雄按∶杏仁、浓朴、半夏、旋复花、枇杷叶、蒌仁、芦菔、海蜇、芦根之类，皆可随证采用。本方地、芍宜去之。
汪按∶下条亦宜去地、芍。
淫热熏蒸，湿浊壅遏，则周身发黄。宜本方增石膏、栀子，加茵陈、滑石、猪苓、泽泻、木通。汪按∶湿盛而用石
膏。似宜佐以苍术、浓朴之类。
雄按∶此证亦有宜下者。汪按。青壳鸭蛋敲小孔纳朴硝于孔中纸封炖熟。日日服之。义取一补一消。治黄胆甚效。
余尝亲试之。初时便溏不爽。服朴硝而便反干畅矣。
疫证循衣摸床、撮空，此肝经淫热也。肝属木，木动风摇，风自火出。《左传》云∶“风淫末疾”，四末四肢也。肢动
即风淫之疾也。宜本方增石膏、犀、连、栀、丹，加胆草。
雄按∶桑枝、菊花、丝瓜络、羚羊角、白薇之类，皆可采用。实者，宜兼通腑；虚者，宜兼养阴。
狐蜮，宜本方增石膏、犀角，加苦参、乌梅、槐子。以上五十证，热疫恶候，变态无恒，失治于前，多致莫救。慎
之！慎之！
疫证热毒盘踞于内，外则遍体炎炎。夫热极之病，是必投以寒凉。火被水克，其焰必伏。火伏于内，必生外寒。阴
阳相搏则战，一战而经气输泄，大汗出而病邪解矣。
疫证瘥后，四肢浮肿，弗遽温补。
雄按∶宜清余热，兼佐充津。
瘥后饮食渐增，而大便久不行，亦无所苦。此营液未充，若误投通利，死不终朝矣。汪按∶宜食黑脂麻。热疫为病，
气血被其煎熬，瘥后饮食渐进，气血滋生，润皮肤而灌筋骸。或痛或痒，宛如虫行，最是佳境，不过数日，气血通畅而
自愈矣。疫证失治于前，热流下部，滞于经络，以致腰膝疼痛，甚者起不能立，卧不能动，误作痿治，必成废人。宜本
方小剂，加木瓜、牛膝、续断、萆 、黄柏、威灵仙。瘥后，不欲饮食，食亦不化。此脾胃虚弱，宜健脾养胃。
雄按∶不欲食，病在胃，宜养以甘凉。食不化，病在脾，当补以温运。医者，须分别论治。汪按。叶香岩论脾胃辨
析最明畅。余以为胜于东垣之专事升脾。学人所当师法也。
瘥后惊悸，属血虚。宜养血镇惊。
雄按∶亦有因痰热未清者，不可不知也。汪按∶因痰者颇多。
瘥后怔忡，乃水衰火旺，心肾不交。宜补水养心。
雄按∶朱砂安神丸最妙。汪按∶亦有兼挟痰者。
瘥后，有声不能言，此水亏不能上接于阳也。宜补水。
雄按∶有痰热滞于肺络者宜清肃；有疫热耗伤肺阴者宜清养。不仅水亏为然也。
瘥后，声颤无力，语不接续，名曰郑声。乃气虚也。宜补中益气汤。汪按∶第五卷方论不录此方，附论在清暑益气
汤下。
雄按∶此证虽属气虚，实由元气无根，补中益气，升阳之剂，切勿误投。宜集灵膏。
瘥后喜唾，胃虚而有余热也。乌梅十个、北枣五枚，俱去核，共杵如泥，加炼蜜丸弹子大，每用一丸噙化。
雄按∶此方甚佳。
言者，心之声也。病中谵妄，乃热扰于心。瘥后多言，余热未净。譬如灭火，其火已息，犹存余焰也。
雄按∶宜导赤散加麦冬、莲子心、朱砂染灯心。
瘥后遗精，宜交心肾。
雄按∶精因火动者多，宜清余热，黄连、黄柏，最是要药。
瘥后触事易惊，梦寐不安，乃有余热挟痰也。痰与气搏故恐惧。
雄按∶宜用竹茹、黄连、石菖蒲、半夏、胆星、栀子、知母、茯苓、旋复花、橘红等药。
瘥后，终日昏睡不醒。或错语呻吟，此因邪热未净，伏于心包络所致。
雄按∶宜用丹参、白薇、栀子、麦冬、甘草、木通、盐水炒黄连、竹叶、朱砂染灯心、细茶等药。挟痰者，花粉、
天竺黄、石菖蒲，省头草之类。或万氏牛黄清心丸，皆可采用。
瘥后自汗、盗汗，虚象也，宜分阴阳而补益。
雄按∶固属虚候，多内余热未清，心阳内炽，慎勿骤补，清养为宜。如西洋参、生地、麦冬、黄连、甘草、小麦、
百合、竹叶、茯苓、莲子心之类，择而为剂可也。
瘥后心神不安，乃心血亏损。宜养心。
雄按∶固是心营不足，亦因余热未清，治如上条可也。
瘥后虚烦不寐者，血虚神不守舍也。
雄按∶非神不守舍也，亦余火扰动耳！治如上法，或加阿胶、或加生鸡子黄、或加珍珠，审证而用得其宜，贵乎医
者之神悟矣。
瘥后余热未净，肠胃虚弱，饮食不节，谷气与热气，两阳相搏，身复发热，名曰食复。
