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Heat aversion is not [excess] heat; it is clearly a deficiency syndrome. The Classics state: "Yin deficiency generates heat." Yang resides outside as the guard of Yin, and Yin resides inside as the guardian of Yang. When spirit and mind wander outward and sexual desires are unrestrained, Yin Qi dissipates, leaving Yang without attachment. Consequently, Yang floats and scatters between the muscle layers and skin surface, manifesting as heat aversion. It should be treated as "Yin deficiency with fire hyperactivity."

Cold aversion is not [excess] cold; it is clearly a heat syndrome. It may also result from long-term consumption of hot-natured drugs. Liu Hejian stated that "extreme fire resembles water"; when heat is extreme, one may feel cold internally, but this is actually not a cold syndrome.
Some cases improve slightly after using hot-natured drugs because pungent flavors can disperse and temporarily open up stagnation. Furthermore, "when fire burns intensely within, cold is driven to the exterior," causing cold aversion, which is essentially not a cold syndrome. For those with severe cold aversion in the back and a floating yet forceless pulse, this indicates Yang deficiency. Use herbs such as Renshen (Ginseng Radix) and Huangqi (Astragali Radix), with a small amount of Fuzi (Aconiti Lateralis Radix Praeparata).
A woman experienced extreme cold aversion in June, fearing wind; even wearing cotton-padded clothes, she felt no warmth. This is "extreme fire resembling water." Her six pulses were surging and rapid, and her urine was scanty and dark red.
I administered Wupiao (Natrii Sulfas) five qian, dissolved in warm water, and she recovered.
An official named Luo suffered abdominal coldness while experiencing external heat aversion during midsummer. Inhaling air made his abdomen feel cold, and he feared wind and felt cold overall. His pulse was large, deficient, and faint. Each time he drank a bowl of hot porridge, he had to consume a bowl of ginger simultaneously. If the porridge cooled down before eating, his abdomen would immediately feel cold. I said, "If heating does not produce warmth, there is no Fire." The appropriate treatment is Bawei Wan (Eight-Ingredient Pill with Rehmannia Root) to strengthen the source of Fire to dispel Yin shadows. Instead, he took Sini Tang (Four-Ingredient Decoction) and Xuanshen (Scrophulariae Radix) and died. What a pity.

(Spontaneous Sweating and Night Sweats)
When the pulse is large, deficient, floating, and soft, it indicates a sweating disorder. Spontaneous sweating manifests at the Cun position, while night sweats manifest at the Chi position. In Shanghan (Cold Damage) disease, if both Yin and Yang pulses are tight, there should be no sweating. If spontaneous sweating occurs, it is termed "Yang Collapse" (Wang Yang) and is difficult to treat.
Spontaneous sweating occurs without fixed timing, worsens with movement, belongs to Yang deficiency, and is governed by Wei Qi (Defensive Qi). Night sweats occur during sleep, covering the whole body like bathing, and stop upon waking; they belong to Yin deficiency and are governed by Ying Blood (Nutritive Blood). Generally, spontaneous sweating should be treated by tonifying Yang and regulating Wei Qi, while night sweats should be treated by tonifying Yin and descending Fire. For heart deficiency causing spontaneous cold sweat, the proper approach is to tonify the Liver and benefit the source of Fire to dispel Yin shadows. For Yin deficiency with flaming Fire, the method is to tonify the Kidney, strengthen the master of Water to control Solar brightness (excess Yang).
Additionally, Fire qi steaming upward into dampness in the Stomach can also generate sweat; this is treated with Liangge San (Cool the Upper Jiao Powder). Cases where sweat wets the hair, flows like oil, or beads up like pearls are all untreatable. Ginger is strictly contraindicated for spontaneous sweating because it opens the Cou Li (pores/skin texture).

