治五脏蒸热
生地 黄连(治心蒸) 柴胡 当归(治肝蒸) 白芍 黄 (治脾蒸) 天门冬 麦
门冬
(治肺蒸) 炒黄柏 知母(治肾蒸) 鳖甲(醋炙) 地骨皮(治骨蒸)
白水煎
自汗属气虚 有阳虚 有湿 有痰 盗汗属血虚 有阴虚 有火
夫汗者心之液也心动则惕然而汗出也有自汗有盗汗自汗者因发表而自然出也盗汗者睡而
汗出及觉而汗即止也大抵体虚之人或为风暑湿热之邪侵伤卫气以致腠理不密阳气外泄而汗自
出矣或因房劳惊怖损伤心血而汗自睡中盗出也
戴云盗汗者谓睡中汗出也不睡则不出方其睡熟也凑然出焉觉则止而不复出矣非若自汗无
拘时而自出也
一自汗古方用 玉屏风散以黄 实表气 白术燥内湿也
一盗汗用当归六黄汤以当归黄 生地黄以补其阴血黄芩黄连黄柏去其内火也此乃药性病
情相对可见立方之妙也
一伤寒风湿湿温等症自有本门求治
一因风伤胃而汗出者固之宜用 桂枝汤
一因暑热而汗出者清之宜用 清暑益气汤
一因湿蒸而汗出者燥之宜用 清燥汤
一因房劳而汗出者温补之宜用 黄 汤 建中汤
一痰逆头眩恶心自汗者宜用 抚芎汤
一漏风症饮酒中风多汗食则汗出如洗宜用 牡蛎白术散
治方
玉屏风散 治自汗
防风 黄 白术
白水煎服
治疗五脏蒸热(五臟之虛熱):生地黄、黄连(治療心經蒸熱)、柴胡、當歸(治療肝經蒸熱)、白芍、黃芪(治療脾經蒸熱)、天門冬、麥門冬(治療肺經蒸熱)、炒黃柏、知母(治療腎經蒸熱)、鱉甲(醋炙)、地骨皮(治療骨蒸勞熱)。用水煎服。
自汗屬於氣虛,有陽虛型,有濕邪型,有痰飲型;盜汗屬於血虛,有陰虛型,有火旺型。
所謂汗,是心的液體。心動則驚惕而汗出。有自汗和盜汗之分。自汗是因發散表邪後自然出汗,或體虛之人被風、暑、濕、熱等邪氣侵傷衛氣,導致腠理不密,陽氣外泄而自然出汗;或因房勞、驚恐損傷心血,而在睡中盜汗而出。
戴元禮說:盜汗是指睡中出汗,不睡則不出。當睡熟時,汗突然流出,醒來即止,不再復出。這不像自汗那樣無時間限制而自然流出。
對於自汗,古方使用玉屏風散,以黃芪固實表氣,白術燥除內濕。
對於盜汗,使用當歸六黃湯,以當歸、黃芪、生地黄補益其陰血,黃芩、黃連、黃柏清除其內火。可見藥物與病情相對應,體現了處方的精妙。
對於傷寒、風濕、濕溫等病症,自有其專門的治療方法。
因風邪傷胃而汗出的,宜固表,使用桂枝湯。
因暑熱而汗出的,宜清熱,使用清暑益氣湯。
因濕熱蒸騰而汗出的,宜燥濕,使用清燥湯。
因房勞過度而汗出的,宜溫補,使用黃芪建中湯。
因痰逆導致頭眩、噁心、自汗的,宜使用撫芎湯。
漏風症,因飲酒後受風,多汗,進食時汗出如洗,宜使用牡蠣白朮散。
治方:
玉屏風散,治療自汗。
防風、黃芪、白朮。
白水煎服。
Treatment for Steaming Heat of the Five Zang Organs: Shengdi Huang (Rehmanniae Radix), Huang Lian (Coptidis Rhizoma) [treats Heart steaming heat], Chai Hu (Bupleuri Radix), Dang Gui (Angelicae Sinensis Radix) [treats Liver steaming heat], Bai Shao (Paeoniae Radix Alba), Huang Qi (Astragali Radix) [treats Spleen steaming heat], Tian Men Dong (Asparagi Radix), Mai Men Dong (Ophiopogonis Radix) [treats Lung steaming heat], Chao Huang Bo (Phellodendri Cortex, stir-fried), Zhi Mu (Anemarrhenae Rhizoma) [treats Kidney steaming heat], Bie Jia (Testudinis et Carapacis et Plastrum, vinegar-processed), Di Gu Pi (Lycii Cortex) [treats bone-steaming fever]. Decoct in water and take.
Spontaneous sweating (Zihan) belongs to Qi deficiency; there are types due to Yang deficiency, dampness, and phlegm. Night sweating (Daohan) belongs to Blood deficiency; there are types due to Yin deficiency and fire.
Sweat is the fluid of the Heart. When the Heart moves, one feels startled and sweats. There are spontaneous sweating and night sweating. Spontaneous sweating occurs naturally after releasing the exterior, or in persons with weak constitutions where pathogenic factors such as wind, summerheat, dampness, and heat invade and injure the Defensive Qi (Wei Qi), causing the pores (Cou Li) to be loose, Yang Qi to escape outward, and sweat to flow out spontaneously. It may also occur due to sexual exhaustion or fright injuring the Heart Blood, causing sweat to leak out during sleep.
Dai Yun stated that night sweating refers to sweating during sleep; it does not occur when awake. When deeply asleep, sweat suddenly flows out, and stops upon waking, without recurring. This is unlike spontaneous sweating, which flows out naturally without time restriction.
For spontaneous sweating, ancient formulas use Yu Ping Feng San (Jade Windscreen Powder), using Huang Qi (Astragali Radix) to consolidate the exterior Qi and Bai Zhu (Atractylodis Macrocephalae Rhizoma) to dry internal dampness.
For night sweating, Dang Gui Liu Huang Tang (Six-Huang Decoction with Angelica) is used, employing Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), and Sheng Di Huang (Rehmanniae Radix) to tonify Yin and Blood, while Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), and Huang Bo (Phellodendri Cortex) clear internal fire. This demonstrates the ingenuity of formula composition by matching drugs to the condition.
For conditions such as Cold Damage (Shanghan), Wind-Dampness, and Damp-Warmth, there are specific chapters dedicated to their treatment.
For sweating caused by wind injuring the Stomach, consolidation is appropriate, using Gui Zhi Tang (Cinnamon Twig Decoction).
For sweating caused by summerheat and heat, clearing is appropriate, using Qing Shu Yi Qi Tang (Clear Summerheat and Tonify Qi Decoction).
For sweating caused by dampness steaming, drying is appropriate, using Qing Zao Tang (Clear Dryness Decoction).
For sweating caused by sexual exhaustion, warming and tonifying are appropriate, using Huang Qi Jian Zhong Tang (Astragalus Build the Middle Decoction).
For spontaneous sweating accompanied by dizziness and nausea due to rebellious phlegm, Fu Xiong Tang (抚芎 Decoction) is appropriate.
For Lou Feng syndrome (Wind Leakage), characterized by excessive sweating after drinking alcohol and being exposed to wind, and profuse sweating like washing during meals, Mu Li Bai Zhu San (Oyster Shell and Atractylodes Powder) is appropriate.
Formulas:
Yu Ping Feng San (Jade Windscreen Powder), treats spontaneous sweating.
Fang Feng (Saposhnikoviae Radix), Huang Qi (Astragali Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma).
Decoct in water and take.