伤寒瘥后热还生。因食因劳辄动经。脉实下之浮即汗。大柴鼠粪气温平。
劳复食复者。谓伤寒新瘥。血气未平。余热未尽。因劳动而复作者。名曰劳复。以枳实
栀子
豉汤及小柴胡汤主之。宜和中以退其热也。又有因过餐而复发者。名曰食复。以栀子大黄汤
及大柴胡汤主之。通其阳以退其热也。
坏病多缘汗下差。过经不解咎医家。柴胡汤内加硝治。解表还兼泻里佳。
过经不解者。谓伤寒十二日当愈不愈。则再传。是谓过经。此即伤寒坏病。多因汗下失
宜所致。宜柴胡加芒硝汤治之。以解表而攻里也。
温疟多因坏病成。后寒先热往来频。小柴加桂专能治。白虎人参实可平。
温疟者。冬受寒邪。复感春寒而发也。其脉尺寸俱盛。其症先热后寒。或寒热往来。此
寒坏病也。宜小柴胡汤少加薄桂主之。如热多倍加柴胡。寒多倍加桂枝。若热甚而烦躁者。
宜人参白虎汤主之。大抵伤寒温疟。不与杂症同。宜参证治之。
大渴饮时能一斗。常令止与二三升。若还不与非其治。强饮无疑别病生。脉浮而渴太阳
有汗而渴阳明症。渴而自利属少阴。三者不同须审定。自非大渴莫与饮。小渴惟宜滋润尔。
若是剧饮心下满。变成水结难调理。
阳明口渴苦头痛。水不下咽将衄血。瘀血停留定发狂。病家外症无寒热。
按阳明内有热者。欲饮水。今漱水不欲咽。是热在经而里无热也。阳明经气血俱多。经
盛。逼血妄行。故知必作衄也。宜犀角地黄汤及茅花汤主之。无表症。不寒热。胸腹满。口
燥渴。漱水不欲咽。小便多者。此为瘀血。必致发狂。宜桃仁承气汤。甚者抵当丸。取尽
黑色为度也。又少阴脉沉细。手足冷。或时烦躁作渴。欲漱水不欲咽者。宜四逆汤主之。又
下利厥逆。无脉干呕、烦渴、欲漱水不欲咽。宜白虎加猪胆汁人尿主之。及唇时不欲咽者。
宜理中汤加乌梅主之。大抵阴症发燥烦渴。不能饮水。或有勉强饮下。良久复吐。或饮水而
呕。或哕逆皆内寒也。盖无根失守之火。游于咽嗌之间。假作燥渴。则不能饮。或有能饮水
不吐。复欲饮者。热也。
伤寒病初愈后，热邪再次产生。因饮食不当或劳累而触动经络。脉象实者用泻下法，脉象浮者用发汗法。大柴胡汤配合鼠粪（即鼠矢），药性温和。
所谓劳复、食复，是指伤寒刚刚痊愈，气血尚未平复，余热未尽，因为劳动而再次发作的，称为劳复。使用枳实栀子豉汤以及小柴胡汤主治。适宜通过调和脾胃来退去热邪。又有因为过度进食而再次发作的，称为食复。使用栀子大黄汤以及大柴胡汤主治，通过通利阳气来退去热邪。
坏病多是因为发汗或泻下治疗失误所致。病邪传经超过十二日仍未解除，责任在于医生。在柴胡汤中加入芒硝进行治疗，既能解表又能兼泻里，是很好的方法。
所谓过经不解，是指伤寒十二天应当痊愈却没有痊愈，病邪再次传变，这叫做过经。这就是伤寒的坏病，多因发汗或泻下失宜所致。适宜用柴胡加芒硝汤治疗，以解表并攻逐里邪。
温疟多因坏病演变而成。表现为先冷后热，寒热往来频繁。小柴胡汤加入桂枝专门能治疗此症，白虎加人参汤确实可以平息病情。
所谓温疟，是冬天感受寒邪，又春天感受寒气而发作的。其脉象寸关尺三部都盛大，症状是先发热后发冷，或者寒热往来，这是由寒邪导致的坏病。适宜用小柴胡汤少量加入薄桂（肉桂）主治。如果热多则加倍加入柴胡，寒多则加倍加入桂枝。如果热势很盛且烦躁不安，适宜用人参白虎汤主治。大体上，伤寒引起的温疟，不与其他杂症相同，应当结合证候进行治疗。
极度口渴饮水时，一次能喝一斗（古代容量单位）。经常只让他喝二三升即可。如果不加以节制给予非正常的饮水量，强行饮水无疑会引发其他疾病。脉浮且口渴属于太阳病；有汗且口渴属于阳明病；口渴且自发性腹泻属于少阴病。这三种情况不同，必须仔细审定。除非是大渴，否则不要随意给水。小渴只适宜滋润口腔。如果是剧烈饮水导致心下胀满，会变成水结胸，难以调理。
阳明病口渴且苦痛头痛，水含在口中不愿咽下，将会出现鼻出血。瘀血停留体内，必定导致发狂。病人外在没有寒热症状。
按照阳明经内有热邪的情况，想要喝水。现在只是含水漱口而不愿咽下，说明热邪在经络而在脏腑内部没有热邪。阳明经气血都很旺盛，经络热盛，逼迫血液妄行，所以知道必定会发生鼻衄。适宜用犀角地黄汤及茅花汤主治。如果没有表证，不恶寒发热，胸腹部胀满，口燥渴，含水漱口而不愿咽下，小便多的，这是瘀血，必定导致发狂。适宜用桃仁承气汤。严重的用抵当丸，直到排出黑色的瘀血为止。另外，少阴病脉象沉细，手脚冰冷，有时烦躁作渴，想含水漱口而不愿咽下的，适宜用四逆汤主治。还有下利厥逆，无脉象，干呕，烦渴，想含水漱口而不愿咽下的，适宜用白虎加猪胆汁人尿主治。还有嘴唇干燥但不想咽水的，适宜用理中汤加乌梅主治。大体上，阴证出现烦躁口渴，不能饮水，或者有勉强喝下去，过了一会儿又吐出来，或者饮水后呕吐，或者呃逆，都是内寒的表现。这是因为无根失守的火，游走在咽喉之间，假装成燥渴，所以不能饮水。或者有能饮水且不吐，还想再喝的，那是热证。
After the recovery from *Shanghan* (Cold Damage), heat may reappear. It is triggered by improper diet or exertion, disturbing the meridians. If the pulse is excess (*Shi*), use purgation; if floating (*Fu*), use sweating. *Da Chai Hu Tang* (Major Bupleurum Decoction) combined with mouse feces (*Shu Shi*) has a mild temperature.
