窦材治一人，额上时时汗出，乃肾气虚也。阳明热，则额上出汗，常人多有此症，未可即断为肾虚也。凡
病虚实，无不对待，未可执一，不治则成痨瘵。先灸脐下百壮，服金液丹而愈。
一人夜多虚汗，亦肾气虚也，服全真丹、黄 建中汤而愈。
一人每日四五遍出汗，灸关元穴亦不止。乃房事后，饮冷伤脾气，复灸右命门，百壮而愈。
常东轩挺，晚苦阴汗，有教之用牡蛎粉扑之者，始虽少减，久之至溃腐，见其睾丸焉，岂非杀之以药乎？
（《志雅堂杂抄》。）
按∶阴汗必由下部湿热而成，以牡蛎收涩之，故郁瘀而溃烂也。
宋怀州知州李治，与一武臣同官，怪其年七十而轻健，面如渥丹，能饮食。叩其术，则服首乌丸也。乃传
其方，后治得病，盛暑中半体无汗已半年。窃自忧之，造丸服至年余，汗遂浃体。其治血治风之功，大有补益。
方用赤白何首乌各半斤，米泔浸三夜，竹刀刮去皮，切焙，石臼捣为末，炼蜜丸梧子大，每空心温酒下五十丸。
亦可末服。（《本草纲目》。）
滑伯仁治一人，暑月病身冷自汗，口干烦躁，坐卧欲于泥水中，脉浮而数，按之豁然空散。曰∶脉至而从，
按之不鼓，诸阳皆然。此为阴甚格阳，得之饮食生冷，坐卧当风所致。以真武汤（附、术、苓、芍。）冷冻饮料，
一进汗止，再进躁去，三饮而安。
按∶江案暑门，滑治一人，汗出如雨，身热烦躁，医误用术、附，乃以黄连、人参白虎，三进愈之，宜参看。
薛立斋治一妇，盗汗不止，遂致废寝，神思疲甚，口干引饮，作血虚有热，用当归补血汤代茶∶炙 一两，
当归三钱。又以六黄汤加人参、五味子，二剂而愈。
陈三农治一人感寒，用麻黄发汗，汗遂不止。用建中汤汗出愈多，痰喘有声。此伤寒损血，兼用药之过，
阴虚而阳无所附，遂用川芎三分，白芍、生地各二钱，当归一钱，（雄按∶芎、归尚有可议。）元胡索、香附各三分，再
服而愈。（四物是矣。加香附、元胡，是所不解。）
一少年人汗出三年不愈，用棉子炒黑，入汤一滚服，四五日脚腿能立，后以归脾、补中等汤而安。
杨乘六治朱氏子，年二十外，劳倦发热，上半身自汗如雨，三昼夜不止。一切敛汗方法无效。脉之，浮细
沉洪，软弱无力，面白无神，舌胖而软且白滑，意此必肺气大虚，而腠理不固也。以黄 汤加五味、附子各二
钱，自子至卯，连进三剂，其汗如故。思之良久，乃用蜜炙黄 二两，人参五钱，白术一两，蜜炙升麻、柴胡、
陈皮各一钱。上半身有汗，下半身无汗，明是阳气不能内敛，（ 按∶柴胡、升麻，究竟无谓。）归身、炙草、炒
黑干姜各二钱，白芍、五味、附子各三钱，大枣五枚，一剂而敛。此症本以劳力，伤其脾肺，中脏之阳，陷而不
升，卫外之阳，虚而不固，以致阴气不肯下降，乘虚外溢。故特用升麻以升提下陷之气，用黑姜以收固卫外之阳，使
在外而为阴之卫，在内而为阳之内守。后用清金滋水等剂而愈。
薛立斋治一妇人，盗汗自汗，遍身酸疼，五心发热，夜间益甚，或咳嗽咽干，月经两三月一至，用加味逍
遥散、六味地黄丸兼服，临卧又服陈术丸，（陈皮、白术。）三月余，诸症悉愈。其经乃两月一至，又服两月而痊。
一妇人患前症，食少倦怠，肌肉消瘦，日晡发热，至夜益甚，月水过期，渐至不通，（犹夺汗者无血也。）时发渴
燥，（汗多而津液涸。）误用通经之剂，热倦愈重，饮食愈少。乃用八珍加升麻、丹皮、山栀、柴胡治之，热
渐退。又用八珍、丹皮、软柴胡，调理而愈。
罗谦甫曰∶齐大兄因感寒邪，头项强，身体痛，自用酒服灵砂丹四五粒，遂大汗出，汗后身轻。至夜前
病复发，以前药复汗，其病不愈。复以通圣散发汗，病添身体沉重，足胫冷而恶寒。是日方命医，医者不究前
治，又以五积散汗之，翌日身重如石，不能反侧，足 如冰，冷及腰背，头汗如贯珠，出而不流，心胸躁热，
烦乱不安，喜饮西瓜、梨、柿、冰水之物，常置左右。病至于此，命诊之，六脉如蛛丝，微微欲绝，乃以死决
之。主家曰∶得汗多矣，焉能为害？曰∶夫寒邪中人者，阳气不足之所致也。而感之有轻重，治之岂可失其宜
