凡病将愈,为劳动而病复作者,谓之劳复。非但强力持重,若梳沐动气,忧愁思
虑,则劳神皆复也。
【解】新瘥后津液未复,气血尚虚,少劳之则生热而病复作。脉浮者,微汗以解
之,枳壳栀子汤、鼠矢豉汤、 鼠矢汤、当归白术汤、干姜汤。
【和】劳役复发热者,冲和汤。
【清】瘥后渴热,竹叶石膏汤。劳复发热欲绝,麦门冬汤。
病后新瘥,胃气未完,但得少食糜粥,常令稍饥,不可过饱若恣所欲,顿食至饱,或
食肥腻脍炙果品等,稍不消化,则邪气乘机而复作,发热烦躁而病愈甚,谓之食复。
【吐】宿食未克者,枳实栀子豉汤吐之。
【消导】腹满烦热,二陈汤加山楂、麦芽、砂仁、神曲。
【下】饮食稍多,经数日不愈,脉沉实热甚,便秘谵语,大柴胡汤、枳实大黄汤。
【补】消导后热不退者,补中益气汤。
伤寒十余日,过经不解,胸满而呕,日晡潮热,大便微利,本大柴胡证,医以丸药
下之,非其治也。(伤寒法以十一日愈,十二日不愈者再传,所谓过经是也。)
【解】有潮热者,实也,先与小柴胡汤以解外,后服柴胡加芒硝。太阳过经十余日,
下之后四五日,柴胡证在,与小柴胡汤。呕不止,心下微烦为未解,大柴胡汤。
【下】伤寒十三日,过经不解,谵语,以有热也,当以汤下之。内实者,调胃承气
汤。太阳过经十余日,心下欲吐,胸痛,大便反溏,腹微满,微烦。若不经吐下者,当
与柴胡汤。若曾经吐下者,则邪气乘虚入胃为实,调胃承气汤。
凡是疾病即将痊愈时,因过度劳累而导致病情复发者,称为劳复。不仅仅是强力负重,如果洗头洗澡扰动气血,或者忧愁思虑,这些导致心神劳累的情况都会引起复发。
【解析】大病初愈后,津液尚未恢复,气血依然虚弱,稍加劳累就会产生内热,导致疾病复发。脉象浮的,用微汗法来解除病邪,可用枳壳栀子汤、鼠矢豉汤、鼠矢汤、当归白术汤、干姜汤。
【清热法】病愈后口渴发热,用竹叶石膏汤。劳复导致发热极度严重,用麦门冬汤。
疾病刚痊愈,胃气尚未完全恢复,只能少量进食米粥,常保持轻微饥饿感,不可过饱。如果放纵欲望,一顿吃得过饱,或者食用肥腻、烤肉、水果等食物,稍微难以消化,邪气就会趁机再次发作,出现发热烦躁且病情加重,这称为食复。
【消食导滞法】腹部胀满、烦热,用二陈汤加山楂、麦芽、砂仁、神曲。
【泻下法】饮食稍多,经过几天仍未痊愈,脉象沉实、热势严重、便秘胡言乱语,用大柴胡汤、枳实大黄汤。
伤寒病十余日,病邪已离开太阳经但病情未解(即“过经不解”),胸部胀满且呕吐,下午定时发热(日晡潮热),大便轻微通利,这本是大柴胡汤证,医生却用丸药攻下,这不是正确的治法。(伤寒病的规律是十一日痊愈,若十二日未愈则病邪传变至下一经,这就是所谓的“过经”。)
【解析】有潮热症状的,属于实证,先用小柴胡汤来解除表邪,随后服用柴胡加芒硝汤。太阳病已过经十余日,在攻下之后四五日,若柴胡证仍在,给予小柴胡汤。呕吐不止,心下部轻微烦闷,说明病邪未解,用大柴胡汤。
【泻下法】伤寒十三日,病邪过经未解,出现胡言乱语,这是因为体内有热,应当用汤剂攻下。体内实热结聚的,用调胃承气汤。太阳病已过经十余日,想呕吐,胸痛,大便反而稀溏,腹部轻微胀满,轻微烦闷。如果没有经过吐法或下法治疗,应当给予柴胡汤。如果曾经经过吐法或下法治疗,那么邪气就会乘虚进入胃部形成实证,用调胃承气汤。
Whenever a disease is about to heal but recurs due to overexertion, it is called *Laofu* (Recurrence due to Labor). This applies not only to carrying heavy weights with force, but also to activities such as washing hair or bathing that disturb the Qi and Blood, or emotional states like worry and excessive thinking that exhaust the Shen (Spirit); all these forms of mental or physical labor can cause recurrence.
