某（二一）脉细自汗。下体怯冷。卫阳式微使然。（卫阳虚）
黄 （三钱） 熟附子（七分） 熟于术（一钱半） 炙草（五分） 煨姜（一钱） 南枣（三钱）
朱（三六）脉微汗淋。右胁高突而 。色痿足冷。不食易饥。食入即饱。此阳气大伤。卫不拥护。法当封固。
人参 黄 制川附子 熟于术
孙（五八）肉 筋惕。心悸汗出。头痛愈。畏风怕冷。阳虚失护。用真武汤。
某 劳伤。阳虚汗泄。
黄 （三钱） 白术（二钱） 防风（六分） 炙草（五分）
顾（氏）劳力怫怒。心背皆热。汗出。往时每以和阳治厥阴肝脏得效。今年春夏。经行病发。且食纳
顿减。褚氏谓独阴无阳。须推异治。通补既臻小效。不必见热投凉。用镇其阳以理虚。
人参 半夏 茯苓 炙草 牡蛎 小麦 南枣
张（五六）脉弦大。身热。时作汗出。良由劳伤营卫所致。经云劳者温之。（营卫虚）
嫩黄 （三钱） 当归（一钱半） 桂枝木（一钱） 白芍（一钱半） 炙草（五分） 煨姜（一钱） 南枣（三
钱）
某（二一） 脉细弱。自汗体冷。形神疲瘁。知饥少纳。肢节酸楚。病在营卫。当以甘温。
生黄 桂枝木 白芍 炙草 煨姜 南枣
某 汗出寒凛。真气发泄。痰动风生。用辛甘化风法。
生黄 桂枝 炙草 茯苓 防风根 煨姜 南枣
梅（四三）案牍积劳。神困食减。五心汗出。非因实热。乃火与元气。势不两立。气泄为热为汗。当治在
无形。以实火宜清。虚热宜补耳。（劳伤心神）议用生脉四君子汤。
方 茹素恶腥。阳明胃弱。致厥阴来乘。当丑时 然汗出。少寐多梦。（胃阴虚）
人参 龙骨 茯神 枣仁 炒白芍 炙草
煎药吞送蒸熟五味子三十粒。
又 镇摄汗止。火升咳嗽。仍属阴虚难得充复。育阴滋液为治。
熟地炭 人参 炒麦冬 五味 炒萸肉 川斛 茯神 女贞子 接服琼玉膏方。
经云。阳之汗以天地之雨名之。又云。阳加于阴。谓之汗。由是推之。是阳热加于阴。津散于外而为汗也。夫心为
主阳之脏。凡五脏六腑表里之阳。皆心主之。以行其变化。故随其阳气所在之处。而气化为津。亦随其火扰所在之处。
而津泄为汗。然有自汗盗汗之别焉。夫汗本乎阴。乃人身之津液所化也。经云。汗者。心之液。又云肾主五液。故凡汗
症。未有不由心肾虚而得之者。心之阳虚。不能卫外而为固。则外伤而自汗。不分寤寐。不因劳动。不因发散。溱溱然
自出。由阴蒸于阳分也。肾之阴虚。不能内营而退藏。则内伤而盗汗。盗汗者。即内经所云寝汗也。睡熟则出。醒则渐
收。由阳蒸于阴分也。故阳虚自汗。治宜补气以卫外。阴虚盗汗。治当补阴以营内。如气虚表弱。自汗不止者。仲景有
黄建中汤。先贤有玉屏风散。如阴虚有火盗汗发热者。先贤有当归六黄汤柏子仁丸。如劳伤心神。气热汗泄者。先生
用生脉四君子汤。如营卫虚而汗出者。宗仲景黄 建中汤。及辛甘化风法。如卫阳虚而汗出者。用玉屏风散。 附汤真
武汤。及甘麦大枣汤。镇阳理阴方法。按症施治。一丝不乱。谓之明医也。夫复奚愧。（邹滋九）
徐评 汗出总由于心火不宁。属热者多。属寒者少。今诸方皆用补阳治法。乃一偏之见。皆由
不知汗出之液在何经也。误人多矣。亡阳之汗。乃阳气飞越。下焦空虚。此乃危急之症。非参附
不能回阳。与自盗等大不相同。医者全然不知。并为一病。贻误无穷。深为可笑。
【案例一】患者，二十一岁。脉象细弱，自发出汗。下半身怯懦寒冷。这是卫阳衰弱所致。（卫阳虚）
方药：黄芪（三钱）、熟附子（七分）、炒白术（一钱半）、炙甘草（五分）、煨生姜（一钱）、南枣（三钱）。
【案例二】患者，三十六岁。脉象微弱，汗出淋漓。右侧胁部高突且疼痛。面色萎黄，足部发冷。不想进食却容易饥饿，吃一点就感到饱胀。这是阳气严重受损，卫气不能固护体表。治法应当封藏固涩。
