脉候 诊其脉寸口弱者，阳气虚，为多汗脉也。（《病源论》）
脉来微而涩，濡而虚，虚而弱，皆主自汗。（《济生》）
汗脉浮虚，或涩或濡。（《崔氏脉诀》）
大都自汗之脉，则必微而弱；盗汗之脉，则必细而涩。微主阳气衰，细主阴气弱，王氏之论，岂欺我乎。
（《痰火点雪》）（按∶王氏当考。）
昼则自汗而夜盗汗者，固为阴阳两虚。惟脉大虚缓不数者，则为阴未甚虚，胃气尚存。借使脉来细数无力者，
则为阴败阳颓，即仓扁复起，又何施耶。（同上）
源由总说 夫自汗多因伤风伤暑，及喜怒惊恐，房室虚劳，皆能致之。无间昏醒，浸浸自出者，名曰自
汗。或睡着汗出，名曰盗汗，或云寝汗。若其饮食劳役，负重涉远，登顿疾走，因动汗出，非自汗也。人之气血，
犹阴阳之水火，平则宁，偏则病。阴虚阳必凑，故发热自汗，如水热自涌。阳虚阴必乘，故发厥自汗，如水溢自
流。考其所因，风暑涉外，喜怒惊恐涉内，房室虚劳涉不内外，理亦甚明。其间如历节、肠痈、香港脚、产蓐等病，
皆有自汗。治之当推其所因为病源，无使混滥。如《经脉别论》所载，但原其汗所出处，初非自汗证也，不可不
知。（《三因》）
自汗盗汗俱因阳虚属心 诸阳主表，在于肤腠之间。若阳气偏虚，则津液发泄，故为汗。汗多则损于心，
心液为汗故也。盗汗者，因眠睡而身体流汗也，此由阳虚所致。久不已，令人羸瘠枯瘦，心气不足，亡津液故也。
（《病源论》）（按∶此出《虚劳诸候》中。更有大病后虚汗候、风虚汗
出候，今不录。）
《难经》云∶心之液为汗。凡自汗出者，皆心之所主也。更有盗汗一证，睡着而汗自出，亦由心虚所致。
（《济生》）
自汗盗汗俱属阴虚 成无己因《金匮要略》叙杂病云∶平人脉虚弱微细，善盗汗。又以《巢氏病源》以
虚劳之人，盗汗有阳虚所致。因即谓杂病之盗汗，悉由于阳虚也。且以《金匮要略》言之，脉虚弱者乃阳气之虚，
细弱者乃阴气之虚，何独举阳而遗其阴，亦智士之一失也。然虚劳之病，或得于大病后，阴气未复，遗热尚留。
或得之劳役七情色欲之火，衰耗阴精。或得之饮食药味，积成内热。皆有以伤损阴血，衰惫阴气。阴气既虚，不
能配阳，于是阳气内蒸，外为盗汗，灼而不已，阳能久存而不破散乎。（《准绳》）
自汗阳虚，古今之定论，但真阴衰弱，亦令自汗。盖阴虚则火动乘于阴位，阴精被火煎熬而出，犹干竹而
以火然之，亦有油也。不可概用参、术、黄 与桂枝敛之，但补其阴，则火自潜伏而汗自止矣，当兼以脉候辨之。
（《锦囊》）
自汗盗汗有阳虚阴虚之别（二证俱有阴阳）自汗属气虚，属湿与热。盗汗属血虚阴虚。（《丹溪纂要》）
自汗与盗汗者，病似而实不同也。其自汗者，无时而 然出，动则为甚，属阳虚，胃气之所司也。盗汗者，
寐中而通身如浴，觉来方知，属阴虚，荣血之所主也。大抵自汗宜补阳调卫，盗汗宜补阴降火。大法，阳虚而
冷汗自出者，理宜补肝，益火之源，以消阴翳也。阴虚火炎者，法当补肾，壮水之主，以制阳光也。（《正传》）
内伤之汗，非营虚则卫弱也。何则？以阴乘阳分，自然汗出者，曰自汗，法当调营以益卫。以阳乘阴分，
睡里汗出
者，曰盗汗，法当滋阴以抑阳。若病久而肌脱肉消者，昼则自汗蒸蒸，夜则盗汗袭袭，又属阴阳两虚也，法当
气血两益之云云。要之自汗盗汗，乃亡津夺液之肇端，但见是证，则当警惕以治，毋寻常一例视也。（《痰火
点雪》）
诸古法云∶自汗者属阳虚。腠理不固，卫气之所司也。人以卫气固其表，卫气不固，则表虚自汗，而津液
为之发泄也，治宜实表补阳。盗汗者属阴虚，阴虚者阳必凑之，故阳蒸阴分则血热，血热则液泄而为盗汗也，
治宜清火补阴。此其大法，固亦不可不知也。然以余观之，则自汗亦有阴虚，盗汗亦多阳虚也。如遇烦劳大热
之类，最多自汗，故或以饮食之火起于胃，劳倦之火起于脾，酒色之火起于肾，皆能令人自汗，若此者谓非阳
盛阴衰者而何。又若人之寤寐，总由卫气之出入，卫气者阳气也，人于寐时则卫气入于阴分，此其时非阳虚于
表者而何。所以自汗盗汗亦各有阴阳之证，不得谓自汗必属阳虚，盗汗必属阴虚也。然则阴阳有异，何以辨之？
曰∶但察其有火无火，则或阴或阳自可见矣。盖火盛而汗出者，以火烁阴，阴虚可知也。无火而汗出者，以表气
不固，阳虚可知也。知斯二者，则汗出之要无余义，而治之之法亦可得其纲领矣。（《景岳》）
汗有因寒致 汗证有阴阳，阳汗者热汗也，阴汗者冷汗也。人但知热能致汗，而不知寒亦致汗。所谓寒
者，非曰外寒，正以阳气内虚，则寒生于中而阴中无阳，阴中无阳，则阴无所主而汗随气泄。故凡大惊大恐大惧，
皆能令人汗出，是皆阳气顿消、真元失守之兆。至其甚者，则如病后产后或大吐大泻失血之后，必多有汗出者，是岂非
气去而然乎。故经曰∶阴胜则身寒汗出，身常清，数栗而寒，寒则厥，厥则腹满死。仲景曰∶极寒反汗出，身必冷如冰。
是皆阴汗之谓也。故凡治阴汗者，但当察气虚之微甚。微虚者，略扶正气，其汗自收。甚虚者，非速救元气不可，即姜、
桂、附子之属，必所当用。余别有治案。在《伤寒》门战汗条中。（《景岳》）
病后多汗 病后多汗，若伤寒，若疟疾，凡系外感寒邪汗出热退，而有汗不即止者，此以表邪初解，
必由腠理卫气开泄，其汗宜然，即数日旬日，亦自无妨，候卫气渐实，汗必自止，无足虑也。若其他杂证，本
非外感之解而有自汗盗汗者，乃非所宜，不容不治。（《景岳》）
有病后多汗，服正元散（见《和剂》，系温补大方）诸重补剂不愈，惟八珍散宜之。（《要诀》）
治有三法 汗出于心，热之所致。汗出于脾，湿气上腾。汗泄于肤，卫气不固。所以清心，则液荣于内
而为血。和胃，液周流而不腾。实腠理，则卫气充而液不泄。知斯三者，治汗毕矣。（《医统》）
疏汗禁汗有法 汗由血液，本乎阴也。经曰∶阳之汗，以天地之雨名之。其义可知。然汗发于阴而出于阳，
此其本根则由阴中之营气，而其启闭则由阳中之卫气。故凡欲疏汗而不知营卫之盛衰，欲禁汗而不知橐龠之牝牡，
亦犹荡舟于陆而驾车于海耳，吾知其不败不已也。（《景岳》）
治例诸说 治自汗，用人参、黄芩，少佐以桂枝。阳虚者，附子亦可用（按∶一作阳虚附子亦可少用，
须小便煮）。火气上蒸，胃中之湿亦能作汗，凉膈散主之。（《丹溪》）
盗汗，用当归六黄汤甚效（方见《伤寒》中。《本草纲目》曰∶加麻黄根甚捷。盖其性能行周身肌表，故
能引诸药外至卫分而固腠理也。又《苍生司命》阴虚自汗，加浮小麦为至当），但药性寒，人虚者只用黄 六一
汤（用黄 、甘草）。盗汗
发热，因阴虚，用四物加黄柏；兼气虚，加人参，黄 、白术。（同上）
无病而常自汗出，与病后多汗，皆属表虚，卫气不固，荣血漏泄，宜黄 建中汤加浮麦少许煎，黄 六一
汤或玉屏风散（防风、黄 、白术）。或身温如常而汗出冷者，或身体冷而汗亦冷，别无他病，并属本证。有
痰证冷汗自出者，宜七气汤。有气不顺而自汗不止，须理气，使荣卫调和，小建中汤加木香。若服药汗仍出者，
小建中汤加熟附子一钱不去皮，或正元饮，仍以温粉扑之。大汗不止，宜于诸药中入 牡蛎粉一分，并吞朱砂丹
（方可疑，不录）或茸朱丹。常自汗出，经年累月者，多用黑锡丹。久病及大病新愈汗出者，亦可用此。若不宜
热补，须交济其阴阳自愈，当以灵砂丹主之。凡此皆非为他病而止病于汗者设，非谓有兼病者也。若服诸药，欲
止汗固表而并无效验，药愈热而汗愈不收，可只理心血。盖汗乃心之液，心无所养，不能摄血，故溢而为汗，宜
用大黄 汤（系十全大补汤加山茱、五味子、肉苁蓉）加炒酸枣仁半钱。有微热者，更加炒石斛半钱，兼下灵砂
丹。应汗多而发虚热者，不当泥于热，宜用收敛之剂。汗出而有邪热者，其人若不渴，小柴胡加桂枝半钱最良。
（《要诀》）
诸汗杂证 凡饮食汗出如洗，日久心虚液耗，令人消渴及半身不遂偏风痿疾，此乃饮食 悍之气，亦不
可不为早治也。（《医统》）（按∶此安胃汤所主，方见清中诸方中。）
如头汗邪在诸经，有蓄血亦有头汗。有头汗，小便不利者死。关格不能得尿，有头汗者死。元气下脱，有头
汗如珠不流者死。（《慈航》）
有别处无汗，独心孔一片有汗，思虑多则汗亦多，病在
用心，宜养心血，只根据一条用药（先君子曰∶此据《准绳》，盖系 猪心、人参、当归方），仍以艾汤调茯苓末
服之，名曰心汗（互见补心方中）。若阴汗，惟密陀僧和蛇床子研末，扑之立止。（《要诀》）（按∶密陀僧方
本出《是斋》。）
阴汗，下焦湿热不行，以致阴间及囊俱有汗出，常常不干是也。治法，去下焦湿热，利小水滋阴而自止（按∶
原处青娥丸方，见《腰痛》。又东垣有治阴汗方数首，今不取）。脚汗，为脾经湿热，内淫于四肢，故令手足心
常有汗，至冬阳气内伏而汗愈多，由此知其湿热内淫也。（《医统》）（按∶手足汗，处有清脾散，出清中方中。
又《医方摘要》曰∶男子手足汗，医用芩、柏、连并补剂皆不效，又足汗常多，后用八物汤加白附、川乌，其
汗即无。）
汗证，非惟自汗、盗汗，亦有头汗者，谓头面多汗，或食汤饭酒面，使热蒸于上，则头面汗出，淋漓疏泄，
故谓之头汗，此阴虚不能以附阳也，宜以当归六黄汤治之。又有心汗者，当心膻中聚而有汗，皆因多虑，有伤心脾，
致汗出心孔，宜以生脉散或六味地黄丸敛之。又有阴汗者，谓至阴之处，或两腿夹中，行走动劳，汗出腥秽，宜
以泽泻为末，盐汤下之。或有鼻汗者，凡遇食饮汤饭，则鼻上多汗，此肺虚乘热也，宜以益肺凉血，可用人参固
本丸。又有腋汗者，两腋之下，遇动作则有汗，此肝虚乘热也，宜以补肝养血，可用六味地黄丸。亦有手足有汗，
遇天寒则汗多，此阳胜其阴也，宜以抑阳补血，可用滋阴补肾丸。（《绳墨》）
死证 汗出如胶之粘，如珠之凝，及淋漓如雨，揩拭不逮者，难治。（《要诀》）
凡汗出不治之证有六∶一，汗出而喘甚者不治；二，汗出而脉脱者不治；三，汗出而身痛甚者不治；四，汗出发
润至颠者不治；五，汗出如油者不治，六，汗出如珠者不治。凡见此类，不得妄为用药。（《景岳》）
固表诸方 深师疗风，多汗恶风，四味防风散方。
防风（五分） 泽泻 牡蛎（熬） 桂心（各三分）
上药捣下筛为散，先食，酒服方寸匕，日再。（《外台》）
又疗风。汗出少气方。（赵子高法）
防风（十分） 白术（九分） 牡蛎（三分熬）
上三味捣筛为散，以酒服方寸匕，日三，增至二、三匕。恶风倍防风，少气倍术，汗出面肿倍牡蛎。（同
上）《千金》牡蛎散，治卧即盗汗，风虚头痛（即本方）。止汗之验，无出于此方。一切泄汗，服之三日皆愈，
神验。《宣明论》漏风，饮酒中风。或汗多，不可单衣，食则汗出，多如液漏，久不治为消渴，白术散主之（即
本方）。
崔氏疗盗汗，夜睡中即汗，汗不休必得风方。
麻黄根（细切） 小麦（各二升）
上二味，以水一斗二升，煮小麦得九升，内麻黄根煮之，得三升，去滓分为三服，常夜服之，不过两剂即止。
（《外台》）
牡蛎散，治诸虚不足，及新病暴虚，津液不固，体常自汗，夜卧即甚，久而不止，羸瘠枯瘦，心忪惊惕，
短气烦倦。
麻黄根（净洗） 黄 （去苗土） 牡蛎（米泔浸刷去土火烧通赤各一两）
上三味为粗散，每服三钱，水一盏半，小麦百余粒，同煎至八分，去滓热服，日二服，不拘时候。（《和
剂》）（按∶此本《延年》疗夜卧盗汗方，今去杜仲，加小麦。）
白龙汤，治男子失精，女人梦交，自汗盗汗等证。（《回春》）（即桂枝加龙蛎汤）
治盗汗方。吴内翰备方云∶余家人服之效。
牡蛎（火 为末） 小麦麸（炒黑焦为末）
上各贴之，每服牡蛎末一钱，麸末二钱，以熟猪皮去尽脂膜煎汤，临卧调服。（《是斋》）《事证》名牡
蛎汤。
治盗汗有效，陈浮麦不拘多少为末，每服二钱，米饮调服。取小麦同枣煎汤服亦可。（《大全》）
扶阳诸方 救汗汤，治阳虚自汗。（筠翁李侍郎传。《叶氏》）（即桂枝加附子汤）
附汤，治盗汗。
附子（二钱炮去皮脐） 黄 （一钱盐水或蜜拌炙）
上为粗末，每服三钱，水一盏半，生姜三片，枣子一枚，煎至七分，去滓食前服。（《魏氏》）
《延年》断汗汤。
黄 （蜜炙） 人参（去芦） 白茯苓（去皮） 芍药（白者） 肉桂（去粗皮不见火） 甘草（炙）
牡蛎粉
Pulse Diagnosis If the pulse at the cunkou (radial artery) is weak, it indicates deficiency of Yang Qi and is a pulse sign for excessive sweating. (*Zhubing Yuanhou Lun*)
If the pulse comes faint and choppy, or soft and deficient, or weak and feeble, all indicate spontaneous sweating. (*Jisheng Fang*)
The pulse for spontaneous sweating is floating and deficient, or choppy, or soft. (*Cui Shi Mai Jue*)
Generally, the pulse for spontaneous sweating must be faint and weak; the pulse for night sweats must be fine and choppy. A faint pulse indicates decline of Yang Qi, a fine pulse indicates weakness of Yin Qi. Can Wang Shuhe's theory deceive us? (*Tan Huo Dian Xue*) [Note: Wang's identity should be verified.]
Those who have spontaneous sweating by day and night sweats by night are indeed suffering from dual deficiency of Yin and Yang. Only when the pulse is large, deficient, slow, and not rapid does it indicate that Yin has not been severely damaged and Stomach Qi still exists. If the pulse is fine, rapid, and forceless, it indicates collapse of Yin essence and decadence of Yang Qi. Even if Cang Gong or Bian Que were to rise again, what could they do? (Ibid.)
