伤寒温热。大邪退后。余热未尽。元气已虚。胃虚少纳。脾弱不运。稍动则复。若调理失当。不
知禁忌。随时可以转复。若非药物调理合宜。瘥后遗症。何能辄除。爰举其要。胪列二十四则于后。
（一）瘥后浮肿 伤寒瘥后。脾虚不能制水。水溢于皮肤络脉间。肢体浮肿者。须实脾利水。宜焦冬术、
茯苓皮、米仁、杜赤豆、 豆、山药、木瓜、车前子、泽泻之属治之。或以糯米、米仁、煮粥食最妙。
有因食滞中宫者。乃病后脾胃大虚。不能消谷也。病者胃中犹燥。偏欲多食。食停心下脐上。则水不得
上输于肺。肺亦不能通水道于膀胱。故溢于肢体而为肿。其症以心下脐上有硬处。按之则痛为异。
小便或利或不利。当用平胃散。加枳实、山楂、麦芽、莱菔子、六神曲、为主。硬处消则肿自愈。
或加苓泽。兼利水亦可。亦有气复未归者。热病大伤阴气之后。由阴精损及阳气。愈后阳气暴复。
阴尚亏歉之至。切忌消利。吴又可所谓病后气复血未复。气无所归。故暂浮肿。不可治肿。调其饮食。
节其劳役。静养自愈。吴鞠通曰。余见世人。每遇浮肿。便与渗利小便方法。岂不畏津液消亡。而成三消证。
快利津液。为肺痈与阴虚咳嗽身热之痨损证哉。余治是证。悉用复脉汤。重加甘草。只补其未足之阴以配其已复之阳。
而肿自消。至其辨法。气肿异于停水食滞者。停水身重。而小便不利。气肿身轻。而小便自利。食滞腹中有
结。气肿腹中自和也。又有脾胃气虚。土不制水。溢于下焦。故从腰以下有水气而为肿也。宜牡蛎泽泻散。利小便
而泄下焦之水也。
（二）虚羸少气 伤寒解后。肺胃津亏气馁。余热挟胃火上升。致虚羸少气。气逆欲吐者。胃有虚
热。气不下降。竹叶石膏汤。加竹茹、白薇、主之。
（三）日暮微烦 热病新瘥。人强与谷。脾胃气尚弱。不能消谷。故令人微烦。损谷则愈。
（四）瘥后发蒸 热症新瘥蒸蒸骨热如痨瘵者。乃余热留于阴分也。不可以其羸瘦。而遽用虚损法。
必察其六府有结邪。则仍以攻邪为主。次察其筋络有壅瘀。仍以通瘀为主。次察其气道有痰涎。仍以祛
其痰涎为主。数者俱无。方可清热。或无邪而阴伤。方可纯用养阴之药。或分其余邪之轻重。亏损之
多少。而兼用养阴清热药进退加减以和之。
（五）瘥后咳嗽 凡热退之后。尚有咳嗽未除。此肺胃津亏。而有余热恋肺。宜滋养肺胃之阴。
其嗽自止。如南沙参、麦冬、地骨皮、川贝母、川石斛、花粉、茯苓、杏仁、桑皮、蔗汁、梨汁之类。
或加生地、玉竹之类。新感风寒。而症见咳嗽。其病为轻。以其邪传入肺。肺主皮毛。邪从外达也。
温热多内伤虚证。见咳则重。五脏传乘。肺受火刑。水源涸竭。每多死症。
（六）自汗盗汗 瘥后自汗盗汗。虽皆属虚。然温热瘥后。多由余热未清。心阳内炽。以致蒸蒸燔灼。
津液外泄而汗出。为阴虚有火。慎勿骤补峻补。苦坚清养为宜。苦坚如当归六黄汤加减。以育阴泻火固表。
清养如西洋参、生地、麦冬、黄连、甘草、小麦、百合、竹叶、茯苓、莲心之类。若无热恶寒。而盗
汗不止者。阳虚也。黄 建中汤加减。自汗不止者亦阳虚也。玉屏风散。加牡蛎、龙骨、收之。以固护腠理。
实表固涩之法也。
（七）瘥后喜唾 病后喜唾。久不了了。中土阳虚。胃中有寒。不能收摄津液。而冷涎上泛也。
宜理中丸。加益智仁。温纳之。亦有胃虚而有余热者。宜用乌梅北枣丸。（乌梅肉十枚、大黑枣五枚、
俱去核、共杵如泥、加炼蜜丸、弹子大。）每用一丸。噙化之。中虚不能摄水者。六君子汤。加益智仁摄之。
若其稠饮自下焦漾漾而起。溢退场门中者。此肾气不纳。浊阴上泛也。宜都气饮。加胡桃肉、补骨脂以
纳之。或少加淡附片以收之。或佐白术以制之。
（八）皮肤甲错 病后身体枯瘦。皮肤甲错者。乃热伤其阴。阴液不能滋润皮肤也。治法以养阴为主。
吴氏人参养荣汤。（方见前）清燥养荣汤。均可酌用。叶氏加减复脉汤。尤效。亦有粥食调理自回者。
又有热毒为病。气血被其煎熬。瘥后饮食渐进。气血滋生。润皮肤而滋筋骸。或痛或痒。宛如虫行。
最是佳境。不过数日。气血通畅而自愈矣。
（九）瘥后发疮 温热新瘥。发疮者最多。乃余热淫于肌肉也。若照寻常疮症。温 妄施。断不能救。
惟多服清凉解毒。兼养气血药自愈。
（十）瘥后发痿 瘥后发痿。四肢不能动移者。热伤筋脉也。吴氏诸养荣汤。酌用。轻者粥食调理自愈。
（十一）瘥后不寐 凡伤寒温热病。热退之后。夜不欲寐者。胃不和也。温胆汤、加秫米、和之。
惊悸不寐者。心气虚也。前方合酸枣仁汤。去川芎清敛之。触事易惊。梦寐不安者。乃有余热挟痰也。宜
用竹茹、黄连、石菖蒲、半夏、胆星、栀子、知母、茯苓、旋复花、橘红等味。虚烦不寐者。
余火扰动也。黄连阿胶汤清滋之。心火内炽不寐者。慎勿骤补。宜清养为主。如西洋参、生地、
麦冬、黄连、甘草、小麦、百合、竹叶、莲心、茯神。或加阿胶、或鸡子黄、珍珠粉、审证酌加。
若终夜清醒。目不得瞑。或目瞑则惊悸梦惕者。余邪内留肝胆。胆气未舒。肝魂不安也。宜酒浸郁李仁、
炒枣仁、猪胆皮、黄连、焦栀、淡竹茹、桑叶等。滑以去着。苦以泄热。
（十二）瘥后昏沉 凡伤寒温热症。新瘥后十余日。或半月。渐至昏沉者。皆缘发汗未尽。余邪
在于心包故也。或见潮热。或兼寒热如疟。宜连翘、栀子、豆豉、麦冬、菖蒲、淡竹叶、钩藤、丹
参之类清解之。然有痰火内伏包络者。亦见昏沉。其人终日昏睡不醒。或错语呻吟。或独语如见鬼。
宜丹参、白薇、麦冬、焦栀子、黄连、竹叶、辰砂染灯心、细芽茶。天竺黄、石菖蒲、川贝母、
广郁金等味。再加厥症返魂丹。轻清以开达之。甚或万氏牛黄清心丸。叶氏神犀丹。皆可采用。
（十三）瘥后怔忡 凡热病新瘥。怔忡惊骇。乃水衰火旺。心肾不交也。宜补水养心。朱砂安神丸。
最妙。半夏秫米汤、合交泰丸、尤妙。
（十四）瘥后妄言 凡伤寒温热病。每有热退身凉之后。其人如痴。神思不清。言语谬妄。或倦卧
不思食者。此心神虚散不复所致。但当调养气血。兼治其心可也。神复妄言自止。吴氏安神养血汤主之。
薛氏参麦茯神汤亦主之。但痰火余邪。内伏包络。亦有此症。当用鲜菖蒲、天竺黄、川贝母、连翘、
钩藤、丹皮、竹茹、辰砂之类。以凉开热痰。则神自清而不妄言矣。若犹不应。加万氏牛黄清心丸。
清宣之。亦有余热未尽。热扰于心。则多言谵妄者。宜导赤散。加麦冬莲心、朱砂拌灯心等。熄余焰而
清心神。
（十五）瘥后语蹇 伤寒温热症。热退后。其舌转动不灵。而语言蹇涩者。因心脾肾三经之脉。皆系
绕于舌
心肾虚则舌不灵动。痰阻脾络。肝风内扰则语言蹇涩不清。多是虚风痰火为病。宜加味逍遥散去白术。加生姜
钩藤、鲜菖蒲、刺蒺藜、僵蚕之类。以熄风豁痰。痰多者。宜导痰汤加菊花、钩藤、白蒺藜、
鲜葛蒲、姜汁、竹沥等。熄虚风而清痰火。若因痰热滞于肺络。有声不能言者。宜顾氏清金散加石菖蒲、
竹沥清肃之。如因余热耗伤肺肾之阴。不能上接于阳者。宜清燥救肺汤。加岩制川贝、鸭梨汁、以清
养之。若声颤无力。语不接续。名曰郑声。乃元气虚而无根也。宜贞元饮合集灵膏峻补之。
（十六）瘥后额热 凡热病热退后。胃中痰食邪热逗留。额属阳明。故额独热。目神似觉呆钝。
宜清疏之。二陈汤、加连翘、黄芩、山楂、神曲之类。清之和之。
（十七）瘥后发颐 俗名遗毒。乃余邪留滞络中而成毒也。因汗下清解未尽。其邪结于少阳阳明二经。发
