注云∶枯，不荣〔旺〕也；涸，无水液也；干，不滋润也；劲，不柔和也。
（然）春秋相反，燥湿不同〔故〕也。大法曰∶身表热为热在表；渴饮水为热在里；
身热饮水，表里俱有热；身凉不渴，表里俱无热。经所不取火化渴者，谓渴非特为
〔热〕，如〔病〕寒吐利，亡液过极，则亦燥而渴也；虽病风热，而液尚未衰，则亦
不渴也。岂可止言渴为热，而痞为寒也。
注云∶皮肤启裂也。干为天，为燥金；坤为地，为湿土。天地相反，燥湿异〔用〕，
（故）燥金主于紧〔敛〕，故秋脉紧细而微；（而）湿土主于纵缓，故六月其脉缓
大而长也。如地湿则纵缓滑泽，干则紧敛燥〔涩〕，皴揭之理明矣。俗言皴揭为
风者，由风能胜湿，而为燥故也。经云∶厥阴所至，为风府，为璺启，由风胜湿而为燥也。
寒者，太阳寒水，乃肾与膀胱之气也。
〔诸病上下所出水液，澄澈清冷， 瘕 疝，痞坚，腹满急痛，下利清白，食已不
饥，吐利腥秽，屈伸不便，厥逆禁固，皆属于寒。〕
注云∶澄湛而不混浊也。水体清净，而其气寒冷，故水谷不化，而吐利清冷，水液
为病寒也。如天气寒，则浊水自然澄清也。
注云∶腹中坚硬，按之应手，谓之 也。水体柔顺，而今反坚硬如地体者，亢则
害，承乃制也。〔故病湿〕过极而为 ，反兼风化制之也。风病过极而反燥，筋脉
劲急，反兼金化制之也。燥病过极而烦渴，反兼火化制之也。热病过极而反出五液，或
为战栗恶寒，反兼水化制之也。其为治者，俾以〔泻〕其过极之气，以为病本，不
可反误治其兼化也。夫五常之道，甚〔而〕无以制之，则造化息矣。如春木旺而多
风，风大则反凉，是反兼金化制其木也。大凉之下，天气反温，乃火化承其金也。夏火
热极，体反出液，是反兼水化制其火也。因而湿〔蒸〕云雨，乃土化承于水也。雨湿
过极，而兼〔烈〕风，乃木化制其土也。飘〔骤〕之下，秋气反凉，乃金化承于木
也。凉极而反燥，乃火化制其金也。因而〔以为冬寒〕，乃水化承于火也。寒极则
水〔凝〕如地，乃土化制其水也。凝冻极而起东风，乃〔木〕化承土而成岁也。
凡不明病之标本者，由未知（此变化之道）也。
注释说：枯，是指失去荣润（旺盛）；涸，是指没有水液；干，是指不滋润；劲，是指不柔和。
（然而）春秋季节相反，是因为燥与湿不同（的缘故）。大法则说：身体表面发热，是热在表；口渴想喝水，是热在里；
身体发热且想喝水，说明表里都有热；身体凉爽且不渴，说明表里都没有热。经典中不单独将“火化”作为口渴的原因，是说口渴并不仅仅是因为（热），比如（患）寒证导致呕吐腹泻，津液耗损过度，也会因为干燥而口渴；虽然患风热病，但津液尚未衰败，也（不会）口渴。怎么可以只说口渴就是热，而痞满就是寒呢。
注释说：皮肤开裂。天对应乾卦，象征燥金；地对应坤卦，象征湿土。天地相反，燥与湿作用不同，
（所以）燥金主司紧〔敛〕，所以秋季的脉象紧细而微；（而）湿土主司纵缓，所以六月其脉缓
大而长。就像地面潮湿则纵缓滑泽，干燥则紧敛燥〔涩〕，皮肤皴裂的道理就很明白了。世俗说皴裂是
风邪所致，是因为风能胜湿，从而产生燥的缘故。经典说：厥阴风木所至，表现为风府，表现为璺启（皮肤裂纹），是由于风胜湿而为燥。
寒，属于太阳寒水，是肾与膀胱的气机。
〔各种疾病上下排出的水液，清澈寒冷，癥瘕、疝气、痞块坚硬、腹部胀满急痛，下利清稀白色，进食后不觉饥饿，呕吐物带有腥秽气味，肢体屈伸不便，四肢厥冷僵硬，都属于寒证。〕
注释说：澄澈湛静而不浑浊。水性清净，而其气寒冷，所以水谷不能消化，而呕吐腹泻物清冷，水液
成为寒病的表现。就像天气寒冷，浑浊的水自然澄清一样。
注释说：腹中坚硬，按压时有抵抗感，称为〔痞〕。水性柔顺，而现在反而坚硬像大地一样，这是亢盛则
为害，有承制才能平衡。（所以病湿）过极而出现〔痞〕，反而兼夹风化的机制来制约它。风病过极而反现燥象，筋脉
劲急，反而兼夹金化的机制来制约它。燥病过极而烦渴，反而兼夹火化的机制来制约它。热病过极而反出五液，或
出现战栗恶寒，反而兼夹水化的机制来制约它。治疗这些情况，应当用〔泻〕法去除过极之气，以治病本，不
可反过来误治其兼化之象。五常之道，如果过于强盛而没有制约，那么造化就会停止。如春季木旺而多
风，风大则反而变凉，这是反兼金化来制约木。大凉之下，天气反而温暖，是火化承受并制约金。夏季火
热极盛，身体反而出汗出液，这是反兼水化来制约火。因而湿气蒸腾形成云雨，是土化承受于水。雨湿
过极，而兼夹〔烈〕风，是木化制约土。飘〔骤〕雨之下，秋气反而变凉，是金化承受于木。
凉极而反现燥象，是火化制约金。因而〔形成冬寒〕，是水化承受于火。寒极则水
〔凝〕结如大地，是土化制约水。凝冻极而起东风，是〔木〕化承受于土而构成一年。
凡是不明白疾病的标本的，是由于不知道（这种变化的道理）啊。
The commentary states: "Ku" (withered) refers to the loss of nourishment and flourishing; "He" (dried up) refers to the absence of body fluids; "Gan" (dry) refers to lack of moistening; "Jin" (stiff/tough) refers to a lack of softness.
