温热二病，凡有遗症者，皆由余邪未尽，或由失于调理，或由不知禁忌所致。今举其要。约二十有四。
一、瘥后发肿 温热症大势已平，伏邪已解，而面目肢体浮肿者，有食滞中宫、水停心下、气复未归三
种。当分别以施治。食滞中宫者，乃病后脾胃大虚，不能消谷也。病者胃中犹燥，偏欲多食，食停心下脐上，
则水不得上输于肺，肺亦不能通水道于膀胱，故溢于肢体而为肿。其症以心下脐上有硬处，按之则痛为异；小
便或利或不利。当用平胃散，加枳实、山楂、麦芽、莱菔、青皮、神曲为主，硬处消，则肿自愈；或加苓、泽，
兼利水亦可。水停心下者，乃脾虚不能消水也。与食滞异者，心腹无硬痛处，而小便必不利也。须实脾利水，
宜白术、米仁、浙苓皮、泽泻、车前、木通之类，利其小便而愈，或苡仁、糯米煮粥食亦佳。气复未归者，温
热大伤阴气之后，由阴精损及阳气，愈后阳气暴复，阴尚亏歉之至。切忌消利。吴又可所谓∶病后气复血未复，
气无所归，故暂浮肿；不可治肿，调其饮食，节其劳役，静养自愈，吴鞠通则曰∶余见世人，每遇浮肿，便与
淡渗利小便方法，岂不畏津液消亡而成三消证，快利津液为肺痈肺痿证，与阴虚咳嗽、身热之痨损证哉。余治是
证，悉用复脉汤，重加甘草，只补其未足之阴，以配其已复之阳，而肿自消。千治千得，无少差谬，敢以告后
之治温热气复者。暑温、湿温不在此例。至其辨法，气肿异于停水、食滞者∶停水身重
而小便不利，气肿身轻而小便自利；食滞腹中有结，气肿腹中自和也。
二、瘥后皮肤甲错 温热愈后，身体枯瘦，皮肤甲错者，乃热伤其阴，阴液不能滋润皮肤也。治法以养
阴为主，吴氏人参养荣汤、清燥养荣汤酌用，叶氏加减复脉汤尤效，亦有粥食调理自回者。
三、瘥后发疮 温热新瘥，发疮者最多，乃余热淫于肌肉也。若照寻常疮症，温托妄施，断不能救；惟
多服清凉解毒，兼养气血药自愈。
四、瘥后发痿 四肢不能动移者，热伤筋脉也。吴氏诸养营汤酌用。轻者，粥食调理自愈。
五、瘥后发蒸 蒸蒸骨热如痨瘵者，乃余热留于阴分也。不可以其羸瘦，而遽用虚损门治法；必察其六
腑有结邪，则仍以攻邪为主；次察其筋络有壅瘀，仍以通瘀为主也；次察其气道有痰涎，仍以祛其痰涎为主。
数者俱无，方可清热。或无邪而阴伤，方可纯用养阴之药；或分其余邪之轻重，亏损之多少，而兼用养阴清热
药，进退加减以和之更妙。
六、瘥后耳聋 温热症身凉后，尚有耳鸣、耳聋等症者，其因有三。一因余邪留于胆经，宜温胆汤加柴
胡、菖蒲、钩藤、池菊、通草、荷叶之类，以清解少阳之郁。二因痰火上升，阻闭清窍，其耳亦聋，宜导痰汤
去半夏、南星，加栝蒌皮、京川贝、枇杷叶、杜兜铃、通草、鲜石菖蒲之类，以轻宣肺气之郁。三因肾虚精脱，
则耳鸣、而聋，宜常服耳聋左慈丸或磁朱丸等，以滋阴镇逆。此二症，不关少阳，皆禁用柴胡升提。外治惟耳
聋神丹，丝棉包裹，纳入耳中多效。
七、瘥后发颐 俗名遗毒，乃余邪留滞络中而成毒也，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。治法以解毒清热、活血疏散为主，误则成脓不出，而牙关紧，咽喉不利，
多不能食而死。毒内陷而复舌燥神昏，亦死；出脓后，气虚血脱，亦死。故宜早治也。古方以普济消毒饮为主；
发在耳后，以柴胡、川芎为主；在项下，以葛根、白芷为主；在项后或巅顶，加羌活、薄荷。时方以连翘败毒
散为主，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。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。总之，此症初起，速宜消散，缓
则成脓，不可轻补于未溃之前，补早则必成脓。尤不可纯用寒凉于将发之际，恐闭遏而毒不得发，故必兼疏散
为要。外治以葱水时时浴之。
八、瘥后额热 凡温热症热退后，独额热未除，目神似觉呆钝，此胃中余滞未清，额属阳明，故独热。
宜清疏之，二陈汤，加连翘、黄芩、山楂、神曲之类，清之和之。
九、瘥后咳嗽 凡温热症热退之后，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、地骨皮、知母、川贝、川斛、花粉、茯苓、甜杏仁、桑皮、蔗汁、梨汁之类，或加生地、玉竹之
类。总之，新感风寒，而症见咳嗽，其病为轻；以其邪传入肺，肺主皮毛，邪从外达也。温热多内伤虚症，见
咳则重；五脏传乘，肺受火刑，水源涸竭，每多死症。
十、瘥后自汗、盗汗 虽皆属虚候，然温热瘥后，多由余热未清，心阳内炽，以致熏蒸燔灼，津液外泄
而汗出。慎勿骤补峻补。苦坚清养为宜。苦坚∶如当归六黄汤加减，以育阴泻火固表；清养∶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。
十一、瘥后惊悸 凡温热新瘥，触事易惊，梦寐不安者，
余热挟痰也。痰与气搏，震荡心宫，故惊悸。宜用竹茄、黄连、石菖蒲、半夏、胆星、栀子、知母、茯苓、旋
复花、橘红等，清余热而消痰。
十二、瘥后怔忡 乃水衰火旺，心肾不交也，宜补水养心，朱砂安神丸最妙，半夏秫米汤合交泰丸尤捷。
十三、瘥后不寐 凡温热症热退之后，夜不欲寐者，胃不和也，温胆汤加秫米和之。惊悸不寐者，心气
虚也，前方合酸枣仁汤，去川芎清敛之。虚烦不寐者，余火扰动也，黄连阿胶汤清滋之。终夜清醒，目不能瞑，
或目瞑，则惊悸梦惕者，余邪内留肝胆，胆气未舒，肝魂不安也。宜酒浸郁李仁、炒枣仁、猪胆皮、黄连、焦
山栀、淡竹茹、冬桑叶等，滑以去着，苦以泄热。
十四、瘥后妄言 凡温热病，每有热退身凉之后，其人如痴，神思不清，言语谬妄，或倦语不思食者，
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。吴氏安神养血汤主之，薛氏参麦茯神汤
亦主之。但痰火余邪，内伏包络，亦有此症，当用鲜菖蒲、天竺黄、川贝母、连翘、钩藤、丹皮、淡竹叶、竹
茹、辰砂之类，以凉开热痰，则神自清而不妄言矣。若犹不应，加万氏牛黄清心丸清宣之。如余热未净，多言