于两颐者。阳明部位也。发于耳之左右者。少阳部位也。治法以解毒清热。活血疏散为主。误则成脓不出。
而牙关紧。咽喉不利。多不能食而死。毒内陷而复舌燥神昏亦死。出脓后气虚血脱亦死。故宜早治也。
古方以普济消毒饮为主。发在耳后。以柴胡、川芎、为主。在项下以葛根。白芷。为主。在项后或巅顶。
加羌活、薄荷。时方以连翘败毒散为主。如羌、独活、荆、防、连翘、赤芍、牛蒡、桔梗、土贝、蒺藜、
薄荷、银花、甘草之类。如元气虚者。须兼归 补托。溃脓后。当大补气血为主。然发于阳明者易治。
发于少阳者难治。总之此症初起。速宜消散。缓则成脓。不可轻补于未溃之前。补早则必成脓。尤不可纯
用寒凉于将发之际。恐闭遏而毒不得发。故必兼疏散为要。外治以葱水时时浴之。
【炳章】按余治此症。常用吴氏加减消毒饮。如银花、连翘、蝉衣、僵蚕、牛蒡、马勃、荆芥、元参、薄
荷、鲜生地捣豆豉。便闭加大黄等。辛凉疏散之剂。多则三帖必愈。如耳下有结核者。加粉重楼、天葵子。外
治用水仙花根捣烂。和金黄散浓涂核上。数日即消散。此屡经试验法也。
（十八）瘥后耳聋 温热症身凉后。尚有耳鸣耳聋等症者。其因有三。一因余邪留于胆经。
宜养阴药中。加柴胡、鲜菖蒲、钩藤、滁菊、通草、荷叶之类。以清解少阳之郁。二因痰火上升。
阻闭清窍。其耳亦聋。宜导痰汤、去半夏、南星。加栝蒌皮、京川贝、枇杷叶、杜兜铃、通草、鲜
菖蒲之类。以轻宣肺气之郁。三因肾虚精脱。则耳鸣而聋。宜常服耳聋左慈丸。或磁朱丸等。以滋
阴镇逆。此二症不关少阳。皆禁用柴胡升提。外治、惟耳聋神丹。（鼠脑一个、青龙齿、朱砂、
梅冰、净乳香、麝香各一分、樟脑半分、上药各研细末、用鼠脑为丸、如桐子大。）用丝绵包裹。
纳入耳中。多效。
（十九）瘥后腹热 凡热病后。身大凉。独腹热未除。此脾火内甚也。养阴药中。加生白芍、自
除。但此症惟伏暑晚发最多。多属肠胃积热。雪羹汤送服陆氏润字丸、最妙。
（二十）瘥后疼痛 热病失治于前。热流下部。滞于经络。以致腰胁疼痛。甚则不能起立。卧
不能动。误作痿治。必成废人。宜清瘟败毒散小剂。加木瓜、牛膝、续断、萆 、黄柏、威灵仙。
以祛风通络。
（二一）瘥后不食 当辨不欲食。食亦不化两端。不欲食者病在胃。宜养以甘凉。《金匮》麦门
冬汤主之。叶氏养胃汤亦主之。食不化者病在脾。当与以温运。香砂理中汤主之。六君子汤亦主之。
虽然不欲食一病。又宜分伤食与停食两项。伤食者饮食自倍。肠胃乃伤。病在不及消化。停食不论食
之多少。或当食而怒。或当食时病在气结而不能化也。治伤食宜注重于食。或吐、或下、或消。若停
食则重在气。惟理气兼之以消。吐下之法。不任用也。医
者须分别治之。
（二二）瘥后不便 凡温热病后。大便不行者。热闭虚闭俱多。风闭气闭者少。热闭者。热搏津液。
肠胃燥结。及肠胃素有积热者。多有此疾。其症面赤腹热。大腹胀满。四肢反冷。或口舌生疮是也。
大黄饮子最妙。三黄枳术丸。枳实导滞丸。陆氏润字丸等。皆可酌用。虚闭有二。一阴虚。一阳虚也。
凡下焦阳虚。则阳气不行。不能传送而阴凝于下。下焦阴虚。则阴血枯燥。津液不到。而肠脏干槁。
治阳虚者。但益其火。则阴凝自化。苁蓉润肠丸主之。老年者。黄 汤、送服半硫丸。治阴虚者但壮
其水。则泾渭自通。六味地黄汤加淡苁蓉、白蜜主之。益血润肠丸、五仁丸等亦效。风闭者。风胜
则干也。由风热搏激肺脏。传于大肠。津液燥烁。传化则难。或其人素有风病者。亦多风闭。或肠胃
积热。久而风从内生。亦能成闭。东垣润肠丸主之。加味皂角丸亦主之。气闭者。气内滞而污物不行
也。其脉沉。其人多噫。心腹痞闷。胁肋膨胀。若用攻药通之。虽或暂通。而其闭益甚矣。或迫之使通。
因而下血者。惟当顺气。气顺则便自通矣。苏子降气汤、加枳壳、杏仁、主之。重则六磨汤主之。
（二三）瘥后下血 温热新瘥。或十日。或半月。忽然下血者。由于初起失汗。邪不外达而内入。
阳邪热甚。热伤阴络而血下溢也。治以清营凉血和络之法。如生地、丹皮、地榆、川断、槐米、白芍、
苡仁、黑荆芥、白茅根、脏连丸。治之自愈。阴虚火旺者。脏连六味丸、尤捷。
（二四）瘥后遗精 病后遗精。因火动者多。宜清余热。固精封髓丹主之。三才封髓丹加黄连
亦主之。以此症黄连、黄柏、二味。最是要药也。
以上瘥后遗症。药物调理各法。大旨已具。其他普通调理。当分补虚清热两项。补虚有两法。一补脾。一补胃。如其
人中气虚者。病退后必纳谷少。运化迟。或大便不实。或恶心吐涎。宜六君子、加减以和中。形寒畏冷。
宜黄 建中汤温补之。凡此症脉皆缓大。舌皆白嫩可辨。如其人阴分虚者。必有余邪未尽。舌燥口渴。二便
艰涩。脉兼微数等症。宜小甘露饮。叶氏养胃汤等清养之。清热亦有两法。初病时之热为实热。宜用苦
【背景信息】
书名：重订通俗伤寒论 作者：俞根初撰，近代徐荣斋重订。 朝代：清 章节：第二节·瘥后药物调理法(1/2) 类别：伤寒
【待处理原文翻译】
伤寒与温热病（感受寒邪或热邪引起的疾病），在大邪气退去之后，余热尚未完全清除，元气已经虚弱，胃气虚弱导致食欲减退，脾气虚弱导致运化无力。稍微活动就会复发，如果调理不当，不知禁忌，随时可能病情反复。如果不是通过适当的药物进行调理，病愈后的后遗症怎么能迅速消除呢？现列举其要点，罗列二十四条如下。
（一）病后浮肿
伤寒病愈后，因脾虚不能制约水湿，水湿溢于皮肤和络脉之间，导致肢体浮肿。必须采用健脾实土、利水渗湿的方法治疗。适宜使用焦白术、茯苓皮、薏苡仁、赤小豆、大豆黄卷、山药、木瓜、车前子、泽泻等药物进行治疗。或者用糯米、薏苡仁煮粥食用最好。
如果是由于饮食停滞在中焦（脾胃）引起的，那是病后脾胃极度虚弱，不能消化食物所致。患者胃中尚觉干燥，偏想吃多食，食物停积在心下（胃脘）和脐上，导致水液不能向上输布给肺，肺也不能通调水道下达膀胱，所以水湿溢出肢体而成为浮肿。其症状特点是心下脐上有硬块，按压则疼痛，这是与其他情况不同的地方。小便可能通利也可能不通利。应当使用平胃散，加枳实、山楂、麦芽、莱菔子、六神曲为主药。硬块消散则浮肿自然痊愈。或者加入茯苓、泽泻，兼以利水也可以。
也有的是因为气机恢复但未归位的情况。在热病严重损伤阴气之后，由阴精亏损波及阳气，病愈后阳气突然恢复，但阴气仍然极度亏虚。切忌使用消导和利水的药物。吴又可所说的“病后气复血未复，气无所归，所以暂时浮肿”，不可治疗浮肿，只需调理饮食，节制劳累，静养即可自愈。吴鞠通说：“我见到世人，每当遇到浮肿，就给予渗利小便的方法，难道不怕津液消耗殆尽，从而形成三消证吗？快速利去津液，会导致肺痈和阴虚咳嗽身热的劳损证。”我治疗这种病症，全部使用复脉汤，重用甘草，只补益那不足的阴气以配合已恢复的阳气，而浮肿自然消退。至于辨别方法：气肿不同于停水和食滞。停水者身体沉重，且小便不利；气肿者身体轻快，且小便自利。食滞者腹中有结块，气肿者腹部自然平和。又有脾胃气虚，土不制水，水湿溢于下焦，所以从腰部以下有水气而浮肿。适宜使用牡蛎泽泻散，利小便以泄除下焦的水湿。
（二）形体消瘦、气短
伤寒病解之后，肺胃津液亏损，肺气虚弱，余热挟带胃火上升，导致形体消瘦、气短，气逆想呕吐。这是胃有虚热，气不下降。用竹叶石膏汤，加竹茹、白薇，主治之。
