〔郑〕夫汗者，心之所藏，在内为血，发外者为汗。盖汗乃心之液，故人之气血
平则宁，偏则病。经云∶阴虚阳必凑，则发热而自汗，阳虚而阴必乘，则发厥而自
汗。皆由阴阳偏胜而致也。小儿血气嫩弱，肤腠未密，若浓衣温暖，熏蒸脏腑，脏腑
生热，热搏于心，为邪所胜，故液不能内藏，熏出肌肤，则为盗汗也。又或伤于冷
热，冷热交争，阴阳不顺，津液走泄，亦令睡中汗自出。其间有虚实之证，虚者谓
诸病后、大汗后、血气尚弱，液溢自汗，或潮热或寒热发过之后身凉自汗，日久令
人黄瘦，失治则变为骨蒸疳劳也。丹溪云∶盗汗者，谓睡而汗出也，不睡则不出，
汗出，方其睡熟也， 然出焉，觉则止而不复出矣，亦是心虚，宜敛心气，益肾
水，使阴阳调和，水火升降，其汗自止。钱氏云∶上至头，下至项，谓之六阳虚汗，
不须治之。
〔薛〕自汗者，汗不待发表而自出也。经曰∶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。又曰∶阴虚而阳必辏，则发热而自汗，
阳虚而阴必乘，则发厥而自汗。束垣云∶表虚自汗，秋冬用桂，春夏用黄 。丹溪云∶汗者，心之液也，自汗之证，未
有不由心肾俱虚而得之者。巢氏云∶虚劳病，若阳气偏虚，则津液发泄而为汗。
夫心为主阳之脏，火也，阳主气，人身津液，随其阳气所在之处而生，亦随其
火所扰之处而泄，则为自汗矣。治法，当用参 甘温益气之药，使阳气外固而津液
内藏，则汗止矣。若元气虚者，夏月用六君子汤加山药山茱萸，冬月用加减八味丸、
十全大补汤。血虚者四物加参 。有热者，当归六黄汤。气血俱虚者，十全大补汤。
心肾虚热者，六味九。虚寒者，八味丸。心经血虚者，团参汤。胃经气虚者，六君
子汤。饮食劳倦者，补中益气汤。嗜卧倦怠者，升阳益胃汤。热伤元气者，清燥汤。
暑干心胞络者，清暑益气汤。外伤风邪者，惺惺散。虚劳羸瘦者，人参养荣汤。思
虑伤脾者，归脾汤。怒动肝火者，小柴胡汤。肝经虚热者，加味逍遥散。肝经湿热
者，龙胆泻肝汤。泄泻脉微者，人参理中汤。手足汗者，补中益气汤。胸腹汗者，
四君子汤。当心一片有汗者、茯苓补心汤。黄汗者，茵陈五苓散。血汗者，血余散
敷之。此皆去汗之大法也，仍推五脏相胜主之。若汗出如油，喘而不休，此为命绝。
柔汗发黄，此为脾绝。汗出不流如贯珠者，为绝汗。数者并不治。若六阳虚，则汗
出上至头，下至项，亦多主难治。〔曾〕小儿脾虚自汗，多出额上，沾黏人手，速
救胃气，全蝎观音散用姜枣煎汤调服，及沉香饮为治。脾虚泻自汗，遍身冷而出有
时，遇泻则无，泻过即有，此候太虚，急当补脾，投益黄散、参苓白术散、附子理
中汤。肺虚自汗，其候右脸色多 白，肺脉按之无力，盖久因咳嗽，连声不已，痰
少不活，乃肺经虚气上壅，致令汗出，宜令补肺散为治，及以藿香饮调脾，此又益
母救子之义也。慢惊自汗，遍体俱有，其冷如水，此证已危，金液丹、固真汤主之。
有实证自汗，外因感冒风邪，发热无间，昏醒浸浸汗出，当救表解肌，用百解
散水煎服，或间投五苓散温白汤调下。
〔钱〕治病有等 张氏三子病，大者汗遍身。次者上至顶下至胸。小者但额有汗。
众医以麦煎散治之，不效。钱曰大者与香瓜丸。次者与益脾散。小者与石膏汤。各
五日而愈。
香瓜丸
胡黄连 大黄瓜（黄色者一枚） 大黄（湿纸裹煨） 柴胡（去芦） 鳖甲（醋炙黄）
黄柏 黄连 芦荟 青皮（各等分）
上，除黄瓜外同为细末，将黄瓜割其顶，填入诸药至满，却盖口，用杖子插
定，火内煨熟，将黄瓜及药同用面糊、丸如绿豆大。每服二三丸，食后冷浆或新
水下，大者五七丸，不及十丸。
胃怯汗，上至顶，下至脐，此胃虚，当补胃，益黄散主之。
〔钱〕六阳虚汗，上至顶，不过胸也，不须治之。喜汗，浓衣卧而额汗出也，止
汗散主之。
止汗散 用故蒲扇灰研细，每服三钱，温酒调下，无时。
薛氏方十全大补汤 治诸虚不足，自汗不食，时发潮热等证。
白茯苓 人参 当归 白术 黄 （炒） 川芎 肉桂 白芍药（炒） 熟地黄 甘草（炒。各等分）
上，每服三五钱，加姜枣，水煎服。
八珍汤（前方去肉桂、黄 ，治验见各门）
人参养荣汤 治病后时自汗，或发潮热，口干食少，心虚惊悸，咳而下利。（前方去川
芎，加陈皮、五味子、远志。）
升阳益胃汤（痢） 加减八味丸（虚羸） 清燥汤 清暑益气汤（并注夏） 惺惺散（痘）
归脾汤（惊悸） 小柴胡汤（发热） 加味逍遥散（女科发热） 龙胆泻肝汤（杂前阴诸疾）
人参理中汤（泻） 茯苓补心汤（喑） 茵陈五苓散（黄胆）
曾氏方
全蝎观音散（吐泻） 沉香饮（吐泻） 益黄散（脾） 参苓白术散（吐泻） 理中汤（吐
泻） 补肺散（咳嗽） 藿香饮（脾弱） 金液丹 固真汤（并慢惊） 百解散 五苓散（并急惊）
团参汤 治小儿虚汗，或心血液盛，亦发为汗，此药收敛心气。
新罗人参 川当归（各三钱）
上锉细，用雄猪心一个，切三片，每服二钱，猪心一片，井水一盏半，煎至一
盏，食前，两次服。
牡蛎散 治血虎自汗，或病后暴虚，津液不固自汗。
牡蛎（ ） 黄 生地黄（各等分）
上锉散。每服二钱，或加浮麦煎。
扑汗方
黄连 牡蛎粉 贝母（各半两）
上，用米粉一升，敷之。
血余散 治汗不止。
用男子乱发一握， ，存性，为细末，以绢袋盛置，干扑之。
