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The *Suwen* (Basic Questions) states: When a febrile disease has just subsided, why does residual heat sometimes remain? Qibo replied: In cases of residual heat, it is because food was forcibly consumed while the pathogenic heat was still intense. In such instances, although the disease has declined, heat remains latent within. The qi generated from the ingested grain combats with the residual heat, and the two heats merge, resulting in residual heat. How should this residual heat be treated? It is answered: Observe the deficiency or excess of the patient's constitution, and regulate the rebellious or smooth flow of qi; thus, the disease can certainly be cured.

The *Suwen* further states: What dietary prohibitions apply during a febrile disease? Qibo replied: When the symptoms of a febrile disease have slightly subsided, consuming meat will cause recurrence (*shi fu*, dietary relapse), and overeating will leave residual heat (*yi*). These are the prohibitions.

Zhang Zhongjing stated: For patients recovering from a major illness who suffer from relapse due to exertion (*lao fu*), Zhi Shi Zhi Zi Chi Tang (Immature Bitter Orange, Gardenia, and Fermented Soybean Decoction) is the primary treatment.

He also stated: After recovery from Shanghan (Cold Damage), if fever recurs, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is indicated. If the pulse is floating, resolve the exterior through sweating; if the pulse is sunken and excess (or tight), resolve the interior through purgation. Chang Qi stated that for sweating, Chai Hu Gui Zhi Tang (Bupleurum and Cinnamon Twig Decoction) is suitable, and for purgation, Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct Downward Decoction) is suitable.

He also stated: After recovery from a major illness, if there is fluid accumulation below the waist, Mu Li Ze Xie San (Oyster Shell and Alisma Powder) is indicated.

He also stated: After recovery from a major illness, if the patient frequently spits saliva without relief for a long time, it is due to cold in the chest. Pill medicines should be used to warm the middle jiao; Li Zhong Wan (Regulate the Middle Pill) is appropriate.

He also stated: After the resolution of Shanghan, if the patient is emaciated, short of breath, and experiences rebellious qi leading to nausea, Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) is indicated.

He also stated: If the patient’s pulse has normalized, but they feel slight vexation in the evening, it is because the disease has just healed, people force-feed them, and the spleen and stomach qi are still weak, unable to digest the food, causing slight vexation. Reducing food intake will lead to recovery.

Hua Tu (courtesy name Yuanhua) stated: After recovery from seasonal diseases, alcohol, meat, five pungent spices (garlic, chives, leeks, scallions, asafetida), oily noodles, raw/cold foods, sour/slick foods, and sexual intercourse must all be prohibited. This is the general principle.

Sun Simiao (honored as Zhenren) stated: After a febrile disease has just healed, or following a major illness, consuming pork, mutton, blood products, fatty fish, or greasy foods will inevitably cause severe diarrhea, which physicians cannot treat, leading to death. If one consumes cakes, millet, malt sugar, dried meat, raw fish slices, roasted meat, dates, chestnuts, various fruits, and jerky, or other hard-to-digest foods, the weak stomach qi cannot digest them, leading to stagnation and renewed heat. If purgatives are used, stomach qi becomes deficient and cold, causing incontinence; if not used, death ensues. Both outcomes are difficult to save. Many die after febrile or major illnesses due to this; caution is essential.

Sun Simiao further stated: For new recoveries, only gruel should be eaten. It is better to eat little and remain slightly hungry than to become full. Do not consume other foods, even if desired. As time passes and condition improves, lamb and white rice gruel can be gradually introduced. Broths may include pheasant, rabbit, or venison, but not pork or dog meat. New recoveries should rest quietly in bed. Early rising, combing hair, or washing the face should be avoided, as these labor the body. Excessive talking or mental exertion should also be avoided, as these cause mental fatigue. All these factors lead to *lao fu* (exertional relapse). For example, Gu Zixian, a district inspector, recovered from illness. Hua Shu diagnosed his pulse and said, "Although recovered, he is still weak and not fully restored; yang qi is insufficient. Avoid labor. Other labors are bearable, but sexual labor leads to death, characterized by the tongue protruding several inches." His wife traveled over a hundred li to visit him. After intercourse overnight, three days later he developed fever and trismus. He died with his tongue protruding several inches. Those who engage in sexual activity within one hundred days of recovery, when qi and strength are not yet restored, almost invariably die. An ancient man named Gai Zheng, sixty days after recovery, could walk and hunt, but died from salivation after sexual activity. Recently, a scholar engaged in sexual activity ten days after a major illness, suffered lower abdominal pain and limb spasms, and died.

