注云∶按之不起，泥之象也，土过湿则为泥。湿为病也，积饮痞隔，中满体重，霍
乱吐下，故甚则〔 〕肿也。
火者，少阳相火之热，乃心包络、三焦之气也。
〔诸热瞀 ，暴喑冒昧，躁扰狂越，骂詈惊骇， 肿疼酸，气逆冲上，禁栗如丧神
守，嚏呕，疮疡喉痹，耳鸣或聋，呕涌溢，食不下，目昧不明，暴注 ，暴病卒死，
是皆属于火。〕
注云∶卒〔哑〕也。金肺主声，火旺水衰，热乘金肺，而神浊气郁，则暴喑而无
声也。
注云∶躁动烦热，扰乱而不宁，火之体也。热甚于外，则肢体躁扰；热甚于内，则
神志躁动，反复颠倒，懊 烦心，不得眠也。由水衰而〔火〕之动也。故心胸躁动，
谓之怔忪，俗云心忪，皆为热也。
注云∶狂者，无正定也；越者，乖越理法而失常也。〔夫〕外清内浊，动乱参
差，火之体也；〔静顺清朗，准则信平，水之体也〕。由是肾水主智，而水火相反，
故心火旺则肾水衰，乃失志而狂越也。凡发热于中，则多干阳明胃经也，故经云∶阳明
之厥，面赤而热，妄言。
注释说：轻清之气上升为天，重浊之气下沉为地，因此土气湿气致病，就会出现身体沉重和胸脘痞闷的症状。
注释说：按压后凹陷不起，是泥土的形象，土气过湿就会变成泥泞。湿气致病，会导致水饮停积、胸膈痞塞阻隔、腹部胀满、身体沉重、霍乱引起的呕吐腹泻，所以严重时会出现浮肿。
【各种热证导致的视物模糊、突然失音、神志昏蒙、烦躁扰乱、狂乱失常、骂人受惊、肿胀疼痛酸楚、气逆冲上、战栗如同丧失神守、打喷嚏呕吐、疮疡喉痹、耳鸣或耳聋、呕吐涌溢、饮食不下、视物昏暗不明、急性泄泻、突发疾病猝死，这些都属于火邪所致。】
注释说：昏，指神志昏沉。（如果）像喝醉酒一样心中火热极盛，那么神志就会浑浊昏昧而视物不清。
注释说：卒哑，指突然失声。肺属金主声音，火旺则肾水衰，热气侵犯肺金，导致神志浑浊、气机郁滞，就会突然失音而无语。
注释说：冒，指昏冒；昧，指昏暗。气热则神志浑浊昏昧，这是火的本体特征。
注释说：躁动烦热，扰乱而不安宁，这是火的本体特征。热邪盛于体表，则肢体烦躁扰动；热邪盛于体内，则神志烦躁扰动，反复颠倒，心中懊恼烦闷，无法入睡。这是由于肾水衰弱而导致火气妄动。所以心胸烦躁跳动，称为怔忪，俗称心忪，都是因为热邪所致。
注释说：狂，指没有正常定力；越，指违背理法而失常态。【外在清静内在浑浊，动作混乱参差不齐，这是火的本体特征；】【安静顺从清朗，准则诚信平和，这是水的本体特征】。因此肾水主智，水火性质相反，所以心火旺盛则肾水衰弱，从而失去意志控制而出现狂乱失常。凡是内部发热，大多会干扰阳明胃经，所以经书说：阳明经的厥逆，表现为面红发热，胡言乱语。
The commentary states: Light and clear qi ascends to form Heaven, while heavy and turbid qi descends to form Earth. Therefore, when dampness of the Earth element causes disease, it results in a sensation of heaviness in the body (Zhongti) and epigastric fullness/stuffiness (Piyi).
The commentary states: Pitting edema that does not rebound upon pressure resembles mud; excessive dampness of the Earth element turns into mud. When dampness causes disease, it leads to accumulation of fluid retention (Jiyin), chest and diaphragm obstruction (Pige), abdominal fullness (Zhongman), body heaviness (Zhongti), cholera-like vomiting and diarrhea (Huoluan), and thus, in severe cases, generalized edema (Zhong).
Fire refers to the heat of Shaoyang Ministerial Fire (Shao Yang Xiang Huo), which is the Qi manifestation of the Pericardium (Xin Bao Luo) and Sanjiao (Triple Burner).
[Various heat syndromes causing visual obscuration (Mou), sudden aphonia (Bao Yin), mental confusion and dizziness (Mao Mei), restlessness and agitation (Zao Rao), mania and aberration (Kuang Yue), abusive language and fright (Ma Li Jing Hai), swelling, pain, and soreness (Zhong Tong Teng Suan), rebellious Qi rushing upward (Qi Ni Chong Shang), trembling as if losing spiritual control (Jin Li Ru Sang Shen Shou), sneezing and vomiting (Ti Ou), sores and ulcers with throat obstruction (Chuang Yang Hou Bi), tinnitus or deafness (Er Ming Huo Long), violent vomiting and overflow (Ou Yong Yi), inability to eat (Shi Bu Xia), blurred vision (Mu Mei Bu Ming), acute watery diarrhea (Bao Zhu), sudden illness, and abrupt death—all these belong to Fire.]
The commentary states: "Mou" refers to mental confusion. If one feels as though drunk due to extreme heart fire heat, the spirit becomes turbid and confused, leading to visual obscurity and dizziness.
The commentary states: "Dong" refers to palpitation or throbbing, which is the physical characteristic of Fire.
The commentary states: "Su Ya" refers to sudden aphonia. The Lung belongs to Metal and governs voice. When Fire is hyperactive and Kidney Water declines, heat attacks the Lung Metal, causing turbid spirit and stagnant Qi, resulting in sudden loss of voice.
The commentary states: "Mao" refers to mental fogginess; "Mei" refers to dimness. Heat in the Qi causes turbid and foggy spirit, which is the characteristic of Fire.
The commentary states: Restlessness, vexation, and heat, causing disturbance and unrest, are characteristics of Fire. When heat is excessive on the exterior, the limbs become restless and agitated; when heat is excessive internally, the spirit becomes restless, tossing and turning, with inner vexation (Ao Nao), and insomnia. This arises from the movement of Fire due to declining Water. Thus, restlessness and palpitation in the chest and heart are called Zheng Zhong (palpitations), commonly known as Xin Zhong, both caused by heat.
The commentary states: "Kuang" means lacking stable mental focus; "Yue" means deviating from reason and law, becoming abnormal. [Externally clear but internally turbid, with chaotic and irregular movements, this is the nature of Fire; [Quiet, compliant, clear, and bright, adhering to standards and peace, this is the nature of Water]]. Therefore, Kidney Water governs wisdom. Since Water and Fire are opposite, when Heart Fire is hyperactive, Kidney Water declines, leading to the loss of willpower and resulting in mania and aberration. Any internal fever often affects the Yangming Stomach Meridian. Thus, the classics state: Jue syndrome of the Yangming meridian presents with red face and heat, and delirious speech.