[Zheng] Sweat is stored by the Heart; within the interior it transforms into Blood, and when emitted to the exterior it becomes sweat. Since sweat is the fluid of the Heart, when a person's Qi and Blood are in harmony, the body remains tranquil; when they are imbalanced, disease arises. The Classics state: "When Yin is deficient, Yang must encroach, resulting in fever and spontaneous sweating (Zi Han); when Yang is deficient, Yin must invade, resulting in cold extremities and spontaneous sweating." All these are caused by an excess of either Yin or Yang. Children have tender and weak Qi and Blood, and their skin pores (Cou Li) are not dense. If clothing is too thick and warmth excessive, it steams the Zang-Fu organs, generating heat within them. This heat clashes with the Heart, overcoming it, so that fluids cannot be stored internally but are steamed out through the skin, resulting in night sweats (Dao Han). Alternatively, injury from cold or heat causes a struggle between the two, disrupting the smooth flow of Yin and Yang, leading to the leakage of fluids and causing spontaneous sweating during sleep. Among these, there are deficiency (Xu) and excess (Shi) patterns. Deficiency refers to cases after various illnesses or profuse sweating, where Qi and Blood are still weak, causing fluids to overflow and sweat spontaneously. It may also occur after tidal fever or alternating chills and fever, when the body feels cool, leading to spontaneous sweating. Over time, this causes emaciation and sallow complexion; if untreated, it may transform into bone-steaming malnutrition (Gu Zheng Gan Lao). Danxi stated: "Night sweats refer to sweating while sleeping; it does not occur when awake. When deeply asleep, sweat flows naturally, and stops upon waking. This is also due to Heart deficiency; one should astringe Heart Qi and nourish Kidney Water to harmonize Yin and Yang, allowing Fire and Water to ascend and descend properly, at which point sweating will cease." Qian Yi stated: "Sweating extending from the top of the head down to the neck is called 'Six-Yang Deficiency Sweating' and requires no treatment."
