诸呕吐酸。暴注下迫。皆属于热。流而不腐。动而不蠹。故吐呕吐酸者。胃膈热甚。则郁滞于气。物不化
而为酸也。酸者肝木之味。或言吐酸为寒者误也。暴注者。是注泄也。乃肠胃热而传化失常。经所谓清气在下。
则生飧泄。下迫者。后重里急。窘迫急痛也。火性急速。而能造物故也。俗云虚坐弩责而痛也。
诸涩枯涸干劲皴揭。皆属于燥。涩枯者。水液气衰少。血不荣于皮肉。气不通利。故皮肤皴揭而涩也。
及甚则麻痹不仁。涸干者。水少火多。系辞云。燥万物者。莫 乎火。故火极热甚。水液干而不润于身。皮肤
乃启裂。手足有如斧伤而深三二分者。冬月甚而夏月衰。故法曰。寒能收敛。收敛则燥涩皴揭。热能纵缓。纵
缓则滋荣润泽。皆属燥金之化也。王注曰。物之生滑利。物之死枯涩。其为治也。宜开通道路。养阴退阳。凉药
调之。荣血通流。麻木不仁涩涸干劲皴揭。皆得其所。慎毋服乌附之药。经所谓金木水火土营运之数。寒暑燥
湿火风临御之化。不失其道。则民病可调。凡受诸病者。皆归于五行六气胜复盛衰之道矣。王注曰。人生有形。
不能无患。既有其患。亦常有逃生化出阴阳者也。故曰谨守病机。各司其属。有者求之。无者求之。盛者责之。
虚者责之。必先五胜。疏其血气。令得调达。而致和平。此之谓也。
各种呕吐酸水，突然腹泻且肛门紧迫窘迫，都归属于热证。水流流动就不会腐败，物体运动就不会生虫蛀蚀。所以呕吐酸水的，是因为胃和膈间热邪极盛，导致气机郁滞，食物不能正常消化而变成酸味。酸味是肝木的本味。有人说吐酸属于寒证，这是错误的。突然腹泻，就是急速的泄泻，这是由于肠胃有热，传导功能失常。《内经》说：“清气在下，则产生完谷不化的泄泻。”肛门紧迫窘迫，是指便意急迫、腹部拘急疼痛。这是因为火性急速，且具有生化万物的特性。俗语所说的“虚坐努责”（因虚而频繁想排便却排不出）并伴有疼痛，也是这个意思。
各种皮肤涩滞、干枯、紧绷、起皱、皲裂脱皮，都归属于燥证。涩滞干枯，是因为津液和气衰少，血液不能濡养皮肉，气机不通利，所以皮肤起皱皲裂且感觉涩滞。如果病情严重，就会出现麻木不仁。干枯，是因为水少火多。《易经·系辞》说：“使万物干燥的，没有比火更厉害的了。”所以火极热甚时，津液干涸而不能滋润身体，皮肤就会开裂，手足像被斧头砍伤一样，深达二三分。这种现象在冬季加重，在夏季减轻。所以治疗原则说：寒性能收敛，收敛就会导致燥涩皲裂；热能舒缓，舒缓就能滋养荣润。这些都归属于燥金的化气。王冰注解说：事物活着时滑利，死亡时枯涩。治疗应当开通道路，滋养阴液，抑制阳热，用凉药调理。使营血通畅流动，麻木不仁、涩滞干枯、紧绷皲裂等症状都能得到缓解。务必不要服用乌头、附子等温热药物。《内经》说：金、木、水、火、土五运的规律，寒、暑、燥、湿、火、风六气的变化，如果不违背其道，那么民众的疾病就可以调治。凡是遭受各种疾病的，都归结于五行六气胜复盛衰的道理了。王冰注解说：人有了形体，就不能没有病患。既然有了病患，也常常有逃避生化、脱离阴阳束缚的情况。所以说：谨慎地守住病机，分别其所属的脏腑经络。有的症状要探究其成因，没有的症状也要探究其机理；实证要责备其邪气盛，虚证要责备其正气虚。必须先明确五脏之气的偏胜情况，疏通其气血，使其调和通达，从而达到平衡和谐的状态。说的就是这个道理。
Various instances of vomiting and acid regurgitation, as well as sudden diarrhea with tenesmus (a feeling of incomplete defecation accompanied by straining), all belong to Heat. Flowing water does not rot; moving objects do not become infested with worms. Therefore, vomiting and acid regurgitation occur because excessive Heat in the Stomach and Diaphragm causes Qi stagnation, preventing food from digesting properly and turning it sour. Sourness is the flavor associated with Liver Wood. It is erroneous to claim that vomiting acid belongs to Cold. "Sudden diarrhea" refers to rapid purging, which results from intestinal and gastric Heat disrupting normal transportation and transformation. The Classic states: "When Clear Yang fails to ascend and remains below, it generates stool containing undigested food." Tenesmus refers to a sense of urgency and heaviness in the rectum, along with cramping abdominal pain. This is due to the swift nature of Fire, which possesses the capacity to generate and transform things. Commonly referred to as "straining while sitting empty" (frequent urge to defecate with little output) accompanied by pain.
Various manifestations of roughness, dryness, witheredness, tension, wrinkling, and skin fissuring all belong to Dryness. Roughness and witheredness arise from a deficiency of body fluids and Qi, causing Blood to fail to nourish the skin and flesh, and Qi to flow unsmoothly. Consequently, the skin becomes wrinkled, fissured, and rough. If severe, numbness and loss of sensation may occur. Witheredness and dryness result from insufficient Yin (Water) and excessive Yang (Fire). The Commentary on the Appended Phrases states: "Nothing dries up the myriad things more than Fire." Thus, when Fire reaches extreme heat, body fluids are depleted and fail to moisten the body, causing the skin to crack. The hands and feet may appear as if cut by an axe, with wounds two or three fen deep. These symptoms worsen in winter and improve in summer. Therefore, the therapeutic principle states: Cold has a contracting effect; contraction leads to dryness, roughness, and fissuring. Heat has a relaxing effect; relaxation promotes nourishment and moisture. All these phenomena belong to the transformation of Dry Metal. Wang Bing’s commentary notes: Living things are smooth and lubricated; dead things are withered and rough. Treatment should aim to open pathways, nourish Yin, subdue Yang, and use cooling herbs to regulate. When Nutritive Blood flows freely, symptoms such as numbness, roughness, dryness, tension, and fissuring will resolve. One must strictly avoid administering Aconite (Fuzi) and similar warming drugs. The Classic states: The cycles of the Five Movements (Metal, Wood, Water, Fire, Earth) and the influences of the Six Qi (Cold, Summer-Heat, Dryness, Dampness, Fire, Wind) must adhere to their proper laws; only then can diseases among the people be regulated. All diseases suffered by humans fall under the principles of the excess, deficiency, and alternation of the Five Elements and Six Qi. Wang Bing’s commentary further states: Humans possess physical form and thus cannot be free from illness. Once illness exists, there are also ways to escape the cycle of generation and destruction, transcending Yin and Yang. Hence it is said: Carefully observe the pathogenesis and assign each condition to its corresponding category. Investigate the presence of symptoms; investigate the absence of symptoms. Address excess conditions by reducing them; address deficiency conditions by tonifying them. First, determine the dominance of any single Zang organ. Unblock the Qi and Blood, allowing them to flow smoothly and harmoniously, thereby achieving balance. This is what is meant.