(旧作举痛论。今从王氏吴氏)
经脉流行不止。环周不休。寒气八经而稽迟，泣(音涩)而不行客于脉外则血少客于
脉中则气不通故卒(音猝)然而痛。寒气客于脉外。则脉寒脉寒则
缩蜷缩蜷则脉绌急。绌急则外引小络。故卒然而痛得炅则痛立止。(蜷。不伸也。绌。屈曲
也。
炅。热也。此其痛或卒然而止者。胃气不得流通所致。故但得炅暖之气。其痛则立止也。)
因重中于寒则痛久矣。(此或痛甚不休者。寒气重盛不易解散。故痛久)寒气客于经脉之中与
炅气相搏则脉满。满则痛而不可按也。(薄摩荡也。阳气行于脉中而寒。袭之。则寒热相搏
。留而不行则邪实于经故脉满此或痛甚不可按者也)寒气稽留。炅气从上则脉充大而血气乱
。故痛甚不可按也。(炅气从上。阳主升也。寒邪遏之。则脉充于内而二气乱故其痛必甚此
重明上文之意。)寒气客于肠胃之间膜原之下血不得散小络急引故痛。按之则血气散。故按
之痛止。(膜。筋膜也。原肓之原也膜原之下皆有空虚之处。血不散而小络满。则急引而痛
。按之则寒气可散。小络可缓。此按之而痛止者也)寒气客于侠脊之脉。则深按之不能及。
故按之无益也。(侠脊者。足太阳经也。其最深者。则伏冲伏膂之脉。按之不能及其处。此
按之无益者也。)寒气客于冲脉。冲脉起于关元随腹直上。寒气客则脉不通。脉不通则气因
之
。故喘动应手矣。(冲脉并足少阴肾经。夹脐上行。会于咽喉。而肾脉上连于肺。若寒气客
之。则脉不通。气亦逆也。此喘动应手。气为阳而主动也。)寒气客于背俞之脉则脉泣。脉
泣则血虚。血虚则痛。其俞注于心。故相引而痛。按之则热气至。热气至则痛止矣。(背俞
。五脏俞也。皆足太阳之脉。循膂当心入散。故寒气客之。则脉涩血虚。为心与背相引而痛
。按之则热至而痛止者。正以血虚故耳。)寒气客于厥阴之脉。厥阴脉者络阴器。系于肝。
寒气客于脉中。则血泣脉急。故胁肋与少腹相引痛矣。(肝之脉循阴股入髦中。抵少腹布胁
肋。故寒气客之。胁肋与少腹相引而痛。)厥气客于阴股。寒气上及少腹。血泣上下相引。(
旧本在下相引。此从吴注。)故腹痛引阴股。(厥气。厥逆之气也。或腹痛引阴股者。以足三
阴冲脉皆行于少腹阴股之间也。)寒气客于小肠膜原之间。络血之中。血泣不得注于大经。
血气稽留不得行。故宿昔而成积矣。(宿昔成积者。寒气凝结也)寒气客于五脏。厥逆上泄。
阴气竭。阳气未入。故卒然痛死不知人。气复反则生矣。(寒伤脏气。则气不得。降而厥逆
。上泄。吐涌也。真阴暴竭。阳气未能遽入。卒然痛死。必待脏气复则生矣)寒气客于肠胃
厥逆上出故痛而呕也。(肠胃。言六腑也。水谷之在六腑。必自上而下。乃其顺也。若寒气
客之。则逆而上出。此痛而呕也。)寒气客于小肠。小肠不得成聚。故后泄腹痛矣。(小肠为
丙火之腑。而寒邪胜之则阳气不化水谷不得停留。故腹痛而后泄也。)热气留于小肠。肠中
痛。瘅热焦渴。则坚干不得出。故痛。而闭不通矣。(热留小肠。是阳藏阳病也。故腹痛而
闭不通。)视其五色。黄赤为热白为寒。青黑为痛。(视面间分部。鼻谓之明堂。肺心肝脾之
候也。其两旁。六腑肾藏之候也。黄赤色者火动于经。故为热白色者。阳气衰微血不上荣。
故为寒青黑色者血凝气滞。故为痛。)视其主病之脉。(视面间五色之所主。)坚而血。及陷
下者。皆可扪而得也。(坚而血。谓邪之聚。络盛而起陷下。如沉伏之类。扪摸也。)
百病生于气也。怒则气上。喜则气缓悲则气消恐则气下寒则气收。炅则气泄。惊则气乱
劳则
气耗。思则气结。九气不同。何病之生。(气之在人。和则为正气。不和则为邪气。)岐伯曰
