治伤寒得汗。瘥后脾胃伤冷物。胸膈不快及寻常血气不和者。
人参 白术 甘草 橘皮（去白） 青皮（去瓤） 干姜（各等分）
上为末。每服三钱。水一盏。煎数沸。热服。入盐点。亦得。
琥按上方。乃温补中气之剂。其用青皮者。泻木。所以扶土。木为土之贼也。
海藏又云。大抵劳者。动也。动非一种。有内外血气之异焉。若劳乎气。无力与精神者。法宜微举之。若劳乎血与
筋骨者。以四物之类补之。若劳在脾。内为中州。调中可已。此为有形病也。但见外证。则谓之复病。非为劳也。如再
感风寒是已。
琥按上论云云。以病后内伤为劳。外感为复。此发仲景未发之旨。又其治有形病。以四物汤之类。其治无形病。
有微举法。又调中之法。未及论方。愚意云。大约是东垣补中益气之类耳。方不尽录。全在医者。以意取之。
云岐子云。大病瘥后。真气未全。强行房事。劳损督任二经。故少腹里急。或引阴中急痛。拘急。热气上冲胸。头
重不能举。目中生花。胫拘急。两足 脉督任四经病。可易取男子妇人 。烧之服。名烧 散。
琥按上论。当是男女劳复证。亦取 烧散者。乃相假而合治之法也。
琥又按阴阳易病。仲景不言何经。兹云督任受伤。阴阳 脉。四经合病。可谓畅发病情。又易老用烧 散。分寒热
而治。病在三阴。煎附子四逆等汤调下。如有热者。以鼠屎竹茹汤之类送下。可见古方。亦不可执也。
张兼善云。假如妇人病。新瘥。未平复而男子与之交。因感外邪而卒病。实非余邪相染。医见病速。谓之阴易于法。
何以别乎。夫易病者。有上条所见之证存焉。其与外所感。岂相侔哉。设若风寒外伤当有表证。安有少腹里急引阴中拘
挛者。乎。或又云假如男子病新瘥。未平复。强合阴阳而自病。仍小腹里急。引阴中。拘挛。证同易病。求其理。何故
不染易他人。而自复。未审其证治。可同何法也。病虽自复理与易同。亦用烧 散。以诱安其正气。夫易病之为合阴阳。
感动余邪。而其人正气本虚。故能染着。不然。安得受其邪哉。今病自复。缘正气尚虚。而余邪因动。悉非外感。故与
易同。亦用烧 散。以安正气。正气安。余邪自平矣。
琥按上张氏论。反复圆活。可谓发仲景之未发。要之既病易。复挟外感者。未必无之。此亦不可执也。
琥又按仲景止言阴阳易。而千金复增女劳复证。昔贤相传。阴阳易犹可生。若女劳复。必死者何也。愚以复病。由
病后正气大虚。余邪不能传易于人。因而自病。则多死。以其人不堪再病。故也。易病由病患正气稍复。不病之人。正
气反虚余邪遂至传易因而忽病。然犹可生。以其人病尚初发也。倘两人正气皆不虚。虽合阴阳。复者不复。易者。亦不
易矣。两人正气皆虚强合阴阳复者。自复。易者。自易。有同时而病者矣。巢氏病源云。易者。阴阳相感动。其毒度着
如人之换易也。若二男二女并不相易。愚又以二女。或不能易。若二男。亦有强相合者。焉知其不易也。古人着书。言
不尽意全在后学。以意会之。
琥又按烧 散一方。海藏云。若果得阴脉。各随三阴经。用四逆等汤调送下。此热因寒用也。吴仁斋以竹皮汤合主
之。此寒因热用也。娄全善煎人参汤调服。此虚者补之也。信哉。用药炎不可执也。
医林云离经脉见。多主死。太过曰至。一呼三至曰至。不及曰损。一呼一至曰损二脉。惟阴阳易病有之。
琥按脉一呼三至由可不死。余脉皆死。
（琥）总按伤寒阴阳易并瘥后病。仲景止引其端至诸家方论。各有变通。是皆彼此祖述。互相发明者也。至于瘥后
病。愚曾细阅病源千金外台等书证。非一候治亦多方。兹不能尽采附焉。
Treats patients who, after sweating in the course of Cold Damage (Shanghan), have damaged their Spleen and Stomach by consuming cold substances during convalescence, resulting in discomfort in the chest and diaphragm, as well as those with chronic disharmony of Qi and Blood.