哉？仲景云∶阴盛阳虚，汗之则愈。汗者助阳退阴之意也，且寒邪不能自汗，必待阳气泄乃能出也。今以时月
论之，大法夏月宜汗，然亦以太过为戒。况冬三月闭藏之时，无扰乎阳，无泄皮肤，使气亟夺，为养脏之道也。
逆之则少阴不藏，此冬气之应也。凡有触冒，宜微汗之，以平为期。邪退乃已，急当衣暖衣，居密室，服实表
补卫气之剂，虽有寒邪勿能为害，此从权之治也。今非其时，而发其汗，乃谓之逆。仲景有云∶一逆尚引日，
再逆促命期。今本伤而并汗，汗而复伤，伤而复汗，汗出数四，使气亟夺，卫气无守，阳泄于外，阴乘于内，
故经云独阳不生，独阴不长，不死何待？虽卢扁不能治活也。是日至夜将半，项强身体不仁，手足搐急，爪甲
青而死矣。《金匮要略》云∶不当汗而妄汗之，夺其津液，枯槁而死。今当汗之症，一过中亦绝其命，况不当汗
而强汗者乎！
华佗传，县吏尹世，苦四肢烦，口中干，不欲闻人声，小便不利。佗曰∶试作热食，得汗则愈，不汗后三
日死。即作热食，而不汗出。佗曰∶脏气已绝于内，当啼泣而绝。果如佗言。（此亦脏气伤燥之病。《三国志》。）
马元仪治沈康生夫人，病经一月，两脉浮虚，自汗恶风，此卫虚而阳弱也。与黄 建中汤，一剂汗遂止。
夫人身之表，卫气主之，凡所以温分肉、实腠理、司开阖者，皆此卫气之用，故《内经》曰∶阳者，卫外而为
固也。今卫气一虚，则分肉不温，腠理不密，周身毛窍，有开无阖，由是风之外入，汗之内出，其孰从而拒之？
故用黄 建中汤，以创建中气，而温卫实表也。越一日，病者叉手自冒心间，脉之虚濡特甚，此汗出过多，
而心阳受伤也。仲景云∶发汗过多，病患叉手自冒心，心下悸者，桂枝甘草汤主之。与一剂良已。
丁庠生头汗火升，食少心悸，恍惚不宁，或议用滋阴。脉之，两寸独鼓，两关尺虚微少神，此脾肾交亏，
真阳欲脱之候也。与人参桂附理中汤，大培火土，以复虚阳。彼以生平不任热剂为辞。曰∶若谓头汗火升，为
火邪上炽耶，不知此乃真气上越也；且谓心悸恍惚，为阴气内亏耶，不知此乃真元无主也。遂与人参四钱，白
术五钱，附子、肉桂各三钱，干姜二钱，炙草一钱，连进四剂，脉始和，症始退。再温养元气，一月而安。
罗谦甫治刑部侍郎王立甫之婿，年二十五，仲冬，因劳役忧思烦恼，饮食失节，而病时发躁热，肢体困倦，
盗汗湿透其衾，不思饮食，气不足以息，面色青黄不泽。诊其脉浮数而短涩，两寸极小，曰∶此危症也。治虽
粗安，春至必死，当令亲家知之。夫人不以为然，遂易医。至正月，躁热而卒。他日，王谓罗曰∶吾婿果如君
言，愿闻其理。曰∶此非难知也。《内经》曰，主胜逆，客胜从，天之道也。盖时令为客，人身为主。冬三月人
皆惧寒，独渠躁热盗汗，是令不固其阳，时不胜其热。天地时令，尚不能制，药何能为？冬乃闭藏之月，阳气
当伏于九泉之下，至春发为雷，动为风，鼓坼万物，此奉生之道也。如冬藏不固，春生不茂，为疫疠之灾。且
人身阳气，亦当潜伏于内，不敢妄扰，无泄皮肤，使气亟夺，此冬藏之应也。令婿汗出于闭藏之月，肾水已涸，
至春何以生木？阳气内绝，无所滋荣，不死何待？乃叹息而去。
施笠泽治一人，服参、 数日后，每将昏反发热，至夜得盗汗而解。曰∶此阴虚不能胜其阳也。参、 虽
能补阳助阴，而阴血未易骤生。乃用六味丸料加参、归、陈皮，一剂而热退汗止。后以六味丸、参苓白术散全愈。
庠友张君牙患寒热，咸作疟治，服解表之剂，乃盗汗潮热，肢节颈项强痛，夜卧则汗出如沐，湿透重衿，
二旬余，目不交睫，诊得左寸浮细欲绝，右尺浮大无力，此汗多亡阳症也。与加味归脾汤不效，自加麦冬，更
服二剂，胸膈满闷，饮食不进，遂疑参、术不可服。一僧欲进大剂苦参汤。施曰∶诊法阴盛阳衰者，不可以柔
药。柔药助阴，阳气衰弱，阴气益着，实实虚虚之祸，其能免乎？今君相二火俱亏，非急进归脾汤加桂心、五
味不可，岂前药有陈腐或泡制失宜耶？令取药一剂，是夜即安，汗亦渐止。间进八味丸，一月而愈。
庠生施尔祁病，脉之曰∶阴虚火动也。病使人发热盗汗，肢节作楚，正合丹溪滋阴降火之剂。服三日后，
服虎潜丸，病全愈。所以知尔祁之病者，切其脉虚而数。经云∶血虚脉虚，肾水之真阴不足，而虚火妄动也。
先是一医谓是历节风，饮以风剂，即肢节浮肿，痿弱不能行，汗出如淋。经云∶足受血而能步。又云∶夺血者
无汗，夺汗者无血。盖风能生火，又能耗血，血虚则内热益甚，肢热则肿，肺热则痿矣。
钱国宾治荆州李山人，年四十余，凡饮食头上汗多，气如烟雾，必频抹乃止。寸关浮洪，两尺沉实，胃脉
倍盛而数。此胃热蒸笼头也。饮食入胃，遇热上蒸心肺，心主汗液，火性上腾，肺主皮毛，腠理不密，故头汗
出若蒸笼之气，因煎迫而如烟雾也。以三黄石膏汤，数剂清胃热愈。（文田按∶此脉真合用白虎汤矣。）
魏玉横曰∶詹渭丰母年六旬外，素有肝病。因患疟，自五月至九月，疟愈而他症蜂起，自汗如洗，彻夜不
眠，食少便溏，胁痛齿痛，口淡恶心，恶风畏寒，头顶皮帽，身袭皮衣，重帏夹幔，犹懔栗不胜。诊时以止汗
为嘱。脉之弦小急，知为阴虚火盛，疟邪未清，误作阳虚，多与补气敛汗之剂而然。叩之，果服归脾、五味子、
麻黄节、浮麦、龙骨甚伙。乃与生地、杞子、地骨、钗斛、首乌、鳖甲、黄连、蒌仁。渭丰曰∶诸医咸谓头为
诸阳之首，恶寒若此，又自汗而喜热饮，明属阳虚，今方中惟与养阴。又口淡，便溏恶心，皆属脾胃虚寒，黄
连、蒌仁安可用？至疟疾已愈，何必用首乌、鳖甲？再所重在汗多，而又全不治汗，其故何也？曰∶此症乃火
郁之极，内真热而外假寒也。疟本胆腑之邪，因肝虚而腑传脏，故寒热止而变为诸症。故以生地、杞子、地骨、
钗斛养肝治其本，黄连清伏暑，蒌仁散郁热以治标，首乌、鳖甲入肝而去疟邪。盖肝火炽盛逆胃，胃络上蒸则
为汗，下迫为泻。若见汗则收敛，见泻则固涩，一药肆人足矣，医云乎哉。如方服之，数剂而愈。《济生》
归脾汤∶人参、龙眼、黄 、甘草、白术、茯苓、木香、当归、枣仁、远志。
何某年七旬矣，偶于冬间苦盗汗，乃水衰肝火内炽，当闭藏之候，反蒸郁而为汗也。或教以黄 煮黑枣服
之，四五日汗果止，而咳嗽作。或以为伤风，与前胡、桔梗、杏仁、苏子、秦艽、防风之类。或以为痰火，与
二陈、姜汁、竹沥。或以为血虚，与四物、知母、黄柏，咸不效，已半年。诊其脉则弦数而促，其症则痰多食
少，天柱已倾，双足浮肿。投以生地、麦冬、杞子、地骨、沙参、女贞，四剂无进退，已召画工传真矣。告曰∶
某本籍越中，今病已膏肓，量不可起，治任欲归，第乞疏一方，俾可服多剂者，以希万一耳。仍前方加熟地、
蒌仁与之。后二年偶退之客坐，彼前致谢甚殷，余茫然，叩其故。曰∶某何姓，昔患咳嗽几毙，蒙惠方，渡江
后服二十余剂，竟获全愈，此再造之德也。视其容貌充腴，迥非畴曩，其病之痊殊意外矣。书此以为轻信单方，
并见汗治汗之戒。（以此条与罗谦甫治王立甫婿之案参看，可见闭藏之令，过汗虽属危症，亦非断无生机，
罗公于此有遗憾矣。）
杨元植年四旬外，早衰须发尽白，素患肝肾病。客吴门病疟，疟愈而汗出不止，凡生脉饮、六黄汤、牡
蛎、龙骨、五味、黑豆，一切敛汗之药，莫不尝之矣。吴医技穷，乃遄归就予诊。脉但虚数，与熟地一两，杞
子五钱，枣仁五钱，麦冬一钱，蒌仁一钱，胡黄连四分，地骨皮三钱，一服减，二服瘥。
赵坤维令正病，自首至胸，汗出如淋，动则尤甚，颇能食，然食入则满面淋漓，衣领尽透，医与玉屏风散、
当归六黄汤，俱不效。延诊，右关寸数大。问面浮及齿痛否。曰∶然。此少厥二阴之火，上逆胃络也。与重剂
玉女煎，入杞子五钱，川连少许，二帖而瘳。
杨兆成病疟，疟愈大汗如雨，一日夜约斗余，医尽力与固表收涩，反较麻黄、羌活为甚。延诊，脉洪数有
力，日啖粥十余瓯犹觉饥。盖疟时多服半夏、豆蔻、苍术、浓朴、藿香、橘皮，诸燥烈之剂，扰动胃火而然，
若与六黄汤，则汗止而疟必更作。乃用生地一两，石膏五钱，黄连八分，麦冬三钱，蒌仁一钱半，一服减，二
服瘥，疟亦不作。
张玉书年近六旬，素患阴虚火甚，两手脉上入溢掌心。夏月偶不快，就混堂澡浴，以图汗解，归而寒热大
Dou Cai treated a patient whose forehead sweated intermittently, which was due to Kidney Qi deficiency. Yangming heat can also cause sweating on the forehead; this symptom is common in ordinary people and should not be immediately diagnosed as Kidney deficiency. In all diseases, deficiency and excess are relative opposites, and one cannot adhere to a single perspective. If untreated, it may develop into consumptive disease (Lao Zhai). The patient was first moxibusted below the navel for one hundred "zhuang" units, then administered Jin Ye Dan (Golden Fluid Pill), resulting in recovery.
Another patient suffered from night sweats, also attributed to Kidney Qi deficiency. He recovered after taking Quan Zhen Dan (Complete Truth Pill) and Huangqi Jianzhong Tang (Astragalus Decoction for Replenishing the Middle).
A third patient sweated four or five times daily. Moxibustion at Guanyuan (CV-4) failed to stop the sweating. This occurred because cold drinks injured Spleen Qi after sexual intercourse. Subsequent moxibustion at Right Mingmen (GV-4) for one hundred "zhuang" units led to recovery.
Chang Dongxuan Ting suffered from genital sweating in his later years. Someone advised applying Oyster Shell Powder (Muli Fen) topically. Although symptoms initially decreased slightly, prolonged use led to ulceration and necrosis, exposing the testicles. Was this not killing him with medicine? (From *Zhiya Tang Za Chao*.)
Commentary: Genital sweating must arise from damp-heat in the lower jiao. Using Oyster Shell (Muli) for its astringent properties caused stagnation and ulceration.
