前人多言阴虚发热，罕言阳虚发热者，惟东垣曾力辨之。夫劳伤阳虚者，大劳大汗，及
强力
入房，汗出如浴，阳气内竭，即亡阳之例也。发为表热，粗看与外感无别，若兼外感，更难
别矣；头面胸腹燔灼如火，自觉心中如焚，又与温病相似。治法却与外感与温病毫不相涉，
若或差误，死在顷刻，轻者亦不出五日七日也。其辨别处∶处感脉必弦紧；温病脉必洪大，
上涌有力；劳伤脉必迟弱无力，或浮虚而促，或沉细而疾，或断而漉漉如珠，或涩而参伍不
调，或应指即回而无势，或软长圆净而无晕。外感四肢俱热；劳伤两足必冷，不能甚热。温
病以手按皮肤上，必久而愈热；劳伤久按反觉冷气侵入。外感热盛，必烦躁气粗；劳伤气平
身静，不能转侧。温病内热，必全腹上下皆热；劳伤只热在心中，是阳气离根，而上结于此
也。温病内热，必渴而索饮无厌；劳伤口干，索水不欲饮，饮亦不多。外感舌苔先白而转黄
；温病舌苔先或白或黄而转黑，干燥生刺；劳伤或舌白苔薄，或淡红无苔，或舌黑而润，或
舌尖有红紫黑点，而舌心自净。外感、温病热盛，面色必赤；劳伤面色不赤，或两颧浮红，
而额上晦暗。外感、温病热盛，必昏惑谵妄，手足躁扰；劳伤神识清明，但卧而身重难动，
睡中呢喃一二句，而声息甚微。如上诸象，即不全见，总有二三处可辨。若舌微强短，及言
谈委婉详尽，异于平日者，此真气已离，神丹莫救矣。治之先宜微酸入温补剂中，敛阳归根
。有外感者，俟中气有权，发见躁扰之象，再以补中加散可也。其中又有夹食、夹血、夹痰
、夹湿、夹郁之辨，更有兼阴虚者，并宜兼顾。若素有痞块，尤难措手。误用白虎、三黄及
犀角地黄，但一入口，即心气衰息，口不能言，万无挽回之策。若外感重而劳伤轻者，即陶
节庵所谓劳力伤寒也，与虚人病感，皆散中加补可已。
前人大多谈论阴虚发热，很少谈论阳虚发热，只有李东垣曾经极力辨析过。所谓劳伤导致的阳虚，多因过度劳累、大量出汗，以及强力行房事，导致汗出如洗澡一般，阳气在内枯竭，这属于亡阳的范畴。这种发热表现为体表发热，粗看与外感病没有区别，如果兼夹外感，就更难辨别了；头面胸腹灼热如火，自觉心中像焚烧一样，又与温病相似。但其治法与外感和温病毫不相干，如果治疗出现差错，患者顷刻间就会死亡，轻者也不超过五到七天。
其辨别要点在于：外感病的脉象必定弦紧；温病的脉象必定洪大，向上涌起且有力；而劳伤病脉象必定迟弱无力，或者浮虚而急促，或者沉细而疾速，或者脉搏中断且漉漉如珠滚动，或者涩滞且参伍不调（节律不齐），或者应指即回而无气势，或者软弱长圆净滑而无晕动感。外感病四肢都发热；劳伤病两脚必定发冷，不能很热。用手按压皮肤，温病患者按久了会更热；劳伤病久按反而觉得冷气侵入。外感病热盛，必定烦躁气粗；劳伤病气息平稳身体安静，不能翻身转动。温病内部热盛，必定全腹部上下都热；劳伤病只感觉心中热，这是阳气脱离根本，而上结聚于此所致。温病内热，必定口渴想喝水且不知满足；劳伤病人口干，想要水但不想喝，即使喝了也不多。外感病舌苔先白后转黄；温病舌苔先或白或黄后转黑，干燥生刺；劳伤病有的舌白苔薄，有的淡红无苔，有的舌黑而润，有的舌尖有红紫黑点，但舌心自然洁净。外感、温病热盛，面色必定发红；劳伤病面色不发红，或者两颧浮红，而额头晦暗。外感、温病热盛，必定神志昏惑谵语妄言，手足躁动不安；劳伤病神识清明，只是躺着身体沉重难以活动，睡中说一两句梦话，但声音气息很微弱。以上各种征象，即使不全出现，总有二三个地方可以辨别。如果出现舌头微强短缩，以及言语委婉详尽，与平日不同的情况，这说明真气已经离散，神仙丹药也无法救治了。
治疗时，先在温补剂中加入少量酸味药，以收敛阳气使其归根。如果有外感，等到中气有权力（恢复），出现躁扰之象时，再用补中益气汤加解表药即可治愈。其中又有夹杂食积、瘀血、痰饮、湿邪、气郁的辨别，更有兼夹阴虚的情况，都应兼顾考虑。如果素有痞块（腹部肿块），尤其难以着手治疗。误用白虎汤、三黄泻心汤及犀角地黄汤，只要入口，就会导致心气衰败气息微弱，口不能言，万无挽回的办法。如果是外感重而劳伤轻的情况，就是陶节庵所说的“劳力伤寒”，与虚人患外感病一样，都在散邪药中加入补益药即可痊愈。
Previous authors mostly discussed fever due to Yin deficiency, rarely mentioning fever due to Yang deficiency; only Li Dongyuan (Li Gao) had vigorously differentiated it. The so-called Yang deficiency caused by labor injury often results from excessive fatigue, profuse sweating, or strenuous sexual intercourse, leading to sweat pouring like a bath and internal exhaustion of Yang Qi, which is an example of the loss of Yang Qi (Wang Yang). This manifests as superficial heat; at first glance, it is indistinguishable from exterior syndrome (Exogenous Disease), and if complicated by an exogenous pathogen, differentiation becomes even more difficult. The head, face, chest, and abdomen burn like fire, with a subjective sensation of burning in the heart, resembling warm disease (Warm Pathogen Disease). However, its treatment has nothing to do with that for exterior syndromes or warm diseases. If mistaken, death may occur within moments; even in mild cases, death occurs within five to seven days.
The points of differentiation are as follows: In exterior syndromes, the pulse must be string-tight (Xian Jin); in warm diseases, the pulse must be surging-large (Hong Da), surging upward and forceful; whereas in labor injuries, the pulse must be slow-weak (Chi Ruo) and powerless, or floating-empty and hurried (Fu Xu Cu), or deep-thin and rapid (Chen Xi Ji), or intermittent and gurgling like rolling pearls, or choppy and irregular (Can Wu Bu Tiao), or rebounding immediately upon pressure without momentum, or soft, long, round, and clean