General Discussion on Etiology Spontaneous sweating is mostly caused by wind-cold or summer-heat injury, as well as emotional disturbances (joy, anger, fear, fright), sexual indiscretion, and consumptive fatigue, all of which can induce sweating. Whether awake or asleep, if sweat oozes out continuously, it is called spontaneous sweating. If sweat occurs during sleep, it is called night sweats, also known as sleep sweating. If sweating occurs due to dietary excess, overwork, carrying heavy loads, traveling far, climbing, or running fast due to physical exertion, it does not belong to spontaneous sweating. Human Qi and Blood are like the water and fire of Yin and Yang; when balanced, there is peace; when imbalanced, disease arises. When Yin is deficient, Yang pathogens inevitably gather, causing fever and spontaneous sweating, similar to hot water surging naturally. When Yang is deficient, Yin pathogens inevitably invade, causing cold limbs and spontaneous sweating, similar to water overflowing naturally. Examining the causes, wind and summer-heat affect the exterior, emotions affect the interior, and sexual indiscretion/consumptive fatigue affect neither purely interior nor exterior. The principles are clear. Diseases such as Jie-jie (joint pain), intestinal abscess, Hong-xiang-jiao (charley horse/foot rot), and postpartum conditions all present with spontaneous sweating. Treatment should trace the cause to identify the source, avoiding confusion. As stated in *Jingmai Bielun*, one should only trace the origin of the sweat; initially, it may not be a spontaneous sweating syndrome, which must be understood. (*Sanyin Ji Yi Bing Zheng Fang Lun*)
Spontaneous and Night Sweats Due to Yang Deficiency Belonging to the Heart All Yang meridians govern the exterior, located between the skin and interstices. If Yang Qi is deficient, body fluids dissipate, resulting in sweat. Excessive sweating damages the Heart, as the fluid of the Heart is sweat. Night sweats occur when the body sweats during sleep, caused by Yang deficiency. If prolonged, it leads to emaciation and thinness, insufficiency of Heart Qi, and loss of body fluids. (*Zhubing Yuanhou Lun*) [Note: This is from *Xulao Zhuhou*. Other patterns like post-illness deficiency sweating and wind-deficiency sweating are not recorded here.]
