疫邪已退,脉证俱平,但元气未复,或因梳洗沐浴,或因多言妄动,遂致发热,
前证复起,惟脉不沉实为辨,此为劳复。盖气为火之舟楫,今则真气方长,劳而复折,真气既
亏,火亦不前,如人欲济、舟楫已坏,其可渡乎?是火也,某经气陷,则火随陷于某经,陷于经络则为表热,陷于脏腑
则为里热,虚甚
热甚,虚微热微。治法∶轻则静养可复,重则大补气血,候真气一回,血脉融和,表里通畅
,所陷之火,随气输泄,自然热退,而前证自除矣。若误用承气及寒凉剥削之剂,变证蜂起
,卒至殒命,宜服安神养血汤。
若因饮食所伤者,或吞酸作嗳,或心腹满闷而加热者,此名食复,轻则损谷自愈,重则消导方
若无故自复者,以伏邪未尽,此名自复,当问前得某证,所发亦某证,稍与前药,以彻其余
邪,自然获愈。
安神养血汤
茯神 枣仁 当归 远志 桔梗 芍药 地黄 陈皮 甘草
加龙眼肉,水煎服。
疫邪伏而未发,因感冒风寒,触动疫邪,相继而发也,既有感冒之因由,复有风寒
之脉证,先投发散,一汗而解,一二日续得头疼身痛,潮热烦渴,不恶寒,此风寒去,疫邪
发也,以疫法治之。
疟疾二三发,或七八发后,忽然昼夜发热、烦渴不恶寒、舌生苔刺、心腹痞满、
饮食不进,下证渐具,此温疫着,疟疾隐也,以疫法治之。
温疫昼夜纯热、心腹痞满、饮食不进、下后脉静身凉,或间日、或每日、时恶寒而后发热如
期者,此温疫解,疟邪未尽也,以疟法治之。
疫邪已经消退,脉象和症状都趋于平稳,但元气尚未恢复。如果因为梳洗沐浴,或者因为多说话、过度活动,导致发热,之前的病症再次出现,只有脉象不沉实可以作为鉴别依据,这称为“劳复”。气是火的舟船(载体),现在真气刚刚生长,劳累又使其折损,真气既然亏损,火也就无法前行,就像人想要渡河,但船只已经损坏,怎么能渡过去呢?这种火,随着某经之气的下陷,就随之陷入该经;陷入经络则表现为表热,陷入脏腑则表现为里热。虚证严重则热象显著,虚证轻微则热象微弱。治疗方法:轻症只需静养即可恢复,重症则需要大补气血,等待真气回复,血脉融和,表里通畅,所陷入的火,随着气的运行而输布排泄,自然热退,之前的病症自然消除。如果误用承气汤及寒凉攻伐的药物,会导致变证蜂拥而起,最终致死,适宜服用安神养血汤。
如果是因饮食不当造成的损伤,出现吞酸打嗝,或者心腹胀满并伴有发热的,这称为“食复”,轻症减少饮食即可自愈,重症则需要使用消食导滞的方法治疗。
如果没有诱因而自行复发的,是因为潜伏的邪气未尽,这称为“自复”,应当询问之前得了什么证,现在发作的也是什么证,稍微给予之前的药物,以清除残余的邪气,自然能够痊愈。
安神养血汤
茯神、枣仁、当归、远志、桔梗、芍药、地黄、陈皮、甘草
加入龙眼肉,用水煎服。
疫邪潜伏而未发作,因为感冒风寒,触动了疫邪,相继发作。既有感冒的原因,又有风寒的脉象和症状,先投用发散药物,通过出汗而解除,一两天后继续出现头痛身痛、潮热烦渴、不恶寒,这是风寒已去,疫邪发作的表现,按照治疗疫病的方法处理。
疟疾发作两三次,或者七八次之后,忽然出现昼夜发热、烦渴不恶寒、舌生苔刺、心腹痞满、饮食不进,下法适用的证候逐渐具备,这是温疫显现,疟疾隐伏的表现,按照治疗疫病的方法处理。
温疫表现为昼夜纯热、心腹痞满、饮食不进,使用下法后脉静身凉,或者间日、或每日,有时恶寒而后发热且时间规律的,这是温疫已解,疟邪未尽的表现,按照治疗疟疾的方法处理。
The epidemic pathogen has receded, and both the pulse and symptoms have normalized, but the primordial qi (vital energy) has not yet recovered. If fever arises due to combing hair, washing, bathing, excessive talking, or overexertion, causing the previous symptoms to reappear, this is distinguished by the absence of a deep and solid pulse; this condition is termed "relapse due to fatigue" (Lao Fu). Qi serves as the vessel for fire (metabolic heat/pathogenic heat); now that the true qi is just beginning to grow, exertion causes it to be broken again. Since the true qi is deficient, the fire cannot advance. It is like a person attempting to cross a river with a damaged boat—how can they cross? This fire follows the sinking of qi in a specific channel; if it sinks into the meridians, it manifests as exterior heat; if it sinks into the zang-fu organs, it manifests as interior heat. Severe deficiency leads to intense heat, while mild deficiency leads to slight heat. Treatment: For mild cases, quiet rest allows recovery; for severe cases, substantial tonification of qi and blood is required. Once the true qi returns, the blood vessels harmonize, and the interior and exterior flow freely, the sunken fire is transported and excreted along with the qi. Naturally, the fever subsides, and the previous symptoms disappear. If Chengqi Decoction (Cathartic Decoction) or cold and cooling purgatives are mistakenly used, various complications will arise, potentially leading to death. It is appropriate to administer Anshen Yangxue Tang (Calming the Spirit and Nourishing Blood Decoction).
If the relapse is caused by dietary injury, manifesting as acid regurgitation, belching, abdominal distension accompanied by fever, this is termed "relapse due to diet" (Shi Fu). Mild cases resolve spontaneously by reducing food intake, while severe cases require digestion-promoting and stagnation-resolving treatments.
If the recurrence happens without any obvious cause, it is because latent pathogens remain unresolved; this is termed "spontaneous relapse" (Zi Fu). One should inquire about the previous syndrome and observe if the current manifestation matches it. Administering a small amount of the previous prescription helps eliminate residual pathogens, leading to natural recovery.
Anshen Yangxue Tang (Calming the Spirit and Nourishing Blood Decoction):
Fushen (Poria with Hostwood), Zaoren (Semen Ziziphi Spinosae), Danggui (Radix Angelicae Sinensis), Yuanzhi (Radix Polygalae), Jiegeng (Radix Platycodonis), Shaoyao (Radix Paeoniae Alba), Dihuang (Radix Rehmanniae Praeparata), Chenpi (Pericarpium Citri Reticulatae), Gancao (Radix Glycyrrhizae).
Add Longyanrou (Arillus Longan), decoct in water, and take orally.
When epidemic pathogens lie latent and unmanifested, a contraction of wind-cold may disturb them, causing subsequent onset. There are both the etiology of common cold and the pulse/symptoms of wind-cold. Initially, administer dispersing agents to resolve the condition through sweating. After one or two days, headache, body pain, tidal fever, irritability, thirst, and absence of aversion to cold may occur; this indicates that wind-cold has departed and the epidemic pathogen is emerging. Treat according to epidemic disease protocols.
After malaria has manifested two or three times, or seven or eight times, sudden onset of day-and-night fever, irritability, thirst, absence of aversion to cold, prickly tongue coating, epigastric and abdominal fullness, and inability to eat occurs, with signs suitable for purgation gradually appearing. This indicates that warm epidemic disease is manifesting while malaria is receding; treat according to epidemic disease protocols.
In warm epidemic disease characterized by constant day-and-night fever, epigastric and abdominal fullness, and inability to eat, if purgation results in a calm pulse and cool body, or if chills followed by fever occur at regular intervals (every other day or daily), this indicates that the warm epidemic has resolved but malaria pathogens remain incomplete; treat according to malaria protocols.