温热复症，有复至再三者，皆由病患不讲卫生，病家不知看护所致。每见屡复之后，多有酿成四损、四不
足者。约计其复之病因，则有四。
一、劳复 温热瘥后，元气未复，余邪未清，稍加劳动，其热复作。不必大费气力，即梳洗、沐浴、多语、
更衣之类，亦能致复。复则诸症复起，惟脉不沉实为辨。轻者静养自愈，重者必先察其虚实，虚则调其营卫，
和其脏腑，待其表里融和方愈；误用攻下清凉，必致不救；安神养血汤主之。实则主以仲景枳实栀豉汤，撤表
邪而清里热∶如兼头痛恶寒，加薄荷、葱白；如兼寒热，寒多加羌活、紫苏，热多加知母、黄芩。一二剂后，
必复汗而解，此屡试屡验者。不可妄投补益，以致闭邪增病。虽然，劳复之中，有气虚劳复、阴虚劳复、房劳
复之分。
气虚劳复者∶温热瘥后，余邪未尽，止因正气大虚，因劳复热，微兼恶寒，四肢倦怠，无气以动，脉虚右
大，舌润无苔，胸膈宽畅者，此真气虚劳复也。宜补中益气汤甘温补之，惟升、柴须蜜炙；如兼汗多恶寒，归
建中汤最妙。若正气虽虚，尚有余热未清，其人虚羸少气，气逆欲呕者，竹叶石膏汤加姜汁主之，或陈氏六神
汤加银胡、地骨皮亦佳。
阴虚劳复者∶由温热伤阴，肾液已亏，稍加劳动，微挟风
寒，其病复作，症仍头痛发热恶风、舌燥口渴、六脉浮数无力者，此真阴虚劳复也，宜七味葱白汤，清润而微汗
之，或金水六君去半夏，用生地，加川斛、丹皮、豆豉、葱白之类，滋养阴液以汗之。如兼呕恶，当留半夏，
加竹茹以和胃；如兼咳嗽，加旋复花、甜杏仁以降气；如兼虚火上冒、目赤颧红、大渴烦躁、呕恶不纳者，亦
宜金水六君煎加麦冬、代赭之类，养阴镇逆。
房劳复者∶即女劳复，一名色复。温热瘥后，气血未充，早犯房事，则内损真气，外触邪气而复作也。其
症头重不举，目中生花，腰胁痛，小腹里急绞痛，憎寒发热，或阴火上冲，头面烘热，胸中烦闷是也。若卵缩
入腹，脉离经者死。舌伸出数寸者亦死。治法必用 鼠屎汤调下烧 散。虚极者，宜六味饮加麦冬、豆豉、
栀子煎汤，调服烧 散；虚极热盛者，则用陶氏逍遥汤调服；若小腹急痛，脉沉足冷，则用当归四逆加吴茱
黄汤调服，外用吴茱萸五钱，食盐二两，拌炒热熨小腹。
二、食复 温热瘥后，胃气尚虚，余邪未尽，若纳谷太骤，则运化不及，余邪假食滞而复作。其症仍发
热头痛，烦闷不纳，宜枳实栀子豉汤，加山楂肉、麦芽、连翘、莱菔汁等凉疏之；腹痛不大便者，加生锦纹。
若温病新瘥，饮酒者，必复热，以酒味辛性热，助其余邪热毒故也，必兼烦闷干呕，口燥不纳等症，急用川连、
葛花、银花、连翘、枳实、焦栀、乌梅、花粉、枳 子等清解之。
三、自复 乃伏邪未尽也。当问前见何症，服何药而解，仍用前药，以涤其余邪则愈。
四、怒复 温热瘥后，因事触怒，怒气伤肝，相火暴发，因而余热复作，症必身热胸闷，心烦懊 ，气
逆喘呼，甚则胁痛呕血，治法宜苏子降香汤，加桑叶、丹皮、银胡、地骨皮等，平其气以清泄之。若瘀血结聚，
少腹急痛者，代抵当汤加杜牛膝
主之，香壳散加延胡索、炮穿山甲尤捷。若不语如喑，形厥如尸者，宜犀角地黄汤加桃仁、归尾、赤芍、白薇，
厥症返魂丹等，甘咸以平之，芳香以宣之。虽然，怒复有大怒、郁怒之分。大怒者，其志愤激，则气血易于奔
迫，而无所节制，经所谓怒则伤志也。脉多浮弦躁盛，症多失血，甚或痛厥。仍用苏子降香汤，加蜜炙延胡、
醋炒锦纹、盐水炒川连等，以降泄之；血虚火旺者，拔萃犀角地黄汤，加白芍、白薇、童便、金汁等，以通降
之。郁怒者，其志怫戾，则气血易于瘀壅，而不克宽舒，经所谓怒则气逆也。脉多弦涩，甚则沉弦搏坚，症多
瘕疝，久则成痨成蛊。治法∶瘕疝，宜开郁正元散、茴香橘核丸等选用；成痨，宜紫菀散、劫痨散、顾氏清金
散、杜瘵膏等选用；成蛊，宜当归活血汤、代抵当汤、下瘀血汤等选用，桃仁承气汤合逍遥散，加细辛、土狗
末，奏功尤捷。
温热病的复发症状，有的会反复两三次，这都是因为患者不注意卫生、家属不懂得护理所导致的。常常看到多次复发之后，往往会演变成“四损”和“四不足”的虚损证候。大概统计其复发的病因，主要有四种。
一、劳复：温热病初愈后，元气尚未恢复，残余的病邪未清，稍微进行体力劳动，热势就会再次发作。不需要耗费很大的气力，即使是梳洗、沐浴、多说话、换衣服这类小事，也能导致复发。复发后各种症状再次出现，只有脉象不沉实可以作为鉴别点。轻症者静养即可自愈；重症者必须先辨别虚实。如果是虚证，应当调理营卫，调和脏腑，等到表里之气融和才能痊愈；如果误用攻下或清凉药物，必然导致无法救治；主用安神养血汤。如果是实证，主要使用张仲景的枳实栀子豉汤，以解除表邪并清除里热：如果兼有头痛恶寒，加薄荷、葱白；如果兼有寒热往来，寒重多加羌活、紫苏，热重多加知母、黄芩。服用一两剂后，必定通过出汗而解病，这是屡试屡验的方法。不可乱投补益药，以免闭门留寇，加重病情。虽然如此，在劳复之中，又分为气虚劳复、阴虚劳复、房劳复三种情况。
