注云∶按之不起，泥之象也，土过湿则为泥。湿为病也，积饮痞隔，中满体重，霍
乱吐下，故甚则〔 〕肿也。
火者，少阳相火之热，乃心包络、三焦之气也。
〔诸热瞀 ，暴喑冒昧，躁扰狂越，骂詈惊骇， 肿疼酸，气逆冲上，禁栗如丧神
守，嚏呕，疮疡喉痹，耳鸣或聋，呕涌溢，食不下，目昧不明，暴注 ，暴病卒死，
是皆属于火。〕
注云∶卒〔哑〕也。金肺主声，火旺水衰，热乘金肺，而神浊气郁，则暴喑而无
声也。
注云∶躁动烦热，扰乱而不宁，火之体也。热甚于外，则肢体躁扰；热甚于内，则
神志躁动，反复颠倒，懊 烦心，不得眠也。由水衰而〔火〕之动也。故心胸躁动，
谓之怔忪，俗云心忪，皆为热也。
注云∶狂者，无正定也；越者，乖越理法而失常也。〔夫〕外清内浊，动乱参
差，火之体也；〔静顺清朗，准则信平，水之体也〕。由是肾水主智，而水火相反，
故心火旺则肾水衰，乃失志而狂越也。凡发热于中，则多干阳明胃经也，故经云∶阳明
之厥，面赤而热，妄言。
The commentary states: Light and clear qi ascends to form Heaven, while heavy and turbid qi descends to form Earth. Therefore, when dampness of the Earth element causes disease, it results in a sensation of heaviness in the body (Zhongti) and epigastric fullness/stuffiness (Piyi).
The commentary states: Pitting edema that does not rebound upon pressure resembles mud; excessive dampness of the Earth element turns into mud. When dampness causes disease, it leads to accumulation of fluid retention (Jiyin), chest and diaphragm obstruction (Pige), abdominal fullness (Zhongman), body heaviness (Zhongti), cholera-like vomiting and diarrhea (Huoluan), and thus, in severe cases, generalized edema (Zhong).
Fire refers to the heat of Shaoyang Ministerial Fire (Shao Yang Xiang Huo), which is the Qi manifestation of the Pericardium (Xin Bao Luo) and Sanjiao (Triple Burner).
[Various heat syndromes causing visual obscuration (Mou), sudden aphonia (Bao Yin), mental confusion and dizziness (Mao Mei), restlessness and agitation (Zao Rao), mania and aberration (Kuang Yue), abusive language and fright (Ma Li Jing Hai), swelling, pain, and soreness (Zhong Tong Teng Suan), rebellious Qi rushing upward (Qi Ni Chong Shang), trembling as if losing spiritual control (Jin Li Ru Sang Shen Shou), sneezing and vomiting (Ti Ou), sores and ulcers with throat obstruction (Chuang Yang Hou Bi), tinnitus or deafness (Er Ming Huo Long), violent vomiting and overflow (Ou Yong Yi), inability to eat (Shi Bu Xia), blurred vision (Mu Mei Bu Ming), acute watery diarrhea (Bao Zhu), sudden illness, and abrupt death—all these belong to Fire.]
The commentary states: "Mou" refers to mental confusion. If one feels as though drunk due to extreme heart fire heat, the spirit becomes turbid and confused, leading to visual obscurity and dizziness.
The commentary states: "Dong" refers to palpitation or throbbing, which is the physical characteristic of Fire.
The commentary states: "Su Ya" refers to sudden aphonia. The Lung belongs to Metal and governs voice. When Fire is hyperactive and Kidney Water declines, heat attacks the Lung Metal, causing turbid spirit and stagnant Qi, resulting in sudden loss of voice.
The commentary states: "Mao" refers to mental fogginess; "Mei" refers to dimness. Heat in the Qi causes turbid and foggy spirit, which is the characteristic of Fire.
The commentary states: Restlessness, vexation, and heat, causing disturbance and unrest, are characteristics of Fire. When heat is excessive on the exterior, the limbs become restless and agitated; when heat is excessive internally, the spirit becomes restless, tossing and turning, with inner vexation (Ao Nao), and insomnia. This arises from the movement of Fire due to declining Water. Thus, restlessness and palpitation in the chest and heart are called Zheng Zhong (palpitations), commonly known as Xin Zhong, both caused by heat.
The commentary states: "Kuang" means lacking stable mental focus; "Yue" means deviating from reason and law, becoming abnormal. [Externally clear but internally turbid, with chaotic and irregular movements, this is the nature of Fire; [Quiet, compliant, clear, and bright, adhering to standards and peace, this is the nature of Water]]. Therefore, Kidney Water governs wisdom. Since Water and Fire are opposite, when Heart Fire is hyperactive, Kidney Water declines, leading to the loss of willpower and resulting in mania and aberration. Any internal fever often affects the Yangming Stomach Meridian. Thus, the classics state: Jue syndrome of the Yangming meridian presents with red face and heat, and delirious speech.