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General Overview: The manifestations of spontaneous sweating in children are diverse; do not treat them as a single uniform condition. One must distinguish between yin and yang, deficiency and excess patterns, and with diligent regulation, peace and health will naturally be restored.

Pulse Diagnosis: A pulse that is large, deficient, floating, and soggy indicates spontaneous sweating when felt at the chi position, and night sweating when felt at the cun position. In cold damage diseases, if the pulse is tight in both yin and yang positions, there should be no sweating; if spontaneous sweating occurs instead, it is a sign of Yang collapse (Wang Yang), which is difficult to cure.

The *Neijing* states: "The fluid of the Heart is sweat." The *Yuanbing Shi* states: "When the Heart is hot, sweat is produced." Li Dongyuan said: "The southwest corresponds to Kun Earth, which in humans relates to the Spleen and Stomach." Human sweat is like rain in heaven and earth; when Yin nourishes dampness, it forms mist, dew, and rain. According to the *Neijing*, sweating is primarily governed by the Heart, while 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, just as earthly moisture rises as clouds and mist into the sky; without descending, it does not become heavy rain. All five Zang organs can cause sweating, but only the Heart and Spleen/Stomach govern Damp-Heat; this is the general principle. Thus, the Classics state: "After eating to fullness, sweat comes from the Stomach; after fright depletes Essence, sweat comes from the Heart; carrying heavy loads and traveling far, sweat comes from the Kidney; running fast and fearing, sweat comes from the Liver; bodily movement and toil, sweat comes from the Spleen." As for spontaneous sweating and night sweating, although the symptoms appear similar, they are fundamentally different, as detailed below.

(If hair becomes wet with sweat after sweating, this is the first untreatable condition; if sweat is oily, this is the second; if sweat coagulates into bead-like drops, this is the third. Sweating over the entire body is called "Heat Wandering" (Re Yue), meaning heat dissipates into the four limbs. Night sweating refers to sweating during deep sleep that stops upon waking. Zhu Danxi said: Spontaneous sweating belongs to Qi deficiency; use Ren Shen (Ginseng) and Huang Qi (Astragalus), slightly supplemented with Guizhi Tang (Cinnamon Twig Decoction). If deficiency is severe, Fuzi Tang (Aconite Decoction) may also be used. Night sweating belongs to Blood deficiency; Danggui Liu Huang Tang (Angelica Six-Huang Decoction) is extremely effective. When Fire Qi steams upward, dampness in the Stomach also transforms into sweat, treated with Liang Ge San (Cooling the Diaphragm Powder).)

For children with spontaneous sweating due to Spleen deficiency, sweat often emerges on the forehead, sticky and clinging to hands. One must quickly rescue Stomach Qi and administer Quanxie Guanyin San (Scorpion Guanyin Powder).

For spontaneous sweating accompanied by Spleen deficiency diarrhea, where the whole body feels cold and sweating occurs intermittently—absent during diarrhea but present after—it indicates severe deficiency. Urgently administer Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder).

For spontaneous sweating due to Lung deficiency, the right side of the face is often pale, and the Lung pulse is weak upon pressure. Long-term incessant coughing causes Lung Qi deficiency to rise and obstruct, leading to sweating. Treat with Bufei San (Tonify Lung Powder) and regulate the Spleen with Huoxiang Yin (Agastache Drink), following the principle of "nourishing the mother to save the child."

Spontaneous sweating associated with slow convulsions occurs all over the body, with the body cold as ice. This condition is critical; see the discussion on slow convulsions.

There are cases of spontaneous sweating due to excess syndromes, caused by external wind-pathogen invasion and fever. Regardless of whether the child is unconscious or awake, profuse spontaneous sweating occurs. Use Baisan Jie (Hundred-Dispersal Powder) or administer Wuling San (Five-Ingredient Powder with Poria) intermittently.

Some children have no disease but sweat like water during sleep, remaining wet long after waking. This is called accumulation-type night sweating (Ji Zheng Dao Han), caused by Cold in the Spleen. Use San Leng San (Curcuma Powder).

Occasional slight leakage of cold sweat, with hair roots resembling beads and a shiny forehead, is called fright-sweat. Use Baolong Wan (Dragon-Holding Pill) and Fushen Tang (Poria Spirit Decoction) added with Mahuang Gen (Ephedra Root).

Sweating automatically during sleep is called night sweating, caused by Yang deficiency. If prolonged, it leads to emaciation of the spine and thinness, insufficiency of Heart Qi, and reckless loss of Jin Ye (Body Fluids). Therefore, use Fushen Tang added with Huang Qi (Astragalus) for decoction and administration.

[Attached Formulas]
Danggui Liu Huang Tang (Angelica Six-Huang Decoction): Dang Gui (Angelicae Sinensis Radix), Sheng Di (Rehmanniae Radix), Shu Di (Prepared Rehmanniae Radix), Huang Qi (Astragali Radix), Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), Huang Bo (Phellodendri Cortex).
Liang Ge San (Cooling the Diaphragm Powder): Jie Geng (Platycodonis Radix), Bo He (Menthae Haplocalycis Herba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Zhi Zi (Gardeniae Fructus), Lian Qiao (Forsythiae Fructus), Da Huang (Rhei Radix et Rhizoma), Mang Xiao (Natrii Sulfas).
Quanxie Guanyin San (Scorpion Guanyin Powder): Lian Rou (Nelumbinis Semen), Ren Shen (Ginseng Radix et Rhizoma), Bian Dou (Dolichoris Lablab Semen), Tian Ma (Gastrodiae Rhizoma), Fang Feng (Saposhnikoviae Radix), Quan Xie (Scorpio), Qiang Huo (Notopterygii Rhizoma et Radix), Bai Zhi (Angelicae Dahuricae Radix), Mu Xiang (Aucklandiae Radix), Huang Qi (Astragali Radix), Fu Ling (Poria), Shen Qu (Massa Medicata Fermentata), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder): See Cholera Syndrome section.
Bufei San (Tonify Lung Powder): E Jiao (Colla Corii Asini), Fu Ling (Poria), Ling [Note: Text says 'Ling', likely referring to Mai Dong or Bai He in context, but extracted as is], Nuo Mi (Oryza Glutinosa Semen), Xing Ren (Armeniacae Semen Amarum), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Huoxiang Yin (Agastache Drink): Ren Shen (Ginseng Radix et Rhizoma), Ban Xia (Pinelliae Rhizoma), Chi Fu Ling (Red Poria), Gan Cao (Glycyrrhizae Radix et Rhizoma), Cang Zhu (Atractylodis Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Huoxiang (Agastaches Herba), Hou Po (Magnoliae Officinalis Cortex).
Baisan Jie (Hundred-Dispersal Powder): See Heat Syndrome section (One formula adds Sheng Ma).
Wuling San (Five-Ingredient Powder with Poria): See Convulsive Disease section.
San Leng San (Curcuma Powder): See Various Vomiting Syndromes section.
Baolong Wan (Dragon-Holding Pill): See Convulsive Disease section.
Fushen Tang (Poria Spirit Decoction): Fu Shen (Poria cum Radice), Ren Shen (Ginseng Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma).