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The *Neijing* (Yellow Emperor's Inner Classic) discusses heart pain without excluding pain involving the five zang organs; it details the heart while briefly mentioning the chest and abdomen, using one example to illustrate the rest. The Heart is the sovereign ruler and, by principle, should not be invaded by pathogenic factors. If invaded, it constitutes a disease of its own meridian, termed *Zhenxintong* (True Heart Pain), which is invariably fatal and incurable. However, classics state: "Pathogens in the Heart cause heart pain, with a tendency toward sadness, dizziness, and collapse." This refers to pathogens invading the Pericardium (Pericardium Meridian of Hand-Jueyin), affecting the fu organ rather than the zang organ. It also states: "Abnormal pulsation of the Shaoyin meridian of Hand causes dryness of the throat, heart pain, thirst, and desire to drink." This refers to pathogens invading the collateral vessels, affecting the collaterals rather than the main meridians. Such invasion of collaterals and fu organs results from fright and excessive thinking, which damage the spirit and deplete blood, making the body vulnerable to empty invasion. These are further categorized into nine types: Yin (Fluid retention), Shi (Food stagnation), Re (Heat), Leng (Cold), Qi (Qi stagnation), Xue (Blood stasis), Ji (Palpitations), Chong (Parasites), and Zhu (Infectious/contagious disease). Without comprehensive recognition of these pathological forms, how can treatment be administered?

The Stomach belongs to Yang Earth, situated in the Middle Jiao, serving as the sea of water and grain. The qi of the five zang organs, six fu organs, and twelve meridians all derive from it. In robust individuals, pathogens cannot invade; in weak individuals, pathogens linger and cause disease. Deviations toward heat or cold, fluid retention, or food stagnation all contend with true qi, resulting in pain. Liver Wood overacting constitutes a "thief pathogen"; Kidney Cold with reversal constitutes a "minor pathogen." When mixed with manifestations from other zang organs, the presentation resembles heart pain, but may include diarrhea or distension, vomiting, inability to eat, acid regurgitation, difficulty defecating, or diarrhea with facial edema and yellowish complexion. The primary disease and exogenous pathogens inevitably present together. Chest pain is synonymous with diaphragm pain. Its distinction from heart pain lies in location: heart pain occurs at the depression below the xiphoid process (Qigu), whereas chest pain fills the chest horizontally. Its distinction from epigastric pain lies in location: the epigastrium is below the heart, while chest pain is above the heart. The classics state: "South wind arises in summer, diseases affect the Heart, manifesting in the chest and hypochondrium," implying the hypochondrium belongs to the Heart. Liver deficiency causes chest pain radiating to the back and hypochondrium; Liver excess causes chest pain preventing turning of the body. This implies the chest belongs to the Liver. Indeed, the chest is the domain of the Lung. References to the Heart arise because the Heart meridian ascends from the Heart system to connect with the Lung. References to the Liver arise because the Liver meridian penetrates the diaphragm and ascends to pour into the Lung. Hypochondriac pain has traditionally been treated via the Liver. However, the Liver indeed houses itself in the pectoral region and hypochondrium; how does this differ from the Heart and Lung housing themselves there? If pain is due to the Liver meridian passing through, how does it differ from pain caused by the Foot-Shaoyang Gallbladder or Hand-Jueyin Pericardium meridians passing through? If pain is due to meridians harboring pathogens, how does it differ from pain simply occurring where meridians pass? Therefore, without observing complexion and palpating pulses, and carefully examining qi transformations in each meridian, one cannot achieve infallible accuracy. Furthermore, the qi, blood, yin, and yang of the left and right Livers have aspects that cannot be rigidly adhered to; must not clinicians examine meticulously during practice?

Abdominal pain is divided into three regions: pain above the umbilicus belongs to the Taiyin Spleen; pain at the umbilicus belongs to the Shaoyin Kidney; pain in the lower abdomen belongs to the Jueyin Liver, as well as the Large Intestine, Small Intestine, Chong Mai, and Ren Mai. Each region involves variations of the Five Thieves, emissions of the Seven Emotions, hardships of the Six Qi, and pathogens of the Five Movements. The situations are complex and extensive. If one can differentiate between deficiency and excess of qi and blood, and distinguish between internal injury and external contraction for appropriate regulation, no treatment will miss the mark of the pathology.