汗为心液，肾主五液，故汗出皆由心肾虚致之。有自汗，有盗汗，自汗属阳虚，盗汗属阴虚，自汗者，
不因劳动，不因发散， 然自出，由阳虚不能卫外而固密也。盗汗者，寐中窃出，醒后倏收，由阴虚不能内
营而敛藏也。阳虚自汗，治宜补气以卫外；阴虚盗汗，治宜补阴以营内。固卫则表气实而腠理不疏；填营则
里真固而阴液不泄。条其治法∶表虚自汗失敛，补阳汤。里虚盗汗有热，益阴汤。表里不固汗出，黄 汤。气
虚而阳弱者必自汗， 附汤。凡肥人多自汗。阴虚而火蒸者多盗汗，当归地黄汤。凡瘦人多盗汗。阳虚者阴
必乘，多发厥自汗；黄 建中汤，阴虚者阳必凑，多发热盗汗。当归六黄汤。阳蒸阴分，则血热，血热则
液泄为盗汗。此从乎表里阴阳为治也。然自汗有属腑脏者，经云∶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。如胃热，食则汗出如洗；二甘汤或牡白散。
饮酒漏风，汗出如浴。白术散。肺虚，腠易疏泄，玉屏风散。心虚，神不安谧，朱砂安神丸、天王补心丹。
肾虚，元府不闭，六味丸、还少丹。肝脾虚，精血久耗，三阴煎。士材亦云∶肺虚者固其皮毛，黄 六一汤。
心虚者益其血脉，当归六黄汤。肾虚者助其封藏，五味子汤。脾虚者壮其中气，补中益气汤。肝虚者禁其疏泄，
白芍汤。此从乎腑脏为治也。其盗汗乃睡中自泄，参苓散。水火不交，心肾丸。阴阳偏胜，黄 汤。虚损心阳，
柏子仁汤、牡蛎散。至如病后气血俱虚自汗，十全大补汤。产后血脱，孤阳无根据，大汗不止，独参汤。
凡津脱者汗大泄，大补元煎去杜仲。痰盛者汗自流，理中降痰汤。发汗过剂，血虚成痉，防风当归汤。汗多
亡阳，身冷拘急，桂枝加附子汤。若夫风湿相搏，时自汗出，防己黄 汤。恶风自汗，桂枝
汤。伤寒，阳明、少阳症盗汗，柴胡汤、葛根汤选用。温热症，三阳合病，目合则汗，白虎汤。额汗湿热上
蒸，或血蓄胃口，迫其津液致之。蓄血头汗，剂颈而还，犀角地黄汤。头汗，小便不利，渴而不饮，此血瘀膀胱
也。桃仁承气汤。胃热上蒸，额汗发黄，小水不利者，五苓散加茵陈，甚则茵陈蒿汤利之。伤寒胁痛耳聋，寒
热口苦，头汗剂颈而还，属少阳，小柴胡汤加桂枝、茯苓、白术和之。少阳挟热，或为盗汗，或腋汗，胁汗，
须知从阴阳交互时，及阴阳交互处发泄者，皆阴阳不和半表半里症。小柴胡汤、逍遥散，皆合剂也。外有头汗，
头者，诸阳之会，邪搏诸阳，津液上凑，则头汗。剂颈而还，属血症。四物汤。湿邪搏阳，亦汗出头额，参用
胜湿汤、调卫汤。水结胸无大热，亦汗出头额，小半夏加茯苓汤。阳明胃实，亦汗出头额，调胃承气汤。胃腑
热蒸，手足自汗，亦阳明病，当下，大柴胡汤。心腋盗汗，久不止，参归腰子。当心一片，津津自汗，名心汗，
补心丹。阴囊汗为肾虚有湿，安肾丸主之。两腋汗，脚心汗，为湿热流注，牡矾丹主之。有血汗，因胆经热血
妄行，与少阴气并，夺命散。产后血汗， 皮汤。有黄汗，因汗出浴水，湿热内郁， 陈汤。一切汗出不止，
外治法，红粉散。惟珠汗不流，汗出如油，额汗如雨，喘促肢冷，皆阳脱不治。
经曰∶阳有余为身热无汗，阴有余为多汗身寒。又曰∶血与汗异名而同类，故夺血者无汗，夺汗者无血。
注云∶夺者迫之使出也。又曰∶肾病者寝汗憎风，寝汗，即盗汗也。
东垣曰∶凡内伤自汗，补中益气汤，稍加附子、麻黄根、浮小麦，其效如神。但升、柴少用，兼蜜炙以抑其
升发暴悍之性，又欲其引参、 等味达肌表也。
凡服止汗固表药，不应，愈敛愈出者，只理心血，以汗乃心液，心不摄血，故溢为汗。大补黄 汤加枣仁。
微热者，加石斛。当心汗，为思虑伤脾，补心丹。凡久病不愈，必气血两虚，自汗热不退，补中益气汤加川附，
或用归脾汤。如便燥自汗，热不退，属阴血，六味地黄汤加生脉散。如病阳虚，热极自汗而解；汗后
又热，汗出如水，此阳被汗散，发泄在外，而不归元，保元汤加浮麦、牡蛎，或炒焦棉子煎汤。如心神不安者，
加安神丸。凡虚阳上攻，必求下达，保元汤加木瓜，使阳气回元。凡汗症有阴阳，阳汗者热汗也，阴汗者冷
汗也。汗之冷者以其阳气内虚，阴中无阳，而汗随气泄。凡大惊恐，及病后产后失血后，多有汗出，是皆阳气
消耗，真元失守候也。故经曰∶阴胜则身寒汗出。又曰∶极寒反汗出，身必冷如冰，是皆阴汗之谓。治必扶其
正气，其汗乃止。若虚甚者，非速救真元不可。姜、桂、附子之属，必所当用。
凡病不当汗而误汗，或当汗而汗之过剂者，皆汗多亡阳之症，是亦阴症之属，当察其虚之或微或甚。微虚
者，三阴煎，或五阴煎、独参汤之类。虚甚者，非用大补元煎、六味回阳饮之类不可。凡卫虚不固，腠理不
密而易汗者，是亦阴症之属。宜黄 六一汤，或 附汤。以上四段本《景岳全书》。
《医通》曰∶病后气血俱虚而汗，服诸止汗药，不应，用十全大补汤半剂，加熟枣仁五钱。若胸臆烦闷，
不能胜阴药者，生脉散加黄 二钱，当归六分，熟枣仁三钱。一服即验。夏月汗止半身，由气血不充，内挟寒
饮，偏枯及夭之兆也。用大剂十全大补汤、人参养营汤、大建中汤，加行经豁痰药治之。若元气稍充，即间用
小续命汤一剂，以开发其表，或防己黄 汤加川乌以散其湿。此症虽属血虚，不可用四物阴药，以其闭滞经
络故也。
丹溪曰∶自汗大忌生姜，以其开腠理也。凡有汗，一切辛辣之味，五辛之属，均忌之。
Sweat is the fluid of the Heart, and the Kidney governs the five fluids; therefore, sweating is always caused by deficiency of the Heart and Kidney. There is spontaneous sweating (Zi Han) and night sweating (Dao Han). Spontaneous sweating belongs to Yang deficiency, while night sweating belongs to Yin deficiency. Spontaneous sweating occurs naturally without physical exertion or diaphoretic treatment, due to deficient Yang failing to protect the exterior and consolidate the interstices (Cou Li). Night sweating occurs secretly during sleep and stops abruptly upon waking, due to deficient Yin failing to nourish the interior and retain fluids. For spontaneous sweating due to Yang deficiency, treatment should tonify Qi to protect the exterior; for night sweating due to Yin deficiency, treatment should