（三）傍晚轻微烦躁
热病刚刚痊愈，人们强行进食，脾胃之气尚弱，不能消化食物，所以使人轻微烦躁。减少饮食量就会痊愈。
（四）病后发热如蒸
热症刚刚痊愈，身体内部发热如蒸，骨节发热像虚劳病一样。这是余热留存在阴分。不可以因为他消瘦，就立即使用治疗虚损的方法。必须检查六腑是否有结聚的邪气，如果有，仍以攻逐邪气为主。其次检查筋络是否有瘀血阻滞，如果有，仍以通化瘀血为主。其次检查气道是否有痰涎，如果有，仍以祛除痰涎为主。这几方面都没有，才可以清热。如果没有邪气而是阴液受伤，才可以纯用养阴的药物。或者根据余邪的轻重、亏损的多少，兼用养阴清热药，进退加减来调和身体。
（五）病后咳嗽
凡是热退之后，还有咳嗽未除的，这是肺胃津液亏损，且有残余热邪留恋于肺。适宜滋养肺胃之阴，咳嗽自然会停止。如南沙参、麦冬、地骨皮、川贝母、川石斛、天花粉、茯苓、杏仁、桑白皮、甘蔗汁、梨汁之类。或者加生地黄、玉竹之类。如果是新近感受风寒，出现咳嗽症状，病情较轻，因为邪气传入肺，肺主皮毛，邪气从外部排出。温热病多属于内伤虚证，见到咳嗽则病情较重，五脏传变相乘，肺受火刑，水源枯竭，往往多是死症。
（六）自汗、盗汗
病后自汗（白天不因劳动而汗出）和盗汗（睡着时汗出），虽然都属于虚证，但温热病愈后，多由余热未清，心阳在内炽盛，导致体内蒸腾灼热，津液外泄而汗出。这是阴虚有火，千万不要急于进补或峻补。宜用苦味坚阴、清润滋养的方法。苦坚如当归六黄汤加减，以育阴泻火、固护肌表。清养如西洋参、生地黄、麦冬、黄连、甘草、小麦、百合、竹叶、茯苓、莲心之类。如果没有热象反而恶寒，且盗汗不止的，是阳虚。用黄芪建中汤加减。自汗不止的也是阳虚。用玉屏风散，加牡蛎、龙骨，收敛止汗。这是固护腠理、实表固涩的方法。
（七）病后喜欢吐唾沫
病后喜欢吐唾沫，久久不能好，这是中焦脾胃阳气虚弱，胃中有寒，不能收摄津液，导致冷涎上泛。适宜用理中丸，加益智仁，温中纳气。也有胃虚而有残余热邪的，适宜用乌梅北枣丸。（乌梅肉十枚、大黑枣五枚，都去掉核，一起捣成泥，加炼蜜做成丸，如弹子大小。）每次用一丸，含在口中慢慢化开。中焦虚弱不能摄水的，用六君子汤，加益智仁摄纳。如果稠厚的饮邪从下焦涌起，溢出肛门外的，这是肾气不纳，浊阴上泛。适宜用都气饮，加胡桃肉、补骨脂以纳气。或者少加淡附片以收敛。或者佐以白术以制约。
（八）皮肤粗糙如鳞甲
病后身体枯瘦，皮肤粗糙如鳞甲，这是热邪伤了阴分，阴液不能滋润皮肤。治疗方法以养阴为主。吴氏的人参养荣汤（方剂见前文）、清燥养荣汤，都可以酌情使用。叶氏的加减复脉汤，尤其有效。也有通过粥食调理自行恢复的。
又有热毒致病，气血被热毒煎熬，病愈后饮食逐渐增加，气血滋生，滋润皮肤和筋骨，有时痛有时痒，宛如虫行，这最是佳境。不过几天，气血通畅就会自愈。
（九）病后发疮
温热病刚痊愈，发疮的最多，这是余热淫溢于肌肉。如果按照寻常疮症，妄用温燥药物治疗，绝对不能治愈。只有多服清凉解毒、兼养气血的药物才能自愈。
（十）病后痿证
病后发生痿证，四肢不能移动的，是热邪伤了筋脉。吴氏的各种养荣汤，酌情使用。轻的用粥食调理就能自愈。
（十一）病后失眠
凡是伤寒温热病，热退之后，夜晚不想睡觉的，是胃不和。用温胆汤，加秫米，调和之。
惊悸失眠的，是心气虚。前方合酸枣仁汤，去掉川芎，以清敛心神。触事易惊，梦寐不安的，是有余邪挟痰。适宜用竹茹、黄连、石菖蒲、半夏、胆南星、栀子、知母、茯苓、旋覆花、橘红等药。虚烦失眠的，是余火扰动。用黄连阿胶汤清滋之。心火内炽失眠的，千万不要急于进补。宜以清养为主。如西洋参、生地黄、麦冬、黄连、甘草、小麦、百合、竹叶、莲心、茯神。或者加阿胶、或者鸡蛋黄、珍珠粉，审察证候酌情加入。
如果整夜清醒，眼睛无法闭合，或者闭眼就惊悸梦惕的，是余邪内留肝胆，胆气未舒，肝魂不安。适宜用酒浸郁李仁、炒酸枣仁、猪胆皮、黄连、焦栀子、淡竹茹、桑叶等。滑利以去除着邪，苦味以泄热。
（十二）病后昏沉
凡是伤寒温热症，刚痊愈后十余日，或半个月，逐渐变得昏沉的，都是因为发汗未尽，余邪在于心包络的缘故。或者见到潮热，或者兼有寒热像疟疾一样。适宜用连翘、栀子、豆豉、麦冬、菖蒲、淡竹叶、钩藤、丹参之类清解之。然而有痰火内伏包络的，也可见昏沉。其人整天昏睡不醒，或者胡言乱语呻吟，或者自言自语像见了鬼一样。适宜用丹参、白薇、麦冬、焦栀子、黄连、竹叶、辰砂染灯心草、细芽茶、天竺黄、石菖蒲、川贝母、广郁金等药。再加厥症返魂丹，轻清以开达之。甚至万氏牛黄清心丸、叶氏神犀丹，都可以采用。
（十三）病后怔忡
凡是热病刚痊愈，心中悸动惊恐，是水衰火旺，心肾不交。适宜补水养心。朱砂安神丸，最好。半夏秫米汤、合交泰丸，尤其妙。
（十四）病后胡言乱语
凡是伤寒温热病，常有热退身凉之后，其人像痴呆一样，神思不清，言语谬妄，或者疲倦卧床不想吃东西的，这是心神虚散不能恢复所致。只当调养气血，兼治心脏就可以了。神志恢复，胡言乱语自然停止。吴氏的安神养血汤主治。薛氏的参麦茯神汤也主治。但是痰火余邪，内伏包络，也有这种症状。应当用鲜菖蒲、天竺黄、川贝母、连翘、钩藤、丹皮、竹茹、辰砂之类。以凉开热痰，则神志自然清明而不胡言乱语。如果还不奏效，加万氏牛黄清心丸，清宣之。也有余热未尽，热扰于心，则多言谵妄的。宜用导赤散，加麦冬莲心、朱砂拌灯心草等，熄灭余焰而清心安神。
（十五）病后语言蹇涩
伤寒温热症，热退后，舌头转动不灵活，而语言蹇涩的，因为心、脾、肾三经的脉络，都环绕于舌。心肾虚则舌头不灵动，痰阻脾络，肝风内扰则语言蹇涩不清。多是虚风痰火为病。适宜用加味逍遥散去白术，加生姜、钩藤、鲜菖蒲、刺蒺藜、僵蚕之类。以熄风豁痰。痰多的，宜用导痰汤加菊花、钩藤、白蒺藜、鲜葛蒲、姜汁、竹沥等。熄虚风而清痰火。如果因痰热滞于肺络，有声不能言的，宜用顾氏清金散加石菖蒲、竹沥清肃之。如果因余热耗伤肺肾之阴，不能上接于阳的，宜用清燥救肺汤，加岩制川贝、鸭梨汁，以清养之。如果声音颤抖无力，话语不接续，名叫郑声，是元气虚而无根。适宜用贞元饮合集灵膏峻补之。
（十六）病后额头发热
凡是热病热退后，胃中痰食邪热逗留。额头属阳明经，所以唯独额头热，眼神似乎呆钝。适宜清疏之。二陈汤，加连翘、黄芩、山楂、神曲之类。清之和之。
（十七）病后发颐
俗称遗毒，是余邪留滞络中而成毒。因为汗、下、清解未尽，邪气结于少阳、阳明二经。发在两腮颊部的，是阳明部位。发在耳朵左右的，是少阳部位。治疗方法以解毒清热、活血疏散为主。误治则成脓不出，而牙关紧闭，咽喉不利，大多不能进食而死。毒邪内陷又舌燥神昏也会死。出脓后气虚血脱也会死。所以适宜早治。古方以普济消毒饮为主。发在耳后的，以柴胡、川芎为主。在项下的，以葛根、白芷为主。在项后或头顶，加羌活、薄荷。时方以连翘败毒散为主。如羌活、独活、荆芥、防风、连翘、赤芍、牛蒡子、桔梗、土贝母、蒺藜、薄荷、银花、甘草之类。如果元气虚的，须兼用当归、黄芪补托。溃脓后，应当以大补气血为主。然而发于阳明的容易治，发于少阳的难治。总之此症初起，速宜消散，缓则成脓，不可在未溃破之前轻率进补，补早了必然成脓。尤其不可纯用寒凉于将要发作之际，恐怕闭遏而毒邪不得发散。所以必须兼用疏散为要。外治用葱水时时洗浴。
