（ 音工，下部病也。俗作肛，非。）
属气血虚与热，气虚参、 、升麻、川芎，血虚四物汤，热加黄柏。外以五倍子为末，托而上之，一次未收，至五
次、七次必收。
又方 以陈壁土泡汤，先熏后洗。
又方 以鳖头烧存性为末，真麻油调敷即收。龟头亦可。
（祖传方）
七花丸 治肠风下血、久痔皆效。
山茶花 芙蓉花 石榴花 检漆花 白茅花（锉，各一两，俱烧存性） 松花（一两，烧存性） 槐花（二两，炒
焦黑） 枳壳（一两，麸炒黄色） 甘草（炙，五钱） 地榆（一钱） 槟榔（二钱五分）
上为细末，醋调面糊为丸，梧桐子大，每服七、八十丸，煎乌梅汤下。
又方 治肠风下血等证。
干柿饼（烧存性，秤灰二两） 乌梅（烧存性，二两） 酒瓶箬（已酒过一年者，或二、三年者，尤良。烧存性，
二两） 槐花（五钱，炒焦黑） 百药煎（一两，如无以五倍子炙焦黄代之） 枳壳（五钱，麸炒黄色）
上为细末，醋糊为丸，如梧桐子大，每服七、八十丸，醋汤下。或加槟榔五钱。
论
《内经》曰∶心之液为汗。《原病式》曰∶心热则出汗。东垣曰∶西南，坤土也，在人则为脾胃，夫人之汗，犹天地
之雨，阴滋其湿，则为雾露为雨也。据内经独主于心，而东垣又指脾胃而言，何也？盖心为君火主热，脾胃属土主湿，
湿热相搏为汗明矣。亦如地之湿气，为云雾而上升，其天气若不下降，则不能成霖雨也。又如甑中烧酒，若非汤火蒸淘，
则不能成汁液也。夫各脏皆能令人出汗，独心与脾胃主湿热，乃总司耳。故内经又曰∶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。若夫自汗与盗汗者，病似而实不同也。
其自汗者，无时而 然出，动则为甚，属阳虚，胃气之所司也。盗汗者，寐中而通身如浴，觉来方知，属阴虚，营血
之所主也。大抵自汗宜补阳调卫，盗汗宜补阴降火。大法∶心虚冷汗自出者，理宜补肝，益火之原，以消阴翳也。阴虚
火炎者，法当补骨，壮水之主，以制阳光也。医者宜详辨之，毋错。
脉法
脉大而虚、浮而濡者汗。在寸为自汗，在尺为盗汗。
伤寒，脉阴阳俱紧，当无汗。若自汗者曰亡阳，不治。
方法
丹溪曰∶自汗，属气虚，属湿与热。盗汗，属血与阴虚。
火气上蒸胃中之湿，亦能作汗，凉膈散主之。
治自汗，用人参、黄 ，少佐以桂枝。阳虚者，附子亦可用。
痰病亦有汗者。
（以上丹溪方法凡四条）
麦煎汤（东垣） 治诸虚不足，及新病暴虚，津液亏欠，体常自汗，夜卧则甚，久而不止，体瘦，心忪惊惕，
短气疲倦。
牡蛎 黄 麻黄根（各一钱）
上细切，作一服，入小麦百余粒，水煎服。
调卫汤（东垣） 治湿胜自汗，补卫气虚弱，表虚不任风寒证。
黄 麻黄根（各一钱） 羌活（二分） 生甘草 当归梢（各五分） 生地黄 麦门冬（各三分） 生黄芩 半
夏（各五分） 猪苓（二分） 苏木 红花（各一分） 五味子（七粒）
愚恐自汗阳虚之证不应下羌活、半夏、生姜三味辛散发表之剂，恐传写之误，姑存之。
上细切，作一服，加生姜三片，水二盏，煎至一盏，去渣稍热服。
当归六黄汤（河间）盗汗之至药也。
当归（一钱） 生地黄 熟地黄 黄柏（各七分） 黄 （一钱） 黄连（七分） 黄芩（七分）
上细切，作一服，水二盏，煎至一盏，食前温服，小儿减半。又曰，小儿不须治。（小儿虽能自愈，然不治，病恐日
甚，治之尤妙。）
黄 建中汤（活人） 治自汗及盗汗皆效（方见伤寒门桂枝汤。或加浮小麦一撮，尤妙。）
四制白术散 治盗汗。
白术（四两，内一两以黄 同炒，一两以石斛同炒，一两以特蛎同炒，一两以麸皮同炒，凡同炒者皆去之）
上取白术一味为末，每服三钱，粟米汤调下。
正气汤（东垣） 治盗汗。
黄柏 知母（各一钱五分） 甘草（炙，五分）
上细切，水煎服之。
白术散（东垣） 治饮酒中风多汗，食即汗出如油漏，久不治必成消渴。
牡蛎（三钱炒） 白术（一两二钱五分） 防风（二两五钱）
上为细末，每服一钱，温水调下，不计时候。如恶风，倍防风、白术。如多汗面肿，倍牡蛎。
（丹溪活套）云∶仲景桂枝汤，治外感风邪自汗之圣药也。黄 建中汤，治外感挟气虚自汗之剂也。东垣补中益气
