疫邪自内蒸出于表，初起作寒热时，多自汗，甚至淋漓不止，不可以表虚论。兼头痛、身痛仍以解表为主，羌、
独、柴、葛之类。兼烦渴，直清阳明之热为主，白虎之类。有热、有结，破结为主，陷胸、三承气之类。若屡经
汗、下，邪已全退，脉虚而舌无苔，二便清利如常，内外
无热证，方可从虚敛汗。盖以时疫得汗，为邪有出路，而宜敛汗者，恒少也。
时疫初起盗汗者，邪在半表半里也。胸胁痞闷，达原饮；无痞闷，小柴胡汤。汗、下后，大热已退，有盗汗
者，余邪不尽也，小承气、小陷胸、吴氏承气养荣汤诸方，清其伏匿余邪，盗汗自止。
时疫不论初起、传变、末后，俱以战汗为佳兆。以战则邪正相争，汗则正逐邪出。然有透与不透之分。凡透
者，汗必淋漓，汗后身凉，口不渴，舌苔净，二便清，胸、腹、胁无阻滞、结痛，始为全解之战汗。否则余邪未
净而复热，则有再作战汗而解者；有战汗须三、四次而后解者，有战汗一次不能再战，待屡下而退者；有不能再
作战汗，即加沉困而死者，总视其本气之强弱何如耳。
凡战汗之时，不可服药。补则战止而汗不透，留邪为患；汗、下则太过，而成虚脱。应听战汗透彻，再
观脉证施治。当战时，或多与热汤饮之，助其作汗。战汗之时，
脉多停止，勿讶，待战汗之后，脉自见也。大抵战汗之脉以浮为佳，邪出于表也，虚、散、微、濡应有变，煎独参
汤以待之，防其脱也。贫者米饮聊代之，然必察其战后，系邪净而气欲脱，方可用。
凡战汗后，神静者吉，昏躁者危；气细者吉，气粗而短者危；舌萎不能言者死；目眶陷者死；目转运者死；
戴眼反折者死；形体不仁，水浆不下者死。
战汗虽为佳兆，亦有吉凶。得战汗固由治得其宜，邪退正复而致，然不可强也。尝见服大发汗药毫不得汗，而
饮冷水得汗者；又有用下药得战汗者；凉血活血得战汗者；生津益气得战汗者，种种不一。当知战汗
乃阴阳交和，表里通达，自然而然，非可强致也。
疫邪从体内蒸腾外达于体表，在疾病初起出现寒热交替时，常伴有自汗，甚至出汗淋漓不止，这种情况不能简单地按照表虚证来论治。如果兼有头痛、身体疼痛，治疗仍以解表为主，可用羌活、独活、柴胡、葛根这类药物。如果兼有烦躁口渴，治疗应以直接清泄阳明经的热邪为主，可用白虎汤这类方剂。如果既有热邪又有积结，治疗应以破除积结为主，可用陷胸汤、三承气汤这类方剂。如果经过多次发汗或攻下治疗后，病邪已经完全消退，脉象虚弱且舌上没有苔垢，大小便通畅正常，体内和体外都没有热证表现，才可以按照虚证来收敛止汗。这是因为时疫（瘟疫）得到汗出，是病邪有了出路，而需要收敛止汗的情况，通常是很少见的。
时疫初起出现盗汗的，说明病邪位于半表半里之间。如果伴有胸胁部痞塞闷胀感，用达原饮；如果没有痞塞闷胀感，用小柴胡汤。在发汗或攻下之后，大热已经退去，但仍有盗汗的，这是余邪未尽的表现，可用小承气汤、小陷胸汤、吴氏承气养荣汤等方剂，清除潜伏隐匿的余邪，盗汗自然就会停止。
时疫无论处于初起、传变还是末期阶段，凡是出现战汗（先寒战而后汗出），都是佳兆。因为“战”意味着正气与邪气相互抗争，“汗”意味着正气驱逐邪气外出。然而，这其中有病邪能否彻底透达的区别。凡是能够透达的，出汗必定淋漓畅达，出汗后身体凉爽，口不渴，舌苔干净，大小便清利，胸、腹、胁肋部没有阻滞感和结痛感，这才算是完全解除的病邪之战汗。否则，如果余邪未净而再次发热，有的会再次发生战汗而痊愈；有的需要经历三到四次战汗才能痊愈；有的战汗一次后不能再战，需等待多次攻下后才能退邪；有的不能再发生战汗，随即出现神志沉困而死亡的，总的来看，这取决于患者本气的强弱程度如何。
凡是在战汗的时候，不可服药。如果服用补药，会导致战栗停止而汗出不透，留滞病邪成为祸患；如果此时再用发汗或攻下法，则过于猛烈，会导致虚脱。应当听任战汗透彻完成，然后再观察脉象和症状进行施治。在将要战栗的时候，可以多给患者喝些热汤，以助其发汗。在战汗的时候，脉搏常常会出现暂时停止的现象，不要惊讶，等到战汗结束后，脉象自然会显现出来。大致来说，战汗时的脉象以浮脉为佳，表示邪气出于体表；如果出现虚、散、微、濡等脉象，应有变化，可煎煮独参汤来等待救治，以防正气虚脱。贫穷者可以用米汤稍微代替，但必须观察战汗之后，确认是邪气已尽而气欲脱，才可以使用。
凡是战汗之后，神志安静的为吉，神志昏乱烦躁的为危；呼吸细微的为吉，呼吸粗重短促的为危；舌体萎缩不能言语的属死证；眼眶凹陷的属死证；眼球固定转动的属死证；眼睛上翻、角弓反张的属死证；形体麻木不仁、水浆饮食不能入口的属死证。
战汗虽然被视为佳兆，但也有吉凶之分。能得到战汗固然由于治疗得当，邪气退去、正气恢复所致，但不能强行追求。我曾见过服用大发汗药却丝毫不得汗，而饮用冷水反而得汗的；又有使用攻下药而引发战汗的；使用凉血活血药而引发战汗的；使用生津益气药而引发战汗的，情况种种不一。应当知道，战汗乃是阴阳交合调和、表里通达的结果，是自然而然发生的，并非可以强行导致的。
When the epidemic pathogen steams out from the interior to the exterior, during the initial onset of alternating chills and fever, spontaneous sweating (Zihan) often occurs, sometimes even profuse and unceasing. This condition should not be simply diagnosed as Exterior Deficiency (Biaoxu). If accompanied by headache and body pain, treatment should primarily focus on releasing the exterior (Jiebiao), using herbs such as Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Chaihu (Bupleuri Radix), and Gegen (Puerariae Lobatae Radix). If accompanied by irritability and thirst, treatment should primarily focus on directly clearing heat in the Yangming channel (Yangming Zhi Re), using formulas like Baihu Tang (White Tiger Decoction). If there is both heat and accumulation/obstruction, treatment should primarily focus on breaking up the obstruction, using formulas like Xianxiong Tang (Chest-Collapsing Decoction) or the three Chengqi Decoctions (San Chengqi Tangs). Only after repeated sweating or purging treatments, when the pathogen has completely retreated, the pulse is deficient, the tongue lacks coating, urination and defecation are clear and normal, and there are no signs of heat inside or outside, can one treat it as a deficiency syndrome to astringe sweat. This is because in epidemics, sweating indicates an exit for the pathogen, and cases requiring astringent treatment for sweat are relatively rare.
When spontaneous sweating (Daohan) occurs at the initial stage of an epidemic, it indicates that the pathogen is located in the half-exterior, half-interior (Banbiao Banli) region. If accompanied by fullness and oppression in the chest and hypochondrium, Daoyin Yin (Daren Decoction) should be used; if there is no fullness or oppression, Xiaochaihu Tang (Minor Bupleurum Decoction) should be used. After sweating or purging, if high fever has subsided but night sweats (Daohan) persist, this indicates incomplete clearance of residual pathogens. Formulas such as Xiaochengqi Tang (Minor Cactus Decoction), Xiao Xianxiong Tang (Minor Chest-Collapsing Decoction), or Wu's Chengqi Yangying Tang (Wu's Cactus Nourishing Nutrient Decoction) can be used to clear the latent residual pathogens, after which the night sweats will naturally cease.