方药：人参、黄芪、制川附子、炒白术。
【案例三】患者，五十八岁。肌肉跳动，筋脉拘急惕动。心悸出汗。头痛已愈，但畏风怕冷。这是阳虚失去护卫作用。使用真武汤治疗。
【案例四】某患者。因劳累损伤，阳虚导致汗液外泄。
方药：黄芪（三钱）、白术（二钱）、防风（六分）、炙甘草（五分）。
【案例五】顾氏患者。因劳力过度且愤怒郁结，心和背部都感觉发热，出汗。以往每当此时，用调和阳气、治疗厥阴肝脏的方法有效。今年春夏季节，月经来潮时病发，并且饮食突然减少。褚氏认为“独阴无阳”，必须推究不同的治疗方法。通补之法已取得微小效果，不必一见热象就用寒凉药物。应用镇潜阳气的方法来调理虚损。
方药：人参、半夏、茯苓、炙甘草、牡蛎、小麦、南枣。
【案例六】患者，五十六岁。脉象弦大。身体发热，时常出汗。这主要是由于劳累损伤了营卫之气所致。《内经》说：“劳者温之。”（营卫虚）
方药：嫩黄芪（三钱）、当归（一钱半）、桂枝木（一钱）、白芍（一钱半）、炙甘草（五分）、煨生姜（一钱）、南枣（三钱）。
【案例七】某患者，二十一岁。脉象细弱。自汗，身体寒冷，形体和精神疲惫憔悴。知道饥饿但进食很少，四肢关节酸痛楚痛。病在营卫之间，应当用甘温的药物。
方药：生黄芪、桂枝木、白芍、炙甘草、煨生姜、南枣。
【案例八】某患者。出汗后感到寒冷凛冽，真气外泄，痰湿涌动，风气内生。采用辛甘化风法治疗。
方药：生黄芪、桂枝、炙甘草、茯苓、防风根、煨生姜、南枣。
【案例九】梅姓患者，四十三岁。因伏案工作积劳，精神困倦，食欲减退。手心、脚心及心口发热出汗（五心烦热），并非因为实热，而是火与元气势不两立。气泄导致发热和出汗。治疗应当在无形之气上下功夫。实热宜清，虚热宜补。（劳伤心神）建议采用生脉散合四君子汤。
【案例十】方姓患者。长期吃素厌恶腥味，阳明胃气虚弱，导致厥阴肝木来乘克。在丑时（凌晨1-3点）必然出汗，睡眠少多梦。（胃阴虚）
方药：人参、龙骨、茯神、酸枣仁、炒白芍、炙甘草。
煎药时吞服蒸熟的五味子三十粒。
【又案】镇摄止汗后，火热上炎引起咳嗽，仍属于阴虚难以迅速恢复。以育阴滋液为治疗原则。
方药：熟地黄炭、人参、炒麦冬、五味子、炒山茱萸、川石斛、茯神、女贞子。接着服用琼玉膏方。
【医论】《内经》说：阳气的汗，用天地间的雨来命名。又说：阳加于阴，称为汗。由此推断，是阳热加于阴分，津液散发于体外而成为汗。心脏是主宰阳气的脏器。凡五脏六腑表里的阳气，都由心主所统辖，以此来运行变化。所以随着阳气所在之处，气化而为津液；也随着火邪扰乱所在之处，津液泄漏而为汗。然而有自汗和盗汗的区别。汗本源于阴，是人体津液所化生的。《内经》说：汗是心的体液。又说：肾主管五种体液。所以凡是汗症，没有不是由心肾虚损而得的。心之阳虚，不能卫护体表而固密，则受外伤而自汗，不分醒着还是睡着，不因劳动，不因发散，溱溱然自行流出，这是由阴蒸腾于阳分所致。肾之阴虚，不能内营而退藏，则受内伤而盗汗。盗汗，就是《内经》所说的寝汗。睡熟时出汗，醒来后逐渐收敛，这是由阳蒸腾于阴分所致。所以阳虚自汗，治宜补气以卫护体表；阴虚盗汗，治当补阴以滋养体内。如气虚表弱，自汗不止的，张仲景有黄芪建中汤。先贤有玉屏风散。如阴虚有火，盗汗发热的，先贤有当归六黄汤、柏子仁丸。如劳伤心神，气热汗泄的，先生用生脉散合四君子汤。如营卫虚而汗出的，效法张仲景的黄芪建中汤，以及辛甘化风法。如卫阳虚而汗出的，用玉屏风散、附子汤、真武汤，以及甘麦大枣汤。镇潜阳气、调理阴阳的方法，根据症状施治，一丝不苟，这就叫做明医。还有什么可惭愧的呢？（邹滋九评）