雄按∶治法与伤寒食复同，更有瘥后起居不慎，作劳太早，虚阳浮扰而发热者，名曰劳复。治宜调气血。
瘥后早犯女色而病者，名女劳复；女犯者，为男劳复。其证头重目眩，腰痛肢酸，面热如烘，心胸烦闷。宜麦冬汤
主之。若舌出寸余，累日不收，名曰阳强。以冰片研细糁之，即缩。长至数寸者，多不救。
雄按∶此方甚妙。宜加竹茹枸杞子。
男子新瘥，余热未净，而女人与之交接得病者，名阳易；女人新瘥，余热未清，而男子与之交接得病者，名阴易。
其证男子则阴肿入腹，绞痛难忍；女人则乳抽里急，腰胯痛引腹内。热攻胸膈，头重难抬，仰卧不安，动摇不得。最危
之证。
雄按∶阴阳二易，余谓之热入精室证。第阴易较重于阳易，以女人疫热之气，本从阴户出也。古人用 裆之义最精，
取其能引热邪，仍由原路去，故阴易，须剪所交接。女人身穿未浣之 裆，《千金》用月经赤帛，亦从此脱胎。阳易，须
剪所交接。男子身穿未浣之 裆。并取近阴处之数寸，烧灰服下，奏效甚捷。后人之用鼠矢，亦取其以浊导浊之义。然
究不如烧 散之贴切矣。余如竹茹、花粉、韭白、滑石、白薇、槐米、楝实、绿豆、甘草梢、土茯苓等药，并走精室，
皆可随证采用。以上三条，温热病后亦同，不仅疫证尔也。
王士雄按语：杏仁、厚朴、半夏、旋覆花、枇杷叶、瓜蒌仁、萝卜、海蜇、芦根等药物，都可以随证选用。本方中的地黄、芍药应当去掉。
淫热熏蒸，湿浊壅遏，则全身发黄。适宜在本方基础上增加石膏、栀子，加入茵陈、滑石、猪苓、泽泻、木通。汪氏按语：湿气盛而使用石膏，似乎应当佐以苍术、厚朴之类。
王士雄按语：此证也有适宜用下法的。汪氏按语：取青壳鸭蛋敲一个小孔，将朴硝纳入孔中，用纸封口炖熟。每日服用。其义理在于一补一消。治疗黄疸非常有效。
我曾亲自尝试过。起初大便溏薄不爽，服用朴硝后大便反而干燥通畅了。
疫病出现循衣摸床、撮空理线等症状，这是肝经淫热所致。肝属木，木动则风摇，风自火出。《左传》说：“风淫末疾”，四末即四肢。肢体动摇就是风淫之疾。适宜在本方基础上增加石膏、犀角、黄连、栀子、丹皮，加入龙胆草。
王士雄按语：桑枝、菊花、丝瓜络、羚羊角、白薇等药物，都可以采用。实证，适宜兼用通腑法；虚证，适宜兼用养阴法。
狐惑病，适宜在本方基础上增加石膏、犀角，加入苦参、乌梅、槐子。以上五十种证候，是热疫的危重征象，变化无常，如果在前期失治，大多导致无法救治。务必谨慎！务必谨慎！
疫病热毒盘踞在体内，体表则遍体发热。凡是热极的病，必须投以寒凉药物。火被水克制，火势必然潜伏。火伏于内，必然产生外寒。阴阳相互搏结则发生战栗，一次战栗后经络之气输泄，大汗出而病邪解除。
疫病痊愈后，四肢浮肿，不要急于温补。
痊愈后饮食逐渐增加，但大便长期不通行，也没有其他痛苦。这是营血津液未充盈，如果误用通利药物，病人不到半天就会死亡。汪氏按语：适宜食用黑芝麻。热疫病，气血被其煎熬，痊愈后饮食渐进，气血滋生，滋润皮肤并灌注筋骨。或者疼痛或者瘙痒，宛如虫行，这是最好的境界，不过几天，气血通畅而自愈了。疫病如果在前期失治，热流注下部，阻滞于经络，以致腰膝疼痛，严重的起立不能，卧床不能动，误当作痿证治疗，必定成为废人。适宜用小剂量的本方，加入木瓜、牛膝、续断、萆薢、黄柏、威灵仙。痊愈后，不想吃东西，吃了也不消化。这是脾胃虚弱，适宜健脾养胃。
王士雄按语：不想吃，病在胃，适宜用甘凉之品滋养。吃不消化，病在脾，应当用温运之品补益。医者，必须分别论治。汪氏按语：叶天士论述脾胃辨析最明畅。我认为他胜过李东垣专门从事升提脾气。学者应当效法。
王士雄按语：也有因为痰热未清的，不可不知道这一点。汪氏按语：因为痰导致的很多。
王士雄按语：有痰热阻滞于肺络的适宜清肃；有疫热耗伤肺阴的适宜清养。不仅仅是水亏才这样。
痊愈后，声音颤抖无力，言语不接续，名叫郑声。这是气虚。适宜补中益气汤。汪氏按语：第五卷方论没有收录此方，附论在清暑益气汤下面。
王士雄按语：此证虽然属于气虚，实际上是由于元气无根，补中益气、升阳的药物，千万不要误用。适宜集灵膏。
痊愈后喜欢吐唾沫，是胃虚而有余热。乌梅十个、北枣五枚，都去核，一起捣成泥状，加炼蜜制成弹子大的丸药，每次用一丸含化。
王士雄按语：这个方子很好。
言语，是心的声音。病中谵妄，是热扰于心。痊愈后多言，是余热未净。就像灭火一样，火已经熄灭，还存有余焰。
王士雄按语：精因火动的情况多，适宜清余热，黄连、黄柏是最主要的药物。
痊愈后触事易惊，梦寐不安，是有余热挟痰。痰与气搏结所以恐惧。
王士雄按语：适宜用竹茹、黄连、石菖蒲、半夏、胆南星、栀子、知母、茯苓、旋覆花、橘红等药物。
痊愈后，整天昏睡不醒。或者错语呻吟，这是因为邪热未净，伏在心包络所致。
王士雄按语：适宜用丹参、白薇、栀子、麦冬、甘草、木通、盐水炒黄连、竹叶、朱砂染灯心草、细茶等药物。挟痰的，花粉、天竺黄、石菖蒲、省头草之类。或者万氏牛黄清心丸，都可以采用。
王士雄按语：确实属于虚候，多因内余热未清，心阳内炽，千万不要骤补，清养为宜。如西洋参、生地、麦冬、黄连、甘草、小麦、百合、竹叶、茯苓、莲子心等药物，选择作为药剂即可。
王士雄按语：确实是心营不足，也因为余热未清，治疗如上条所述即可。
痊愈后虚烦不寐，是血虚神不守舍。
王士雄按语：不是神不守舍，也是余火扰动罢了！治疗如上法，或者加阿胶、或者加生鸡蛋黄、或者加珍珠，审察证候而使用得当，贵在医者的神悟。
痊愈后余热未净，肠胃虚弱，饮食不节，谷气与热气，两阳相搏，身体再次发热，名叫食复。
王士雄按语：治疗方法与伤寒食复相同，更有痊愈后起居不慎，劳作太早，虚阳浮扰而发热的，名叫劳复。治疗适宜调气血。
痊愈后过早犯女色而病的，名叫女劳复；女人犯的，为男劳复。其证头重目眩，腰痛肢酸，面热如烘，心胸烦闷。适宜麦冬汤主治。如果舌头伸出寸余，多天收不回，名叫阳强。用冰片研细撒在上面，即缩回。长至数寸的，大多无法救治。
男子新近痊愈，余热未净，而女人与之交接得病的，名叫阳易；女人新近痊愈，余热未清，而男子与之交接得病的，名叫阴易。
其证男子则阴肿入腹，绞痛难忍；女人则乳抽里急，腰胯痛引腹内。热攻胸膈，头重难抬，仰卧不安，动摇不得。是最危险的证候。
王士雄按语：阴阳二易，我称之为热入精室证。只是阴易比阳易重，因为女人的疫热之气，本来从阴户出来。古人用裤裆的意义最精妙，取其能引热邪，仍由原路出去，所以阴易，须剪下所交接时女人身穿未洗的内裤，《千金方》用月经赤帛，也是从此脱胎。阳易，须剪下所交接时男人身穿未洗的内裤。并取靠近阴处之数寸，烧灰服下，奏效很快。后人用鼠矢，也是取其以浊导浊的意义。然而终究不如烧裤裆散贴切。其余如竹茹、花粉、韭白、滑石、白薇、槐米、楝实、绿豆、甘草梢、土茯苓等药物，都走精室，都可以随证选用。以上三条，温热病后也一样，不仅限于疫病。
Wang Shixiong's commentary: Almond (Xingren), Magnolia Bark (Houpo), Pinellia Rhizome (Banxia), Inula Flower (Xuanfuhua), Loquat Leaf (Pipaye), Trichosanthes Fruit (Gualouren), Radish (Lufu), Jellyfish (Haihe), and Reed Rhizome (Lugen) can all be selected according to the syndrome. The Rehmannia Root (Dihuang) and Peony Root (Shaoyao) in this formula should be removed.
Wang's commentary: The following clause also suggests removing Rehmannia Root (Dihuang) and Peony Root (Shaoyao).
