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Ping An: This chapter, from the beginning to the end, is found in Volume XI, Chapter 39 of *Suwen* (Basic Questions), titled "Ju Tong Lun" (Discourse on Pain). Additionally, the section from "The five zang and six fu organs have their fixed regions" to "Blue-black indicates pain" is found in Volume I, Chapter 15 of *Jiayijing* (Systematic Classic of Acupuncture and Moxibustion).

Yellow Emperor asked Qibo: I have heard that those who are good at discussing the Way of Heaven must have verification in humanity; (Those who are good at discussing the Way of Heaven apply the principles of Heaven to describe human physiology and pathology, thus having verification in humans.) Those who are good at discussing ancient matters must align with the present; (By examining the past to serve as a model for the present, one necessarily aligns with the present.) Those who are good at discussing human nature must satisfy themselves. (To be good at understanding others, one must first enrich oneself; without self-enrichment, attempting to understand others is impossible. Ping An: The character "You" appears before "Yan" in *Suwen*.) In this way, the Great Dao will not be confused, and its essentials and principles can be fully understood, which is called wisdom. (With these three virtues, one is not confused by the Dao. This is because one grasps the ultimate principles and is enlightened. "Shu" refers to principles or numbers.) Now I ask you, Master, hoping that it can be verified in myself, expressed in words and known, seen visually, and obtained through touch. I hope this verification is like removing blindness or resolving confusion. May I hear about it? (First practice it yourself, and it can be verified in yourself. Then inquire about the cause of illness, so it can be known through speech. Observe complexion to know disease, so it is visible. Diagnose pulse to know disease, so it is obtainable by touch. These knowledges are first verified in one's own body, thus enabling one to remove blindness from others' eyes and ears, and resolve confusion in their heart and bowels. Regarding this Dao, may I hear it? Ping An: In *Suwen*, the twelve characters "Ling ke yan yu ji ling zhi ke yan er zhi ye" are condensed into five characters "Ling yan er ke zhi", and "Ru fa meng" is written as "Er fa meng".)

Qibo bowed twice and said: What question does Your Majesty ask? Yellow Emperor said: I wish to hear about sudden pain in the five zang organs of humans; what qi causes this? Qibo said: The qi of the meridians flows endlessly, circulating continuously. When cold qi enters, the blood in the meridians moves slowly, stagnates, and does not flow. If cold lodges outside the vessels, blood becomes deficient; if it lodges inside the vessels, qi becomes obstructed, causing sudden pain. (Ping An: In *Suwen*, "Ru yan jing xue ji liu" is written as "Ru jing er ji liu", and "Gu zu tong yi" is written as "Gu tu ran er tong".)

Yellow Emperor said: Regarding this pain, sometimes it stops suddenly, sometimes it persists severely without ceasing, sometimes it is too painful to press, sometimes pressing stops the pain, sometimes pressing has no effect, sometimes the pulse throbs under the hand, sometimes the heart and back pull each other in pain, (Ping An: In *Suwen*, "Xiang ying" is written as "Xiang yin".) sometimes the heart, hypochondrium, ribs, and lower abdomen pull each other in pain, (Ping An: In *Suwen, there is no "Xin" before "Xie".) sometimes abdominal pain radiates to the medial thigh, sometimes pain forms an accumulation over time, sometimes sudden severe pain causes unconsciousness, followed by recovery after a while, (Ping An: In *Suwen*, "You jian" is written as "You shao jian".) sometimes abdominal pain with vomiting, sometimes abdominal pain with diarrhea, sometimes pain with constipation. (The outer part of the thigh is called Bi, the inner part Gu, and the part below the yin area is Yin Gu. The sound is like "Men". Ping An: In *Suwen*, "Huo fu tong er Ou zhe" is written as "Huo tong er ou zhe". Note: Yin Gu was misprinted as Yin Bing in Yuan edition.) All these pains differ in form; how should they be distinguished? (There are fourteen types of distinct diseases mentioned above: thirteen are caused by cold pathogen invading internally, and one is caused by heat pathogen leading to obstruction. All are pain conditions, but the cause is unknown, hence the inquiry. Ping An: Zhu tong was printed as Zhu bing in Yuan edition.)