without turbidity. In exterior syndromes, all four limbs are hot; in labor injuries, both feet must be cold and cannot be very hot. Upon manual pressure on the skin, warmth increases the longer one presses in warm diseases; in labor injuries, prolonged pressure feels like cold air invading. In exterior syndromes with intense heat, there is necessarily irritability and coarse breathing; in labor injuries, the breath is calm and the body is still, unable to turn over. In warm diseases with internal heat, the entire abdomen from top to bottom is hot; in labor injuries, only the heart region feels hot, indicating that Yang Qi has detached from its root and gathered above. In warm diseases with internal heat, there is necessarily thirst and an insatiable desire to drink; in labor injuries, the mouth is dry, the patient desires water but does not want to drink, and if they do, they drink little. In exterior syndromes, the tongue coating turns from white to yellow; in warm diseases, the coating turns from white or yellow to black, becoming dry with prickles; in labor injuries, the tongue may have thin white coating, be pale red without coating, be black and moist, or have red-purple-black spots on the tip while the center remains clean. In exterior and warm diseases with intense heat, the complexion must be red; in labor injuries, the complexion is not red, or shows floating redness on the malar bones while the forehead appears dull. In exterior and warm diseases with intense heat, there is necessarily confusion, delirium, and restlessness of hands and feet; in labor injuries, consciousness is clear, but the patient lies down with a heavy body difficult to move, muttering one or two sentences in sleep with very faint voice and breath. Among the aforementioned signs, even if not all appear, two or three places can always be used for differentiation. If the tongue is slightly stiff and short, or speech is overly polite and detailed, differing from usual, this indicates that the True Qi has departed, and no divine medicine can save them.
Treatment should initially involve adding a slight amount of sour flavor to warming tonics to astringe Yang Qi and return it to its root. If there is an exterior syndrome, wait until the Middle Qi regains strength and signs of restlessness appear, then use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with added dispersing herbs to cure it. Differentiation is also needed for complications involving food retention, blood stasis, phlegm-dampness, dampness, and qi stagnation, as well as concurrent Yin deficiency, all of which require simultaneous consideration. If there are pre-existing masses (Pi Kuai), treatment is particularly difficult. Misuse of Baihu Tang (White Tiger Decoction), Sanhuang Xie Xin Tang (Three Yellow Heart-Draining Decoction), or Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) will cause immediate decline of Heart Qi and faintness, inability to speak, with no hope of recovery. If the exterior syndrome is severe and the labor injury is mild, this is what Tao Jian'an called "labor-induced cold damage" (Laoli Shanghan), similar to exogenous disease in deficient individuals; it can be cured by adding tonifying herbs to dispersing formulas.