Sun Simiao also stated: Within five days of recovering from a seasonal disease, eating any meat or noodles will cause the disease to recur with severe debility.

He also stated: Rising shortly after recovery and consuming alcohol or chives will cause the disease to recur.

He also stated: Eating raw fish or fresh seafood after new recovery causes unceasing diarrhea. Eating raw vegetables causes lifelong dull complexion. Eating raw fruits or lamb causes steaming heat above the diaphragm. Eating dog or mutton causes steaming heat in the bones. Eating fish, melons, or raw vegetables causes edema. Eating garlic and raw fish causes disease recurrence and severe debility. Drinking cold water immediately after sweating resolves the exterior, causing cold in the pericardium and weakness that cannot be replenished. Gu Yong stated: Shanghan and other heat-toxin diseases require strict vigilance against sequelae, fearing the reactivation of toxins. One instance is already severe; how much more so a second? Alcohol, dates, lamb, and dog meat are hot-natured foods; consuming them causes relapse and severe debility. After sweating or purging, both exterior and interior are deficient, and stomach qi is weak. Overeating, consuming raw/cold foods, or slight exertion will inevitably cause relapse. Is caution not necessary? Gu Yong observed many such cases in the north and noted调养 (nourishing/regulating) methods: For three days post-recovery, eat only white rice gruel and avoid speaking. After three days, add flavor to the gruel. After six days, eat very soft rice, adding thin noodles, scallion, and garlic soup. Combing hair and washing hands/feet are strictly forbidden. Since the disease often originates from the feet, even after twenty days, foot washing must be avoided to prevent relapse. Earlier texts differed on avoiding lamb vs. pork, but both should be avoided. Pork induces wind and diarrhea; lamb induces heat relapse. In northern regions, pork may be tolerated after one to two months, but lamb requires two months to a hundred days. Even fully recovered individuals should eat sparingly. Northern lamb broth is particularly heating; pork from Luoyuan rarely causes issues. However, from northwest to Qin/Jin, south to Han River, pork is forbidden, especially in Qin/Jin. Southern regions have abundant pork and lamb, but selection is crucial post-illness as zang-fu and qi-blood differ from normal times. Adhering to prohibitions for three days ensures safety for seven days; seven days ensures fourteen and twenty-one days; twenty-one days ensures one to three months. Proper initial care leads to rapid recovery. Sexual abstinence is required for one hundred days. Sun’s words must not be ignored. One relapse makes the condition worse than the original; a second relapse is worse than the first. Multiple relapses are unbearable, often leading to death. Wealthy families often indulge daughters; after sweating/purging, empty guts crave food, leading to indigestion and illness. Parents must understand, and attendants must regulate diet. If the patient prefers only white rice gruel post-recovery, disaster is averted.

*Qianjin Fang* (Prescriptions Worth a Thousand Gold) states: After Shanghan recovery, if headache, high fever, and vexation recur, Huang Long Tang (Yellow Dragon Decoction) is indicated.

It also states: For men recovering from new illness who relapse due to sexual activity, Chi Bi Shao San (Burnt Red Silk Powder) is indicated.

It also states: For relapse due to early rising or overexertion/diet, Shu Shi Chi Tang (Mouse Dropping and Fermented Soybean Decoction) is used. Cui’s formula adds Zhi Zi (Gardenia).

