瘥后浮肿 伤寒瘥后。肢体浮肿者。脾虚有水故也。须实脾利水。宜冬术、茯苓皮、
米仁、扁豆、山药、木瓜、车前、泽泻之属治之。或以米仁、糯米煮粥食。佳。
邵评∶有不因于水而亦浮肿者。此元气大虚。肝木侮土。名为气肿。与水肿见象不同。须分别治之。
瘥后昏沉 伤寒瘥后十余日。或半月。渐至昏沉者。皆缘发汗未尽。余邪在于心
包故也。或兼潮热。或兼寒热似疟。宜连翘、栀子、豆豉、麦冬、菖蒲、淡竹叶、钩丁、丹参之类。清之解之。
邵评∶邪在心包。症见昏沉。然有痰热内伏者。亦见昏沉。宜分辨之。
汗后头疼 伤寒发汗后。热势略减。头痛仍在者。邪未尽也。宜再汗之。若汗后反
剧。而烦扰者。必挟火挟痰。或挟斑疹未透也。宜细审之。凡大汗后。热不退。脉
不静者。作危症断之。或误发温病湿温之汗。亦反剧。
邵评∶头疼虽是表症。然有肝阳痰火独热上攻诸内因。且有虚实不同。当审因治之。
解后额热 如热退后。额热未除。目神似觉呆钝。此胃中余滞未清。额属阳明。故
独热。宜清疏之。二陈、加连翘、黄芩、山楂、神曲之类。清之和之。
邵评∶胃中痰食邪热逗遛。故额热未除。阳明行身之前。额为阳位。阳盛则热也。清和的是正法。
解后腹热 如已身凉。独腹热未除。此脾火内甚也。养阴药中。加生白芍。自除。
瘥后耳聋 伤寒身凉后。尚有耳鸣耳聋等症。乃余邪留于少阳故也。宜养阴药
中加柴胡、菖蒲、钩丁、池菊、通草、荷叶之类。以清解少阳之郁。
邵评∶耳聋一症。半属少阳。然其因不一。有虚实之不同。肾开窍于耳。肾虚精脱。
则耳聋也。痰火上升。阻闭清窍。其耳亦聋。又温暑热病之耳聋。由于阴亏邪盛。
不关少阳。禁用柴胡升提。种种各因。虚实不同。当分别施治。
瘥后语蹇 伤寒热退之后。其舌转动不灵。语言蹇涩不清者。亦系邪留肝脾所
致。宜加味逍遥散。去白术、加生地、钩藤、菖蒲、蒺藜、天虫之类。
邵评∶心脾肾三经之脉。皆萦绕于舌。心肾虚。则舌不灵动。痰阻脾络。肝风内扰。
则语言蹇涩不清。总是虚风痰火为病。须分因治之。
瘥后不寐 伤寒热退之后。夜不欲寐者。胃不和也。温胆汤和之。惊悸不宁者。心
气虚也。加枣仁、远志。
解后咳嗽 如热退之后。尚有咳嗽未除。此余热在肺也。宜滋养肺胃之阴。其嗽
自止。如南沙参、麦冬、骨皮、知母、象贝、川斛、花粉、茯苓、杏仁、桑皮、蔗汁、梨汁之类。
或加生地、玉竹之类。
邵评∶凡感外邪而有病者。症见咳嗽。其病为轻。以其邪传入肺。肺主皮毛。邪从
外达也。内伤虚症。见咳则重。五脏传乘。肺受火刑。水源涸竭。每多死症。故咳嗽
一症。虚实病因。当细细分辨而治焉。
瘥后盗汗 伤寒瘥后。余热盗汗不止者。阴虚有火也。当归六黄汤加减。无热
恶寒。而盗汗不止者。阳虚也。黄 建中汤加减。
邵评∶阴亏火盛。内蒸燔灼。津液外泄也。育阴泻火固表为治。
自汗不止者。阳虚也。玉屏风加牡蛎、龙骨收之。
邵评∶卫阳虚弱。不能固护腠理。表虚而自汗出也。实表固涩之法。此方极验。
瘥后妄言 凡伤寒热病。每有身凉热退之后。其人如痴。言语谬妄者。此心神虚
散不复所致。但当调养气血。兼治其心。可也。神复。妄言自止。
邵评∶病退而妄言人痴。自是心神虚散。但痰火余邪。内伏包络肝胆诸经。亦有此症。当辨别论治。
瘥后吐涎沫 此土虚不能摄水也。六君加益智仁摄之。若其稠饮。自下焦漾漾
而起。溢退场门中者。此肾气不纳。浊阴上泛也。宜都气饮。加胡桃、补骨以纳之。或
少佐熟附以收之。或佐白术以制之。
邵评∶涎沫者。寒饮也。其人胃有寒饮。病后脾虚。土不制水。水饮上逆而吐也。病
属脾胃。尚在中焦。治以温胃和脾涤饮之法。若从下焦泛上而出者。是肾阳大
虚。阴浊上干。是肾水上泛之症。急当温纳肾阳。镇逆制水主治。
解后下血 伤寒解后。复有下血者。乃失汗之余邪也。当清之。生地、丹皮、地榆、川
断、槐米、魁芍、薏苡仁、黑荆芥之类治之。自愈。
邵评∶病解下血。由于初起失汗。邪不外达而内入。阳邪热盛。热伤阴络。而血下
溢也。治以清营凉血和络之法。
瘥后颐毒 颐毒因汗下清解未尽。其邪结于少阳阳明二经。发于两颐者。阳明
部位也。发于耳之左右者。少阳部位也。宜连翘败毒散。消散之。如二活、荆防、连