One discussion states that spontaneous sweating due to Yang deficiency, occurring frequently, is suitable for Shenqi Tang (Ginseng and Astragalus Decoction):
Huangqi (Astragali Radix, honey-fried) 1 qian, Renshen (Ginseng Radix) 1 qian, Baizhu (Atractylodis Macrocephalae Rhizoma, de-rhizome and fried) 1 qian, Baifuling (Poria, peeled) 1 qian, Danggui (Angelicae Sinensis Radix, wine-washed) 1 qian, Shudihuang (Rehmanniae Radix Praeparata) 1 qian, Baishao (Paeoniae Radix Alba, wine-fried) 1 qian, Suanzaoren (Ziziphi Spinosae Semen, fried) 1 qian, Muli (Ostreae Concha, calcined) 1 qian, Chenpi (Citri Reticulatae Pericarpium) 7 fen, Gancao (Licorice Root, fried) 2 fen, Wumei (Mume Fructus) 1 piece.
Crush these ingredients for one dose. Add one Jujube (Ziziphus jujuba) and a pinch of Xiaomai (Triticum aestivum). Decoct in water and take warm.

For weak patients with spontaneous sweating, Dabu Huangqi Tang (Great Tonification Astragalus Decoction) is suitable:
Huangqi (Astragali Radix, honey-fried) 1 qian, Renshen (Ginseng Radix) 1 qian, Baizhu (Atractylodis Macrocephalae Rhizoma, de-rhizome and fried) 1 qian, Baifuling (Poria, peeled) 1 qian, Danggui (Angelicae Sinensis Radix, wine-washed) 1 qian, Baishao (Paeoniae Radix Alba, wine-fried) 1 qian, Shudihuang (Rehmanniae Radix Praeparata) 1 qian, Shanzhuyu (Corni Fructus, wine-steamed, pitted) 1 qian, Rongshurong (Cistanches Herba, wine-washed) 1 qian, Wuweizi (Schisandrae Chinensis Fructus) 10 grains, Rougui (Cinnamomi Cortex) 5 fen, Fangfeng (Saposhnikoviae Radix) 7 fen, Gancao (Licorice Root, fried) 3 fen.
Crush these ingredients for one dose. Add two Jujubes. Decoct in water and take warm.

Night sweats belonging to Yin deficiency, occurring during sleep and stopping upon waking, are best treated with this holy medicine for night sweats:
Danggui Liuhuang Tang (Six-Huang Decoction with Angelica):
Danggui (Angelicae Sinensis Radix, wine-washed) 2 qian, Huangqi (Astragali Radix, honey-fried) 2 qian, Shengdihuang (Rehmanniae Radix) 2 qian, Shudihuang (Rehmanniae Radix Praeparata) 2 qian, Huangbai (Phellodendri Cortex) 1 qian, Huanglian (Coptidis Rhizoma) 1 qian, Huangqin (Scutellariae Radix) 1 qian.
Crush these ingredients for one dose. Decoct in water and take on an empty stomach.

For night sweats due to dual deficiency of Qi and Blood, Ziyin Yiyang Tang (Nourish Yin and Benefit Yang Decoction) is suitable:
Danggui (Angelicae Sinensis Radix, wine-washed) 1 qian, Shudihuang (Rehmanniae Radix Praeparata) 1 qian, Shengdihuang (Rehmanniae Radix) 1 qian, Baishao (Paeoniae Radix Alba, wine-fried) 1 qian, Huangbai (Phellodendri Cortex, honey-water fried) 8 fen, Zhimu (Anemarrhenae Rhizoma, honey-water fried) 8 fen, Renshen (Ginseng Radix) 5 fen, Baizhu (Atractylodis Macrocephalae Rhizoma, de-rhizome) 1 qian, Baifuling (Poria, peeled) 1 qian, Huangqi (Astragali Radix, honey-water fried) 1 qian, Chenpi (Citri Reticulatae Pericarpium) 8 fen, Gancao (Licorice Root, fried) 8 fen.
Crush these ingredients for one dose. Add two Jujubes and a pinch of clean Xiaomai (Triticum aestivum). Decoct in water and take warm.

To consolidate the Cou Li (skin texture) for spontaneous and night sweats, especially for men with seminal emission and women with dream intercourse, Bailong Jiao (White Dragon Gel/Paste Formula) is suitable:
Guizhi (Cinnamomi Ramulus) 3 qian, Baishao (Paeoniae Radix Alba, wine-fried) 3 qian, Longgu (Fossilia Ossis Mastodi et Scapulae, calcined) 3 qian, Muli (Ostreae Concha, calcined) 3 qian, Gancao (Licorice Root, fried) 1 qian.
Crush these ingredients for one dose. Add two Jujubes. Decoct in water and take.
Sizhi Baizhu San (Four-Processed Atractylodes Powder):
Baizhu (Atractylodis Macrocephalae Rhizoma) 4 liang, Huangqi (Astragali Radix, fried) 1 liang, Shihu (Dendrobii Caulis, fried) 2 liang, Muli (Ostreae Concha, calcined) 1 liang, Gancao (Licorice Root, fried) 1 qian, Maifan (Triticum frumentum bran, fried) 1 liang.
Alternatively, use only Baizhu powdered, taking 3 qian per dose mixed with millet.

