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Huangdi Neijing · The Yellow Emperor’s Inner Canon
Suwen 39 · An Account of Pain
Read in English. Switch to Original for word notes, or select text to ask a question.
The Yellow Emperor asked: “I have heard that one who speaks well of Heaven must verify it in people; one who speaks well of antiquity must accord with the present; one who speaks well of people must test it in oneself. Then the Way is unconfused and its essential measures fully understood: this is called clarity. I now ask you for words that can be understood, signs visible to the eyes and findings obtainable by touch, so that testing them in myself dispels obscurity and resolves doubt. May I hear them?”
Qi Bo bowed twice and touched his head to the ground: “What Way do you ask about?”
The Emperor said: “I wish to hear what qi causes sudden pain in the five zang organs.”
Qi Bo replied: “The channel vessels flow without stopping, circling without rest. Cold qi enters the channels and delays them, making their flow rough and immobile. Lodging outside the vessels reduces blood; lodging within them obstructs qi. Thus sudden pain arises.”
The Emperor asked: “Some pain suddenly stops; some is severe and unceasing. Some severe pain cannot bear pressure; some stops with pressure; some gains nothing from pressure. Some throbs and moves against the hand. Some draws between Heart and back; some between flanks and lower abdomen; some from abdomen into the inner thighs. Some remains overnight or longer and forms an accumulation. Some strikes suddenly as though fatal, with no recognition of people, yet life returns after a short interval. Some comes with vomiting, some abdominal pain followed by diarrhea, and some pain with complete blockage. All these pains have different forms. How are they distinguished?”
Qi Bo said: “Cold qi lodging outside the vessels makes them cold. Cold makes them contract and curl; contraction shortens and tightens them, pulling the small networks outside. Thus pain arises suddenly. Warmth immediately stops it. Repeated exposure to cold makes the pain prolonged.”
Cold qi lodging within the channel vessels presses against warm qi and fills the vessels, producing pain that cannot bear pressure. Lingering cold draws warm qi from above; vessels become full and enlarged and blood and qi disordered. Thus severe pain cannot bear pressure.
Cold qi lodging between intestines and Stomach, below the membrane-source region, prevents blood from dispersing. The small networks draw tight and cause pain. Pressure disperses blood and qi, so pressing stops the pain.
Cold qi lodging in the vessels beside the spine lies beyond even deep pressure. Thus pressure gives no benefit.
Cold qi lodges in the Chong vessel, which begins at Guanyuan and runs directly upward along the abdomen. Cold obstructs the vessel; qi follows into obstruction, producing a panting, throbbing movement that answers the hand.
Cold qi lodging in the back transport vessels roughens blood flow. Rough vessels bring blood deficiency, which causes pain. Their transport flow pours into Heart, so pain draws between Heart and back. Pressure brings warm qi; when warmth arrives, pain stops.
Cold qi lodges in the Jueyin vessel, which networks with the private parts and connects to Liver. Cold within the vessel roughens blood and tightens the vessel. Thus pain draws between the flanks and lower abdomen.
Counterflow qi lodges in the inner thigh, and cold qi rises to the lower abdomen. Roughened blood below draws the regions together, so abdominal pain pulls into the inner thigh.
Cold qi lodges between Small Intestine and the membrane-source region, within the network blood. Roughened blood cannot pour into the great channels. Blood and qi remain and cannot move; thus lingering pain forms an accumulation.
Cold qi lodges in the five zang organs. Counterflow surges and discharges upward, yin qi is exhausted and yang qi has not yet entered. Thus sudden pain brings an apparently fatal collapse with no recognition of people. When qi returns, life returns.
Cold qi lodges in intestines and Stomach, and counterflow rises outward. Thus pain is accompanied by vomiting.
Cold qi lodges in Small Intestine, preventing it from completing its gathering function. Thus diarrhea follows, with abdominal pain.
Heat qi remains in Small Intestine, causing pain within the bowel. Burning heat and parching thirst make its contents hard and dry, unable to emerge. Thus there is pain with blockage and no passage.
The Emperor said: “This is what can be known through words. How can it be seen by looking?”
Qi Bo said: “The five zang and six fu organs all have their regions. Observe the five colors: yellow and red indicate heat; white cold; blue-green and black pain. This is what can be seen by looking.”
The Emperor asked: “How is it obtained by touch?”
Qi Bo said: “Examine the vessels governing the illness. Firmness, blood-filled places and sunken regions can all be obtained by touch.”
The Emperor said: “Good. I know that the hundred illnesses arise from qi. Anger makes qi rise; joy relaxes it; grief dissipates it; fear makes it descend; cold gathers it; warmth discharges it; startlement disorders it; toil consumes it; thought binds it. The nine qi movements differ: what illnesses do they produce?”
Qi Bo said: “Anger makes qi move contrary. When severe, it brings vomiting of blood and flux of undigested food. Thus qi rises.”
Joy harmonizes qi and frees intention; nutritive and defensive qi flow freely. Thus qi relaxes.
Grief tightens Heart’s connecting system and raises Lung’s spreading lobes. The upper burner is obstructed; nutritive and defensive qi fail to disperse, leaving heat qi within. Thus qi dissipates.
Fear makes essence withdraw. Withdrawal closes the upper burner; closure turns qi back; its return distends the lower burner. Thus qi fails to move.
Cold closes the interstices, preventing qi from moving. Thus qi gathers.
Warmth opens the interstices, allowing nutritive and defensive qi to pass and sweat to discharge greatly. Thus qi discharges.
Startlement leaves Heart without support, spirit without a place to return and thought without a settled direction. Thus qi becomes disordered.
Toil brings panting and sweat, with both exterior and interior exceeding their bounds. Thus qi is consumed.
Thought gives Heart something to hold and spirit a place to return. Correct qi remains instead of moving. Thus qi becomes bound.”
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