自汗者，汗无时而自出也。经曰∶饮食饱甚，汗出于胃。惊而夺精，汗出于心。持重远行，
汗出于肾。疾走恐惧，汗出于肝。摇体劳苦，汗出于脾。又云∶阴虚而阳必辏，则发热而自
汗。阳虚而阴必乘，则发厥而自汗。东垣云∶表虚自汗，秋冬用桂，春夏用黄 。丹溪云∶
汗者心之液也。自汗之症，未有不因心肾俱虚而得之者。巢氏云∶虚劳病若阳气偏虚，则津
液发泄而为汗。天自心为主，阳之藏，火也。阳主气，人身津液，随其阳气所在之处而生，
亦随其火所扰之处而泄，则为自汗矣。治法当用参、 甘温益气之药，使阳气外固，而津液
内藏则汗止矣。若元气虚者，夏月用六君子汤加山药、山茱萸，冬月用加减八味丸、十全大
补汤。血虚者，四物加参、 。有热者，当归六黄汤。气血俱虚者，十全大补汤。心肾虚热
者，六味丸。虚寒者，八味丸。心经血虚者，团参汤。胃经气虚者，六君子汤。饮食劳倦者
，补中益气汤。嗜卧倦怠者，升阳益胃汤。热伤元气者，清燥汤。暑干心胞络者，清暑益气汤
。外伤风邪者，惺惺散。虚劳羸瘦者，人参养荣汤。思虑伤脾者，归脾汤。怒动肝火者，小柴胡汤。
肝经虚热者，加味逍遥散。肝经湿热者，龙胆泻肝汤。泄泻脉微者，人参理中汤。手汗者，
补中益气汤。胸腹汗者，四君子汤。当心一片有汗者，茯苓补中汤。黄汗者，茵陈五苓散。
血汗者，血余散敷之。此皆云汗之大法也，仍推五脏相胜主之。若汗出如油，喘而不休，此为命绝；
柔汗发黄，此为脾绝；汗出不流，如贯珠者，为绝汗；数者并不治。若六阳虚则汗出上至头
、下至项，亦多主难治。
治验
一小儿四岁，因惊自汗，左关无脉，以此为忧。余曰∶肝主惊，此禀肝气不足，因惊则气散
，脉必在臂腕。于尺部尽处候之，果得。用补中益气汤、六味地黄丸，半载脉复本位。其脉
在合谷之间者，皆自幼被惊而然也。
一小儿五岁，因惊自汗发热，虚证悉具，右寸脉短，此胃气复伤也，用独参汤月余，又用补
中益气汤，仍佐以六君子及加味地黄汤，半载而愈。
一小儿自汗，目直项强顿闷，余谓肝经实热，先用柴胡栀子散，随用六味地黄丸而愈。后因
惊自汗，切牙呵欠，属肝经虚热生风，用六味地黄丸、补中益气汤而痊。后又惊，自汗怔悸
，面赤发热，悉属肝经虚热，用六味丸而愈。
一小儿自汗面青善怒，小便频数，睡间惊悸，或发搐目直，此肝火血燥生风也，先用加味四
物汤、加味逍遥散各四剂，与间服，诸症渐愈，又用四君、山栀而痊。
一小儿自汗盗汗，颈间结核，两目连札，此兼肝脾疳症也，用四味肥儿丸及大芜荑汤而痊。
后每伤食发热，便血自汗，用五味异功散加升麻、柴胡渐愈，又用六味地黄丸而痊。
一女子十四岁，自汗寒热，月经先期，余谓肝火血热，用加味逍遥散、地黄丸而痊。后因怒
，经行不止，自汗盗汗，先用加味小柴胡汤，次用加味逍遥散而愈。
一小儿自汗，叫哭发热，作渴饮水，抽搐仰睡，乃心经实热也，用导赤散治之而愈。后又自
汗，发热饮汤，抽搐无力，惊窜切牙，覆睡面赤，心经虚热也，用茯苓补心汤而愈。
一小儿自汗恶风，用补中益气汤加炒浮麦而止。因饮食停滞，患吐泻，用六君子汤而愈，又
用四君、当归、浮麦而汗止。出痘时，自汗盗汗，用十全大补汤而痘愈。后因风咳嗽，自汗腹胀。余
谓脾肺俱虚，宜用六君、桔梗，因惑于人言，先服发表之剂，更加气喘盗汗，余用四君、五
味子、炮姜，四剂不应，每剂又加人参五钱、炮姜一钱，稍止，又三剂而痊。
十全大补汤 治诸虚不足，自汗不食，时发潮热等症。
白茯苓 人参 当归 白术 黄 （炒） 川芎 肉桂 白芍药（炒） 熟地黄 甘草（炒。各等分）
上三五钱，姜枣水煎服。
八珍汤 （前方去肉桂、黄 ，治验见各门）
人参养荣汤 治病后时自汗，或发潮热，口干食少，心虚惊悸，咳而下痢。前方去川芎，加
陈皮、五味子、远志。
百解散 治感冒风邪，发热自汗者。
荆芥 白芷 麻黄（去节） 陈皮 苍术 甘草（炒。各三分）
上姜三片，葱白三根，水煎服。
清暑益气汤 治暑邪干卫，身热自汗。
黄 苍术（泔浸去皮。各一钱） 升麻（七分） 人参 白术 陈皮（炒） 神曲（炒） 泽泻（各五分） 甘
草（炙） 黄柏（酒浸，炒） 当归身 麦门冬（去心） 青皮（炒） 葛根（各三分） 五味子（九粒，杵）
上水煎服。
茵陈五苓散 治伏暑发黄烦渴，小便不利。
赤茯苓 猪苓 泽泻 白术 茵陈（各三分）
上水煎服。
血余散 治汗不止。
用男子乱发一握， 存性，为细末，以绢袋盛置，干扑之。
清燥汤 治小儿自汗，或因热伤元气，大小便秘涩。
黄 （炒） 苍术（各五分） 白术 陈皮 泽泻 人参 白茯苓 升麻 麦门冬 当归身 生地黄
神曲（炒） 猪苓 黄柏（酒拌炒。各三分） 五味子（五粒，杵） 黄连（炒） 甘草（炙。各二分）
上姜一片，水一钟，水煎服。
升阳益胃汤（方见诸痢）
六君子汤
加味归脾汤
四君子汤
加味逍遥散
五味异功散（五方见内钓）
柴胡栀子散（方见发热）
小柴胡汤（方见肝脏）
补中益气汤（方见虚羸）
龙胆泻肝汤
人参理中汤
茯苓补心汤（三方见喑）
团参汤
当归六黄汤（二方见盗汗）
惺惺散
四物汤（二方见急惊）
六味丸（方见肾脏）
四味肥儿丸（方见寒吐）
加味八味丸（即六味丸加肉桂、五味子，方见肾脏）
大芜荑汤（方见疳症）
导赤散（方见心脏）
**Translation of Classical Chinese to Modern Vernacular**
Self-sweating (Zihan) refers to sweating that occurs spontaneously without a specific time. The *Classic of Internal Medicine* states: After overeating, sweat comes from the Stomach; due to fright consuming essence, sweat comes from the Heart; carrying heavy loads and traveling far, sweat comes from the Kidney; running fast and feeling fear, sweat comes from the Liver; bodily movement causing labor and hardship, sweat comes from the Spleen. It is also said: When Yin is deficient, Yang must gather, leading to fever and self-sweating; when Yang is deficient, Yin must overpower, leading to