【因】大病瘥后。血气津液未平复。余热未尽。若因劳动。再发热为劳复。孙真人云。新瘥后、
当静卧以养血气。慎勿早起梳洗。以劳其体。亦不可多言语用心。使意劳烦。凡此皆令劳复。喻嘉言云。
劳复乃起居作劳。复生余热之病。
【证】舌红淡。或微有白苔。身发热。肢体疲倦。懒于言语。或自汗出。神志虽清。沉迷欲睡。
饮食无味。陶氏云、劳役使血气沸腾。而邪热遂还于经络而发热也。谓之遗热。
【脉】凡劳后发热。在表脉浮。在里脉沉。气弱脉细。
【治】大凡热在表者。脉浮。宜汗解。热在里者。脉沉。宜下解。小柴胡汤。随证增损和解之。
或然汗出而解。或战而汗解。气弱脉细而复者。补中益气汤。劳神而复者。宜归脾汤。杨仁斋云。
《千金》治劳复。以麦门冬汤。（麦冬、甘草、粳米、人参、黄 、当归、柴胡、知母、姜、枣、水煎服。）
若身热食少无力。以柴胡三白汤。（人参、茯苓、白芍、白术、柴胡、姜、枣、煎服。）心烦不安者。
加麦冬、五味。口渴加花粉、知母。阴火动。加黄柏、知母。走精加 牡蛎。心烦口苦痞满。加枳实、
黄连。不眠加远志、竹茹、辰砂。吴又可云。劳复者。大病后因劳碌而复。复则复热。诸症复起。惟脉不沉实为
辨。轻者静养自愈。重者必大补。以调其营卫。待其表里融和方愈。误用攻下清凉。必致不救。安神养血汤。（茯神、
枣仁、当归、远志、桔梗、甘草、地黄、陈皮、龙眼肉引。）若身热虚烦不寐。或食少无力。用参胡温胆汤。
（人参、柴胡、茯苓、枳实、橘红、半夏、甘草、姜、枣。）加枣仁、远志。气虚烦呕。竹叶石膏汤。渴甚。去半夏、
加知母。倍花粉、若虚热不止者。《千金》麦冬汤。（方见前）
【廉勘】劳复之证。吴坤安分挟邪劳复。气虚劳复。阴虚劳复。更为清明。采录于后。
一夹邪劳复 感症瘥后。元气未复。余邪余热。留结于中。稍加劳动。或复受外邪。其热复作。即或多语梳头
洗面更衣。皆能致复。既复复热。宜枳实栀豉汤主之。以豆豉彻表邪。栀子清里热。枳实开胸中余邪之结。凡
治夹邪劳复。当以此方为主。如兼呕恶痞满。痰结胃府。加半夏、竹茹。如阳明胃热。舌黄口渴者。加黄芩、
连翘。如食滞中宫。胸脘饱闷者。加楂肉、麦芽。如复受表邪。必兼头痛恶寒。加薄荷、葱白。如兼寒热。寒
多加桂枝、苏叶。热多加柴、苓。一二剂后。必复汗而解。此屡试屡验者。不可妄投补中。以致闭邪增病。
二气虚劳复 亦有瘥后余火余邪已尽。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。甘温补中。升柴须蜜炙。若汗多恶寒者。归
建中汤最妙。
三阴虚劳复 热病伤阴。肾气已亏。稍加劳动。微挟风寒。其病复作（热伤阴液、肾精亏乏、劳动即复、受外
邪亦是劳复）。症仍头痛。发热恶风。舌燥口渴。六脉浮数者。此阴虚劳复也。凡复症必兼风寒外邪。仍宜栀
子豉汤。加葱白、薄荷、鲜生地、淡竹叶、麦冬、骨皮之类。微汗之。如见太阳。加羌活。阳明。加葛根。少
阳。加柴胡。
【病因】大病初愈之后，气血津液尚未恢复平静，体内余热未尽。如果因为劳作活动，再次出现发热，称为劳复。孙思邈说：新近病愈后，应当静卧以滋养气血，切勿早起梳洗，以免劳累身体。也不可多说话、用心思，使心神劳烦。凡是这些情况都会导致劳复。喻嘉言说：劳复是指起居劳作后，再次产生余热的病症。
【证候】舌质红而淡，或微有白苔，身体发热，肢体疲倦，懒于言语，或有自汗出，神志虽然清醒，但精神萎靡嗜睡，饮食无味。陶氏说：劳役使气血沸腾，邪热于是回归经络而发热，这叫做遗热。
【脉象】凡是劳后发热，病在表的脉象浮，病在里的脉象沉，气弱的脉象细。
【治法】大凡热在表者，脉浮，宜用发汗法解表；热在里者，脉沉，宜用攻下法解里。小柴胡汤（Xiao Chai Hu Tang, Minor Bupleurum Decoction），根据症状增减变化以和解少阳。或者通过出汗而解，或者通过战栗后出汗而解。气弱脉细而复发的，用补中益气汤（Bu Zhong Yi Qi Tang, Tonify the Middle and Augment Qi Decoction）。因劳神而复发的，宜用归脾汤（Gui Pi Tang, Restore the Spleen Decoction）。杨仁斋说：《千金方》治疗劳复，使用麦门冬汤（Mai Men Dong Tang, Ophiopogon Decoction）。（组成：麦冬、甘草、粳米、人参、黄芩、当归、柴胡、知母、生姜、大枣，水煎服。）如果身体发热、食欲少、无力，用柴胡三白汤（Chai Hu San Bai Tang, Bupleurum Three Whites Decoction）。