怒则气逆。甚则呕血。及飧泄。故气上矣。(怒动于肝。则气逆。而上。气逼血升。故呕
血
。肝木乘脾。故飧泄。○及飧泄。甲乙作食而气逆)喜则气和志达。荣卫通利。故气缓矣。
悲
则心系急。肺布叶举。而上焦不通。荣卫不散。热气在中故气消矣。(悲生于心。并于肺。
故心系急。肺叶举。上焦不通。荣卫不散。致热伤气也。)恐则精却。却则上焦闭。闭则气
还。还则下焦胀。故气不行矣。(却者退也。精却。则升降不交。故上焦闭。上焦闭。则气
归于下。病为胀满而气不行。故曰恐则气下。○本神篇曰。喜乐者。神惮散而不藏。愁忧者
。气闭塞而不行。恐惧者。神荡惮而不收。)寒则腠理闭气不行。故气收矣。(寒束于外。则
表气不能宣达也。)炅则腠理开。荣卫通。汗大泄。故气泄矣。(阳从汗散故气亦泄)惊则心
无所倚。神无所归。虑无所定故气乱矣。(血气分离)劳则喘息汗出。外内皆越故气耗矣。(
阳动则散。)思则心有所存。神有所归。正气留而不行故气结矣。(思之无已。则系恋不释。
神留不散故气结也。)
（旧本名为《举痛论》，现依王冰、吴崑之说改称《素问·卒痛论》）
经脉中的气血流行不息，环绕周身循环不止。若寒气侵入经脉，导致气血运行迟缓、凝涩而不通；寒气客于脉外，则使血脉中血液减少；寒气客于脉中，则使气机阻滞不通，因此突然发生疼痛。
当寒气客于脉外时，经脉受寒而收缩蜷曲，收缩蜷曲则经脉拘急，经脉拘急则向外牵引细小的络脉，所以突然发生疼痛。遇到温热之气，疼痛立即停止。（注：蜷，指不伸展；绌，指屈曲；炅，指热。这种疼痛有时突然停止，是因为胃气未能流通所致，所以只要得到温热的阳气，疼痛就会立刻停止。）如果再次受到寒邪侵袭，疼痛就会持续很久。（注：这是指疼痛剧烈不止的情况，因为寒气重盛，不易解散，所以疼痛持久。）
寒气客于经脉之中，与体内的热气相互搏结，导致经脉充盈胀满，胀满则疼痛且不可按压。（注：薄摩荡，指寒气与阳气在脉中相互搏击激荡。阳气行于脉中，寒气袭之，寒热相搏，停留而不行，致使邪气实于经脉，故经脉充盈。这是指疼痛剧烈不可按压的情况。）寒气滞留，热气从上而来，则经脉充大而气血紊乱，所以疼痛剧烈且不可按压。（注：热气从上，是因为阳主升发。寒邪遏制它，则脉气充盛于内，寒热二气混乱，所以疼痛必然剧烈。这是对上文意思的进一步阐明。）
寒气客于肠胃之间、膜原之下，血液不能散行，小络拘急牵引，所以发生疼痛。按压时，血气得以疏散，所以按压后疼痛停止。（注：膜，指筋膜；原，指肓之原。膜原之下都是空虚之处。血液不散而小络充盈，则拘急牵引而痛。按压则寒气可散，小络可缓，这就是按压后疼痛停止的原因。）
寒气客于夹脊的经脉（足太阳膀胱经），位置较深，重按也达不到病所，所以按压没有益处。（注：夹脊者，指足太阳经。其最深处的有伏冲、伏膂之脉，按压不能触及病处，所以按压无效。）
寒气客于冲脉，冲脉起于关元穴，沿腹部直上。寒气客入则脉道不通，脉道不通则气随之逆乱，所以出现喘息跳动、手按即感跳动的现象。（注：冲脉并足少阴肾经而行，夹脐上行，会于咽喉，肾脉上连于肺。若寒气客入，则脉道不通，气亦逆乱。此处的“喘动应手”，是因为气属阳而主动。）
寒气客于背俞脉（五脏之俞穴所在，皆属足太阳经），则脉道涩滞，脉道涩滞则血虚，血虚则痛。背俞脉注于心，所以心与背相互牵引而痛。按压则热气到达，热气到达则疼痛停止。（注：背俞，指五脏之俞穴，皆属足太阳经脉，循脊柱当心而入散。所以寒气客入，则脉涩血虚，导致心与背相引而痛。按压则热至而痛止，正是因为血虚的缘故。）