tonify Yin to nourish the interior. Consolidating the defensive Qi makes the exterior Qi solid and the interstices tight; replenishing the Ying (Nutritive) Yin makes the inner essence firm and prevents leakage of Yin fluids. Listing the treatment methods: For exterior deficiency causing spontaneous sweating with loss of retention, use Bu Yang Tang (Tonify Yang Decoction). For interior deficiency causing night sweating with heat, use Yi Yin Tang (Nourish Yin Decoction). For failure of both exterior and interior causing sweating, use Huang Qi Tang (Astragalus Decoction). For Qi deficiency with weak Yang inevitably causing spontaneous sweating, use Fu Zi Tang (Aconite Decoction). Generally, obese people tend to have spontaneous sweating. For Yin deficiency with fire steaming causing night sweating, use Dang Gui Di Huang Tang (Angelica and Rehmannia Decoction). Generally, thin people tend to have night sweating. When Yang is deficient, Yin must invade, often causing cold limbs and spontaneous sweating; use Huang Qi Jian Zhong Tang (Astragalus and Middle-Regulating Decoction). When Yin is deficient, Yang must gather, often causing fever and night sweating; use Dang Gui Liu Huang Tang (Angelica and Six-Yellow Decoction). When Yang steams the Yin portion, blood becomes hot; when blood is hot, fluids leak out as night sweating. This treats based on the exterior-interior and Yin-Yang dynamics. However, spontaneous sweating can also be attributed to Zang-Fu organs. The Classics state: After excessive eating, sweat comes from the Stomach; after fright depleting Jing (Essence), sweat comes from the Heart; after carrying heavy loads and traveling far, sweat comes from the Kidneys; after running fast and fearing, sweat comes from the Liver; after bodily shaking and hard labor, sweat comes from the Spleen. If there is Stomach heat, sweating like a wash occurs after eating; use Er Gan Tang (Two-Sweet Decoction) or Mu Li Bai San (Oyster Shell White Powder). After drinking alcohol and catching wind, sweating like a bath occurs; use Bai Zhu San (Atractylodes Macrocephala Powder). Lung deficiency leads to easy dispersion of interstices; use Yu Ping Feng San (Jade Windscreen Powder). Heart deficiency leads to unsettled spirit; use Zhu Sha An Shen Wan (Cinnabar Calming Spirit Pill) or Tian Wang Bu Xin Dan (Emperor of Heaven Tonifying Heart Decoction). Kidney deficiency leads to open Yuan Fu (pores); use Liu Wei Wan (Six-Ingredient Pill) or Huan Shao Dan (Return to Youth Pill). Liver and Spleen deficiency with long-term depletion of Jing and Blood; use San Yin Jian (Three-Yin Decoction). Shitai (Li Zhongzi) also said: For Lung deficiency, consolidate the skin and hair; use Huang Qi Liu Yi Tang (Astragalus and Six-to-One Decoction). For Heart deficiency, benefit the blood vessels; use Dang Gui Liu Huang Tang. For Kidney deficiency, assist its sealing and storing; use Wu Wei Zi Tang (Schisandra Decoction). For Spleen