（附盗汗 头汗 手足汗 无汗 不得汗）
卫气者护卫皮肤肥实腠理禁固津液不得妄泄邪气干之则不能卫固于外由是津液妄泄 然润 然出不因发散而
自汗出也伤风则发热自汗中 则汗出恶风而渴风湿甚者则汗多而濡是风与暑湿为邪皆令自汗惟寒邪伤荣而不伤卫是以
肤腠闭密汗不出也始虽无汗及传入里而为热则荣卫通腠理开亦令汗自出矣自汗又有表里之别虚实之异若汗出恶风及微
恶寒者皆表未解宜发散至于漏不止而恶风及发汗后恶寒者表虚也宜温之此皆邪气在表若汗出不恶风寒者此表解里病下
之则愈如阳明发热汗出此为热越及阳明发热汗多急下之者是也自汗虽常证或汗出发润如油如贯珠着身不流皆为不治必
手足俱周遍身悉润 然一时汗出热已身凉乃为佳兆
身热汗出恶寒属表
病常自汗出者此为荣气和荣气和者外不谐以卫气不共荣气和谐故尔以荣行脉中卫行脉外复发其
汗荣卫和则愈宜桂枝汤（风则伤卫寒则伤荣卫受风邪而荣不病者为荣气和也卫既客邪则不能与荣气和谐亦不能卫护皮腠
是以常自汗出与桂枝汤解散风邪调和荣卫则愈 余详见前太阳病条）兼项强痛者桂枝加葛根汤（项强）兼骨节烦疼不得
屈伸小便不利者甘草附子汤（论见风湿身热条）
若发汗后遂漏不止恶风者桂枝附子汤（论见后条）汗出而渴者五苓散不渴者茯苓甘草汤
活人云伤风自汗桂枝汤难用须子细消息之假令伤风自汗若脉浮而弱设当行桂枝服汤后无桂枝脉息证候而烦者即不
可再服也若伤风自汗出而小便数者切不可与桂枝也又太阳病自汗四肢拘急难以屈伸若小便难者可桂枝汤内加附子服之
若小便数者慎不可与桂枝附子汤宜服芍药甘草汤若误行桂枝附子攻表便咽干烦躁厥逆呕吐作甘草干姜汤与之以复其阳
若厥愈足温更作芍药甘草汤与之其脚即伸
赵 有发汗漏风小便难与自汗小便数二证相近似温仲景亦恐后人误认故重出一章问答以明之前一证云太阳病发
汗
遂漏不止其人恶风小便难四肢微急难以屈伸桂枝附子汤主之盖是因邪发汗遂漏不止乃服汗药太过非自汗也恶风者余邪
未尽也小便难四肢急为亡津液筋失所养也乃汗多亡阳外虚经气病带表邪不在里也故宜附子温经桂枝解表芍药益血舒筋
也此又一证云盖是脉浮为虚也汗自出微恶寒者阳虚无以卫外也小便数为下焦虚寒不能制水也心烦为阴虚血少也脚挛急
乃血为汗夺筋无以润养也此初得病便自表里俱虚外无阳证病不在表固不得与桂枝同法设若误用桂枝攻表重发其汗是虚
虚也固得之便厥咽干烦躁吐逆厥为亡阳不能与阴相顺接咽干为津液寡烦躁吐逆为寒格而上也故宜干姜以温里复阳甘草
芍药益其汗夺之血然后可以复阴阳不足之气得脚伸后或谵语者由自汗小便数胃中先自津液干少又服干姜性燥之药以致
阳明内结谵语虽然非邪实大满故但用调胃承气以调之仍少与之也原其芍药甘草汤乃是厥愈足温后专治两胫挛急之药非
正治脉浮自汗出小便数之药也今活人书却云芍药甘草汤主脉浮自汗出小便数者何也又云通治误服桂枝汤后病证仍存者
愚不知病证何似可用如上仲景药法盖尝复玩味而细绎焉自常人观之岂不曰自汗小便数证又无自利遽用干姜温之因而以
致结燥谵语后却用芒硝大黄寒药以解其热似若失次病家遇此必咎医者以为误用干姜热燥之失后药先解之差矣殊不知仲
