（附阴阳易）
【因】喻嘉言云。伤寒瘥后。热毒遗于精髓中者。无由发泄。骤难消散。故新瘥人与不病患交媾。
而无病之人反得病也。男病新瘥。妇人与之交合而得病。名曰阳易。妇人病新瘥。男子与之交合而得病。
名曰阴易。所以呼为易者。以阴阳相感动。其毒遗着于人。如换易然也。若新瘥人。因交合而自病复发。
不遗传与人。谓之房劳复。钱天来云。男女一交之后。自然元气空虚。余邪错杂于精气之中。走入精隧。
溢入经络。乘其交后虚隙之中。入而浸深于藏府筋骨脉络俞穴之间。则正气因邪而益虚。邪气因虚而益盛。
故有此阴盛阳衰之诸证也。邪入阴经。身体必重。真阳亏虚。三焦不运。宗气不行。所以少气。邪从阴
窍而溜入少阴厥阴。故少腹里急。若里急之甚。或引阴中拘挛。皆阴邪之所致也。阴邪在下。而虚阳上
走。故热上冲胸。头重不欲举。眼中生花。下焦虚冷。所以膝胫拘急也。此真所谓阴阳之患。故以烧
散主之。
【证】其候身重气乏。百节解散。头重不举。目中生花。热上冲胸。火浮头面。憎寒壮热。在男子则
阴肿。少腹绞痛。在妇人里急。连腰胯内痛。甚者。手足冷挛蜷。男子卵陷入腹。妇人痛引阴中。皆难
治也。其有不即死者。筋脉
缓弱。血气虚。骨髓竭。恍恍翕翕。（《千金方》作嘘嘘吸吸。）气力转少。着床不能动摇。起止仰人。或牵
引岁月方死矣。舌出数寸者死。若卵缩入阴。手足拳亦死。
【脉】虚弱者。脉微。四肢逆冷者。脉沉。离经脉见者死。
【治】《伤寒蕴要》云。房劳复。阴阳易。仲景治以烧 散。（治男子病、用妇人 裆近阴处、一
般样、剪取一块、烧灰、调入药服、或白汤下、亦治妇人、取男子 裆如前法。）水服方寸匕。日三服。
小便即利。阴头微肿。此为愈矣。（方义）钱天来云。男女之交媾。易所谓二气感应。以相与也。
以未净之邪随交合之情。精神魂魄。无不动摇。翕然而感。感而遂通。混入于少阴之里。故以近阴处之 裆。
引出其阴中之邪。所谓物从其类。同气相求之义也。
【廉勘】病后气阴两虚。早犯房事。真元大伤。而复触外邪。深入下焦阴分。销烁阴精。为病极重。其症
头重不举。目中生花。腰胁痛。小腹里急绞痛。增寒发热。或阴火上冲。头面烘热。胸中烦闷是也。宜用吴氏
六味饮。加麦冬、豆豉、栀子、煎汤。调下烧 散。若小腹急痛。脉灶足冷。须用当归四逆。加吴茱萸汤。煎
成、调下烧 散。
【炳章按】王士雄云。阴阳二易。余谓之热入血室症。第阴易较重于阳易。以女人病热之气。本从阴户出
也。古人用烧 之义最精。取其能引热邪。仍由原路去。故阴易须剪所交接女人未浣 裆。《千金》用月经
赤帛。亦从此脱胎。《活人书》治房劳头重眼花。小腹绞痛。用 鼠粪汤。（鼠粪两头尖者十四粒、韭白根一握、
水二钟煎。）不可热服。随症加减。有粘汗为效。或调烧 散、同服。女劳复。头重目花。腹中绞痛有热者。
用刮青竹皮半升。煎服。随症加减。调烧 散。赤衣散。（治女劳复、并阴易、以室女月经布近阴处、剪一方、烧灰、
调药服下。）虚弱脉微者。以四君子汤。送烧 散。或人参三白汤。调赤衣散服之。小腹里急。脉沉逆
冷、当归四逆汤。加附子、吴萸。送赤衣散。仍以吴萸一升。酒炒熨少腹。大便不通。昏乱惊惕者。宜妙香丸。
（辰砂三钱、冰片三分、腻粉、麝香、牛黄各三分、金箔五张、巴豆霜一钱、上为末、另研入黄蜡三钱、
蜜一匙、同炼匀、和药为丸、每两作三十丸。）弱者、服三丸。壮者五丸。米汤送下。大便通即止。若妇人病
未平复。有犯房事。小腹急痛。连腰胯痛。四肢不仁。无热者。宜当归白术散。（当归、白术、附子、桂
枝、炙甘、白芍、黄 、人参、姜、枣、水煎。）调服烧 散。阴阳易病。热气上冲。胸中烦闷。手足挛
拳。搐搦如风状者。宜栝蒌竹茹汤。（栝蒌根、青竹茹、水煎。）吞服烧 散。易老则分寒热而治。若伤
在少阴肾经。有寒无热者。以附子汤。调下烧 散。若伤在厥阴肝经者。以当归四逆汤。加吴茱萸、附子。
送下烧 散主之。如有热者、以鼠屎竹茹汤之类。送下烧 散主之。要在审察脉证。分其寒热而治矣。
《阴证咯例》云。阴阳房劳。果得阴脉。当随证用之。若脉在厥阴。当归四逆汤。送下烧 散。若脉在
少阴。通脉四逆汤。送下烧 散。若脉在太阴。四顺理中丸。送下烧 散。王肯堂曰。尝治伤寒病未
平复。犯房室。命在须臾。用独参汤。调烧 散。凡服参一二斤余。得愈者三四人。信哉、用药不可
执一也。
又按 余尝治温热瘥后房复。头重眼花。腰背痛。小腹里急绞痛。串胯筋挛。身热。心胸烦闷。便闭
溲短。用鼠屎二钱。人中白三钱、晚蚕砂三钱。鲜生地五钱、捣生锦纹一钱。蜣螂虫一钱。桃仁钱半。冬
葵子三钱。川黄柏一钱。木通钱半。甘草梢八分。取其以浊导浊。效如桴 。经治验多人。而不用烧
散亦能取效。王士雄云。竹茹、花粉、韭白、滑石、白薇、川楝子、槐米、绿豆、甘草梢、土茯苓等药。亦可采用。
(Attached: Yin-Yang Exchange)
[Etiology] Yu Jiayan stated: After the recovery from Shanghan (Cold Damage), heat toxins remain lodged in the essence and marrow, with no outlet for discharge, making it difficult to dissipate rapidly. Therefore, if a person who has just recovered engages in sexual intercourse with a healthy individual, the healthy person may contract the disease. If a man who has just recovered engages in intercourse with a woman and she contracts the disease, it is called "Yang Yi" (Yang Exchange). If a woman who has just recovered engages in intercourse with a man and he contracts the disease, it is called "Yin Yi" (Yin Exchange). It is termed "Exchange" because of the mutual induction between Yin and Yang, where the residual toxin transfers to the other person, akin