Exuberant heat steaming and damp-turbidity obstructing will cause yellowing of the whole body. It is appropriate to add Gypsum (Shigao) and Gardenia (Zhizi) to this formula, and add Yinchen (Artemisia Capillaris Herb), Talcum (Huashi), Polyporus (Zuling), Alisma Rhizome (Zexie), and Akebia Caulis (Mutong). Wang's commentary: When dampness is abundant and Gypsum (Shigao) is used, it seems appropriate to assist with Atractylodes Rhizome (Cangzhu) and Magnolia Bark (Houpo).
Wang Shixiong's commentary: This syndrome may also require purgation. Wang's commentary: Take a green-shelled duck egg, make a small hole, insert Mirabilite (Puxiao) into the hole, seal with paper, and steam until cooked. Take daily. The principle lies in one tonifying and one reducing. It is very effective for treating jaundice.
I have personally tried it. Initially, the stool was loose and unsatisfactory; after taking Mirabilite (Puxiao), the stool became dry and smooth.
In epidemic febrile diseases, behaviors such as grasping at clothes and picking at empty air indicate exuberant heat in the Liver Meridian. The Liver belongs to Wood; when Wood moves, Wind shakes, and Wind arises from Fire. The *Zuo Zhuan* states: "Wind causes disorders in the extremities." The four extremities are the limbs. Limb tremors are the disorder caused by Wind. It is appropriate to add Gypsum (Shigao), Rhinoceros Horn (Xijiao - note: modern substitutes like Water Buffalo Horn are used), Coptis Rhizome (Lian), Gardenia (Zhizi), and Moutan Cortex (Danpi) to this formula, and add Gentian Root (Longdancao).