*Nan Jing* states: The fluid of the Heart is sweat. All cases of spontaneous sweating are governed by the Heart. Furthermore, night sweats, where sweat occurs spontaneously during sleep, are also caused by Heart deficiency. (*Jisheng Fang*)
Spontaneous and Night Sweats Due to Yin Deficiency Cheng Wuji, citing *Jingui Yaolüe* which describes miscellaneous diseases: "Normally, people with weak, faint, and fine pulses are prone to night sweats." He also cited *Chaoshi Bingyuan* stating that consumptive patients' night sweats can be caused by Yang deficiency. Thus, he concluded that night sweats in miscellaneous diseases are entirely due to Yang deficiency. However, according to *Jingui Yaolüe*, a weak pulse indicates Yang deficiency, while a fine and weak pulse indicates Yin deficiency. Why single out Yang and omit Yin? This is a lapse even for a wise man. Nevertheless, consumptive disease may arise after a severe illness where Yin has not recovered and residual heat remains. Or it may result from labor, seven emotions, or sexual desire generating fire that depletes Yin essence. Or it may stem from diet and medication accumulating internal heat. All these damage Yin blood and weaken Yin Qi. Once Yin Qi is deficient and cannot harmonize with Yang, Yang Qi steams internally and manifests externally as night sweats. If this burning continues, can Yang Qi survive long without disintegrating? (*Yixue Gangmu*)
Spontaneous sweating due to Yang deficiency is an established view since ancient times, but true Yin deficiency can also cause spontaneous sweating. Because when Yin is deficient, Fire moves and attacks the Yin position, and Yin essence is boiled out by Fire, like dry bamboo burning releases oil. One should not generally use Ginseng, Atractylodes, Astragalus, and Cinnamon Twig to astringe. Only by tonifying Yin will the Fire subside and sweating stop. Pulse diagnosis should be combined. (*Yizong Bidu*)
Distinction between Yang and Yin Deficiency in Spontaneous and Night Sweats (Both syndromes involve Yin and Yang) Spontaneous sweating belongs to Qi deficiency, dampness, and heat. Night sweats belong to Blood deficiency and Yin deficiency. (*Danxi Zuanyao*)
Spontaneous and night sweats appear similar but are fundamentally different. Spontaneous sweating occurs without specific timing and worsens with movement; it belongs to Yang deficiency and is governed by Stomach Qi. Night sweats occur throughout the body during sleep like bathing, known only upon waking; they belong to Yin deficiency and are governed by Ying 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. The general principle: For Yang deficiency with cold sweat, one should tonify the Liver and benefit the source of Fire to eliminate Yin shadows. For Yin deficiency with flaming Fire, one should tonify the Kidney and strengthen the master of Water to control Solar brightness. (*Yixue Zhengchuan*)
Sweating due to internal injury is either Ying deficiency or Wei weakness. Why? When Yin invades the Yang division and sweat occurs naturally, it is called spontaneous sweating; the method is to regulate Ying to benefit Wei. When Yang invades the Yin division and sweat occurs during sleep, it is called night sweats; the method is to nourish Yin to suppress Yang. If the disease is chronic with muscle wasting, daytime spontaneous sweating is profuse, and nighttime night sweats are frequent; this belongs to dual deficiency of Yin and Yang, and the method is to tonify both Qi and Blood. In summary, spontaneous and night sweats are the beginning of losing Jin-Ye (body fluids). Upon seeing this syndrome, one must be vigilant and treat it, not treating it as a common case. (*Tan Huo Dian Xue*)
Ancient methods state: Spontaneous sweating belongs to Yang deficiency. Interstices are not secure, governed by Wei Qi. Humans rely on Wei Qi to consolidate the exterior; if Wei Qi is insecure, the exterior is deficient leading to spontaneous sweating, and body fluids dissipate. Treatment should consolidate the exterior and tonify Yang. Night sweats belong to Yin deficiency. When Yin is deficient, Yang inevitably gathers, so Yang steaming the Yin division causes Blood heat, and Blood heat causes fluid leakage leading to night sweats. Treatment should clear Fire and tonify Yin. This is the general principle, which must be known. However, in my observation, spontaneous sweating can also be due to Yin deficiency, and night sweats are often due to Yang deficiency. For example, in cases of mental fatigue and high fever, spontaneous sweating is most common. Thus, fire from diet arising in the Stomach, fire from fatigue arising in the Spleen, and fire from alcohol and sex arising in the Kidney can all cause spontaneous sweating. Such cases cannot be described as anything other than excess Yang and deficient Yin. Regarding wakefulness and sleep, they depend on the entry and exit of Wei Qi. Wei Qi is Yang Qi; during sleep, Wei Qi enters the Yin division. At this time, is it not because of exterior Yang deficiency? Therefore, spontaneous and night sweats each have Yin and Yang syndromes. One cannot say spontaneous sweating must be Yang deficiency, nor that night sweats must be Yin deficiency. How to distinguish them? Say: Observe whether there is Fire or not. If Fire is abundant and sweating occurs, it is due to Fire scorching Yin, indicating Yin deficiency. If no Fire and sweating occurs, it is due to insecure exterior Qi, indicating Yang deficiency. Knowing these two, the essentials of sweating are understood, and treatment principles can be grasped. (*Jingyue Quanshu*)