错语者，宜导赤散，加麦冬、莲子心、朱砂染灯心等，熄余焰而清心神。
十五、瘥后语蹇 凡温热症热退之后，其舌转动不灵，而语言蹇涩者，因心脾肾三经之脉，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。宜导痰汤，加菊花、钩藤、
白蒺藜、皂角炭、石菖蒲、姜汁、竹沥等，熄虚风而清痰火。若因痰热滞于肺络者，宜顾氏清金散加石菖蒲、
竹沥，清肃之；如因余热耗伤肺阴者，宜清燥救肺汤加岩制川贝、雅梨汁，清养之；若声颤无力，语不接续，
似蹇非蹇者，阴气大虚，元气无根也，宜贞元饮合集灵膏峻补之。
十六、瘥后昏沉 凡温热症新瘥后，十余日或半月渐至昏沉者，皆缘发汗未尽，余邪在于心胞故也。或
兼潮热，或兼寒热似疟，宜连翘、栀子、豆豉、麦冬、菖蒲、淡竹叶、钩藤、丹参之类，清解之。然有痰火内
伏胞络者，亦见昏沉，其人终日昏睡不醒，或错语呻吟，或独语如见鬼，宜用东白薇、天竺黄、京川贝、广郁
金、石菖蒲、皂角刺、鲜竹叶、细芽茶、朱砂染灯心、厥症返魂丹等，轻清以开达之；甚或万氏牛黄清心丸、
叶氏神犀丹，皆可采用。
十七、瘥后喜唾 即多吐涎沫是也。审其胃虚而有余热者，宜用乌梅北枣丸噙化之；土虚不能摄水者，
六君子汤加益智仁摄之。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、
补骨脂以纳之，或少加淡附片以收之，或佐白术以制之。
十八、瘥后不食 当辨不欲食、食亦不化两端。不欲食者，病在胃，宜养以甘凉，金匮麦门冬汤主之，
叶氏养胃汤亦主之。食不化，病在脾，当补以温运，香砂理中汤主之，六君子汤亦主之。虽然，不欲食一症，
宜分伤食与停食两项。伤食者，饮食自倍，肠胃乃伤，病在不及消化。停食，不论食之多少。或当食而怒，或
当食而病，在气结而不能化也。治伤食宜偏重于食，或吐、或下、或消。若停食，则偏重在气，惟理气而兼之
以消，吐下之法不可用也。医者须分别治之。
十九、瘥后不便 凡温热症后，大便不行者，热闭、虚闭居多，风闭、气闭者少。热闭者，热搏津液，
肠胃燥结，及肠胃素有积热者，多有此疾。其症面赤腹热，大腹胀闷，四肢反冷，或口舌生疮是也。大黄饮子
最妙，三黄枳术丸、枳实导滞丸、
陆氏润字丸等，亦可酌用，虚闭有二∶一阴虚，一阳虚也。凡下焦阳虚，则阳气不行，不能传送，而阴凝于下；
下焦阴虚，则精血枯燥，津液不到，而肠脏干槁。治阳虚者，但益其火，则阴凝自化，苁蓉润肠丸主之；老年者，
黄汤送服半硫丸。治阴虚者，但壮其水，则泾渭自通，六味地黄汤加淡苁蓉、白蜜主之，益血润肠丸、五仁丸
等亦效。风闭者，风胜则干也，由风热搏激肺脏，传于大肠，津液燥涩，传化则难；或其人素有风病者，亦多风闭∶
或肠胃积热，久而风从内生，亦能成闭。东垣润肠丸主之，加味皂角丸亦主之。气闭者，气内滞而污物不行也。
其脉沉，其人多噫，心腹痞闷，胁肋膨胀。若用攻药通之，虽或暂通，而其闭益甚矣∶或迫之使通，因而下血者。
惟当顺气，气顺则便自通矣。苏子降气加枳壳、杏仁主之，重则六磨汤主之。
二十、瘥后腹热 凡温热症身大凉，独腹热未除，此脾火内甚也，养阴药中加生白芍自除。但此症惟伏
暑、晚发最多，多属肠胃积热，雪羹送服陆氏润字丸最妙。
二十一、瘥后下血 凡温热新瘥，或十日或半月忽然下血者，由于伏火未净，热伤阴络，而血下溢也。
治以清营、凉血、和络之法，如生地、丹皮、地榆、川断、槐米、白芍、苡仁、黑荆芥、白茅根、脏连丸治之，
自愈。阴虚火旺者，脏连六味丸尤捷。
二十二、瘥后遗精 因火动者多，宜清余热，固精封髓丹主之，三才封髓丹加黄连亦主之。以此症黄连、
黄柏二味，最是要药也。
二十三、瘥后调理 当分补虚、清热二项。补虚有二法∶一补脾，一补胃。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，宜六君子加减以和中。形寒
畏冷，宜黄 建中汤温补之，凡此症脉皆缓大，舌皆白嫩可辨。如其人阴分虚者，必有余邪未尽，舌燥口渴，
二便艰涩，脉兼微数等症，宜小甘露饮、叶氏养胃汤等清养之。清热亦有二法∶初病时之热为实热，宜用苦寒
药清之∶大病后之热为虚热，宜用甘寒药清之。二者有霄壤之殊。凡人身天真之气，全在胃口，津液不足，即
是虚；生津液，即是补虚。故以生津之药合甘寒泻热之药，而治感后之虚热，如麦冬、生地、丹皮、北沙参、
西洋参、鲜石斛、梨汁、蔗汁、竹沥、茅根之类，皆为合法；仲景河间主用竹叶石膏汤、天水散以清虚热，亦
取甘凉之义也。设误投参、 、苓、术补脾之药为补，宁不并邪热而补之乎？至于饮食之补，但取其气，不取
其味，如五谷之气以养之，五菜之气以充之。每食之间，便觉津津汗透，将身中蕴蓄之邪热，以渐运出于毛孔，
何其快哉！人皆不知此理，急于用肥甘之味以补之，临时虽精采健旺可喜，不思油腻阻滞经络，邪热不能外出，
久久充养完固，愈无出期矣！前哲庞氏安常，有鉴于此，如所云∶凡病新瘥，只宜先进白稀粥，次进浓者，又
次进糜粥，亦须少少与之；不得早吃肉食，旨哉言乎！
二十四、瘥后禁忌 温热大病后，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。且其气血必
虚，凡费心费力，过喜过怒，多言多动，皆可因劳而复病也。因劳而动其既虚之血气，生其未尽之余热，热邪
退而病瘥，热邪生而病复。凡病皆然，温热症为尤甚，病者务宜自重。
温热病与温病，凡是有后遗症的，都是由余邪未尽，或者因为缺乏调理，或者因为不知道禁忌所导致。现在列举其要点，大约二十四条。
一、病后浮肿