deficiency, strengthen middle Qi; use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For Liver deficiency, prohibit excessive dispersion; use Bai Shao Tang (White Peony Decoction). This treats based on Zang-Fu organs. As for night sweating, which leaks spontaneously during sleep, use Shen Ling San (Ginseng and Poria Powder). When Water and Fire do not interact, use Xin Shen Wan (Heart-Kidney Pill). When Yin and Yang are imbalanced, use Huang Qi Tang. For deficient and damaged Heart Yang, use Bai Zi Ren Tang (Biota Seed Decoction) or Mu Li San (Oyster Shell Powder). For post-illness Qi and Blood dual deficiency causing spontaneous sweating, use Shi Quan Da Bu Tang (Ten Complete Great Tonification Decoction). For postpartum blood loss where solitary Yang has no basis, causing continuous profuse sweating, use Du Shen Tang (Single Ginseng Decoction). For general Jin Ye (Body Fluids) depletion with massive sweating, use Da Bu Yuan Jian (Great Tonify Origin Decoction) removing Du Zhong. For abundant Phlegm with free-flowing sweat, use Li Zhong Jiang Tan Tang (Regulate Middle and Descend Phlegm Decoction). For excessive sweating leading to Blood deficiency and spasms, use Fang Feng Dang Gui Tang (Saposhnikovia and Angelica Decoction). For excessive sweating causing Yang collapse with cold body and stiffness, use Gui Zhi Jia Fu Zi Tang (Cinnamon Twig plus Aconite Decoction). If Wind-Dampness combats, causing frequent spontaneous sweating, use Fang Ji Huang Qi Tang (Stephania and Astragalus Decoction). For aversion to wind and spontaneous sweating, use Gui Zhi Tang (Cinnamon Twig Decoction). In Shang Han (Cold Damage), for night sweating in Yang Ming or Shao Yang syndromes, select Chai Hu Tang (Bupleurum Decoction) or Ge Gen Tang (Kudzu Decoction). In Wen Re (Warm Heat) diseases, for Tai Yang, Yang Ming, and Shao Yang combined disease where sweating occurs upon closing eyes, use Bai Hu Tang (White Tiger Decoction). Forehead sweating due to Damp-Heat steaming upward, or blood stasis accumulating at the stomach gate forcing fluids out. Head sweating due to blood stasis stopping at the neck; use Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction). Head sweating with difficult urination, thirst but no desire to drink, indicates Blood stasis in the Bladder; use Tao Ren Cheng Qi Tang (Peach Kernel and Order the Qi Decoction). Stomach heat steaming upward causing forehead sweating and jaundice with difficult urination; use Wu Ling San (Five-Ingredient Powder) plus Yin Chen, or severe cases use Yin Chen Hao Tang (Artemisia Capillaris Decoction) to drain dampness. Shang Han with hypochondriac pain, deafness, alternating chills and fever, bitter taste, and head sweating stopping at the neck belongs to Shao Yang; use Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Gui Zhi, Fu Ling, and Bai Zhu to harmonize. Shao Yang with heat may cause night sweating, axillary sweating, or hypochondriac sweating. Note that sweating