Sweating Caused by Cold Sweat syndromes have Yin and Yang. Yang sweat is hot sweat; Yin sweat is cold sweat. People know that heat causes sweating, but do not know that cold also causes sweating. By "cold," we do not mean external cold, but rather internal deficiency of Yang Qi, generating cold from within. When there is no Yang in the Yin, Yin has no master, and sweat follows Qi leakage. Thus, great fright, terror, or fear can cause sweating, all signs of sudden consumption of Yang Qi and loss of True Yuan. Severe cases, such as after illness, postpartum, or after severe vomiting, diarrhea, or blood loss, often present with sweating. Is this not due to the departure of Qi? Hence, the Classic says: "When Yin prevails, the body is cold and sweats; the body feels constantly cold, shivering and chilled; cold leads to cold limbs; cold limbs lead to abdominal fullness and death." Zhang Zhongjing said: "Extreme cold reversely causes sweating, and the body becomes cold as ice." These refer to Yin sweat. Therefore, when treating Yin sweat, one must assess the degree of Qi deficiency. Mild deficiency requires slight support of Righteous Qi, and sweat will cease. Severe deficiency requires urgent rescue of Yuan Qi; Ginger, Cinnamon Twig, and Aconite are necessary. I have separate case records in the *Shanghan* section on Battle Sweat. (*Jingyue Quanshu*)
Excessive Sweating After Illness Excessive sweating after illness, if due to Shanghan (Cold Damage), malaria, or any exogenous cold pathogen where heat subsides after sweating but sweating does not stop immediately, this is because the exterior pathogen has just resolved, and interstitial Wei Qi is open and leaking. This sweating is expected; even if it lasts days or ten days, it is harmless. Wait for Wei Qi to gradually solidify, and sweating will stop naturally. There is no need to worry. If it is other miscellaneous diseases, not resolving from exogenous pathogens, presenting with spontaneous or night sweats, this is inappropriate and must be treated. (*Jingyue Quanshu*)
For excessive sweating after illness, if Zhengyuan San (see *Heji Jufang*, a warm-tonic formula) and other strong tonics fail, Bazhen San is suitable. (*Zhengzhi Yaojue*)
Three Methods of Treatment Sweat originating from the Heart is caused by Heat. Sweat originating from the Spleen is due to Dampness rising. Sweat leaking from the skin is due to insecure Wei Qi. Therefore, clearing the Heart makes fluids nourish the interior and become Blood. Harmonizing the Stomach allows fluids to circulate without rising. Consolidating interstices fills Wei Qi and prevents fluid leakage. Knowing these three completes the treatment of sweating. (*Yitong*)
Methods for Promoting and Restricting Sweating Sweat originates from Blood, fundamentally belonging to Yin. The Classic says: "Yang sweat is named after the rain of heaven and earth." The meaning is clear. However, sweat emerges from Yin and exits through Yang. Its root lies in Ying Qi within Yin, and its opening/closing is governed by Wei Qi within Yang. Thus, those who wish to promote sweating without knowing the abundance/excess of Ying and Wei, or restrict sweating without knowing the bellows' female/male aspects, are like sailing a boat on land or driving a cart on the sea. I know they will not stop until failure. (*Jingyue Quanshu*)
Discussion on Treatment Examples To treat spontaneous sweating, use Ren Shen (Ginseng Root), Huang Qin (Scutellaria Root), with a small amount of Guizhi (Cinnamon Twig). For Yang deficiency, Fuzi (Aconite Lateralis Radix Preparata) can also be used [Note: Some say a small amount of Fuzi can be used for Yang deficiency, boiled in urine]. If Fire Qi steams upward, dampness in the Stomach can also cause sweating; Liangge San is indicated. (*Danxi Xinfa*)
For night sweats, Danggui Liu Huang Tang is very effective (Formula seen in *Shanghan*. *Bencao Gangmu* says: Adding Mahuang Gen (Ephedrae Radix et Rhizoma) is very quick. Because its nature travels through the whole body surface, it guides other medicines to the Wei level to consolidate interstices. Also, *Cangsheng Siming* suggests adding Fu Xiaomai (Floating Wheat) for Yin deficiency spontaneous sweating as most appropriate). However, the medicine is cold in nature. For deficient persons, only Huangqi Liuyi Tang (using Huangqi and Gancao) should be used. For night sweats with fever due to Yin deficiency, use Siwu Tang plus Huangbai; if accompanied by Qi deficiency, add Renshen, Huangqi, and Baizhu. (Ibid.)