【炳章】按：我治疗此症，常用吴氏加减消毒饮。如银花、连翘、蝉衣、僵蚕、牛蒡、马勃、荆芥、元参、薄荷、鲜生地捣豆豉。便秘加大黄等。辛凉疏散的药剂，多则三帖必愈。如果耳下有结核的，加粉萆薢、重楼、天葵子。外治用水仙花根捣烂，和金黄散浓涂在核上。数日即消散。这是屡经试验的方法。
（十八）病后耳聋
温热症身凉后，还有耳鸣耳聋等症状的，原因有三。一是余邪留于胆经。适宜在养阴药中，加柴胡、鲜菖蒲、钩藤、滁菊、通草、荷叶之类。以清解少阳之郁。二是痰火上升，阻闭清窍，耳朵也聋。宜用导痰汤，去半夏、南星，加栝蒌皮、京川贝、枇杷叶、杜兜铃、通草、鲜菖蒲之类。以轻宣肺气之郁。三是肾虚精脱，则耳鸣而聋。宜常服耳聋左慈丸，或磁朱丸等。以滋阴镇逆。后两种症状不关少阳，都禁用柴胡升提。外治，惟有用耳聋神丹。（鼠脑一个、青龙齿、朱砂、梅冰、净乳香、麝香各一分、樟脑半分，上药各研细末，用鼠脑为丸，如桐子大。）用丝绵包裹，纳入耳中，多有效。
（十九）病后腹部发热
凡是热病后，身体很凉，唯独腹部热未除，这是脾火内甚。在养阴药中，加生白芍，自然消除。但这种症状惟伏暑晚发的最多，多属肠胃积热。雪羹汤送服陆氏润字丸，最好。
（二十）病后疼痛
热病在前失治，热流下部，滞于经络，以致腰胁疼痛，甚至不能起立，卧不能动。误作痿证治疗，必成废人。宜用小剂量的清瘟败毒散，加木瓜、牛膝、续断、萆薢、黄柏、威灵仙。以祛风通络。
（二十一）病后不食
应当辨别是不欲食，还是食亦不化两端。不欲食的，病在胃，适宜用甘凉之品滋养。《金匮》麦门冬汤主治。叶氏养胃汤也主治。食不化的，病在脾，应当给予温运。香砂理中汤主治。六君子汤也主治。
虽然是不欲食这一病，又宜分伤食与停食两项。伤食者是饮食加倍，肠胃乃伤，病在不及消化。停食不论食之多少，或者是当食时愤怒，或者是当食时病在气结而不能化。治伤食宜注重于食，或用吐法、或下法、或消法。若停食则重在气，惟有理气兼之以消。吐下之法，不任用。医者须分别治疗。
（二十二）病后不便（便秘）
凡是温热病后，大便不行的，热闭和虚闭居多，风闭和气闭较少。热闭者，热搏津液，肠胃燥结，以及肠胃素有积热的，多有此疾。其症状面赤腹热，大腹胀满，四肢反冷，或者口舌生疮。大黄饮子最好。三黄枳术丸、枳实导滞丸、陆氏润字丸等，都可酌情使用。
虚闭有二种，一是阴虚，一是阳虚。凡下焦阳虚，则阳气不行，不能传送而阴凝于下。下焦阴虚，则阴血枯燥，津液不到，而肠脏干槁。治阳虚者，只益其火，则阴凝自化。苁蓉润肠丸主治。老年者，用黄芪汤，送服半硫丸。治阴虚者只壮其水，则泾渭自通。六味地黄汤加淡苁蓉、白蜜主治。益血润肠丸、五仁丸等也有效。
风闭者，风胜则干。由风热搏激肺脏，传于大肠，津液燥烁，传化则难。或者其人素有风病的，也多风闭。或者肠胃积热，久而风从内生，也能成闭。东垣润肠丸主治。加味皂角丸也主治。
气闭者，气内滞而污物不行。其脉沉，其人爱打嗝，心腹痞闷，胁肋膨胀。如果用攻药通之，虽然或许暂通，而其闭益甚矣。或者迫之使通，因而下血的，只当顺气，气顺则便自通了。苏子降气汤，加枳壳、杏仁，主治。重的用六磨汤主治。
（二十三）病后下血
温热病刚痊愈，或者十日，或者半月，忽然下血的，是由于初起失于发汗，邪气不外达而内入。阳邪热甚，热伤阴络而血下溢。治疗以清营凉血和络的方法。如生地、丹皮、地榆、川断、槐米、白芍、薏苡仁、黑荆芥、白茅根、脏连丸。治疗自愈。阴虚火旺的，用脏连六味丸，尤其快捷。
（二十四）病后遗精
病后遗精，因火动的多。宜清余热。固精封髓丹主治。三才封髓丹加黄连也主治。以此症黄连、黄柏，二味是最要的药。
以上病后后遗症，药物调理各法，大旨已经具备。其他普通调理，应当分补虚和清热两项。补虚有两法，一补脾，一补胃。如其人中气虚的，病退后必纳谷少，运化迟，或者大便不实，或者恶心吐涎，宜用六君子汤加减以和中。形寒畏冷的，宜用黄芪建中汤温补之。凡此症脉皆缓大，舌皆白嫩可辨。如其人阴分虚的，必有餘邪未尽，舌燥口渴，二便艰涩，脉兼微数等症。宜用小甘露饮、叶氏养胃汤等清养之。清热也有两法。初病时之热为实热，宜用苦...
[Background Information]
Book: *Chongding Tongsu Shanghan Lun* (Revised Popular Treatise on Cold Damage). Author: Written by Yu Genchu, revised in modern times by Xu Rongzhai. Dynasty: Qing. Chapter: Section 2 - Post-Recovery Medicinal Regulation Methods (Part 1/2). Category: Shanghan (Cold Damage).
[English Translation]
**Shanghan and Warm-Heat Diseases:** After the major pathogenic factors have receded, residual heat may not be completely cleared, while the primordial Qi has become deficient. The Stomach Qi is weak, leading to poor appetite; the Spleen Qi is weak, leading to impaired transportation and transformation. Slight movement may cause recurrence. If regulation is improper or contraindications are ignored, relapse can occur at any time. Without appropriate medicinal regulation, how can post-recovery sequelae be quickly eliminated? Therefore, I list the essential points as follows in twenty-four items.
**(1) Edema after Recovery**
After recovery from Shanghan, Spleen deficiency fails to control water, causing water to overflow into the skin and collateral vessels, resulting in limb edema. It is necessary to strengthen the Spleen and promote diuresis. Suitable herbs include Jiao Baizhu (Charred Atractylodis Rhizoma), Fulingpi (Poria Peel), Yiyiren (Coicis Semen), Chixiaodou (Vigna Angularis Seed), Douchi (Soybean Fermented), Shanyao (Dioscoreae Rhizoma), Mugua (Chaenomelis Fructus), Cheqianzi (Plantaginis Semen), and Zexie (Alismatis Rhizoma). Alternatively, cooking porridge with Nuomi (Oryza Sativa Glutinosa) and Yiyiren is excellent.