气虚劳复：温热病初愈后，余邪未尽，只因为正气大虚，因劳累导致热势复发，轻微伴有恶寒，四肢倦怠，没有力气活动，脉象虚而右部偏大，舌面湿润无苔，胸膈宽畅的，这是真气虚导致的劳复。宜用补中益气汤甘温补益，其中升麻、柴胡必须用蜜炙；如果兼有汗多恶寒，用归建中汤最为巧妙。如果正气虽虚，但尚有余热未清，患者身体虚弱消瘦、气短、气逆想呕吐的，用竹叶石膏汤加姜汁主治，或者陈氏六神汤加银胡、地骨皮也很好。
阴虚劳复：由于温热病损伤阴液，肾精已亏，稍微进行劳动，轻微夹杂风寒，疾病就会复发，症状仍然是头痛发热恶风、舌燥口渴、六脉浮数无力，这是真正的阴虚劳复，宜用七味葱白汤，清润并使其微微出汗，或者用金水六君汤去掉半夏，改用生地，加川斛、丹皮、豆豉、葱白之类，滋养阴液以发汗。如果兼有呕吐恶心，应当保留半夏，加竹茹以和胃；如果兼有咳嗽，加旋复花、甜杏仁以降气；如果兼有虚火上炎、眼睛红赤、颧骨发红、极度口渴烦躁、呕吐恶心不能进食的，也宜用金水六君煎加麦冬、代赭石之类，以养阴镇逆。
房劳复：即女劳复，又名色复。温热病初愈后，气血尚未充盈，过早行房事，则内伤真气，外触邪气而导致复发。其症状是头重抬不起来，眼中见花，腰胁疼痛，小腹拘急绞痛，憎寒发热，或者阴火上冲，头面部烘热，胸中烦闷。如果睾丸收缩入腹，脉象离经的，预后不良（死）。舌头伸出数寸的也预后不良（死）。治疗方法必须用鼠屎汤调服烧裈散。虚极者，宜用六味地黄饮加麦冬、豆豉、栀子煎汤，调服烧裈散；虚极且热盛者，则用陶氏逍遥汤调服；如果小腹急痛，脉沉足冷，则用当归四逆加吴茱萸汤调服，外用吴茱萸五钱，食盐二两，拌炒热熨小腹。
二、食复：温热病初愈后，胃气尚虚，余邪未尽，如果进食太急，则运化不及，余邪借食滞而再次发作。其症状仍然是发热头痛，烦闷不想进食，宜用枳实栀子豉汤，加山楂肉、麦芽、连翘、莱菔汁等凉疏之；腹痛不大便的，加生锦纹（大黄）。如果温病刚痊愈，饮酒的，必定复发热，因为酒味辛性热，助长其余邪热毒的缘故，必定兼有烦闷干呕、口燥不想进食等症状，急用川连、葛花、银花、连翘、枳实、焦栀、乌梅、花粉、枳椇子等清解之。
三、自复：这是伏邪未尽所致。应当询问之前是什么症状，服用什么药而痊愈的，仍然使用之前的药物，以涤除残余病邪则痊愈。
四、怒复：温热病初愈后，因事情触动愤怒，怒气伤肝，相火暴发，因而余热再次发作，症状必定身热胸闷，心烦懊恼，气逆喘呼，甚至胁痛呕血，治疗方法宜用苏子降香汤，加桑叶、丹皮、银胡、地骨皮等，平抑气机以清泄之。如果有瘀血结聚，少腹急痛的，用代抵当汤加杜牛膝主治，香壳散加延胡索、炮穿山甲尤其快捷。如果不语如哑，形体厥冷如尸的，宜用犀角地黄汤加桃仁、归尾、赤芍、白薇，以及厥症返魂丹等，用甘咸之品以平之，芳香之品以宣通之。虽然如此，怒复有大怒、郁怒之分。大怒者，情绪愤激，则气血容易奔迫，而没有节制，经书所说“怒则伤志”。脉象多浮弦躁盛，症状多为失血，甚至痛厥。仍用苏子降香汤，加蜜炙延胡、醋炒锦纹、盐水炒川连等，以降泄之；血虚火旺者，用拔萃犀角地黄汤，加白芍、白薇、童便、金汁等，以通降之。郁怒者，情绪抑郁乖戾，则气血容易瘀滞壅塞，而不能宽舒，经书所说“怒则气逆”。脉象多弦涩，甚至沉弦搏坚，症状多为瘕疝，日久则成痨成蛊。治疗方法：瘕疝，宜选用开郁正元散、茴香橘核丸等；成痨，宜选用紫菀散、劫痨散、顾氏清金散、杜瘵膏等；成蛊，宜选用当归活血汤、代抵当汤、下瘀血汤等，桃仁承气汤合逍遥散，加细辛、土狗末，奏效尤其快捷。
Recurrence of symptoms in warm-heat diseases may happen two or three times, all caused by patients' neglect of hygiene and families' lack of proper nursing. It is often observed that after multiple recurrences, conditions may deteriorate into "Four Damages" (Si Sun) and "Four Deficiencies" (Si Bu Zu). The causes of recurrence can be roughly categorized into four types.