温热病症势已平，伏邪已解，但面目肢体出现浮肿的，有食滞中宫（脾胃）、水停心下（胃脘部）、气复未归三种情况。应当分别施治。食滞中宫者，是病后脾胃大虚，不能消化谷物。患者胃中尚燥，偏好多食，食物停滞在心下脐上部位，则水液不得上输于肺，肺也不能通调水道至膀胱，所以溢出肢体而成为浮肿。其症状以心下脐上有硬块，按压则疼痛为特征；小便或通利或不通利。应当用平胃散，加枳实、山楂、麦芽、莱菔子、青皮、神曲为主药，硬块消散，则肿自愈；或者加茯苓、泽泻，兼以利水也可以。水停心下者，是脾虚不能运化水湿。与食滞不同的地方在于，心腹部没有硬痛之处，而小便一定不通利。需要实脾利水，适宜用白术、薏苡仁、浙茯苓皮、泽泻、车前子、木通之类，利其小便而痊愈，或者用薏苡仁、糯米煮粥食用也很好。气复未归者，是在温热大病损伤阴气之后，由阴精亏损波及阳气，痊愈后阳气暴复，阴气尚且极度亏虚。切忌使用消导利水之法。吴又可所说：病后气复血未复，气无所归，所以暂时浮肿；不可治疗浮肿，调理饮食，节制劳役，静养即可自愈。吴鞠通则说：我见过世人，每当遇到浮肿，就用淡渗利小便的方法，难道不怕津液消亡而成三消证吗？快速利去津液会导致肺痈肺痿证，以及阴虚咳嗽、身热的劳损证啊。我治疗这种证候，全部使用复脉汤，重用甘草，只补其不足的阴气，以配合其已复的阳气，而肿自然消除。千治千得，没有丝毫差错，敢以此告知后来治疗温热病气复的患者。暑温、湿温不在此例。至于辨别方法，气肿不同于停水、食滞的是：停水身体沉重而小便不利，气肿身体轻快而小便自利；食滞腹中有结块，气肿腹部自然平和。
二、病后皮肤甲错
温热病痊愈后，身体枯瘦，皮肤粗糙如鳞甲般的，是热邪损伤了阴气，阴液不能滋润皮肤所致。治疗方法以养阴为主，吴氏人参养荣汤、清燥养荣汤酌情选用，叶氏加减复脉汤尤为有效，也有通过粥食调理自行恢复的。
三、病后发疮
温热病刚痊愈，发生疮疡的很多，是余热淫溢于肌肉所致。如果按照寻常疮症，妄用温托之法，绝对不能救治；只有多服清凉解毒，兼养气血的药物才能自愈。
四、病后发痿
四肢不能移动的，是热邪损伤筋脉所致。吴氏诸养营汤酌情选用。轻症的，通过粥食调理即可自愈。
五、病后发蒸
身体蒸蒸骨热如同痨瘵病的，是余热留于阴分所致。不可以因为其形体羸瘦，就急忙使用虚损门的治法；必须观察其六腑是否有结聚之邪，如果有，仍以攻邪为主；其次观察其筋络是否有壅滞瘀血，如果有，仍以通瘀为主；其次观察其气道是否有痰涎，如果有，仍以祛除痰涎为主。这几项都没有，才可以清热。或者没有邪气而是阴伤，才可以纯用养阴的药物；或者根据其余邪的轻重、亏损的多少，兼用养阴清热药，进退加减来调和更为巧妙。
六、病后耳聋
温热病身体凉后，还有耳鸣、耳聋等症状的，原因有三。一是余邪留于胆经，适宜温胆汤加柴胡、石菖蒲、钩藤、池菊、通草、荷叶之类，以清解少阳之郁结。二是痰火上升，阻闭清窍，耳朵也会聋，适宜导痰汤去掉半夏、南星，加瓜蒌皮、京川贝母、枇杷叶、杜兜铃、通草、鲜石菖蒲之类，以轻宣肺气之郁结。三是肾虚精脱，则耳鸣、耳聋，适宜常服耳聋左慈丸或磁朱丸等，以滋阴镇逆。这两种情况（指痰火和肾虚），不涉及少阳，都禁用柴胡升提。外治法只有耳聋神丹，用丝棉包裹，纳入耳中，效果很好。
七、病后发颐
俗称遗毒，是余邪留滞络中而成毒，因为汗下清解未尽，邪气结于少阳、阳明二经。发于两腮部的，是阳明部位；发于耳朵左右的，是少阳部位。治疗方法以解毒清热、活血疏散为主，误治则成脓不出，牙关紧闭，咽喉不利，大多不能进食而死。毒邪内陷又舌燥神昏，也死；出脓后，气虚血脱，也死。所以适宜早治。古方以普济消毒饮为主；发在耳后的，以柴胡、川芎为主；在项下的，以葛根、白芷为主；在项后或头顶的，加羌活、薄荷。时方以连翘败毒散为主，如羌活、独活、荆芥、防风、连翘、赤芍、牛蒡子、桔梗、土贝母、蒺藜、薄荷、金银花、甘草之类。如果元气虚者，须兼用当归、黄芪补托，溃脓后，当以大补气血为主。然而发于阳明的容易治疗，发于少阳的难治。总之，此症初起，速宜消散，迟缓则成脓，不可在未溃破之前轻率进补，补早则必成脓。尤其不可在将发之际纯用寒凉药，恐怕闭遏而毒邪不得发散，所以必须兼用疏散为要。外治法用葱水时时洗浴患处。
八、病后额热
凡是温热病热退后，唯独额头热未除，眼神似乎呆钝，这是胃中余滞未清，额头属阳明经，所以单独发热。适宜清疏之法，用二陈汤，加连翘、黄芩、山楂、神曲之类，清之和之。
九、病后咳嗽
凡是温热病热退之后，还有咳嗽未除的，这是余热在肺。适宜滋养肺胃之阴，咳嗽自止，如南沙参、麦冬、地骨皮、知母、川贝母、川石斛、花粉、茯苓、甜杏仁、桑白皮、蔗汁、梨汁之类，或者加生地、玉竹之类。总之，新感风寒，见到咳嗽，病情较轻；因为邪气传入肺，肺主皮毛，邪气从外表达。温热病多内伤虚症，见到咳嗽则重；五脏传乘，肺受火刑，水源涸竭，每多死症。
十、病后自汗、盗汗
虽然都属于虚候，但温热病痊愈后，多由余热未清，心阳内炽，以致熏蒸燔灼，津液外泄而汗出。切勿骤补峻补。苦坚清养为宜。苦坚：如当归六黄汤加减，以育阴泻火固表；清养：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，择而为剂即可。
十一、病后惊悸
凡是温热病刚痊愈，遇事易惊，梦寐不安的，是余热挟痰。痰与气搏结，震荡心宫，所以惊悸。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，清余热而消痰。
十二、病后怔忡
是水衰火旺，心肾不交所致，适宜补水养心，朱砂安神丸最妙，半夏秫米汤合交泰丸尤其快捷。
十三、病后不寐
凡是温热病热退之后，夜间不想睡觉的，是胃不和，用温胆汤加秫米调和。惊悸不寐的，是心气虚，前方合酸枣仁汤，去掉川芎的清敛之性。虚烦不寐的，是余火扰动，用黄连阿胶汤清滋之。整夜清醒，眼睛不能闭合，或者眼睛闭上，则惊悸梦惕的，是余邪内留肝胆，胆气未舒，肝魂不安。适宜用酒浸郁李仁、炒枣仁、猪胆皮、黄连、焦山栀、淡竹茹、冬桑叶等，滑以去着，苦以泄热。
十四、病后妄言
凡是温热病，多有热退身凉之后，其人如痴，神思不清，言语谬妄，或者倦语不思食的，这是心神虚散不复所致。只当调养气血，兼治其心即可。神复，妄言自止。吴氏安神养血汤主之，薛氏参麦茯神汤也主之。但是痰火余邪，内伏包络，也有此症，应当用鲜石菖蒲、天竺黄、川贝母、连翘、钩藤、丹皮、淡竹叶、竹茹、辰砂之类，以凉开热痰，则神自清而不妄言了。如果还不应，加万氏牛黄清心丸清宣之。如果余热未净，多言错语的，适宜导赤散，加麦冬、莲子心、朱砂染灯心等，熄余焰而清心神。