If caused by food stagnation in the Middle Jiao, it is due to extreme weakness of the Spleen and Stomach after illness, unable to digest food. The patient feels dryness in the Stomach and desires to eat more. Food stops below the heart and above the umbilicus, preventing water from transporting upward to the Lung, and the Lung cannot regulate water passages downward to the Bladder. Thus, water overflows into the limbs causing edema. The distinguishing symptom is hardness below the heart and above the umbilicus, which is painful upon pressure. Urination may be normal or obstructed. One should use Pingwei San (Calm the Stomach Powder) added with Zhishi (Aurantii Fructus Immaturus), Shanzha (Crataegi Fructus), Maiya (Hordei Fructus Germinatus), Laifuzi (Raphani Semen), and Liushenqu (Medicated Leaven) as main ingredients. Once the hardness dissipates, the edema will heal naturally. Adding Fuling and Zexie to jointly promote diuresis is also acceptable.
There are cases where Qi returns but has not settled. After severe damage to Yin Qi by heat disease, Yin essence loss affects Yang Qi. Upon recovery, Yang Qi suddenly rebounds while Yin remains severely deficient. One must strictly avoid resolving stagnation and promoting diuresis. As Wu Keyi stated, "After illness, Qi returns but Blood has not; Qi has no place to reside, hence temporary edema." Do not treat the edema directly; regulate diet, labor, and rest quietly for self-healing. Wu Jutong said, "I see people treating every edema with diuretics. Are they not afraid of consuming Jin-Ye (Body Fluids) until Sanxiao (Three Wasting-Thirst syndromes) develops? Rapidly draining fluids leads to Feiyong (Lung Abscess) and Lao Sun (Consumption syndrome) characterized by Yin deficiency cough and fever." I treat this condition using Fumai Tang (Restore the Pulse Decoction) with heavy Gancao (Glycyrrhizae Radix et Rhizoma), solely tonifying insufficient Yin to harmonize with recovered Yang, and the edema subsides naturally. Differentiation: Qi-type edema differs from water retention and food stagnation. Water retention causes heaviness and oliguria; Qi edema causes lightness and normal urination. Food stagnation presents with abdominal masses; Qi edema presents with a peaceful abdomen. Another type involves Spleen-Stomach Qi deficiency failing to control water, overflowing into the Lower Jiao, causing edema from the waist down. Muli Zexie San (Ostrea and Alisma Powder) is suitable to promote urination and drain Lower Jiao water.