to an exchange. If a recently recovered person suffers a relapse due to sexual activity without transmitting the disease to others, it is called "Fang Lao Fu" (Relapse due to Sexual Exhaustion). Qian Tianlai stated: Following sexual intercourse, Yuan Qi (Original Qi) naturally becomes deficient. Residual pathogens mix with Jing Qi (Essence-Qi), enter the spermatic channels, overflow into the meridians, and take advantage of the bodily deficiency after intercourse to penetrate deeply into the Zang-Fu organs, sinews, bones, collaterals, and Shu points. Consequently, Zheng Qi (Upright Qi) becomes more deficient due to the pathogen, and the pathogen becomes more vigorous due to the deficiency, leading to various syndromes of Yin excess and Yang deficiency. When pathogens invade the Yin meridians, the body becomes heavy. Due to the deficiency of True Yang, the San Jiao (Triple Burner) fails to transport and transform, and Zong Qi (Gathering Qi) fails to circulate, resulting in shortness of breath. Pathogens slip from the Yin orifices into the Shaoyin (Lesser Yin) and Jueyin (Terminal Yin) meridians, causing lower abdominal urgency and pain. If the urgency is severe, it may牵引 (draw) to spasms and cramping in the genitalia, all caused by Yin pathogens. With Yin pathogens below and deficient Yang floating upward, heat rushes to the chest, the head feels heavy and unwilling to lift, vision blurs ("seeing flowers"), and due to cold deficiency in the Lower Jiao, the knees and calves become stiff and cramped. This is truly a disorder of Yin and Yang, hence treated with Shao Kun San (Burning Underwear Powder).
[Symptoms] The manifestations include heaviness of the body, lack of breath, sensation of joints loosening and falling apart, heavy head unable to be lifted, blurred vision, heat rushing to the chest, fire floating on the head and face, aversion to cold with high fever. In men, there is swelling of the penis and colicky pain in the lower abdomen; in women, there is lower abdominal urgency and pain radiating to the waist and hips. Severe cases present with cold, cramped, and curled hands and feet; in men, the testicles retract into the abdomen; in women, pain radiates to the vagina. These are difficult to treat. Those who do not die immediately exhibit flaccid tendons and vessels, deficiency of Blood and Qi, exhaustion of bone marrow, and shallow, rapid breathing (described as "xu xu xi xi" in *Qianjin Fang*). Strength diminishes, inability to move while lying in bed, requiring assistance to rise or walk, or death after dragging on for months. Protrusion of the tongue several inches indicates death; retraction of the testicles into the scrotum or clenched fists that cannot be extended also indicate death.
