病患里虚而表实。玄府不开腠理密。无能作汗润皮肤。阳气上行头上出。津液既竭五内干。误下重虚成大疾。（病患
表实。玄府不开。汗不能浃于周身。故上腾而发于颈额也。汗既出多。五脏津液寡少。又重责之以汗。必成大疾。）头有
汗兮多涂径。剂颈而还发黄病。（仲景云。若不结胸。但头汗出。余处无汗。剂颈而还。小便不利。多必发黄。）往来寒
热表未解。（仲景云。伤寒五六日。其人已发汗。而复下之。胸胁微满硬。小便不利。渴而不呕。但头汗出。往来寒热而
烦。此为未解。小柴胡汤桂枝汤。）手足冷时非阴证。（仲景云。伤寒七八日。头汗出。微恶寒。手足冷。心下满。口不
欲食。大便坚。其脉细。此为阳微结。有表复有里也。脉虽沉紧。不得为少阴。所以然者。阴不得有汗。今头汗出。故
知非少阴也。可与小柴胡汤。）肝乘肺部刺期门。（仲景云。伤寒。发热。啬啬恶寒。其人大渴欲饮酢浆。其腹必满。身
自汗出。小便利。其病欲解。此肝乘肺。名曰横。当刺期门。期门穴在乳下。）心中懊 栀子应。（仲景云。阳明病。下
之。其外有热。手足温不结胸。心中懊 。若饥不能食。但头有汗出者。宜用栀子汤主之。）膈间坚满茯苓汤。六者看详
宜审订。
阳加于阴有汗期。过关之脉要须知。（素问云。阳加于阴。谓之有汗。俗谓过关之脉也。）有时两手忽无脉。恰似重
阴欲雨时。（有时一手无脉。或两手无脉者。有汗证也。）病患本虚必发颤。不虚得汗颤何为。不颤不汗自然解。阳阴和
顺更何疑。先曾吐下并亡血。内无津液故如斯。（仲景云。病有战而汗出。因得解者。何也。答曰。脉浮而紧。按之反芤。
此为本虚。故当战而汗出也。若脉浮而数。按之不芤。此人本不虚。若欲自解。但汗出耳。不发战也。病有不战。不汗
出而解者。何也。答曰。其脉自微。此以当发汗。若吐若下。若亡血。内无津液。此阴阳自和。必自愈。）止爱 周身
润。来时最忌水淋漓。（凡得汗欲令手足皆周。 一时益佳。但不欲流离。）汗出如油是恶证。忽加喘急病倾危。（仲景
云。汗出如油喘而不休。此为命绝也。）停痰 癖皆隔汗。先须荡涤要医治。（伤寒最怕先有宿患。如痰饮癖块。皆能隔
汗。不能得。先开达管道。经络通为佳。）水升火降阴阳合。大汗来时命得回。（肾水升。心火降。坎离得交。阴阳合和。
必大汗至矣。）
患者体内正气虚弱而体表邪气盛实。玄府（汗孔）闭塞，腠理致密。无法通过出汗滋润皮肤，阳气向上逆行，仅从头部渗出。津液已经枯竭，五脏内部干燥。若误用攻下法，会进一步损伤正气，导致严重的疾病。（患者表实，玄府不开，汗液不能通达周身，所以向上蒸腾发于颈部和额头。汗出过多后，五脏津液减少，如果再强行发汗，必然造成严重疾病。）头部有汗，往往沿着经络路径分布，汗止于颈部，随后可能出现发黄病。（张仲景说：如果不形成结胸证，只是头部出汗，身体其他部位无汗，汗止于颈部，小便不利，大多会出现发黄。）寒热往来，表证未解。（张仲景说：伤寒五六天，病人已经发过汗，又用了攻下法，出现胸胁部微满硬，小便不利，口渴但不呕吐，只有头部出汗，寒热往来且烦躁，这是表证未解，可用小柴胡汤合桂枝汤。）手足发冷时并非阴证。（张仲景说：伤寒七八天，头部出汗，轻微恶寒，手足冷，心下痞满，口不想吃东西，大便坚硬，脉象细，这是阳微结证，既有表证又有里证。脉虽然沉紧，但不能诊断为少阴病。之所以这样，是因为阴证不应该有汗，现在头部出汗，所以知道不是少阴病。可以给予小柴胡汤。）肝气乘肺，针刺期门穴。（张仲景说：伤寒，发热，怕冷，病人极度口渴想喝醋浆，腹部必然胀满，身体自然出汗，小便通畅，病情将要解除。这是肝气乘肺，称为“横”证，应当针刺期门穴。期门穴位于乳头下方。）心中烦闷懊恼，应用栀子汤。（张仲景说：阳明病，经过攻下治疗后，体表仍有热，手足温暖且不形成结胸，心中烦闷懊恼，感觉饥饿却不能吃，只有头部出汗的，适宜用栀子汤主治。）膈间坚满，使用茯苓汤。这六种情况需要仔细审察订正。
阳气作用于阴分，才有出汗的时机。关于过关之脉的要领必须知晓。（《素问》说：阳加于阴，称为有汗。俗称过关之脉。）有时两手突然没有脉搏，恰似重阴欲雨之时。（有时一手无脉，或两手无脉的情况，属于有汗证的范畴。）患者原本虚弱必定会发生战栗，如果不虚弱，出汗后为何会战栗？不战栗也不出汗，自然就会痊愈，阴阳调和还有什么可疑虑的呢？先前曾经吐下并失血，体内没有津液，所以才会这样。（张仲景说：有病发生战栗而后出汗，因而得以痊愈的，是什么原因呢？回答说：脉浮而紧，按之反觉中空，这是因为本身体虚，所以应当战栗而后出汗。如果脉浮而数，按之不中空，这个人本来不虚，如果想要自愈，只是出汗罢了，不会发生战栗。有病不发生战栗，不出汗而痊愈的，是什么原因呢？回答说：其脉自微，这是因为本该发汗，如果经过吐、下治疗，或者失血，体内没有津液，此时阴阳自行调和，必定自愈。）喜欢全身湿润均匀，来时最忌讳大汗淋漓。（凡是得汗，希望手足都周遍，一时之间最为佳妙，但不希望流离不止。）汗出如油是坏证，忽然加上气喘急促，病情危殆。（张仲景说：汗出如油，喘息不停，这是命绝之兆。）停痰和癖块都会阻隔汗出，必须先荡涤清除才能医治。（伤寒最怕先有宿疾，如痰饮癖块，都能阻隔汗出，不能得汗，先开通管道，使经络通畅为佳。）水升火降，阴阳合一，大汗来时性命可回。（肾水上升，心火下降，坎离相交，阴阳合和，必然会有大汗到来。）
The patient presents with deficiency in the interior and excess in the exterior. The Xuanfu (sweat pores) are closed, and the Couli (interstices) are dense. There is an inability to produce sweat to moisten the skin, so Yang Qi ascends and exits only from the head. Once body fluids are exhausted, the five Zang organs become dry. Misusing purgative methods will further deplete healthy Qi, leading to