1. Recurrence due to Labor (Lao Fu): After the recovery from a warm-heat disease, if vital energy (Yuan Qi) has not recovered and residual pathogenic factors remain, slight physical exertion can cause the heat to reappear. Even without great effort, activities such as combing hair, bathing, talking excessively, or changing clothes can trigger recurrence. Upon recurrence, various symptoms return; the distinguishing feature is that the pulse is not deep and solid. Mild cases heal with rest alone; severe cases require differentiation between deficiency and excess. In deficiency patterns, one must regulate Ying and Wei (Nutritive and Defensive Qi), harmonize the Zang-Fu organs, and wait for the exterior and interior to harmonize before healing; misusing purgatives or cooling agents will inevitably lead to untreatable conditions. The main formula is Anshen Yangxue Tang (Spirit-Calming and Blood-Nourishing Decoction). In excess patterns, Zhang Zhongjing's Zhishi Zhizi Chi Tang (Immature Bitter Orange, Gardenia, and Fermented Soybean Decoction) is used to release exterior pathogens and clear interior heat: if accompanied by headache and aversion to cold, add Bohe (Menthae Haplocalycis Herba) and Congbai (Allii Fistulosi Bulbus); if accompanied by alternating chills and fever, increase Qianghuo (Notopterygii Rhizoma et Radix) and Zisu (Perillae Folium) for chills, or Zhimu (Anemarrhenae Rhizoma) and Huangqin (Scutellariae Radix) for heat. After one or two doses, sweating usually resolves the condition, a method proven effective repeatedly. Do not recklessly administer tonics, which might trap pathogens and worsen the illness. Within labor recurrence, there are subtypes: Qi deficiency labor recurrence, Yin deficiency labor recurrence, and sexual fatigue recurrence.