景之意不患乎干姜之热燥惟患乎正气之虚正气之长邪气之所由消也且自汗小便数等证为表里俱虚治法必先复其阴阳不
足之正气然非干姜芍药甘草不可至于正气阴阳已复而内有所主则虽胃燥谵语不过大便内结大黄芒硝润滑而去之而正气
内强不至下脱结燥而正气安矣以上用药次第先热后寒先补后泻似逆而实顺非仲景之妙孰能至是哉后之学人可不以此推
广而应变又何暇辩病家之谬谤也耶
若夏月中暑自汗身热恶寒脉微弱口渴足冷者白虎加人参汤主之（治法详见杂病中暑门）
身热汗出不恶寒属里为阳明本证
问曰阳明外证云何答曰身热汗自出不恶寒反恶热也（大承气汤）问曰病有得之一
日不发热而恶寒何也答曰虽得之一日恶寒将自罢即自汗出而恶热也问曰恶寒何故自罢答曰阳明居中土也万物所归无所
复传始虽恶寒二日自止此为阳明病也 伤寒转属阳明者其人 然微汗出也（中风则有汗伤寒无汗惟入阳明乃有汗故经曰
阳明病法多汗）
兼便硬谵语者下之
汗出身热不恶寒便硬谵语者宜承气汤（论见谵语）阳明病发热汗多者急下之宜大承气汤
许 有人患伤寒目痛鼻干不得卧大便不通尺寸脉俱大已数日一夕汗出予谓速以大柴胡汤下之医骇曰阳明自汗津
液
已涸法当用蜜煎何须苦用下药予谓曰子虽知蜜煎为稳当还用大柴胡汤此仲景不传之妙公安能知之予力争竟投大柴胡汤
二帖愈仲景论阳明之病多汗者急下之人多谓已是自汗若又下之岂不表里俱虚又如论少阴云少阳病一二日口干燥者急下
之人多谓病发于阴得之日浅但见干燥若更下之岂不阴气愈甚举此二端则其可疑者不可胜数此仲景之书世人罕能读也予
谓仲景称急下之者亦犹急当救表急当救里之说凡称急者有三变谓才觉汗未至津液干燥便速下之则为精捷免致用蜜煎也
若胸中识得了了自无可疑若未能了误用之反不若蜜煎之为稳也
兼脉浮紧口苦者忌汗不针宜和解
阳明病脉浮而紧咽燥口苦腹满而喘发热汗出不恶寒反恶热身重若发汗则心愦愦
反谵语若加烧针必怵惕躁不得眠若下则胃中空虚客气动膈心中懊 舌上有苔者栀子豉汤主之若渴欲饮水口干舌燥者白
虎加人参汤主之若脉浮发热渴欲饮水小便不利者猪苓汤主之（注云脉浮发热口苦者邪在表脉紧自汗腹满不恶寒者邪在里
此表里俱有邪宜和解）
兼小便不利者分欲食不欲食
阳明欲食小便反不利大便自调其人骨节疼翕翕如有热状奄然发狂 然汗出而解此水
不胜谷气与汗共并脉紧则愈（桂枝汤羌活汤之类）阳明病若中寒不能食小便不利手足 然汗出此欲作痼瘕必大便初硬后
溏以胃中冷水谷不别故也（浓朴生姜甘草半夏人参汤吴茱萸汤理中汤之类）
兼心下痞
汗出心下痞满有二证其痞按之濡软不通而恶寒者宜附子泻心汤其痞按之硬引胁痛而身体不恶寒者宜十
枣汤（方论见痞门）
兼下利
汗出下利热不去厥逆恶寒者四逆汤 下利清谷者通脉四逆汤 汗出下利有微热者其脉数自愈脉紧未愈
六七日后发热而利其人汗出不止者死（俱见下利）
兼吐利
脉紧反汗出而咽痛吐利者少阴病亡阳 吐利汗出手足厥冷脉微欲绝四逆汤 吐利止汗出而厥脉微欲绝者
通脉四逆加猪胆汁汤（俱见吐利）
海 太阳自汗桂枝汤 阳明自汗白虎汤 少阴自汗四逆汤
阳明证身热目痛鼻干不得卧不恶寒而自汗或恶热而尺寸俱浮者白虎汤主之 伤寒尺寸脉俱长自汗大出身表如冰石
