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(Formerly titled "Discourse on Lifting Pain," now changed to "Suwen: Discourse on Sudden Pain" following the interpretations of Wang Bing and Wu Kun.)

The Qi and Blood in the meridians circulate ceaselessly, revolving around the body without end. When Cold Evil invades the meridians, it causes stagnation and delay, making the flow sluggish and obstructed. If Cold lodges outside the vessels, Blood becomes deficient; if Cold lodges inside the vessels, Qi becomes obstructed. Therefore, sudden pain occurs.

When Cold lodges outside the vessels, the vessels become cold, contract, and curl up. Contraction leads to cramping and tension, which then pulls on the collateral vessels externally, resulting in sudden pain. Upon exposure to warmth (Jiong), the pain stops immediately. (Note: "Quan" means not extending; "Chu" means bending or flexing; "Jiong" means heat. The reason this pain sometimes stops suddenly is due to the failure of Stomach Qi to circulate freely. Thus, once warmed by Yang Qi, the pain ceases instantly.) If subjected to repeated Cold injury, the pain persists for a long time. (Note: This refers to cases where pain is severe and unceasing because the Cold is heavy and abundant, making it difficult to dissipate, hence the prolonged pain.)

When Cold lodges within the meridians and contends with Warmth (Yang Qi), the vessels become full. Fullness causes pain that cannot be pressed upon. (Note: "Bo Mo Dang" refers to the friction and agitation between Cold and Yang Qi. Yang Qi moves within the vessels; when invaded by Cold, Cold and Heat contend, remaining stagnant and causing pathogenic excess in the meridians, leading to vessel fullness. This describes severe pain that cannot be tolerated by pressure.) When Cold lingers and Warmth rises from above, the vessels become distended and large, and Qi and Blood become chaotic, resulting in severe pain that cannot be pressed upon. (Note: Warmth rising from above is due to the ascending nature of Yang. When restrained by Cold, Qi fills the interior, and the two energies become disordered, causing severe pain. This further clarifies the previous statement.)

When Cold lodges between the intestines and stomach, below the membrane source (Mo Yuan), Blood cannot disperse, and the small collaters contract and pull, causing pain. Pressing on the area disperses Qi and Blood, so the pain stops upon pressure. (Note: "Mo" refers to fascia; "Yuan" refers to the origin of Huang. Below the membrane source are hollow spaces. When Blood does not disperse and the small collaters become full, they contract and pull, causing pain. Pressure allows Cold to dissipate and the small collaters to relax, explaining why pain stops with pressing.)

When Cold lodges in the meridians flanking the spine (Foot Taiyang Bladder Meridian), deep pressure cannot reach the affected area, so pressing is ineffective. (Note: Those flanking the spine refer to the Foot Taiyang Meridian. Its deepest parts include the Fu Chong and Fu Lü meridians, which are beyond the reach of palpation, rendering pressure useless.)

When Cold lodges in the Chong Mai (Penetrating Vessel), which originates at Guan Yuan (CV4) and ascends straight up the abdomen, the Cold causes obstruction in the vessel. Obstruction leads to rebellious Qi movement, resulting in panting and pulsation palpable to the touch. (Note: The Chong Mai runs alongside the Foot Shaoyin Kidney Meridian, ascending beside the umbilicus, meeting at the throat, and connecting to the Lung via the Kidney meridian. If Cold lodges there, vessel obstruction occurs, and Qi rebels. The "panting and pulsation" occurs because Qi is Yang and active.)

When Cold lodges in the Back-Shu meridians (acupoints of the Zang organs, all belonging to the Foot Taiyang Meridian), the vessels become sluggish, leading to Blood deficiency and pain. Since the Back-Shu points connect to the Heart, mutual pulling pain between the Heart and the back occurs. Pressing brings warmth, which stops the pain. (Note: Back-Shu points belong to the Foot Taiyang Meridian, running along the spine towards the heart. Cold lodging here causes sluggish vessels and Blood deficiency, leading to mutual pulling pain between the Heart and back. Pressing brings warmth to stop the pain precisely because of Blood deficiency.)

When Cold lodges in the Jueyin (Liver) Meridian, which connects to the genitalia and attaches to the Liver, Cold inside the vessels causes Blood stasis and vessel tension, resulting in mutual pulling pain between the hypochondrium/ribs and the lower abdomen. (Note: The Liver meridian travels through the inner thigh, enters the pubic region, reaches the lower abdomen, and spreads over the hypochondrium. Cold lodging here causes mutual pulling pain between these areas.)

Jue Qi (Rebellious Qi) lodges in the inner thighs, and Cold extends upward to the lower abdomen. Blood stasis causes mutual pulling between the upper and lower regions. (Note: Old texts read "pulling downward," but this follows Wu Kun's annotation correcting it to "upper and lower.") Thus, abdominal pain radiates to the inner thighs. (Note: Jue Qi refers to rebellious Qi. Abdominal pain radiating to the inner thighs occurs because the Foot Three Yin Meridians and the Chong Mai all traverse the lower abdomen and inner thighs.)

When Cold lodges in the membrane source and collaterals of the Small Intestine, Blood stasis prevents flow into the major meridians. Stagnant Qi and Blood fail to move, eventually forming masses over time. (Note: Masses forming over days indicate condensation due to Cold.)

