Pain

A more or less localized feeling of discomfort, distress, or agony that is felt as a resultof knocks and falls, cuts in the flesh, severe hunger, contact with fire or hot objects, orvarious ailments of the body. It can affect any part of the body and occurs in both externallycontracted disease and internal damage. Pain is a major item of diagnostic information, andits significance depends on its nature and location.

Types of Pain

Aching pain (痠痛 suān tòng) is a pain of continuous duration, felt in the sinews and bones. It is attributable to yīn vacuity, yáng vacuity, or evils such as cold and dampness. An example is aching lumbus.

Distending pain (胀痛 zhàng tòng), or distension and pain, is pain associated with a feeling of expansion or inflation that may or may not be accompanied by visible or palpable enlargement. It may be experienced in the head, eyes, trunk, or limbs. It is essentially the manifestation of depressed qì dynamic. Qì is formless (insubstantial) and likes to move without being obstructed. When cold congealing in the channels, exuberant fire-heat, impairment of organ function, or poor supply of nourishment to the channels and vessels cause inhibition of qì dynamic, qì ceases to flow smoothly and becomes depressed and gathers. Stomach duct pain due to cold stagnating in the center burner, chest and rib-side pain due to depressed liver qì, and headache due to ascendant liver yáng are forms of distending pain.

Dull pain (隐痛 yǐn tòng) is a muted, usually persistent pain that is generally bearable. It is attributable to insufficiency of qì and blood, or to yáng qì vacuity failing.

Empty pain (空痛 kōng tòng) is pain associated with a feeling of emptiness and lightness, that likes warmth and pressure. It is associated mainly with insufficiency of essence-blood and may be observed in yáng vacuity, yīn vacuity, blood vacuity, or in dual vacuity of yīn and yáng.

Cold pain (冷痛 lěng tòng) is pain associated with an icy sensation. If it is in the body's surface, the coldness can be felt with the hand. Cold pain is usually accompanied by a desire for warm and hot things. It is attributed to internal or external cold congealing in the sinew vessels and obstructing the channels. Cold is a yīn evil that is cold in nature; it easily damages yáng qì, and causes a loss in warmth of yáng qì wherever it becomes lodged.

Gripping pain (绞痛 jiǎo tòng) is an excruciating acute pain that feels as if the affected area were being wrung and twisted or gouged by a knife. It is usually caused by tangible evils obstructing the channels and network vessels or congealing cold depressing normal qì dynamic. Gripping pain is observed in heart pain due to heart blood stasis (chest impediment) or lower abdominal or lumbar pain due to stone strangury, stomach duct pain and abdomen due to roundworm reversal, or in heat cholera.

Heavy pain (重痛 zhòng tòng) is a pain associated with a feeling of heaviness. It causes a tendency to remain in a lying posture and move little. The pain itself is often an aching pain. Heavy pain is attributable to dampness evil—invading the body from outside or arising within it from spleen vacuity—obstructing qì dynamic. Headache with head heavy as if swathed (bag-over-the-head sensation) and heavy aching limbs are examples of heavy pain.

Pulling pain (掣痛 chè tòng) is a pain associated with a sensation of tension or pulling or a pain that stretches into another area. It arises when the sinew vessels are deprived of nourishment or obstructed. For example, when heart blood stasis deprives the sinew network vessels of nourishment, the sinews become hypertonic. This causes the pulling pain characteristic of chest impediment patterns, where pain stretches through to the back. The liver governs the sinews, and when there is heat in the liver channel, scorching of the sinew vessels causes the sinews to become hypertonic, or when liver yīn is insufficient, the sinews are deprived of nourishment and similarly become hypertonic. Hence, pulling pain is largely attributed to the liver. It is observed in chest impediment, liver yīn vacuity, and liver channel repletion heat.

Scorching pain (灼痛 zhuó tòng) is a hot burning pain. If the pain is on the body's surface (such as in sores), the heat can actually be felt with the hand. Usually, it is ascribed to fire-heat evils in the channels or to vacuity heat scorching the channels and network vessels; it is associated with a desire for cool and cold things. Examples include scorching pain the both rib-sides due to liver fire invading the network vessels, and scorching stomach duct pain due to insufficiency of stomach yīn. Sores due to heat toxin also commonly manifest in scorching pain and swelling.

Scurrying pain (窜痛 cuàn tòng) is one that repeatedly changes location or one whose location is difficult to pinpoint. Its general location and movement are related to channel pathways. It is associated with qì stagnation or with wind evil obstructing the channels. Hence it is often seen in binding depression of the liver qì and in wind impediment.

Stabbing pain (刺痛 cì tòng) is like the stabbing of a needle or knife and is limited to a small area of fixed location. It is often described as being like the cutting of a knife, the stabbing of a knife, or the piercing of an awl. It arises when the blood, owing to qì vacuity, qì stagnation, blood vacuity, etc., is obstructed and becomes static, thus blocking channel qì. This type of pain is often referred to as stasis pain.

Soreness² (痛 tòng) is pain associated with open wounds or with redness and swelling (e.g., of the eyes or throat). The distinction between pain and soreness made in English does not exist in Chinese. The significance of pain in different locations is discussed on the entries listed below.

See also qì pain; impediment.