(However), spring and autumn are opposite because dryness and dampness differ [thus]. The general principle states: Fever on the body surface indicates heat in the exterior; thirst with desire to drink water indicates heat in the interior;
fever accompanied by thirst indicates heat in both the interior and exterior; cool body without thirst indicates no heat in either the interior or exterior. The classics do not solely attribute thirst to the transformation of Fire, stating that thirst is not exclusively due to [heat]; for instance, in [illnesses involving] cold patterns with vomiting and diarrhea, if body fluids are excessively depleted, dryness and thirst will also occur; even in wind-heat illnesses, if body fluids have not yet declined, there will be [no] thirst. How can one simply say that thirst signifies heat, while palpable masses signify cold?
The commentary states: Cracking of the skin. Heaven corresponds to the Qian trigram, symbolizing Dry Metal; Earth corresponds to the Kun trigram, symbolizing Damp Earth. Heaven and Earth are opposite, and Dryness and Dampness function differently,
(thus) Dry Metal governs contraction [and gathering], hence the pulse in autumn is tight, fine, and slight; (while) Damp Earth governs relaxation and laxity, hence in the sixth month its pulse is slow, large, and long. Just as wet ground is relaxed, slippery, and lustrous, while dry ground is contracted, gathered, dry, and [rough], the principle of skin cracking is clear. Popular opinion attributes cracking to Wind, because Wind overcomes Dampness, thereby creating Dryness. The classics state: Where Jueyin Liver Wind prevails, it manifests as the Wind Mansion and as cracks (skin fissures), due to Wind overcoming Dampness to create Dryness.
Cold belongs to Taiyang Cold Water, which is the Qi mechanism of the Kidney and Bladder.
[All diseases where fluids discharged from above and below are clear, cold, and pure; abdominal masses, hernias, palpable masses, hardness, abdominal distension with urgent pain, profuse watery white diarrhea, feeling no hunger after eating, vomiting and diarrhea with fishy/foul odors, difficulty in flexing and extending limbs, cold extremities with stiffness and immobility, all belong to Cold.]
The commentary states: Clear and tranquil, not turbid. Water nature is pure and clear, and its Qi is cold; therefore, food and fluids fail to transform, resulting in clear and cold vomiting and diarrhea, making fluid disorders manifestations of Cold. Just as when the weather is cold, turbid water naturally clarifies.
The commentary states: Hardness in the abdomen, which offers resistance upon pressure, is called [Pi] (palpable mass). Water nature is soft and compliant, but now it appears hard like the earth; this is because excess leads to harm, and balance is maintained through counter-control. ([Thus, when illness-dampness] becomes extreme and results in [Pi], it paradoxically incorporates the mechanism of Wind transformation to control it.) When Wind pathology becomes extreme and paradoxically shows Dryness, causing tendons and vessels to become stiff, it paradoxically incorporates the mechanism of Metal transformation to control it. When Dryness pathology becomes extreme causing irritability and thirst, it paradoxically incorporates the mechanism of Fire transformation to control it. When Heat pathology becomes extreme and paradoxically produces the five fluids, or presents with shivering and aversion to cold, it paradoxically incorporates the mechanism of Water transformation to control it. In treating these conditions, one should use [draining] methods to remove the excessive Qi, addressing the root cause of the disease, rather than mistakenly treating the paradoxical transformations. The Way of the Five Constants dictates that if something becomes too strong without restraint, creation ceases. For example, in Spring, Wood is prosperous and Wind is abundant; if Wind is excessive, it paradoxically turns cool, which is Metal transformation controlling Wood. Under great cold, the weather paradoxically warms, which is Fire transformation receiving and controlling Metal. In Summer, when Fire heat is extreme, the body paradoxically sweats and produces fluids, which is Water transformation controlling Fire. Thus, dampness steams into clouds and rain, which is Earth transformation receiving Water. When rain and dampness become excessive and are accompanied by [fierce] wind, Wood transformation controls Earth. Under sudden [heavy] rains, Autumn Qi paradoxically cools, which is Metal transformation receiving Wood.
When cold becomes extreme and paradoxically shows Dryness, it is Fire transformation controlling Metal. Thus, [Winter Cold forms], which is Water transformation receiving Fire. When Cold is extreme, Water [freezes] like the earth, which is Earth transformation controlling Water. Extreme freezing gives rise to East Wind, which is [Wood] transformation receiving Earth to complete the year.
Anyone who does not understand the root and branch of diseases does so because they do not know (this way of transformation).