**(2) Emaciation and Shortness of Breath**
After resolution of Shanghan, Lung and Stomach Jin-Ye are depleted, and Lung Qi is weak. Residual heat carries Stomach fire upward, causing emaciation, shortness of breath, and rebellious Qi with nausea. This is deficient heat in the Stomach with descending Qi failure. Zhuye Shigao Tang (Leaf of Bambusa and Gypsum Decoction) added with Zhuru (Bambusa Caulis in Taenia) and Baiwei (Anemarrhenae Rhizoma) treats this.
**(3) Mild Irritability at Dusk**
After new recovery from heat disease, forcing food intake when Spleen-Stomach Qi is still weak and unable to digest food causes mild irritability. Reducing food intake leads to recovery.
**(4) Steaming Fever after Recovery**
After new recovery from heat symptoms, internal steaming fever and bone heat resembling consumptive disease indicate residual heat lingering in the Yin divisions. Do not immediately use tonification methods for deficiency just because the patient is thin. First, check if there are accumulated pathogens in the Six Fu Organs; if so, focus on expelling pathogens. Second, check for blood stasis in meridians; if so, focus on unblocking stasis. Third, check for phlegm-fluids in the airways; if so, focus on resolving phlegm. Only if none of these exist should one clear heat. If there are no pathogens but Yin injury exists, pure Yin-nourishing drugs may be used. Adjust Yin-nourishing and heat-clearing herbs based on the severity of residual pathogens and degree of deficiency to harmonize the body.
**(5) Cough after Recovery**
If cough persists after heat subsides, it indicates Lung-Stomach Yin depletion with residual heat lingering in the Lung. Nourishing Lung-Stomach Yin will stop the cough naturally. Herbs include Nan Shashen (Glehniae Radix), Maidong (Ophiopogonis Tuber), Digupi (Lycii Cortex), Chuan Beimu (Fritillariae Cirrhosae Bulbus), Chuan Shihu (Dendrobii Caulis), Huafen (Trichosanthis Radix), Fuling (Poria), Xingren (Armeniacae Semen Amarum), Sangpiao (Mori Cortex), Zhizhi juice (Sugar Cane Juice), and Lizi juice (Pear Juice). Added herbs may include Shengdi (Rehmanniae Radix) and Yuzhu (Polygonati Odorati Rhizoma). If newly contracted Wind-Cold causes cough, the disease is mild as the pathogen enters the Lung and exits via the skin/hair. Warm-heat diseases often involve internal deficiency; cough indicates severity, with Five Viscera transmitting pathology to the Lung, Fire punishing Metal, and exhaustion of the Water source, often leading to death.
**(6) Spontaneous and Night Sweats**
Spontaneous sweating (daytime) and night sweats after recovery belong to deficiency. However, in post-warm-heat recovery, it is often due to unresolved residual heat and blazing Heart Yang internally, causing steaming and burning, leading to fluid leakage. This is Yin deficiency with Fire. Avoid sudden or harsh tonification. Use bitter-astringent and clearing-nourishing methods. Bitter-astringent examples include Danggui Liu Huang Tang (Angelica Sinensis and Six-Huang Decoction) modified to nourish Yin, purge fire, and secure the exterior. Clear-nourishing examples include Xiyangshen (American Ginseng), Shengdi (Rehmanniae Radix), Maidong (Ophiopogonis Tuber), Huanglian (Coptidis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Xiaomai (Tritici Fructus), Baihe (Lilii Bulbus), Zhuye (Bamboo Leaf), Fuling (Poria), and Lianxin (Nelumbinis Plumula). If there is aversion to cold without heat and persistent night sweats, it is Yang deficiency. Huangqi Jianzhong Tang (Astragalus and Cinnamon Twig Decoction) modified treats this. Persistent spontaneous sweating is also Yang deficiency. Yupingfeng San (Jade Windscreen Powder) added with Muli (Ostrea Concha) and Longgu (Fossilia Ossis Mastodi) secures the exterior and consolidates astringency.
**(7) Excessive Salivation after Recovery)**
Excessive salivation persisting long after illness indicates Middle Earth Yang deficiency and Cold in the Stomach, failing to grasp fluids, causing cold saliva to float up. Lizhong Wan (Regulate the Middle Pill) added with Yizhiren (Alpiniae Oxyphyllae Fructus) warms and grasps. Cases with Stomach deficiency and residual heat are treated with Wumei Beizao Wan (Mume and Date Pill). Take one pill, holding it in the mouth to dissolve. For Middle Deficiency failing to control water, Liujunzi Tang (Six-Gentlemen Decoction) added with Yizhiren is used. If thick fluid rises from the Lower Jiao and overflows from the anus, it is Kidney Qi failing to grasp and Turbid Yin floating up. Duqi Yin (Duqi Decoction) added with Hutaorou (Juglandis Semen) and Buguzhi (Psoraleae Fructus) grasps Qi. Add Dan Fupian (Prepared Aconiti Lateralis Radix) slightly to consolidate, or Baizhu (Atractylodis Macrocephalae Rhizoma) to control.
**(8) Skin Roughness like Armor**
Post-illness emaciation and skin roughness like armor result from Heat injuring Yin, leaving insufficient fluids to moisten the skin. Treatment focuses on nourishing Yin. Wu Shi's Ren Shen Yang Rong Tang (Ginseng and Nourish-Vigor Decoction) and Qingzao Yangrong Tang (Clear-Dryness and Nourish-Vigor Decoction) are suitable. Ye Shi's Jiawei Fumai Tang (Modified Restore Pulse Decoction) is especially effective. Some recover through dietary porridge regulation.
Another scenario involves Heat-Toxin boiling Blood and Qi. After recovery, as diet increases and Blood/Qi regenerate, moistening skin and sinews, pain or itching like insects crawling may occur. This is a good sign indicating smooth circulation and self-healing within days.
**(9) Sores after Recovery)**
Sores appearing shortly after warm-heat recovery are common, caused by residual heat invading muscles. Treating as ordinary sores with warm/acrid drugs is fatal. Frequent administration of cooling-toxin-resolving and Blood/Qi-nourishing herbs leads to self-healing.
**(10) Flaccidity after Recovery)**
Flaccidity (Wei Syndrome) with immobility of limbs after recovery results from Heat damaging sinews and vessels. Wu Shi's various Yangrong Tangs are used酌情ly. Mild cases heal with porridge regulation.
**(11) Insomnia after Recovery)**
Insomnia after heat subsidence in Shanghan/Warm-heat diseases indicates Disharmony of the Stomach. Wendan Tang (Warm Gallbladder Decoction) added with Shumi (Sorghum) harmonizes. Palpitations with insomnia indicate Heart Qi deficiency; combine previous formula with Suanzaoren Tang (Ziziphus Seed Decoction), removing Chuanxiong for clearing/astringing. Startle easily and restless dreams indicate residual heat carrying Phlegm. Use Zhuru, Huanglian, Shichangpu (Acori Tatarinowii Rhizoma), Banxia (Pinelliae Rhizoma), Dansheng (Arisaematis Cum Bile), Zhizi (Gardeniae Fructus), Zhimu (Anemarrhenae Rhizoma), Fuling, Xuanfuhua (Inulae Flos), and Juhong (Citri Reticulatae Pericarpium Rubrum). Deficient irritability with insomnia is disturbed by residual fire; Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction) clears and nourishes. Internal blazing Heart Fire with insomnia requires avoiding sudden tonification; use clearing/nourishing herbs like Xiyangshen, Shengdi, Maidong, Huanglian, Gancao, Xiaomai, Baihe, Zhuye, Lianxin, Fushen (Poria with Hostwood). Add Ejiao (Donkey-Hide Gelatin), Jizihuang (Chicken Egg Yolk), or Zhenzhufen (Pearl Powder) as indicated.
