此复论阳明之气。不能分布于四末。而为痿厥也。痿者。手足委弃而不为我所用。厥者。手足
清冷也。夫阳明为阖。气不通则阖折。阖折则气无所止息而痿疾起矣。阳受气于四末。阳明之气不
行。故手足逆冷也。阳明
居中土。为水谷之海。海之所以行云气者。天下也。是以上文论阳明之气。不能升降于上下。此论
不得分布于四方。朱永年曰。 、闷也。为四末束 者。束缚其手足。使满闷而疾解之。导其气之
通达也。夫按之束之。皆导引之法。犹尺蠖之欲伸而先屈也。身半以上为阳。身半以下为阴。昼以
前为阳。昼以后为阴。日二者。使上下阴阳之气。表章而交通也。不仁者。荣血不行也。十日者。
阴数之周也。
岁。以草刺鼻嚏。嚏而已。无息而疾迎引之。立已。大惊之亦可已。（岁作哕嚏音啻）
哕、呃逆也。言其发声。如车銮之声而有输序。故名曰哕。此阳明所受之谷气。欲从肺而转达
于肤表。肺气逆还于胃。气并相逆。复出于胃。故为哕。故以草刺鼻取嚏以通肺气。肺气疏通。则
谷气得以转输而呃逆止矣。无息。鼻息不通也。疾迎引之。连取其嚏也。夫谷入于胃。散精于心肝。
大惊则肝心之气分散。胃之逆气。亦可从之而外达也。按、胃络上通于心。肝脏之脉挟胃。此言阳
明之气。从肺气而出于气分。亦可从肝心而出于血分也。此章论杂病之因。有因于气者。有厥在经
脉者。有经气之并逆者。首论太阳而末结阳明。盖太阳为诸阳主气。阳明乃血气之生原。故行于上下
四旁。气分血分。夫人之百病。不越外内二因。外内之病。皆能令血气厥逆。是以凡病多本于郁逆。
学人以数篇厥逆之因证。细心参求。为治之要。思过半矣。张介宾曰。岁、当作哕。
这一段再次论述阳明经之气不能布散到四肢末端，从而形成痿证和厥证。所谓“痿”，是指手足软弱无力，无法受意识支配；所谓“厥”，是指手足清冷。阳明经主司“阖”（闭合、收敛），如果气机不通畅导致“阖折”（闭合功能受损），那么气就会无所停驻而运行紊乱，痿病便由此产生。阳气在四肢末端受纳，若阳明经之气不能正常运行，就会导致手足逆冷。
阳明经居中属土，是受纳水谷的“海”。正如大海能行云气于天下一样，上文论述了阳明经之气不能升降于上下，此处论述其不能布散于四方。朱永年说：“束”意为闷塞。所谓“束缚手足”，是指通过束缚手足使其感到满闷，然后解除束缚以治疗疾病，这是为了引导气机通达。按压和束缚都属于导引的方法，就像尺蠖想要伸展身体时先要弯曲身体一样。身体上半部分属阳，下半部分属阴；白昼前半段属阳，后半段属阴。“日二”是指使上下阴阳之气得以彰显并交通融合。所谓“不仁”，是指营血运行不畅。十天是阴数循环一周的时间。
用草刺激鼻子引起打喷嚏，喷嚏打出后病就好了。如果不通气且迅速迎引气息，病也会立即停止。受到大惊吓也可以治愈。（注：原文中的“岁”字应读作“哕”，音同“嚏”）。
“哕”就是呃逆。指发出的声音像车铃铛的声音且有节奏，所以叫作“哕”。这是因为阳明经受纳的谷气，想要从肺脏转达至体表，但肺气上逆返回胃中，气机相并且相互逆乱，又从胃中复出，所以发生呃逆。因此用草刺激鼻子取嚏以疏通肺气，肺气一旦疏通，谷气就能顺利转输，呃逆也就停止了。“无息”指鼻息不通畅，“疾迎引之”指连续诱发喷嚏。食物进入胃中，精微物质散布于心肝。大惊会使心肝之气分散，胃中的逆气也可以随之向外发散。按经络理论，胃的络脉上通于心，肝脏的经脉夹行于胃旁。这里说的是阳明经之气，既可以从肺气而出于气分，也可以从肝心而出于血分。
本章讨论杂病的成因，有的因于气机失调，有的是厥邪在经脉中，有的是经气共同上逆。开头论述太阳经，结尾归结于阳明经。大概因为太阳经是诸阳之主气，阳明经是气血生成的源头，所以气机能行于上下及四周。无论是气分还是血分，人的各种疾病，不外乎外感和内伤两种原因。内外之病，都能导致血气厥逆。因此，凡是疾病大多源于郁滞和逆乱。学者若能仔细研读这几篇关于厥逆的成因和证候，就掌握了治疗的要点，理解也就超过一半了。张介宾说：“岁”字应当作“哕”。
This passage further discusses the Qi of the Yangming channel failing to distribute to the four extremities, resulting in Wei syndrome (flaccidity) and Jue syndrome (cold limbs). "Wei" refers to the weakness of the hands and feet such that they cannot be controlled by one's will. "Jue" refers to the coldness of the hands and feet. The Yangming channel governs the "He" (closing function); if Qi flow is obstructed leading to a fracture of the closing function (He Zhe), the Qi has no place to rest and becomes disordered, giving rise to flaccidity diseases. Yang Qi receives nourishment at the four extremities; when the Qi of the Yangming channel fails to circulate normally, it results in cold extremities.
