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Treats deficiency sweating and night sweats in children. However, the Heart governs blood; when blood is abundant, it can also transform into sweat, so it is appropriate to astringe Heart Qi.
Ren Shen (Ginseng Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix) (stir-fried, 2 qian each). Grind together into a powder. Take one male pig heart, slice it into three pieces. For each dose, take 2 qian of the powder with one slice of pig heart, decoct together with well water, and administer at a time far removed from meals. Another prescription adds Huang Qi (Astragali Radix) (honey-fried, 2 qian).

Treats spontaneous sweating in children.
Mu Li (Ostreae Concha) (calcined), Huang Qi (Astragali Radix) (honey-fried), Sheng Di Huang (Rehmanniae Radix). Add Fu Xiao Mai (Tritici Levis Fructus) and Ma Huang Gen (Ephedrae Radix et Rhizoma) for decoction. Administer before meals.

Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Huang Qi (Astragali Radix) (honey-fried), Dang Gui (Angelicae Sinensis Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma) (roasted, 1 qian each). Use one slice of Sheng Jiang (Zingiberis Rhizoma Recens), add Mai Fu (Tritici Vulgaris Bran) for decoction. Administer before meals.

Mu Li (Ostreae Concha), Ma Huang Gen (Ephedrae Radix et Rhizoma) (each 1 liang), Chi Shi Zhi (Halloysit Rubrum), Nuomi Fen (Oryzae Sativae Glutinosa Farina), Long Gu (Fossilia Ossis Mastodi) (each 5 qian). Grind into a fine powder. Wrap the medicine in cotton cloth and apply as a dusting powder on the body.

Spontaneous sweating belongs to Qi deficiency; Yang deficiency, Blood deficiency, and Damp-Phlegm can also cause it. It is appropriate to use Ren Shen (Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix), with a small addition of Gui Zhi (Cinnamomi Ramulus). If Yang deficiency is severe, Fu Zi (Aconiti Lateralis Radix Preparata) can be used in small amounts. Fire Qi steaming upwards dampness in the Stomach can also produce sweat; Liang Ge San (Cool the Upper Jiao Powder) is the primary treatment. Both spontaneous sweating and night sweats contraindicate the use of Sheng Jiang (Zingiberis Rhizoma Recens), because it opens the Cou Li (skin pores and interstitial spaces). Night sweats belong to Blood deficiency and Yin deficiency. In children, specific treatment is not always necessary; Dang Gui Da Huang Tang (Angelica and Rheum Decoction) is very effective. However, since the medicinal nature is cold and the patient is deficient, it should be combined with Huang Qi (Astragali Radix) and Gan Cao (Glycyrrhizae Radix et Rhizoma) to tonify Qi. Ma Huang Gen (Ephedrae Radix et Rhizoma) treats night sweats very rapidly because its property can circulate through the exterior of the whole body, guiding other medicines to the Wei (Defensive) level to consolidate the Cou Li. Night sweats with fever due to Yin deficiency are treated with Si Wu Tang (Four Substances Decoction) plus Huang Bo (Phellodendri Cortex); if accompanied by Qi deficiency, add Ren Shen (Ginseng Radix et Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma). Night sweats refer to sweating on both the interior and exterior, not flowing out naturally like spontaneous sweating; they are mostly caused by Heart deficiency. It is appropriate to astringe Heart Qi and benefit Kidney Water, harmonizing Yin and Yang, normalizing the ascending and descending of Water, so that sweat stops spontaneously. The *Classic* states: "Excess Yang manifests as body heat without sweat; excess Yin manifests as profuse sweating with cold body." Fullness from diet causes sweat from the Stomach; fright consuming Essence causes sweat from the Heart; carrying heavy loads and traveling far causes sweat from the Kidneys; panic and fear cause sweat from the Liver; bodily exertion causes sweat from the Spleen. Fat people often have spontaneous sweating because they tend to have Qi deficiency. Thin people often have night sweats because they tend to have Yin deficiency with Fire. Although the Zang-Fu organs originally contain Jin-Ye (Body Fluids), once damaged by fatigue and overwork, all can lead to sweating. Blood and sweat have different names but are of the same category; therefore, those who lose blood will not sweat, and those who sweat excessively will not lose blood.

