【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。
[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).