十五、病后语蹇
凡是温热病热退之后，舌头转动不灵，而语言蹇涩的，因为心脾肾三经的脉络，都萦绕于舌，心肾虚则舌不灵动；痰阻脾络，肝风内扰，则语言蹇涩不清。总是虚风痰火致病。适宜导痰汤，加菊花、钩藤、白蒺藜、皂角炭、石菖蒲、姜汁、竹沥等，熄虚风而清痰火。如果因痰热滞于肺络的，适宜顾氏清金散加石菖蒲、竹沥，清肃之；如果因余热耗伤肺阴的，适宜清燥救肺汤加岩制川贝、雅梨汁，清养之；如果声颤无力，语不接续，似蹇非蹇的，是阴气大虚，元气无根，适宜贞元饮合集灵膏峻补之。
十六、病后昏沉
凡是温热病刚痊愈后，十余日或半月渐至昏沉的，都是因为发汗未尽，余邪在于心胞所致。或者兼潮热，或者兼寒热似疟，适宜连翘、栀子、豆豉、麦冬、菖蒲、淡竹叶、钩藤、丹参之类，清解之。但是有痰火内伏胞络的，也见昏沉，其人终日昏睡不醒，或者错语呻吟，或者独语如见鬼，适宜用东白薇、天竺黄、京川贝母、广郁金、石菖蒲、皂角刺、鲜竹叶、细芽茶、朱砂染灯心、厥症返魂丹等，轻清以开达之；甚至万氏牛黄清心丸、叶氏神犀丹，都可以采用。
十七、病后喜唾
就是多吐涎沫。审察其胃虚而有余热的，适宜用乌梅北枣丸噙化之；土虚不能摄水的，用六君子汤加益智仁摄之。如果稠饮自下焦漾漾而起，溢退场门中的，这是肾气不纳，浊阴上泛，适宜都气饮加胡桃、补骨脂以纳之，或者少加淡附片以收之，或者佐白术以制之。
十八、病后不食
应当辨别不欲食、食亦不化两端。不欲食的，病在胃，适宜用甘凉养护，金匮麦门冬汤主之，叶氏养胃汤也主之。食不化的，病在脾，应当用温运补益，香砂理中汤主之，六君子汤也主之。虽然如此，不欲食一症，应当分伤食与停食两项。伤食者，饮食自倍，肠胃乃伤，病在不及消化。停食，不论食之多少。或者当食而怒，或者当食而病，在气结而不能化也。治伤食宜偏重于食，或吐、或下、或消。若停食，则偏重在气，惟理气而兼之以消，吐下之法不可用也。医者须分别治之。
十九、病后不便
凡是温热病后，大便不行的，热闭、虚闭居多，风闭、气闭者少。热闭者，热搏津液，肠胃燥结，及肠胃素有积热者，多有此疾。其症状面赤腹热，大腹胀闷，四肢反冷，或者口舌生疮是大黄饮子最妙，三黄枳术丸、枳实导滞丸、陆氏润字丸等，也可酌情选用。虚闭有二：一阴虚，一阳虚也。凡下焦阳虚，则阳气不行，不能传送，而阴凝于下；下焦阴虚，则精血枯燥，津液不到，而肠脏干槁。治阳虚者，但益其火，则阴凝自化，苁蓉润肠丸主之；老年者，黄汤送服半硫丸。治阴虚者，但壮其水，则泾渭自通，六味地黄汤加淡苁蓉、白蜜主之，益血润肠丸、五仁丸等也效。风闭者，风胜则干也，由风热搏激肺脏，传于大肠，津液燥涩，传化则难；或者其人素有风病者，也多风闭：或者肠胃积热，久而风从内生，也能成闭。东垣润肠丸主之，加味皂角丸也主之。气闭者，气内滞而污物不行也。其脉沉，其人常打嗝，心腹痞闷，胁肋膨胀。如果用攻药通之，虽然或许暂通，而其闭益甚矣：或者迫之使通，因而下血的。只当顺气，气顺则便自通了。苏子降气加枳壳、杏仁主之，重则六磨汤主之。
二十、病后腹热
凡是温热病身体大凉，唯独腹部热未除，这是脾火内甚，在养阴药中加生白芍自除。但这种症候惟伏暑、晚发最多，多属肠胃积热，雪羹送服陆氏润字丸最妙。
二十一、病后下血
凡是温热病刚痊愈，或者十日或半月忽然下血的，由于伏火未净，热伤阴络，而血下溢也。治以清营、凉血、和络之法，如生地、丹皮、地榆、川断、槐米、白芍、苡仁、黑荆芥、白茅根、脏连丸治之，自愈。阴虚火旺者，脏连六味丸尤其快捷。
二十二、病后遗精
因火动者多，适宜清余热，固精封髓丹主之，三才封髓丹加黄连也主之。以此症黄连、黄柏二味，最是要药也。
二十三、病后调理
应当分补虚、清热二项。补虚有二法：一补脾，一补胃。如其人中气虚者，病退后，必纳谷少，运化迟，或者大便不实，或者恶心吐涎，适宜六君子加减以和中。形寒畏冷，适宜黄芪建中汤温补之，凡此症脉皆缓大，舌皆白嫩可辨。如其人阴分虚者，必有余邪未尽，舌燥口渴，二便艰涩，脉兼微数等症，适宜小甘露饮、叶氏养胃汤等清养之。清热亦有二法：初病时之热为实热，适宜用苦寒药清之：大病后之热为虚热，适宜用甘寒药清之。二者有霄壤之殊。凡人身天真之气，全在胃口，津液不足，即是虚；生津液，即是补虚。故以生津之药合甘寒泻热之药，而治感后之虚热，如麦冬、生地、丹皮、北沙参、西洋参、鲜石斛、梨汁、蔗汁、竹沥、茅根之类，皆为合法；仲景河间主用竹叶石膏汤、天水散以清虚热，也是取甘凉之义也。设误投参、芪、苓、术补脾之药为补，难道不是并邪热而补之乎？至于饮食之补，但取其气，不取其味，如五谷之气以养之，五菜之气以充之。每食之间，便觉津津汗透，将身中蕴蓄之邪热，以渐运出于毛孔，何其快哉！人皆不知此理，急于用肥甘之味以补之，临时虽精采健旺可喜，不思油腻阻滞经络，邪热不能外出，久久充养完固，愈无出期矣！前哲庞氏安常，有鉴于此，如所云：凡病新瘥，只宜先进白稀粥，次进浓者，又次进糜粥，亦须少少与之；不得早吃肉食，旨哉言乎！
二十四、病后禁忌
温热大病后，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。且其气血必虚，凡费心费力，过喜过怒，多言多动，皆可因劳而复病也。因劳而动其既虚之血气，生其未尽之余热，热邪退而病瘥，热邪生而病复。凡病皆然，温热症为尤甚，病者务宜自重。
Warm-heat diseases and warm diseases, those with sequelae, are all caused by residual pathogens not yet exhausted, or due to lack of proper care, or because of ignorance of taboos. Now I list the essentials, approximately twenty-four points.