Wang Shixiong's commentary: Mulberry Twig (Sangzhi), Chrysanthemum (Juhua), Luffa Network (Sigualuo), Antelope Horn (Lingyangjiao), and Anemone Root (Baiwei) can all be adopted. For excess syndromes, it is appropriate to combine with methods to unblock the bowels; for deficiency syndromes, it is appropriate to combine with nourishing Yin methods.
For Hu-Huo disease (Fox-Hu Syndrome, characterized by oral/genital ulcers), it is appropriate to add Gypsum (Shigao) and Rhinoceros Horn (Xijiao) to this formula, and add Sophora Root (Kushen), Plum Fruit (Wumei), and Sophora Seed (Huaizi). The above fifty syndromes are severe manifestations of epidemic heat, varying constantly. If mismanaged initially, they often lead to untreatable conditions. Be cautious! Be cautious!
When epidemic heat-toxin lodges internally, the exterior presents with generalized fever. For diseases of extreme heat, cold-cooling herbs must be administered. When Fire is controlled by Water, its flame must subside. When Fire subsides internally, external cold necessarily arises. When Yin and Yang contend, chills occur. After one episode of chills, the Qi of the meridians is discharged, profuse sweating occurs, and the pathogenic factor is resolved.
After recovery from an epidemic disease, if the limbs swell, do not rush to use warming-tonifying methods.
Wang Shixiong's commentary: It is appropriate to clear residual heat and simultaneously supplement fluids.
If dietary intake gradually increases after recovery but defecation remains prolonged without discomfort, this indicates that Ying-Fluids are not yet replenished. If purgatives are mistakenly administered, death may occur within half a day. Wang's commentary: Black Sesame Seed (Heizhima) should be eaten. Epidemic heat diseases consume Qi and Blood; as diet gradually resumes post-recovery, Qi and Blood regenerate, moistening the skin and nourishing the sinews and bones. Pain or itching, resembling insect crawling, is a favorable sign. Within a few days, Qi and Blood flow smoothly, and self-healing occurs. If the epidemic disease was mismanaged initially, heat flows downward and stagnates in the meridians, causing lower back and knee pain. Severe cases result in inability to stand or move. Misdiagnosing this as Wei Syndrome (Flaccidity Syndrome) will inevitably lead to disability. It is appropriate to use a small dose of this formula, adding Quince (Mugua), Achyranthes Root (Niuxi), Dipsacus Root (Xuduan), Dioscorea Hypoglauca Rhizome (Bixie), Phellodendron Bark (Huangbai), and Clematis Root (Weilingxian). Post-recovery, loss of appetite and indigestion indicate Spleen-Stomach deficiency; it is appropriate to strengthen the Spleen and nourish the Stomach.
Wang Shixiong's commentary: Loss of appetite indicates pathology in the Stomach; it is appropriate to nourish with sweet-cool substances. Indigestion indicates pathology in the Spleen; it is appropriate to tonify with warm-moving substances. Physicians must differentiate and treat accordingly. Wang's commentary: Ye Tianshi’s discussion on differentiating Spleen and Stomach is the clearest. I believe he surpasses Li Dongyuan’s focus solely on lifting Spleen Qi. Scholars should emulate him.
Palpitations and fright after recovery belong to Blood deficiency. It is appropriate to nourish Blood and calm fright.
Wang Shixiong's commentary: There are also cases due to unresolved Phlegm-Heat; this must be known. Wang's commentary: Cases due to Phlegm are numerous.
Palpitations after recovery indicate Water deficiency and Fire hyperactivity, with Heart-Kidney non-interaction. It is appropriate to tonify Water and nourish the Heart.
Wang Shixiong's commentary: Cinnabar Anshen Pill (Zhusha Anshen Wan) is excellent. Wang's commentary: There are also cases complicated by Phlegm.
Post-recovery, having voice but being unable to speak indicates Yin deficiency failing to connect upward with Yang. It is appropriate to tonify Yin.