All-night wakefulness or eye-closing triggering palpitations/dreams indicates residual pathogens in Liver/Gallbladder, unsoothed Gallbladder Qi, and unsettled Liver Soul. Use Jiuyu Yuliren (Alcohol-soaked Prunus Yedoensis Seed), Chao Suanzaoren, Zhu Danpi (Pig Gallbladder Membrane), Huanglian, Jiao Zhizi, Dan Zhuru, Sangye (Mori Folium). Slippery herbs remove adherence; bitter herbs drain heat.
**(12) Drowsiness after Recovery)**
Drowsiness developing 10-15 days post-recovery from Shanghan/Warm-heat is due to incomplete sweating leaving residual pathogens in the Pericardium. Symptoms may include tidal fever or alternating chills/fever like malaria. Use Lianqiao (Forsythiae Fructus), Zhizi, Douchi (Fermented Soybean), Maidong, Changpu, Dan Zhuye, Gouteng (Uncariae Ramulus cum Uncis), and Danshen (Salviae Miltiorrhizae Radix et Rhizoma) to clear and resolve.
Phlegm-Fire lurking in the Pericardium also causes drowsiness, with constant sleepiness, muttering, or talking to unseen entities. Use Danshen, Baiwei, Maidong, Jiao Zhizi, Huanglian, Zhuye, Chen Sha Ran Dengxin Cao (Cinnabar-dyed Juncus Stamen), Xi Ya Cha (Fine Bud Tea), Tianzhuhuang (Calami Tiphoides), Shichangpu, Chuan Beimu, Guang Yujin (Curcumae Radix). Add Jue Zheng Fan Hun Dan (Revive Soul Pill for Collapse Syndromes) for light clearing. Wan Shi's Niuhuang Qingxin Wan (Cow-bezoar Clear Heart Pill) or Ye Shi's Shenxi Dan (Divine Dew Pill) are also options.
**(13) Palpitations after Recovery)**
Palpitations and fright after new heat recovery indicate Water deficiency and Fire hyperactivity, with Heart-Kidney non-interaction. Tonify Water and nourish the Heart. Zhusha Anshen Wan (Cinnabar Calming Spirit Pill) is best. Banxia Shumi Tang combined with Jiaotai Wan (Interact Decoction) is excellent.
**(14) Delirium after Recovery)**
After heat subsides and body cools, patients may appear dazed, confused, speak absurdly, or lie tiredly without appetite. This is scattered Heart Spirit failing to return. Regulate Blood/Qi and treat the Heart. When Spirit returns, delirium stops. Wu Shi's Anshen Yangxue Tang (Calming Spirit and Nourishing Blood Decoction) treats this. Xue Shi's Shenmai Fushen Tang (Ginseng, Ophiopogon, and Poria Decoction) also treats it. However, Phlegm-Fire residual pathogens in the Pericardium cause similar symptoms. Use fresh Changpu, Tianzhuhuang, Chuan Beimu, Lianqiao, Gouteng, Danpi (Moutan Cortex), Zhuru, and Chen Sha to cool-open Phlegm-Heat, clarifying Spirit. If ineffective, add Wan Shi's Niuhuang Qingxin Wan. Residual Heat disturbing the Heart causes verbose delirium; Daochi San (Direct Red Out Powder) added with Maidong, Lianxin, and Chen Sha Ran Dengxin extinguishes residual flames and calms the Heart.
**(15) Slurred Speech after Recovery)**
Sluggish tongue movement and slurred speech after heat subsidence occur because meridians of Heart, Spleen, and Kidney surround the tongue. Heart/Kidney deficiency makes the tongue inflexible; Phlegm blocking Spleen collaterals and internal Liver Wind cause slurred speech. This is mostly deficiency-Wind, Phlegm, and Fire. Use Jiawei Xiaoyao San (Modified Free Wanderer Powder) removing Baizhu, adding Shengjiang (Fresh Ginger), Gouteng, fresh Changpu, Ciji Li (Tribuli Fructus), and Jiangcan (Bombyx Batryticatus) to extinguish wind and resolve phlegm. For much phlegm, Daotan Tang (Great Phlegm Decoction) added with Juhua (Chrysanthemi Flos), Gouteng, Baijili, fresh Ge Pu, Jiangzhi (Ginger Juice), and Zhuli (Bamboo Sap) extinguishes deficiency wind and clears Phlegm-Fire. If Phlegm-Heat blocks Lung collaterals causing voice loss but ability to speak, Gu Shi's Qingjin San (Clear Metal Powder) added with Shichangpu and Zhuli clears and肃ifies. If residual heat damages Lung-Kidney Yin preventing connection to Yang, Qingzao Jiufei Tang (Clear Dryness Rescue Lung Decoction) added with Yanzhi Chuanbei and Yali juice (Duck Pear Juice) clears and nourishes. Trembling voice and discontinuous speech called "Zhengsheng" indicates deficient Yuan Qi without root. Zhenyuan Yin combined with Ling Gao tonifies severely.
**(16) Forehead Heat after Recovery)**
After heat subsides, residual Phlegm-Food-Heat lingers in the Stomach. The forehead belongs to the Yangming channel, so only the forehead is hot, with dull eyesight. Clear and disperse. Erchen Tang (Two-Chen Decoction) added with Lianqiao, Huangqin (Scutellariae Radix), Shanzha, and Shenqu clears and harmonizes.
**(17) Parotitis after Recovery)**
Commonly called "Leftover Toxicity," this is toxicity formed by residual pathogens lingering in collaterals due to incomplete sweating, purging, or clearing. Pathogens knot in Shaoyang and Yangming channels. Eruption on cheeks is Yangming location; around ears is Shaoyang location. Treatment focuses on detoxifying, clearing heat, invigorating blood, and dispersing. Mistreatment leads to pus formation without discharge, trismus, dysphagia, and death. Internal sinking with dry tongue/confusion is fatal. Qi/Blood collapse after pus discharge is fatal. Early treatment is crucial. Ancient formulas prioritize Puji Xiaodu Yin (Universal Benefit Detoxification Decoction). For behind ears, use Chaihu (Bupleuri Radix) and Chuanxiong (Ligustici Chuanxiong Rhizoma). For neck, Ge Gen (Puerariae Lobatae Radix) and Baizhi (Angelicae Dahuricae Radix). For back of neck/crown, add Qianghuo (Notopterygii Rhizoma et Radix) and Bohe (Menthae Haplocalycis Herba). Modern formulas prioritize Lianqiao Baidu San (Forsythia Toxin-Resolving Powder): Qianghuo, Duhuo (Angelicae Pubescentis Radix), Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Lianqiao, Chishao (Paeoniae Radix Rubra), Niubangzi (Arctii Fructus), Jiegeng (Platycodonis Radix), Tubei Mu (Fritillariae Thunbergii Bulbus), Jili, Bohe, Yinhua (Lonicerae Japonicae Flos), Gancao. If Yuan Qi is deficient, add Danggui (Angelicae Sinensis Radix) and Huangqi (Astragali Radix) to support. After ulceration, heavily tonify Blood/Qi. Yangming eruptions are easier to treat; Shaoyang are harder. Initially, resolve quickly to prevent suppuration. Do not tonify prematurely before ulceration, as early tonification causes suppuration. Do not use purely cold/bitter herbs at onset to avoid trapping toxins. Dispersal is key. External treatment: wash frequently with Scallion water.