Qibo replied: When cold qi lodges outside the intestines, the intestines become cold. Cold causes contraction and curling; curling leads to intestinal cramping. Cramping pulls on the small collateral vessels, causing sudden pain. Upon receiving warmth, the pain stops immediately. If re-exposed to cold, the pain becomes chronic. (Chu means sewing; it refers to the intestines contracting and curling like sewn fabric. Chu belongs to the small collaterals of the Intestine Meridian scattered around the intestines. Thus, cold causes Chu and cramping, pulling the collaterals and causing pain; warmth stops it immediately. Jiong means heat. Ping An: In *Suwen*, "Chang" is written as "Mai", "Juan" as "Quan", and "Li yi" as "Li zhi".)

When cold qi lodges within the meridians and contends with warm qi, the vessels become full. Fullness causes pain that cannot be pressed. If cold qi lingers and warm qi rises, the vessels swell, and blood and qi become chaotic, causing pain that cannot be pressed. (There are two interpretations for pain unresponsive to pressure: First, cold and heat contend within the vessels, causing fullness and pain unresponsive to pressure. Second, cold stays below while heat rises, disrupting blood and qi, making pressure ineffective. Ping An: In *Suwen*, "Gu tong" is written as "Gu tong shen".)

When cold qi lodges between the stomach and intestines, below the Mu-Yuan points, and cannot disperse, the small collaterals contract and pull, causing pain. Pressing disperses the qi, stopping the pain. (Both stomach and intestines have Mu and Yuan points. Below these points lie Sun-collaterals. Cold lodging here causes Sun-collaterals to contract and pull, causing pain; pressing disperses the qi and stops the pain. Ping An: In *Suwen*, "Er bu de san" is written as "Xue bu de san", and "Gu tong zhi" as "Gu an zhi tong zhi".)

When cold qi lodges in the meridians flanking the spine, deep pressure cannot reach them, so pressing is ineffective. (The meridians flanking the spine refer to the Du Mai (Governing Vessel). It runs deeply within the spine, so superficial pressure cannot reach it, rendering pressing useless.)

When cold qi lodges in the Chong Mai (Penetrating Vessel), which originates at Guan Yuan and ascends straight up the abdomen, the vessel becomes obstructed. Obstruction causes qi to rebel, resulting in pulsation felt under the hand. (Guan Yuan is located in the lower abdomen below the umbilicus, corresponding to the Bao Gong (Uterus/Womb). Hence, it is previously stated that the Chong Mai originates from the Bao Gong and ascends. Pathogenic qi lodging here causes pulsation. Some versions omit the phrase "originates at Guan Yuan". Ping An: In *Suwen*, three characters "Han qi ke" appear after "Zhi shang".)

When cold qi lodges in the Back-Shu meridians, the blood vessels stagnate. Stagnation leads to blood deficiency, and deficiency causes pain. Since the Shu points connect to the Heart, the heart and back pull each other in pain. Pressing brings warmth, which stops the pain. (The Back-Shu meridians refer to the Foot-Taiyang Bladder Meridian. Its collaterals connecting to the Heart enter the Heart. Thus, cold lodging in Taiyang pulls the Heart, causing pain. Keeping the hand pressed generates heat, stopping the pain. Ping An: In *Suwen*, "Ze mai qi" is written as "Ze xue mai se". Note: "Zhu yu xin" was misprinted as "Zhu yu xin" in Yuan edition. Note: "Han ke Taiyang" was misprinted as "Han ke Da Chang" in Yuan edition.)