For those without illness who constantly sweat spontaneously, and excessive sweating after illness, all belong to exterior deficiency with insecure Wei Qi and leaking Ying Blood. Use Huangqi Jianzhong Tang with a little Fu Mai (Floating Wheat), Huangqi Liuyi Tang, or Yupingfeng San (Fangfeng, Huangqi, Baizhu). If the body temperature is normal but sweat is cold, or the body is cold and sweat is cold, with no other diseases, all belong to this syndrome. For phlegm syndromes with cold spontaneous sweating, use Qiqi Tang. For Qi stagnation with continuous spontaneous sweating, regulate Qi to harmonize Ying and Wei; Xiao Jianzhong Tang plus Muxiang. If sweating persists after taking medicine, use Xiao Jianzhong Tang plus Shu Fuzi (Prepared Aconite) 1 qian without peel, or Zhengyuan Yin, and apply warm powder externally. For continuous profuse sweating, add Musli Fen (Oyster Shell Powder) 1 fen to various formulas, and swallow Zhusha Dan (Cinnabar Pill) or Rongzhu Dan. For chronic spontaneous sweating lasting years, use Heixi Dan frequently. For long-term illness or new recovery from severe illness with sweating, this can also be used. If hot tonification is unsuitable, and Yin-Yang must be harmonized for self-healing, Lingsha Dan is indicated. All these are set for stopping sweating itself, not for cases with concurrent diseases. If taking various formulas to stop sweating and consolidate the exterior yields no effect, and hotter medicines cause more sweating, one should only nourish Heart Blood. Since sweat is the fluid of the Heart, if the Heart lacks nourishment and cannot control Blood, it overflows as sweat. Use Dahuang Tang (Shiquan Dabu Tang plus Shanzhuyu, Wuweizi, Rongrong) plus Chao Suanzaoren 0.5 qian. For slight heat, add Chao Shihu 0.5 qian, and take Lingsha Dan concurrently. For excessive sweating with deficiency heat, do not stick to heat-clearing; use astringent formulas. For sweating with evil heat, if the person is not thirsty, Xiaochaihu Tang plus Guizhi 0.5 qian is best. (*Zhengzhi Yaojue*)
Miscellaneous Syndromes of Sweating Those who sweat profusely like washing after eating, over a long period, deplete Heart Yin and fluids, leading to Xiao Ke (Wasting-Thirst) and hemiplegia or flaccidity. This is due to the fierce Qi of food and drink, and early treatment is necessary. (*Yitong*) [Note: This is treated by Anwei Tang, see formulas in Qingzhong.]
Head sweating: Pathogens in various meridians, including blood stasis, can cause head sweating. Head sweating with difficulty urinating indicates death. Guan-Ge syndrome unable to urinate with head sweating indicates death. Collapse of Yuan Qi with head sweating like beads not flowing indicates death. (*Cihang*)
No sweating elsewhere, but only a patch on the heart area sweats. More thinking leads to more sweating. The disease lies in the Heart's usage. Nourish Heart Blood. Use one prescription [Ancestor said: Based on *Yixue Gangmu*, likely Zhu Xin, Renshen, Danggui formula], mixed with mugwort water and Poria powder, taken orally. Named Xin Han (Heart Sweat) (See Bu Xin Fang). For Yin sweat (genital sweating), only Mituo Seng (Lead Monoxide) and Chuangzi (Cnidium Fruit) ground into powder, applied externally, stops it immediately. (*Zhengzhi Yaojue*) [Note: Mituo Seng formula originally from *Shizhai*.]
Yin sweat (genital sweating): Damp-Heat in the Lower Jiao fails to circulate, causing sweating in the genitals and scrotum, which remains constantly damp. Treatment: Clear Damp-Heat from Lower Jiao, promote urination, nourish Yin, and it will stop naturally [Note: Original Qing'e Wan formula seen in Yao Tong. Dongyuan has several formulas for Yin sweat, not taken here]. Foot sweat: Damp-Heat in the Spleen Meridian invades internally to the four limbs, causing constant sweating on palms and soles. In winter, when Yang Qi hides internally, sweating increases, indicating internal invasion of Damp-Heat. (*Yitong*) [Note: For hand/foot sweat, Qingspi San is available in Qingzhong. *Yifang Jaoyao* says: For men's hand/foot sweat, doctors using Huangqin, Huangbai, Huanglian and tonics failed. Later, using Bawu and Chuanwu added to Bawu Tang stopped the sweat.]