The Yang of the exterior and interior of the Five Zang and Six Fu organs are all governed by the Heart to facilitate their transformations, ascending and descending at all times, generating Jin-Ye where they reside; they also exude as sweat where disturbed by Fire. Thus, sweat originates entirely from the Heart. Sweating while awake is called spontaneous sweating, belonging to Yang deficiency. Sweating while sleeping is called night sweating, belonging to Yin deficiency. Sweat is the Yang of the Heart; sleep is the Yin of the Kidney. One case involves Yang deficiency failing to secure the exterior; the other involves Yin deficiency failing to close the interior. Some cases involve Stomach Qi reaching outward, manifesting as hand and foot sweat; some involve Stomach Heat steaming upward, causing head sweat which is excess in nature; thus, early stages of external contraction often present with spontaneous sweating. Hai Zang (Zhang Yuansu) said: "Administer Han Mai San (Cold Pulse Powder) and San Huang Wan (Three Yellow Pill); the disease resolves in three days." This is because the Kidney governs the Five Fluids, transforming them into five types of dampness. When Kidney Water ascends, it exploits Heart deficiency; Heart Fire flares upward into the Lung, bullying the Lung's inability to protect the skin and hair, thereby opening the Cou Li and causing sweat. First, use Liang Ge San (Cool the Upper Jiao Powder) to drain the Ministerial Fire in the chest; then use San Huang Wan (Three Yellow Pill) to drain Heart Fire to assist Yin. Then Kidney Water retreats to its origin, the Xuan Fu (mysterious gates/pores) close firmly, and sweat stops naturally. This demonstrates one manifestation of initial excess-heat causing sweat, but it cannot be generally treated with methods for excess conditions to address deficiency.

The *Classic* states: "The fluid of the Heart is sweat." Dong Yuan (Li Gao) said: "Kun Earth governs dampness; in humans, this is the Spleen and Stomach. Human sweat is like the Yin Qi of Heaven and Earth, transforming into mist and rain." The *Nei Jing* emphasizes the Heart alone, while Dong Yuan points to the Spleen and Stomach. This is because the Heart belongs to Fire and governs Heat, while the Spleen and Stomach belong to Earth and govern Dampness; the interaction of Dampness and Heat clearly produces sweat. Just as heavenly energy descends and earthly dampness rises to form rain, or wine in a steamer requires fire and water vapor to condense into drops, similarly, the Clear Yang Qi of the human body ascends to the exterior, filling the Cou Li and protecting the skin and hair, known as Wei Qi (Defensive Qi). Wei Qi resembles Heaven; just as Heaven envelops Earth, unified by one Qi, so Wei Qi protects the whole body. The *Classic* says, "Yang must be dense to be secure"; density of Yang refers to dense Cou Li. This Qi is dominated by the Lung but rooted in the Stomach; thus, when the Stomach is full, Wei Qi is solid. Spontaneous sweating and night sweating are symptoms of the same disease but have different origins. Spontaneous sweating is due to Yang deficiency, Qi deficiency, and Dampness; when Yang Qi is deficient, it cannot protect the muscle surface, so Jin-Ye flows profusely while awake. Night sweating is due to Yin deficiency, Blood deficiency, and Fire; when Yin-Blood is deficient, it cannot nourish the interior, so sweat emerges subtly during sleep. The Kidney often governs this because its function of storing and sealing has failed. Although spontaneous sweating due to Yang deficiency is an established theory, true Yin weakness can also cause spontaneous sweating. When Yin is deficient, Fire moves and attacks the Yin position; Yin Essence is boiled by Fire and exits, like burning dry bamboo which releases oil. One cannot generally use Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Huang Qi (Astragali Radix), and Gui Zhi (Cinnamomi Ramulus) to astringe; instead, tonifying Yin will cause Fire to subside and sweat to stop spontaneously. Pulse diagnosis should be combined for differentiation.