severe illness. (When the exterior is excess and Xuanfu are closed, sweat cannot permeate the whole body, thus it steams upward and emerges at the neck and forehead. After excessive sweating, the fluids of the five Zang organs are diminished; forcing more sweat will inevitably cause serious disease.) Head sweating often follows meridian pathways, stopping at the neck, followed by jaundice. (Zhang Zhongjing stated: If there is no Jie Xiong [Chest Binding] syndrome, but only head sweating with no sweat elsewhere on the body, stopping at the neck, accompanied by difficulty in urination, jaundice will likely occur.) Alternating chills and fever indicate the exterior pattern has not resolved. (Zhang Zhongjing stated: In Shang Han [Cold Damage] after five or six days, if the patient has already undergone diaphoresis and then purgation, presenting with slight fullness and hardness in the chest and hypochondrium, difficulty in urination, thirst without vomiting, only head sweating, alternating chills and fever, and irritability, this indicates the exterior pattern remains unresolved. Xiao Chai Hu Tang (Minor Bupleurum Decoction) combined with Guizhi Tang (Cinnamon Twig Decoction) may be used.) Cold extremities do not necessarily indicate a Yin pattern. (Zhang Zhongjing stated: In Shang Han after seven or eight days, presenting with head sweating, slight aversion to cold, cold hands and feet, epigastric fullness, desire not to eat, hard stools, and a fine pulse, this is Yang Wei Jie [Yang Mild Binding], involving both exterior and interior patterns. Although the pulse is deep and tight, it cannot be diagnosed as Shao Yin [Lesser Yin] disease. This is because Yin patterns should not have sweat; since there is head sweating, it is known not to be Shao Yin. Xiao Chai Hu Tang (Minor Bupleurum Decoction) can be administered.) Liver Qi invading the Lungs requires needling of Qimen (LR14). (Zhang Zhongjing stated: In Shang Han, with fever and shivering aversion to cold, extreme thirst desiring vinegar water, abdominal fullness, spontaneous sweating, and free urination, the condition is about to resolve. This is Liver Qi invading the Lungs, named Heng [Horizontal] syndrome, requiring needling of Qimen acupoint. Qimen is located below the nipple.) Mental restlessness and vexation require Zhi Zi Tang (Gardenia Decoction). (Zhang Zhongjing stated: In Yang Ming [Greater Yang] disease, after purgation, if there is external heat, warm hands and feet, no Jie Xiong syndrome, mental restlessness and vexation, feeling hungry but unable to eat, and only head sweating, Zhi Zi Tang (Gardenia Decoction) is appropriate.) Fullness and hardness in the diaphragm region require Fu Ling Tang (Poria Decoction). These six scenarios must be carefully examined and verified.