It also states: For indigestion after full meals and relapse with an excess pulse, Zhi Zi Xiang Chi Shu Shi Da Huang Fang (Gardenia, Aromatic Fermented Soybean, Mouse Dropping, and Rhubarb Formula) is indicated.

It also states: For *lao fu* with near-extinction of qi, Mai Men Dong Tang (Ophiopogon Decoction) is indicated. It revives the dying and alleviates exhaustion.

It also states: One year after Shanghan recovery, if water retention under the heart prevents eating, Di Huang Bai Zhu Mian Tang (Rehmannia and Atractylodes Noodle Decoction) is indicated.

Pang Anshi (known as Pang Shi) stated: After new recovery, qi, blood, and fluids are depleted. Avoid all activities. Mental labor from speech/thought, physical labor from grooming/bathing/exertion generates heat, causing relapse. Furthermore, essence and marrow are dry post-recovery; sexual activity is strictly forbidden and fatal, as seen in Gu Zixian. This is called *nv lao fu* (female-induced exertional relapse), distinct from *yin yang yi*. The *Suwen* notes that overeating causes indigestion and relapse, called *shi fu* (dietary relapse). Strong persons need two months of rest; weak persons need one hundred days to prevent relapse.

Pang Shi also stated: For epidemic *lao fu* with headache and limb pain, Cong Chi Shu Shi Tang (Scallion, Fermented Soybean, and Mouse Dropping Decoction) is excellent.

For epidemic *lao fu* with fever worsening from morning to night, accompanied by backache and stiff neck, Ge Gen Jiang Chi Tang (Kudzu, Ginger, and Fermented Soybean Decoction) is indicated.

For Shanghan relapse resembling the initial state with floating pulse and no sweat, Gui Zhi Zhi Zi Tang (Cinnamon Twig and Gardenia Decoction) is indicated. Remove Ma Huang (Ephedra) if spontaneous sweating occurs.

For Shanghan relapse with floating pulse and no sweat, the condition is severe.

For Shanghan relapse with spontaneous sweating, floating pulse, and severe irritability, Zhi Zi Shi Gao Xiang Chi Tang (Gardenia, Gypsum, and Fermented Soybean Decoction) plus male mouse droppings is indicated.

After recent recovery, if exertion causes fever, heat attacking the chest, and limb spasms resembling wind-stroke, Gua Lou Zhu Ru Tang (Trichosanthes and Bamboo Sap Decoction) is indicated.

For epidemic recovery relapse with fever, vomiting, and inability to eat, Lu Gen Ju Pi Tang (Phragmites Root and Tangerine Peel Decoction) is indicated.

For men relapsing due to sexual labor, Shu Shi Xie Gen Tang (Mouse Dropping and Shallot Root Decoction) is indicated. It also treats *yin yang yi* effectively.

For men relapsing from sexual labor with trismus and protruding tongue, death occurs. Initial *lao fu* with joint pain like beating, heaviness, confusion, and intermittent pulse is incurable. Uncontrollable salivation or delirious agitation is also incurable.

For women whose illness has not fully resolved, if moved by their husband, causing lower abdominal/genital pain, lumbar/hip pain, and immobility without fever, Fu Zi Huang Qin Tang (Aconite and Scutellaria Decoction) is indicated.

*Huoren Shu* (Book of Vitality) stated: New recovery leaves qi and blood deficient and fluids unreplenished. Exertion generates heat, which returns to the meridians, called *lao fu*. Zhang Zhongjing prescribed Xiao Chai Hu Tang. Dietary relapse (*shi fu*) occurs when strong eating after major illness causes stagnation and fever. Zhang Zhongjing added Rhubarb to Zhi Shi Zhi Zi Tang for retained food. Guang Ji’s Xiong Shu Shi Tang and Xu Renze’s Qi Wei Cong Bai Tang are also selectable options. Gu Yong noted that post-recovery grooming is easy to prohibit, but hunger leads to overeating and *shi fu*. While medication helps *lao fu*, repeated relapses are the concern.