（组成：人参、茯苓、白芍、白术、柴胡、生姜、大枣，煎服。）心烦不安的，加麦冬、五味子。口渴的加天花粉、知母。阴火动的，加黄柏、知母。精气滑脱的加煅牡蛎。心烦口苦痞满的，加枳实、黄连。不眠的加远志、竹茹、辰砂。吴又可说：劳复是大病后因劳碌而复发，复发则再次发热，各种症状重新出现，只有脉象不沉实作为鉴别点。轻者静养可自愈，重者必须大补，以调和营卫，等待表里融和才能痊愈。误用攻下清凉药物，必定导致无法救治。安神养血汤（An Shen Yang Xue Tang, Calm Spirit and Nourish Blood Decoction）。（组成：茯神、枣仁、当归、远志、桔梗、甘草、地黄、陈皮，龙眼肉为引。）如果身体发热、虚烦不寐，或食欲少、无力，用参胡温胆汤（Shen Hu Wen Dan Tang, Ginseng and Bupleurum Warm Gallbladder Decoction）。（组成：人参、柴胡、茯苓、枳实、橘红、半夏、甘草、生姜、大枣。）加枣仁、远志。气虚烦呕的，用竹叶石膏汤（Zhu Ye Shi Gao Tang, Bamboo Leaf and Gypsum Decoction）。渴甚的，去半夏，加知母，加倍天花粉。如果虚热不止的，《千金方》麦冬汤。（方剂见前文）
【廉勘】劳复的证候，吴坤安分为挟邪劳复、气虚劳复、阴虚劳复，更为清晰明了，采录如下。
一、挟邪劳复：感症初愈后，元气未复，余邪余热留结于中焦，稍加劳动，或再次感受外邪，其热再次发作。即使只是多语、梳头、洗面、更衣，都能导致复发。既然后又发热，宜用枳实栀豉汤（Zhi Shi Zhi Chi Tang, Aurantium and Soja Seed Decoction）主治。用豆豉透达表邪，栀子清泄里热，枳实开散胸中余邪之结。凡是治疗挟邪劳复，当以此方为主。如兼有呕吐恶心痞满，痰结胃腑，加半夏、竹茹。如阳明胃热，舌黄口渴的，加黄芩、连翘。如食滞中焦，胸脘饱闷的，加山楂肉、麦芽。如再次感受表邪，必兼头痛恶寒，加薄荷、葱白。如兼寒热往来，寒多加桂枝、苏叶，热多加柴胡、黄芩。一二剂后，必然通过出汗而解。这是屡试屡验的方法，不可妄投补益药，以致闭门留寇增加病情。
二、气虚劳复：也有病愈后余火余邪已尽，只因为正气大虚，因劳作而复发发热，微兼恶寒，四肢倦怠，无气以动，脉虚右大，舌润无苔，胸膈宽畅的，这是真气虚劳复。宜用补中益气汤，甘温补中，升麻、柴胡须蜜炙。如果汗多恶寒的，归建中汤最为巧妙。
三、阴虚劳复：热病伤阴，肾气已亏，稍加劳动，微挟风寒，其病复发（热伤阴液，肾精亏乏，劳动即复发，受外邪也是劳复）。症状仍头痛，发热恶风，舌燥口渴，六脉浮数，这是阴虚劳复。凡是复发症必兼风寒外邪，仍宜用栀子豉汤，加葱白、薄荷、鲜生地、淡竹叶、麦冬、地骨皮之类，使其微汗而解。如见太阳经证，加羌活。阳明经证，加葛根。少阳经证，加柴胡。
[Pathogenesis] After a major illness has subsided, the Qi, Blood, and Body Fluids have not yet returned to equilibrium, and residual heat remains incomplete. If fever recurs due to physical exertion, it is termed Lao Fu (Labor Recurrence). Sun Simiao stated: "After a recent recovery, one should lie quietly to nourish Qi and Blood. One must be cautious about rising early to comb hair or wash, as this tires the body. One should also avoid excessive speech and mental effort to prevent mental fatigue. All these factors can cause Lao Fu." Yu Jia Yan stated: "Lao Fu refers to a condition where residual heat re-emerges following daily activities and exertion."
