《内经》云∶汗者心之液。又云∶阳加于阴谓之汗。由此推之，是阳热加于阴血，散于
外而为汗也。然有自汗盗汗之别焉。成无己云∶自汗者，不因发散而自汗出也；盗汗者，睡
而汗出也。因而思之，自汗盗汗，其一液也，其出异也。盗如盗窃之盗，窥人息而潜出，行
于阴也；自汗如自然之自，居常有而明显，见于阳也。皆因腠理空疏，卫护气虚，不能致密
收敛于表，虚则阳热泄焉。阳主动而散津液，走于肝，若阳蒸阳分而液出者为自汗，阳蒸阴
分而液出者为盗汗，由是内分阴阳之虚，外闭腠理之气，乃得其源也。皆由心肾俱虚以致此
。阴虚阳必凑，发热自汗；阳虚阴必乘，发厥而自汗。阴阳偏胜，有伤风中暑。故经云∶风
从外入，令人汗出头痛，身重恶寒，天热衣浓则为汗，天寒衣薄则为溺。病痹多汗而濡者，
其湿甚也。阴气有余为多汗身寒，阳气有余为身热无多，劳则气耗，喘且汗出。饮食饱甚，
汗出于胃；惊而夺精，汗出于心；持重远行，汗出于肾；疾走恐惧，汗出于肝；摇体劳苦，
汗出于脾。或人有热饮食下胃，其气未定汗则出，或出于面，或背或身，其不循胃气之道
出。此因伤于风，内开腠理，毛蒸理泄，卫气走之，固不得循其常道。此气剽悍而出，故不
得从其道，名曰漏泄。惊怖房劳，虚极痰饮，亦成此证。诊法尺脉涩滑谓之多汗，男子平人
脉虚细微者，善盗汗也。参之表里虚实之异其药，条列诸家方论者，察其所宜而用之。经言
有病身热解堕，汗出如浴，恶风少气，名曰酒风。长沙言∶太阳病头痛发热，汗出恶风者，
太阳病发汗，遂漏不止，其人恶风，小便难，四肢微急，难以屈伸者，太阳中热者， 是也
，汗出恶寒，身热而渴者，且太阳此五证，全在乎医于本经内药治之。当凉反热，当热反凉
，医之过欤。《金匮要略》曰∶风湿脉浮身重，汗出恶风者，除湿固腠理为先。东坦云∶饮
食劳倦皆自汗，当用甘温之剂，滋益皮毛之气，不合自汗损其元气也。暑邪干卫，故身热自
汗，当用清暑益气治之。《试效方》云；湿热大作，汗出不休，胜湿之剂，最为稳当。王海
藏云∶太阳自汗桂枝汤，阳明自汗白虎汤，少阴自汗四逆汤，阳明发热自汗多者大承气汤。
此皆内伤外感之邪，干卫而出也。此方论皆前人注立，后之学人识经络，用之取效，不明脉
理，错认经络，用之反祸不轻。其于盗汗，非若自汗，犹有实者，此则阳热侵行于蒸出，阴
液复越于表，是阴亏而表亦虚也。其汗因寝而至，寝则卫气亦行于里，觉则气散于表，而汗
止矣。故经曰∶太阳所至为寝汗，东坦谓太阳老阳也。太阳标有阳之名，无阳之实，以膀胱
之真寒为纯阴之气也。《兰室秘藏》治疗之证以黄 黄连生地黄当归之属，滋阴以制阳热，
静而汗止，此其论也。
《黄帝内经》说：汗是心的体液。又说：阳气作用于阴液就称为汗。由此推断，这是阳热之气加于阴血，发散到体外而成为汗。然而有自汗和盗汗的区别。成无己说：自汗，是不因发汗治疗而自然出汗；盗汗，是睡着时出汗。进而思考，自汗和盗汗，是同一种体液，但排出的方式不同。盗如同盗窃的“盗”，窥探人呼吸时潜出，行于阴分；自汗如同自然的“自”，平时常有且明显，见于阳分。这都是因为腠理（皮肤毛孔）疏松，卫气虚弱，不能在体表致密收敛，虚则阳热外泄。阳主动而散失津液，走窜于肝，如果阳热蒸腾阳分而液出的是自汗，阳热蒸腾阴分而液出的是盗汗，由此区分内部的阴阳虚损，外部的腠理闭塞之气，才能找到病源。这都是由于心肾两虚导致此症。阴虚则阳必凑集，发热自汗；阳虚则阴必乘袭，四肢厥冷而自汗。阴阳偏盛，有伤风中暑的情况。所以经书说：风从外部侵入，使人汗出头痛，身体沉重恶寒，天气炎热衣服厚则出汗，天气寒冷衣服薄则小便多。患痹证多汗且湿润的，是因为湿气很重。阴气有余导致多汗身寒，阳气有余导致身热但不多汗，劳累则耗气，气喘且出汗。饮食过饱，汗出于胃；受惊而耗损精气，汗出于心；负重远行，汗出于肾；快跑恐惧，汗出于肝；肢体摇动劳苦，汗出于脾。有人吃热食入胃，胃气尚未安定汗就出来，或出于面部，或背部或全身，这不遵循胃气正常之道而出。这是因为伤于风邪，内部开启腠理，毛发蒸腾腠理开泄，卫气游走，本来不能遵循其常道。这种气剽悍疾速而出，所以不能从其正道，名叫漏泄。惊恐、房劳过度，极度虚弱且有痰饮，也会形成此证。诊法中尺脉涩滑表示多汗，男子平人脉象虚细微小的，容易盗汗。参考表里虚实不同的情况，其用药各异，条列各家方论，观察适宜者而使用。经书说有病身热懈怠，汗出如浴，恶风少气，名叫酒风。长沙太守张仲景说：太阳病头痛发热，汗出恶风的，是太阳病发汗后，于是汗漏不止，其人恶风，小便困难，四肢轻微拘急，难以屈伸的，是太阳中热者，汗出恶寒，身热而渴的，以及太阳病的这五种证候，全在于医生在本经内用药治疗。应当凉反热，应当热反凉，是医生的过错吗？《金匮要略》说：风湿脉浮身体沉重，汗出恶风的，以除湿固护腠理为先。李东垣说：饮食劳倦导致的都是自汗，应当用甘温的药剂，滋益皮毛之气，不应当自汗损伤元气。暑邪侵犯卫气，所以身热自汗，应当用清暑益气汤治疗。《试效方》说：湿热大作，汗出不止，用胜湿的药剂，最为稳妥恰当。王好古说：太阳自汗用桂枝汤，阳明自汗用白虎汤，少阴自汗用四逆汤，阳明发热自汗多的用大承气汤。这些都是内伤外感的邪气，侵犯卫气而外出。这些方论都是前人注解确立的，后来的学人认识经络，使用它取得疗效，如果不明白脉理，错认经络，使用它反而祸害不轻。至于盗汗，不像自汗那样还有实证，这是阳热侵行蒸腾而出，阴液复越于体表，是阴亏而表亦虚。其汗因睡眠而至，睡眠时卫气也运行于体内，醒来则气散于体表，而汗就停止了。所以经书说：太阳所至为睡中出汗，李东垣认为太阳是老阳。太阳标有阳的名称，没有阳的实质，以膀胱的真寒为纯阴之气。《兰室秘藏》治疗此证的方剂以黄连、生地黄、当归之类，滋阴以制约阳热，静下来汗就停止，这是它的论述。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: Sweat is the fluid of the Heart. It also states: When Yang acts upon Yin, it is called sweat. From this, we can deduce that this is Yang-heat acting upon Yin-blood, dispersing to the exterior to become sweat. However, there is a distinction between spontaneous sweating (Zihan) and night sweating (Daohan). Cheng Wuji stated: Spontaneous sweating is sweating without the use of