Sweating occurs when Yang acts upon Yin. One must understand the pulse of "passing the pass." (Su Wen states: When Yang adds to Yin, it is called having sweat. Commonly referred to as the pulse of passing the pass.) Sometimes the pulses in both wrists suddenly disappear, resembling the time before rain under heavy Yin conditions. (Absence of pulse in one or both wrists belongs to the category of sweating syndromes.) If the patient was originally deficient, trembling/shivering will definitely occur; if not deficient, why would trembling occur after sweating? Without trembling and without sweating, natural recovery occurs; with harmonious Yin and Yang, what is there to doubt? Previous emesis, purgation, and blood loss led to internal fluid depletion, hence this presentation. (Zhang Zhongjing stated: Why does a patient shiver and then sweat to recover? Answer: A floating and tight pulse that feels hollow upon pressure indicates original deficiency, necessitating shivering before sweating. If the pulse is floating and rapid without hollowness, the person is not originally deficient; for self-recovery, simple sweating occurs without shivering. Why does some recover without shivering or sweating? Answer: A naturally weak pulse indicates that diaphoresis was indicated. If preceded by emesis, purgation, or blood loss, resulting in internal fluid depletion, Yin and Yang will spontaneously harmonize, leading to inevitable self-healing.) Uniform moisture over the whole body is desired; profuse dripping sweat is contraindicated. (Sweat should reach all parts of the hands and feet evenly; this is ideal, but continuous dripping is undesirable.) Sweat like oil is a bad omen; sudden worsening with panting indicates critical danger. (Zhang Zhongjing stated: Sweat like oil with incessant panting indicates the end of life.) Phlegm retention and Pi masses [abdominal lumps] obstruct sweating; they must first be cleared through treatment. (Shang Han is most feared when pre-existing conditions exist, such as phlegm-fluid retention or Pi masses, which can obstruct sweating. One must first open the pathways and ensure meridian patency.) When Kidney Water ascends and Heart Fire descends, Yin and Yang unite; the arrival of profuse sweat can save life. (Kidney Water rises, Heart Fire descends, Kan and Li interact, Yin and Yang harmonize, and profuse sweat will inevitably arrive.)