脉传至于里细而小及疟疾但寒不热其人动作如故此阳明传入少阴戊合癸即夫传妇也白虎加桂枝主之然脉虽细小当以迟
疾别之此证脉疾而非迟故用此法（白虎加桂枝汤方见杂病疟门如中暑自汗微恶寒者亦宜服之）
活 伤寒应发汗而动气在左不可发汗发汗则头眩汗出筋惕肉 此为逆难治先服防风白术牡蛎散次服建中汤
防风白术牡蛎散 治发汗多头眩汗出筋惕肉
防风 牡蛎（炒成粉） 白术（各等分）上为细末每服二钱以酒调下米饮亦得日二三服汗止后服小建中汤
集 伤寒汗多不止 内庭（泻） 合谷（泻） 复溜（泻）
似阳明外证
太阳病吐后汗出不恶寒发热关上脉细数曰小逆（吐后似阳明而关脉细）太阳病发热汗出不恶寒者为柔
痉（柔痉似阳明而身反张）发汗已身灼热者名风温 风温为病脉浮汗出身重多眠
汗吐下后自汗
二阳并病太阳初得病时发其汗汗先出不彻因转属阳明续自微汗出不恶寒若太阳证不罢者不可下下
之为逆如此可小发汗设面色缘缘正赤者阳气怫郁在表当解之熏之若发汗不彻不足言阳气怫郁不得越当汗不汗其人躁烦
不知痛处乍在腹中乍在四肢按之不可得其人短气但坐以汗出不彻故也更发汗则愈何以知汗出不彻以脉涩故知也（成 太
阳病未解传并入阳明而太阳证未罢者名曰并病续自微汗出不恶寒者为太阳证罢阳明证具也法当下之若太阳证未罢者为
表未解则不可下当小发其汗先解表也阳明之脉循面面色缘缘正赤者阳气怫郁在表也当解之熏之以取其汗若发汗不彻者
不足言阳气怫郁止是当汗不汗阳气不得越散邪无从出拥甚于经故躁烦也邪循经行则痛无常处或在腹中或在四肢按之不
可得而短气但责以汗出不彻更发汗则愈内经曰诸过者切之涩者阳气有余为身热无汗是以脉涩知阳气拥郁而汗出不彻○
凡经文言或言若言设言假令者皆更端之词即成氏所谓或为之证也○不彻不足言正与可小字相反○因太阳故当汗因并阳
明故当小发先字最有次第仲景之枢机也）下后不可更行桂枝汤若汗出而喘无大热者与麻黄杏仁甘草石膏汤 发汗后不可
更行桂枝汤汗出而喘无大热者麻黄杏仁甘草石膏汤 服桂枝大汗出脉洪大者仍与桂枝若形如疟日再发者汗出必解桂枝
二麻黄一汤 太阳病发汗后大汗出胃中干燥不得眠欲饮水者少少与之胃和则愈若脉浮小便不利微热消渴者五苓散 伤
寒五六日呕而发热柴胡证具而以他药下之柴胡证仍在者复与柴胡汤虽下之不为逆必蒸蒸而振发热汗出而解 太阳病桂
枝证医反下之利遂不止脉促者表未解也喘而汗出者葛根黄连黄芩汤主之（成 经言不宜下而便攻之内虚热入挟热遂利桂
枝证者邪在表也而反下之虚其肠胃为热所乘遂利不上邪在表则见阳脉邪在里则见阴脉下利脉微迟邪在里也促为阳盛虽
下利而脉促者知表未解也病有汗出而喘者为自汗而喘也即邪气外甚所致喘而汗出者为因喘而汗出也即里热气逆所致与
葛根黄连黄芩汤以散表邪除里热○清肌脉促有此证者宜用此方厥阴证脉促手足厥即以当归四逆汤加吴茱萸主之）脉浮数
者法当汗出而愈若下之身重心悸者不可发汗当自汗出乃解所以然者尺中脉微此里虚须表里实津液自和便自汗出愈（成
经云诸脉浮数当发热而淅洒恶寒言邪气在表也是当汗出愈若下之身重心悸者损其津液虚其胃气若身重心悸而尺脉实者
则下后里虚邪气来虚传里也今尺脉微身重心悸者知下后里虚津液不足邪气不传里但在表也然以津液不足则不可发汗须
里气实津液足便自汗出而愈○宜麻黄汤桂枝加白术茯苓甘草汤下后桂枝加芍药汤）太阳病当恶寒发热今自汗出不恶寒发
热关上脉细数者以医吐之过也（详发热）太阳病寸缓关浮尺弱其人发热汗出恶寒不呕但心下痞者此以医下之也如不应下
病患不恶寒而渴者此转属阳明渴欲饮水少少与之宜五苓散 伤寒大吐大下之极虚复极汗出者以其人外气怫郁复与之水
以发其汗因得哕所以然者胃中寒冷故也（详哕）
亡阳
伤寒脉浮医以火迫劫之亡阳必惊狂起卧不安者桂枝去芍药加蜀漆牡蛎龙骨救逆汤主之 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桂枝加附子汤主之 发汗多若重发汗亡其阳谵语脉短者死脉自和者不死（亡阳胃
燥谵语者脉短津液已绝不可复治脉自和为正气未衰而犹可生也○宜小柴胡加桂）脉阳微而汗出少者为自和也汗出多者为
太过阳脉实因发其汗出多者亦为太过太过为阳绝于里亡津液大便因硬也 少阴病脉微不可发汗亡阳故也阳已虚尺脉弱
涩者复不可下之（脉微为亡阳表虚不可发汗脉弱涩为亡阴里虚复不可下宜桂枝芍药炙甘草汤四逆汤）病患脉阴阳俱紧反
汗出者亡阳也此属少阴法当咽痛而复吐利（或用桂枝加干姜汤四逆汤）
盗汗
盗汗者谓睡而汗出也方其睡熟凑凑然出觉则止而不复出矣（睡则胃气行里表中阳气不致故津液得泄觉则气行
于表而汗止矣）杂病盗汗责其阴虚伤寒盗汗由邪气在半表半里使然也若邪气在表则又谓之自汗矣经曰微盗汗出反恶寒者
表未解也又阳明当作里实而脉浮者云必盗汗是犹有表邪也又三阳合病目合则汗是知盗汗邪在表里之间而悉属和解明矣
非若自汗有表里虚实之别也 太阳病脉浮动数头痛发热微盗汗出反恶寒者表未解也（详见结胸）阳明病脉浮而紧必潮热
发作有时但浮者必盗汗出（活人云脉浮盗汗黄芩汤或柴胡姜桂汤桂枝茯苓白术汤）三阳合病脉浮大上关上但欲眠睡目合
则汗（成 关脉以候少阳之气太阳之脉浮阳明之脉大脉浮上关上知三阳合病胆热则睡少阴病但欲眠睡目合则无汗以阴不
得有汗但欲眠睡目合则汗知三阳合病胆有热也小柴胡汤泻心汤 张 或谓此证俱属少阳篇中亦可用小柴胡否答曰可用
夫三阳合病其邪发见于脉也浮者太阳也大者阳明也上关上者少阳也但欲眠睡目合则汗此胆有热脉证相符故出于少阳篇
下盖浮脉无证不可汗大脉无证不可下浮大之脉俱上关知三阳合病而热在胆也然胆居在半表半里用小柴胡亦当）
头汗
头乃诸阳之会热蒸于阳故但头汗出也三阴无头汗其经不上头故也遍身有汗谓之热越但头汗出而身无汗者热
卫气具有护卫皮肤、充实腠理、固摄津液防止其妄泄的功能。若邪气侵犯，导致卫气不能在外固护，津液就会妄泄。然而这种润湿般的出汗，并非因发散药力而致，而是自然出汗。伤风则发热并自汗；中湿则汗出、恶风且口渴；风湿严重者则汗多且身体濡湿。风与暑湿为邪，皆会导致自汗。唯独寒邪伤及营气而不伤卫气，因此肌肤腠理闭密，不出汗。起初虽然无汗，但若病邪传入体内化为热，则营卫通畅、腠理开泄，也会令汗自然流出。
