《伤寒论》无汗者九，不得汗者四，不汗出者一。《明理论》、陶氏书，惟寒邪一条，失之太
简。以无汗为表症居多则可，以无汗为止是寒邪则不可。《伤寒论》太阳症无汗，发热身
痛，手足冷，脉浮紧，冬用麻黄汤。太阳中风，脉浮紧，无汗而烦躁，乃营卫两伤，冬用大
青龙汤。阳明症，头痛鼻干，脉浮无汗而喘，冬用干葛汤。此皆是寒邪在表而无汗，用发表
者。若阳明症无汗，身必发黄，茵陈栀子豆豉汤。阳明无汗，渴欲饮水，无表症者，白虎
汤。此皆热邪在里而无汗，用清里者。又云结胸症，但头汗，用大陷胸汤；但头汗，身发
黄，用茵陈汤；心中懊 ，但头汗，栀子豆豉汤。此水饮内结而无汗也。又云脉浮而迟，迟
为无阳，不能作汗，身必痒，此阳虚人外冒表邪，不能作汗外解，用扶元发汗者。以上皆伤
寒门无汗之症也。今有呕吐恶心，胸膈满闷，无汗喘急，脉滑不数，此痰结无汗，用二陈
汤、导痰汤。有饱闷嗳气，发热无汗，右关滑大，此食滞中焦，胃阳不得敷布而无汗，用平
胃保和散等。又有发热恶寒，无汗脉不出，此表邪内伏用升阳散火汤。又有发热无汗，寒凉
抑遏，而用温中升散者。凡此皆不得已而推展治法也。然无汗之症，到底用发散者多。例如
脉伏无汗。用升发，正也；脉大无汗而用升发，无得也；即脉细用升发、寒凉抑遏用升发、
痰凝食滞用升发、皆无碍也。至如双解散、小柴胡汤、栀子豆豉汤治表有邪里有热之无汗
者，若治脉伏无汗，则内有一半寒药而碍表邪；若治胸满痰结，寒凝食滞，则内有一半寒药
而犯凝滞。又如白虎汤，阳明和解发汗者也。而条下注明表汗未出，表症尚在者，未可服。
唇口干渴，不能消水，脉不数大，亦未可服。夫石膏汤尚如此，则黄连、大黄更不宜矣。惟
热郁火闭之无汗，不忌寒凉耳。然无汗症，第一在脉上消息。经云热病脉躁盛，不得汗，阳
脉之极也，死。又云阳病而见阴脉者，死。今细详阳脉躁盛无汗一条，后来不论生死，原能
作汗外出。若战栗而出汗后气和者，生。若不战栗，洋洋汗出，气粗口张，随汗而死。若阳
症脉阴无汗一条，则胃阳不足，津液内涸，到底无汗而死者多。大凡发热无汗之症，必得汗
多，则身热方解。以其热在皮肤，无汗。则热邪何处发泄？故治无汗发热，不论日数，须善
为发汗。要知麻黄、桂枝，但发冬月未郁热之寒邪无汗，不可用于三时热令。羌活汤、干葛
柴胡汤，能发在表无汗，不能发在里火闭无汗。滑石、石膏能发在里火闭无汗，不能发在表
无汗。淡豆豉、白豆蔻能辛散中焦抑遏无汗，不能发皮毛闭郁无汗。枳壳、木通能发大小便
下窍不通无汗，不能发在外表邪无汗。桑白皮、地骨皮、桔梗能发肺气壅遏皮毛无汗，不能
发他经闭郁无汗。仲景发表，加杏仁，妙以开润肺之皮毛，亦发汗良法。是以发汗，亦有理
肺气而出者。然治无汗，必要互看头汗条者。
桂枝汤本为解肌，若其人脉浮紧发热，汗不出者，不可与也。当须识此，勿令误也。
此以下五节，皆寒邪在表无汗。北方冬月，用麻黄以发汗，故曰桂枝汤不可与也。
太阳病，头痛发热，身疼腰痛，骨节疼，恶风，无汗而喘者，麻黄汤主之。
此条申明上章发热无汗之症，不可与桂枝汤，宜麻黄汤。详注恶寒头痛。太阳中风，脉浮
紧，发热恶寒，身疼痛，不汗出而烦躁者，大青龙汤主之。
此条申明营卫两伤，不可与麻黄汤，宜用大青龙汤。详注烦躁。
太阳病，脉浮紧，无汗发热，身疼痛，八九日不解，表症仍在，此当发其汗。服药已微除，
其人发烦热目瞑，剧者必衄，衄乃解。所以然者，阳气重故也。麻黄汤主之。
此条详注衄血。麻黄汤主之一句，在当发其汗下。
太阳病，脉浮紧，发热身无汗，自衄者愈。
太阳病脉浮紧，发热无汗，当用麻黄汤。因其人正气旺，未服麻黄汤而自衄出病愈。此申
明上章太阳无汗症，若自衄乃解，不必再用麻黄汤也。
伤寒脉浮，发热无汗，其表不解，不可与白虎汤。若渴欲饮水，无表症者，白虎加人参汤。
上半节言无汗之症，宜发汗，戒用白虎；下半节言渴欲饮水，无表症者，忌发汗，宜用白虎。
阳明病，无汗，小便不利，心中懊 者，身必发黄。
阳明病无汗，小便又不利，则温热抑遏不得发泄，故心中烦闷懊 ，湿热久郁，身必发
黄。此条不立一方，而暗示阳明无汗，四条治法。无汗表热，干葛防风汤发表，一法也；
无汗小便不利，猪苓汤清利，一法也；无汗心中懊 ，栀子豆豉汤治烦，一法也；无汗身
发黄，茵陈汤治黄，一法也。
少阴病，但厥无汗，而强发之，必动其血，未知从何道出，或从口鼻，或从耳目出，名下厥
上竭，为难治。
此条少阴传经里热症，医见其手足冷而无汗，绝似伤寒表邪未伸，误用麻黄桂枝，辛温强
散其汗，则血得热而妄行，或从口鼻耳目而出。
大青龙汤 见烦躁。
干葛汤 见似疟。
茵陈栀子豆豉汤 三味。
此阳明热瘀在内，蒸发黄，家秘加干葛、防风，兼散表郁，则全内外分消之治。
白虎汤 见潮热。
小青龙汤 见咳嗽。
补中益气汤
人参 白术 当归 黄 陈皮 柴胡 升麻 甘草
表邪闭郁而无汗，纯用发表，中气虚微不能作汗，则用此方。家秘加荆芥、防风，治劳力感冒。
二陈汤 导痰汤 二方见似疟。
平胃散 见谵语。
升阳散火汤
升麻 葛根 独活 羌活 人参 柴胡 防风 甘草 白芍
表邪内伏，寒冷抑遏，发热无汗，手足反冷，此邪热不得发越，故用火郁发之。
消滞升阳汤
浓朴 半夏 枳壳 广皮 升麻 葛根
阳明无汗，胸前饱闷，必是胃家有痰饮食滞，故用半夏、枳朴，以消胃滞，再加升、葛，
宣发表邪。
双解散 见发狂。
纯是表邪无汗，则用发表，若表有邪里有热，则用此方双解。
小柴胡汤 见恶寒头痛。
三阳表有邪里有热者，用前方双解；少阳表有邪里有热，则用此方。
理肺发表汤 家秘治肺气抑遏，发热无汗。
羌活 独活 柴胡 干葛 枳桔 桑皮
平胃发表汤 家秘治胃气抑遏，发热无汗。
羌活 独活 柴胡 干葛 枳朴 半夏
仲景首条，立麻黄汤，治无汗发热，气逆喘满，用杏仁。默示肺主皮毛，肺气壅遏则喘
逆无汗，开发润肺气为发汗之真诀。又桂枝汤下云∶服药后，食稀粥以助药力。此默示
发热有汗，必是胃无凝滞，故可食稀粥，以助药力散邪。若发热无汗，必是胃有凝结，不