**Commentary by Bingzhang:** I commonly use Wu Shi's Modified Detoxification Powder: Yinhua, Lianqiao, Chan Yi (Cicadae Periostracum), Jiangcan, Niubangzi, Mabo (Fly Agaric), Jingjie, Yuan Shen (Scrophulariae Radix), Bohe, fresh Shengdi pounded with Douchi. Constipation adds Dahuang (Rhei Radix et Rhizoma). Acrid-cool dispersants cure in three doses. Subcutaneous nodules behind ears add Fenjing (Paris Polyphylla) and Tiankuizi (Coccinae Fructus). External: crushed Narcissus root mixed with Jinhuang San applied thickly. Dissipates in days. Proven method.
**(18) Deafness after Recovery)**
Deafness/tinnitus after warmth resolves has three causes. 1. Residual pathogens in Gallbladder channel: Add Chaihu, fresh Changpu, Gouteng, Chu Ju (Chrysanthemi Indici Flos), Tongcao (Tetrapanacis Medulla), He Ye (Nelumbinis Folium) to Yin-nourishing herbs to clear Shaoyang stagnation. 2. Phlegm-Fire rising blocking clear orifices: Daotan Tang removing Banxia/Dansheng, adding Gualou Pi (Trichosanthis Pericarpium), Jing Chuanbei, Pipa Ye (Loquat Leaf), Dudouling (Campanulae Fructus), Tongcao, fresh Changpu to gently ventilate Lung Qi stagnation. 3. Kidney deficiency and Essence depletion: Chronic use of Erlong Zuoci Wan (Ear-Lifting Left-Side Pill) or Cizhu Wan (Magnetite and Cinnabar Pill) nourishes Yin and anchors rebellion. These latter two do not involve Shaoyang; Chaihu lifting is forbidden. External: Erlong Shendan (Ear-Losing Divine Pill) made of Rat Brain, Qinglongchi (Dragon Bone), Zhusha, Bingpian (Borneolum Syntheticum), Ning Xixiang (Frankincense), Shexiang (Moschus), Zhangnao (Camphor). Grind fine, form pills with rat brain, wrap in silk, insert into ear. Effective.
**(19) Abdominal Heat after Recovery)**
Body cool but abdomen hot after heat disease indicates intense Spleen Fire internally. Add Sheng Baishao (White Peony Root) to Yin-nourishing herbs to resolve. Common in late-onset Summer-Heat with Intestinal/Stomach accumulated heat. Xue Geng Tang (Snow Broth Decoction) with Lushi Runzi Wan is best.
**(20) Pain after Recovery)**
Prior mistreatment of heat disease allows heat to flow lower, stagnating in meridians, causing lumbar/flank pain, inability to stand/move. Mistaking for Wei Syndrome causes disability. Use small dose of Qingwen Baidu San (Plague-Toxin Resolving Powder) added with Mugua, Niuxi (Achyranthis Bidentatae Radix), Xuduan (Dipsaci Radix), Bibi (Smilacis Glabrae Rhizoma), Huangbai (Phellodendri Cortex), Weilingxian (Syneilesis Rhizoma) to dispel wind and unblock collaterals.
**(21) Anorexia after Recovery)**
Differentiate between lack of desire to eat and inability to digest. Lack of desire indicates Stomach issue; nourish with sweet-cool. *Jinkui* Maidong Tang (Ophiopogon Decoction) or Ye Shi's Yangwei Tang (Nourish Stomach Decoction) treat this. Inability to digest indicates Spleen issue; warm and transport. Xiangsha Lizhong Tang (Amomum and Amomum-regulating Regulate-Middle Decoction) or Liujunzi Tang treat this.
Further differentiate Food Injury vs. Food Retention. Food Injury (overeating) damages digestion; treat focusing on food (vomit, purge, or resolve). Food Retention (Qi knotting prevents digestion regardless of amount) focuses on regulating Qi with mild resolution. Vomiting/purging are contraindicated for retention. Physicians must distinguish.
**(22) Constipation after Recovery)**
Post-warm-heat constipation is mostly Heat Closure or Deficiency Closure; Wind/Air closure is rare. Heat Closure: Heat binds fluids, drying intestines, or pre-existing intestinal heat. Symptoms: red face, abdominal heat/fullness, cold limbs, mouth ulcers. Dahuang Yinzi is best. Sanhuang Zhizhu Wan, Zhishi Daozhi Wan, Lushi Runzi Wan are options.
Deficiency Closure: Yin or Yang deficiency. Lower Jiao Yang deficiency fails to transmit, causing Yin condensation. Tonify Fire; Congrong Runchang Wan (Cistanche Moist Intestine Pill) treats. Elderly: Huangqi Tang with Banshu Wan. Lower Jiao Yin deficiency causes dry blood/fluids, dry intestines. Strengthen Water; Liuwei Dihuang Tang added with Dan Congrong and white honey treats. Yixue Runchang Wan, Wuren Wan are effective.
Wind Closure: Wind dominance causes dryness. Wind-Heat attacks Lung, transmits to Large Intestine, drying fluids. Or pre-existing wind disease. Or chronic intestinal heat generating internal wind. Dongyuan Runchang Wan or Jiawei Zaojiao Wan treat.
Air Closure: Qi stagnation blocks waste. Deep pulse, belching, chest/abdominal fullness, flank distension. Purging worsens closure or causes bleeding. Regulate Qi; Su Zi Jiangqi Tang added with Zhike (Aurantii Fructus) and Xingren treats. Severe cases: Momo Tang (Seven-Pound Decoction).
**(23) Hematochezia after Recovery)**
Bleeding from rectum 10-15 days post-recovery results from initial failure to sweat, allowing Yang-Heat pathogen to enter inward, damaging Yin collaterals. Treat with Ying-level clearing, blood-cooling, and collateral-harmonizing methods. Shengdi, Danpi, Diyuyu (Sanguisorbae Radix), Chuanduan (Dipsaci Radix), Huaimi (Sophorae Flavescentis Flos), Baishao, Yiyiren, Hei Jingjie, Baimaogen (Imperatae Rhizoma), Zanglian Wan (Intestine-Coating Pill) heal spontaneously. Yin deficiency with Fire hyperactivity: Zanglian Liuwei Wan is swift.
**(24) Nocturnal Emission after Recovery)**
Nocturnal emission post-illness is mostly due to Fire agitation. Clear residual heat. Gujing Fengsui Dan (Secure Essence and Seal Marrow Pill) treats. Santai Fengsui Dan added with Huanglian also treats. Huanglian and Huangbo are key herbs here.
The above covers the main principles of medicinal regulation for post-recovery sequelae. General regulation divides into Tonifying Deficiency and Clearing Heat. Tonifying Deficiency has two methods: Tonify Spleen and Tonify Stomach. Middle Qi deficiency post-illness shows poor appetite, slow digestion, loose stools, or nausea/vomiting saliva. Liujunzi Tang modified harmonizes. Cold intolerance uses Huangqi Jianzhong Tang to warm/tonify. Pulse is slow/large; tongue is white/tender. Yin deficiency post-illness shows residual pathogens, dry tongue/thirst, difficult urination/defecation, rapid/fine pulse. Xiaoganlu Yin or Ye Shi's Yangwei Tang clear/nourish. Clearing Heat has two methods: Initial illness heat is Excess Heat, treated with bitter...