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma), Gan Cao (Licorice Radix et Rhizoma), Ju Pi (Citri Reticulatae Pericarpium, remove white pith), Qing Pi (Citri Reticulatae Pericarpium Viride, remove seeds/pith), Gan Jiang (Zingiberis Rhizoma) — equal parts each.
Grind the above herbs into a fine powder. Take three qian per dose. Add one zhan of water, boil for several boils. Take hot. Adding a pinch of salt is also acceptable.
Wang Hu notes: The above prescription is a formula that warms and tonifies Middle Jiao Yuan Qi (Primary Qi of the Middle Burner). The use of Qing Pi is to drain Liver Wood Qi, thereby supporting Spleen Earth. Because excessive Wood becomes a thief to Earth.
Zhang Yuansu (Hai Zang) further states: Generally speaking, "Lao" (Consumptive Disease/Fatigue) refers to movement. This movement is not uniform; it differs between internal Qi-Blood disturbances and other types. If it is Qi Lao, characterized by weakness and listlessness, the treatment method should be to gently lift and raise Yang Qi. If it is Blood or Sinew-Bone Lao, tonify using formulas similar to Si Wu Tang (Four Substances Decoction). If the Lao affects the Spleen, located in the Central Region (Zhong Zhou), regulating the Middle can cure it. This belongs to diseases with tangible pathology. However, if only external symptoms are seen, it is called "Fu Bing" (Relapse Disease), not Lao. For example, contracting Wind-Cold again falls into this category.
Wang Hu notes: The aforementioned discussion defines post-illness internal injury as "Lao" and external contraction as "Fu". This elucidates principles not explicitly stated by Zhang Zhongjing. Furthermore, regarding the treatment of tangible diseases, formulas like Si Wu Tang are used; for intangible diseases, there is a method of gentle lifting; and methods for regulating the Middle are mentioned without specific formulas listed. My opinion is that these are likely similar to Li Dongyuan's Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). They are not fully recorded here; the physician must select them based on clinical judgment.
Yun Qi Zi states: After a major illness has resolved, if True Qi is not yet fully restored, forcing sexual intercourse will damage the Du Mai (Governing Vessel) and Ren Mai (Conception Vowel), leading to urgency and tightness in the lower abdomen, or pain radiating to the genitalia, muscle spasms, rising heat rushing to the chest, heaviness of the head making it difficult to lift, visual disturbances (seeing spots), calf spasms, and weakness in both feet. These are pathologies of the Du, Ren, Yin Wei, and Yang Wei vessels. One may alternatively use Shao Kun San (Burned Underwear Powder) for either men or women. Burn it and take it orally; it is named Shao Kun San.
Wang Hu notes: The above discussion refers to male and female Lao Fu (Post-illness Relapse due to Fatigue/Intercourse). The use of Shao Kun San here implies a therapeutic principle of mutual analogy and combined treatment.
Wang Hu further notes: Regarding Yin Yang Yi (Mutual Transmission of Pathogen via Intercourse), Zhang Zhongjing did not specify which meridians were injured. Here, it is stated that the Du and Ren meridians are injured, combining with Yin Wei and Yang Wei, affecting four meridians simultaneously. This thoroughly expounds the pathological mechanism. Additionally, Yi Lao (Zhang Yuansu) uses Shao Kun San, treating differently based on cold or heat patterns. If the disease is in the Three Yin meridians, administer the powder mixed with decoctions of Fu Zi Si Ni Tang (Aconite Four Reversal Decoction); if there is heat, send it down with formulas like Shu Shi Zhu Ru Tang (Mouse Dropping and Bamboo Sheath Decoction). This demonstrates that ancient prescriptions should not be applied rigidly.