[Symptoms] The tongue is red and pale, or slightly coated with white fur. The body feels feverish, limbs are fatigued, there is reluctance to speak, or spontaneous sweating occurs. Although consciousness is clear, the patient is listless and desires sleep. Food tastes bland. Tao Shi said: "Exertion causes Qi and Blood to boil, causing pathogenic heat to return to the meridians and generate fever. This is called Wei Re (Residual Heat)."
[Pulse] In cases of fever after labor, if the pathology is in the Exterior, the pulse is Floating; if in the Interior, the pulse is Deep; if Qi is weak, the pulse is Fine.
[Treatment] Generally, if heat is in the Exterior, indicated by a Floating pulse, sweating method should be used to resolve it. If heat is in the Interior, indicated by a Deep pulse, purgation method should be used to resolve it. Xiao Chai Hu Tang (Minor Bupleurum Decoction) is used to harmonize, with modifications based on symptoms. Resolution may occur through sweating or through chills followed by sweating. For recurrence due to weak Qi and Fine pulse, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment Qi Decoction) is indicated. For recurrence due to mental exertion, Gui Pi Tang (Restore the Spleen Decoction) is appropriate. Yang Renzhai stated: "The *Qian Jin Fang* treats Lao Fu using Mai Men Dong Tang (Ophiopogon Decoction)." (Ingredients: Radix Ophiopogonis, Radix Glycyrrhizae, Semen Oryzae Sativum, Radix Ginseng, Radix Scutellariae, Radix Angelicae Sinensis, Radix Bupleuri, Rhizoma Anemarrhenae, Rhizoma Zingiberis Recens, Fructus Ziziphi Jujubae, decocted in water.) If there is body heat, poor appetite, and weakness, use Chai Hu San Bai Tang (Bupleurum Three Whites Decoction). (Ingredients: Radix Ginseng, Poria, Radix Paeoniae Alba, Rhizoma Atractylodis Macrocephalae, Radix Bupleuri, Rhizoma Zingiberis Recens, Fructus Ziziphi Jujubae, decocted.) For restlessness and anxiety, add Radix Ophiopogonis and Fructus Schisandrae Chinensis. For thirst, add Radix Platycodi and Rhizoma Anemarrhenae. For moving Yin Fire, add Cortex Phellodendri and Rhizoma Anemarrhenae. For seminal emission, add Concha Ostreae. For restlessness, bitter taste in mouth, and fullness, add Fructus Aurantii Immaturus and Rhizoma Coptidis. For insomnia, add Radix Polygalae, Caulis Bambusae in Taenia, and Cinnabaris. Wu Keyou stated: "Lao Fu is a recurrence after a major illness due to busyness/exertion. Upon recurrence, fever returns, and various symptoms reappear. The distinguishing feature is that the pulse is not Deep and Excess. Mild cases heal with quiet rest; severe cases require strong tonification to regulate Ying and Wei, waiting for the harmony of Interior and Exterior before healing. Misuse of purgatives or cooling agents will inevitably lead to untreatable conditions." An Shen Yang Xue Tang (Calm Spirit and Nourish Blood Decoction) is used. (Ingredients: Poria Cum Radix, Semen Ziziphi Spinosae, Radix Angelicae Sinensis, Radix Polygalae, Radix Platycodi, Radix Glycyrrhizae, Radix Rehmanniae Preparata, Pericarpium Citri Reticulatae, with Fructus Longan Arillus as guide.) If there is body heat, deficiency-related restlessness, and insomnia, or poor appetite and weakness, use Shen Hu Wen Dan Tang (Ginseng and Bupleurum Warm Gallbladder Decoction). (Ingredients: Radix Ginseng, Radix Bupleuri, Poria, Fructus Aurantii Immaturus, Pericarpium Citri Reticulatae, Rhizoma Pinelliae Preparatum, Radix Glycyrrhizae, Rhizoma Zingiberis Recens, Fructus Ziziphi Jujubae.) Add Semen Ziziphi Spinosae and Radix Polygalae. For Qi deficiency with restlessness and vomiting, use Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction). For extreme thirst, remove Rhizoma Pinelliae Preparatum, add Rhizoma Anemarrhenae, and double the dose of Radix Platycodi. If deficiency heat persists, refer to the *Qian Jin Fang* Mai Men Dong Tang (see above).