[Xue] Spontaneous sweating refers to sweating without the need for diaphoretic therapy. The Classics state: "After a full meal, sweat comes from the Stomach; after fright depleting Jing, sweat comes from the Heart; after carrying heavy loads and traveling far, sweat comes from the Kidneys; after running fast and feeling fear, sweat comes from the Liver; after physical labor and fatigue, sweat comes from the Spleen." It also states: "When Yin is deficient, Yang encroaches, causing fever and spontaneous sweating; when Yang is deficient, Yin invades, causing cold extremities and spontaneous sweating." Shuyuan stated: "For spontaneous sweating due to Exterior deficiency, use Cinnamon Twig (Gui Zhi) in autumn and winter, and Astragalus (Huang Qi) in spring and summer." Danxi stated: "Sweat is the fluid of the Heart. There is no case of spontaneous sweating that does not arise from dual deficiency of the Heart and Kidney." Chao Yuanfang stated: "In consumptive diseases, if Yang Qi is excessively deficient, fluids leak out as sweat." The Heart is the organ governing Yang, belonging to Fire. Yang governs Qi. Body fluids are generated where Yang Qi resides and are discharged where Fire disturbs, thus becoming spontaneous sweating. The treatment method should employ sweet-warm Qi-tonifying herbs such as Ginseng (Ren Shen) and Licorice (Gan Cao) to secure Yang Qi externally and store fluids internally, thereby stopping sweating. For those with deficient Yuan Qi, use Liu Jun Zi Tang (Six Gentlemen Decoction) with Dioscorea (Shan Yao) and Cornus (Shan Zhu Yu) in summer, and Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill) or Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction) in winter. For Blood deficiency, use Si Wu Tang (Four Substance Decoction) plus Ginseng. For those with heat, use Dang Gui Liu Huang Tang (Angelica Six-Huang Decoction). For dual Qi and Blood deficiency, use Shi Quan Da Bu Tang. For Heart and Kidney deficiency-heat, use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia). For deficiency-cold, use Ba Wei Wan (Eight-Ingredient Pill). For Heart channel Blood deficiency, use Tuan Shen Tang. For Stomach channel Qi deficiency, use Liu Jun Zi Tang. For injury from diet and overwork, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For lethargy and fatigue, use Sheng Yang Yi Wei Tang (Raise Yang and Benefit the Stomach Decoction). For heat injuring Yuan Qi, use Qing Zao Tang. For Summer-heat invading the Pericardium channel, use Qing Shu Yi Qi Tang. For external Wind pathogen invasion, use Xing Xing San. For consumptive emaciation, use Ren Shen Yang Rong Tang. For worry injuring the Spleen, use Gui Pi Tang. for anger stirring Liver Fire, use Xiao Chai Hu Tang (Minor Bupleurum Decoction). For Liver channel deficiency-heat, use Jia Wei Xiao Yao San (Modified Free Wanderer Powder). For Liver channel damp-heat, use Long Dan Xie Gan Tang (Gentian Drain the Liver Decoction). For diarrhea with faint pulse, use Ren Shen Li Zhong Tang (Ginseng Regulate the Middle Decoction). For sweating on hands and feet, use Bu Zhong Yi Qi Tang. For sweating on chest and abdomen, use Si Jun Zi Tang (Four Gentlemen Decoction). For sweating only on the heart region, use Fu Ling Bu Xin Tang. For yellow sweat, use Yin Chen Wu Ling San (Artemisia Capillaris Five-Ling Powder). For blood sweat, apply Xue Yu San (Hair Remnant Powder) externally. These are the major principles for treating sweating, yet one must still deduce the controlling relationships among the Five Zang organs to treat the root. If sweat is like oil and accompanied by incessant panting, this indicates the end of life. If soft sweat turns the skin yellow, this indicates Spleen exhaustion. If sweat does not flow but hangs like beads, this is 'extinction sweat.' None of these are treatable. If it is Six-Yang deficiency, with sweat extending from head to neck, it is also mostly difficult to treat. [Zeng] For children with Spleen deficiency spontaneous sweating, it often appears on the forehead, sticking to the hand; one must quickly rescue Stomach Qi using Quan Xie Guan Yin San (Scorpion Guanyin Powder) mixed with ginger and jujube decoction, and Chen Xiang Yin (Agarwood Drink). For Spleen deficiency diarrhea with spontaneous sweating, the body is cold with intermittent sweating; there is no sweat during diarrhea, but it returns immediately after; this indicates extreme deficiency, requiring urgent Spleen tonification with Yi Huang San, Shen Ling Bai Zhu San, or Fu Zi Li Zhong Tang. For Lung deficiency spontaneous sweating, the right cheek color is often pale, and the Lung pulse is forceless upon pressure; this is likely due to chronic coughing, continuous barking cough, scanty phlegm, causing deficiency Qi to obstruct upward in the Lung channel, leading to sweating; treat with Bu Fei San (Tonify Lung Powder), and regulate the Spleen with Huo Xiang Yin (Patchouli Drink), following the principle of "benefiting the mother to save the child." For slow convulsion with spontaneous sweating, the whole body sweats and feels cold as water; this condition is critical, treated with Jin Ye Dan and Gu Zhen Tang. For excess pattern spontaneous sweating due to external Wind invasion, with unceasing fever and dripping sweat during drowsiness and wakefulness, one must rescue the Exterior and release the muscle layer using Bai Jie San (Hundred Resolutions Powder) decocted in water, or alternatively use Wu Ling San (Five-Ling Powder) taken warm with white rice water.
[Qian] Treatment has different levels. The three sons of Zhang were ill: the eldest had sweating all over the body; the second had sweating from the top of the head to the chest; the youngest had sweating only on the forehead. Many physicians treated them with Mai Jian San (Wheat Decoction) without effect. Qian said: Give the eldest Xiang Gua Wan (Melon Pill); the second, Yi Pi San (Benefit Spleen Powder); the youngest, Shi Gao Tang (Gypsum Decoction). Each recovered after five days.
Xiang Gua Wan
Coptis Rhizome (Hu Huang Lian), Large Yellow Melon (Da Huang Gua - one yellow melon), Rhubarb (Da Huang - wrapped in wet paper and baked), Bupleurum Root (Chai Hu - remove rhizome), Turtle Shell (Bie Jia - vinegar-fried until yellow), Phellodendron Bark (Huang Bo), Coptis Rhizome (Huang Lian), Aloe (Lu Hui), Green Tangerine Peel (Qing Pi) (all equal parts).
Grind all except the melon into fine powder. Cut off the top of the melon, fill with the powder, cover the opening, secure with a stick, and bake in fire until cooked. Mix the melon and medicine with flour paste to make pills the size of mung beans. Take 2-3 pills after meals with cold well water or new water; for older children, 5-7 pills, not exceeding 10.