翘、赤芍、牛蒡、桔梗、土贝、蒺藜、薄荷、银花、甘草之类。少阳加柴胡。此症初起。速宜
消散。缓则成脓。如元气虚者。须兼归 补托。溃脓后。当大补气血为主。然发于
阳明者易治。发于少阳者难治。
邵评∶阳明多气多血。且为中土。万物所归。无所传变。故易治。少阳属胆。胆为清净之腑。受邪则难治。
瘥后酒复 伤寒身凉后。因饮酒复热。以酒性热有火。能助余邪故也。必兼烦闷
干呕。口燥不纳等症。急用川连、葛花、连翘、生栀、枳实、乌梅、银花等解之。
邵评∶余邪未尽。得酒以助其湿火。胃热气升而复病也。宜清热和胃治之。
瘥后食复 伤寒热退之后。胃气尚虚。余邪未尽。若纳谷太骤。则运化不及。余邪
假食滞而复作也。仍发热头痛。烦闷不纳。宜枳实栀子豉汤。加生楂肉、麦芽、连
翘、莱菔子等凉疏之。无火。舌润。不渴者。调中汤亦可。
瘥后劳复 伤寒瘥后。元气未复。余邪未清。稍加劳动。其热复作。即多语、梳头、洗
面、更衣之类。皆能致复。既经复热。必有余火余邪结于中。所以仲景主以枳实
栀子豉汤。盖豆豉撤表邪。栀子清里热。枳实开胸中余邪之结。凡治劳复。当以
此方为主。如兼呕恶痞满。加半夏、竹茹。如见舌黄口渴。加黄芩、连翘。如兼饱闷
挟食。加楂肉、麦芽。如兼头疼恶寒。加苏荷、葱白。如兼寒热。寒多加桂枝、紫苏。热
多加柴、芩。一二剂后。必复汗而解。此屡试屡验者。不可妄投补中。以致闭邪增病。
邵评∶病后元虚。余邪余火。留结于中。又加劳动。复受外邪。而病。故名劳复。此虚
而有邪。用表里并治之法。此与但虚无邪之劳复。自是二种。
气虚劳复 亦有瘥后。余火余邪已尽。止因正气大虚。因劳复热。微兼恶寒。四肢倦怠。
无气以动。脉虚右大。舌润无苔。胸膈宽畅者。此真气虚劳复也。宜补中益
气汤。甘温补之。升柴须蜜炙。汗多恶寒。归 建中妙。
邵评∶病退邪去。劳而复作。见症俱是虚象。与上条挟邪劳复之症不同。
阴虚劳复 热病伤阴。肾气已亏。稍加劳动。微挟风寒。其病复作。症仍头痛。发热。
恶风。舌燥口渴。六脉浮数者。此阴虚劳复也。凡复症。必挟风寒外邪。仍宜栀子。豉汤、加葱
白、薄荷、鲜生地、淡竹叶、麦冬、骨皮之类。微汗之。如兼太阳。加羌活。阳明加葛根。少阳加柴胡。
瘥后色复 伤寒瘥后。气血未充。早犯房事。则内损真气。外触邪气而复作也。其
症头重不举。目中生花。腰胁痛。小腹里急绞痛。憎寒发热。或阴火上冲。头面烘
热。胸中烦闷是也。若卵缩入腹。脉离经者死。舌伸出数寸者。亦死。宜六味饮。加
麦冬、豆豉、栀子。煎汤调下烧 散。若小腹急痛。脉沉足冷。须用当归四逆加吴
茱萸汤。煎成。调下烧 散。
邵评∶病后气阴两虚。早犯房事。真元大伤。而复着外邪。邪入下焦阴分。销烁阴
精。为病极重。临症极宜细辨。
阴阳易 男女新愈交接。病男传不病之女。曰阳易。病女传不病之男。曰阴易。此
感其余邪而生疾也。其症身重气乏。百节解散。头重不举。目中生花。热上冲胸。
憎寒壮热。头面大热。在男子。则阴肿。痛引小腹。在妇人。则里急。痛连腰胯。甚者
手足冷挛拳。男子卵陷入腹。妇人痛引阴中。皆难治也。若见舌吐出者死。治法
用竹茹半升煎汤。调下烧 散。有粘汗出。阴头微肿为效。或用韭白根一握。两
头尖十四枚。水煎候冷服。取粘汗为效。亦可调下烧 散。
瘥后调理 伤寒热退之后。有宜和中者。有宜养阴者。如其人中气虚者。病退
后。必纳谷少。运化迟。或大便不实。或恶心吐涎。宜六君子加减和中。形寒畏冷。
宜黄 建中温补之。凡此症。脉皆缓大。舌皆白嫩可辨。如其人阴分虚者。必
有余热未尽。舌燥口渴。二便艰涩。脉兼微数等症。宜生金滋水饮。或甘露饮加减养之。
邵评∶感症热退之后。有宜和中者。有宜养阴者。调理之法。须分阴虚气虚。
瘥后禁忌 大病后。正气未复。凡饮食起居。俱不可不慎也。如酒肴甘脆。肥鲜生
冷等物。皆不可犯。只宜糜粥自养。少食而频。则易运化。不可过饱。及他有所食。
虽思之。勿与也。新瘥后。当静卧。非但体动劳复。即梳头、洗面、濯足、多言。皆能
令人劳复。若新瘥未满百日。而犯房事者。不治。
Edema after Recovery
