Pain is a biological and subjective phenomenon. Clear understanding of its features is essential. Wierzbicka’s analysis accomplishes this. This comment discusses the relevance of her approach for the study of early evolution of medicine. The comment has six parts: (a) Wierzbicka’s theory and method; (b) its application to pain; (c) relevance of pain for the study of ethnomedicine, the cultural understanding of sickness and healing; (d) significance of natural semantic metalanguage (NSM) for understanding the evolution of human thought and behavior; (...) (e) relevance of NSM for studying biological and cultural evolution of early medicine; and (f) summary and conclusion. (shrink)