Wang Shixiong's commentary: Cases with Phlegm-Heat obstructing the Lung collaterals should be cleared and purified; cases where epidemic heat consumes Lung Yin should be cleared and nourished. It is not only Yin deficiency that causes this.
Post-recovery, trembling voice and weakness, with disjointed speech, is called Zheng-Sheng (repetitive speech). This indicates Qi deficiency. It is appropriate to use Buzhong Yiqi Decoction (Tonify the Middle and Augment the Qi Decoction). Wang's commentary: This formula is not recorded in the formula discussions of Volume 5; the attached discussion is under Qing Shu Yi Qi Tang (Clear Summerheat and Augment Qi Decoction).
Wang Shixiong's commentary: Although this syndrome belongs to Qi deficiency, it is essentially due to rootless Yuan-Qi. Do not mistakenly administer Buzhong Yiqi Decoction or other Yang-lifting agents. It is appropriate to use Jiling Gao (Ji Ling Paste).
Frequent spitting after recovery indicates Stomach deficiency with residual heat. Take ten Sour Plums (Wumei) and five Northern Dates (Beizao), remove pits, pound into paste, add refined honey, and form pills the size of bullet seeds. Take one pill and hold it in the mouth to dissolve each time.
Wang Shixiong's commentary: This formula is excellent.
Speech is the voice of the Heart. Delirium during illness indicates Heat disturbing the Heart. Excessive talking after recovery indicates residual heat not yet cleared. It is like extinguishing fire; although the fire is out, embers remain.
Wang Shixiong's commentary: It is appropriate to use Dao Chi San (Guide Out Redness Powder) plus Ophiopogon Root ( Maidong), Lotus Plumule (Lianzixin), and Cinnabar-dyed Nard Root (Zhusha Ran Dengxin).
Nocturnal emission after recovery requires harmonizing Heart and Kidney.
Wang Shixiong's commentary: Emissions are mostly due to Fire stirring; it is appropriate to clear residual heat. Coptis Rhizome (Huanglian) and Phellodendron Bark (Huangbai) are key herbs.
Post-recovery, being easily startled by events and having restless sleep indicates residual heat carrying Phlegm. Fear arises from Phlegm contending with Qi.
Wang Shixiong's commentary: It is appropriate to use Bamboo Shavings (Zhuru), Coptis Rhizome (Huanglian), Acorus Rhizome (Shichangpu), Pinellia Rhizome (Banxia), Arisaema Cum Bile (Danning), Gardenia (Zhizi), Anemone Root (Zhimu), Poria (Fuling), Inula Flower (Xuanfuhua), and Tangerine Peel (Juhong).
Post-recovery, constant drowsiness and inability to wake, or muttering and groaning, is caused by lingering pathogenic heat lodging in the Pericardium Collateral.
Wang Shixiong's commentary: It is appropriate to use Salvia Root (Danshen), Anemone Root (Baiwei), Gardenia (Zhizi), Ophiopogon Root ( Maidong), Licorice Root (Gancao), Akebia Caulis (Mutong), Salt-fried Coptis Rhizome (Yanshui Chao Huanglian), Bamboo Leaf (Zhuye), Cinnabar-dyed Nard Root (Zhusha Ran Dengxin), and fine tea. For cases with Phlegm, Trichosanthes Root (Huafen), Buddha Hand (Tianzhuhuang), Acorus Rhizome (Shichangpu), and Mint (Shengtoucao) can be added. Alternatively, Wan Shi's Niuhuang Qingxin Wan (Wan Shi's Calming the Heart and Clearing Heat Pill) can be used.
Spontaneous sweating and night sweats after recovery are signs of deficiency; it is appropriate to differentiate Yin and Yang and tonify.
Wang Shixiong's commentary: Although it is indeed a deficiency pattern, it is often due to residual internal heat not cleared and blazing internal Heart Yang. Do not rush to tonify; clearing and nourishing is appropriate. Herbs such as American Ginseng (Xiyangshen), Rehmannia Root (Shengdi), Ophiopogon Root ( Maidong), Coptis Rhizome (Huanglian), Licorice Root (Gancao), Wheat (Xiaomai), Lily Bulb (Baihe), Bamboo Leaf (Zhuye), Poria (Fuling), and Lotus Plumule (Lianzixin) can be selected for the prescription.
