注云∶卒暴〔注〕泄，肠胃热甚，则传化失常，火性疾速，故〔如〕是也。
注云∶转，反戾也，热气燥烁于筋，〔则〕挛 而痛也。所谓转者，动也，阳动
阴静，热证明矣。多因热甚，霍乱吐泻，以致脾胃土衰，则肝木自甚，而热燥于
筋，故转筋也。大法曰∶渴则为热，凡霍乱转筋〔而〕不渴者，未之有也。或不因
吐泻，而但外冒于风，腠理闭密，阳气郁结，怫〔热〕内作，热燥于筋，则转
筋也。故诸转筋，以汤渍之，而使腠理开泄，阳气散而愈也。因汤渍之而愈，故反
〔疑〕为寒也。
注云∶天气热则水混浊，寒则水清洁，水体清，火体浊故也。又如清水为汤，则自
然浊也。
注云∶气为阳，阳为热，气甚则然也。
注云∶浅而大也。经曰∶热胜血则为痈脓也。
注云∶深而恶也。
注云∶有头小疮也。
注云∶浮而小瘾疹也。
注云∶赤瘤〔丹〕 ，热胜〔气〕也，火之色也。
注云∶火气热甚，则郁结坚硬如果中核也，不必溃发，但以热气散，则自消也。
注云∶三焦为水谷传化之路，热气甚，则传化失常，而吐下霍乱，火性燥动故也。
大法曰∶吐利烦渴为热，不渴〔为〕寒。或〔热〕吐〔泻〕，始得之亦有不渴者，若不
止，则亡液而后必渴也。或〔寒〕本不渴，若不止，〔亡〕津液过多，则亦燥而渴
也。若寒者，脉当沉细而迟；热者，脉当实大〔而〕数。或损气亡液过极，则脉亦不
能实数，而反缓弱也，虽尔，亦不为热矣。
The commentary states: Sudden and violent diarrhea (Bao Zhu) occurs when intestinal and stomach heat is excessive, leading to dysfunction in transmission and transformation. Since the nature of fire is rapid, this condition arises accordingly.
The commentary states: Tenesmus (Hou Zhong Li Ji) refers to a sense of urgency and painful straining in the lower abdomen. This is due to the rapid nature of fire and its ability to dry substances.
The commentary states: "Zhuan" refers to reverse flexion or spasmodic contraction. Heat scorching the sinews causes them to contract and become painful. The term "Zhuan" implies movement; Yang governs movement, while Yin governs stillness, clearly indicating a heat syndrome. This often results from extreme heat causing Huoluan (cholera-like vomiting and diarrhea), which weakens the Spleen and Stomach (Earth element), allowing the Liver Wood to become relatively excessive. Heat then dries the sinews, causing muscle cramps (Zhuan Jin). The general principle states: Thirst indicates heat. There has never been a case of Huoluan with muscle cramps without thirst. Alternatively, if not caused by vomiting and diarrhea but by external wind invasion closing the pores (Cou Li), causing Qi stagnation and internal accumulation of stifling heat (Fu Re), the heat dries the sinews, also causing muscle cramps. Therefore, for various muscle cramps, soaking in hot water opens the pores, dissipates the Yang Qi, and leads to recovery. Because recovery follows hot water soaking, it was mistakenly suspected to be a cold syndrome.
The commentary states: When the weather is hot, water becomes turbid; when cold, it remains clear. This is because the substance of water is clear, while the substance of fire is turbid. Furthermore, when clear water turns into hot soup, it naturally becomes turbid.
The commentary states: Qi belongs to Yang, and Yang represents heat; thus, excessive Qi results in this state.
The commentary states: The lesion is superficial and large. The Classic states: When heat overcomes blood, it forms carbuncles and pus.
The commentary states: The lesion is deep and loathsome.
The commentary states: A small boil with a head.
The commentary states: Superficial and small urticaria (Yin Zhen).
The commentary states: Red tumors (Dan Du/erysipelas) indicate heat overcoming Qi, reflecting the color of fire.
The commentary states: When fire-heat is extremely severe, it condenses and hardens like a pit in fruit. It does not necessarily need to suppurate; once the heat dissipates, it resolves spontaneously.
The commentary states: The San Jiao (Triple Burner) is the pathway for the transmission and transformation of food and fluids. When heat is excessive, transmission and transformation fail, resulting in vomiting, diarrhea, and Huoluan, due to the drying and agitating nature of fire. The general principle states: Vomiting and diarrhea with irritability and thirst indicate heat; absence of thirst indicates cold. In cases of heat-induced vomiting and diarrhea, there may initially be no thirst, but if it persists, fluid loss will inevitably lead to thirst. Conversely, cold syndromes typically present without thirst, but if prolonged, excessive loss of body fluids can cause dryness and thirst. For cold syndromes, the pulse should be deep, fine, and slow; for heat syndromes, the pulse should be full, large, and rapid. However, if Qi damage and fluid loss are extreme, the pulse may lose its fullness and rapidity, becoming instead slow and weak. Even so, it is no longer considered a heat syndrome.