from the time and place of Yin-Yang interaction indicates disharmony of Yin and Yang in the half-exterior half-interior stage. Xiao Chai Hu Tang and Xiao Yao San (Free and Easy Wanderer Powder) are compound formulas. Additionally, head sweating: the head is the meeting point of all Yang meridians; when pathogenic factors combat the Yang meridians, fluids gather upward, causing head sweating. Sweating stopping at the neck indicates blood disorders; use Si Wu Tang (Four Substances Decoction). Dampness combing Yang also causes forehead sweating; use Sheng Shi Tang (Overcome Dampness Decoction) or Diao Wei Tang (Regulate Defense Decoction). Water accumulation in the chest without high fever also causes forehead sweating; use Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia plus Poria Decoction). Yang Ming Stomach excess also causes forehead sweating; use Tiao Wei Cheng Qi Tang (Regulate the Walls Order the Qi Decoction). Stomach organ heat steaming causing spontaneous sweating of hands and feet is also a Yang Ming disease requiring purgation; use Da Chai Hu Tang (Greater Bupleurum Decoction). Heart and axillary night sweating persisting long-term; use Shen Gui Yao Zi (Ginseng and Angelica Kidney). A patch of sweat directly over the heart is called Xin Han (Heart Sweat); use Bu Xin Dan (Tonify Heart Pill). Scrotal sweating is Kidney deficiency with Dampness; treat with An Shen Wan (Calming Kidney Pill). Axillary and sole sweating is Damp-Heat flowing downward; treat with Mu Fan Dan (Oyster Alum Pill). There is Xue Han (Blood Sweat) due to reckless movement of hot blood in the Gallbladder meridian combining with Shao Yin Qi; use Duo Ming San (Life-Taking Powder). Postpartum blood sweat; use Xiong Gui Tang (Peony and Angelica Decoction). There is Huang Han (Yellow Sweat) due to bathing in cold water while sweating, causing internal stagnation of Damp-Heat; use Yin Chen Tang (Artemisia Capillaris Decoction). For all continuous sweating, external treatment uses Hong Fen San (Red Powder Powder). Only Zhu Han (Pearl Sweat) does not flow, sweat like oil, forehead sweat like rain, panting and cold limbs indicate Yang collapse and are untreatable.
The Classics say: Excess Yang manifests as body heat without sweat; Excess Yin manifests as profuse sweating with cold body. It also says: Blood and sweat are different names but same category; thus, those who lose blood cannot sweat, and those who lose sweat cannot have blood. Commentary states: 'Duo' means forcing it out. It also says: Kidney disease patients have Qin Han (sleep sweat) and aversion to wind; Qin Han is night sweating.
Dongyuan (Li Gao) said: For all internal injury spontaneous sweating, use Bu Zhong Yi Qi Tang, adding slightly Fu Zi, Ma Huang Gen, and Fu Xiao Mai, with miraculous effect. But Sheng Ma and Chai Hu should be used sparingly, honey-fried to suppress their violent ascending nature, yet guiding Ren Shen and Huang Qi to the muscle surface.
