注云∶此热在表也。邪热在表而浅,邪畏其正,故病热而反恶寒也。仲景云∶无
阳不可发汗。又云∶身热〔恶〕寒,麻黄汤汗之。汗泄热去,身凉即愈。
注云∶〔战栗〕动摇,火之象也。阳动阴静,而水火相反。故厥逆禁固,屈伸不
便,为病寒也。栗者,寒冷〔也〕。此由心火热甚,亢极而战,反兼水化制之,故寒
栗也。然寒〔栗〕者,由火甚似水,实非兼有寒气也。故以大承气汤下之,多有燥
粪,下后热退,战栗愈矣。
注云∶心卒动而不宁也。火主〔于〕动,心火热甚〔故〕也。虽尔,止为热极于
里,乃火极而似水,则喜惊也。反兼肾之恐者,亢则害,承乃制故也。
注云∶疑惑、犹豫、浊乱,而志不一也。象火参差而惑乱,故火实则水衰,失志而
惑〔乱〕也。〔志〕者,肾〔水〕之神也。
注云∶金肺之志也。金〔本〕燥,能令燥者,火也。所谓悲泣五液俱出〔者〕,
火热亢极,而反兼水化制之故也。
注云∶蕃茂鲜淑,舒荣彰显,火之化也,故喜为心火之志也。喜极而笑者,犹燔烁
火喜而鸣,笑之象也。
注云∶多言也。言为心声,犹火燔而鸣,故心火热则多言,犹心醉而热,故多言也。
注云∶虚妄也。火为阳,故外清明而内浊昧,其主动乱。故心火热甚,则肾水衰而
志不专一,虚妄见闻,而〔自为〕问答,则神志失常,而如见鬼神也。
注释说:这是热邪在体表。邪热位于体表且病位浅,邪气畏惧正气,所以出现发热反而恶寒的症状。张仲景说:没有阳气(指津液或阴精)不可发汗。又说:身体发热且恶寒,用麻黄汤发汗治疗。汗出后热邪随汗而解,身体变凉即痊愈。
注释说:战栗是动摇的表现,属于火的征象。阳主动,阴主静,水和火性质相反。所以四肢厥冷、拘挛固着,屈伸不便,这是寒病的表现。栗,指寒冷。这是由于心火过盛,亢极而战栗,反而兼有水(肾)的化制作用,所以出现寒战栗抖。然而寒战栗,是因为火极似水,实际上并非兼有寒气。所以用大承气汤攻下,往往能排出燥结粪便,下后热退,战栗症状也就好了。
注释说:心突然跳动而不安宁。火主于动,这是因为心火过盛所致。虽然如此,这只是热邪极盛于里,乃火极而似水,所以表现为易受惊吓。反过来兼有肾所主的恐惧情绪,是因为亢盛则为害,承袭制约才能平衡的缘故。
注释说:疑惑、犹豫、神志浊乱,导致意志不专一。像火苗参差摇曳而使人惑乱,所以火实盛则肾水衰,失去意志控制而惑乱。志,是肾水的精神体现。
注释说:悲是肺金的志。金本属燥,能使人体干燥的,是火邪。所谓悲伤哭泣时五液俱出,是因为火热亢极,反而兼有水(肾)的化制作用所致。
注释说:蕃茂鲜淑,舒展荣显,这是火的化育作用,所以喜是心火的志。喜极而笑,就像燃烧的火喜欢鸣响一样,笑就是这种征象。
注释说:多言。言语是心声的外露,就像火燃烧而发出声响,所以心火过盛就会多言,就像心醉酒而发热,所以多言。
注释说:虚妄。火为阳,所以外表清明而内部浊昧,其性主动乱。所以心火过盛,则肾水衰败而意志不专一,产生虚妄的见闻,并且自问自答,导致神志失常,好像看见鬼神一样。
Note states: This indicates heat in the exterior. The pathogenic heat is in the exterior and shallow; the pathogen fears the healthy qi, thus presenting with fever but aversion to cold. Zhang Zhongjing stated: "Without Yang (referring to body fluids or yin essence), sweating should not be induced." He also stated: "When the body is hot with aversion to cold, treat with Mahuang Tang (Ephedra Decoction) to induce sweating." After sweating, the heat dissipates, the body becomes cool, and recovery ensues.
Note states: [Tremors] refer to shaking, which is a manifestation of Fire. Yang moves, Yin is still, and Water and Fire are contrary. Therefore, cold extremities, rigidity, and difficulty in flexion and extension constitute a Cold disease. Trembling denotes coldness. This arises because Heart Fire is excessively severe; when it reaches an extreme, it trembles and is counteracted by the transformation of Water (Kidney), thus resulting in cold trembling. However, cold trembling occurs because extreme Fire resembles Water; in reality, there is no concurrent Cold pathogen. Therefore, Dachengqi Tang (Major Order the Qi Decoction) is used for purgation. Often, dry feces are expelled; after purgation, the heat recedes, and the trembling subsides.
Note states: Sudden palpitations and restlessness of the Heart. Fire governs movement, caused here by excessive Heart Fire. Nevertheless, this merely indicates heat extreme in the interior, where extreme Fire resembles Water, leading to a tendency toward fright. Conversely, the emotion of fear (associated with Kidney) appears because "excess causes harm, and subjugation brings control" (Kang ze hai, cheng nai zhi).
Note states: Doubt, hesitation, mental turbidity, and lack of focused will. Like flickering flames causing confusion, when Fire is excess, Kidney Water declines, leading to loss of will and confusion. Zhi (Will/Intention) is the spirit of Kidney Water.
Note states: Grief is the emotion associated with Metal and the Lung. Metal inherently relates to Dryness, but what causes dryness is Fire. The phenomenon where all five fluids flow out during weeping due to grief occurs because extreme Heat/Fire is counteracted by the transformation of Water.
Note states: Lushness and freshness,舒展 and brilliance, are transformations of Fire; thus, Joy is the emotion of Heart Fire. Extreme joy leads to laughter, similar to how fire crackles when burning; laughter is the image of this.
Note states: Excessive talking. Speech is the voice of the Heart, just as fire makes noise when burning; therefore, excessive Heart Fire leads to talkativeness, akin to the heart being intoxicated and heated.
Note states: Delusion. Fire is Yang, so the exterior is clear while the interior is turbid, and its nature is active and chaotic. Thus, when Heart Fire is excessive, Kidney Water declines, and the will is unfocused, leading to delusional perceptions and self-answered dialogues. This results in abnormal spirit and mind, resembling seeing ghosts or spirits.