Qi Deficiency Labor Recurrence: After recovery, residual pathogens remain, but the primary cause is significant deficiency of healthy Qi. Exertion triggers heat recurrence, slightly accompanied by aversion to cold, limb fatigue, lack of energy to move, a deficient pulse that is larger on the right side, a moist tongue coatingless surface, and a comfortable chest and diaphragm. This is true Qi deficiency labor recurrence. Use Buzhong Yiqi Tang (Middle-Boosting and Qi-Supplementing Decoction) with sweet-warm properties; Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) must be honey-fried. If accompanied by excessive sweating and aversion to cold, Guijianzhong Tang (Cinnamon Twig and Brown Sugar Decoction) is excellent. If healthy Qi is deficient but residual heat remains, with emaciation, shortness of breath, and rebellious Qi causing nausea, use Zhuye Shigao Tang (Phyllostachys Leaf and Gypsum Decoction) with ginger juice, or Chen's Liushen Tang (Six-God Decoction) with Yin Hu (likely referring to a specific preparation or herb like Yinhua/Yuju) and Digupi (Lycii Cortex) are also good.
Yin Deficiency Labor Recurrence: Caused by warm-heat damaging Yin fluids, depleting Kidney essence. Slight exertion combined with mild wind-cold triggers recurrence. Symptoms include headache, fever, aversion to wind, dry tongue, thirst, and floating, rapid, powerless pulses in all six positions. This is true Yin deficiency labor recurrence. Use Qiwei Congbai Tang (Seven-Ingredient Scallion Bulb Decoction) to clear, moisten, and induce mild sweating, or Jinsui Liu Jun Tang (Golden Water Six-Herbs Decoction) removing Banxia (Pinelliae Rhizoma), using Shengdi (Rehmanniae Radix), adding Chuanhu (Dendrobii Caulis), Danpi (Moutan Cortex), Douchi (Sojae Semen Praeparatum), and Congbai to nourish Yin fluids and induce sweating. If accompanied by vomiting/nausea, retain Banxia and add Zhuru (Bambusae Caulis in Taenia) to harmonize the Stomach; if accompanied by cough, add Xuanjinhua (Inulae Flos) and Tian Xingren (Prunus Armeniacae Semen Dulce) to descend Qi; if accompanied by deficient fire flaming upward, red eyes, malar flush, extreme thirst, irritability, vomiting, and inability to eat, use Jinsui Liu Jun Jian (Decoction) with Maidong (Ophiopogonis Radix) and Daizhe Shi (Haematitum) to nourish Yin and suppress rebellion.
Sexual Fatigue Recurrence (Fang Lao Fu): Also known as female labor recurrence or color recurrence. After recovery, when Qi and Blood are not yet replenished, early sexual activity damages internal True Qi and contacts external pathogens, causing recurrence. Symptoms include heavy head unable to lift, visual disturbances (seeing spots), waist and hypochondriac pain, abdominal urgency and cramping pain, aversion to cold with fever, or rising Yin fire causing facial flushing and chest oppression. If the testes retract into the abdomen and the pulse is irregular/disordered, the prognosis is fatal. If the tongue extends several inches, it is also fatal. Treatment must use Shushi Tang (Mouse Dropping Decoction) to administer Shaokun San (Burned Underwear Powder). For extreme deficiency, use Liuwei Yin (Six-Ingredient Drink) with Maidong, Douchi, and Zhizi decocted to administer Shaokun San; for extreme deficiency with intense heat, use Tao's Xiaoyao Tang (Free and Easy Wanderer Decoction); if lower abdominal urgency/pain, deep pulse, and cold feet occur, use Danggui Sini Tang (Angelica Sinensis and Cinnamon Twig Decoction) plus Wuzhuyu (Evodiae Fructus) administered internally, and externally apply Wuzhuyu (5 qian) and Salt (2 liang) stir-fried hot to compress the lower abdomen.