[Analysis] After a new recovery, the Body Fluids have not yet replenished, and the Qi and Blood remain deficient. Slight exertion generates Heat, causing the disease to recur. If the pulse is Floating (*Fu*), resolve the pathogen via mild sweating using Zhike Zhizi Tang (Bitter Orange and Gardenia Decoction), Shushi Chi Tang (Mouse Dropping and Fermented Soybean Decoction), Shushi Tang (Mouse Dropping Decoction), Danggui Baizhu Tang (Angelica Sinensis and Atractylodes Macrocephala Decoction), or Ganjiang Tang (Dried Ginger Decoction).
[Harmonizing Method] For fever recurring due to labor and fatigue, use Chonghe Tang (Harmonizing Decoction).
[Cooling Method] For thirst and fever after recovery, use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction). For severe fever due to *Laofu*, use Maimendong Tang (Ophiopogon Decoction).
After an illness, when the body has just recovered, the Stomach Qi is not yet fully restored. One should consume only small amounts of congee and maintain a slight feeling of hunger; one must not eat until full. If one indulges desires, eating a large meal at once, or consuming fatty, greasy foods, roasted meats, or fruits, which are slightly difficult to digest, the Pathogenic Factor will take advantage of this weakness to recur. This manifests as fever, irritability, and worsening of the condition, known as *Shifu* (Recurrence due to Diet).
[Vomiting Method] For retained food that has not been cleared, induce vomiting with Zhishi Zhizi Chi Tang (Immature Bitter Orange, Gardenia, and Fermented Soybean Decoction).
[Digestive Promoting Method] For abdominal distension, irritability, and heat, use Erchen Tang (Two-Cured Decoction) added with Shanzha (Hawthorn Fruit), Maiya (Sprouted Barley), Sharen (Amomum Fruit), and Shenqu (Medicated Leaven).
[Purgative Method] If slightly excessive food intake leads to no improvement after several days, accompanied by a Deep (*Chen*) and Excess (*Shi*) pulse, severe heat, constipation, and delirium, use Da Chaihu Tang (Major Bupleurum Decoction) or Zhishi Dahuang Tang (Immature Bitter Orange and Rhubarb Decoction).
[Tonifying Method] If heat persists after digestive promotion, use Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi).
In Shaoyin Cold Damage (*Shanghan*), after more than ten days, if the disease has passed through the meridians but remains unresolved (*Guojing Bu Jie*), presenting with chest fullness and vomiting, afternoon tidal fever (*Ribu Chao Re*), and slight loose stools, this originally constitutes a Da Chaihu Tang pattern. However, if the physician used pill-based purgatives, this is incorrect treatment. (According to Shaoyin Cold Damage principles, healing occurs on the eleventh day; if not healed by the twelfth day, the pathogen transmits to the next meridian, which is referred to as "passing through the meridians".)
[Analysis] The presence of tidal fever indicates an Excess syndrome. First, administer Xiao Chaihu Tang (Minor Bupleurum Decoction) to resolve the exterior, followed by Chaihu Jia Mangxiao Tang (Bupleurum with Natron Decoction). If Taiyang disease has passed through the meridians for more than ten days, and four to five days after purgation, the Chaihu patterns persist, administer Xiao Chaihu Tang. If vomiting continues incessantly and there is slight irritability in the epigastrium, indicating the pathogen has not resolved, use Da Chaihu Tang.
[Purgative Method] In Shaoyin Cold Damage on the thirteenth day, if the disease has passed through the meridians without resolution and delirium occurs due to internal heat, purgation with a decoction is indicated. For internal excess, use Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction). If Taiyang disease has passed through the meridians for more than ten days, presenting with a desire to vomit, chest pain, loose stools, slight abdominal fullness, and slight irritability: if no emetic or purgative treatment has been applied previously, administer a Chaihu Decoction. If emetic or purgative treatments were previously applied, the pathogen enters the Stomach vacuity to form an excess syndrome; in this case, use Tiaowei Chengqi Tang.