The Yangming channel resides in the center and belongs to Earth, serving as the "Sea" of water and grain. Just as the ocean generates clouds and mist across the world, the previous text discussed how the Qi of the Yangming channel fails to ascend and descend between the upper and lower parts, while this section discusses its failure to distribute to the four directions. Zhu Yongnian stated: "Shu" means stuffiness. The phrase "binding the four extremities" implies binding the hands and feet to induce a sensation of fullness, then releasing them to treat the disease, thereby guiding the free flow of Qi. Pressing and binding are both methods of Daoyin (guiding and pulling exercises), similar to how the inchworm must first curl up before extending itself. The upper half of the body belongs to Yin-Yang (Yang), and the lower half belongs to Yin; the first half of the day belongs to Yang, and the second half belongs to Yin. "Ri Er" (two days/times) signifies enabling the Qi of Yin and Yang above and below to manifest and communicate with each other. "Bu Ren" (loss of sensation) refers to the stagnation of Ying Blood (Nutritive Blood). Ten days represent the completion of one cycle of the Yin number.
Stimulating the nose with grass to induce sneezing (Ti) cures the condition once the sneeze occurs. If nasal breathing is blocked, rapidly guiding and attracting the Qi will also stop the condition immediately. Being greatly startled can also cure it. (Note: The character "Sui" here should be read as "Yue", pronounced like "Ti").
"Yue" refers to hiccuping. It is named so because the sound produced resembles the ringing of carriage bells with a rhythmic order. This occurs because the Grain Qi received by the Yangming channel attempts to transfer from the Lung to the skin surface, but Lung Qi rebels and returns to the Stomach. The Qi merges and rebels together, exiting again from the Stomach, thus causing hiccups. Therefore, stimulating the nose to induce sneezing is used to unblock Lung Qi. Once Lung Qi is unblocked, Grain Qi can be transported smoothly, and the hiccups cease. "Wu Xi" refers to blocked nasal breathing; "Ji Ying Yin Zhi" refers to continuously inducing sneezes. When food enters the Stomach, its essence scatters to the Heart and Liver. Great fright causes the Qi of the Liver and Heart to scatter, allowing the rebellious Qi of the Stomach to dissipate outward. According to meridian theory, the collaterals of the Stomach connect upwards to the Heart, and the meridians of the Liver flank the Stomach. This indicates that the Qi of the Yangming channel can exit via Lung Qi into the Qi aspect, or via the Liver and Heart into the Blood aspect.
This chapter discusses the causes of miscellaneous diseases: some arise from Qi dysfunction, some involve Jue pathogens in the meridians, and some involve the simultaneous rebellion of meridian Qi. It begins with the Taiyang channel and concludes with the Yangming channel. This is likely because the Taiyang channel is the master Qi of all Yang channels, and the Yangming channel is the source of Qi and Blood generation, allowing Qi to circulate through the upper, lower, and surrounding areas. Whether in the Qi aspect or the Blood aspect, human diseases do not exceed external and internal causes. Both external and internal diseases can cause Qi and Blood to rebel and become stagnant. Therefore, most diseases originate from stagnation and rebellion. If students carefully study the causes and syndromes of Jue rebellion described in these sections, they will grasp the essentials of treatment and understand more than half of the subject matter. Zhang Jiabin stated that "Sui" should be written as "Yue".