diaphoretic treatment; night sweating is sweating during sleep. Reflecting on this, spontaneous sweating and night sweating are the same fluid, but their exit differs. "Night" (Dao) is like theft, emerging stealthily when one breathes, moving within the Yin; "Spontaneous" (Zi) is like nature, always present and obvious, manifesting in the Yang. Both occur because the Couli (skin pores) are loose, and the Wei-Qi (Defensive Qi) is deficient, failing to consolidate and converge at the exterior. Deficiency leads to the leakage of Yang-heat. Yang moves and scatters body fluids, traveling to the Liver. If Yang-heat steams the Yang aspect causing fluid discharge, it is spontaneous sweating; if Yang-heat steams the Yin aspect causing fluid discharge, it is night sweating. Thus, by distinguishing internal Yin-Yang deficiency and external Couli closure, one finds the source. All these result from the deficiency of both the Heart and Kidney. Yin deficiency causes Yang to gather, leading to fever and spontaneous sweating; Yang deficiency causes Yin to invade, leading to cold extremities and spontaneous sweating. Yin-Yang excess involves wind-stroke and heatstroke. Therefore, the classics state: Wind entering from outside causes sweating, headache, heavy body, and aversion to cold; hot weather with thick clothes causes sweating, while cold weather with thin clothes causes increased urination. Patients with Bi syndrome often sweat and are damp due to severe dampness. Excess Yin leads to excessive sweating and cold body; excess Yang leads to hot body but not much sweating; labor consumes Qi, causing panting and sweating. Overeating causes sweat from the Stomach; fright depletes Essence, causing sweat from the Heart; carrying heavy loads and walking far causes sweat from the Kidneys; running fast and fearing causes sweat from the Liver; bodily exertion causes sweat from the Spleen. Sometimes, after eating hot food, sweat appears before the Stomach Qi settles, appearing on the face, back, or body, not following the normal path of Stomach Qi. This is because wind injury opens the Couli internally, hair steams, and Couli leak, causing Wei-Qi to wander, thus not following its usual path. This Qi is fierce and rapid, so it cannot follow its proper route, named "Lou Xie" (Leakage). Fright, sexual exhaustion, extreme deficiency, and phlegm-fluid retention can also cause this condition. In diagnosis, a choppy and slippery Chi pulse indicates excessive sweating; in men, a flat pulse that is deficient, fine, and minute indicates susceptibility to night sweating. Considering the differences in exterior-interior and deficiency-excess, their medications vary. Listing various schools' formulas and theories, one should observe suitability and use them. The classics