胆实，脉实，精神不守，宜泻热，半夏、生地、黄芩、远志、茯神、枣仁、秫米，长流
水煎服。烦闷不眠，去生地、远志，加麦冬、桂心、甘草、人参。胆虚，脉虚，烦扰不眠，
温胆汤加人参、茯神、远志。胆寒不眠，枣仁炒为末，竹叶汤下三四钱。忧惊不眠，人参
、枳壳、五味、桂心各三钱，柏子仁、熟地各一两，山茱萸、菊花、茯神、杞子各三两。共
自汗，卫不固也。恶风自汗，冬月桂枝汤，不止，建中汤；亡阳加附子、白术；表虚，
四君
散；结胸、心痞满，无大热，半夏茯苓汤；谵语，内热，头汗，承气汤；心下懊 ，头汗，
栀子豉汤；半表半里，小柴胡汤；实热在内，小便利，大便滴血，轻则犀角汤，重则承气汤
；发黄，渴欲饮水，轻则五苓散加茵陈，重则茵陈大黄汤；手足汗，津液旁达，四肢蕴热，
燥粪谵语，承气汤；夹寒水谷不分，理中汤；凡病久而不愈，必是气血两虚，自汗热不退，
补中益气汤加附子；久久不愈，保元汤加归、芍、麦冬、五味；冷汗自出，黄 建中汤加姜
、附、人参；内热脉洪大自汗，六黄汤；便燥自汗，热不退，六味汤加生脉散；脉浮大无力
，保元汤加减。
头汗，咳嗽连声或哑，口舌俱碎，久不愈，脾虚也。白术四两，生姜一两半捣，人参八
钱，甘草六钱，茯神一两半，五味六钱，煎膏服。身无大热，冷汗自出，保元加附子；泄泻
，呕吐，脉微无力，四君加姜、附；精神恍惚，汗出于心，归脾汤；恐而汗出于肾，地黄汤
汗出不止，致成痿证，用小麦炒煎汤服，或棉子仁炒，泡汤服。
盗汗，睡中汗出也，棉子仁煎汤服。
汗乃心液，汗多则火起而渴，麦冬煎服。
头汗如贯珠者死；头汗而喘，二便难者死；冷汗不止者死。
验案
一人自汗足冷，不能行动，尺脉沉大。此脾气下陷也，故肺失养而汗出。足乃脾、肾经
地，脾阳不舒，肾气亦郁，所以冷也。以起脾养肺为本，温肾为标，用参、 、山药、补脾
阴，固表扶肺，稍加肉桂温之而愈。
Gallbladder Excess Pattern: Pulse is excess, spirit fails to remain within; suitable for clearing heat and purging fire. Herbs: Banxia (Pinelliae Rhizoma), Shengdi (Rehmanniae Radix), Huangqin (Scutellariae Radix), Yuanzhi (Polygalae Radix), Fushen (Poria with Hostwood), Zaoren (Ziziphi Spinosomi Semen), Shumi (Sorghum). Decoct in long-flowing water for oral administration. If accompanied by irritability and insomnia, remove Shengdi and Yuanzhi, add Maidong (Ophiopogonis Radix), Guixin (Cinnamomi Ramulus), Gancao (Glycyrrhizae Radix et Rhizoma), Renshen (Ginseng Radix). Gallbladder Deficiency Pattern: Pulse is deficient, restless insomnia; use Wendan Tang (Warm the Gallbladder Decoction) added with Renshen, Fushen, Yuanzhi. Gallbladder Cold causing insomnia: Stir-fry Zaoren into powder, take 3-4 qian with Zhuye (Bambusae Folium) decoction. Insomnia due to worry and fright: Renshen, Zhike (Aurantii Fructus), Wuwei (Schisandrae Fructus), Guixin each 3 qian; Baiziren (Platycladi Semen), Shudi (Rehmanniae Radix Preparata) each 1 liang; Shanzhuyu (Corni Fructus), Juhua (Chrysanthemi Flos), Fushen, Gouqi (Lycii Fructus) each 3 liang.