Sweat syndromes include not only spontaneous and night sweats, but also head sweating. Head sweating refers to excessive sweating on the head and face, often after eating hot soup, rice, wine, or noodles, causing heat to steam upward. This is called head sweating, due to Yin deficiency failing to attach to Yang. Treat with Danggui Liu Huang Tang. Heart sweating: Sweat gathers at the chest/sternum, caused by excessive worry damaging Heart and Spleen, causing sweat from the heart pore. Treat with Shengmai San or Liuwei Dihuang Wan to astringe. Yin sweat (genital): Sweating in the most Yin areas, or between thighs, after walking/exertion, with foul odor. Take Zexie powder with salt water. Nasal sweating: Excessive sweating on the nose when eating/drinking, due to Lung deficiency with heat. Benefit Lung and cool Blood; use Ren Shen Guben Wan. Axillary sweating: Sweating in armpits upon movement, due to Liver deficiency with heat. Tonify Liver and nourish Blood; use Liuwei Dihuang Wan. Hand/foot sweating: More sweating in cold weather, due to Yang prevailing over Yin. Suppress Yang and tonify Blood; use Ziyin Bushen Wan. (*Shengmo*)
Death Signs Sweat sticky like glue, congealed like beads, or pouring down like rain, impossible to wipe up quickly, is difficult to treat. (*Zhengzhi Yaojue*)
Six untreatable sweating syndromes: 1. Sweating with severe asthma; 2. Sweating with pulse disappearance; 3. Sweating with severe body pain; 4. Sweating with moist hair reaching the crown; 5. Sweating like oil; 6. Sweating like beads. Upon seeing these, do not prescribe medications rashly. (*Jingyue Quanshu*)
Formulas to Consolidate the Exterior Shenshi treats wind, excessive sweating, and aversion to wind. Siwei Fangfeng San Formula.
Fangfeng (5 fen) Zexia Musli (roasted) Guixin (each 3 fen)
Grind and sieve the above herbs into powder. Take before meals, dose one cubic inch spoon with wine, twice daily. (*Waitai Miyao*)
Another formula for wind. Sweating with shortness of breath. (Method of Zhao Zigao)
Fangfeng (10 parts) Baizhu (9 parts) Musli (3 parts, roasted)
Grind and sieve the above three into powder. Take one cubic inch spoon with wine, three times daily, increase to two or three spoons. Increase Fangfeng for aversion to wind, Baizhu for shortness of breath, Musli for sweating and facial swelling. (Ibid.) *Qianjin* Musli San treats night sweats upon lying down and wind-deficiency headache (same formula). No formula is more effective for stopping sweating. All types of leaking sweat heal in three days. Divine efficacy. *Xuanming Lun* Lou Feng (Leaking Wind), windstroke after drinking alcohol. Or excessive sweating, cannot wear thin clothes, sweats upon eating, like liquid leaking. If untreated long-term, becomes Xiao Ke. Baizhu San is indicated (same formula).
Cui Shi treats night sweats. Sweating immediately during night sleep. If sweating does not stop, must obtain wind formula.
Mahuang Gen (finely cut) Xiaomai (each 2 sheng)
Take the above two, boil Xiaomai in 12 dou of water until 9 sheng remain. Add Mahuang Gen and boil until 3 sheng remain. Remove dregs, divide into three doses. Take nightly. Stops within two doses. (*Waitai Miyao*)
Musli San treats all deficiencies and new acute deficiency, insecure Jin-Ye, constant spontaneous sweating, worse at night, prolonged without stopping, emaciation, palpitations, fright, shortness of breath, and fatigue.
Mahuang Gen (clean washed) Huangqi (remove sprouts and soil) Musli (soaked in rice wash, scrubbed clean, fired red, each 1 liang)
Grind the above three into coarse powder. Take 3 qian per dose, with 1.5 cups of water and over 100 grains of Xiaomai. Decoct to 0.8 cup. Remove dregs and take hot. Twice daily, any time. (*Heji Jufang*) [Note: Originally *Yannian* formula for night sweats, now remove Duzhong, add Xiaomai.]
Bailong Tang treats male seminal emission, female dream intercourse, spontaneous and night sweats. (*Huichun*) (Same as Guizhi Jia Longmu Tang)
Formula for night sweats. Wu Neihan's prepared formula says: My family members took it with effect.
Musli (calcined to powder) Xiaomai Fu (stir-fried black/burnt to powder)
Mix each. Take 1 qian Musli powder and 2 qian Bran powder per dose. Decoct cooked pork skin (degreased) in water, mix and take before bed. (*Shizhai Baiyi Xuanfang*). *Shizheng* names it Musli Tang.
Effective for night sweats: Chen Fumai (aged floating wheat) ground to powder, any amount. Take 2 qian per dose, mixed with rice water. Boiling Xiaomai with dates in water and drinking is also acceptable. (*Dquan*)
Formulas to Support Yang Jiu Han Tang treats Yang deficiency spontaneous sweating. (Passed down by Li Shilang Yunweng. *Ye Shi*) (Same as Guizhi Jia Fuzi Tang)
Fu Tang treats night sweats.
Fuzi (2 qian, processed, peel and umbilicus removed) Huangqi (1 qian, stir-fried with salt water or honey)
Grind into coarse powder. Take 3 qian per dose, with 1.5 cups of water, 3 slices of fresh ginger, and 1 jujube. Decoct to 0.7 cup. Remove dregs and take before meals. (*Wei Shi Jiacang Fang*)
*Yannian* Duan Han Tang.
Huangqi (honey-roasted) Renshen (remove rhizome) Baifuling (peeled) Shaoyao (white) Rougui (remove rough bark, avoid fire) Gancao (roasted) Musli Fen