【徐灵胎评注】出汗总归是由于心火不宁静，属热证的多，属寒证的少。现在这些方子都用补阳的治疗方法，这是一偏之见。都是因为不知道汗出的津液在哪条经络。误人很多。亡阳之汗，是阳气飞越，下焦空虚，这是危急的病证，非人参、附子不能回阳。这与自汗、盗汗等大不相同。医生全然不知，把它们混为一谈，贻误无穷，深为可笑。
[Case 1] Patient, 21 years old. Pulse is fine and weak (Xì Mài), spontaneous sweating (Zì Hàn). The lower body feels cold and timid. This is due to the decline of Wei Yang (Defensive Yang) (Wèi Yáng Shì Wēi). (Wei Yang Deficiency)
Prescription: Huang Qi (Astragali Radix, 3 qian), Shu Fu Zi (Prepared Aconiti Lateralis Radix, 0.7 qian), Shu Zhu Yu (Stir-fried Atractylodis Macrocephalae Rhizoma, 1.5 qian), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma, 0.5 qian), Wei Jiang (Baked Ginger Rhizome, 1 qian), Nan Zao (Chinese Jujube, 3 qian).
[Case 2] Patient, 36 years old. Pulse is faint (Wēi Mài), sweat pours down like rain (Lín Hàn). The right hypochondrium is protruding and painful. Complexion is sallow (Wěi Huáng), feet are cold. No appetite but easy hunger; feeling full after eating a little. This is severe damage to Yang Qi, and Wei Qi fails to protect the exterior. The treatment method should be to seal and consolidate.
Prescription: Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), Zhi Chuan Fu Zi (Prepared Sichuan Aconiti Radix), Shu Zhu Yu (Stir-fried Atractylodis Macrocephalae Rhizoma).
[Case 3] Patient, 58 years old. Muscle twitching (Ròu Tiào), sinew tremors (Jīn Tì). Palpitations with sweating. Headache has resolved, but aversion to wind and cold persists. This is Yang deficiency failing to provide protection. Use Zhen Wu Tang (True Warrior Decoction).