汤，治伤寒气虚自汗之妙剂也。甚者六脉浮软而虚，本方加附子以治阳虚，其效如 应桴。如左寸脉浮洪而自汗者，心
火炎也，本方倍参、 ，加麦门冬、五味子、黄连各五分。如左关脉浮弦而自汗者，挟风邪也，本方加桂枝、芍药各五
分。若不阴虚，只有桂枝汤可用也。右关脉浮洪无力而自汗者，只宜本方倍参、 而自愈。右尺脉洪数无力而自汗或盗
汗者，相火挟君火之势而克伐肺金也，本方加黄连、黄芩、黄柏各五分，只用当归六黄汤。左尺脉浮洪无力而自汗者，
水亏火盛也，本方加知母、黄柏各五分，熟地黄一钱，壮水之主，以制阳光也。凡内伤及一切虚损之证自汗不休者，总
用补中益气汤，少加附子、麻黄根、浮小麦，其效捷如影响。但升麻柴胡俱用蜜水制炒，以杀其升发勇悍之性，又欲其
引参、 等药至肌表，故不可缺也，凡上所云，皆指内伤虚损自汗之证，故皆以补中益气汤为主治之药也。
（医案）
上湖吕俊文，得内伤虚证，发热自汗，如雨不止，服补中益气汤十数帖不效。予以前方加减，每帖用蜜制黄 一钱，
人参一钱，白术、甘草、陈皮各七分，当归、白芍药各一钱，升麻、柴胡各一分，加桂枝三分，麻黄根七分，浮小麦一
撮，炮附子三分，三帖而汗止，热亦退而安。
("Gang" sounds like "gong", referring to diseases of the lower anus. The common character "gang" is incorrect.)
This condition belongs to deficiency of Qi and Blood combined with Heat. For Qi deficiency, use Renshen (Ginseng Radix), Huangqi (Astragali Radix), Shengma (Cimicifugae Rhizoma), and Chuanxiong (Ligustici Chuanxiong Rhizoma); for Blood deficiency, use Siwu Tang (Four Substances Decoction); if there is Heat, add Huangbai (Phellodendri Cortex). Externally, use Wubeizi (Galae Chinensis) ground into powder, applied to lift and support the area; if not resolved after one application, it will certainly be resolved after five or seven applications.
Another prescription: Use Chenbitu (soil from old walls) soaked in water, fumigate first, then wash.
Another prescription: Burn Bie Tou (Testudinis Carapax et Plastrum head) until it retains its medicinal properties (charred but retaining essence), grind into powder, mix with genuine Sesame Oil (Sesami Oleum) and apply; it will retract immediately. This can also be used on the glans penis. (Ancestral prescription)
Qihua Wan (Seven-Flower Pill): Effective for treating Changfeng Xiexue (Intestinal Wind with bleeding) and chronic hemorrhoids.