1. Edema after recovery
When the major symptoms of a warm-heat disease have subsided and latent pathogens have resolved, but edema appears on the face, eyes, and limbs, there are three types: food stagnation in the Middle Jiao (Spleen and Stomach), water retention in the Heart Below (epigastrium), and Qi returning without settling. Treatment should be differentiated accordingly. Food stagnation in the Middle Jiao occurs when the Spleen and Stomach are severely deficient after illness and cannot digest grains. The patient's stomach feels dry, leading to overeating; food stops below the heart and above the navel, preventing water from ascending to the Lung, and the Lung cannot regulate water passages to the Bladder, causing overflow into the limbs as edema. Its characteristic symptom is hardness below the heart and above the navel, painful upon pressure; urination may be free or obstructed. One should use Pingwei San (Calm the Stomach Powder) as the base, adding Zhi Shi (Immature Bitter Orange), Shan Zha (Hawthorn Fruit), Mai Ya (Barley Sprout), Lai Fu Zi (Radish Seed), Qing Pi (Green Tangerine Peel), and Shen Qu (Medicated Leaven). Once the hardness dissipates, the edema will heal spontaneously; alternatively, adding Fu Ling (Poria) and Ze Xie (Alisma Rhizome) to promote diuresis is also acceptable. Water retention in the Heart Below is due to Spleen deficiency failing to transform water. Unlike food stagnation, there is no hardness or pain in the heart and abdomen, but urination is definitely obstructed. One must strengthen the Spleen and promote diuresis, suitable for Bai Zhu (Atractylodes Macrocephala Rhizome), Yi Yi Ren (Coix Seed), Zhe Fu Ling Pi (Poria Peel), Ze Xie (Alisma Rhizome), Che Qian Zi (Plantago Seed), and Mu Tong (Akebia Caulis). Healing is achieved by promoting urination, or cooking Yi Yi Ren (Coix Seed) and Nuomi (Glutinous Rice) into porridge for consumption is also good. Qi returning without settling occurs after warm-heat disease severely damages Yin Qi, where Yin essence damage affects Yang Qi. After recovery, Yang Qi suddenly rebounds while Yin remains extremely deficient. One must strictly avoid resolving and draining methods. Wu Keyi stated: "After illness, Qi returns but Blood has not; Qi has no place to settle, hence temporary edema; do not treat the edema directly, regulate diet, restrain labor, and rest quietly for spontaneous healing." Wu Juzhong said: "I have seen people who, upon encountering edema, immediately use light and渗 (permeating) methods to promote urination. Are they not afraid of consuming Jin Ye (Body Fluids) leading to San Xiao (Three Wasting-Thirst syndromes)? Rapidly draining Jin Ye leads to Fei Yong (Lung Abscess) and Fei Wei (Lung Atrophy), as well as Yin-deficiency cough and consumptive fever syndromes." In treating this syndrome, I exclusively use Fumai Tang (Restore the Pulse Decoction), heavily weighting Gan Cao (Licorice Root), only supplementing the insufficient Yin to harmonize with the rebounding Yang, and the edema disappears naturally. It works perfectly every time without error; I dare to share this with future practitioners treating warm-heat Qi rebound. Shu Wen (Summerheat-Warmth) and Shi Wen (Dampness-Warmth) are not included here. Regarding differentiation, Qi edema differs from water retention and food stagnation: water retention presents with heavy body and obstructed urination, while Qi edema presents with a light body and free urination; food stagnation presents with abdominal knots, while Qi edema presents with a peaceful abdomen.
2. Skin roughness like scales after recovery
After recovery from warm-heat disease, if the body is emaciated and skin is rough like fish scales, it is because heat damaged Yin, and Yin fluids fail to nourish the skin. The treatment method focuses on nourishing Yin. Wu's Renshen Yangrong Tang (Ginseng Nourishing Vigor Decoction) and Qingzao Yangrong Tang (Clear Dryness Nourishing Vigor Decoction) can be used酌情 (as appropriate); Ye's Jiawei Fumai Tang (Modified Restore the Pulse Decoction) is particularly effective. Some recover through porridge dietary therapy alone.
3. Sores after recovery
It is common for sores to appear shortly after recovery from warm-heat disease, caused by residual heat overflowing into the muscles. If treated as ordinary sores with inappropriate warming and supporting methods, rescue is impossible; one must take plenty of cooling, detoxifying, and Qi-Blood nourishing medicines for spontaneous recovery.
4. Flaccidity after recovery
Inability to move the limbs is due to heat damaging the sinews and vessels. Wu's various Yingying Tang (Nourishing Camp Decoctions) can be used as appropriate. Mild cases recover through porridge dietary therapy.
5. Steaming sensation after recovery
A steaming bone-heat resembling tuberculosis is due to residual heat lingering in the Yin divisions. Do not hastily apply treatments from the Consumption chapter just because the patient is emaciated; first observe if there are knotted pathogens in the Six Fu Organs, and if so, prioritize expelling pathogens; second, observe if there is congestion and stasis in the sinews and collaterals, and if so, prioritize unblocking stasis; third, observe if there is phlegm-fluid in the air passages, and if so, prioritize eliminating phlegm-fluid. Only if none of these exist can one clear heat. If there is no pathogen but Yin injury, one can purely use Yin-nourishing medicines; or, based on the severity of residual pathogens and degree of deficiency, combine Yin-nourishing and heat-clearing medicines, adjusting dosage for better harmony.
6. Deafness after recovery
After body temperature normalizes in warm-heat disease, tinnitus and deafness may persist due to three causes. First, residual pathogens remain in the Gallbladder Meridian; use Wendan Tang (Warm the Gallbladder Decoction) added with Chai Hu (Bupleurum Root), Chang Pu (Acorus Rhizome), Gou Teng (Uncaria Ramulus), Chi Ju (Chrysanthemum Indicum), Tong Cao (Tetrapanax Pith), and He Ye (Lotus Leaf) to clear Shaoyang (Lesser Yang) depression. Second, Phlegm-Fire rises, blocking the clear orifices, causing deafness; use Daotan Tang (Eliminate Phlegm Decoction) removing Ban Xia (Pinellia Tuber) and Nan Xing (Arisaema Rhizome), adding Gua Lou Pi (Trichosanthes Peel), Jing Chuan Bei (Fritillaria Thunbergii Bulb), Pi Pa Ye (Loquat Leaf), Du Dou Ling (Campanula Flower), Tong Cao (Tetrapanax Pith), and Xian Chang Pu (Fresh Acorus Rhizome) to lightly ventilate Lung Qi depression. Third, Kidney Essence depletion causes tinnitus and deafness; regularly服用 (take) Erlong Zuoci Wan (Left-Court Pill for Deafness) or Cizhu Wan (Magnetite Pill) to nourish Yin and suppress rebellion. These two conditions (Phlegm-Fire and Kidney Deficiency) do not involve Shaoyang, so Chai Hu (Bupleurum Root) lifting agents are strictly forbidden. For external treatment, Erlong Shendan (Divine Spirit Pill for Deafness) wrapped in silk cotton and inserted into the ear is highly effective.
