注云∶怫热结滞，而气不通畅也。所谓热甚则腠理闭密而郁结也。〔则〕如火炼
物，反相合而不离也。故热郁则闭塞不通畅也。然寒水〔主〕于闭藏，而今反属
热者，谓〔火〕热亢甚，则反兼水化制之故也。
注云∶热胜于内，则气郁而为肿也。阳热气甚则腹胀。火主长而高茂，形貌彰显，
升明舒荣，皆肿胀〔之象〕也。
注云∶窒，塞也。火主 肿胀，故阳明热，而鼻中〔 胀〕，则窒塞也。
注云∶〔鼽者〕，鼻出清涕也。夫五常之道，微则当其本化，甚则兼其鬼贼，故
经曰∶亢则害，承乃制也。由是肝热甚则出〔泣，心热甚则出〕汗，脾热甚则出涎，
肺热甚则出涕，肾热甚则出唾。此乃寒〔伤〕皮毛，则腠理闭密，阳热怫郁，〔而病愈
甚〕也。
注云∶〔血溢者〕，上出也。心养于血，故热甚则血有余而妄行也。
注云∶热在下焦，而大小便血也。
注云∶小便涩痛，热客膀胱，郁结而不能渗泄故也。可用开结利小便之寒药，以使
结散热退，血气宣通，荣卫和平，精神清利而已。
注云∶大便涩滞也。热耗其液，则粪坚结，大〔肠〕燥涩紧敛故也。俗谓风热结
〔者〕，谓火甚则制金，不能平木，则肝木自甚故也。或大便溏而〔 〕者，燥
热在乎肠胃之外，而湿热在内故也。
注释说：这是指昏昧。热气极盛，就会导致浊气扰乱，使人神志昏沉模糊。
注释说：这是指热邪郁结阻滞，导致气机运行不畅。所谓热势极盛时，腠理（皮肤毛孔及间隙）闭合紧密而气机郁结，就像用火冶炼物体一样，反而使物质融合粘合而不分离。因此，热邪郁结会导致闭塞不通畅。然而，寒水本主闭藏，现在却归属于热证范畴，这是因为火热亢盛到了极点，反而兼有水气的化生来制约它（即“亢则害，承乃制”的道理）。
注释说：热邪在体内偏胜，导致气机郁滞而形成肿胀。阳热之气极盛则引起腹胀。火性主生长、高大茂盛，形态外貌彰显，升发明亮、舒展繁荣，这些都是肿胀的征象。
注释说：窒，就是堵塞的意思。火性主肿胀，所以阳明经有热，鼻中感到胀满，就会造成鼻塞不通。
注释说：鼽，是指鼻子流出清涕。五行的常道是，气微时表现为其本性的化生，气极盛时则兼见克制它的“鬼贼”之象。所以《内经》说：亢盛则为害，有所承受制约才能平衡。因此，肝热极盛则流泪，心热极盛则出汗，脾热极盛则流涎，肺热极盛则流涕，肾热极盛则吐唾。这往往是因为寒邪损伤皮毛，导致腠理闭合紧密，阳气被热邪郁遏，从而使病情加重。
注释说：阳热郁结于足阳明胃经，导致上部热势极盛，血液妄行而出，形成鼻衄（鼻出血）。
注释说：血溢，是指血液从上窍溢出。心主血脉并滋养血液，所以热势极盛时，血分有余而妄行。
注释说：热邪位于下焦，导致大小便出血。
注释说：小便涩痛，是因为热邪客居膀胱，郁结阻滞而不能正常渗泄。可以使用具有开结、利小便作用的寒凉药物，以使郁结散开、热势消退，气血宣通，营卫调和，精神清爽便利即可。
注释说：大便涩滞难解。热邪耗伤津液，导致粪便坚硬结块，大肠燥涩紧缩收敛。世俗所说的风热结滞，是指火气极盛制约了金（肺），不能平抑木（肝），导致肝木过旺的缘故。或者大便溏薄但伴有肛门灼热疼痛的，是因为燥热在肠胃之外，而湿热蕴结在内部所致。
Note states: This refers to confusion. When heat qi is excessive, turbid qi becomes chaotic, leading to mental confusion and obscurity.
Note states: This refers to the stagnation and blockage of heat pathogen, resulting in unsmooth qi movement. It is said that when heat is extreme, the couli (skin pores and interstices) become closed and dense, causing qi stagnation. Just as fire smelts objects, causing them to fuse and adhere rather than separate. Therefore, heat stagnation leads to blockage and unsmoothness. However, cold water governs closure and storage; now it is attributed to heat because when fire-heat is excessively hyperactive, it counteracts itself by generating water transformations (following the principle of "excess causes harm, and restraint brings balance").
Note states: Heat prevailing internally causes qi stagnation and subsequent swelling. Excessive yang-heat leads to abdominal distension. Fire governs growth, height, and luxuriance; its form and appearance are manifest. Ascending, bright, spreading, and flourishing are all images of swelling.
Note states: Zhi (obstruction) means blockage. Fire governs swelling; thus, when the Yangming channel has heat, nasal fullness occurs, leading to obstruction.
Note states: Qiu (rhinorrhea) refers to the discharge of clear mucus from the nose. The way of the Five Constants is that when subtle, it manifests its own transformation; when extreme, it assumes the characteristics of its conquering element ("ghost thief"). Thus, the Classic says: "Excess causes harm, and constraint brings balance." Consequently, when Liver heat is extreme, tears flow; when Heart heat is extreme, sweat flows; when Spleen heat is extreme, saliva flows; when Lung heat is extreme, nasal discharge flows; when Kidney heat is extreme, spit is produced. This often occurs because cold pathogen damages the skin and hair, closing the couli, causing yang-heat to be constrained and郁 (depressed), thereby worsening the disease.
Note states: When yang-heat is constrained in the Foot-Yangming Stomach channel, upper heat becomes extreme, causing blood to move recklessly and resulting in epistaxis (nosebleed).
Note states: Xueyi (blood effusion) refers to bleeding from upper orifices. The Heart nourishes blood; thus, when heat is extreme, blood surplus leads to reckless movement.
Note states: Heat located in the Lower Jiao results in hematochezia and hematuria.
Note states: Dysuria with pain occurs because heat pathogen lodges in the Bladder, causing stagnation and preventing normal excretion. Cold-natured herbs that resolve stagnation and promote urination can be used to dissipate the blockage, reduce heat, promote the free flow of qi and blood, harmonize Ying and Wei, and restore clarity to the spirit.
Note states: Constipation with difficulty in defecation. Heat consumes body fluids, leading to hard, bound feces due to dryness, astringency, and contraction of the Large Intestine. Laypeople refer to this as wind-heat binding, meaning fire is so extreme that it controls Metal (Lung), failing to subdue Wood (Liver), causing Liver Wood to become excessive. Alternatively, loose stools accompanied by burning pain occur because燥热 (dry-heat) is outside the intestines and stomach, while damp-heat is internal.