注云∶言为〔心〕之声也。骂詈，言之恶也。今病阳实阴虚，则水弱火强，制金
而不能平木，而善言恶发，骂詈不避亲疏，〔本〕火热之所生也。
注云∶惊〔骇〕者，〔惊〕愕也，火之用也。
注云∶热胜〔肉〕而阳气郁滞故也。
注云∶酸疼也。由火实制金，不能平木，则木旺而为兼化，故酸疼也。
注云∶火气炎上故也。
注云∶战栗禁冷也。如丧神守者，神能御形，而反禁栗，则如丧失保守形体之神
也。
注云∶鼻中因痒，气〔喷作〕声〔也〕。鼻为肺窍，痒为火化，心火邪热，干于阳
明，发于鼻〔而〕痒，则〔嚏〕也。
注云∶君火〔化〕同也。
注云∶痹，不仁也，俗作闭，犹塞也。火主肿胀，故〔热客〕于上焦，而咽噎肿
胀也。
注云∶有声非妄闻也。耳为肾窍，交会〔手〕太阳、少阴、足厥阴、少阴、少阳
之经，若水虚火实，而热气上甚，客其经络，冲于耳中，则鼓其听〔户〕，随其脉气
微甚而作音声也。故经曰∶阳气为物，上甚而跃，故耳鸣也。然音在耳中，故微亦
闻之也。
注云∶聋为肾虚冷，俗已误之矣。夫《正理》曰∶心火本热，衰则寒矣；肾水本寒，
衰则热矣。肾水既少，岂能反为寒邪？故经言∶足少阴肾水虚，则〔腹〕满身重，濡
〔泻〕，疮疡，大便难，口苦，舌干，咽肿，上气，嗌干及痛，烦心心痛，黄胆，肠
下血，皆热证也。凡治聋者，适其所宜，若热证已退，其聋不已者，当以辛热发之；
二三服不愈者，不可久服，〔恐热极而成他病耳〕。若聋有热证相兼者，宜以散风退
热凉药调之，热退结散而愈也。然聋甚闭绝，亦为难矣。慎不可攻之，过极，则伤
正气也。
注解说：言语是心的声音表现。骂詈（恶语伤人），是言语中的恶劣表现。如今若患阳实阴虚之证，则肾水虚弱而心火强盛，制约肺金而不能平抑肝木，因而喜好恶言发作，骂詈时不分亲疏远近，这原本是由火热邪气所生成的病机。
注解说：惊骇，是指惊恐愕然的状态，这是火邪作用的表现。
注解说：这是因为热邪偏胜导致肌肉病变，且阳气郁滞不通的缘故。
注解说：酸疼，即肌肉酸痛。由于火邪强盛制约肺金，不能平抑肝木，致使肝木亢旺并发生兼化（五行相兼变化），因此出现酸疼的症状。
注解说：这是因为火性炎上的缘故。
注解说：战栗禁冷，是指身体颤抖且畏寒。所谓“如丧神守”，意思是神本应统御形体，现在反而出现颤抖畏寒，就像失去了能够保守形体的神志一样。
注解说：鼻中因发痒，气息喷出发出声音。鼻为肺之窍，痒感由火邪转化所致。心火与邪热干扰阳明经，引发于鼻部而产生痒感，从而引起喷嚏。
注解说：君火的变化与其他火相同。
注解说：痹症，指肢体麻木不仁，俗写作“闭”，意为闭塞。火邪主司肿胀，因此热邪客居于上焦，导致咽喉噎塞、肿胀。
注解说：耳鸣是有声而非胡乱听闻。耳为肾之窍，交会着手太阳、手少阴、足厥阴、足少阴、足少阳等经脉。若肾水虚弱而心火实盛，热气上冲严重，客居于经络，冲击耳中，震动其听户（听觉门户），随着脉气的微甚而发出声音。所以《内经》说：阳气作为物象，上冲过甚则跳跃，因此产生耳鸣。因为声音在耳中，所以无论声音大小都能听到。
注解说：耳聋被解释为肾虚寒冷，这是世俗的错误观点。《正理》中说：心火本性属热，衰退时才变寒；肾水本性属寒，衰退时才变热。既然肾水已经亏少，怎么能反而变成寒邪呢？所以经文说：足少阴肾水虚弱，会出现腹部胀满、身体沉重、濡泻（稀便）、疮疡、大便困难、口苦、舌干、咽喉肿痛、气逆上冲、咽干疼痛、心烦心痛、黄疸、肠下血等症状，这些都是热证。凡是治疗耳聋者，需适宜其证候。如果热证已退，但耳聋仍未痊愈，应当用辛热药物发散治疗；服用二三剂若不愈，不可久服，恐怕热极会引发其他疾病。若耳聋伴有热证夹杂者，宜用散风退热的凉药调理，待热退结散即可痊愈。然而耳聋严重至完全闭塞者，也难以治愈。切记不可攻伐太过，过度则会损伤正气。
Note states: Speech is the voice of the Heart (Shen). Malicious cursing (Malice in speech) represents the vicious aspect of speech. In cases of Excess Yang and Deficient Yin, Kidney Water is weak while Heart Fire is strong. This fails to control Lung Metal, thereby failing to pacify Liver Wood. Consequently, there is a propensity for vicious words to erupt, with cursing that disregards kinship or distance. This originates from the generation of Heat-Fire pathogenic factors.
