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The *Ju Tong Lun* (Treatise on Pain) states: When cold qi enters the meridians, its movement becomes sluggish and congealed, failing to flow smoothly. If cold lodges outside the vessels, blood volume decreases; if it lodges inside the vessels, qi circulation is obstructed, resulting in sudden pain. This pain may cease suddenly, or be so severe that it cannot be pressed upon; pressing may relieve the pain, or have no effect; the pain may pulsate and be felt under the hand; there may be pulling pain between the hypochondrium and the lower abdomen; abdominal pain may radiate to the medial thigh; sudden severe pain may cause fainting and loss of consciousness, with recovery after a short while; pain may be accompanied by vomiting; abdominal pain may be followed by diarrhea; or pain may be accompanied by constipation. The forms of these pains vary greatly. According to this treatise, all the aforementioned pathological manifestations and symptoms are caused by cold qi, recorded in considerable detail, and the original text should be studied carefully. Only the case of "pain accompanied by constipation" is due to heat qi lingering in the small intestine, where intestinal heat toxicity is flourishing, scorching fluids causing dryness and thirst, leading to hard, dry feces that cannot be expelled; this is classified as heat pain. This describes the pathogenesis that both cold and heat can cause pain. Generally, cold-induced pains are more common, while heat-induced pains are less frequent.

The *Mai Jing* (Pulse Classic) states: A pulse that is fine, small, and urgent indicates rapid disease progression, with the pathology located in the middle abdomen, presenting as stabbing pain. A yin-chord-like pulse indicates abdominal pain; a string-taut and urgent pulse indicates lower abdominal pain. A tight chi pulse indicates pain below the umbilicus; a hidden chi pulse indicates lower abdominal pain and hernia syndromes; a solid chi pulse indicates lower abdominal pain, which should be treated by promoting bowel movements. For heart and abdominal pain with difficulty breathing, a fine, small, and slow pulse indicates a favorable prognosis (life), whereas a firm, large, and rapid pulse indicates an unfavorable prognosis (death). Abdominal pain with a pulse that is unexpectedly floating, large, and long indicates an unfavorable prognosis (death).

The *Shang Han Lun* (Treatise on Cold Damage Disorders) states: In cold damage diseases, a pulse that is superficially choppy and internally string-taut, accompanied by acute abdominal pain, indicates deficiency-cold within.

Cheng Wuji stated: When yin-cold acts as the pathogenic factor, it causes abdominal fullness, vomiting, inability to eat, spontaneous diarrhea that worsens, and spontaneous abdominal pain; this is a Taiyin syndrome. If sweating fails to resolve the condition and the physician erroneously applies purgation, resulting in abdominal fullness and intermittent pain, it belongs to the Taiyang stage complications, and Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction plus Peony Root) should be used as the primary treatment. For cases of severe pain indicating excess, Guizhi Jia Dahuang Tang (Cinnamon Twig Decoction plus Rhubarb) should be used.

Li Dongyuan stated: Various types of abdominal pain arise from excessive labor and improper diet, leading to insufficiency of Middle Qi, allowing cold pathogens to invade due to deficiency, thus causing sudden onset. Generally, as mentioned in the Da Jing, pain relieved by warmth ("Jiong," meaning heat) confirms that treating cold with heat is the correct approach. However, abdominal pain has specific locations, and the zang-fu organs are situated at different heights; therefore, treatment must distinguish between them.

Commentary: The aforementioned pulse discussions describe various deficiency-type pains. However, when pathogens transmit inward, heat binds in the lower jiao, presenting with excess fullness, blood stasis causing hard pain, etc., these are all excess pains. The *Mai Jing* states: Abdominal fullness without pain upon palpation indicates deficiency; pain upon palpation indicates excess. This elucidates the difference between excess and deficiency pathologies, while also addressing the high and low positions of the affected areas.