cold extremities and self-sweating. Li Dongyuan stated: For exterior deficiency self-sweating, use Cinnamon Twig in autumn and winter, and Astragalus in spring and summer. Zhu Danxi stated: Sweat is the fluid of the Heart. There is no case of self-sweating that does not arise from the dual deficiency of the Heart and Kidney. Chao Yuanfang stated: In consumptive diseases, if Yang Qi is predominantly deficient, body fluids will be released as sweat. Heaven regards the Heart as the master; the Heart is the residence of Yang Qi and belongs to Fire. Yang Qi governs Qi transformation; human body fluids are generated where Yang Qi resides and are excreted where Fire disturbs, thus forming self-sweating. The treatment method should employ sweet-warm Qi-tonifying herbs such as Ginseng and Licorice, so that Yang Qi is secured on the exterior and body fluids are stored within, thereby stopping the sweat. If one has deficient Yuan Qi, use Liu Jun Zi Tang (Six Gentlemen Decoction) with Dioscorea and Cornus in summer, and Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill) or Shi Quan Da Bu Tang (Ten Significant Great Tonifying Decoction) in winter. For blood deficiency, use Si Wu Tang (Four Substance Decoction) plus Ginseng and Astragalus. For those with heat, use Dang Gui Liu Huang Tang (Angelica Six Yellow Decoction). For dual Qi and Blood deficiency, use Shi Quan Da Bu Tang (Ten Significant Great Tonifying Decoction). For Heart and Kidney Yin deficiency with internal heat, use Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill). For deficiency-cold, use Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet, also known as Ba Wei Wan). For Heart channel blood deficiency, use Tuan Shen Tang. For Stomach channel Qi deficiency, use Liu Jun Zi Tang (Six Gentlemen Decoction). For cases caused by diet and fatigue, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For lethargy and fatigue, use Sheng Yang Yi Wei Tang (Raise Yang and Benefit the Stomach Decoction). For heat damaging Yuan Qi, use Qing Zao Tang (Clear Dryness Decoction). For Summerheat invading the Pericardium collateral, use Qing Shu Yi Qi Tang (Clear Summerheat and Augment Qi Decoction). For external wind pathogen invasion, use Xing Xing San. For consumptive emaciation, use Ren Shen Yang Rong Tang (Ginseng Nourishing Courage Decoction). For worry injuring the Spleen, use Gui Pi Tang (Restore the Spleen Decoction). For anger stirring Liver Fire, use Xiao Chai Hu Tang (Minor Bupleurum Decoction). For Liver channel deficiency heat, use Jia Xiao Yao San (Modified Free and Easy Wanderer Powder). For Liver channel damp-heat, use Long Dan Xie Gan Tang (Gentian Drain the Liver Decoction). For diarrhea with faint pulse, use Ren Shen Li Zhong Tang (Ginseng Regulate the Middle