《内经》云∶汗者心之液。又云∶阳加于阴谓之汗。由此推之,是阳热加于阴血,散于
外而为汗也。然有自汗盗汗之别焉。成无己云∶自汗者,不因发散而自汗出也;盗汗者,睡
而汗出也。因而思之,自汗盗汗,其一液也,其出异也。盗如盗窃之盗,窥人息而潜出,行
于阴也;自汗如自然之自,居常有而明显,见于阳也。皆因腠理空疏,卫护气虚,不能致密
收敛于表,虚则阳热泄焉。阳主动而散津液,走于肝,若阳蒸阳分而液出者为自汗,阳蒸阴
分而液出者为盗汗,由是内分阴阳之虚,外闭腠理之气,乃得其源也。皆由心肾俱虚以致此
。阴虚阳必凑,发热自汗;阳虚阴必乘,发厥而自汗。阴阳偏胜,有伤风中暑。故经云∶风
从外入,令人汗出头痛,身重恶寒,天热衣浓则为汗,天寒衣薄则为溺。病痹多汗而濡者,
其湿甚也。阴气有余为多汗身寒,阳气有余为身热无多,劳则气耗,喘且汗出。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。或人有热饮食下胃,其气未定汗则出,或出于面,或背或身,其不循胃气之道
出。此因伤于风,内开腠理,毛蒸理泄,卫气走之,固不得循其常道。此气剽悍而出,故不
得从其道,名曰漏泄。惊怖房劳,虚极痰饮,亦成此证。诊法尺脉涩滑谓之多汗,男子平人
脉虚细微者,善盗汗也。参之表里虚实之异其药,条列诸家方论者,察其所宜而用之。经言
有病身热解堕,汗出如浴,恶风少气,名曰酒风。长沙言∶太阳病头痛发热,汗出恶风者,
太阳病发汗,遂漏不止,其人恶风,小便难,四肢微急,难以屈伸者,太阳中热者, 是也
,汗出恶寒,身热而渴者,且太阳此五证,全在乎医于本经内药治之。当凉反热,当热反凉
,医之过欤。《金匮要略》曰∶风湿脉浮身重,汗出恶风者,除湿固腠理为先。东坦云∶饮
食劳倦皆自汗,当用甘温之剂,滋益皮毛之气,不合自汗损其元气也。暑邪干卫,故身热自
汗,当用清暑益气治之。《试效方》云;湿热大作,汗出不休,胜湿之剂,最为稳当。王海
藏云∶太阳自汗桂枝汤,阳明自汗白虎汤,少阴自汗四逆汤,阳明发热自汗多者大承气汤。
此皆内伤外感之邪,干卫而出也。此方论皆前人注立,后之学人识经络,用之取效,不明脉
理,错认经络,用之反祸不轻。其于盗汗,非若自汗,犹有实者,此则阳热侵行于蒸出,阴
液复越于表,是阴亏而表亦虚也。其汗因寝而至,寝则卫气亦行于里,觉则气散于表,而汗
止矣。故经曰∶太阳所至为寝汗,东坦谓太阳老阳也。太阳标有阳之名,无阳之实,以膀胱
之真寒为纯阴之气也。《兰室秘藏》治疗之证以黄 黄连生地黄当归之属,滋阴以制阳热,
静而汗止,此其论也。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: Sweat is the fluid of the Heart. It also states: When Yang acts upon Yin, it is called sweat. From this, we can deduce that this is Yang-heat acting upon Yin-blood, dispersing to the exterior to become sweat. However, there is a distinction between spontaneous sweating (Zihan) and night sweating (Daohan). Cheng Wuji stated: Spontaneous sweating is sweating without the use of diaphoretic treatment; night sweating is sweating during sleep. Reflecting on this, spontaneous sweating and night sweating are the same fluid, but their exit differs. "Night" (Dao) is like theft, emerging stealthily when one breathes, moving within the Yin; "Spontaneous" (Zi) is like nature, always present and obvious, manifesting in the Yang. Both occur because the Couli (skin pores) are loose, and the Wei-Qi (Defensive Qi) is deficient, failing to consolidate and converge at the exterior. Deficiency leads to the leakage of Yang-heat. Yang moves and scatters body fluids, traveling to the Liver. If Yang-heat steams the Yang aspect causing fluid discharge, it is spontaneous sweating; if Yang-heat steams the Yin aspect causing fluid discharge, it is night sweating. Thus, by distinguishing internal Yin-Yang deficiency and external Couli closure, one finds the source. All these result from the deficiency of both the Heart and Kidney. Yin deficiency causes Yang to gather, leading to fever and spontaneous sweating; Yang deficiency causes Yin to invade, leading to cold extremities and spontaneous sweating. Yin-Yang excess involves wind-stroke and heatstroke. Therefore, the classics state: Wind entering from outside causes sweating, headache, heavy body, and aversion to cold; hot weather with thick clothes causes sweating, while cold weather with thin clothes causes increased urination. Patients with Bi syndrome often sweat and are damp due to severe dampness. Excess Yin leads to excessive sweating and cold body; excess Yang leads to hot body but not much sweating; labor consumes Qi, causing panting and sweating. Overeating causes sweat from the Stomach; fright depletes Essence, causing sweat from the Heart; carrying heavy loads and walking far causes sweat from the Kidneys; running fast and fearing causes sweat from the Liver; bodily exertion causes sweat from the Spleen. Sometimes, after eating hot food, sweat appears before the Stomach Qi settles, appearing on the face, back, or body, not following the