[Case 4] Certain patient. Due to labor injury, Yang deficiency leads to sweat leakage.
Prescription: Huang Qi (Astragali Radix, 3 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 2 qian), Fang Feng (Saposhnikoviae Radix, 0.6 fen), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma, 0.5 fen).
[Case 5] Patient Gu. Due to physical labor and anger stagnation, both heart and back feel hot, with sweating. Previously, treating this by harmonizing Yang and addressing the Jueyin Liver channel was effective. In the spring and summer of this year, the disease flared up during menstruation, and food intake suddenly decreased. Chu Shi stated "Yin alone without Yang," requiring different treatment strategies. The method of tonifying and unblocking has achieved slight effect; there is no need to use cooling herbs just because heat signs appear. Use methods to anchor Yang and manage deficiency.
Prescription: Ren Shen (Ginseng Radix), Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Mu Li (Ostreae Concha), Xiao Mai (Tritici Fructus), Nan Zao (Chinese Jujube).
[Case 6] Patient, 56 years old. Pulse is wiry and large (Xián Dà Mài). Body heat, intermittent sweating. This is mainly caused by labor injuring Ying and Wei (Nutritive and Defensive Qi). The Classic says: "For exhaustion, use warmth." (Ying and Wei Deficiency)
Prescription: Nen Huang Qi (Young Astragali Radix, 3 qian), Dang Gui (Angelicae Sinensis Radix, 1.5 qian), Gui Zhi Mu (Cinnamomi Ramulus, 1 qian), Bai Shao (Paeoniae Radix Alba, 1.5 qian), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma, 0.5 fen), Wei Jiang (Baked Ginger Rhizome, 1 qian), Nan Zao (Chinese Jujube, 3 qian).
[Case 7] Certain patient, 21 years old. Pulse is fine and weak. Spontaneous sweating, body cold, form and spirit exhausted. Feeling hungry but eating little, limb joints sore and painful. The disease is in Ying and Wei. Treatment should employ sweet and warm methods.
Prescription: Sheng Huang Qi (Raw Astragali Radix), Gui Zhi Mu (Cinnamomi Ramulus), Bai Shao (Paeoniae Radix Alba), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Wei Jiang (Baked Ginger Rhizome), Nan Zao (Chinese Jujube).
[Case 8] Certain patient. Sweating followed by chilling cold, True Qi leaks out, phlegm moves, wind generates. Use the Xin Gan Hua Feng (Acrid-Sweet Transforming Wind) method.
Prescription: Sheng Huang Qi (Raw Astragali Radix), Gui Zhi (Cinnamomi Ramulus), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), Fu Ling (Poria), Fang Feng Gen (Radix Saposhnikoviae), Wei Jiang (Baked Ginger Rhizome), Nan Zao (Chinese Jujube).
[Case 9] Patient Mei, 43 years old. Accumulated labor from desk work, spirit tired, appetite reduced. Five-center sweating (Wǔ Xīn Hàn - heat in palms, soles, and chest), not due to excess heat, but because Fire and Yuan Qi (Original Qi) cannot coexist. Qi leakage causes heat and sweating. Treatment should focus on the Formless Qi. Excess heat should be cleared, deficiency heat should be tonified. (Labor injuring Heart Spirit) Propose using Sheng Mai San combined with Si Jun Zi Tang.
[Case 10] Patient Fang. Vegetarian diet, dislikes fishy smells, Yangming Stomach is weak, leading to Jueyin Liver overacting. Sweat occurs inevitably at Chou hour (1-3 AM), sleep is scant with many dreams. (Stomach Yin Deficiency)
Prescription: Ren Shen (Ginseng Radix), Long Gu (Fossilia Ossis Mastodi), Fu Shen (Poria with Hostwood), Zao Ren (Ziziphi Spinosae Semen), Chao Bai Shao (Stir-fried Paeoniae Radix Alba), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma).