Heart sweat, where sweat appears only at the heart region and nowhere else, is treated with FulingBXixin Tang (Poria Heart-Nourishing Decoction):
Baifuling (Poria, peeled), Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, de-rhizome), Danggui (Angelicae Sinensis Radix), Shengdihuang (Rehmanniae Radix), Suanzaoren (Ziziphi Spinosae Semen, fried), Maidong (Ophiopogonis Radix, de-core), Chenpi (Citri Reticulatae Pericarpium), Huanglian (Coptidis Rhizoma, fried)—all equal parts. Gancao (Licorice Root, fried) 8 fen, Chensha (Cinnabar, ground fine, added just before taking) 5 fen.
Crush these ingredients for one dose. Add two Jujubes, one Wumei (Mume Fructus), and a pinch of Xiaomai (Triticum aestivum). Decoct in water and take well after meals.

Secret recipe for spontaneous cold sweat: Clean a male pig's stomach thoroughly, fill it with glutinous rice until full, sew it shut with thread, and boil it in a clay pot until tender. Eat both the stomach and the soup together. Dry the glutinous rice, grind into powder, take one small cup on an empty stomach mixed with rice water.

Forehead sweating occurring year-round, caused by exposure to wind after drunkenness, is called "Leakage Wind" (Lou Feng). The head is the meeting point of all Yang meridians, and alcohol promotes Yang rising. After drinking, Yang rises, opening the pores of the head and face. Sitting or lying in the wind allows pathogenic wind to enter, causing sweating on the head and face. Huangqi Liuyi Tang (Astragalus Six-to-One Powder) is suitable:
Huangqi (Astragali Radix) 6 liang, Gancao (Licorice Root) 1 liang. Adding Rougui (Cinnamomi Cortex) and Baishao (Paeoniae Radix Alba) creates Huangqi Jianzhong Tang (Astragalus Middle-Tonifying Decoction).
Fry each herb with honey over ten times to remove fire toxicity. Take 1 liang per dose, decocted in water, taken warm.

For unceasing spontaneous sweating caused by internal injury and all deficiency consumptive diseases, Buyi Yiqi Tang (Supplement Middle and Boost Qi Decoction) is used. Chaihu (Bupleuri Radix) and Shengma (Cimicifugae Rhizoma) are honey-water fried, with a small amount of Zhifuzi (Prepared Aconite Lateralis Radix), Mahuanggen (Ephedrae Radix et Rhizoma), and Xiaomai (Triticum aestivum). (See Internal Injury section).

For Kidney Qi deficiency causing fever after sweating, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) is used. (See Tonification section).

For Kidney Qi deficiency causing night sweats and cold aversion, Bawei Wan (Eight-Ingredient Pill) is used. (See Tonification section).

For dual deficiency of Qi and Blood causing night sweats, Shiquan Dabu Tang (Ten-Ingredient Great Tonification Decoction) is used. (See Tonification section).

Secret recipe for night and spontaneous sweating: Grind Wubeizi (Galla Chinensis) into powder, mix with saliva, apply to the umbilicus, and bind tightly with silk. Stops overnight.
Another formula: Apply He Shouwu (Polygoni Multiflori Radix) powder mixed with saliva to the umbilicus; also effective.