When antiperspirant and exterior-consolidating medicines fail and sweating increases with more astringents, only regulate Heart Blood, because sweat is the fluid of the Heart; if the Heart fails to control blood, it overflows as sweat. Use Da Bu Huang Qi Tang (Great Tonify Astragalus Decoction) plus Zao Ren. For slight heat, add Shi Hu. Heart sweat is caused by overthinking damaging the Spleen; use Bu Xin Dan. For chronic illness not resolving, inevitably Qi and Blood are dual deficient; for spontaneous sweating with unrelenting heat, use Bu Zhong Yi Qi Tang plus Chuan Fu Zi, or Gui Pi Tang (Restore the Spleen Decoction). For dry stool with spontaneous sweating and unrelenting heat, belonging to Yin-Blood deficiency, use Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Pill) plus Sheng Mai San (Generate Pulse Powder). If Yang deficiency causes extreme heat resolved by sweating; if fever returns after sweating with watery sweat, this is Yang dispersed outward by sweat and failing to return to origin; use Bao Yuan Tang (Protect Origin Decoction) plus Fu Xiao Mai and Mu Li, or fried cotton seeds decocted. If Spirit is unsettled, add An Shen Wan. For floating Yang attacking upward, seek to direct it downward; use Bao Yuan Tang plus Mu Gua, to return Yang to origin. All sweating syndromes have Yin and Yang aspects. Yang sweat is hot sweat; Yin sweat is cold sweat. Cold sweat occurs because internal Yang is deficient, lacking Yang within Yin, so sweat follows Qi leakage. After great fright, or post-illness/postpartum blood loss, sweating is common; this is all due to Yang consumption and loss of true Yuan guarding. Thus the Classics say: Yin excess causes cold body and sweating. It also says: Extreme cold reversely causes sweating, body cold as ice; this refers to Yin sweat. Treatment must support righteous Qi for sweating to stop. If deficiency is severe, rapid rescue of true Yuan is necessary. Ginger, Cinnamon, and Aconite are essential.
For diseases where sweating is inappropriate but mistakenly induced, or where sweating was excessive, these are symptoms of Yang collapse from excessive sweating, belonging to Yin syndromes. Observe if deficiency is mild or severe. For mild deficiency, use San Yin Jian, or Wu Yin Jian, or Du Shen Tang. For severe deficiency, Da Bu Yuan Jian or Liu Wei Hui Yang Yin (Six-Ingredient Return Yang Drink) are indispensable. For Wei Qi deficiency failing to consolidate, loose interstices prone to sweating, this also belongs to Yin syndromes. Use Huang Qi Liu Yi Tang or Fu Zi Tang. The above four paragraphs originate from Jing Yue Quan Shu (Complete Works of Jingyue).
Yi Tong states: Post-illness Qi and Blood dual deficiency causing sweating, unresponsive to various antiperspirants; use half dose of Shi Quan Da Bu Tang plus 5 qian of cooked Zao Ren. If chest oppression and irritability prevent tolerance of Yin medicines, use Sheng Mai San plus 2 qian Huang Qi, 6 fen Dang Gui, 3 qian cooked Zao Ren. Effective after one dose. Summer sweating stopping at half-body, due to insufficient Qi and Blood, internal cold-fluid retention, is a sign of hemiplegia and premature death. Use large doses of Shi Quan Da Bu Tang, Ren Shen Yang Ying Tang (Ginseng Nourishing Ying Decoction), Da Jian Zhong Tang (Great Establish Middle Decoction), plus meridian-moving and phlegm-resolving herbs. If Yuan Qi slightly recovers, occasionally use Xu Ming Tang (Continuing Life Decoction) once to open the exterior, or Fang Ji Huang Qi Tang plus Chuan Wu to disperse dampness. Although this syndrome belongs to Blood deficiency, Si Wu Tang (Yin medicines) must not be used as they block and stagnate meridians.
Danxi (Zhu Zhenheng) said: Spontaneous sweating strictly forbids Sheng Jiang (Fresh Ginger) because it opens interstices. For any sweating, all spicy flavors and Wu Xin (Five Pungent Herbs) are forbidden.