Decoction). For excessive hand sweating, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For chest and abdominal sweating, use Si Jun Zi Tang (Four Gentlemen Decoction). For sweating only on the center of the chest, use Fu Ling Bu Zhong Tang (Poria Tonify the Middle Decoction). For yellow sweat, use Yin Chen Wu Ling San (Artemisia Five Porias Powder). For bloody sweat, apply Xue Yu San (Hair Remains Powder) externally. These are the general principles for treating sweating, but one must still deduce the controlling relationships among the Five Zang organs for primary treatment. If sweat flows like oil and panting does not cease, this indicates the end of life; if cold sweat turns yellow, this indicates the end of the Spleen; if sweat does not flow and resembles beads strung together, this is "Jue Han" (Extinction Sweat); none of these are treatable. If the six Yang channels are deficient, sweat may rise to the head and descend to the neck, which also mostly indicates difficult-to-treat conditions.
**Case Records**
A four-year-old child suffered from self-sweating due to fright, with no pulse palpable at the left Guan position, causing family concern. I said: The Liver governs fright; this is a congenital insufficiency of Liver Qi. Due to fright, Qi scatters, and the pulse must manifest at the arm and wrist. Palpating at the end of the Chi position, I indeed felt it. Using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill), the pulse returned to its original position after half a year. Pulses appearing between the Hegu points were all caused by fright since childhood.
A five-year-old child suffered from self-sweating and fever due to fright, presenting all deficiency symptoms, with a short pulse at the right Cun position, indicating further injury to Stomach Qi. I used Du Shen Tang (Single Ginseng Decoction) for over a month, then used Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), assisted by Liu Jun Zi Tang (Six Gentlemen Decoction) and Jia Di Huang Tang (Modified Rehmannia Decoction), resulting in recovery after half a year.
A child with self-sweating had straight eyes, stiff neck, and dizziness. I diagnosed it as excess heat in the Liver channel, first using Chai Hu Zhi Zi San (Bupleurum and Gardenia Powder), followed by Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill), leading to recovery. Later, due to fright causing self-sweating, teeth grinding, and yawning, it was attributed to deficiency heat in the Liver channel generating wind, treated with Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) for cure. Subsequently, another fright caused self-sweating, palpitations, red face, and fever, all belonging to Liver channel deficiency heat, cured with Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill).
