涂蔚生曰∶汗者气分之水,由而气变为汗。如空中之气,遇寒冷变而为雨;口鼻之气,遇漆石变而为水也。
古人有阳虚自汗,阴虚盗汗之说。因阳气既虚,则卫外者无所统御,而内部化生充溢皮肤之气,即无所摄收。故
当醒寤之时,发而为自汗也。宜用六君子汤,加炙 、枣仁,茯神以治之。阴血既虚,则营内者无所主宰,而外
部化生根据归营血之气,即无所收容。故当梦寐之时,虚火干犯阳分,发而为盗汗也。宜用六味地黄汤加牡蛎、龙
骨、寸冬、五味以治之,重者须当归六黄汤治之。然但头汗出,身不得汗者,乃阳气内郁,冒于上而为汗,宜以
小柴胡汤解之。手足 然汗出,与醒后遍体出汗许久不干者,乃胃中瘀血食积之火,结聚中州也。宜用玉烛散,
加枳壳、浓朴以治之。若夫时汗时止,时冷时热,则为风淫腠理,宜用柴胡桂枝汤,以解其外来之邪。久病之阳,
大汗不止,则谓之阳将脱。宜用参附汤,以扶其内竭之阳,临症酌而用之,幸毋胶柱鼓瑟。
六君子汤(见前咳嗽方内)
六味地黄汤(见前喘哮方内)
当归六黄汤
生地(二钱) 熟地(二钱) 黄连(一钱) 黄芩(一钱) 黄柏(一钱) 黄 (一钱) 当归(一钱)
小柴胡汤(见前咳嗽方内)
玉烛散
生地(一钱) 当归(一钱) 川芎(六分) 白芍(一钱) 朴硝(一钱) 大黄(一钱) 枳壳(六分)
浓朴(五分) 大枣(一枚)
柴胡桂枝汤(见前风症谈)
参附汤
人参(一钱) 附片(三分)
Tu Weisheng stated: Sweat is water within the Qi aspect, transformed from Qi. It is like moisture in the air turning into rain when encountering cold; or vapor from the mouth and nose condensing into water upon contact with lacquer or stone.
The ancients spoke of spontaneous sweating due to Yang deficiency and night sweats due to Yin deficiency. When Yang Qi is deficient, the defensive Qi that protects the exterior loses its command, and the Qi generated internally and filling the skin lacks control. Therefore, during wakefulness, this Qi escapes externally, resulting in spontaneous sweating. It is appropriate to use Liujunzi Tang (Six Gentlemen Decoction), adding Zhi Gancao (Honey-fried Licorice Root), Suanzaoren (Ziziphus Seed), and Fushen (Poria with Hostwood) for treatment. When Yin Blood is deficient, the Ying (Nutritive) Qi within loses its master, and the Qi generated externally and returning to the Ying-Blood lacks containment. Therefore, during sleep and dreaming, deficient Fire harasses the Yang aspect, causing Qi to escape externally, resulting in night sweats. It is appropriate to use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) adding Muli (Oyster Shell), Longgu (Fossilized Bone), Maidong (Ophiopogon Tuber), and Wuweizi (Schisandra Fruit) for treatment; for severe cases, Danggui Liuhuang Tang (Angelica Hexa-Huang Decoction) should be used. However, if only the head sweats while the body does not, it indicates internal stagnation of Yang Qi rising to the head to transform into sweat; Xiaochaihu Tang (Minor Bupleurum Decoction) is appropriate to harmonize. If there is continuous sweating on the hands and feet, or profuse whole-body sweating after waking that remains wet for a long time, it indicates Fire from blood stasis and food accumulation in the Stomach knotting in the Middle Jiao. Yuzhu San (Jade Candle Powder) adding Zhike (Aurantii Fructus) and Houpo (Magnolia Bark) is appropriate for treatment. If sweating comes and goes intermittently, accompanied by alternating chills and fever, it indicates Wind pathogen invading the interstices (Couli); Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction) is appropriate to resolve external pathogens. In chronic illness, if Yang is deficient and profuse sweating continues without stopping, it is termed impending Yang collapse. Shenfu Tang (Ginseng and Aconite Decoction) is appropriate to support the internally depleted Yang; apply according to clinical judgment, and do not adhere rigidly to fixed rules.
Liujunzi Tang (See previous cough formulas)
Liuwei Dihuang Tang (See previous asthma/wheezing formulas)
Danggui Liuhuang Tang
Shengdi (2 qian) Shudi (2 qian) Huanglian (1 qian) Huangqin (1 qian) Huangbai (1 qian) Huangqi (1 qian) Danggui (1 qian)
Xiaochaihu Tang (See previous cough formulas)
Yuzhu San
Shengdi (1 qian) Danggui (1 qian) Chuanxiong (6 fen) Baishao (1 qian) Poxiao (1 qian) Dahuang (1 qian) Zhike (6 fen)
Houpo (5 fen) Dazao (1 piece)
Chaihu Guizhi Tang (See previous wind syndrome discussions)
Shenfu Tang
Renshen (1 qian) Fupian (3 fen)