[Pulse] In deficiency cases, the pulse is faint (Wei). In cases of cold extremities, the pulse is deep (Chen). The appearance of Li Mai (Departing Pulse) indicates death.
[Treatment] *Shanghan Yun Yao* states: For Fang Lao Fu and Yin-Yang Exchange, Zhang Zhongjing used Shao Kun San. (For treating men, cut a piece of the woman's underwear near the crotch, burn it to ash, mix with medicine and ingest, or swallow with plain water; similarly for women, use the man's underwear). Take one Cun Bi (approx. 3-5 grams) mixed with water, three times daily. Upon urination becoming smooth and slight swelling of the glans penis, the patient is cured. [Formula Rationale] Qian Tianlai stated: Sexual intercourse represents the mutual induction of Yin and Qi described in the I Ching. Unresolved pathogens, driven by sexual desire, shake the Spirit and Soul, inducing connection, allowing pathogens to mix into the interior of the Shaoyin. Thus, the underwear near the crotch is used to draw out pathogens from the Yin, embodying the principle that "objects follow their kind, and similar energies attract."
[Lian Kan (Clinical Analysis)] After illness, both Qi and Yin are deficient. Early engagement in sexual activity severely damages True Yuan, and external pathogens touch the surface, penetrating deep into the Yin aspect of the Lower Jiao, consuming Yin Essence. The disease is extremely severe. Symptoms include heavy head unable to lift, blurred vision, waist and hypochondriac pain, lower abdominal urgency and colic, chills and fever, or Yin Fire rushing upward causing facial flushing and chest oppression. It is appropriate to use Wu Shi Liu Wei Yin (Wu's Six-Ingredient Decoction), add Mai Dong (Ophiopogonis Radix), Dou Chi (Fermented Soybean), and Zhi Zi (Gardeniae Fructus), decoct in water, and take with Shao Kun San. If there is lower abdominal urgency and pain, with a deep pulse and cold feet, use Dang Gui Si Ni Tang (Angelica Sinensis Decoction for Cold Extremities) added with Wu Zhu Yu Tang (Evodia Decoction), decoct, and take with Shao Kun San.
[Bingzhang's Note] Wang Shixiong stated: Yin-Yang Exchange is what I call Re Ru Xue Shi (Heat Entering the Blood Chamber), though Yin Yi is heavier than Yang Yi because the heat qi of a sick woman originates from the vaginal orifice. The ancient use of Shao Kun San is exquisite, as it guides heat pathogens out through their original pathway. Hence, for Yin Yi, one must cut the un-washed underwear of the woman engaged in intercourse. *Qianjin Fang*'s use of menstrual cloth derives from this. *Huo Ren Shu* treats Fang Lao with head heaviness, blurred vision, and lower abdominal colic using Shu Fen Tang (Mouse Feces Decoction: 14 mouse feces with pointed ends, a handful of Chinese Leek roots, decocted in two cups of water). Do not take hot; modify according to symptoms. Efficacy is indicated by sticky sweating. Alternatively, take with Shao Kun San. For female sexual relapse with head heaviness, blurred vision, colicky abdominal pain, and heat, scrape half a Sheng of green bamboo skin, decoct, modify according to symptoms, and take with Shao Kun San. Chi Yi San (Red Cloth Powder): Treats female sexual relapse and Yin Yi. Cut a square of virgin girl's menstrual cloth near the crotch, burn to ash, mix with medicine and ingest. For weak patients with faint pulses, use Si Jun Zi Tang (Four Gentlemen Decoction) to deliver Shao Kun San, or Ren Shen San Bai Tang (Ginseng Three Whites Decoction) to deliver Chi Yi San. For lower abdominal urgency, deep pulse, and cold extremities, use Dang Gui Si Ni Tang added with Fu Zi (Aconiti Lateralis Radix Praeparata) and Wu Zhu Yu (Evodiae Fructus), delivering Chi Yi San. Also, stir-fry one Sheng of Wu Zhu Yu with wine and apply as a warm compress to the lower abdomen. For constipation, confusion, and palpitations, use Miao Xiang Wan (Wonderful Incense Pill): Chen