治阴虚有火,盗汗发热(心之所藏于内者为血,发于外者为汗,汗乃心之液也。五脏六
腑,表里之阳,皆心主之以行其变化,随其阳气所在之处而生津,亦随其火扰所在之处泄而
为汗,是
寝者肾
气复而
有面赤
血虚、
又云∶
于肝;
液自胃
当归生地黄熟地黄黄芩黄柏黄连(等分)黄 (加倍)。
此手足少阴药也。盗汗由于阴虚,当归、二地所以滋阴;汗由火扰,黄芩柏连所以泻火
(湿无热不作汗,湿得热蒸则令人汗出);汗由腠理不固,倍用黄 ,所以固表(李时珍曰∶
当归六黄汤加麻黄根,治盗汗甚捷。盖其性能行周身肌表,引诸药至卫分而固腠理也。按∶
此盗汗与伤寒盗汗不同∶伤寒盗汗邪在半表半里,故以和表为主,古法小柴胡加桂主之;此
属阴虚,故以补阴为主。李士材曰∶阴虚则元气有降而无升,而复用此苦寒肃杀之剂,得毋
犯虚虚之戒乎,惟火实气强者宜之;不然,苦寒损胃,祸弥深耳。《准绳》曰∶阴虚阳必凑,
故发热盗汗,当归六黄汤加地骨皮;阳虚阴必乘,故发厥自汗,黄 建中汤;甚者加附子,
或附汤;有湿热合邪、汗出不休,以风药胜其湿,苦药泄其热,羌活胜湿汤;有痰证冷汗
自出,宜理气降痰,痰去则汗自止;有用固涩药汗愈不收止,可理心血,汗乃心之液,心失
所养,不能摄血,故溢而为汗,宜大补黄 汤加酸枣仁;有微热者,更加石斛,下灵砂丹。
王海藏
化
先
附∶扑汗法∶白术 本 川芎(各二钱半) 米粉(两半)。为末。绢袋盛,周身扑
之,治汗出不止。又方∶龙骨 牡蛎 糯米,等分。为末,扑之。
Treating night sweats and fever caused by Yin deficiency with fire hyperactivity. What the Heart stores within is Blood, and what manifests externally is Sweat; Sweat is the fluid of the Heart. The Qi of the Five Zang and Six Fu organs, as well as the Yang Qi of the interior and exterior, are all governed by the Heart to facilitate their transformations. Fluids are generated where this Yang Qi resides, and sweat is secreted where Fire pathogenic factors disturb.
[Note: The original text contains fragmented phrases such as "sleeping involves Kidney Qi restoring," "facial redness," "Blood deficiency," "said: in the Liver; fluid from the Stomach" which lack complete syntactic structure in the provided excerpt. These fragments are omitted for coherence.]
Dang Gui (Angelicae Sinensis Radix), Sheng Di Huang (Rehmanniae Radix), Shu Di Huang (Rehmanniae Radix Preparata), Huang Qin (Scutellariae Radix), Huang Bo (Phellodendri Cortex), Huang Lian (Coptidis Rhizoma) [in equal parts], Huang Qi (Astragali Membranacei Radix) [doubled dosage].
These are herbs acting on the Hand-Shaoyin and Foot-Shaoyin meridians. Night sweats arise from Yin deficiency; Dang Gui, Sheng Di Huang, and Shu Di Huang are used to nourish Yin. Sweating arises from Fire disturbance; Huang Qin, Huang Bo, and Huang Lian are used to purge Fire (Moisture does not transform into sweat without Heat; when Moisture is steamed by Heat, it causes sweating). Sweating arises from insecure Cou Li (pores/skin texture); doubling the use of Huang Qi secures the Exterior (Li Shizhen stated: Adding Mahuang Gen (Ephedrae Radix et Rhizoma) to Danggui Liu Huang Tang treats night sweats very effectively. Its nature allows it to circulate through the entire body surface, guiding the other herbs to the Wei Qi level to consolidate the Cou Li. Note: This type of night sweat differs from that caused by Shang Han (Cold Damage): Shang Han night sweat occurs because the pathogen is at the Half-Exterior Half-Interior stage, so the primary treatment is harmonizing the Exterior; the ancient method uses Xiao Chai Hu Tang (Minor Chest Pivot Decoction) plus Guizhi (Cinnamon Twig). This condition belongs to Yin deficiency, so the primary treatment is tonifying Yin. Li Shicai said: In Yin deficiency, Yuan Qi (Original Qi) descends but does not ascend; using bitter-cold and austere agents like this might violate the prohibition against making deficiency worse (Xu Xu). It is only suitable for those with excess Fire and strong Qi; otherwise, bitter-cold herbs damage the Stomach Qi, deepening the disaster. *Zhun Sheng* states: When Yin is deficient, Yang must encroach, causing fever and night sweats; treat with Danggui Liu Huang Tang plus Digupi (Lycii Cortex). When Yang is deficient, Yin must overpower, causing cold limbs and spontaneous sweating; treat with Huang Qi Jian Zhong Tang (Astragalus Decoction to Establish and Enrich the Middle). For severe cases, add Fuzi (Aconiti Lateralis Radix Preparata), or use Fuzi Tang (Aconite Decoction). For damp-heat combined pathogens with incessant sweating, use wind-dispersing herbs to overcome dampness and bitter herbs to drain heat, such as Qianghuo Shengshi Tang (Notopterygium Decoction to Overcome Dampness). For phlegm syndromes with spontaneous cold sweat, regulate Qi and descend phlegm; once phlegm is resolved, sweating stops. If astringent herbs fail to stop sweating, regulate Heart Blood; since Sweat is the fluid of the Heart, if the Heart lacks nourishment and cannot control Blood, it overflows as sweat; treat with Da Bu Huang Qi Tang (Great Tonification Astragalus Decoction) plus Suanzaoren (Ziziphi Spinosae Semen). For slight heat, add Shibei (Dendrobii Caulis) and administer Lingsha Dan (Cinnabar Pill). Wang Haicang... [text missing] ... first... [text missing]."
Appendix: Puhan Fa (Powdering Method for Sweating): Baizhu (Atractylodis Macrocephalae Rhizoma), Ben Cao (Ligustici Rhizoma et Radix), Chuanxiong (Chuanxiong Rhizoma) [each 2.5 qian], Rice Flour (1 liang half). Grind into powder. Place in a silk bag and dust over the whole body to treat incessant sweating. Another prescription: Longgu (Fossilia Ossis Mastodi et Ossis Femoris), Muli (Concha Ostreae), Nuomi (Oryza Sativa Glutinosa), in equal parts. Grind into powder and dust.