自汗又有表证与里证的区别，以及虚证与实证的差异。若汗出伴有恶风或轻微恶寒，说明表证未解，适宜用发散法治疗。至于汗漏不止且恶风，或发汗后出现恶寒，属于表虚，适宜用温补法。这些情况都是邪气在表。若汗出但不恶风寒，说明表证已解，是里证，通过攻下即可痊愈。例如阳明病发热汗出，这是热势向外发散；以及阳明病发热汗多，需要紧急攻下的情况，就是此类。自汗虽然是常见症状，但如果汗出如油、如串珠般附着在身上且不流动，都属于不治之症。必须等到手足周身完全湿润，片刻之后汗出停止、身体转凉，这才是佳兆。
身热、汗出、恶寒，属于表证。
病人经常自汗出，这是因为营气平和，但营气与外界不协调，由于卫气不能与营气和谐共处所致。营气行于脉中，卫气行于脉外。此时应再次发汗，待营卫调和则痊愈，宜用桂枝汤。（风邪伤卫，寒邪伤营。卫受风邪而营气未病，称为“营气和”。卫气既被邪气客居，就不能与营气和谐，也不能护卫皮腠，所以经常自汗出。给予桂枝汤以解散风邪、调和营卫，即可痊愈。其余详细内容见前文太阳病条。）兼有项背强痛者，用桂枝加葛根汤（主治项强）。兼有关节烦疼、屈伸不利、小便不利者，用甘草附子汤（论述见风湿身热条）。
若在发汗后出现汗漏不止、恶风，用桂枝附子汤（论述见后文条）。汗出且口渴者，用五苓散；不渴者，用茯苓甘草汤。
《活人书》说：伤风自汗，使用桂枝汤需谨慎斟酌。假如伤风自汗，若脉象浮而弱，假设应当服用桂枝汤，服药后若无桂枝汤证候反而出现烦躁，就不可再服用。如果伤风自汗且小便频数，切不可给予桂枝汤。另外，太阳病自汗、四肢拘急难以屈伸，若小便困难，可在桂枝汤中加入附子服用。若小便频数，则严禁使用桂枝附子汤，宜服用芍药甘草汤。如果误用桂枝附子汤攻表，导致咽干、烦躁、四肢厥逆、呕吐，应给予甘草干姜汤以恢复阳气。若四肢回暖，再给予芍药甘草汤，脚部即可伸展。
赵氏指出：有发汗后汗漏不止伴小便难，与自汗伴小便数这两个证候相近似。张仲景也担心后人误认，故专门重出一章问答以阐明区别。前一证说：太阳病发汗，遂致汗漏不止，其人恶风，小便难，四肢微急难以屈伸，主方为桂枝附子汤。这是因为因邪气发汗，导致汗漏不止，乃是因为服汗药太过，并非自汗。恶风是因为余邪未尽。小便难、四肢急是因为亡失津液，筋脉失去滋养。这是汗多亡阳，外虚经气病变，带有表邪，不在里。所以适宜用附子温经，桂枝解表，芍药益血舒筋。
另一证说：脉浮为虚，汗自出、微恶寒，是因为阳虚无以卫外。小便数为下焦虚寒不能制约水液。心烦为阴虚血少。脚挛急是因为血液被汗夺去，筋脉无以润养。此证初得病便表里俱虚，外无阳证，病不在表，固然不能用桂枝汤同法治疗。如果误用桂枝汤攻表，重新发汗，这就是“虚虚”之误，必然导致四肢厥冷、咽干、烦躁、吐逆。厥冷是因为亡阳，阴阳不能顺接；咽干是因为津液匮乏；烦躁吐逆是因为寒格于上。所以适宜用干姜温里复阳，甘草、芍药补充被汗夺去的血液，然后可以恢复阴阳不足之气。待脚伸展后，如果出现谵语，是因为自汗和小便数导致胃中津液先已干燥，又服用了性燥的干姜，致使阳明内结谵语。虽然这不是邪实大满，但仍需用调胃承气汤来调理，且要少量给予。