Li Zhi, Prefect of Huazhou in the Song Dynasty, served alongside a military officer who, despite being seventy years old, remained agile and vigorous, with a ruddy complexion like wet cinnabar and a good appetite. Upon asking for his secret, Li learned he took Shouwu Wan (Polygonum Pill). Li obtained the formula. Later, Li fell ill and had no sweat on half his body for six months during midsummer. Worried, he prepared pills himself and took them for over a year, eventually achieving profuse sweating throughout his body. The formula's efficacy in treating blood and wind disorders was highly beneficial. The prescription used equal parts (half a jin each) of Red and White Polygonum multiflorum (He Shou Wu), soaked in rice wash water for three nights, scraped with a bamboo knife, sliced, dried, pounded in a stone mortar into powder, and formed into pills the size of wutong seeds. Take fifty pills with warm wine on an empty stomach. It can also be taken as powder. (From *Bencao Gangmu*.)
Hua Bowen treated a patient in summer who presented with cold body, spontaneous sweating, dry mouth, irritability, and a desire to sit or lie in muddy water. The pulse was floating and rapid, but hollow and scattered upon deep pressure. Hua stated: "The pulse appears compliant superficially but does not throb deeply; this applies to all yang pulses." This indicated extreme yin cold repelling yang, caused by consuming raw/cold foods and sitting/lying in drafts. He prescribed Zhenwu Tang (Fuzi, Baizhu, Fuling, Shaoyao) served frozen. After one dose, sweating stopped; after two doses, irritability ceased; after three doses, the patient was calm.
Commentary: In Jiang's case under Summer Heat, Hua treated a patient sweating profusely with fever and irritability. Doctors mistakenly used Baizhu and Fuzi. Recovery was achieved with Huanglian, Renshen, and Baihu Tang after three doses. Refer to this for comparison.
Xue Lizhai treated a woman with continuous night sweats, leading to neglect of sleep and severe mental fatigue, along with dry mouth and thirst. Diagnosed as Blood deficiency with heat, she was given Danggui Buxue Tang (Angelica Sinensis Decoction for Replenishing Blood) as tea: Zhi Huangqi (one liang) and Danggui (three qian). She was also treated with Liu Huang Tang (Six Yellow Decoction) plus Renshen and Wuweizi, recovering after two doses.
Chen Sansan treated a patient who contracted cold and was given Mahuang (Ephedra) to induce sweating, resulting in uncontrollable sweating. Jianzhong Tang increased the sweating further, accompanied by phlegm and wheezing. This was damage to blood from Shanghan (Cold Damage) compounded by medication error, leading to Yin deficiency with Yang having no anchor. Treatment involved Chuanxiong (three fen), Baishao and Shengdi (two qian each), Danggui (one qian), [Note: Xiong comments that Chuanxiong and Danggui are debatable], Yanhusuo and Xiangfu (three fen each). Recovery occurred after another dose. (Four Substance Decoction was correct. Adding Xiangfu and Yanhusuo is puzzling.)
A young man suffered from sweating for three years without cure. Stir-fried black Cottonseed (Mianzi) was boiled in water and consumed. Within four to five days, he could stand on his legs. He was subsequently stabilized with Guipi Tang (Spleen-Restoring Decoction) and Buzhong Yiqi Tang (Middle-Warming Decoctions).
Yang Chengliu treated Zhu's son, aged twenty-something, who suffered from fatigue-induced fever and profuse upper-body sweating for three days and nights. All astringent methods failed. Pulse was fine on floating and large on deep pressure, weak and powerless. Face was pale and spiritless; tongue was swollen, soft, white, and slippery. Yang suspected severe Lung Qi deficiency with insecure cou-li (pores). He prescribed Huangqi Tang (Astragalus Decoction) with Wuweizi and Fuzi (two qian each). From Zi hour to Mao hour, three doses were given, but sweating persisted. After deep thought, he prescribed: Honey-fried Huangqi (two liang), Renshen (five qian), Baizhu (one liang), honey-fried Shengma and Chaihu (one qian each). Upper body sweated, lower body did not, indicating Yang failing to internalize. Added Danggui shen, Zhi Gancao, and stir-fried black Ganjiang (two qian each), Baishao, Wuweizi, and Fuzi (three qian each), and five Dazao (Jujubes). One dose stopped the sweating. The condition resulted from labor injuring Spleen and Lung, sinking middle-jiao Yang, and deficient exterior-guarding Yang, allowing Yin to overflow outward. Shengma lifted the sunk Qi, while black Ganjiang secured the exterior Yang. Later, Qingjin Zishui agents cured him.