7. Parotitis after recovery
Commonly known as residual toxin, it is toxin formed by residual pathogens stagnating in the collaterals, due to incomplete sweating, purging, or clearing. Pathogens knot in the Shaoyang (Lesser Yang) and Yangming (Yang Brightness) meridians. Eruption on both cheeks is in the Yangming region; eruption around the ears is in the Shaoyang region. Treatment prioritizes detoxification, heat-clearing, blood-invigorating, and dispersing. Mismanagement leads to pus formation without discharge, trismus (lockjaw), throat obstruction, inability to eat, and death. Internal sinking of toxin with dry tongue and coma also leads to death; post-pus discharge Qi deficiency and Blood collapse also lead to death. Hence, early treatment is essential. Ancient formulas prioritize Puji Xiaodu Yin (Universal Relief Detoxification Decoction); for eruptions behind the ears, prioritize Chai Hu (Bupleurum Root) and Chuan Xiong (Ligusticum Rhizome); for the neck, Ge Gen (Kudzu Root) and Bai Zhi (Angelica Dahurica Root); for the back of the neck or vertex, add Qiang Huo (Notopterygium Rhizome) and Bo He (Mint). Contemporary formulas prioritize Lianqiao Baidu San (Forsythia Detoxification Powder), such as Qiang Huo, Du Huo, Jing Jie, Fang Feng, Lian Qiao, Chi Shao, Niu Bang Zi, Jie Geng, Tu Bei Mu, Ji Li, Bo He, Jin Yin Hua, and Gan Cao. If Yuan Qi (Original Qi) is deficient, combine Dang Gui (Angelica Sinensis) and Huang Qi (Astragalus Root) to support and expel; after ulceration, prioritize massive tonification of Qi and Blood. However, Yangming eruptions are easier to treat, while Shaoyang eruptions are difficult. In summary, at onset, rapid dispersion is crucial; delay leads to pus formation. Do not lightly tonify before ulceration, as early tonification guarantees pus formation. Especially avoid pure cold-cooling herbs at the onset, lest they close and trap the toxin; thus, combining dispersing agents is key. External treatment involves frequent bathing with scallion water.
8. Forehead heat after recovery
After warm-heat disease resolves, if only forehead heat persists and eyes appear dull, this is residual stagnation in the Stomach not cleared. The forehead belongs to the Yangming meridian, hence isolated heat. Clear and disperse using Erchen Tang (Two-Aged Decoction) added with Lian Qiao (Forsythia Fruit), Huang Qin (Scutellaria Root), Shan Zha (Hawthorn Fruit), and Shen Qu (Medicated Leaven) to clear and harmonize.
9. Cough after recovery
If cough persists after heat subsides in warm-heat disease, residual heat remains in the Lung. Nourish Lung and Stomach Yin, and cough will stop. Use Nan Sha Shen (Adenophora Root), Mai Dong (Ophiopogon Tuber), Di Gu Pi (Lycium Bark), Zhi Mu (Anemarrhena Rhizome), Chuan Bei Mu (Fritillaria Bulb), Chuan Shi Hu (Dendrobium Stem), Hua Fen (Trichosanthes Root), Fu Ling (Poria), Tian Xing Ren (Sweet Apricot Seed), Sang Bai Pi (Mulberry Root Bark), Zhe Zhi (Sugarcane Juice), and Li Zhi (Pear Juice), or add Sheng Di Huang (Rehmannia Root) and Yu Zhu (Polygonatum Rhizome). Generally, new Wind-Cold invasion with cough is mild because pathogens enter the Lung, which governs skin and hair, allowing pathogens to exit externally. Warm-heat diseases often involve internal deficiency; cough indicates severity. Five-Zang transmission burning the Lung dries the Water Source, often leading to fatal cases.
10. Spontaneous and Night Sweats after recovery
Although both belong to deficiency patterns, post-warm-heat recovery sweats are mostly due to residual heat not cleared, internal blazing Heart Yang, steaming and scorching, causing Jin Ye (Body Fluids) to leak out as sweat. Avoid sudden or drastic tonification. Bitter-astringent and clear-nourishing methods are suitable. Bitter-astringent: e.g., Danggui Liu Huang Tang (Six-Yellow Decoction with Angelica) modified to nourish Yin, drain fire, and secure the exterior. Clear-nourishing: e.g., Xi Yang Shen (American Ginseng), Sheng Di Huang (Rehmannia Root), Mai Dong (Ophiopogon Tuber), Huang Lian (Coptis Rhizome), Gan Cao (Licorice Root), Xiao Mai (Wheat), Bai He (Lily Bulb), Zhu Ye (Bamboo Leaf), Fu Ling (Poria), and Lian Zi Xin (Lotus Plumule). Select ingredients to form a decoction.
11. Palpitations and Fright after recovery
Shortly after recovery from warm-heat disease, being easily frightened by events and restless in sleep is due to residual heat carrying Phlegm. Phlegm and Qi struggle, shaking the Heart Palace, causing palpitations and fright. Use Zhu Ru (Bamboo Shavings), Huang Lian (Coptis Rhizome), Shi Chang Pu (Acorus Rhizome), Ban Xia (Pinellia Tuber), Dan Xing (Arisaema with Ginger Juice), Zhi Zi (Gardenia Fruit), Zhi Mu (Anemarrhena Rhizome), Fu Ling (Poria), Xuan Fu Hua (Inula Flower), and Ju Hong (Tangerine Peel) to clear residual heat and eliminate phlegm.
12. Palpitations (Zhengchong) after recovery
This is Water deficiency and Fire hyperactivity, with Heart and Kidney failing to interact. Supplement Water and nourish the Heart. Zhusha Anshen Wan (Cinnabar Calming Spirit Pill) is best; Banxia Shumi Tang (Pinellia and Coix Decoction) combined with Jiaotai Wan (Harmonizing Heaven and Earth Pill) is particularly swift.
13. Insomnia after recovery
After heat subsides in warm-heat disease, inability to sleep at night is due to Stomach disharmony; use Wendan Tang (Warm the Gallbladder Decoction) added with Shumi (Coix Seed) to harmonize. Palpitation-induced insomnia is due to Heart Qi deficiency; combine the previous formula with Suanzaoren Tang (Ziziphus Decoction), removing Chuan Xiong (Ligusticum Rhizome) for its astringent properties. Empty vexation-induced insomnia is due to residual fire disturbing; use Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction) to clear and nourish. All-night wakefulness with inability to close eyes, or closing eyes leading to fright and nightmares, is due to residual pathogens remaining in Liver and Gallbladder, Gallbladder Qi not relaxing, and Liver Hun (Ethereal Soul) unsettled. Use wine-soaked Yuli Ren (Apricot Kernel variant), fried Suanzaoren (Ziziphus Seed), Zhu Danpi (Pig Gallbladder Membrane), Huang Lian (Coptis Rhizome), Jiao Shan Zhi (Charred Gardenia), Dan Zhu Ru (Light Bamboo Shavings), and Dong Sang Ye (Mulberry Leaf) to lubricate and remove sticking, bitter to drain heat.