Ingredients: Shanchahua (Camellia Japonica Flower), Furonghua (Hibisci Rosa-Sinensis Flower), Shiliuhua (Punica Granatum Flower), Jianqicha (unknown flower, likely a typo or local name), Baimaohua (Imperatae Rhizoma Flower) (chopped, each 1 liang, all charred to retain essence), Songhua (Pinus Flower) (1 liang, charred to retain essence), Huaihua (Sophorae Flos) (2 liang, stir-fried until charred black), Zhike (Aurantii Fructus Immaturus) (1 liang, stir-fried with bran until yellow), Gancao (Glycyrrhizae Radix et Rhizoma) (roasted, 5 qian), Diyü (Sanguisorbae Radix) (1 qian), Binglang (Arecae Semen) (2.5 qian).
Grind all into fine powder, mix with vinegar and wheat paste to form pills the size of Sophora seeds. Take 70-80 pills per dose, washed down with Wu Mei Tang (Mume Decoction).
Another prescription: Treats Changfeng Xiexue and other syndromes.
Ingredients: Ganshibing (Dried Persimmon) (charred to retain essence, weigh 2 liang of ash), Wumei (Mume Fructus) (charred to retain essence, 2 liang), Jiupingruo (Bamboo leaf from wine bottle, aged 1-3 years in wine, preferably charred to retain essence, 2 liang), Huaihua (Sophorae Flos) (5 qian, stir-fried until charred black), Baiyaojian (Fermented Medicinal Pill) (1 liang, substitute with Wubeizi stir-fried until yellow if unavailable), Zhike (Aurantii Fructus Immaturus) (5 qian, stir-fried with bran until yellow).
Grind all into fine powder, mix with vinegar paste to form pills the size of Sophora seeds. Take 70-80 pills per dose, washed down with vinegar water. Can add Binglang (Arecae Semen) 5 qian.
Discussion
The *Neijing* states: The fluid of the Heart is sweat. The *Yuanbing Shi* states: When the Heart is hot, sweating occurs. Li Dongyuan states: The southwest direction corresponds to Kun Earth, which in the human body corresponds to the Spleen and Stomach. Human sweat is like rain in heaven and earth; Yin nourishes dampness, forming mist, dew, and rain. According to the *Neijing*, sweat is primarily governed by the Heart, yet Li Dongyuan points to the Spleen and Stomach. Why? Because the Heart belongs to Minister Fire and governs Heat, while the Spleen and Stomach belong to Earth and govern Dampness. It is clear that the interaction of Damp-Heat produces sweat. This is similar to how moisture on the earth rises as clouds and mist; if Heaven's Qi does not descend, rain cannot form. It is also like steaming alcohol in a steamer; without fire and water steaming, liquid juice cannot be formed. All organs can cause sweating, but only the Heart and Spleen/Stomach govern Damp-Heat, acting as the general hub. Thus, the *Neijing* further states: After eating too much, sweat comes from the Stomach; after fright and loss of Essence, sweat comes from the Heart; after carrying heavy loads and traveling far, sweat comes from the Kidney; after running fast and fearing, sweat comes from the Liver; after physical labor and fatigue, sweat comes from the Spleen. As for spontaneous sweating (Zihan) and night sweating (Daohan), the symptoms are similar but the nature is different. Spontaneous sweating occurs at any time, worsens with movement, belongs to Yang deficiency, and is governed by Stomach Qi. Night sweating occurs throughout the body during sleep like bathing, known only upon waking, belongs to Yin deficiency, and is governed by Ying Blood. Generally, spontaneous sweating should be treated by tonifying Yang and harmonizing Wei Qi, while night sweating should be treated by tonifying Yin and descending Fire. The general principle is: For Heart deficiency causing cold spontaneous sweating, one should tonify the Liver, benefit the source of Fire, to eliminate Yin shadows. For Yin deficiency with flaming Fire, one should tonify the Kidney, strengthen the master of Water, to control Solar brilliance. Physicians must distinguish carefully to avoid errors.
Pulse Method
A pulse that is large and empty, or floating and soggy, indicates sweating. In the Cun position, it indicates spontaneous sweating; in the Chi position, it indicates night sweating.
In Shanghan (Cold Damage), when both Yin and Yang pulses are tight, there should be no sweat. If spontaneous sweating occurs, it is called Wangyang (Loss of Yang), which is difficult to treat.