Spontaneous sweating is caused by insecure Wei Qi (Defensive Qi). For spontaneous sweating with aversion to wind, use Guizhi Tang (Cinnamon Twig Decoction) in winter; if ineffective, switch to Jianzhong Tang (Establish the Middle Decoction); if Yang collapse occurs, add Fuzi (Aconiti Lateralis Radix Preparata) and Baizhu (Atractylodis Macrocephalae Rhizoma); for Exterior Deficiency, use Sijunzi San (Four Gentlemen Powder); for Jie Xiong (Chest Binding) and epigastric fullness without high fever, use Banxia Fuling Tang (Pinellia and Poria Decoction); for delirium indicating Internal Heat with head sweat, use Chengqi Tang (Order the Qi Decoction); for chest oppression and restlessness with head sweat, use Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction); for Shaoyang syndrome (half-exterior, half-interior), use Xiaochaihu Tang (Minor Bupleurum Decoction); for Internal Excess Heat with free urination but bloody stools, mild cases use Xijiao Tang (Rhinoceros Horn Decoction), severe cases use Chengqi Tang; for jaundice with thirst for drinking water, mild cases use Wuling San (Five-Ingredient Powder with Poria) added with Yinchen (Artemisiae Scopariae Herba), severe cases use Yinchin Dahuang Tang (Yinchen and Rheum Decoction); for sweating on hands and feet due to fluids reaching peripherally and heat accumulating in limbs, especially with dry stool and delirium, use Chengqi Tang; for cold-dampness with indistinguishable food and water in stool, use Lizhong Tang (Regulate the Middle Decoction); for chronic illness not resolving, typically involving Qi and Blood deficiency with persistent spontaneous sweating and fever, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fuzi; for prolonged non-resolution, use Baoyuan Tang (Protect the Origin Decoction) added with Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), Maidong, Wuwei; for spontaneous cold sweat, use Huangqi Jianzhong Tang (Astragalus Establish the Middle Decoction) added with Shengjiang (Zingiberis Rhizoma Recens), Fuzi, Renshen; for Internal Heat with surging pulse and spontaneous sweating, use Liuhuang Tang (Six Yellow Decoction); for dry stool with spontaneous sweating and persistent fever, use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) added with Shengmai San (Generate the Pulse Powder); for floating, large, and forceless pulse, modify Baoyuan Tang.
Head sweat with continuous cough or hoarseness, mouth and tongue ulcers persisting for a long time indicates Spleen Deficiency. Use Baizhu 4 liang, Shengjiang 1.5 liang crushed, Renshen 8 qian, Gancao 6 qian, Fushen 1.5 liang, Wuwei 6 qian; decoct into an electuary for administration. No high fever but spontaneous cold sweat: Baoyuan Tang added with Fuzi; diarrhea and vomiting with weak, forceless pulse: Sijunzi Tang added with Shengjiang, Fuzi; mental confusion with sweat originating from the Heart: Guipi Tang (Restore the Spleen Decoction); fear-induced sweat originating from the Kidney: Dihuang Tang (Rehmannia Decoction). Unremitting sweat leading to Wei Syndrome (Flaccidity Syndrome): stir-fried wheat decocted in water for drinking, or stir-fried cottonseed soaked in water for drinking.
Nocturnal sweating refers to sweating during sleep; treat with cottonseed decoction.
Sweat is the fluid of the Heart; excessive sweating generates Fire and thirst; treat with Maidong decoction.
Head sweat like beads indicates death; head sweat with asthma and difficulty in urination/defecation indicates death; unremitting cold sweat indicates death.
Case Record
A patient presented with spontaneous sweating, cold feet, inability to walk, and a deep, large Chi pulse at the radial artery. This is Spleen Qi sinking, causing Lung malnourishment and sweating. The feet are the territory of the Spleen and Kidney meridians; Spleen Yang stagnation leads to Kidney Qi constraint, hence coldness. Treatment focused on strengthening Spleen and nourishing Lung as the root, warming Kidney as the branch. Used Renshen, [missing character], Shan Yao (Dioscoreae Rhizoma) to tonify Spleen Yin, secure the exterior and support Lung, with slight addition of Rougui (Cinnamomi Cortex) for warming, resulting in recovery.