14. Delirious Speech after recovery
After warm-heat disease, once heat subsides and body cools, the patient may act foolishly, have unclear thoughts, speak absurdly, or be lethargic and refuse food. This is due to Heart Spirit deficiency and scattering. Tonify Qi and Blood, and treat the Heart. When Spirit recovers, delirious speech stops. Wu's Anshen Yangxue Tang (Calming Spirit Nourishing Blood Decoction) is primary; Xue's Shenmai Fushen Tang (Ginseng-Ophiopogon and Polyporus Decoction) is also used. However, if residual Phlegm-Fire lies hidden in the Pericardium, this symptom also occurs. Use fresh Shi Chang Pu (Acorus Rhizome), Tian Zhu Huang (Heavenly Bamboo Slurry), Chuan Bei Mu (Fritillaria Bulb), Lian Qiao (Forsythia Fruit), Gou Teng (Uncaria Ramulus), Mu Dan Pi (Moutan Cortex), Dan Zhu Ye (Bamboo Leaf), Zhu Ru (Bamboo Shavings), and Chen Sha (Cinnabar) to cool-open Phlegm-Heat, clearing Spirit and stopping delirium. If ineffective, add Wanshi Niuhuang Qingxin Wan (Wan's Calculus Bovis Clearing Heart Pill). If residual heat remains with confused speech, use Daochi San (Direct Red Powder) added with Mai Dong (Ophiopogon Tuber), Lian Zi Xin (Lotus Plumule), and Zhu Sha Ran Deng Xin (Cinnabar-dyed Lamp Wick) to extinguish residual flames and clear Heart Spirit.
15. Slurred Speech after recovery
After heat subsides in warm-heat disease, stiff tongue and slurred speech occur because the meridians of Heart, Spleen, and Kidney surround the tongue. Heart/Kidney deficiency makes the tongue inflexible; Phlegm blocking Spleen collaterals and internal Liver Wind cause slurred speech. This is always Disease of Deficient Wind, Phlegm, and Fire. Use Daotan Tang (Eliminate Phlegm Decoction) added with Ju Hua (Chrysanthemum Flower), Gou Teng (Uncaria Ramulus), Bai Ji Li (Tribulus Fruit), Zao Jiao Tan (Carob Charcoal), Shi Chang Pu (Acorus Rhizome), Jiang Zhi (Ginger Juice), and Zhu Li (Bamboo Shavings) to extinguish deficient wind and clear Phlegm-Fire. If Phlegm-Heat stagnates in Lung collaterals, use Gu's Qingjin San (Clear Metal Powder) added with Shi Chang Pu (Acorus Rhizome) and Zhu Li (Bamboo Shavings) to clear and descend; if residual heat consumes Lung Yin, use Qingzao Jiufei Tang (Clear Dryness Rescue Lung Decoction) added with Yan Zhi Chuan Bei (Rock-processed Fritillaria) and Ya Li Zhi (Pear Juice) to clear and nourish; if voice trembles and lacks strength, speech interrupts, resembling slurring but not quite, it is severe Yin deficiency and rootless Original Qi. Use Zhenyuan Yin (True Origin Decoction) combined with Linggao (Spirit Paste) for drastic tonification.
16. Drowsiness/Coma after recovery
After recent recovery from warm-heat disease, gradual drowsiness after ten days or half a month is due to incomplete sweating, leaving residual pathogens in the Pericardium. Accompanied by tidal fever or chills/fever resembling malaria, use Lian Qiao (Forsythia Fruit), Zhi Zi (Gardenia Fruit), Dou Chi (Fermented Soybean), Mai Dong (Ophiopogon Tuber), Chang Pu (Acorus Rhizome), Dan Zhu Ye (Bamboo Leaf), Gou Teng (Uncaria Ramulus), and Dan Shen (Salvia Root) to clear and resolve. However, if Phlegm-Fire lies hidden in the Pericardium, drowsiness also occurs. The patient sleeps all day without waking, speaks confusedly, groans, or talks alone as if seeing ghosts. Use Dong Bai Wei (Eastern Codonopsis/Clerodendrum - *Note: Context implies Clerodendrum or similar clearing herb, likely typo for Bai Wei or similar, keeping literal*), Tian Zhu Huang (Heavenly Bamboo Slurry), Jing Chuan Bei (Fritillaria Bulb), Guang Yu Jin (Curcuma Aromatica Rhizome), Shi Chang Pu (Acorus Rhizome), Zao Jiao Ci (Carob Thorn), Xian Zhu Ye (Fresh Bamboo Leaf), Xi Ya Cha (Fine Bud Tea), Zhu Sha Ran Deng Xin (Cinnabar-dyed Lamp Wick), and Juezhuang Fanhun Dan (Reviving Spirit Pill for Collapse) to lightly clear and open. Even Wanshi Niuhuang Qingxin Wan (Wan's Calculus Bovis Clearing Heart Pill) or Ye's Shenxi Dan (Divine Dew Pill) can be adopted.
17. Excessive Salivation after recovery
This is excessive spitting of saliva. If Stomach deficiency with residual heat, use Wumei Beizao Wan (Mume and Northern Date Pill) to dissolve in mouth. If Earth deficiency fails to control water, use Liujunzi Tang (Six-Gentlemen Decoction) added with Yizhi Ren (Alpinia Oxyphylla Fruit) to grasp water. If thick fluid rises from Lower Jiao and overflows, it is Kidney Qi failing to grasp, turbid Yin rising. Use Duqi Yin (Duqi Decoction) added with Hetao (Walnut) and Buguzhi (Psoralea Fruit) to grasp, or add small amount of Dan Fupian (Processed Aconite Slice) to gather, or assist with Bai Zhu (Atractylodes Macrocephala Rhizome) to control.
18. Loss of Appetite after recovery
Differentiate between unwillingness to eat and inability to digest. Unwillingness to eat indicates Stomach pathology; nourish with sweet-cool. Jinkui Maimendong Tang (Golden Cabinet Ophiopogon Decoction) is primary; Ye's Yangwei Tang (Nourish Stomach Decoction) is also used. Inability to digest indicates Spleen pathology; tonify with warm-moving. Xiangsha Lizhong Tang (Amomum and Aucklandia Regulating Middle Decoction) is primary; Liujunzi Tang (Six-Gentlemen Decoction) is also used. However, loss of appetite should be divided into Food Injury and Food Retention. Food Injury: excessive eating damages intestines/stomach, failure to digest. Food Retention: regardless of amount, due to anger or illness causing Qi knotting and failure to transform. Treat Food Injury focusing on food: induce vomiting, purge, or digest. Treat Food Retention focusing on Qi: regulate Qi and assist digestion; vomiting/purging are forbidden. Physicians must differentiate.