Regardless of whether the epidemic is in its initial, progressing, or terminal stage, the occurrence of Zhanshan (Shivering Sweat) is generally considered a favorable sign. "Shivering" signifies the struggle between healthy qi and the pathogen, while "sweating" signifies healthy qi driving the pathogen out. However, there is a distinction between complete penetration and incomplete penetration. In cases of complete penetration, sweating is profuse and continuous; after sweating, the body becomes cool, there is no thirst, the tongue coating is clean, urination and defecation are clear, and there is no obstruction or painful knotting in the chest, abdomen, or hypochondrium. This constitutes a complete resolution via shivering sweat. Otherwise, if residual pathogens remain and fever recurs, some patients may resolve through subsequent shivering sweat episodes; some may require three or four episodes of shivering sweat to resolve; some may have only one episode of shivering sweat and cannot repeat it, requiring repeated purging to eliminate the pathogen; some may be unable to produce further shivering sweat and succumb to lethargy and death. Ultimately, the outcome depends on the strength of the patient's original qi (Benqi).
During the phase of shivering sweat, medication should not be administered. Administering tonics will stop the shivering but prevent thorough sweating, leaving the pathogen behind to cause harm; administering excessive sweating or purging methods will lead to collapse due to deficiency. One should allow the shivering sweat to proceed thoroughly before observing the pulse and symptoms to determine treatment. During the pre-shivering phase, providing warm water or broth can help induce sweating. During shivering sweat, the pulse may temporarily cease; do not be alarmed, as the pulse will reappear after the sweating episode. Generally, a floating pulse (Fu Mai) during shivering sweat is auspicious, indicating the pathogen emerging to the exterior. Changes such as deficient, scattered, minute, or soggy pulses may occur; in such cases, prepare Danshen Tang (Single Ginseng Decoction) in anticipation, to prevent collapse. For those with limited means, rice water can serve as a substitute, but it must be confirmed after the shivering sweat that the pathogen is cleared and qi is about to collapse before use.
After shivering sweat, quiet spirit indicates good prognosis, while confusion and restlessness indicate danger; fine breathing indicates good prognosis, while coarse and short breathing indicates danger; a flaccid tongue unable to speak indicates death; sunken eye sockets indicate death; fixed or rolling eyes indicate death; upward staring eyes and opisthotonos (back arching) indicate death; numbness of the body and inability to take fluids or food indicate death.
Although shivering sweat is generally a favorable sign, it can also indicate either good or bad outcomes. The occurrence of shivering sweat is indeed due to appropriate treatment, leading to the retreat of the pathogen and recovery of healthy qi, but it cannot be forced. I have observed cases where potent diaphoretics failed to induce sweat, yet cold water induced it; cases where purgatives induced shivering sweat; cases where blood-cooling and blood-invigorating agents induced shivering sweat; and cases where fluids-generating and qi-nourishing agents induced shivering sweat. These situations vary widely. It must be understood that shivering sweat is the natural result of the harmony of yin and yang and the free flow between the interior and exterior; it cannot be artificially forced.