Methods
Zhu Danxi says: Spontaneous sweating belongs to Qi deficiency, Dampness, and Heat. Night sweating belongs to Blood deficiency and Yin deficiency.
Fire Qi steaming upward the Dampness in the Stomach can also cause sweating, treated with Liangge San (Cool the Chest Powder).
To treat spontaneous sweating, use Renshen (Ginseng Radix), Huangqi (Astragali Radix), with a small amount of Guizhi (Cinnamomi Ramulus). For Yang deficiency, Fuzi (Aconiti Lateralis Radix Praeparata) can also be used.
Phlegm diseases can also present with sweating.
(Above are four methods from Danxi)
Maijian Tang (Wheat Decoction) (Li Dongyuan): Treats various deficiencies and insufficiencies, as well as sudden deficiency from new illness, deficient Jin-Ye (Body Fluids), frequent spontaneous sweating, worse at night, persisting for a long time, emaciation, palpitations, fright, shortness of breath, and fatigue.
Ingredients: Muli (Ostreae Concha), Huangqi (Astragali Radix), Mahuanggen (Ephedrae Radix et Rhizoma) (each 1 qian).
Cut finely, take as one dose, add over 100 grains of Xiaomai (Tritici Fructus), decoct in water and drink.
Tiaowei Tang (Regulate Wei Qi Decoction) (Li Dongyuan): Treats spontaneous sweating due to excessive Dampness, tonifies weak Wei Qi, and treats exterior deficiency unable to withstand Wind-Cold.
Ingredients: Huangqi (Astragali Radix), Mahuanggen (Ephedrae Radix et Rhizoma) (each 1 qian), Qianghuo (Notopterygii Rhizoma et Radix) (2 fen), Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Danggui Shao (Salviae Miltiorrhizae Radix tip) (each 5 fen), Sheng Dihuang (Rehmanniae Radix), Maidong (Ophiopogonis Radix) (each 3 fen), Sheng Huangqin (Scutellariae Radix), Banxia (Pinelliae Rhizoma) (each 5 fen), Zhuling (Polyporus) (2 fen), Sumu (Pterocarpus Santalinus Wood), Honghua (Carthami Flos) (each 1 fen), Wuweizi (Schisandrae Fructus) (7 grains).
I fear that for spontaneous sweating due to Yang deficiency, using Qianghuo, Banxia, and Shengjiang (Fresh Zingiberis Rhizoma) – three acrid-warm dispersing exterior-releasing agents – is inappropriate. This may be a transcription error, so I preserve it tentatively.
Cut finely, take as one dose, add 3 slices of Shengjiang (Fresh Zingiberis Rhizoma), 2 cups of water, decoct to 1 cup, remove dregs, and drink slightly warm.
Danggui Liu Huang Tang (Six-Huang Decoction with Angelica) (Liu Hejian): The best medicine for treating night sweating.
Ingredients: Danggui (Angelicae Sinensis Radix) (1 qian), Sheng Dihuang (Rehmanniae Radix), Shu Dihuang (Prepared Rehmanniae Radix), Huangbai (Phellodendri Cortex) (each 7 fen), Huangqi (Astragali Radix) (1 qian), Huanglian (Coptidis Rhizoma) (7 fen), Huangqin (Scutellariae Radix) (7 fen).
Cut finely, take as one dose, 2 cups of water, decoct to 1 cup, take warm before meals. Children take half. Also says: Children do not need treatment. (Although children may recover spontaneously, without treatment the disease may worsen daily; treatment is especially excellent.)
Huangqi Jianzhong Tang (Astragalus Decoction to Establish the Middle) (Huoren Shu): Effective for both spontaneous and night sweating (Formula seen in Shanghan section under Guizhi Tang. Or add Fu Xiaomai (Tritici Fructus) a pinch, which is excellent.)
Sizhi Baizhu San (Four-Processed Atractylodes Macrocephala Powder): Treats night sweating.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma) (4 liang, of which 1 liang is stir-fried with Huangqi, 1 liang with Shihu (Dendrobii Caulis), 1 liang with Te Li (Ostreae Concha - note: text says 'Te Li', likely a variant or typo for Muli/Oyster shell, but keeping original term contextually as processed ingredient), 1 liang with Bran; all ingredients used for stir-frying are removed).