After the initial recovery from a Shanghan (Cold Damage) disease, if edema of the limbs occurs, it is due to Spleen deficiency leading to water retention. Treatment must strengthen the Spleen and promote diuresis. It is appropriate to use herbs such as Bai Zhu (Atractylodis Rhizoma), Fu Ling Pi (Poria Peel), Yi Yi Ren (Coicis Semen), Bian Dou (Dolichoris Lablabis Semen), Shan Yao (Dioscoreae Rhizoma), Mu Gua (Chaenomelis Fructus), Che Qian Zi (Plantaginis Semen), and Ze Xie (Alismatis Rhizoma). Alternatively, cooking Yi Yi Ren and Nuomi (Glutinous Rice) into porridge for consumption is beneficial.
Shao's Commentary: There are cases of edema not caused by water accumulation but by severe depletion of Yuan Qi (Original Qi), where Liver Wood overacts on Spleen Earth, termed "Qi Edema." Its presentation differs from Water Edema, requiring differentiated treatment.
Mental Cloudiness after Recovery
Ten days or half a month after the initial recovery from Shanghan, if mental cloudiness gradually develops, it is because sweating was incomplete, leaving residual pathogens in the Pericardium (Xin Bao). This may be accompanied by tidal fever or alternating chills and fever resembling malaria. It is appropriate to use herbs such as Lian Qiao (Forsythiae Fructus), Zhi Zi (Gardeniae Fructus), Dou Chi (Sojae Preparata Semen), Mai Dong (Ophiopogonis Radix), Chang Pu (Acori Tatarinowii Rhizoma), Dan Zhu Ye (Lophatheri Herba), Gou Teng (Uncariae Ramulus cum Uncis), and Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma) to clear heat and resolve stagnation.
Shao's Commentary: Pathogens in the Pericardium manifest as mental cloudiness. However, internal phlegm-heat can also cause cloudiness; differentiation is necessary.