[Commentary] Regarding Lao Fu syndromes, Wu Kun'an divided them into Lao Fu with Pathogen Retention, Qi Deficiency Lao Fu, and Yin Deficiency Lao Fu, which is clearer. These are recorded below.
1. Lao Fu with Pathogen Retention: After recovery from an infectious disease, Yuan Qi has not recovered, and residual pathogens/heat remain lodged in the Middle. Slight exertion, or re-exposure to external pathogens, causes heat to recur. Even actions like talking excessively, combing hair, washing face, or changing clothes can trigger recurrence. Once recurrent fever occurs, Zhi Shi Zhi Chi Tang (Aurantium and Soja Seed Decoction) should be primarily used. Fermented Soybean (Dan Dou Chi) releases exterior pathogens; Gardenia Fruit (Zhi Zi) clears interior heat; Immature Bitter Orange (Zhi Shi) opens the accumulation of residual pathogens in the chest. This formula is the mainstay for treating Lao Fu with Pathogen Retention. If accompanied by nausea, vomiting, and fullness with phlegm stagnation in the Stomach, add Rhizoma Pinelliae Preparatum and Caulis Bambusae in Taenia. If Yangming Stomach Heat is present with yellow tongue coating and thirst, add Radix Scutellariae and Flos Lonicerae Japonicae. If food stagnation in the Middle Jiao causes chest and epigastric fullness, add Sarcotesta Litchi Chinensis (or Hawthorn) and Fructus Hordei Germinatus. If re-exposed to exterior pathogens, headache and aversion to cold will accompany; add Herba Menthae and Bulbus Allii Cepae. If alternating chills and fever occur, increase Guizhi Tang (Cinnamon Twig Decoction) ingredients like Ramulus Cinnamomi and Folium Perillae for more chills, or Radix Bupleuri and Radix Scutellariae for more heat. After one or two doses, resolution through sweating is certain. This has been repeatedly verified; do not recklessly administer tonics, which would trap pathogens and worsen the disease.
2. Qi Deficiency Lao Fu: In some cases, residual fire and pathogens have cleared after recovery, but recurrence of fever due to exertion occurs solely because Zheng Qi (Upright Qi) is severely deficient. There is slight aversion to cold, limb fatigue, lack of energy to move, a Deficient and large pulse on the right side, a moist tongue without coating, and a comfortable chest/diaphragm. This is True Qi Deficiency Lao Fu. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment Qi Decoction) is indicated, using sweet-warm methods to tonify the Middle. Sheng Ma and Chai Hu must be honey-fried. If there is profuse sweating and aversion to cold, Gui Jian Zhong Tang (Cinnamon and Sugar Decoction modified) is excellent.
3. Yin Deficiency Lao Fu: Febrile diseases injure Yin, and Kidney Qi is already depleted. Slight exertion, combined with mild Wind-Cold, causes the disease to recur (Febrile injury to Yin fluids, depletion of Kidney Essence, exertion triggers recurrence, external pathogen exposure is also Lao Fu). Symptoms still include headache, fever with aversion to wind, dry tongue, thirst, and Floating-Rapid pulses in all six positions. This is Yin Deficiency Lao Fu. Recurrent syndromes must be accompanied by external Wind-Cold pathogens. Therefore, Zhi Zi Chi Tang (Gardenia and Soja Seed Decoction) should still be used, adding Bulbus Allii Cepae, Herba Menthae, Radix Rehmanniae Recens, Folium Phragmitis, Radix Ophiopogonis, and Cortex Phellodendri, inducing slight sweating. If Taiyang channel signs appear, add Radix Notopterygii. If Yangming channel signs appear, add Radix Puerariae Lobatae. If Shaoyang channel signs appear, add Radix Bupleuri.