Swallow thirty steamed Wu Wei Zi (Schisandrae Chinensis Fructus) pills with the decoction.
[Follow-up Case] After anchoring and stopping sweat, fire rising causes cough. This still belongs to Yin deficiency which is hard to replenish quickly. Treat by nourishing Yin and moistening fluids.
Prescription: Shu Di Tan (Charred Rehmanniae Radix), Ren Shen (Ginseng Radix), Chao Mai Dong (Stir-fried Ophiopogonis Radix), Wu Wei (Schisandrae Chinensis Fructus), Chao Yu Rou (Stir-fried Corni Fructus), Chuan Hu (Dendrobii Caulis), Fu Shen (Poria with Hostwood), Nv Zhen Zi (Ligustri Lucidi Fructus). Follow with Qiong Yu Gao formula.
[Medical Theory] The Classic states: The sweat of Yang is named after the rain of heaven and earth. It also states: When Yang acts upon Yin, it is called sweat. From this, we deduce that Yang heat acting upon Yin causes Jin Ye (Body Fluids) to scatter outward as sweat. The Heart is the organ that masters Yang. All Yang of the five zang and six fu organs, interior and exterior, are governed by the Heart Master to facilitate changes. Thus, where Yang Qi resides, Qi transforms into Jin Ye; and where Fire disturbs, Jin Ye leaks out as sweat. However, there is a distinction between spontaneous sweating (Zì Hàn) and night sweats (Dào Hàn). Sweat originates from Yin; it is transformed from the body's Jin Ye. The Classic says: Sweat is the fluid of the Heart. It also says: The Kidney governs the five fluids. Therefore, all sweat disorders arise from Heart and Kidney deficiency. Heart Yang deficiency cannot defend the exterior and consolidate, leading to external invasion and spontaneous sweating, occurring regardless of wakefulness or sleep, not due to labor or diaphoresis, flowing profusely on its own; this is Yin steaming into the Yang aspect. Kidney Yin deficiency cannot nourish internally and store, leading to internal injury and night sweats. Night sweats are what the Neijing calls "sweat during sleep" (Qǐn Hàn); they occur when asleep and gradually stop upon waking; this is Yang steaming into the Yin aspect. Therefore, for Yang deficiency spontaneous sweating, treatment should tonify Qi to defend the exterior. For Yin deficiency night sweats, treatment should tonify Yin to nourish the interior. For Qi deficiency and weak exterior with persistent spontaneous sweating, Zhang Zhongjing has Huang Qi Jian Zhong Tang. Ancient sages have Yu Ping Feng San. For Yin deficiency with fire causing night sweats and fever, ancient sages have Dang Gui Liu Huang Wan and Bai Zi Ren Wan. For labor injuring Heart Spirit with Qi heat and sweat leakage, the author uses Sheng Mai San combined with Si Jun Zi Tang. For Ying and Wei deficiency causing sweating, follow Zhang Zhongjing's Huang Qi Jian Zhong Tang and the Xin Gan Hua Feng method. For Wei Yang deficiency causing sweating, use Yu Ping Feng San, Fu Zi Tang, Zhen Wu Tang, and Gan Mai Da Zao Tang. Methods to anchor Yang and regulate Yin, applied according to symptoms without error, constitute a wise physician. What else could one be ashamed of? (Commentary by Zou Zijiu)
[Review by Xu Lingtai] Sweating generally results from restless Heart Fire; cases are mostly heat-related, few are cold-related. The current prescriptions all use Yang-tonifying methods, which is a one-sided view. This stems from not knowing which meridian the sweat fluid belongs to. Many have been misled. Sweat of Yang collapse (Wáng Yáng) involves flying away of Yang Qi and emptiness of the lower jiao; this is a critical condition, requiring Ren Shen and Fu Zi to restore Yang. It is vastly different from spontaneous or night sweats. Physicians completely fail to distinguish them, merging them into one disease, causing endless errors, which is truly laughable.