Headache after Sweating
After sweating for Shanghan, if the fever subsides slightly but headache persists, the pathogen has not been fully cleared. Re-sweating is appropriate. If the condition worsens after sweating with irritability, it indicates an accompaniment of Fire, Phlegm, or unexanthematous macules/rashes. Careful examination is required. In cases of profuse sweating where fever does not subside and the pulse remains restless, it should be judged as a critical condition. Misapplying sweating methods for Warm Diseases or Damp-Warmth diseases can also lead to worsening conditions.
Shao's Commentary: Although headache is a exterior syndrome, it can also result from internal factors such as rising Liver Yang or Phlegm-Fire, presenting as either deficiency or excess. Etiology must be assessed for treatment.
Forehead Heat after Resolution
If forehead heat persists after fever subsides, accompanied by a dull gaze, it is due to residual stagnation in the Stomach. The forehead belongs to the Yangming channel, hence the isolated heat. Clearing and dispersing is appropriate. Er Chen Tang (Two-Aged Decoction) with added Lian Qiao, Huang Qin (Scutellariae Radix), Shan Zha (Crataegi Fructus), and Shen Qu (Medicated Leaven) can be used to clear heat and harmonize.
Shao's Commentary: Phlegm-food stagnation and residual pathogens lingering in the Stomach cause persistent forehead heat. The Yangming channel runs along the anterior body, and the forehead is a Yang position; Yang excess generates heat. Clearing and harmonizing is the correct method.
Abdominal Heat after Resolution
If the body is cool but abdominal heat persists, this indicates excessive internal Spleen Fire. Adding Sheng Bai Shao (Raw Paeoniae Radix Alba) to Yin-nourishing formulas will naturally resolve it.
Deafness after Recovery
After the body cools down post-Shanghan, tinnitus or deafness may persist due to residual pathogens remaining in the Shaoyang channel. It is appropriate to add Chai Hu (Bupleuri Radix), Chang Pu, Gou Teng, Chi Ju (Chrysanthemi Flos), Tong Cao (Tetrapanacis Medulla), and He Ye (Nelumbinis Folium) to Yin-nourishing formulas to clear and resolve Shaoyang stagnation.
Shao's Commentary: Deafness is partly related to the Shaoyang channel, but causes vary, including deficiency and excess. The Kidney opens into the ears; Kidney deficiency and essence depletion cause deafness. Rising Phlegm-Fire blocking the clear orifices also causes deafness. Furthermore, deafness in Warm/Summer-heat diseases stems from Yin deficiency and pathogen excess, unrelated to Shaoyang, so Chai Hu (which lifts) is contraindicated. Different etiologies require differentiated treatments.
Slurred Speech after Recovery
After fever subsides in Shanghan, if tongue movement is stiff and speech is slurred and unclear, it is caused by pathogens lingering in the Liver and Spleen. Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) is appropriate, removing Bai Zhu and adding Sheng Di Huang (Rehmanniae Radix), Gou Teng, Chang Pu, Ji Li (Tribuli Fructus), and Tian Chong (Bombyx Batryticatus).
Shao's Commentary: The meridians of the Heart, Spleen, and Kidney all surround the tongue. Heart/Kidney deficiency leads to tongue stiffness. Phlegm obstructing Spleen collaterals and internal stirring of Liver Wind lead to slurred speech. These are always diseases of deficient wind, phlegm, and fire, requiring etiology-based treatment.
Insomnia after Recovery
After fever subsides in Shanghan, inability to sleep at night indicates Disharmony of the Stomach. Wen Dan Tang (Warm Gallbladder Decoction) harmonizes this. Palpitations and restlessness indicate Heart Qi deficiency; add Suan Zao Ren (Ziziphi Spinosae Semen) and Yuan Zhi (Polygalae Radix).
Cough after Resolution
If cough persists after fever subsides, residual heat remains in the Lung. Nourishing Lung and Stomach Yin will stop the cough naturally. Herbs include Nan Sha Shen (Adenophorae Radix), Mai Dong, Gu Pi (Cortex Lycii), Zhi Mu (Anemarrhenae Rhizoma), Xiang Bei (Fritillariae Thunbergii Bulbus), Chuan Hu (Dendrobii Caulis), Hua Fen (Trichosanthis Radix), Fu Ling, Xing Ren (Armeniacae Semen Amarum), Sang Bai Pi (Mori Cortex), Zhe Zhi (Sacchari Candidi Sucus), and Li Zhi (Pyrri Fructus). Sheng Di Huang and Yu Zhu (Polygonati Odorati Rhizoma) may also be added.