mention a disease with hot body, flaccidity, profuse sweating like bathing, aversion to wind, and shortness of breath, named "Jiu Feng" (Wine Wind). Zhang Zhongjing of Changsha stated: Taiyang disease with headache, fever, sweating, and aversion to wind; after treating Taiyang with diaphoretics, sweating continues unceasingly, the person feels aversive to wind, has difficulty urinating, slight stiffness in the four limbs making flexion and extension difficult; this is Taiyang Heatstroke, characterized by sweating, aversion to cold, hot body, and thirst. These five Taiyang syndromes depend entirely on the physician treating them with appropriate herbs for the meridian. Should cooling be used when heat is indicated, or heating when cooling is indicated? This is the physician's fault. The *Jingui Yaolue* states: For wind-dampness with floating pulse, heavy body, sweating, and aversion to wind, removing dampness and consolidating Couli is the priority. Li Dongyuan stated: Self-sweating due to diet and fatigue should be treated with sweet-warm agents to nourish the Qi of skin and hair; one should not allow self-sweating to damage Yuan Qi. Summer-heat invading Wei-Qi causes hot body and spontaneous sweating, treated with Qing Shu Yi Qi Tang. The *Shixiao Fang* states: For severe damp-heat with continuous sweating, agents that overcome dampness are most appropriate. Wang Haocang stated: Taiyang spontaneous sweating uses Guizhi Tang; Yangming spontaneous sweating uses Baihu Tang; Shaoyin spontaneous sweating uses Sini Tang; Yangming fever with excessive spontaneous sweating uses Dachengqi Tang. These are all pathogens of internal injury and external contraction invading Wei-Qi and exiting. These formula theories were established by predecessors; later students who understand meridians can achieve efficacy using them. Those who do not understand pulse theory and misidentify meridians will cause serious harm. Regarding night sweating, unlike spontaneous sweating which may have excess patterns, this is caused by Yang-heat invading and steaming out, with Yin fluids overflowing to the exterior, indicating Yin deficiency and exterior deficiency. The sweat occurs during sleep; during sleep, Wei-Qi moves inward; upon waking, Qi disperses to the exterior, and sweating stops. Thus, the classics state: Taiyang manifestations include night sweating. Li Dongyuan considered Taiyang as Old Yang. Taiyang has the name of Yang but lacks the substance of Yang, regarding the true cold of the Bladder as pure Yin Qi. The *Lanshi Micang* treats this syndrome with agents such as Huanglian (Coptidis Rhizoma), Shengdihuang (Rehmanniae Radix), and Danggui (Angelicae Sinensis Radix) to nourish Yin and restrain Yang-heat, stopping sweat through stillness. This is its discussion.