A child with self-sweating, blue-green complexion, irritability, frequent urination, sleep startles, and occasional convulsions with straight eyes was diagnosed with Liver fire and dry blood generating wind. First, Jia Si Wu Tang (Modified Four Substance Decoction) and Jia Xiao Yao San (Modified Free and Easy Wanderer Powder) were given alternately for four doses each, gradually improving symptoms, followed by Si Jun Zi Tang (Four Gentlemen Decoction) and Gardenia for cure.
A child with self-sweating and night sweats, cervical lymph node swelling, and frequent blinking was diagnosed with concurrent Liver and Spleen malnutrition syndrome (Gan disease). Treated with Si Wei Fei Er Wan (Four-Ingredient Fattening Children Pill) and Da Wu Yi Tang (Greater Wormwood Decoction) for cure. Later, after every food stagnation causing fever, bloody stool, and self-sweating, WU Wei Yi Gong San (Five-Ingredient Extraordinary Function Powder) plus Cimicifuga and Bupleurum gradually improved the condition, followed by Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) for cure.
A fourteen-year-old girl with self-sweating, alternating chills and fever, and early menstruation was diagnosed with Liver fire and blood heat. Treated with Jia Xiao Yao San (Modified Free and Easy Wanderer Powder) and Di Huang Wan (Rehmannia Pill) for cure. Later, due to anger causing continuous menstruation, self-sweating, and night sweats, she was first treated with Jia Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction), then Jia Xiao Yao San (Modified Free and Easy Wanderer Powder) for recovery.
A child with self-sweating, crying, fever, thirst, drinking water, convulsions, and sleeping on back was diagnosed with excess heat in the Heart channel, treated with Dao Chi San (Guide Out Redness Powder) for cure. Later, self-sweating, fever, desire for hot drinks, weak convulsions, fright, teeth grinding, side-sleeping, and red face indicated deficiency heat in the Heart channel, cured with Fu Ling Bu Xin Tang (Poria Tonify Heart Decoction).
A child with self-sweating and aversion to wind stopped sweating using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus stir-fried floating wheat. Due to food stagnation causing vomiting and diarrhea, Liu Jun Zi Tang (Six Gentlemen Decoction) cured it, followed by Si Jun Zi Tang (Four Gentlemen Decoction), Angelica, and floating wheat to stop sweating. During smallpox eruption, self-sweating and night sweats were treated with Shi Quan Da Bu Tang (Ten Significant Great Tonifying Decoction) for smallpox resolution. Later, wind-induced cough with self-sweating and abdominal distension led me to diagnose dual Spleen and Lung deficiency, recommending Liu Jun Zi Tang (Six Gentlemen Decoction) and Platycodon. Confused by others' advice, the patient first took exterior-releasing agents, worsening panting and night sweats. I used Si Jun Zi Tang (Four Gentlemen Decoction), Schisandra, and roasted ginger. After four doses with no effect, I added five qian of Ginseng and one qian of roasted ginger per dose, slightly stopping symptoms, and cured after three more doses.
Shi Quan Da Bu Tang (Ten Significant Great Tonifying Decoction) treats various deficiencies, self-sweating, anorexia, and periodic tidal fever.
White Poria, Ginseng, Angelica, Atractylodes, Astragalus (stir-fried), Ligusticum, Cinnamon Twig, White Peony Root (stir-fried), Prepared Rehmannia, Licorice (stir-fried). Equal parts.
Take 3-5 qian, decoct with ginger and jujube, and drink.
Ba Zhen Tang (Eight Treasures Decoction) (Remove Cinnamon Twig and Astragalus from the previous formula; see case records in respective sections).
Ren Shen Yang Rong Tang (Ginseng Nourishing Courage Decoction) treats post-illness spontaneous sweating, periodic tidal fever, dry mouth, poor appetite, heart deficiency with palpitations, cough, and dysentery. Remove Ligusticum from the previous formula, add Tangerine Peel, Schisandra, and Polygala.