寒气客于厥阴肝脉，厥阴肝脉络于阴器，系于肝脏。寒气客于脉中，则血液凝涩，经脉拘急，所以胁肋与小腹相互牵引而痛。（注：肝脉循行于阴股，进入毛际，抵少腹，布胁肋。所以寒气客入，胁肋与少腹相引而痛。）
厥逆之气客于阴股，寒气向上波及少腹，血液凝涩，上下相互牵引。（注：旧本写作“在下相引”，此处依吴崑注释改正。）所以腹痛牵引至阴股。（注：厥气，指厥逆之气。有的腹痛牵引阴股，是因为足三阴经和冲脉都行于少腹和阴股之间。）
寒气客于小肠的膜原之间、络脉之中，血液凝涩不能注入大经脉，血气稽留不行，所以久而久之形成积块。（注：宿昔成积，是因为寒气凝结所致。）
寒气客于五脏，导致厥逆之气上泄，阴气竭绝，阳气未能入内，所以突然剧痛而死，不知人事。若气能回复，则可生还。（注：寒伤脏气，则气不得降而厥逆上泄，表现为吐涌。真阴暴竭，阳气未能迅速入内，导致突然剧痛昏死，必须等待脏气恢复才能生还。）
寒气客于肠胃，导致厥逆之气上出，所以疼痛且呕吐。（注：肠胃，泛指六腑。水谷在六腑中，必自上而下运行，这才是顺行。若寒气客入，则逆而上出，所以疼痛且呕吐。）
寒气客于小肠，小肠不能正常受盛化物，所以出现腹泻和腹痛。（注：小肠为丙火之腑，若寒邪胜之，则阳气不化，水谷不能停留，所以腹痛而后泄。）
热气留于小肠，肠中疼痛，郁热焦渴，则大便坚硬干燥无法排出，所以疼痛且闭塞不通。（注：热留小肠，是阳脏受阳病，所以腹痛且闭塞不通。）
观察面部的五色变化：黄赤色为热，白色为寒，青色黑色为痛。（注：观察面部各分部，鼻头称为明堂，是肺、心、肝、脾的候诊部位；其两旁是六腑和肾脏的候诊部位。黄赤色者，是火动于经脉，所以为热；白色者，是阳气衰微，血液不能上荣，所以为寒；青黑色者，是血凝气滞，所以为痛。）
观察主治疾病的脉象。（注：观察面部五色所主的病证对应的脉象。）脉象坚实而有血瘀，以及脉象下陷的，都可以通过触摸诊察到。（注：坚实而有血瘀，是指邪气聚集，络脉盛大而起；下陷如沉伏之类，通过扪摸可以得知。）
百病都生于气的失调。怒则气上逆，喜则气缓和，悲则气消减，恐则气下沉，寒则气收敛，热则气外泄，惊则气紊乱，劳则气耗损，思则气结聚。这九种气的变化不同，会产生什么疾病呢？（注：气在人身上，调和则为正气，不调和则为邪气。）
岐伯说：怒则气逆，严重时呕血，或患飧泄，这是因为气上逆了。（注：怒动于肝，则气逆而上，气逼血升，所以呕血；肝木乘脾土，所以患飧泄。○及飧泄，《甲乙经》作食而气逆。）
喜则气和志达，营卫通利，所以气缓和。（注：喜能使气和顺，情志通达，营卫通畅流利，所以气机缓和。）
悲则心系紧急，肺叶张举，而上焦不通，营卫不能散布，热气郁结在中，所以气消减。（注：悲生于心，并于肺，所以心系紧急，肺叶张举，上焦不通，营卫不散，导致热气伤气。）
恐则精气退缩，退缩则上焦闭塞，闭塞则气还归下焦，还归下焦则下焦胀满，所以气不行。（注：却，指退。精气退缩，则升降不交，所以上焦闭塞；上焦闭塞，则气归于下，病为胀满而气不行，所以说恐则气下。○《本神篇》说：喜乐者，神惮散而不藏；愁忧者，气闭塞而不行；恐惧者，神荡惮而不收。）
寒则腠理闭塞，气不行，所以气收敛。（注：寒束于外，则表气不能宣达。）
热则腠理开，营卫通，汗大泄，所以气外泄。（注：阳随汗散，所以气亦泄。）
惊则心无所倚，神无所归，虑无所定，所以气紊乱。（注：气血分离。）
劳则喘息汗出，内外之气皆越散，所以气耗损。（注：阳动则散。）
(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.)