注云∶肠胃寒而传化失常，我子〔能〕制鬼贼，〔则己当自实〕，故寒胜火
衰金旺，而吐利腥秽也。腥者，金之臭也，由是热则吐利酸臭，而寒则吐利腥秽也。
〔亦犹〕饭浆，热则喜酸，寒则水腥也。
注云∶阴水〔主〕于清净，故病寒则四肢逆冷，而禁止坚固，舒卷不便〔利〕
也。故冬脉沉（而）短以敦，病之象也，或病〔寒〕尚微，而未至于厥逆〔者〕，
不可反以为热；或热〔甚〕而成阳厥者，不可反以为病寒也。然阴厥者〔之〕病脉
候，皆为阴证，身凉不渴，脉迟细而微，未〔尝〕见于阳证也。其阳厥者〔之〕病脉
证，皆为阳证，热极而反厥，〔时〕复反温，虽厥而烦渴谵妄，身热而脉数也。若阳
厥〔极〕深，而至身冷，反见阴脉，而欲绝者，止为热极而欲死也。经曰∶一阴一阳
之谓道，偏阴偏阳之谓疾，阴阳以平为和，以偏为病，万物皆负阴抱阳而生，故孤阴不
〔长〕，独阳不成；是以阳气极甚，而阴气极衰，则阳气怫郁，阴阳偏倾，而不能
宣行，则阳气蓄聚于内，而不能营运于四肢，则手足厥冷为阳厥。仲景曰∶热深则厥亦
深，热微则厥亦微。又曰∶厥当下之，下后厥愈。当以凉药养阴退阳，凉膈散、调胃承
气汤下之是也。大凡治病者，必先明其标本，标者末，本者根源也。故经曰∶先病
为本，后病为标。又曰∶标本相传，先以治其急者。〔又〕言∶六气为本，三
阴三阳为标，故病气为本，受病经络脏腑〔谓〕之标。夫标本微甚，治以逆从，
不可不通〔也〕。故经曰∶知逆与从，正行无问；明知标本，万举万当；不知标本，
是〔谓〕妄行。正此谓也。
注释说：肠胃受寒导致传化功能失常，按照五行生克理论，我（脾土）之子（金）能制约鬼贼（木），那么我自身应当充实，所以出现寒邪胜、火气衰、金气旺的情况，从而发生呕吐和腹泻，排泄物气味腥臭。腥味是金的气味，因此热证时呕吐腹泻气味酸臭，而寒证时呕吐腹泻气味腥秽。这也就像饭食和汤水，受热后容易变酸，受寒后则带有水腥味。
注释说：阴寒之水主司清净，所以患寒病时四肢逆冷，且拘急僵硬，舒展卷曲不便。因此冬季的脉象沉短而敦厚，这是寒病的征象。如果寒邪尚轻微，尚未发展到四肢厥冷的程度，不可错误地将其当作热证；或者热邪极盛导致阳厥的患者，也不可错误地将其当作寒证。然而，阴厥这类疾病的脉象表现，都属于阴证，表现为身体凉爽、不口渴、脉象迟细而微弱，这些从未出现在阳证中。其阳厥这类疾病的脉象和症状，都属于阳证，表现为热极反而四肢厥冷，有时又恢复温暖，虽然四肢厥冷但伴有烦躁、口渴、胡言乱语，身体发热且脉数。如果阳厥极深，导致身体冰冷，反而出现欲绝的阴脉，这仅仅是因为热极而濒临死亡。经文说：一阴一阳交替运行叫做“道”，偏于阴或偏于阳叫做“疾”（病）。阴阳以平衡为和谐，以偏颇为疾病，万物都背负阴怀抱阳而生，所以孤阴不能生长，独阳不能成就。因此，当阳气极盛而阴气极衰时，阳气就会郁结，阴阳偏倾而不能宣通运行，导致阳气蓄积在体内，而不能营运于四肢，于是手足厥冷成为阳厥。张仲景说：热邪越深，厥冷也越深；热邪越微，厥冷也越微。又说：厥证应当用下法治疗，下法之后厥冷痊愈。应当使用凉药滋养阴液、消退阳热，如凉膈散、调胃承气汤等攻下即可。大凡治病的人，必须先明确标本关系，标是末梢，本是根源。所以经文说：先发生的病为本，后发生的病为标。又说：标本相互传变时，先治疗其急迫者。又说：六气为本，三阴三阳经络为标，所以致病之气为本，受病的经络脏腑称为标。对于标本的轻重缓急，治疗要采取逆治或从治的方法，这是不可不通晓的。所以经文说：懂得逆治与从治，正行其道无需疑问；明白标本关系，万举万当；不明白标本关系，这就叫做妄行。正是这个意思。
The commentary states: Cold in the intestines and stomach leads to dysfunction of transmission and transformation. According to the Five Elements theory, the child element (Metal) controls the "ghost thief" (Wood), thereby strengthening the self (Earth). Consequently, cold prevails while Fire declines and Metal prospers, resulting in vomiting and diarrhea with a fishy odor. The fishy smell is the odor associated with Metal; thus, heat syndromes present with sour-smelling vomit and diarrhea, whereas cold syndromes present with fishy-smelling vomit and diarrhea. This is analogous to food and liquids: when heated, they tend to become sour; when cooled, they retain a watery, fishy scent.
The commentary states: Yin Water governs purity and clarity. Therefore, in cold diseases, the four limbs become cold and reversed, accompanied by stiffness and rigidity, making extension and flexion difficult. Hence, the winter pulse is deep, short, and robust, which is the manifestation of disease. If the cold pathogen is slight and has not yet progressed to reversal cold (Jue Ni), it should not be mistaken for heat; conversely, if extreme heat causes Yang Reversal (Yang Jue), it should not be mistaken for a cold disease. However, the pulse signs of Yin Reversal belong entirely to Yin syndromes, characterized by a cool body, absence of thirst, and a slow, fine, and faint pulse, none of which appear in Yang syndromes. In contrast, the pulse and symptoms of Yang Reversal belong entirely to Yang syndromes, characterized by extreme heat manifesting as reversal cold, occasional return of warmth, irritability, thirst, delirium despite cold extremities, fever, and a rapid pulse. If Yang Reversal is extremely severe, leading to a cold body and a pulse that appears Yin and nearly imperceptible, this indicates that extreme heat is approaching death. The Classic states: "The alternation of one Yin and one Yang constitutes the Dao; deviation toward Yin or Yang constitutes disease." Yin and Yang achieve harmony through balance and disease through deviation. All things are born carrying Yin and embracing Yang; thus, isolated Yin cannot grow, and solitary Yang cannot form. Therefore, when Yang Qi is extremely excessive and Yin Qi is extremely deficient, Yang Qi becomes constrained and stagnant. Due to the imbalance between Yin and Yang, their circulation fails, causing Yang Qi to accumulate internally rather than circulate to the four limbs, resulting in cold hands and feet known as Yang Reversal. Zhang Zhongjing stated: "The deeper the heat, the deeper the reversal; the slighter the heat, the slighter the reversal." He also stated: "Reversal syndromes should be treated with purgation; after purgation, the reversal resolves." One should use cooling herbs to nourish Yin and subdue Yang, such as using Liang Ge San (Cool the Chest Powder) or Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct Downward Decoction) to purge. Generally, in treating diseases, one must first clarify the Biao (Branch/Surface) and Ben (Root/Origin). Biao refers to the superficial manifestations, while Ben refers to the root cause. Thus, the Classic states: "The primary disease is the Root; the secondary disease is the Branch." It further states: "When Root and Branch transmit to each other, treat the urgent condition first." It also says: "The Six Qi are the Root; the Three Yin and Three Yang meridians are the Branch." Therefore, the pathogenic factor is the Root, and the affected meridians and organs are the Branch. Regarding the severity of Root and Branch, treatment must employ contrary (Ni) or following (Cong) methods, which requires thorough understanding. Thus, the Classic states: "Knowing contrary and following methods allows correct practice without doubt; clearly understanding Root and Branch ensures success in every attempt; failing to understand Root and Branch is termed reckless action." This is precisely what is meant.