能作汗，故开发。胃主肌肉，疏利胃阳，为发汗真诀。又于头汗条中，申明但头有汗，遍
身无汗，皆系水饮淤热，凝结中焦，隔绝周身之道路。治宜宣发胃气，疏通经络。细玩麻
桂，宜北不宜南，故家秘化立败毒散方法，加枳、桔、桑皮，名理肺发表汤，治风寒壅
肺，发热喘逆无汗之症。此从麻黄杏仁方中，化出治法。又以败毒散方，加枳朴、半夏、
苍术，名平胃发表汤，治痰涎食滞，胸满发热，头痛身痛，无汗之症，此从太阳病有表
症，心下有水饮，用小青龙汤，辛散水饮，敷布胃中，则内伏之水饮作汗而出，外冒之表
邪随汗而解，此一举两解，化法用方之妙悟也。
《伤寒论》中论述无汗的条文有九条，论述不得汗出的有四条，论述不汗出的有一条。《明理论》及陶华（陶氏）的著作，只有寒邪这一条，论述过于简略。认为无汗多为表证是可以的，但认为无汗仅仅是寒邪所致则是不对的。《伤寒论》中太阳病表现为无汗、发热、身体疼痛、手足冷、脉浮紧，冬季使用麻黄汤。太阳中风病，脉浮紧，无汗且烦躁，这是营卫两伤，冬季使用大青龙汤。阳明病，头痛鼻干，脉浮无汗且喘，冬季使用干葛汤。这些都是寒邪在表而无汗，采用发表法治疗。如果是阳明病无汗，身体必然发黄，使用茵陈栀子豆豉汤。阳明病无汗，口渴想喝水，没有表证的，使用白虎汤。这些都是热邪在里而无汗，采用清里法治疗。又说结胸证，仅头部出汗，使用大陷胸汤；仅头部出汗，身体发黄，使用茵陈汤；心中烦闷懊恼，仅头部出汗，使用栀子豆豉汤。这是水饮内结而无汗。又说脉浮而迟，迟脉代表无阳，不能作汗，身体必然瘙痒，这是阳虚之人外感表邪，不能作汗外解，使用扶正发汗法。以上都是伤寒门中无汗的症状。现在有呕吐恶心，胸膈满闷，无汗喘急，脉滑而不数，这是痰结导致无汗，使用二陈汤、导痰汤。有饱闷嗳气，发热无汗，右关脉滑大，这是食滞在中焦，胃阳不能敷布而导致无汗，使用平胃保和散等方剂。又有发热恶寒，无汗且脉象隐伏不出，这是表邪内伏，使用升阳散火汤。又有发热无汗，因寒凉抑制遏阻，而使用温中升散法治疗的。凡此种种，都是不得已而推展出来的治法。然而无汗之症，最终多用发散法。例如脉伏无汗，用升发法，是正确的；脉大无汗却用升发法，就不对了；即使是脉细用升发、寒凉抑遏用升发、痰凝食滞用升发，都没有妨碍。至于双解散、小柴胡汤、栀子豆豉汤治疗表有邪里有热的无汗者，如果用来治疗脉伏无汗，则方中有一半寒药会阻碍表邪外解；如果用来治疗胸满痰结、寒凝食滞，则方中有一半寒药会造成凝滞。又如白虎汤，是阳明病的和解发汗方。但在条文下注明：表汗未出，表证尚在的，不可服用。唇口干渴，不能消水，脉不数大的，也不可服用。石膏汤尚且如此，那么黄连、大黄就更不宜使用了。只有热郁火闭导致的无汗，才不忌寒凉。然而无汗之症，关键在于从脉象上仔细辨析。经文说热病脉躁盛，不得汗，是阳脉的极盛表现，主死。又说阳病见到阴脉的，主死。现在详细考察“阳脉躁盛无汗”这一条，后来不论生死，原本都能作汗外出。如果战栗后出汗，脉气和缓的，为生；如果不战栗，大汗淋漓，气粗口张，随汗而出的，为死。若是“阳症脉阴无汗”这一条，则是胃阳不足，津液内涸，最终多因无汗而死。大凡发热无汗之症，必须得汗，身热才能解除。因为热在皮肤，若无汗，热邪何处发泄？所以治疗无汗发热，不论患病天数，须善于发汗。要知道麻黄、桂枝，只能发散冬季未郁积化热的寒邪所致的无汗，不可用于春夏秋三时的热令季节。羌活汤、干葛柴胡汤，能发散在表的无汗，不能发散在里的火闭无汗。滑石、石膏能发散在里的火闭无汗，不能发散在表的无汗。淡豆豉、白豆蔻能辛散中焦抑遏导致的无汗，不能发散皮毛闭郁导致的无汗。枳壳、木通能发散大小便下窍不通导致的无汗，不能发散在外表邪导致的无汗。桑白皮、地骨皮、桔梗能发散肺气壅遏皮毛导致的无汗，不能发散其他经络闭郁导致的无汗。仲景在发表方中加入杏仁，妙在开润肺之皮毛，也是发汗的好方法。因此发汗，也有通过理肺气而排出的。然而治疗无汗，一定要参照头汗的条文来互参。
桂枝汤本为解肌而设，如果病人脉浮紧发热，汗不出，不可给予桂枝汤。应当认识这一点，不要弄错。
以下五节，都是寒邪在表无汗的情况。北方冬季，用麻黄发汗，所以说桂枝汤不可用。
太阳病，头痛发热，身疼腰痛，骨节疼痛，恶风，无汗而喘的，主治用麻黄汤。
此条阐明上一章发热无汗之症，不可用桂枝汤，宜用麻黄汤。详细注解了恶寒头痛。
太阳中风病，脉浮紧，发热恶寒，身体疼痛，无汗且烦躁的，主治用大青龙汤。
此条阐明营卫两伤，不可用麻黄汤，宜用大青龙汤。详细注解了烦躁。
太阳病，脉浮紧，无汗发热，身体疼痛，经过八九日仍未解除，表证仍在，这应当发其汗。服药后症状轻微缓解，其人出现心烦发热、眼睛闭合欲睡，严重的必定衄血，衄血后病愈。之所以这样，是因为阳气重的缘故。主治用麻黄汤。
此条详细注解了衄血。“麻黄汤主之”一句，位于“当发其汗”之下。
太阳病脉浮紧，发热无汗，应当用麻黄汤。因为此人正气旺盛，未服麻黄汤而自行衄血病愈。此条阐明上一章太阳无汗症，若自行衄血则病解，不必再用麻黄汤。
伤寒脉浮，发热无汗，其表不解，不可与白虎汤。若渴欲饮水，无表证的，用白虎加人参汤。
上半节言无汗之症，宜发汗，告诫不要用白虎汤；下半节言渴欲饮水，无表证的，忌发汗，宜用白虎汤。
阳明病无汗，小便又不利，则温热抑遏不得发泄，所以心中烦闷懊恼，湿热久郁，身体必然发黄。此条未立一方，而是暗示阳明无汗的四种治法。无汗表热，用干葛防风汤发表，是一法；无汗小便不利，用猪苓汤清利，是一法；无汗心中懊恼，用栀子豆豉汤治烦，是一法；无汗身体发黄，用茵陈汤治黄，是一法。
少阴病，仅厥冷无汗，而强行发汗的，必动其血，不知从哪条道而出，或从口鼻，或从耳目出，名为下厥上竭，属难治之症。
此条是少阴传经里热症，医生见其手足冷而无汗，极像伤寒表邪未伸，误用麻黄桂枝，辛温强散其汗，则血得热而妄行，或从口鼻耳目而出。
大青龙汤 见烦躁条。
干葛汤 见似疟条。
茵陈栀子豆豉汤 由三味药组成。
这是阳明热瘀在内，蒸发发黄，家秘（作者自注）加入干葛、防风，兼散表郁，则全内外分消的治疗。
白虎汤 见潮热条。
小青龙汤 见咳嗽条。
补中益气汤
人参 白术 当归 黄芪 陈皮 柴胡 升麻 甘草
表邪闭郁而无汗，纯用发表，中气虚微不能作汗，则用此方。家秘加入荆芥、防风，治疗劳力感冒。
二陈汤 导痰汤 二方见似疟条。
平胃散 见谵语条。
升阳散火汤
升麻 葛根 独活 羌活 人参 柴胡 防风 甘草 白芍
表邪内伏，寒冷抑遏，发热无汗，手足反冷，这是邪热不得发越，故用火郁发之。
消滞升阳汤
厚朴 半夏 枳壳 广皮 升麻 葛根
阳明无汗，胸前饱闷，必然是胃家有痰饮食滞，故用半夏、枳朴，以消胃滞，再加升麻、葛根，宣发表邪。
双解散 见发狂条。
纯是表邪无汗，则用发表，若表有邪里有热，则用此方双解。
小柴胡汤 见恶寒头痛条。
三阳表有邪里有热的，用前方双解；少阳表有邪里有热的，则用此方。
理肺发表汤 家秘治疗肺气抑遏，发热无汗。
羌活 独活 柴胡 干葛 枳桔 桑白皮
平胃发表汤 家秘治疗胃气抑遏，发热无汗。
羌活 独活 柴胡 干葛 枳朴 半夏
仲景首条，立麻黄汤，治无汗发热，气逆喘满，用杏仁。默示肺主皮毛，肺气壅遏则喘逆无汗，开发润肺气为发汗的真诀。又在桂枝汤下云：服药后，喝稀粥以助药力。此默示发热有汗，必然是胃无凝滞，故可食稀粥，以助药力散邪。若发热无汗，必然是胃有凝结，不能作汗，故需开发。胃主肌肉，疏利胃阳，为发汗的真诀。又在头汗条中，申明仅头部有汗，遍身无汗，皆系水饮淤热，凝结中焦，隔绝周身之道路。治宜宣发胃气，疏通经络。细细玩味麻黄、桂枝，适宜于北方而不适宜于南方，所以家秘化裁创立败毒散方法，加入枳壳、桔梗、桑白皮，名为理肺发表汤，治疗风寒壅肺，发热喘逆无汗之症。这是从麻黄杏仁方中化出的治法。又以败毒散方，加入枳实、厚朴、半夏、苍术，名为平胃发表汤，治疗痰涎食滞，胸满发热，头痛身痛，无汗之症。这是从太阳病有表症，心下有水饮，用小青龙汤，辛散水饮，敷布胃中，则内伏之水饮作汗而出，外冒之表邪随汗而解，这是一举两解，化法用方的妙悟啊。
There are nine clauses in the *Shanghan Lun* (Treatise on Cold Damage) discussing anhidrosis (lack of sweating), four discussing inability to sweat, and one discussing non-sweating. The *Mingli Lun* (Theory of Manifestations) and the works of Tao Hua (Tao Shi) only address cold pathogen, which is too brief. It is acceptable to consider anhidrosis as mostly a exterior syndrome, but it is incorrect to assert that anhidrosis is solely caused by cold pathogen. In the *Shanghan Lun*, Taiyang disease presents with anhidrosis, fever, body pain, cold hands and feet, and a floating-tight pulse; in winter, Mahuang Tang (Ephedra Decoction) is used. Taiyang wind-strike disease presents with a floating-tight pulse, anhidrosis, and irritability; this indicates injury to both Ying (Nutritive) and Wei (Defensive) levels, and Da Qinglong Tang (Major Blue Green Dragon Decoction) is used in winter. Yangming disease presents with headache, nasal dryness, floating pulse, anhidrosis, and wheezing; in winter, Gange Tang (Pueraria Decoction) is used. These are all cases where cold pathogen is at the exterior causing anhidrosis, treated with exterior-releasing methods. If Yangming disease presents with anhidrosis and the body must become jaundiced, Yinchen Zhizi Douchi Tang (Artemisia Capillaris, Gardenia, and Fermented Soybean Decoction) is used. If Yangming disease presents with anhidrosis, thirst for drinking water, and no exterior syndrome, Baihu Tang (White Tiger Decoction) is used. These are all cases where heat pathogen is at the interior causing anhidrosis, treated with interior-clearing methods. It is also stated that Jie Xiong syndrome (Chest Binding Syndrome) presenting with sweating only on the head is treated with Da Xiexiong Tang (Major Interior-Draining Decoction); sweating only on the head with body jaundice is treated with Yinchen Tang (Artemisia Decoction); mental restlessness and oppression with sweating only on the head is treated with Zhizi Douchi Tang (Gardenia and Fermented Soybean Decoction). This is due to internal accumulation of fluid retention causing anhidrosis. It is also stated that a floating and slow pulse indicates "no Yang," inability to produce sweat, and inevitable body itching; this occurs when a person with Yang deficiency is exposed to exterior pathogens but cannot produce sweat to resolve them externally, thus requiring methods to support Yuan Qi (Primal Qi) and induce sweating. The above are all symptoms of anhidrosis within the Shanghan category. Currently, there are cases of vomiting and nausea, chest and diaphragm fullness, anhidrosis with wheezing, and a slippery but not rapid pulse; this is phlegm accumulation causing anhidrosis, treated with Er Chen Tang (Two-Cured Decoction) or Daotan Tang (Phlegm-Resolving Decoction). There are cases of bloating, belching, fever, anhidrosis, and a slippery-large pulse at the Right Guan position; this is food stagnation in the Middle Jiao, where Stomach Yang cannot distribute, causing anhidrosis, treated with Pingwei Baohe San (Stomach-Pacifying and Harmony Powder) etc. There are cases of fever, aversion to cold, anhidrosis, and a pulse that does not emerge; this is exterior pathogen lying latent internally, treated with Shengyang Sanhuo Tang (Raising Yang and Dispersing Fire Decoction). There are cases of fever and anhidrosis suppressed by cold-cooling measures, treated with warming the middle and dispersing upward. All these are extended treatment methods employed out of necessity. However, for anhidrosis symptoms, dispersing methods are predominantly used. For example, if the pulse is hidden and there is anhidrosis, using ascending-dispersing methods is correct; if the pulse is large and there is anhidrosis, using ascending-dispersing methods is inappropriate; even if the pulse is fine, or if cold suppression is present, or if phlegm coagulation and food stagnation exist, using ascending-dispersing methods causes no hindrance. As for Shuangjie San (Double-Resolution Powder), Xiaochaihu Tang (Minor Bupleurum Decoction), and Zhizi Douchi Tang treating anhidrosis with exterior pathogen and interior heat, if used for hidden-pulse anhidrosis, the half-cold nature of the herbs will hinder exterior resolution; if used for chest fullness, phlegm accumulation, cold coagulation, and food stagnation, the half-cold nature will cause further stagnation. Similarly, Baihu Tang is a harmonizing and sweating formula for Yangming disease. The clause notes that if exterior sweat has not occurred and exterior signs remain, it should not be taken. If lips and mouth are dry and thirsty but unable to consume water, and the pulse is not rapid and large, it should not be taken either. Since Shigao Tang (Gypsum Decoction) is so restricted, Huanglian (Coptis) and Dahuang (Rhubarb) are even less suitable. Only anhidrosis caused by heat depression and fire closure does not forbid cold-natured herbs. However, for anhidrosis, the first step is to examine the pulse. The Classics state: "In febrile diseases, if the pulse is restless and strong, and there is no sweat, it is the extreme of Yang pulses, indicating death." It also states: "If Yang disease presents with Yin pulses, it indicates death." Examining the "Yang pulse restless-strong with anhidrosis" clause closely, regardless of life or death prognosis, sweat can originally be produced and expelled outward. If sweating occurs after chills and shivering, and the Qi becomes harmonious, the patient lives. If there are no chills, but profuse sweating ensues, with coarse breathing and open mouth, the patient dies with the sweat. Regarding the "Yang disease with Yin pulse and anhidrosis" clause, this indicates insufficient Stomach Yang and depletion of fluids internally, leading to persistent anhidrosis and often death. Generally, for fever with anhidrosis, sweat must be obtained for the body heat to resolve. Since the heat is in the skin, without sweat, where can the heat pathogen dissipate? Therefore, treating fever with anhidrosis, regardless of the number of days, requires skillful induction of sweating. One must know that Mahuang (Ephedra) and Guizhi (Cinnamon Twig) can only disperse cold pathogen causing anhidrosis in winter that has not yet郁 (depressed/accumulated) into heat; they should not be used during the hot seasons of spring, summer, and autumn. Qianghuo Tang (Notopterygium Decoction) and Ganche Chaihu Tang (Pueraria and