Restlessness of the Spirit after recovery indicates Heart Blood depletion. It is appropriate to nourish the Heart.
Wang Shixiong's commentary: It is indeed Heart-Ying deficiency, but also due to residual heat not cleared. Treatment is as described in the previous clause.
Post-recovery, emptiness, vexation, and insomnia indicate Blood deficiency with the Spirit not residing in its house.
Wang Shixiong's commentary: It is not that the Spirit does not reside in its house, but rather disturbance by residual Fire. Treatment is as above, or add Donkey-hide Gelatin (Ejiao), raw Egg Yolk (Sheng Jizihuang), or Pearl (Zhenzhu). Judging the syndrome and using them appropriately relies on the physician's spiritual insight.
Residual heat not cleared after recovery, combined with weak intestines and stomach and irregular diet, causes Grain Qi and Heat to contend (two Yangs clashing), resulting in recurrent fever. This is called Food Relapse (Shi Fu).
Wang Shixiong's commentary: The treatment method is the same as for Food Relapse in Cold Damage. Additionally, if improper daily life or early overexertion after recovery causes floating deficient Yang and fever, this is called Labor Relapse (Lao Fu). Treatment should regulate Qi and Blood.
Relapse due to sexual activity shortly after recovery in men is called Female Labor Relapse (Nü Lao Fu); if women engage in sex, it is called Male Labor Relapse (Nan Lao Fu). Symptoms include heavy head and dizzy eyes, lower back pain and sore limbs, face feeling hot like roasting, and chest/heart oppression. Mai Dong Decoction (Ophiopogon Decoction) is indicated. If the tongue protrudes more than an inch and cannot retract for days, it is called Yang Strength (Yang Qiang). Apply finely ground Borax (Bingpian) to it, and it will retract. If it extends several inches, it is mostly untreatable.
Wang Shixiong's commentary: This formula is excellent. Add Bamboo Shavings (Zhuru) and Goji Berry (Gouqizi).
If a man newly recovered, with residual heat not cleared, engages in intercourse with a woman and becomes ill, it is called Yang Yi (Yang Exchange). If a woman newly recovered, with residual heat not cleared, engages in intercourse with a man and becomes ill, it is called Yin Yi (Yin Exchange).
Symptoms in men include penile swelling moving into the abdomen and unbearable colicky pain; symptoms in women include nipple retraction and abdominal urgency, with lower back and hip pain radiating into the abdomen. Heat attacks the chest and diaphragm, making the head too heavy to lift, unable to lie flat, and unable to move. This is a critical syndrome.
Wang Shixiong's commentary: I refer to Yin-Yang Yi as Heat Entering the Essence Chamber Syndrome. Yin Yi is heavier than Yang Yi because the epidemic heat Qi in women originates from the vaginal opening. The ancient use of underwear is profound, utilizing its ability to guide heat pathogens out through their original path. Therefore, for Yin Yi, cut the unworn underwear worn by the woman during intercourse; *Qian Jin Fang* uses red cloth from menstruation, derived from this concept. For Yang Yi, cut the unworn underwear worn by the man during intercourse. Take a few inches near the crotch, burn to ash, and ingest orally; efficacy is rapid. Later generations used rat feces, based on the principle of guiding turbidity with turbidity. However, burning underwear powder is still more precise. Other herbs such as Bamboo Shavings (Zhuru), Trichosanthes Root (Huafen), Garlic Sprout (Jiu Bai), Talcum (Huashi), Anemone Root (Baiwei), Sophora Flower (Huaimi), Melia Fruit (Lianshi), Mung Bean (Lv Dou), Licorice Tip (Gan Cao Shao), and Smilax Rhizome (Tu Fuling) all target the Essence Chamber and can be selected according to the syndrome. The above three clauses apply equally to post-heat disease recovery, not just epidemic diseases.