Xue Lizhai treated a woman with night sweats, spontaneous sweating, generalized soreness, five-palm heat worsening at night, occasional cough and dry throat, and irregular menstruation (every 2-3 months). She took Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Liuwei Dihuang Wan (Six Ingredient Pill with Rehmannia) concurrently, plus Chen Zhu Wan (Tangerine Peel and Atractylodes Pill) before bed. After three months, all symptoms resolved. Menstruation normalized to every two months, and full recovery followed after two more months.
Another woman with similar symptoms had poor appetite, fatigue, emaciation, afternoon fever worsening at night, delayed amenorrhea progressing to cessation, thirst, and dryness. Mistaken treatment with blood-invigorating agents worsened heat, fatigue, and anorexia. She was treated with Bazhen Tang (Eight Treasure Decoction) plus Shengma, Danpi, Zhizi, and Chaihu. Heat subsided. Further调理 with Bazhen Tang, Danpi, and soft Chaihu led to recovery.
Luo Qianfu stated: Qi Da's brother contracted cold, presenting with stiff neck and body pain. He self-medicated with Lingsha Dan (Cinnabar Pill) taken with wine, inducing profuse sweating and temporary relief. The illness recurred at night. Repeating the medication induced more sweating without curing the illness. Tongsheng San was used to induce sweating, adding heaviness, cold calves, and aversion to cold. Only then was a doctor called. The doctor, ignoring previous treatments, prescribed Wuji San (Five Accumulations Powder) to induce sweating. The next day, the patient was heavy as stone, unable to turn, feet icy cold extending to the waist, head sweating in beads that did not flow, chest irritability, restlessness, and craving for watermelon, pear, persimmon, and ice water. Pulse was thread-like and nearly imperceptible. Luo declared death inevitable. The family asked how excessive sweating could be harmful. Luo explained: Cold invasion stems from insufficient Yang. Severity varies, so treatment must be appropriate. Zhang Zhongjing said: "Yin excess and Yang deficiency require sweating to resolve." Sweating aids Yang to retreat Yin. Cold pathogens do not sweat spontaneously; they require Yang release. In summer, sweating is appropriate but excessive sweating is warned against. In winter (the season of storage), one should not disturb Yang or vent skin pores, preventing Qi depletion. Violating this causes Shaoyin failure to store, opposing winter energy. Minor sweating is appropriate for invasions, stopping when pathogens retreat. Warm clothing and solidifying exterior Qi agents are needed. Sweating out of season is contrary. Zhang Zhongjing said: "One mistake delays death; two hasten it." Here, injury was compounded by repeated sweating, depleting Qi and Wei Qi, leaking Yang externally, and allowing Yin internally. "Independent Yang does not generate; independent Yin does not grow." Death was inevitable. By midnight, neck stiffness, numbness, convulsions, and cyanotic nails led to death. *Jingui Yaolue* states: "Inducing sweating when inappropriate drains fluids, leading to withered death." Even if sweating were indicated, missing the window kills; forcing sweating when inappropriate is fatal.
*Huatuo Biography*: Yin Shi, a county official, suffered from limb vexation, dry mouth, aversion to sound, and difficult urination. Huatuo said: "Eat hot food; if sweating occurs, you will recover. If not, you will die in three days." Hot food was prepared, but no sweating occurred. Huatuo predicted internal organ Qi exhaustion and weeping death, which came true. (This is a disease of organ Qi injury and dryness. *Records of the Three Kingdoms*.)
Ma Yuanyi treated Shen Kangsheng's wife, ill for a month with floating-empty pulses, spontaneous sweating, and aversion to wind. This indicated Wei Qi deficiency and weak Yang. Huangqi Jianzhong Tang (Astragalus Decoction for Replenishing the Middle) stopped sweating after one dose.
Wei Qi governs the exterior, warming muscles, securing pores, and regulating opening/closing. *Neijing* states: "Yang guards the exterior and secures." When Wei Qi is deficient, muscles are unwarmed, pores loose, and only open, allowing wind entry and sweat exit. Huangqi Jianzhong Tang builds Middle Qi, warms Wei, and secures the exterior. The next day, the patient held her hands over her heart with a very weak pulse, indicating Heart Yang injury from excessive sweating. Zhang Zhongjing stated: "Excessive sweating causing hand-over-heart sensation and palpitations is treated with Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction)." One dose cured her.