normal path of Stomach Qi. This is because wind injury opens the Couli internally, hair steams, and Couli leak, causing Wei-Qi to wander, thus not following its usual path. This Qi is fierce and rapid, so it cannot follow its proper route, named "Lou Xie" (Leakage). Fright, sexual exhaustion, extreme deficiency, and phlegm-fluid retention can also cause this condition. In diagnosis, a choppy and slippery Chi pulse indicates excessive sweating; in men, a flat pulse that is deficient, fine, and minute indicates susceptibility to night sweating. Considering the differences in exterior-interior and deficiency-excess, their medications vary. Listing various schools' formulas and theories, one should observe suitability and use them. The classics mention a disease with hot body, flaccidity, profuse sweating like bathing, aversion to wind, and shortness of breath, named "Jiu Feng" (Wine Wind). Zhang Zhongjing of Changsha stated: Taiyang disease with headache, fever, sweating, and aversion to wind; after treating Taiyang with diaphoretics, sweating continues unceasingly, the person feels aversive to wind, has difficulty urinating, slight stiffness in the four limbs making flexion and extension difficult; this is Taiyang Heatstroke, characterized by sweating, aversion to cold, hot body, and thirst. These five Taiyang syndromes depend entirely on the physician treating them with appropriate herbs for the meridian. Should cooling be used when heat is indicated, or heating when cooling is indicated? This is the physician's fault. The *Jingui Yaolue* states: For wind-dampness with floating pulse, heavy body, sweating, and aversion to wind, removing dampness and consolidating Couli is the priority. Li Dongyuan stated: Self-sweating due to diet and fatigue should be treated with sweet-warm agents to nourish the Qi of skin and hair; one should not allow self-sweating to damage Yuan Qi. Summer-heat invading Wei-Qi causes hot body and spontaneous sweating, treated with Qing Shu Yi Qi Tang. The *Shixiao Fang* states: For severe damp-heat with continuous sweating, agents that overcome dampness are most appropriate. Wang Haocang stated: Taiyang spontaneous sweating uses Guizhi Tang; Yangming spontaneous sweating uses Baihu Tang; Shaoyin spontaneous sweating uses Sini Tang; Yangming fever with excessive spontaneous sweating uses Dachengqi Tang. These are all pathogens of internal injury and external contraction invading Wei-Qi and exiting. These formula theories were established by predecessors; later students who understand meridians can achieve efficacy using them. Those who do not understand pulse theory and misidentify meridians will cause serious harm. Regarding night sweating, unlike spontaneous sweating which may have excess patterns, this is caused by Yang-heat invading and steaming out, with Yin fluids overflowing to the exterior, indicating Yin deficiency and exterior deficiency. The sweat occurs during sleep; during sleep, Wei-Qi moves inward; upon waking, Qi disperses to the exterior, and sweating stops. Thus, the classics state: Taiyang manifestations include night sweating. Li Dongyuan considered Taiyang as Old Yang. Taiyang has the name of Yang but lacks the substance of Yang, regarding the true cold of the Bladder as pure Yin Qi. The *Lanshi Micang* treats this syndrome with agents such as Huanglian (Coptidis Rhizoma), Shengdihuang (Rehmanniae Radix), and Danggui (Angelicae Sinensis Radix) to nourish Yin and restrain Yang-heat, stopping sweat through stillness. This is its discussion.