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The *Mai Jing* (Pulse Classic) states: When the pulse is fine, small, and tight, the disease progresses rapidly; pain in the middle abdomen is stabbing. ○ If the Yin pulse is wiry, abdominal pain occurs, characterized by tension and lower abdominal pain. ○ A tight Chi pulse indicates pain below the umbilicus. ○ A hidden Chi pulse indicates lower abdominal pain with mass or hernia (Jia Shan). ○ An excess pulse with lower abdominal pain indicates that acupuncture should be applied. ○ For heart and abdominal pain where breathing is obstructed due to pain, a fine, small, and slow pulse indicates survival, whereas a firm and large pulse indicates death. ○ For abdominal pain, if the pulse is unexpectedly large and long, it indicates death.

The *Nei Jing* (Inner Canon), in the chapter "Discourse on Pain" (Ju Tong Lun), asks: What causes sudden pain in the five zang organs? Qibo replies: The flow of qi and blood in the meridians never ceases, circulating endlessly. When cold pathogen enters the meridians, its flow becomes sluggish, stagnant, and obstructed. If it lodges outside the vessels, blood volume decreases; if it lodges in the lungs, qi mechanism is blocked, resulting in sudden pain. The Yellow Emperor asks: Regarding this pain, some stops suddenly, some persists, some is so severe it cannot be pressed, some stops when pressed, some is unaffected by pressure, some pulsates under the hand, some involves mutual pulling pain between the heart and back, some between the hypochondrium and lower abdomen, some radiating from the abdomen to the medial thigh, some causing sudden syncope with recovery after a short time, some accompanied by vomiting, some followed by diarrhea, and some accompanied by constipation. How can these different pains be distinguished? Qibo says: When cold lodges outside the vessels, the vessels become cold, contract, and curl; contraction leads to tension and cramping of the vessels, which pulls on the collateral vessels, causing sudden pain that stops quickly. If re-exposed to cold, the pain becomes chronic. When cold lodges within the vessels and combats with heat, the vessels become full, causing pain that cannot be pressed. If cold lingers and heat rises, the vessels become distended, and qi and blood become chaotic, causing severe pain unresponsive to pressure. When cold lodges between the intestines and stomach, beneath the membrane origins, the blood cannot disperse, and small collaterals are pulled tightly, causing pain; pressing disperses the qi and blood, relieving the pain. When cold lodges in the meridians alongside the spine, deep pressure cannot reach the site, so pressing is ineffective. When cold lodges in the Chong Mai (Penetrating Vessel), which originates at Guanyuan (CV4) and ascends vertically, obstruction of the vessel blocks qi flow, causing pulsation felt under the hand. Cold lodging in the Back-Shu meridians (see Heart Pain section). Cold lodging in the Jueyin Meridian of Foot-Shaoyin, which connects to the genitalia and attaches to the Liver, causes blood stagnation and vessel tension, leading to mutual pulling pain between the hypochondrium and lower abdomen. Rebellious qi lodging in the medial thigh allows cold to ascend to the lower abdomen; blood stagnation below causes mutual pulling, resulting in abdominal pain radiating to the thigh. Cold lodging beneath the membrane origins of the Small Intestine and among the collateral blood causes blood stagnation without flowing into the major vessels; qi and blood stagnate, eventually forming masses over time. Cold lodging in the five zang organs causes rebellious qi to escape upward, depleting yin qi while yang qi fails to enter, causing sudden severe pain and syncope; recovery of vital qi leads to survival. Cold lodging in the intestines and stomach causes rebellious qi to move upward, resulting in pain with vomiting. Cold lodging in the Small Intestine prevents proper digestion and accumulation, leading to subsequent diarrhea and abdominal pain. Heat flowing into the Small Intestine causes intestinal pain and constipation; intense heat and dryness cause hard, dry stool that cannot be expelled, resulting in pain with obstinate constipation.