Shao's Commentary: Cough in external contraction diseases is mild because the pathogen enters the Lung, which governs skin and hair, allowing expulsion from outside. In internal injury deficiency patterns, cough is severe; transmission among organs affects the Lung with Fire, drying up the Water source, often leading to death. Thus, cough requires careful differentiation of deficiency/excess etiology.
Night Sweats after Recovery
Post-Shanghan night sweats persisting due to residual heat indicate Yin deficiency with Fire. Dang Gui Liu Huang Tang (Angelica Six-Huang Decoction) modified is used. Night sweats without heat but with aversion to cold indicate Yang deficiency; Huang Qi Jian Zhong Tang (Astragalus Build the Middle Decoction) modified is used.
Shao's Commentary: Yin deficiency with vigorous Fire steams internally, causing fluid leakage. Treatment involves nourishing Yin, draining Fire, and consolidating the exterior.
Spontaneous sweating that does not stop indicates Yang deficiency. Yu Ping Feng San (Jade Windscreen Powder) plus Mu Li (Ostrea Concha) and Long Gu (Fossilia Ossis Mastodi) consolidates the exterior.
Shao's Commentary: Deficient Wei Yang fails to secure the pores, causing spontaneous sweating due to exterior deficiency. Consolidating the exterior and astringing is effective with this formula.
Delirious Speech after Recovery
In Shanghan febrile diseases, after the body cools and fever subsides, patients may appear dazed and speak deliriously. This is due to the scattering of Heart Spirit without recovery. Tonifying Qi and Blood while treating the Heart is sufficient. Once the Spirit recovers, delirium ceases.
Shao's Commentary: Delirium after illness indicates scattered Heart Spirit. However, residual Phlegm-Fire lurking in the Pericardium and Liver/Gallbladder meridians can also cause this; differentiation is needed.
Saliva and Froth after Recovery
This is due to Spleen Earth deficiency failing to control Water. Liu Jun Zi Tang (Six-Gentlemen Decoction) plus Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) controls it. If thick fluids rise from the lower Jiao and overflow from the mouth, it is Kidney Qi failing to grasp, with turbid Yin flooding upward. Du Qi Yin (Duqi Drink) plus Walnut and Bu Gu Zhi (Psoraleae Fructus) grasps Qi. Shu Fu Zi (Prepared Aconiti Lateralis Radix) can be added to astringe, or Bai Zhu to restrain.
Shao's Commentary: Saliva/froth is cold-fluid retention. Post-illness Spleen deficiency allows Cold-Fluid in the Stomach to reverse upward. Disease is in the Middle Jiao (Spleen/Stomach); treat by warming Stomach, harmonizing Spleen, and eliminating fluid. If rising from the Lower Jiao, it is severe Kidney Yang deficiency with Yin-Turbidity flooding; urgently warm and grasp Kidney Yang, suppress rebellion, and control water.
Blood in Stool after Resolution
Hematochezia after resolution of Shanghan is due to residual pathogens from missed sweating. Clearing is appropriate. Use Sheng Di Huang, Mu Dan Pi (Moutan Cortex), Di Yu (Sanguisorbae Radix), Chuan Duan (Dipsaci Radix), Huai Mi (Sophorae Flavescentis Flos), Chi Shao (Paeoniae Radix Rubra), Yi Yi Ren, and Hei Jing Jie (Schizonepetae Herba Carbonisata) to cure spontaneously.
Shao's Commentary: Hematochezia after resolution stems from missed early sweating, preventing external expulsion and forcing pathogens inward. Excess Yang-Heat damages Yin collaterals, causing bleeding downward. Treat by clearing Ying level, cooling Blood, and harmonizing collaterals.