Note states: Fright and alarm (Jing Hai) refer to a state of shock and astonishment, which is an effect of Fire.
Note states: This is due to Heat excess affecting muscles and the stagnation of Yang Qi.
Note states: Soreness and pain (Suan Teng). When Fire excess controls Lung Metal, it fails to pacify Liver Wood. Liver Wood becomes hyperactive and undergoes combined transformation (Jian Hua), resulting in soreness and pain.
Note states: This is because the nature of Fire is to flare upward.
Note states: Trembling and aversion to cold. The phrase "as if losing the guardian spirit" implies that while Spirit (Shen) should govern the body, the occurrence of trembling and fear indicates a loss of the Spirit's ability to conserve and protect the physical form.
Note states: Itching in the nose causes air to be expelled with sound. The nose is the orifice of the Lung. Itching arises from Fire transformation. When Heart Fire and evil heat interfere with the Yangming Meridian, manifesting as nasal itching, sneezing occurs.
Note states: The transformation of Ministerial Fire (Jun Huo) is similar [to other fires].
Note states: Bi Syndrome (Bi) refers to numbness and insensitivity, commonly written as "closed," meaning obstruction. Fire governs swelling; thus, when Heat pathogens lodge in the Upper Jiao, it results in throat obstruction, swelling, and distension.
Note states: Tinnitus involves sound and is not a hallucination. The ear is the orifice of the Kidney and intersects with the Hand-Taiyang, Hand-Shaoyin, Foot-Jueyin, Foot-Shaoyin, and Foot-Shaoyang meridians. If Kidney Water is deficient and Fire is excessive, with severe upward-rushing Heat lodging in the meridians and impacting the ears, it vibrates the auditory aperture. Sound is produced according to the strength or weakness of the meridian Qi. Thus, the Classics state: "When Yang Qi acts as a phenomenon, excessive upward rushing causes jumping, hence tinnitus." Since the sound is within the ear, even faint sounds are heard.
Note states: The notion that deafness is caused by Kidney deficiency and cold is a vulgar error. The *Zhengli* states: Heart Fire is inherently hot but becomes cold when deficient; Kidney Water is inherently cold but becomes hot when deficient. If Kidney Water is already scant, how can it transform into Cold Evil? Therefore, the Classics state: When Foot-Shaoyin Kidney Water is deficient, symptoms include abdominal fullness, heavy body, loose stools, sores and ulcers, difficulty in defecation, bitter taste in the mouth, dry tongue, swollen and painful throat, rebellious Qi rising, dry and painful pharynx, vexation and heart pain, jaundice, and blood in the stool. All these are Heat syndromes. In treating deafness, one must match the treatment to the syndrome. If Heat signs have subsided but deafness persists, acrid-warm herbs should be used to disperse it. If ineffective after two or three doses, prolonged use is contraindicated, lest extreme Heat generate other diseases. If deafness is accompanied by Heat signs, wind-dispersing and heat-clearing cooling herbs should be used to regulate the condition; once Heat recedes and stagnation resolves, recovery occurs. However, severe deafness leading to complete closure is difficult to treat. One must strictly avoid aggressive purging, as excessive treatment will damage Righteous Qi (Zheng Qi).