Zhang Jianshan says: Suppose a woman has just recovered from an illness and her body has not yet stabilized, and she engages in intercourse with a man, thereby contracting external pathogens and falling ill suddenly. This is actually not a transmission of residual pathogens. Physicians seeing the rapid onset call it "Yin Yi" (Female Mutual Transmission). How can one distinguish it? The so-called Yi Bing (Transmission Disease) presents with the symptoms described in the preceding clause. Is it comparable to diseases caused by external pathogens? If it were merely Wind-Cold external invasion, there would be exterior syndrome signs. How could there be lower abdominal urgency radiating to genital spasms? Others say: Suppose a man has just recovered and forces intercourse, causing himself to fall ill, presenting with lower abdominal urgency and genital spasms, identical to Yi Bing. Seeking the rationale, why does he not transmit it to others but relapse himself? Without examining the syndrome and treatment, what method applies? Although the pathology is self-relapse, the principle is the same as Yi Bing; thus, Shao Kun San is also used to guide and stabilize Righteous Qi. The term "Yi Bing" implies that through intercourse, residual pathogens are stirred, and because the patient's Righteous Qi was originally deficient, transmission occurs. Otherwise, how could they receive the pathogen? Now, self-relapse occurs because Righteous Qi is still weak, and residual pathogens move accordingly; these are not external contractions. Hence, it is treated similarly to Yi Bing, using Shao Kun San to stabilize Righteous Qi. Once Righteous Qi is stable, residual pathogens naturally subside.
Wang Hu notes: Zhang's discussion above is comprehensive and flexible, elucidating points not previously made by Zhang Zhongjing. In summary, cases where Yi Bing or Fu Bing is complicated by external pathogens do exist. Rigidity in application is inadvisable.
Wang Hu further notes: Zhang Zhongjing only mentioned Yin Yang Yi, while Qian Jin Fang added the syndrome of Nv Lao Fu (Female Fatigue Relapse). Ancient sages transmitted that Yin Yang Yi could survive, but Nv Lao Fu was invariably fatal. Why? I believe that Fu Bing results from severe deficiency of Righteous Qi post-illness; residual pathogens cannot transmit to others and instead cause self-relapse, often leading to death because the body cannot withstand another illness. Yi Bing occurs when the patient's Righteous Qi has slightly recovered, but the healthy partner's Righteous Qi is relatively weak, allowing residual pathogens to transmit and cause sudden illness in the healthy person. Survival is possible because the new illness is in its early stage. If both parties have strong Righteous Qi, even with intercourse, neither will relapse nor transmit. If both have weak Righteous Qi and force intercourse, the sick party relapses, and the healthy party transmits; simultaneous illness may occur. Chao Yuanfang's *Zhu Bing Yuan Hou Lun* (Source Book of All Categories of Diseases) states: Yi Bing involves mutual stimulation of Yin and Yang, where toxic qi transfers and attaches, akin to changing clothes. Two men or two women do not transmit to each other. I argue that two women might not transmit; however, two men forcing intercourse—how do we know they do not transmit? Ancient authors' words do not always capture full intent; later scholars must interpret the meaning.
Wang Hu further notes: Regarding Shao Kun San, Zhang Yuansu states: If Yin pulses are indeed present, treat according to the Three Yin meridians using Si Ni Tang etc. for administration. This is "treating heat with cold" (using cold-natured delivery for heat pathology, or vice versa depending on interpretation context, here implying adapting vehicle to pulse). Wu Renzhai combines it with Zhu Pi Tang. This is "treating cold with heat". Lou Quanshan administers it with Ren Shen Tang. This is "tonifying the deficient". Indeed, the application of medicines must not be rigid.
*Yi Lin* states: The appearance of Li Jing Mai (Departing Pulse) mostly indicates death. Excessive speed is called "Zhi" (Arrival), defined as three beats per exhalation. Insufficient speed is called "Sun" (Damage), defined as one beat per exhalation. These two pulse conditions are unique to Yin Yang Yi disease.
Wang Hu notes: A pulse of three beats per exhalation may not necessarily lead to death; all other such abnormal pulses indicate death.
(Wang Hu) General Commentary: In Cold Damage, regarding Yin Yang Yi and post-illness syndromes, Zhang Zhongjing only introduced the beginning. Various schools' prescriptions and theories offer modifications. These are mutual inheritances and illuminations of each other. Regarding post-illness syndromes, I have carefully reviewed *Bing Yuan*, *Qian Jin*, *Wai Tai*, etc. The syndromes are numerous, and treatments are manifold. I cannot record them all here.