Discussion: Spontaneous sweating with pathogens in various meridians, blood stasis, or head sweating. Head sweating with difficulty urinating leads to death. Guan Ge (Obstruction and Reversal) with inability to urinate and head sweating leads to death. Collapse of Yuan Qi (Primal Qi) with head sweating leads to death. Head sweating like pearls that do not flow leads to death. Soft sweat with yellowing of the skin leads to death.
Zhenye Dan (Liquid-Stabilizing Pill):
Fangfeng (Saposhnikoviae Radix, de-rhizome and wine-washed) 3 liang, Huangqi (Astragali Radix, honey-fried) 2.5 liang, Baizhu (Atractylodis Macrocephalae Rhizoma, de-rhizome and lightly fried) 1 liang, Zhonggui (Cinnamomi Cortex) 1 liang, Baishao (Paeoniae Radix Alba, wine-fried) 1.5 liang, Dafuzi (Aconiti Lateralis Radix, bread-wrapped and baked, peel and navel removed, stir-fried in child's urine) 2 liang.
Grind into fine powder, make pills with wine paste, size of Sophora japonica seeds. Take 50-70 pills on an empty stomach with wine. Add 1 liang of fried Suanzaoren (Ziziphi Spinosae Semen).

Formula for foot sweat:
Binfan (Alumen) 5 qian, Jiang (Dried Ginger) 5 qian.
Grind into powder, wash feet daily for five consecutive days; sweat will naturally cease.

Formula for night sweats: Use one pig heart, boil in two bowls of water in a clay pot until tender. Discard the heart. Take Danggui (Angelicae Sinensis Radix) and Renshen (Ginseng Radix), 2 qian each. Add half to the heart boiling liquid, simmer until reduced to nearly half a bowl. Strain and take at any time. Whether to eat the heart is optional.

Discussion: For internal injury and all deficiency consumptive diseases causing unceasing spontaneous sweating, Yiqi Tang (Boost Qi Decoction) with Shufuzi (Prepared Aconite Lateralis Radix), Mahuanggen (Ephedrae Radix et Rhizoma), and Xiaomai (Triticum aestivum) works swiftly. However, Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) must be honey-water fried to reduce their ascending and aggressive nature. This helps guide Renshen and Huangqi to the muscle layer.
If the left Cun pulse is floating and surging with spontaneous sweating, it indicates Heart Fire blazing; double Renshen and Huangqi in the base formula, add Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Chinensis Fructus), and Huanglian (Coptidis Rhizoma), 5 fen each.
If the left Guan pulse is floating and wiry with spontaneous sweating, it involves Wind pathogen; use Guizhi (Cinnamomi Ramulus) and Shaoyao (Paeoniae Radix) from the base formula. If not Yin deficient, only Guizhi is needed.
If the left Chi pulse is floating, surging, forceless, with sweating, it indicates Water deficiency and Fire excess; add Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma), 5 fen each, and Shudihuang (Rehmanniae Radix Praeparata) 1 qian to strengthen Water to control Fire.
If the right Guan pulse is floating, surging, forceless, with sweating, double Renshen and Huangqi in the base formula.
If the right Chi pulse is surging, rapid, forceless, with spontaneous or night sweating, it indicates Ministerial Fire carrying Heart Fire to attack Lung Metal; use Danggui Liuhuang Tang (Six-Huang Decoction with Angelica).

Discussion: Spontaneous and night sweats due to dual deficiency of Yin and Yang, occurring during sleep or wakefulness. Remove Shengma (Cimicifugae Rhizoma) from Yiqi Tang (Boost Qi Decoction), add Baifuling (Poria), Jiushaoyao (Wine-fried Paeoniae Radix), Chao Suanzaoren (Fried Ziziphi Spinosae Semen), and Muli (Ostreae Concha), 1 qian each. Add Mi Huangbai (Honey-fried Phellodendri Cortex) and Mi Zhimu (Honey-fried Anemarrhenae Rhizoma), one Wumei (Mume Fructus), one Jujube, and a pinch of Xiaomai (Triticum aestivum). Decoct in water and take.

A patient sweated throughout the four seasons, feared wind, required cotton clothes even in summer, suffered asthma in winter with disconnected breath, and occasionally had cloudy urine. Bazhu Tang (Eight-Ingredient Decoction) was ineffective. Buyi Yiqi Tang (Supplement Middle and Boost Qi Decoction) provided slight relief. I prescribed Jingjie (Schizonepetae Spica), Fangfeng (Saposhnikoviae Radix), Guizhi (Cinnamomi Ramulus), Bohe (Menthae Haplocalycis Herba), Gancao (Licorice Root), and Qianghuo (Notopterygii Rhizoma et Radix); cured in one dose.

Formula for chronic unceasing spontaneous and night sweats: Gather mulberry leaves with morning dew, dry and powder them. Take 3 qian on an empty stomach with rice water.