Sha (Cinnabar) 3 qian, Bing Pian (Borneolum Syntheticum) 0.3 qian, Ni Fen (Calomelas), She Xiang (Moschus), Niu Huang (Bovis Calculus) each 0.3 qian, Jin Bo (Gold Leaf) 5 sheets, Ba Dou Shuang (Crotonis Semen Pulvis) 1 qian. Grind to powder, separately grind Huang La (Beeswax) 3 qian and Honey 1 spoon, refine together, mix with medicine to form pills. Each liang of powder makes 30 pills. Weak patients take 3 pills, strong patients take 5 pills, delivered with Rice Decoction. Stop when stool passes. If a woman's illness has not resolved and she engages in intercourse, causing lower abdominal urgency and pain radiating to the waist/hips, numbness of limbs, and no fever, use Dang Gui Bai Zhu San (Angelica and Atractylodes Macrocephala Powder): Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Zi, Gui Zhi (Cinnamomi Ramulus), Zhi Gan Cao (Prepared Licorice Root), Bai Shao (Paeoniae Radix Alba), Huang Qi (Astragali Radix), Ren Shen (Ginseng Radix), Sheng Jiang (Zingiberis Rhizoma Recens), Da Zao (Jujubae Fructus), decoct in water, and take with Shao Kun San. For Yin-Yang Exchange with heat rushing upward, chest oppression, and hand/foot cramping/spasming like wind syndrome, use Gua Lou Zhu Ru Tang (Trichosanthes Root and Bamboo Sap Decoction): Gua Lou Gen (Trichosanthis Radix), Qing Zhu Ru (Bambusa Caulis in Taenia), decoct in water, and swallow with Shao Kun San. Yi Lao differentiated treatment by Cold and Heat. If injury is in the Shaoyin Kidney Meridian, with Cold but no Heat, use Fu Zi Tang (Aconite Decoction) delivered with Shao Kun San. If injury is in the Jueyin Liver Meridian, use Dang Gui Si Ni Tang added with Wu Zhu Yu and Fu Zi, delivered with Shao Kun San. If there is Heat, use Shu Shi Zhu Ru Tang (Mouse Feces and Bamboo Sap Decoction) or similar, delivered with Shao Kun San. The key is to examine Pulse and Symptoms, differentiate Cold and Heat, and treat accordingly. *Yin Zheng Ge Li* states: For Yin-Yang sexual relapse, if a Yin pulse is obtained, treat according to the syndrome. If the pulse is in Jueyin, use Dang Gui Si Ni Tang delivered with Shao Kun San. If in Shaoyin, use Tong Mai Si Ni Tang (Pulse-Recovering Decoction for Cold Extremities) delivered with Shao Kun San. If in Taiyin, use Si Shun Li Zhong Wan (Four-Obedient Regulating Middle Pill) delivered with Shao Kun San. Wang Kentang stated: I once treated a case where Shanghan had not resolved, and the patient engaged in intercourse, life hanging by a thread. I used Du Shen Tang (Single Ginseng Decoction) to deliver Shao Kun San. Patients who consumed over one to two jin of Ginseng recovered in three or four cases. Indeed, medication should not be applied rigidly.
Furthermore: I once treated cases of relapse after Warm Disease recovery due to sexual activity, presenting with head heaviness, blurred vision, back pain, lower abdominal urgency and colic, cramping radiating to the hips, fever, chest distress, constipation, and scanty urine. I used Shu Fen (Mouse Feces) 2 qian, Ren Zhong Bai (Nitrified Soil) 3 qian, Wan Can Sha (Mulberry Silkworm Feces) 3 qian, Xian Sheng Di (Fresh Rehmanniae Radix) 5 qian, Dao Sheng Jin Wen (Fresh Rhubarb) 1 qian, Qiang Lang Chong (Dung Beetle) 1 qian, Tao Ren (Pruni Semen) 1.5 qian, Dong Kui Zi (Malvae Semen) 3 qian, Chuan Huang Bo (Phellodendri Cortex) 1 qian, Mu Tong (Akebiae Caulis) 1.5 qian, Gan Cao Shao (Licorice Tip) 0.8 qian. This utilizes turbid substances to guide out turbidity, yielding immediate results. Verified on many patients, effective even without Shao Kun San. Wang Shixiong stated: Zhu Ru (Bambusa Caulis in Taenia), Hua Fen (Trichosanthis Radix), Jiu Bai (Chinese Leek White), Hua Shi (Talcum), Bai Wei (Cynanchi Atrati Radix), Chuan Lian Zi (Toosendan Fructus), Huai Mi (Sophorae Flos), Lu Dou (Phaseoli Volubilis Semen), Gan Cao Shao, Tu Fu Ling (Smilacis Glabrae Rhizoma) can also be adopted.