属气虚、阳气。有痰亦自汗,湿亦自汗,热亦自汗。大法宜人参、黄 ,少佐以桂枝。阳虚者,附子亦可用;气
虚自汗,黄 建中汤;气虚寒热自汗,劳倦少食脉弱者,补中益气汤;劳役大虚,脉沉细,汗大出,舌上润,不烦躁,
但惊动亦汗出,似伤寒虚脱者,补中益气去柴加五味、麻黄根;火气上蒸胃中之湿,亦能作汗,宜凉膈散主之,或用
粉扑法;胃实并手足两腋多汗,大便涩结,大承气汤主之;痰实膈滞,寒热自汗,能食而大便秘结,脉实者,大柴胡汤
主之,大抵气热汗出,多是有余证也。饮食,便汗出 悍之气,按而收之,安胃汤。汗大泄者乃津脱,宜急止,用人
参、黄 、麦冬、五味、炒柏、知母;湿热自汗,卫气虚弱不任风寒者,调卫汤;伤寒虚脱自汗,真武汤,外用
扑法。
属阴虚、血虚。小儿盗汗不须治,宜服凉膈散。盗汗发热属阴虚,用四物汤加黄柏;若气虚加人参、黄 、白
术。别处无汗,独心头一片有汗,思虑多则汗亦多,病在用心,名曰心汁,宜养心血,以艾汤调茯苓末服。当归六
黄汤,盗汗之圣药也。黄 加倍用之,余各等分,上为末,每服五钱,小儿减半。又方∶本方内再加知母、参、术、
甘草、地骨、浮麦、桑叶,汗不止加赤根牡蛎,惊不睡加远志,间服朱砂安神丸。一方治盗汗四炒白术散甚效,(方见
《医要》。)一人忧郁出盗汗,胸膈不宽,当归六黄汤加防风、青皮、枳壳、香附、砂仁。
属于气虚、阳气不足导致的自汗。有痰湿也能引起自汗,湿气重也能引起自汗,热邪也能引起自汗。治疗的大法适宜用人参、黄芪,少量佐以桂枝。阳气虚弱的,附子也可以使用;气虚引起的自汗,用黄芪建中汤;气虚伴有寒热往来、自汗,且因劳倦导致食欲减退、脉象虚弱的,用补中益气汤;因劳役过度导致极度虚弱,脉象沉细,大汗淋漓,舌面湿润,没有烦躁感,只是受到惊扰就会出汗,症状类似伤寒导致的虚脱证候的,用补中益气汤去掉柴胡,加入五味子、麻黄根;火气上蒸胃中的湿邪,也能导致出汗,适宜用凉膈散主治,或者使用外用的扑粉法;胃腑实热并见双手足及两侧腋下多汗,大便干涩难解的,用大承气汤主治;痰实阻滞胸膈,伴有寒热往来和自汗,能进食但大便秘结,脉象有力的,用大柴胡汤主治,大抵气分有热导致的汗出,大多是有余(实证)的证候。饮食后随即出汗,这是卫外的悍气不固,按压穴位以收敛之,用安胃汤。汗出如大水泄般的,这是津液耗脱,应当紧急止汗,用人参、黄芪、麦冬、五味子、炒黄柏、知母;湿热引起的自汗,卫气虚弱不能耐受风寒的,用调卫汤;伤寒导致的虚脱性自汗,用真武汤,外用扑粉法。
属于阴虚、血虚导致的盗汗。小儿盗汗不需要特别治疗,适宜服用凉膈散。盗汗伴有发热属于阴虚,用四物汤加黄柏;如果兼有气虚,加入人参、黄芪、白术。身体其他部位无汗,唯独心口一片区域有汗,思虑过多则汗出更多,病位在于用心过度,名为“心汁”,适宜滋养心血,用艾叶汤调服茯苓末。当归六黄汤,是治疗盗汗的神效药物。黄芪加倍使用,其余药材各等分,研为细末,每次服用五钱,小儿减半。另一个方子:在本方内再加知母、人参、白术、甘草、地骨皮、浮小麦、桑叶,汗不止时加入煅牡蛎,受惊失眠时加入远志,间服朱砂安神丸。还有一个方子治疗盗汗的四炒白术散非常有效(方剂见《医要》)。有一人因忧郁出现盗汗,胸膈部感觉不宽畅,用当归六黄汤加防风、青皮、枳壳、香附、砂仁。
Self-sweating (Zihan) is attributed to Qi deficiency and Yang Qi insufficiency. Phlegm-dampness can also cause self-sweating, dampness can cause self-sweating, and heat can cause self-sweating. The general treatment principle involves using Renshen (Ginseng Root) and Huangqi (Astragalus Root), with a small amount of Guizhi (Cinnamon Twig) added as an assistant. For those with Yang deficiency, Fuzi (Prepared Aconite Lateralis Radix) may also be used; for self-sweating due to Qi deficiency, Huangqi Jianzhong Tang (Astragalus Decoction for Building the Middle) is indicated; for self-sweating accompanied by alternating chills and fever due to Qi deficiency, resulting from overwork and fatigue with poor appetite and a weak pulse, Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) is indicated; for severe deficiency due to laborious work, with a deep and fine pulse, profuse sweating, a moist tongue coating, no irritability, but sweating triggered easily by fright, resembling the collapse syndrome in Cold Damage diseases, Buzhong Yiqi Tang without Chaihu (Bupleurum Root), plus Wuweizi (Schisandra Fruit) and Mahuanggen (Ephedra Root) is indicated; when Fire Qi steams upward affecting dampness in the Stomach, it can also produce sweating, which should be treated primarily with Liangge San (Cool the Upper Jiao Powder), or alternatively using external powder-puffing methods; for excess heat in the Stomach accompanied by excessive sweating on both hands, feet, and axillae, with dry and difficult bowel movements, Dachengqi Tang (Major Order the Qi Decoction) is indicated; for phlegm-excess obstructing the chest and diaphragm, with alternating chills and