When Cold lodges in the Five Zang Organs, it causes rebellious Qi to escape upward, exhausting Yin Qi while Yang Qi fails to enter. This results in sudden severe pain, unconsciousness, and apparent death. If Qi returns, life is preserved. (Note: Cold injures Zang Qi, preventing descent and causing rebellion and upward expulsion (vomiting). Sudden exhaustion of True Yin and delayed entry of Yang cause sudden severe pain and coma. Recovery depends on the restoration of Zang Qi.)

When Cold lodges in the intestines and stomach, causing rebellious Qi to exit upward, pain and vomiting occur. (Note: "Intestines and stomach" generally refers to the Six Fu Organs. Food and drink in the Fu organs must descend from top to bottom to maintain harmony. Cold lodging causes rebellion and upward exit, leading to pain and vomiting.)

When Cold lodges in the Small Intestine, it fails to properly receive and transform contents, resulting in diarrhea and abdominal pain. (Note: The Small Intestine is the organ of Bing Fire. If overcome by Cold, Yang Qi fails to transform, and food/water cannot remain, causing abdominal pain followed by diarrhea.)

When Heat lingers in the Small Intestine, intestinal pain occurs. Severe heat and thirst lead to dry, hard stool that cannot pass, resulting in pain and obstipation. (Note: Heat lingering in the Small Intestine is a disease of Yang affecting Yang organs, causing abdominal pain and obstruction.)

Observing the five colors of the face: Yellow and Red indicate Heat; White indicates Cold; Green and Black indicate Pain. (Note: Observing facial zones: the nose tip is the Ming Tang, reflecting the Lung, Heart, Liver, and Spleen; the sides reflect the Six Fu Organs and Kidneys. Yellow/Red indicates Fire moving in the meridians (Heat); White indicates deficient Yang Qi failing to nourish the blood (Cold); Green/Black indicates Blood stasis and Qi stagnation (Pain).)

Observe the pulse associated with the primary disease. (Note: Observe the pulse corresponding to the diseases indicated by facial colors.) A firm pulse indicates Blood accumulation; a sunken pulse can be detected by palpation. (Note: Firmness indicates pathogenic aggregation and full collaterals; sunken pulses, such as those hidden deep, are detectable by touch.)

All diseases arise from disturbances in Qi. Anger causes Qi to rise; Joy causes Qi to slacken; Grief causes Qi to consume; Fear causes Qi to sink; Cold causes Qi to contract; Heat causes Qi to leak; Fright causes Qi to become chaotic; Labor causes Qi to exhaust; Thought causes Qi to knot. These nine types of Qi changes differ; what diseases do they produce? (Note: In humans, harmonious Qi is Healthy Qi; disharmonious Qi is Pathogenic Qi.)

Qibo said: Anger causes Qi to rebel; severely, it leads to hematemesis or undigested food diarrhea, because Qi rises. (Note: Anger affects the Liver, causing Qi to rebel upward, forcing Blood up (hematemesis), and Liver Wood overacting on Spleen Earth (undigested food diarrhea). ○ *Jia Yi Jing* reads "undigested food" instead of "Qi rebellion".)

Joy makes Qi harmonious and will open, allowing Ying and Wei to flow smoothly, so Qi slackens. (Note: Joy harmonizes Qi and opens the mind, ensuring smooth circulation of Nutritive and Defensive Qi, thus relaxing Qi dynamics.)

Grief tightens the Heart connection and raises the Lung leaves, blocking the Upper Jiao. Ying and Wei cannot disperse, trapping Heat in the center, so Qi consumes. (Note: Grief originates in the Heart and affects the Lung, tightening the Heart connection and raising Lung leaves. This blocks the Upper Jiao, preventing Ying/Wei dispersion, trapping Heat, and consuming Qi.)

Fear causes Essence to retreat. Retreat leads to closure of the Upper Jiao. Closure causes Qi to return downward. Return downward causes Lower Jiao distension, so Qi fails to move. (Note: "Que" means retreat. Essence retreating disrupts ascent/descent, closing the Upper Jiao. Closed Upper Jiao forces Qi down, causing distension and immobility, hence "Fear causes Qi to sink." ○ *Ben Shen Pian* states: Joy scatters Spirit; Sorrow blocks Qi; Fear agitates and scatters Spirit.)

Cold closes the Cou Li (pores), stopping Qi flow, so Qi contracts. (Note: Cold constricts the exterior, preventing surface Qi from venting.)

Heat opens the Cou Li, allowing Ying and Wei to flow, causing profuse sweating, so Qi leaks. (Note: Yang escapes with sweat, so Qi also leaks.)

Fright leaves the Heart without support, Spirit without refuge, and thoughts without focus, so Qi becomes chaotic. (Note: Separation of Qi and Blood.)

Labor causes panting and sweating, with internal and external Qi escaping, so Qi exhausts. (Note: Yang activity leads to dispersion.)

Thought keeps the Mind focused and Spirit anchored, causing Healthy Qi to stagnate and not move, so Qi knots. (Note: Unending thought creates attachment, keeping Spirit stagnant, thus knotting Qi.)