Bai Jie San (Hundred Releases Powder) treats colds with wind pathogen, fever, and self-sweating.
Schizonepeta, Angelica Dahurica, Ephedra (nodes removed), Tangerine Peel, Atractylodes, Licorice (stir-fried). Each 3 fen.
Decoct with 3 slices of ginger and 3 stalks of green onion white in water.
Qing Shu Yi Qi Tang (Clear Summerheat and Augment Qi Decoction) treats Summerheat invading the Defensive layer, body heat, and self-sweating.
Astragalus, Atractylodes (soaked in rice water, peeled). Each 1 qian. Cimicifuga 7 fen. Ginseng, Atractylodes, Tangerine Peel (stir-fried), Medicated Leaven (stir-fried), Alisma. Each 5 fen. Licorice (roasted), Phellodendron (wine-soaked, stir-fried), Angelica Sinensis root, Ophiopogon (heart removed), Green Citrus Peel (stir-fried), Kudzu Root. Each 3 fen. Schisandra (9 grains, crushed).
Decoct in water and drink.
Yin Chen Wu Ling San (Artemisia Five Porias Powder) treats latent summerheat causing jaundice, irritability, thirst, and difficult urination.
Red Poria, Polyporus, Alisma, Atractylodes, Artemisia Capillaris. Each 3 fen.
Decoct in water and drink.
Xue Yu San (Hair Remains Powder) treats incessant sweating.
Take a handful of human hair, calcine until carbonized but retaining nature, grind into fine powder, place in a silk bag, and apply dryly to the affected area.
Qing Zao Tang (Clear Dryness Decoction) treats pediatric self-sweating, or heat damaging Yuan Qi causing constipation and difficult urination.
Astragalus (stir-fried), Atractylodes. Each 5 fen. Atractylodes Macrocephala, Tangerine Peel, Alisma, Ginseng, White Poria, Cimicifuga, Ophiopogon, Angelica Sinensis root, Raw Rehmannia, Medicated Leaven (stir-fried), Polyporus, Phellodendron (wine-mixed, stir-fried). Each 3 fen. Schisandra (5 grains, crushed), Coptis (stir-fried), Licorice (roasted). Each 2 fen.
Decoct with one slice of ginger and one cup of water.
Sheng Yang Yi Wei Tang (Raise Yang and Benefit the Stomach Decoction) (See section on Various Dysenteries).
Liu Jun Zi Tang (Six Gentlemen Decoction).
Jia Gui Pi Tang (Modified Restore the Spleen Decoction).
Si Jun Zi Tang (Four Gentlemen Decoction).
Jia Xiao Yao San (Modified Free and Easy Wanderer Powder).
Wu Wei Yi Gong San (Five-Ingredient Extraordinary Function Powder) (See five formulas in section on Internal Hook).
Chai Hu Zhi Zi San (Bupleurum and Gardenia Powder) (See section on Fever).
Xiao Chai Hu Tang (Minor Bupleurum Decoction) (See section on Liver Channel).
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) (See section on Emaciation).
Long Dan Xie Gan Tang (Gentian Drain the Liver Decoction).
Ren Shen Li Zhong Tang (Ginseng Regulate the Middle Decoction).
Fu Ling Bu Xin Tang (Poria Tonify Heart Decoction) (See three formulas in section on Aphonia).
Tuan Shen Tang.
Dang Gui Liu Huang Tang (Angelica Six Yellow Decoction) (See two formulas in section on Night Sweating).
Xing Xing San.
Si Wu Tang (Four Substance Decoction) (See two formulas in section on Acute Convulsion).
Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) (See section on Kidney Channel).
Si Wei Fei Er Wan (Four-Ingredient Fattening Children Pill) (See section on Cold Vomiting).
Jia Ba Wei Wan (Modified Eight-Ingredient Pill) (i.e., Liu Wei Di Huang Wan plus Cinnamon Twig and Schisandra; See section on Kidney Channel).
Da Wu Yi Tang (Greater Wormwood Decoction) (See section on Malnutrition Syndrome).
Dao Chi San (Guide Out Redness Powder) (See section on Heart Channel).