19. Constipation after recovery
After warm-heat disease, constipation is mostly Heat Closure or Deficiency Closure; Wind Closure and Qi Closure are rare. Heat Closure: heat binds fluids, intestines/stomach dry and knotted, or chronic intestinal heat. Symptoms: red face, hot abdomen, distension, cold limbs, mouth/tongue ulcers. Dahuang Yinzi (Rhubarb Decoction) is best; Sanhuang Zhizhu Wan (Three-Yellow Atractylodes Pill), Zhishi Daozhi Wan (Immature Bitter Orange Directing Away Pill), and Lu's Runzi Wan (Lu's Moistening Seed Pill) can be used. Deficiency Closure has two types: Yin and Yang deficiency. Lower Jiao Yang deficiency: Yang Qi fails to move, cannot transport, Yin condenses below. Treat Yang deficiency by benefiting Fire; Congrong Runchang Wan (Cistanche Intestine-Moistening Pill) is primary; for elderly, Ban Shou Wan (Half-Sulfur Pill) sent down with Huang Tang (Yellow Decoction). Lower Jiao Yin deficiency: Essence/Blood dry, fluids fail to reach, intestines wither. Treat Yin deficiency by strengthening Water; Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) added with Dan Congrong (Cistanche) and Bai Mi (White Honey) is primary; Yixue Runchang Wan (Blood-Nourishing Intestine-Moistening Pill) and Wuren Wan (Five-Kernel Pill) are also effective. Wind Closure: Wind dominance causes dryness, from Wind-Heat attacking Lung transmitting to Large Intestine, drying fluids; or chronic Wind disease; or chronic intestinal heat generating internal Wind. Dongyuan Runchang Wan (Dongyuan's Intestine-Moistening Pill) is primary; JiaWei Zaojiao Wan (Modified Carob Pill) is also used. Qi Closure: Qi stagnates internally, waste does not move. Pulse is deep, patient belches, chest/abdominal fullness, hypochondriac distension. Using purgatives may temporarily relieve but worsens closure or causes bleeding. Only regulate Qi; when Qi flows freely, stool passes. Suzi Jiangqi Tang (Perilla Descending Qi Decoction) added with Zhi Ke (Bitter Orange) and Xing Ren (Apricot Seed) is primary; severe cases use Limo Tang (Six-Moaning Decoction).
20. Abdominal Heat after recovery
After warm-heat disease body cools significantly, but abdominal heat persists, this is intense Spleen Fire internally. Adding Sheng Bai Shao (Raw White Peony Root) to Yin-nourishing medicines clears it. This syndrome is most common in Fu Shu (Latent Summerheat) and Wan Fa (Late Onset), mostly intestinal/stomach accumulated heat. Xue Geng (Winter Melon and Fernbrake Decoction) sent down with Lu's Runzi Wan (Lu's Moistening Seed Pill) is best.
21. Rectal Bleeding after recovery
Shortly after recovery, or 10-15 days later, sudden rectal bleeding is due to latent fire not cleared, heat damaging Yin collaterals, causing blood overflow. Treat with clearing Ying (Nutrient) level, cooling Blood, and harmonizing collaterals. Use Sheng Di Huang (Rehmannia Root), Mu Dan Pi (Moutan Cortex), Di Yu (Sanguisorba Root), Chuan Duan (Dipsacus Root), Huai Mi (Sophora Flower), Bai Shao (White Peony Root), Yi Yi Ren (Coix Seed), Hei Jing Jie (Charred Schizonepeta), Bai Mao Gen (Imperata Rhizome), and Zanglian Wan (Viscera-Lining Pill) for spontaneous recovery. For Yin deficiency with Fire hyperactivity, Zanglian Liuwei Wan (Viscera-Lining Six-Ingredient Pill) is particularly swift.
22. Nocturnal Emission after recovery
Mostly due to Fire stirring; clear residual heat. Gujing Fengsui Dan (Secure Essence Seal Marrow Pill) is primary; Santai Fengsui Dan (Three-Talent Seal Marrow Pill) added with Huang Lian (Coptis Rhizome) is also used. Huang Lian and Huang Bai (Phellodendron Bark) are the most important herbs for this condition.
23. Post-Recovery Regulation
Divide into Tonifying Deficiency and Clearing Heat. Tonifying Deficiency has two methods: Tonify Spleen and Tonify Stomach. If Middle Qi is deficient, after illness retreat, appetite is low, transformation slow, loose stools, or nausea/vomiting saliva; use modified Liujunzi Tang (Six-Gentlemen Decoction) to harmonize middle. Cold intolerance requires Huangqi Jianzhong Tang (Astragalus Regulating Middle Decoction) for warming tonification. Pulse is slow and large, tongue white and tender. If Yin division is deficient, residual pathogens remain, dry tongue/thirst, difficult urination/defecation, pulse slightly rapid; use Xiaoganlu Yin (Little Sweet Dew Decoction) or Ye's Yangwei Tang (Nourish Stomach Decoction) for clear nourishment. Clearing Heat has two methods: Initial illness heat is Excess Heat, clear with Bitter-Cold herbs; post-major illness heat is Deficiency Heat, clear with Sweet-Cold herbs. They differ vastly. True Qi resides in the Stomach Gate; insufficient fluids is deficiency; generating fluids is tonifying deficiency. Thus, combining fluid-generating and Sweet-Cold heat-clearing herbs treats post-infection deficiency heat: Mai Dong (Ophiopogon Tuber), Sheng Di Huang (Rehmannia Root), Mu Dan Pi (Moutan Cortex), Bei Sha Shen (Glehnia Root), Xi Yang Shen (American Ginseng), Xian Shi Hu (Fresh Dendrobium), Li Zhi (Pear Juice), Zhe Zhi (Sugarcane Juice), Zhu Li (Bamboo Shavings), Mao Gen (Imperata Rhizome) are all correct. Zhang Zhongjing and He Jian primarily use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) and Tiansan San (Heavenly Three Powder) to clear deficiency heat, taking the meaning of Sweet-Cool. Mistakenly using Shen (Ginseng), Qi (Astragalus), Ling (Poria), Zhu (Atractylodes) as tonification would inadvertently tonify pathogenic heat! Dietary tonification should focus on Qi, not flavor. Grain Qi nourishes, Vegetable Qi fills. Between meals, slight sweating transports accumulated heat out through pores—how refreshing! People ignore this, rushing to use rich/sweet foods to tonify. Though initially energetic, grease blocks collaterals, trapping heat, making recovery impossible. Elder Pang Anchang noted: "For new recovery, start with thin white rice porridge, then thicker, then congee, giving small amounts frequently; do not eat meat early." Wise words!
24. Taboos after recovery
After major warm-heat disease, Zheng Qi (Upright Qi) is not recovered; diet and lifestyle must be cautious. Alcohol, sweets, crisp/fatty/fresh foods, and cold/raw items are forbidden. Only self-nourish with congee, eat small frequent meals for easy digestion, avoid overeating, and deny cravings for other foods. Qi and Blood are necessarily deficient; mental/physical exertion, excessive joy/anger, talking/moving too much can cause relapse due to labor. Labor agitates deficient Qi/Blood, generates residual heat. Heat retreats = recovery; Heat arises = relapse. This applies to all diseases, especially warm-heat. Patients must value themselves.