Cheek Abscess after Recovery
Cheek abscess results from incomplete sweating, purging, or clearing, with pathogens knotting in the Shaoyang and Yangming channels. Eruptions on the cheeks belong to Yangming; those around the ears belong to Shaoyang. Lian Qiao Bai Du San (Forsythia Resolving Toxin Powder) disperses them. Herbs include Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), Lian Qiao, Chi Shao, Niu Bang Zi (Arctii Fructus), Jie Geng (Platycodonis Radix), Tu Bei Mu (Fritillariae Cirrhosae Bulbus), Ji Li, Bo He (Menthae Haplocalycis Herba), Yin Hua (Lonicerae Japonicae Flos), and Gan Cao (Glycyrrhizae Radix et Rhizoma). Add Chai Hu for Shaoyang. Early rapid dispersion is crucial; delay leads to suppuration. For deficient Yuan Qi, add Dang Gui (Angelicae Sinensis Radix) to tonify and push out toxin. After suppuration, major tonification of Qi and Blood is primary. Yangming eruptions are easy to treat; Shaoyang eruptions are difficult.
Shao's Commentary: Yangming has abundant Qi and Blood and belongs to Central Earth, accepting all pathogens without transmission, hence easy to treat. Shaoyang belongs to Gallbladder, a pure organ, difficult to treat when invaded.
Relapse due to Alcohol after Recovery
After body cooling in Shanghan, relapse of fever due to alcohol consumption occurs because wine is hot and fiery, aiding residual pathogens. Symptoms include irritability, dry retching, dry mouth, and anorexia. Urgently use Chuan Lian (Coptidis Rhizoma - *Note: Text says Chuan Lian but context implies Huang Lian/Coptis based on standard practice for clearing heat, though strictly translating text as written*), Ge Hua (Puerariae Flos), Lian Qiao, Sheng Zhi Zi, Zhi Shi (Aurantii Fructus Immaturus), Wu Mei (Mume Fructus), and Yin Hua to resolve.
Shao's Commentary: Residual pathogens aided by wine's damp-heat cause Stomach heat and rising Qi, re-inducing illness. Treat by clearing heat and harmonizing Stomach.
Relapse due to Food after Recovery
After fever subsides in Shanghan, Stomach Qi is still weak and residual pathogens remain. Rapid food intake overwhelms transformation, allowing residual pathogens to recur via food stagnation. Symptoms include recurrent fever, headache, irritability, and anorexia. Zhi Shi Zhi Zi Chi Tang (Immature Bitter Orange, Gardenia, and Fermented Soybean Decoction) plus raw Hawthorn, Mai Ya (Hordei Fructus Germinatus), Lian Qiao, and Lai Fu Zi (Radish Seed) clears and disperses coolly. Without Fire signs, moist tongue, and no thirst, Tiao Zhong Tang (Harmonize Middle Decoction) is also suitable.
Relapse due to Labor after Recovery
After initial recovery from Shanghan, if Yuan Qi is unrecovered and residual pathogens uncleared, slight labor causes fever recurrence. Activities like talking excessively, combing hair, washing face, or changing clothes can trigger relapse. Recurrent fever indicates residual Fire/pathogens knotting in the Middle. Zhang Zhongjing advocates Zhi Shi Zhi Zi Chi Tang. Dou Chi releases exterior pathogens, Zhi Zi clears interior heat, and Zhi Shi opens chest stagnation. This formula is primary for labor relapse. Add Ban Xia (Pinelliae Rhizoma) and Zhu Ru (Bambusae Caulis in Taenia) for vomiting/fullness. Add Huang Qin and Lian Qiao for yellow tongue/thirst. Add Hawthorn and Mai Ya for food stagnation. Add Su Ye (Perillae Folium), Bo He, and Cong Bai (Allii Fistulosi Bulbus) for headache/chills. Add Gui Zhi (Cinnamomi Ramulus) and Zi Su for chills; add Chai Hu and Huang Qin for heat. One to two doses usually induce sweating and resolution. Do not misuse tonics to trap pathogens.
Shao's Commentary: Post-illness deficiency with residual pathogens/fire, aggravated by labor and new external pathogens, is called Labor Relapse. This is deficiency with pathogens, treated by addressing both interior and exterior. This differs from labor relapse with only deficiency and no pathogens.
Qi Deficiency Labor Relapse
Sometimes, after recovery, residual fire/pathogens are gone, but severe Zheng Qi deficiency causes fever upon labor, with slight chills, limb fatigue, lack of energy, deficient/right-large pulse, moist tongue without coating, and open chest/diaphragm. This is True Qi deficiency labor relapse. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment Qi Decoction) tonifies with sweet-warm properties. Sheng Ma and Chai Hu must be honey-fried. For heavy sweating and chills, Huang Qi Jian Zhong Tang is excellent.