Bupleurum Decoction) can disperse exterior anhidrosis but cannot disperse interior fire-closure anhidrosis. Huashi (Talcum) and Shigao (Gypsum) can disperse interior fire-closure anhidrosis but cannot disperse exterior anhidrosis. Dansh Douchi (Fermented Soybean) and Bai Doukou (Amomum Villosum Fruit) can acridly disperse Middle Jiao suppression-induced anhidrosis but cannot disperse skin-hair pore closure-induced anhidrosis. Zhike (Aurantii Fructus) and Mutong (Akebia Vine) can disperse anhidrosis caused by blockage of the lower orifices (urination and defecation) but cannot disperse exterior pathogen-induced anhidrosis. Sangbaipi (Mulberry Root Bark), Digupi (Lycium Root Bark), and Jiegeng (Platycodon Root) can disperse anhidrosis caused by Lung Qi congestion affecting the skin-hair pores but cannot disperse anhidrosis caused by closure of other meridians. Zhang Zhongjing adds Xingren (Apricot Seed) to exterior-releasing formulas; its brilliance lies in opening and moistening the Lung to affect the skin-hair pores, which is also an excellent method for inducing sweating. Thus, inducing sweat can also be achieved by regulating Lung Qi. However, treating anhidrosis requires cross-referencing the clauses on head sweating.
Guizhi Tang (Cinnamon Twig Decoction) is originally intended for resolving the muscle layer. If the patient has a floating-tight pulse, fever, and no sweat, it must not be administered. One must recognize this to avoid error.
The following five sections all describe anhidrosis due to cold pathogen at the exterior. In northern winters, Mahuang is used to induce sweat, hence it is said that Guizhi Tang should not be used.
Taiyang disease presenting with headache, fever, body pain, lower back pain, joint pain, aversion to wind, anhidrosis, and wheezing is primarily treated with Mahuang Tang (Ephedra Decoction).
This clause clarifies that for the fever-without-sweat syndrome mentioned in the previous chapter, Guizhi Tang should not be used, and Mahuang Tang is appropriate. It details the aversion to cold and headache.
Taiyang wind-strike disease presenting with a floating-tight pulse, fever, aversion to cold, body pain, anhidrosis, and irritability is primarily treated with Da Qinglong Tang (Major Blue Green Dragon Decoction).
This clause clarifies that for injury to both Ying and Wei levels, Mahuang Tang should not be used, and Da Qinglong Tang is appropriate. It details the irritability.
Taiyang disease presenting with a floating-tight pulse, anhidrosis, fever, and body pain, persisting for eight or nine days without resolution, with exterior signs still present, should be treated by inducing sweat. After taking the medicine, symptoms may slightly improve; the patient may experience vexation, heat, and closed eyes. In severe cases, nosebleed (Xue Ni) will occur, and the disease resolves after the bleed. This happens because the Yang Qi is heavy. It is primarily treated with Mahuang Tang (Ephedra Decoction).
This clause details nosebleed. The phrase "primarily treated with Mahuang Tang" appears under "should induce sweat."
Taiyang disease with a floating-tight pulse, fever, and body anhidrosis, if spontaneous nosebleed occurs, the disease heals itself.
For Taiyang disease with a floating-tight pulse, fever, and anhidrosis, Mahuang Tang should be used. Because the patient's Zheng Qi (Upright Qi) is robust, the disease resolves via spontaneous nosebleed before administering Mahuang Tang. This clarifies the Taiyang anhidrosis syndrome from the previous chapter: if spontaneous nosebleed occurs, the disease resolves, and Mahuang Tang need not be used again.
Shanghan (Cold Damage) with a floating pulse, fever, and anhidrosis, where the exterior is not resolved, Baihu Tang (White Tiger Decoction) must not be given. If there is thirst for drinking water and no exterior syndrome, Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) is used.
The first half states that for anhidrosis, inducing sweat is appropriate, warning against using Baihu Tang; the second half states that for thirst for water with no exterior syndrome, inducing sweat is contraindicated, and Baihu Tang is appropriate.
Yangming disease with anhidrosis, difficulty in urination, and mental restlessness/oppression results in inevitable body jaundice.
In Yangming disease, anhidrosis combined with difficulty in urination means heat-dampness is suppressed and cannot dissipate, causing mental restlessness and oppression. Prolonged depression of damp-heat inevitably leads to body jaundice. This clause does not prescribe a specific formula but implies four treatments for Yangming anhidrosis: 1. Anhidrosis with exterior heat is treated with Gange Fangfeng Tang (Pueraria and Saposhnikovia Decoction) to release the exterior; 2. Anhidrosis with difficulty in urination is treated with Zhu Ling Tang (Polyporus Decoction) to clear and drain; 3. Anhidrosis with mental oppression is treated with Zhizi Douchi Tang (Gardenia and Fermented Soybean Decoction) to relieve vexation; 4. Anhidrosis with body jaundice is treated with Yinchen Tang (Artemisia Decoction) to treat jaundice.
Shaoyin disease presenting only with cold limbs and anhidrosis, if forcibly induced to sweat, will disturb the blood. It is unknown which pathway the blood will exit, whether from the mouth/nose or ears/eyes. This is named "Lower Cold and Upper Exhaustion" and is difficult to treat.
This clause describes a Shaoyin transmitted interior heat syndrome. The physician sees cold limbs and anhidrosis, mistaking it for unextended exterior cold pathogen, and erroneously uses Mahuang and Guizhi to forcibly disperse sweat with acrid-warm herbs. The blood, heated by these herbs, flows recklessly and exits from the mouth, nose, ears, or eyes.
Da Qinglong Tang (Major Blue Green Dragon Decoction) - See Irritability clause.
Gange Tang (Pueraria Decoction) - See Malaria-like Symptom clause.
Yinchen Zhizi Douchi Tang (Artemisia, Gardenia, and Fermented Soybean Decoction) - Composed of three ingredients.
This is interior heat stasis evaporating to cause jaundice. The author's secret addition includes Gange and Fangfeng to simultaneously disperse exterior depression, achieving complete interior-exterior dispersion.
Baihu Tang (White Tiger Decoction) - See Tidal Fever clause.
Xiao Qinglong Tang (Minor Blue Green Dragon Decoction) - See Cough clause.
Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction)
Renshen (Ginseng) Baizhu (Atractylodes Macrocephala) Danggui (Angelica Sinensis) Huangqi (Astragalus) Chenpi (Citrus Reticulata Peel) Chaihu (Bupleurum) Shengma (Cimicifuga) Gancao (Licorice)
When exterior pathogen is closed and depressed causing anhidrosis, and pure exterior-releasing fails because Middle Qi deficiency prevents sweat production, this formula is used. The author's secret addition includes Jingjie and Fangfeng to treat fatigue-induced common cold.
Er Chen Tang (Two-Cured Decoction) and Daotan Tang (Phlegm-Resolving Decoction) - Both see Malaria-like Symptom clause.
Pingwei San (Stomach-Pacifying Powder) - See Delirium clause.