Ding Xiangsheng suffered from head sweating, rising fire sensation, poor appetite, palpitations, and anxiety. Some suggested Yin-nourishing. Pulses were drumming at both Cun positions but weak at Guan and Chi, indicating Spleen/Kidney decline and impending True Yang collapse. Ren Shen Gui Fu Li Zhong Tang (Ginseng, Cinnamon, Aconite, Ginger Decoction for Regulating the Middle) was given to strengthen Fire and Earth and restore deficient Yang. He refused hot medicines, claiming head sweating/fire was excess heat and palpitations were Yin deficiency. I countered: Head sweating is ascending True Qi, not fire; palpitations are lack of True Yuan mastery. Prescribed Renshen (four qian), Baizhu (five qian), Fuzi and Rougui (three qian each), Ganjiang (two qian), Zhi Gancao (one qian). Four doses harmonized pulse and reduced symptoms. Further tonic care restored health in a month.
Luo Qianfu treated the son-in-law of Vice Minister Wang Lifu, aged 25, in mid-winter. Fatigue, worry, and dietary irregularities caused intermittent fever, limb fatigue, night sweats soaking bedding, anorexia, shortness of breath, and sallow complexion. Pulse was floating, rapid, short, and choppy, with extremely small Cun pulses. Luo declared this critical: "Though temporarily stable, he will die in spring." The wife disagreed, changing doctors. The patient died of fever in January. Wang later asked for the reasoning. Luo cited *Neijing*: "Host wins is adverse, Guest wins is following." Season is Guest, Body is Host. Winter requires fear of cold; his fever/sweating showed failure to secure Yang against seasonal heat. Heaven/Earth cannot control this, so medicine cannot either. Winter is for storage; Yang should be hidden. Failure leads to epidemic disasters. His sweating in winter depleted Kidney Water, preventing Spring Wood generation. Internal Yang extinction meant inevitable death.
Shi Lizze treated a patient who developed evening fever and night sweats after taking Renshen and Huangqi for several days. This indicated Yin deficiency failing to control Yang. While herbs tonify Yang/Yin, Blood does not regenerate quickly. Liuwei Wan (Six Flavor Pill) material plus Renshen, Danggui, and Chenpi stopped fever and sweating in one dose. Full recovery followed with Liuwei Wan and Shenling Baizhu San.
Friend Zhang Ya suffered chills and fever, treated as malaria with exterior-releasing agents. This led to night sweats, tidal fever, joint/neck stiffness, and profuse night sweating soaking clothes for 20+ days, insomnia. Left Cun pulse was floating/fine/nearly absent; Right Chi was floating/large/powerless. This was Yang loss from excessive sweating. Jiawei Guipi Tang failed. Adding Maidong made him bloated and anorexic, leading him to suspect Renshen/Baizhu. A monk suggested bitter Shen (Sophora) decoction. Shi argued: Yin excess/Yang deficiency cannot be treated with soft/yin-tonic drugs, which aid Yin and weaken Yang further. Jun/Xiang fires were deficient. Urgent Guipi Tang plus Rougui and Wuweizi was needed. One dose brought peace and stopped sweating. Intermittent Bawei Wan cured him in a month.
Student Shi Erqi suffered from Yin deficiency with fire hyperactivity, causing fever, night sweats, and limb pain. This matched Danxi's Yin-nourishing and fire-descending approach. After three days, Hujian Wan (Tiger Kneeling Pill) cured him. Pulse was deficient and rapid. *Classic* states: Blood deficiency yields deficient pulse; Kidney True Yin insufficiency causes false fire. Previously, a doctor diagnosed Lijie Feng (Joint Wind) and gave wind agents, causing edema, weakness, and profuse sweating. *Classic* states: Feet walk on blood; draining blood prevents sweating, draining sweat prevents blood. Wind generates fire and consumes blood; blood deficiency increases internal heat, limb heat causes swelling, lung heat causes flaccidity.
Qian Guobin treated Li Shanshan from Jingzhou, 40+, who sweated heavily on the head during meals, with smoky breath requiring frequent wiping. Cun/Guan pulses were floating/large; Chi pulses were sunken/solid; Stomach pulse was double strength and rapid. This was Stomach heat steaming the head. Food heat steamed Heart/Lung; Heart governs sweat, fire rises, Lung governs skin/pores. Head sweat resembled steamer vapor. Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction) cleared Stomach heat in several doses. (Wentian notes: This pulse truly fits Baihu Tang.)