Prescription books often state that Blood and Sweat have different names but are of the same category. Dan Xi (Zhu Zhenheng) followed this, proposing that Blood is inside and Sweat is outside, implying Blood is Sweat and Sweat is Blood. However, the origins of Blood and Sweat cannot simply be grouped as the same category. The *Classic* says: "The Heart governs Blood; Blood is born in the Heart." It also says: "The Kidney governs the Five Fluids; entering the Heart, it becomes Sweat." And again: "Sweat is the fluid of the Heart." This means Sweat is the fluid of the Heart, not the Blood of the Heart. Blood is born in the Heart, controlled by the Spleen, stored in the Liver; its source is the essence of food and drink, received in the Middle Jiao, transformed into juice, harmonized among the Five Zang, distributed to the Six Fu, to nourish life. Sweat, however, is the Jin-Ye of the body. When the Cou Li are loose and the skin/hair fail to protect externally, pathogenic factors of Summer-Heat, Dampness, and Heat invade, transforming Jin-Ye into Sweat. Sweat is transformed by the Yang Qi of the body; thus, the *Classic* says: "When Yang acts upon Yin, it is called Sweat." This can be discussed in terms of Qi, but not classified as Blood. Furthermore, in summer, when pores are not tight, drinking hot water causes immediate sweating, depleting Jin-Ye externally and reducing urine volume. In winter, when Cou Li are closed, sweat does not overflow, and urination is frequent. This further proves that Sweat belongs to Jin-Ye and cannot be classified as Blood. Moreover, the body has nasal mucus, tears, saliva, phlegm, feces, and urine, all derived from the same water transformation, emerging from the nine orifices. What comes from the nose is mucus; from the eyes, tears; from the mouth, saliva and phlegm; from the two lower orifices, feces and urine; and from the skin, sweat. If Sweat could be classified as Blood, then mucus, tears, saliva, and phlegm could also be called Blood. However, since the Heart is the Sovereign and Sweat is the Heart's fluid, the harm of excessive sweat is not far from the harm of blood loss, unlike feces and urine which have less critical impact.

Spontaneous sweating belongs to Yang deficiency with Dampness; night sweating belongs to Yin deficiency with Fire. This is the established view of ancient sages. However, the *Classic* states: "Yang guards the exterior and secures it." Fire and Original Qi cannot coexist peacefully; thus, when Fire is excessive, Yang declines; when Yang declines, Wei Qi becomes deficient. When this deficient Wei Qi enters the Yin, during sleep, Zheng Qi (Upright Qi) lacks strength to secure the exterior, so the Cou Li open, and Jin-Ye leaks out as sweat. Upon waking, the eyes open, the Qi that entered the Yin returns to the exterior, and sweating stops. This is called night sweating; the *Classic* calls it "sweat during sleep" (Qin Han). Although spontaneous and night sweating are divided into Yin and Yang deficiency, they all belong to Wei Qi. Wei Qi is actually transformed from Grain Qi and distributed by the Lung; it is the True Tian-Zhen Yang. It must be sufficient to become robust; without it, it becomes weak, leading to myriad pathological changes, not just sweating.

Sweat is transformed from Blood; Blood is generated from Qi. Inside is Blood, outside is Sweat. Yet Sweat is the fluid of the Heart, and the Kidney governs the Five Fluids. Therefore, there is no sweating syndrome that does not originate from Heart and Kidney deficiency. Heart Yang deficiency fails to guard the exterior and secure it, leading to external injury and spontaneous sweating, occurring regardless of wakefulness or sleep, and without labor. Kidney Yin decline fails to nourish internally and store, leading to internal injury and night sweating, occurring during sleep and stopping abruptly upon waking. The *Classic* says: "When Jin-Ye is depleted, the Cou Li open, and sweat drains profusely." However, these two types of sweat have cold and hot distinctions. Caused by Cold Qi attacking Yang Qi, the sweat will be cold. Caused by Heat Qi attacking Yin deficiency, the sweat will be hot. Although extreme Heat may reverse and manifest as cold due to the principle of "excess leads to counteracting manifestations," this must be carefully observed. Comparatively, spontaneous sweating is more severe. Night sweating indicates the True Yuan (Original Energy) is not yet fully deficient; spontaneous sweating indicates True Yuan is exhausted, Cou Li are all open, the Lung loses its authority to govern Qi, and cannot secure the exterior. Thus, pores are loose, allowing uncontrolled leakage, inevitably leading to Yang collapse and Yin exhaustion. Therefore, for spontaneous sweating due to Yang deficiency, treatment should tonify Qi to guard the exterior; for night sweating due to Yin deficiency, treatment should nourish Yin to enrich the interior. One uses warm and tonifying methods, the other cool and nourishing methods; both ultimately focus on astringing and consolidating. If the Lung is deficient and fails to secure the skin and hair, tonify the Lung; if the Spleen is deficient, gather its Middle Qi; if the Heart is deficient, benefit its Blood vessels; if the Liver is deficient, restrict its dispersing action; if the Kidney is deficient, assist its storing function. One must observe the Five Zang, determining whether to warm, tonify, moisten, or dry, without adhering rigidly to fixed rules.