Take only Baizhu, grind into powder, take 3 qian per dose, mixed with Millet Soup (Sumi Tang).
Zhengqi Tang (Upright Qi Decoction) (Li Dongyuan): Treats night sweating.
Ingredients: Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma) (each 1.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (roasted, 5 fen).
Cut finely, decoct in water and drink.
Baizhu San (Atractylodes Macrocephala Powder) (Li Dongyuan): Treats excessive sweating from Wind-stroke after drinking alcohol, sweating like oil leakage after eating; if not treated long-term, it will become Xiao Ke (Wasting-Thirst).
Ingredients: Muli (Ostreae Concha) (3 qian, stir-fried), Baizhu (Atractylodis Macrocephalae Rhizoma) (1.25 liang), Fangfeng (Saposhnikoviae Radix) (2.5 liang).
Grind into fine powder, take 1 qian per dose, mixed with warm water, regardless of meal times. If aversion to wind, double Fangfeng and Baizhu. If excessive sweating and facial swelling, double Muli.
(Danxi Flexible Application) says: Zhang Zhongjing's Guizhi Tang is the holy medicine for treating spontaneous sweating due to external Wind pathogen. Huangqi Jianzhong Tang is the formula for treating spontaneous sweating due to external pathogen complicated by Qi deficiency. Li Dongyuan's Buzhong Yiqi Tang is the excellent agent for treating spontaneous sweating due to Cold damage and Qi deficiency. If severe, with six pulses floating, soft, and empty, add Fuzi (Aconiti Lateralis Radix Praeparata) to the base formula to treat Yang deficiency, with effect like drum and mallet. If the Left Cun pulse is floating, surging, and accompanied by spontaneous sweating, it is Heart Fire blazing; double Renshen and Huangqi in the base formula, add Maidong, Wuweizi, and Huanglian each 5 fen. If the Left Guan pulse is floating, wiry, and accompanied by spontaneous sweating, it is complicated by Wind pathogen; add Guizhi and Shaoyao each 5 fen. If there is no Yin deficiency, only Guizhi Tang is applicable. If the Right Guan pulse is floating, surging, forceless, and accompanied by spontaneous sweating, only double Renshen and Huangqi in the base formula for self-healing. If the Right Chi pulse is surging, rapid, forceless, and accompanied by spontaneous or night sweating, it is Minister Fire borrowing the momentum of Sovereign Fire to attack Lung Metal; add Huanglian, Huangqin, and Huangbai each 5 fen to the base formula, or use only Danggui Liu Huang Tang. If the Left Chi pulse is floating, surging, forceless, and accompanied by spontaneous sweating, it is Water deficiency and Fire excess; add Zhimu and Huangbai each 5 fen, and Shu Dihuang 1 qian to the base formula, to strengthen the master of Water to control Solar brilliance. For all internal injury and deficiency-damage syndromes with unceasing spontaneous sweating, generally use Buzhong Yiqi Tang, adding a little Fuzi, Mahuanggen, and Fu Xiaomai, with swift effect like shadow following form. However, Shengma and Chaihu must be stir-fried with honey-water to kill their vigorous ascending nature, and to guide Renshen and Huangqi to the muscle surface, so they cannot be omitted. All the above refers to spontaneous sweating from internal injury and deficiency-damage, hence Buzhong Yiqi Tang is the primary governing medicine.
(Medical Case)
Lu Junwen from Shanghu suffered from an internal injury deficiency syndrome, with fever and spontaneous sweating profuse as rain, unrelenting. Taking Buzhong Yiqi Tang for over ten doses was ineffective. I modified the previous formula, using Honey-processed Huangqi 1 qian, Renshen 1 qian, Baizhu, Gancao, and Chenpi each 7 fen, Danggui and Baishao each 1 qian, Shengma and Chaihu each 1 fen, plus Guizhi 3 fen, Mahuanggen 7 fen, Fu Xiaomai a pinch, and Pao Fuzi 3 fen per dose. After three doses, sweating stopped, fever subsided, and he recovered.