2. Recurrence due to Diet (Shi Fu): After recovery, Stomach Qi is still weak, and residual pathogens remain. If food intake is too rapid, digestion cannot keep up, and residual pathogens exploit food stagnation to recur. Symptoms include fever, headache, oppression, and anorexia. Use Zhishi Zhizi Chi Tang with Shan Zha Rou (Crataegi Fructus), Mai Ya (Hordei Fructus Germinatus), Lian Qiao (Forsythiae Fructus), and Laifu Zhi (Radish Juice) to cool and disperse; if abdominal pain and constipation occur, add Sheng Jinwen (Raw Rheum Palmatum Root and Rhizome). If a warm disease patient drinks alcohol upon recovery, heat will definitely recur because wine is pungent and hot, aiding residual pathogenic heat-toxin. Symptoms include oppression, dry retching, dry mouth, and anorexia. Urgently use Chuanlian (Coptidis Rhizoma), Gehua (Puerariae Flos), Yinhua (Lonicerae Japonicae Flos), Lianqiao, Zhishi, Jiao Zhi (Charred Gardeniae Fructus), Wu Mei (Mume Fructus), Huafen (Trichosanthis Radix), and Zhizaozi (Choerospondiadis Axillaris Seed) to clear and resolve.
3. Spontaneous Recurrence (Zi Fu): This is due to lingering latent pathogens. One should ask what symptoms were present previously and what medication led to resolution, then reuse the previous prescription to purge residual pathogens for cure.
4. Recurrence due to Anger (Nu Fu): After recovery, anger triggered by events injures the Liver, causing Ministerial Fire to erupt, leading to the recurrence of residual heat. Symptoms include body heat, chest oppression, mental restlessness, rebellious Qi with wheezing, and potentially hypochondriac pain and hematemesis. Treatment uses Suzi Jiangxiang Tang (Perilla Fruit and Aquilaria Wood Decoction) plus Sangye (Mori Folium), Danpi, Yin Hu, and Digupi to calm Qi and clear/drain. If blood stasis accumulates with lower abdominal urgency/pain, use Daididang Tang (Substitute Mars Attack Decoction) plus Duniuqi (Achyranthis Bidentatae Radix); Xiangke San (Aromatic Shell Powder) plus Yanhusuo (Corydalis Rhizoma) and Pao Chuanshanjia (Pangolin Scale) is particularly effective. If muteness resembling aphonia and cold limbs resembling death occur, use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) plus Taoren (Pruni Semen), Guiwei (Cinnamomi Ramulus/Cortex variant or Angelica caudex - context implies blood activating part), Chishao (Paeoniae Radix Rubra), Baiwei (Cleistanthi Radix), and Juezhuang Fanhun Dan (Reviving Soul Pill for Cold Extremities), using sweet-salty flavors to calm and aromatic flavors to diffuse. Although, anger recurrence divides into Great Anger and Depressed Anger. Great Anger involves fierce emotions where Qi and Blood rush uncontrollably, injuring the Will (Zhi), as stated in classics. Pulses are typically floating, wiry, and restless; symptoms involve bleeding or pain/collapse. Use Suzi Jiangxiang Tang plus honey-fried Yanhusuo, vinegar-processed Jinwen, and salt-water processed Chuanlian to drain downward; for Blood deficiency with hyperactive fire, use Babei Xijiao Dihuang Tang plus Baishao (Paeoniae Radix Alba), Baiwei, Tongbian (Child's Urine), and Jinzhi (Gold Solution) to unblock and descend. Depressed Anger involves stifled emotions where Qi and Blood easily stagnate and fail to relax, described as "Anger causes Qi rebellion." Pulses are wiry and choppy, or deep/wiry/hard; symptoms involve masses/hernias, progressing to consumption or abdominal distension over time. Treatment: For masses/hernias, use Kaiyu Zhengyuan San or Huixiang Juhe Wan; for consumption, use Ziwan San, Jie Lao San, Gu's Qingjin San, or Du Zhai Gao; for abdominal distension/masses, use Danggui Huoxue Tang, Daididang Tang, or Xiayuxue Tang. Tao Ren Chengqi Tang combined with Xiaoyao San plus Xixin (Asari Radix) and Tougou Mo (Ground Ground Beetle) yields especially rapid results.