Shengyang Sanhuo Tang (Raising Yang and Dispersing Fire Decoction)
Shengma (Cimicifuga) Gegen (Pueraria) Duhuo (Angelica Pubescens) Qianghuo (Notopterygium) Renshen (Ginseng) Chaihu (Bupleurum) Fangfeng (Saposhnikovia) Gancao (Licorice) Baishao (White Peony)
When exterior pathogen lies latent internally, suppressed by cold, causing fever and anhidrosis with cold hands and feet, this is heat pathogen unable to vent forth, thus treated by "venting fire depression."
Xiaozhi Shengyang Tang (Eliminate Stagnation and Raise Yang Decoction)
Houpo (Magnolia Bark) Banxia (Pinellia) Zhike (Aurantii Fructus) Guangpi (Citrus Peel) Shengma (Cimicifuga) Gegen (Pueraria)
Yangming anhidrosis with chest fullness indicates phlegm and food stagnation in the Stomach. Thus, Banxia and Zhipo are used to eliminate gastric stagnation, supplemented by Shengma and Gegen to vent and release exterior pathogen.
Shuangjie San (Double-Resolution Powder) - See Mania clause.
If purely exterior pathogen causes anhidrosis, use exterior-releasing methods; if exterior has pathogen and interior has heat, use this formula for double resolution.
Xiaochaihu Tang (Minor Bupleurum Decoction) - See Aversion to Cold and Headache clause.
For Three Yang channels with exterior pathogen and interior heat, use the former Double-Resolution formula; for Shaoyang channel with exterior pathogen and interior heat, use this formula.
Lifei Fabiao Tang (Regulate Lung and Release Exterior Decoction) - Author's secret prescription for Lung Qi suppression causing fever and anhidrosis.
Qianghuo (Notopterygium) Duhuo (Angelica Pubescens) Chaihu (Bupleurum) Gange (Pueraria) Zhijie (Aurantium and Platycodon) Sangpi (Mulberry Root Bark)
Pingwei Fabiao Tang (Stomach-Pacifying and Release Exterior Decoction) - Author's secret prescription for Stomach Qi suppression causing fever and anhidrosis.
Qianghuo (Notopterygium) Duhuo (Angelica Pubescens) Chaihu (Bupleurum) Gange (Pueraria) Zhipo (Aurantium and Magnolia) Banxia (Pinellia)
Zhang Zhongjing's first clause establishes Mahuang Tang to treat fever with anhidrosis, rebellious Qi, wheezing, and fullness, using Xingren (Apricot Seed). This implicitly reveals that the Lung governs the skin-hair pores; Lung Qi congestion causes wheezing, rebellious Qi, and anhidrosis. Developing and moistening Lung Qi is the true secret of inducing sweat. Under the Guizhi Tang clause, it says: "After taking the medicine, eat thin porridge to assist the medicinal power." This implicitly reveals that fever with sweating indicates no gastric stagnation, allowing thin porridge to assist the medicine in dispersing pathogens. If fever with anhidrosis occurs, it indicates gastric coagulation preventing sweat production, thus requiring development. The Stomach governs muscles; smoothing and benefiting Stomach Yang is the true secret of inducing sweat. In the head-sweat clause, it clarifies that sweating only on the head with no body sweat is due to fluid retention and stagnant heat coagulating in the Middle Jiao, blocking pathways throughout the body. Treatment should focus on venting Stomach Qi and unblocking meridians. Carefully studying Mahuang and Guizhi, they are suitable for the North but not the South. Therefore, the author modified the Baidu San (Anti-Toxin Powder) method, adding Zhike, Jiegeng, and Sangpi, naming it Lifei Fabiao Tang (Regulate Lung and Release Exterior Decoction), to treat wind-cold congesting the Lung, causing fever, wheezing, rebellious Qi, and anhidrosis. This treatment is derived from the Mahuang-Xingren formula. Furthermore, by adding Zhishi, Houpo, Banxia, and Cangzhu to the Baidu San formula, it is named Pingwei Fabiao Tang (Stomach-Pacifying and Release Exterior Decoction), to treat phlegm-saliva and food stagnation, chest fullness, fever, headache, body pain, and anhidrosis. This is derived from the Taiyang disease with exterior signs and fluid retention under the Diaphragm, treated with Xiao Qinglong Tang (Minor Blue Green Dragon Decoction). By acridly dispersing fluid retention and distributing it in the Stomach, the internally retained fluid transforms into sweat, and the externally contracted exterior pathogen resolves with the sweat. This achieves two solutions with one action, demonstrating the profound understanding of transforming methods and applying formulas.