Zhong Jing (Zhang Zhongjing) said: "Profuse sweating leads to Yang collapse; when Yang departs, Yin prevails." Repeatedly damaging the exterior, Yang deficiency becomes extreme. Severe cold affects the interior. If antiperspirant and exterior-securing medicines fail, and sweating increases with astringents, one should only regulate Heart Blood. Since sweat is the fluid of the Heart, if the Heart lacks nourishment, it cannot control Blood, causing it to overflow as sweat. Use Da Bu Huang Qi Tang (Great Tonification of Astragalus Decoction) with Suan Zao Ren (Ziziphi Spinosae Semen). Add Shi Hu (Dendrobii Caulis) if there is slight heat. In treating spontaneous sweating, after using Ren Shen (Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix), one must add small amounts of Gui Zhi (Cinnamomi Ramulus) and Fang Feng (Saposhnikoviae Radix) to assist their power to reach the exterior. If Yang deficiency is severe, add small amounts of Fu Zi (Aconiti Lateralis Radix Preparata) to support Ren Shen and Huang Qi. For internal injury and deficiency damage, generally use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), adding small amounts of Ma Huang Gen (Ephedrae Radix et Rhizoma) and Zhi Fu Zi (Prepared Aconite Root) as assistants. Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix) must be used sparingly and honey-fried to suppress their violent ascending nature, while still guiding Ren Shen and Huang Qi to the exterior, which is indispensable. Food stagnation in the Middle Palace causes Heat to gather in the Stomach and flare upward, resulting in head sweat. However, after illness or postpartum, this all belongs to Yang deficiency; misdiagnosis will be fatal. Heart sweating is named Xin Han (Heart Sweat), caused by overthinking injuring the Spleen; treat with Sheng Mai San (Generate the Pulse Powder) or Bu Xin Dan (Tonify the Heart Pill). At Yin locations, such as between the thighs, sweating with a foul odor during walking or labor indicates stagnant Damp-Heat in the Lower Jiao; treat primarily by draining Damp-Heat. Excessive sweating on the nose when eating or drinking indicates Lung deficiency compounded by Heat; benefit the Lung and cool the Blood. Frequent sweating under the costal margins indicates Liver deficiency compounded by Heat; tonify the Liver and nourish the Blood. Sweating profusely like washing after meals, prolonged Heart deficiency and fluid depletion, can lead to Xiao Ke (Wasting-Thirst) and Bi Syndrome (Paralysis); treat early. Damp-Heat in the Spleen Meridian flooding the limbs causes constant sweating on the palms and soles; suppress Yang and drain Dampness. Half-body sweating in healthy individuals, or half-body sweating in summer, indicates insufficient Qi and Blood, a sign of premature death. Epistaxis or hematemesis with excessive forehead sweat but no body sweat indicates Yang collapse and Yin exhaustion; sweating that does not reach the feet is fatal. Sweating with moist hair, sticky like oil, bead-like, or pouring like rain, unable to be wiped dry, constitutes the "Six Yang Absolute Sweat" (Jue Han) and is untreatable. A pulse that does not weaken after sweating indicates death. Forehead sweat like rain, panting, abnormal facial color, cold limbs, and vomiting all medicines indicate death. Sweat beads large as strings of pearls, turning but not flowing, indicates the extinction of the Six Yang Qi and death.