Wei Yuheng stated: Mother of Zhan Weifeng, 60+, had chronic Liver disease. Malaria from May to September left her with profuse sweating, insomnia, poor appetite, loose stools, hypochondriac/tooth pain, bland taste, nausea, aversion to wind/cold, bundled in furs yet shivering. Pulse was string-tight-small-rapid, indicating Yin deficiency with fire hyperactivity and lingering malaria pathogen, misdiagnosed as Yang deficiency and treated with Qi-tonifying/astringent herbs. She had taken Guipi, Wuweizi, Mahuangjie, Fumai, Longgu extensively. Wei prescribed Shengdi, Gouqi, Digupi, Tiehuhu, Shouwu, Biejia, Huanglian, Louren. Weifeng questioned why only Yin-nourishing herbs were used despite cold signs and digestive issues, and why malaria herbs were used post-malaria. Wei explained: This is extreme Fire depression, internal true heat with external false cold. Malaria (Gallbladder pathogen) transferred to Liver due to Liver deficiency. Shengdi/Gouqi/Digupi/Tiehuhu nourish Liver (root); Huanglian clears latent summerheat; Louren disperses depressed heat (branch); Shouwu/Biejia enter Liver to remove malaria pathogen. Liver fire invading Stomach causes sweat (steaming) and diarrhea (pressing). Astringents would be useless. Several doses cured her. *Jisheng* Guipi Tang: Renshen, Longyan, Huangqi, Gancao, Baizhu, Fuling, Muxiang, Danggui, Zaoren, Yuanzhi.
Mr. He, 70, suffered night sweats in winter due to Water deficiency and Liver fire blazing during the storage season. Huangqi boiled with black dates stopped sweating in 4-5 days but triggered cough. Treated as wind-cold (Qianhu, Jiegeng, Xingren, Su Zi, Qinjiao, Fangfeng), phlegm-fire (Erchen, Jiangzhi, Zhulü), or blood deficiency (Siwu, Zhimu, Huangbai) without effect for six months. Pulse was string-tight-rapid-hurried; symptoms included phlegm, poor appetite, collapsing Tianzhu (neck), and leg edema. Shengdi, Maidong, Gouqi, Digupi, Shashen, Nvzhen were given for four doses with no change; portrait painter was summoned. Mr. He asked for a formula to take home for hope of survival. Shudi and Louren were added. Two years later, he thanked me, revealing he was cured after 20+ doses across the river. Appearance was robust, unexpected recovery. Written as a warning against trusting single formulas and treating sweat merely as sweat. (Compare with Luo Qianfu's case of Wang Lifu's son-in-law: even critical sweating in winter has hope if managed correctly.)
Yang Yuanzhi, 40+, premature aging with white hair/beard, chronic Liver/Kidney disease. Contracted malaria in Wu, which resolved but left uncontrollable sweating. Shengmai Yin, Liu Huang Tang, Muli, Longgu, Wuweizi, Heidou, and all astringents failed. Wu doctors exhausted. Pulse was deficient/rapid. Prescription: Shudi (one liang), Gouqi (five qian), Zaoren (five qian), Maidong (one qian), Louren (one qian), Huhuanglian (four fen), Digupi (three qian). Reduced after one dose, cured after two.
Zhao Kunwei's wife suffered sweating from head to chest, worse with movement, able to eat but sweating profusely upon eating, soaking collar. Yupingfeng San and Danggui Liu Huang Tang failed. Right Guan/Cun pulses were rapid/large. Facial edema and tooth pain confirmed. This was Shaoyin/Jueyin fire reversing up Stomach collaterals. Heavy Yinvu Jian (Jade Woman Decoction) plus Gouqi (five qian) and Chuanlian (small amount) cured in two doses.
Yang Zhaocheng had malaria, which resolved but left profuse sweating (approx. one dou/day/night). Doctors used exterior-solidifying/astringent agents excessively, worse than Mahuang/Qianghuo. Pulse was large/rapid/powerful; ate porridge ten bowls daily yet felt hungry. Malaria treatment involved Banxia, Doukou, Cangzhu, Houpo, Huoxiang, Chenpi (drying/hot agents) stirring Stomach fire. Liu Huang Tang would stop sweat but relapse malaria. Prescription: Shudi (one liang), Shigao (five qian), Huanglian (eight fen), Maidong (three qian), Louren (one qian half). Reduced after one dose, cured after two; malaria did not return.
Zhang Yushu, near sixty, chronic Yin deficiency with strong fire, pulses overflowing palms. Summer discomfort led to bathing for sweating. Returned with severe chills and fever.