Shao's Commentary: After pathogen clearance, relapse due to labor shows purely deficiency symptoms, differing from the previous pathogen-accompanied labor relapse.
Yin Deficiency Labor Relapse
Febrile disease damaging Yin and depleting Kidney Qi, combined with slight labor and minor Wind-Cold, causes relapse with headache, fever, aversion to wind, dry tongue/thirst, and floating-rapid pulse. This is Yin deficiency labor relapse. Relapse syndromes always involve external Wind-Cold. Use Zhi Zi Chi Tang plus Cong Bai, Bo He, Xian Sheng Di Huang, Dan Zhu Ye, Mai Dong, and Gu Pi to induce slight sweating. Add Qiang Huo for Taiyang, Ge Gen (Puerariae Lobatae Radix) for Yangming, and Chai Hu for Shaoyang.
Relapse due to Sexual Activity after Recovery
After Shanghan recovery, if Qi and Blood are not replenished and sexual activity occurs early, internal damage to True Qi and external contact with pathogens cause relapse. Symptoms include heavy head unable to lift, visual disturbances ("seeing flowers"), waist/flank pain, lower abdominal urgency/cramping, aversion to cold/fever, or surging Yin Fire causing facial flushing and chest irritability. If testicles retract into abdomen or pulse is irregular/deadly, prognosis is fatal. Tongue protruding several inches is also fatal. Liu Wei Di Huang Yin (Six-Ingredient Rehmannia Drink) plus Mai Dong, Dou Chi, and Zhi Zi, taken with Shao Kun San (Burned Underwear Powder), is indicated. For lower abdominal urgency/cold feet, Dang Gui Si Ni Jia Wu Zhu Yu Tang (Angelica Four-Cold Plus Evodia Decoction) taken with Shao Kun San is used.
Shao's Commentary: Post-illness Qi/Yin deficiency and early sexual activity severely damage True Yuan, inviting external pathogens into the Lower Jiao Yin aspect, consuming Yin essence. This is severe and requires careful differentiation.
Yin-Yang Exchange
Intercourse shortly after recovery transmits disease. Sick male to healthy female is Yang Exchange. Sick female to healthy male is Yin Exchange. This arises from residual pathogens. Symptoms include heavy body, fatigue, joint laxity, heavy head, visual disturbances, heat rushing to chest, aversion to cold/high fever, and facial heat. In males: scrotal swelling, pain radiating to lower abdomen. In females: inner urgency, pain radiating to waist/hips. Severe cases: cold/contracted hands/feet, testicular retraction, vaginal pain. All are difficult to treat. Protruding tongue is fatal. Treatment: Decoct Ban Xia (Pinelliae Rhizoma) - *Note: Text says Zhu Ru (Bambusae Caulis in Taenia) half sheng*, take with Shao Kun San. Sticky sweat and slight penile swelling indicate efficacy. Alternatively, boil Jiu Bai Gen (Allii Tuberosi Radix) with 14 tips of both ends, cool, and drink. Sticky sweat indicates efficacy. Can also take with Shao Kun San.
Post-Recovery Regulation
After Shanghan fever subsides, some need harmonizing Middle, others need nourishing Yin. If Middle Qi is deficient, appetite is low, digestion slow, stool loose, or nausea/saliva after illness. Liu Jun Zi Tang modified harmonizes Middle. Aversion to cold requires Huang Qi Jian Zhong Tang to warm/tonify. Pulse is slow-large, tongue white/tender. If Yin aspect is deficient, residual heat remains: dry tongue/thirst, difficult urination/bowel, micro-rapid pulse. Sheng Jin Zi Shui Yin (Generate Metal Nourish Water Drink) or Gan Lu Yin (Sweet Dew Drink) modified nourishes.
Shao's Commentary: After fever subsides, regulation depends on distinguishing Yin vs. Qi deficiency.
Post-Recovery Taboos
After major illness, before Zheng Qi recovers, diet and lifestyle must be cautious. Avoid alcohol, rich/greasy foods, sweets, raw/cold items. Only consume millet porridge for self-nourishment. Eat small amounts frequently for easy digestion. Do not overeat. Even if craving other foods, do not give. Rest quietly after recovery. Physical movement causes labor relapse. Combing hair, washing face, foot bathing, and excessive talking also cause labor relapse. Sexual activity within 100 days of recovery is incurable.