【注】亡阳阴盛，燥而无热，虽大便硬者，此乃不大便无所苦之硬也，下之则中寒犹盛，故必利清谷腹满矣。
【集注】成无己曰∶无阳者，亡津液也。阴多者，寒多也。大便硬，则为阴结。下之虚胃，阴寒内甚，故
清谷腹满。
方有执曰∶阴，以寒言。强，犹言多也。清谷，阴不能化也。腹满阴寒，凝滞而内胀也。
伤寒，发热头痛，微汗出，发汗则不识人；熏之则喘，不得小便，心腹满；下之则短气，小便难，头痛背
强；加温针则衄。
【注】伤寒发热，头痛背强，微汗出，若不恶寒，非温病即邪传阳明也。若误发汗，不成风温，外热如灼，
必成阳明，热甚神昏不识人也。以火熏、温针劫之，火气入里，壅塞于胸则喘，于腹则满也。火伤卫分津液，
则不得小便，火伤营分血脉，则必作衄也。若下之，则中气伤，故气短；津液伤，故小便难也。
【集注】程应旄曰∶此证近于温，有热无寒，汗下温针，均在所禁也。
下利脉大者，虚也，以强下之故也。设脉浮革，因尔肠鸣者，属当归四逆汤。
【注】下利脉大，里虚也，以其不当下而强下之故也。设脉浮革者，谓脉浮大，按之空虚，表急里虚，
因尔肠鸣，属当归四逆汤，和其表而温其里也。
【集注】成无己曰∶浮为虚，革为寒，寒虚相搏，则肠鸣，与当归四逆汤。
【注】亡阳（阳气耗散）且阴寒内盛，表现为身体干燥而无发热。即使出现大便干硬的情况，这属于虽然不大便但并无痛苦不适的“硬”，若使用泻下法，会导致中焦寒邪更加炽盛，因此必然会出现排泄未消化食物（完谷不化）和腹部胀满的症状。
【集注】成无己说：所谓“无阳”，是指津液枯竭。所谓“阴多”，是指寒邪偏盛。大便干硬，属于阴结（寒凝便秘）。若误用泻下法，会使胃气虚弱，导致体内阴寒极盛，从而出现排泄未消化食物和腹部胀满。
方有执说：“阴”指寒邪。“强”意为多。“清谷”指阴寒太盛无法腐熟水谷。“腹满”是因阴寒凝滞导致的气机内胀。
伤寒病，出现发热、头痛、微微汗出，此时若误用发汗法，会导致神志不清、不认识人；若用火熏法治疗，会导致气喘、小便不通、心腹部胀满；若误用泻下法，会导致呼吸短促、小便困难、头痛和背部僵硬；若加用温针疗法，则会导致鼻出血。
【注】伤寒病出现发热、头痛、背部僵硬、微微汗出，如果不伴有恶寒症状，那要么是温病，要么是邪气传入阳明经。如果误用发汗法，不仅不能治愈风温，反而会导致体表热势如火灼烧，必然演变为阳明病，热势极盛导致神志昏迷、不认识人。如果用火熏或温针强行劫夺津液，火热之气入里，壅塞在胸部就会气喘，壅塞在腹部就会胀满。火邪损伤卫分和津液，就会导致小便不通；火邪损伤营分和血脉，就会导致鼻出血。如果误用泻下法，会损伤中焦正气，所以呼吸短促；损伤津液，所以小便困难。
【集注】程应旄说：此证接近温病，有热象而无寒象，发汗、泻下、温针均在禁忌之列。
腹泻且脉象大的，属于虚证，是因为不当泻下而强行泻下的缘故。假如脉象浮而革（如按葱管），并因此出现肠鸣音，属于当归四逆汤证。
【注】腹泻且脉象大，说明里气虚弱，是因为不该用泻下法却强行泻下的缘故。假如脉象浮而革，意思是脉象浮大，但重按空虚，表示表气急迫而里气虚弱，并因此出现肠鸣音，这属于当归四逆汤证，该方能调和表气并温补里气。
[Annotation] When Yang Qi is depleted (Yang collapse) and Yin-cold is excessive internally, the body appears dry without heat. Even if hard stools occur, this refers to hardness accompanied by no discomfort despite infrequent bowel movements. If purgatives are used, the cold in the Middle Jiao will become even more severe, inevitably leading to the passage of undigested food (Qinggu) and abdominal fullness.
[Collected Annotations] Cheng Wuji stated: "No Yang" refers to the depletion of body fluids. "Excess Yin" refers to an abundance of cold pathogens. Hard stools indicate Yin-binding (cold coagulation constipation). Purging weakens Stomach Qi, causing severe internal Yin-cold, resulting in the passage of undigested food and abdominal fullness.
Fang Youzhi stated: "Yin" refers to cold. "Qiang" means excessive. "Qinggu" indicates the inability to transform food due to extreme Yin-cold. "Abdominal fullness" results from the stagnation of Yin-cold causing internal distension.
In Shaoyang disease (Taiyang Cold Damage), presenting with fever, headache, and slight sweating, misapplication of diaphoresis leads to confusion and inability to recognize people; moxibustion or fire fumigation causes asthma, urinary retention, and epigastric/abdominal fullness; purging leads to shortness of breath, difficult urination, headache, and stiffness of the back; adding warm needle therapy causes epistaxis.
[Annotation] In Taiyang Cold Damage, presenting with fever, headache, back stiffness, and slight sweating, if there is no aversion to cold, it is either a Warm Disease (Wenbing) or the pathogen has transmitted to the Yangming channel. Misapplication of diaphoresis may result in Wind-Warmth, characterized by intense surface heat like burning, inevitably evolving into Yangming disease where extreme heat causes coma and loss of recognition. Fire fumigation or warm needles forcibly deplete fluids; fire qi enters the interior, obstructing the chest causing asthma, or the abdomen causing fullness. Fire damaging the Wei level and fluids leads to urinary retention; fire damaging the Ying level and blood vessels leads to epistaxis. Purging damages Middle Qi, causing shortness of breath, and depletes fluids, causing difficult urination.
[Collected Annotations] Cheng Yingmao stated: This condition resembles Warm Disease, having heat signs but no cold signs; diaphoresis, purging, and warm needles are all contraindicated.
Diarrhea with a large pulse indicates deficiency, caused by inappropriate forced purging. If the pulse is floating and wiry/tense (Ge pulse), accompanied by borborygmus, it belongs to Danggui Sini Tang (Angelica Sinensis Decoction for Frigid Extremities).
[Annotation] Diarrhea with a large pulse indicates interior deficiency, caused by forced purging when it was not indicated. A floating and Ge pulse implies a pulse that is floating and large but empty upon deep pressure, indicating exterior urgency and interior deficiency. Accompanied by borborygmus, this pattern is treated with Danggui Sini Tang (Angelica Sinensis Decoction for Frigid Extremities), which harmonizes the exterior and warms the interior.
[Collected Annotations] Cheng Wuji stated: Floating pulse indicates deficiency; Ge pulse indicates cold. The interaction of cold and deficiency causes borborygmus; administer Danggui Sini Tang (Angelica Sinensis Decoction for Frigid Extremities).