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Sweatlessness refers to cold pathogenic factors invading the meridians, causing the couli (skin pores and interstices) to be tight and solid, with body fluids seeping inward rather than outward, resulting in an absence of sweating. Wind, summerheat, and dampness all typically induce sweating; only cold pathogenic factors alone cause sweatlessness. In Taiyang syndrome, for cases without sweating: use Mahuang Tang (Ephedra Decoction) in winter, Qianghuo Chonghe Tang (Notopterygium Harmonizing Decoction) in spring and autumn, and Shenzhu Tang (Divine Atractylodes Decoction) in summer. For cases with stiffness and tension in the nape and back accompanied by sweatlessness, use Gegen Tang (Kudzu Decoction). For Yangming disease presenting with sweatlessness and wheezing, use Mahuang Tang. If the pulse is weak and powerless, making it difficult to produce sweat, this indicates Blood deficiency; use Huangqi Jianzhong Tang plus Baizhu (Atractylodes Macrocephala Rhizome) and Fuzi (Prepared Aconite Lateral Root). Gang Jing (Stiff Spasm) with sweatlessness has its own specific textual discussion. Regarding conditions that should be treated with diaphoresis, if two or three doses of Mahuang Tang fail to induce sweating, the condition is considered difficult to treat.

Spontaneous sweating occurs when Wei Qi (Defensive Qi) is disturbed by pathogens, losing its ability to secure and consolidate, leading to loose couli and subsequent sweating. This presents distinctions between exterior/interior and deficiency/excess. If there is aversion to wind and cold with spontaneous sweating, it is due to the unresolved Taiyang exterior syndrome: use Guizhi Tang (Cinnamon Twig Decoction) in winter, and Jiajian Chonghe Tang (Modified Harmonizing Decoction) in other months. If aversion to wind and cold persists after sweating, it indicates Exterior Deficiency; if sweating does not stop, use Huangqi Jianzhong Tang (Astragalus Decoctum to Build the Middle). In Taiyang syndrome, if excessive sweating leads to unceasing leakage, this signifies Yang Collapse; use Baizhu Fuzi Tang (Atractylodes and Prepared Aconite Decoction). If there is spontaneous sweating without aversion to wind and cold, the exterior syndrome has resolved while interior Excess Syndrome has formed; treat with Chengqi Tang (Purgative Decoction) to purge downward. If urination is normal and sweating occurs, it indicates a shortage of body fluids; urgent purging is required. If sweating is accompanied by thirst and difficulty in urination, use Wuling San (Five-Ingredient Powder with Poria) to promote urination. Later, if sweating resembles oil, beads flowing continuously without stopping, accompanied by incessant wheezing, this indicates the extinction of Wei Qi, and such cases are untreatable.

Head sweating occurs when pathogens contend with the Yang meridians, causing sweat to appear on the head but stopping at the neck. If the entire body sweats spontaneously, it is called "Heat Ventilation" (releasing heat outward). Currently, since heat cannot vent outward, Yang Qi ascends, and body fluids gather upward, resulting in sweating on the head. Interior deficiency precludes purging, and internal dryness precludes diaphoresis; since there is already sweating on the head, further diaphoresis is contraindicated. Alternatively, if excess heat resides internally, with free urination but black stools, this is Blood Stasis; for head sweating, use Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) for mild cases, or Taoren Chengqi Tang (Peach Kernel and Purgative Decoction) for severe cases. When Heat enters the Blood Chamber, presenting with half-exterior/half-interior symptoms and head sweating, use Xiaochaihu Tang (Minor Bupleurum Decoction). For Jaundice with head sweating, difficulty in urination, and thirst prompting intake of liquids, this is Dampness: use Yinchen Wuling San (Artemisia Capillaris Five-Ingredient Powder) for mild cases, or Yinchen Dahuang Tang (Artemisia Capillaris and Rhubarb Decoction) for severe cases. Water accumulation in the chest, with palpitations in the epigastrium, fullness, slight heat, and head sweating; or mistreatment of a Dampness patient leading to sweating on the forehead with wheezing, difficulty in urination, and free stool, also indicates Yang Collapse.