking/Flowing," then it makes sense. Thus, the classic says: Unobstructed means no pain; painful means obstructed. This refers to this principle.

Regarding Yunqi (Five Movements and Six Qi): All pain belongs to Fire. The classic says: All pain and soreness belong to Fire. One type is Fire Excess. The classic says: When Fire is depressed and erupts, people suffer bone pain and joint movement. Another type is Fire Deficiency. The classic says: Insufficient Fire is called "Fu Ming" (Hidden Brightness). In the Fu Ming cycle, eruptions manifest as pain.

Zhu Danxi stated: All pain belongs to Fire. Cold-Cooling herbs should not be used aggressively; warm-dispersing herbs must be used. Ginseng Radix et Rhizoma (Renshen) should not be used for pain, because tonifying Qi increases Qi abundance, which worsens obstruction and intensifies pain.