Stomach weakness sweating, extending from the top of the head to the navel, indicates Stomach deficiency; tonify the Stomach with Yi Huang San.
[Qian] Six-Yang deficiency sweating extends from the top of the head but does not go below the chest; it requires no treatment. "Joy sweating" refers to sweating on the forehead after sleeping in thick clothes; treat with Zhi Han San (Stop Sweat Powder).
Zhi Han San
Use ash from old palm leaves, ground fine. Take 3 qian each time, mixed with warm wine, at any time.
Xue's Formula: Shi Quan Da Bu Tang treats various deficiencies, spontaneous sweating, loss of appetite, and occasional tidal fever.
Poria (Bai Fu Ling), Ginseng (Ren Shen), Angelica Sinensis (Dang Gui), Atractylodes Macrocephala (Bai Zhu), Astragalus (Huang Qi - fried), Ligusticum Chuanxiong (Chuan Xiong), Cinnamon Bark (Rou Gui), White Peony Root (Bai Shao Yao - fried), Prepared Rehmannia (Shu Di Huang), Licorice (Gan Cao - fried) (all equal parts).
Take 3-5 qian each time, add ginger and jujube, decoct in water and drink.
Ba Zhen Tang (Former formula minus Cinnamon and Astragalus; efficacy see respective sections).
Ren Shen Yang Rong Tang treats post-illness spontaneous sweating, tidal fever, dry mouth, poor appetite, Heart deficiency with palpitations, cough with diarrhea. (Former formula minus Ligusticum, add Tangerine Peel, Schisandra, and Polygala).
Sheng Yang Yi Wei Tang (for dysentery), Jia Jian Ba Wei Wan (for emaciation), Qing Zao Tang, Qing Shu Yi Qi Tang (note: summer), Xing Xing San (for smallpox), Gui Pi Tang (for palpitations), Xiao Chai Hu Tang (for fever), Jia Wei Xiao Yao San (for gynecological fever), Long Dan Xie Gan Tang (for various anterior genital diseases), Ren Shen Li Zhong Tang (for diarrhea), Fu Ling Bu Xin Tang (for aphonia), Yin Chen Wu Ling San (for jaundice).
Zeng's Formulas:
Quan Xie Guan Yin San (for vomiting/diarrhea), Chen Xiang Yin (for vomiting/diarrhea), Yi Huang San (for Spleen), Shen Ling Bai Zhu San (for vomiting/diarrhea), Li Zhong Tang (for vomiting/diarrhea), Bu Fei San (for cough), Huo Xiang Yin (for weak Spleen), Jin Ye Dan, Gu Zhen Tang (for slow convulsion), Bai Jie San, Wu Ling San (for acute convulsion).
Tuan Shen Tang treats pediatric deficiency sweating, or sweating caused by excessive Heart Blood; this formula astringes Heart Qi.
Korean Ginseng (Xin Luo Ren Shen), Sichuan Angelica (Chuan Dang Gui) (each 3 qian).
Cut finely. Use one male pig heart, sliced into three pieces. Take 2 qian of herbs with one piece of pig heart, and 1.5 cups of well water. Decoct to 1 cup. Take before meals, divided into two doses.
Mu Li San treats "Blood Tiger" spontaneous sweating (sweating due to blood heat forcing fluids out), or sudden deficiency after illness with insecure fluids causing spontaneous sweating.
Oyster Shell (Mu Li - calcined), Astragalus (Huang Qi), Rehmannia Root (Sheng Di Huang) (all equal parts).
Cut into pieces. Take 2 qian each time, or decoct with floating wheat.
Pu Han Fang (Sweat-Powdering Formula)
Coptis Rhizome (Huang Lian), Oyster Shell Powder (Mu Li Fen), Fritillaria Bulb (Bei Mu) (each half liang).
Mix with one sheng of rice flour and apply externally.
Xue Yu San treats incessant sweating.
Take a handful of human hair, calcine until carbonized but retaining nature, grind to fine powder. Place in a silk bag and apply dry to the skin.