When cold qi lodges in the Jueyin Meridian, whose vessels connect to the genitalia and tie to the Liver, cold lodging in the vessels causes blood stagnation and vessel tension, pulling the hypochondrium and lower abdomen. (The Jueyin Liver Meridian belongs to the Liver, connects to the Gallbladder, and spreads over the hypochondrium. Thus, cold causes blood stagnation and vessel tension, pulling the hypochondrium and lower abdomen. Ping An: In *Suwen*, two characters "Zhi mai" appear after "Ke yu Jueyin", and "Yin xie yu shao fu" is written as "Gu xie lei yu shao fu xiang yin tong".)

Juevi qi lodges in the medial thigh, and cold qi ascends to the lower abdomen. Blood stagnates below and pulls, causing pain. (Jueqi lodges in the medial thigh, where blood stagnates. Thus, the qi pulls upward to the lower abdomen, causing pain. Ping An: In *Suwen*, "Gu tong" is written as "Gu fu tong yin Yin gu".)

When cold qi lodges in the five Zang organs, causing Jue-ni (rebellious Qi) to ascend and leak, Yin qi is exhausted, and Yang qi fails to enter. This causes sudden severe pain, unconsciousness, and death-like state. If Qi returns, life is preserved. (Cold entering the five Zang organs causes Jue-ni and vomiting, exhausting Yin qi. Between the exhaustion of Yin and the entry of Yang, sudden pain and unconsciousness occur. Entry of Yang into the Zang restores life.)

When cold qi lodges between the Intestine-Mu point and Guan Yuan, in the collateral blood, blood stagnates and cannot flow into the major meridians. Blood and qi stagnate and fail to move, forming an accumulation suddenly. (Intestines refer to Large and Small Intestines. The Large Intestine Mu point is Tian Shu, two cun left and right of the umbilicus; the Yuan point is between the big toe. The Small Intestine Mu point is Guan Yuan, three cun below the umbilicus; the Yuan point is Wan Gu, anterior to the wrist bone on the radial side. Cold lodging below these Mu-Yuan points in the blood collaterals causes stagnation and accumulation over time. Ping An: In *Suwen*, "Chang mu Guan Yuan" is written as "Xiao chang mu yuan", "Cu ran" as "Su xi", and this section precedes "Han qi ke yu wu zang".)

When cold qi lodges in the stomach and intestines, Jue-ni Qi rebels and exits upwards, causing pain and vomiting. (Cold lodging in stomach and intestines causes Qi to rebel upwards, resulting in pain and vomiting.)

When cold qi lodges in the Small Intestine, food and fluids fail to aggregate properly, causing diarrhea and abdominal pain. (Cold lodging in Small Intestine prevents aggregation, leading to loose stools and abdominal pain.)

When heat qi remains in the Small Intestine, it causes internal heat and drying. The feces become dry and hard, unable to pass. (Heat remaining in the Small Intestine causes internal heat, drying out waste material, making stool hard and difficult to pass. Ping An: In *Suwen*, "Xiao chang zhong dan re" is written as "Chang zhong tong dan re", there is no "Gu" before "Jian", and six characters "Gu tong er bi bu tong" follow "Bu de chu". Note: "Liu zhi" was printed as "Liu yu" in Yuan edition.)

Yellow Emperor said: What do you mean by "known through speech"?

Qibo said: The five Zang and six Fu organs have specific facial color regions. Observing the five colors: yellow and red indicate heat, white indicates cold, blue and black indicate pain. This is what is meant by "visible observation". (Each Zang and Fu organ has a corresponding color region on the face. Observing the colors revealed in these regions allows one to know the disease of the organs. This is visible observation.) (Ping An: In *Jiayijing*, "Qing hei wei tong" precedes "Huang chi wei re".)

Yellow Emperor said: What do you mean by "obtained through hearing/inquiry"?

Qibo said: By observing the firmness of the pulse governing the disease and the state of the blood, as well as the floating, sinking, or depressed state of the skin, one can obtain knowledge through inquiry. (Observing the pulse and skin conditions, and asking for the cause, constitutes obtaining knowledge through inquiry. Ping An: In *Suwen*, "Wen" is written as "Men". Based on the earlier text "Men er ke de", it should be "Men". There is no "Pi" after "Xue".)

Yellow Emperor said: Excellent.