"Laofu" (Relapse due to exertion) and "Shifu" (Relapse due to diet) refer to conditions where, shortly after recovering from *Shanghan*, the blood and qi are not yet balanced, and residual heat remains. If it recurs due to physical labor, it is called Laofu. It is treated with Zhishi Zhizi Chi Tang (Gardenia, Immature Bitter Orange, and Fermented Soybean Decoction) and Xiao Chai Hu Tang (Minor Bupleurum Decoction). The appropriate method is to harmonize the middle jiao to dissipate the heat. If it recurs due to overeating, it is called Shifu. It is treated with Zhizi Dahuang Tang (Gardenia and Rhubarb Decoction) and Da Chai Hu Tang (Major Bupleurum Decoction), clearing yang to dissipate heat.
Complicated diseases (*Huabing*) often arise from errors in sweating or purging. Failure to resolve after the meridian cycle has passed (exceeding twelve days) is the fault of the physician. Adding Mangxiao (Mirabilite) to Chai Hu Tang treats this, effectively releasing the exterior while simultaneously purging the interior.
"Guojing bujie" (Failure to resolve after passing the meridian) refers to cases where *Shanghan* should have healed within twelve days but has not, leading to further transmission. This is termed Guojing and constitutes a Huabing. It is mostly caused by inappropriate sweating or purging. It should be treated with Chai Hu Jia Mangxiao Tang (Bupleurum Decoction with Mirabilite) to release the exterior and attack the interior.
Wenre (Warm Malaria) often develops from complicated diseases. Symptoms include alternating chills and fever, starting with cold followed by heat, occurring frequently. Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Gui Zhi (Cinnamon Twig) is specifically effective. Baihu Jia Renshen Tang (White Tiger Decoction with Ginseng) can effectively calm the condition.
Wenre occurs when winter cold pathogens are contracted, followed by spring cold triggering an outbreak. The pulse is vigorous at all three positions (Cun, Guan, Chi). Symptoms present as fever preceding chills, or alternating chills and heat. This is a complicated disease caused by cold. It is treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction) with a small amount of Bo Gui (Thin Cinnamon Bark). If heat predominates, double the Chai Hu (Bupleurum); if cold predominates, double the Gui Zhi (Cinnamon Twig). If heat is severe accompanied by irritability, Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction) is indicated. Generally, Wenre associated with *Shanghan* differs from miscellaneous diseases and must be treated based on syndrome differentiation.
Extreme thirst may lead to drinking up to one Dou (ancient unit) at once. One should limit intake to two or three Sheng. If uncontrolled water intake is allowed without proper treatment, forcing fluids will undoubtedly cause other diseases. Floating pulse with thirst indicates Taiyang disease; sweating with thirst indicates Yangming disease; thirst with spontaneous diarrhea indicates Shaoyin disease. These three must be carefully distinguished. Do not offer water unless there is extreme thirst. For mild thirst, only moistening is suitable. Excessive drinking leading to fullness below the heart results in Water Binding (*Shui Jie*), which is difficult to regulate.
Yangming disease involves thirst, bitter taste, and headache. Water held in the mouth is not swallowed, potentially leading to epistaxis (nosebleed). Stagnant blood causes mania. The patient presents externally without chills or fever.
According to the principle that Yangming interior heat induces desire to drink, holding water in the mouth without swallowing indicates heat in the meridians but no heat in the interior. Yangming meridians have abundant blood and qi; excessive meridian heat forces blood to move recklessly, predicting epistaxis. Treat with Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) and Maohua Tang (Reed Flower Decoction). In the absence of exterior symptoms, without chills or fever, with chest/abdominal fullness, dry mouth/thirst, holding water without swallowing, and frequent urination, this is blood stasis leading to mania. Treat with Tao Ren Cheng Qi Tang (Peach Kernel and Martial Law-Decreasing Decoction). Severe cases use Didang Wan (Didang Pill), administered until black stool is expelled. Additionally, for Shaoyin disease with deep/fine pulse, cold limbs, occasional irritability/thirst, and desire to hold water without swallowing, Si Ni Tang (Four Reversal Decoction) is indicated. For diarrhea, reversal cold, absent pulse, dry retching, irritability/thirst, and desire to hold water without swallowing, Baihu Zhu Zhuyejia Zhuru Nianye (White Tiger Decoction with Pig Gallbladder and Human Urine) is indicated. For dry lips without desire to swallow, Lizhong Tang (Regulate the Middle Decoction) with Wumei (Mume Fruit) is indicated. Generally, Yin syndromes presenting with dryness, irritability, and thirst where drinking is impossible, or where drinking leads to vomiting later, or belching, indicate internal cold. This is rootless fire wandering the throat, feigning dryness/thirst, thus preventing drinking. Conversely, if the patient can drink without vomiting and desires more, it is a Heat syndrome.