fever, self-sweating, ability to eat, constipation, and a forceful pulse, Daichaihu Tang (Minor Bupleurum Decoction) is indicated. Generally speaking, sweating caused by Qi-heat is mostly a syndrome of excess. Sweating immediately after eating is due to the instability of Wei-Qi (Defensive Qi); acupressure should be applied to consolidate it, using Anwei Tang (Stomach-Calming Decoction). Profuse sweating represents the depletion of Body Fluids (Jin-Ye) and requires urgent cessation; use Renshen (Ginseng Root), Huangqi (Astragalus Root), Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Fruit), Chao Baipian (Fried Phellodendron Bark), and Zhimu (Anemarrhena Rhizome). For self-sweating due to Damp-Heat, where Defensive Qi is weak and unable to withstand wind-cold, Tiaowei Tang (Regulate Defense Decoction) is indicated. For collapse-type self-sweating due to Cold Damage, Zhenwu Tang (True Warrior Decoction) is used, along with external powder-puffing methods.
Night sweats (Daohan) are attributed to Yin deficiency and Blood deficiency. Night sweats in children do not require specific treatment; Liangge San (Cool the Upper Jiao Powder) is appropriate. Night sweats accompanied by fever belong to Yin deficiency; Siwu Tang (Four Substances Decoction) with Huangbai (Phellodendron Bark) is used. If Qi deficiency is present, add Renshen (Ginseng Root), Huangqi (Astragalus Root), and Baizhu (Atractylodes Macrocephala Rhizome). When there is no sweat elsewhere on the body, but only a patch of sweat on the heart region, and sweating increases with excessive mental exertion, the pathology lies in the overuse of the mind, termed "Heart Juice" (Xinzhi); it is appropriate to nourish Heart Blood by taking Pufen (Poria Cocos) powder mixed with Aiye Tang (Mugwort Leaf Decoction). Danggui Liu Huang Tang (Danggui Six-Huang Decoction) is the supreme medicine for night sweats. Use double the amount of Huangqi (Astragalus Root), and equal parts of the other herbs; grind into powder, take 5 qian per dose, and half that amount for children. Another prescription: Add Zhimu (Anemarrhena Rhizome), Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome), Gancao (Licorice Root), Digupi (Dogwood Cortex/Golden Thread Bark - *Note: Context implies Di Gu Pi usually, but text says Di Gu, likely short for Di Gu Pi*), Fumai (Floating Wheat), and Sangye (Mulberry Leaf) to this formula. If sweating persists, add Chidigujie Muli (Calcined Oyster Shell); if fright and insomnia occur, add Yuanzhi (Polygala Root); administer Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill) intermittently. Another prescription, Sicui Baizhu San (Four-Fried Atractylodes Powder), is very effective for treating night sweats (formula seen in *Yiyao*). One patient suffered from night sweats due to depression and a sensation of tightness in the chest and diaphragm; Danggui Liu Huang Tang was modified with Fangfeng (Saposhnikovia Root), Qingpi (Aged Tangerine Peel), Zhike (Bitter Orange Fruit), Xiangfu (Cyperus Rhizome), and Sharen (Amomum Fruit).