追溯其源，芍药甘草汤乃是四肢厥逆缓解、足温后，专门治疗两小腿拘急的药物，并非正治脉浮、自汗出、小便数的药物。如今《活人书》却说芍药甘草汤主治脉浮、自汗出、小便数，又说通治误服桂枝汤后病证仍存的情况。我不明白病证究竟如何才可用上述仲景的药法。我曾反复玩味细绎：从常人看来，难道不是说自汗小便数等证，又没有下利，就急于用干姜温之，因而导致结燥谵语，后来却用芒硝、大黄等寒药来解热，似乎次序颠倒？病家遇到这种情况，必定责怪医生误用干姜热燥之失，而后药先解之差矣。殊不知仲景之意，不怕干姜的热燥，只怕正气虚弱。正气的增长是邪气消除的原因。而且自汗、小便数等证属于表里俱虚，治法必须先恢复其阴阳不足的正气，非干姜、芍药、甘草不可。至于正气阴阳已复，体内有所主宰，那么即使胃燥谵语，也不过是大便内结，用大黄、芒硝润滑而去之，而正气内强，不至于因下法而脱失，结燥解除而正气安宁。以上用药次第，先热后寒，先补后泻，看似逆序实则顺理，若非仲景之妙，谁能达到如此境界？后之学人可不据此推广应变，又何暇辩驳病家的谬误诽谤呢？
如果在夏季中暑，出现自汗、身热、恶寒、脉微弱、口渴、足冷者，主方为白虎加人参汤（治法详见杂病中暑门）。
身热、汗出、不恶寒，属于里证，为阳明本证。
问：阳明外证是什么？答：身热、汗自出、不恶寒反恶热。（大承气汤）
问：有的病得之一日，不发热而恶寒，为什么？答：虽然得病一日恶寒，但很快会自行停止，随即自汗出而恶热。
问：恶寒为何会自行停止？答：阳明居中属土，万物所归，无所复传。开始虽恶寒，二日后自止，此为阳明病。
伤寒转属阳明者，其人濈然微汗出。（中风则有汗，伤寒无汗，只有入阳明才有汗，所以经文说“阳明病法多汗”）。
兼有大便硬、谵语者，宜攻下。
汗出身热、不恶寒、大便硬、谵语者，宜用承气汤（论述见谵语条）。阳明病发热汗多者，需紧急攻下，宜用大承气汤。
许氏记载：有人患伤寒，目痛、鼻干、不得卧、大便不通，寸关尺脉俱大，已数日。一夕汗出，我谓速以大柴胡汤攻下。医生惊骇说：“阳明自汗，津液已枯竭，法当用蜜煎导，何须苦用下药？”我说：“你虽知蜜煎稳妥，但还是应用大柴胡汤，这是仲景不传之妙，你怎能知道？”我极力争辩，最终投予大柴胡汤两帖而愈。仲景论阳明病多汗者急下，世人多认为已是自汗，若又下之，岂不表里俱虚？又如论少阴云：“少阳病一二日口干燥者急下”，世人多认为病发于阴，得之日浅，仅见干燥，若更下之，岂不阴气愈甚？举此两端，可疑者不可胜数，这是仲景之书世人罕能读懂的缘故。我认为仲景称“急下之”，也如同“急当救表”、“急当救里”的说法。凡称“急”者有三变：谓刚觉汗出未到津液干燥时，便速下之，则为精捷，免致用蜜煎。若胸中识得了了，自无可疑；若未能明了，误用之，反而不如蜜煎稳妥。
兼有脉浮紧、口苦者，忌用汗法和针法，宜和解。
阳明病脉浮而紧，咽燥口苦，腹满而喘，发热汗出，不恶寒反恶身重。若发汗则心愦愦反谵语；若加烧针必怵惕躁不得眠；若下则胃中空虚，客气动膈，心中懊憹，舌上有苔者，栀子豉汤主之。若渴欲饮水，口干舌燥者，白虎加人参汤主之。若脉浮发热，渴欲饮水，小便不利者，猪苓汤主之。（注云：脉浮发热口苦者邪在表，脉紧自汗腹满不恶寒者邪在里，此表里俱有邪，宜和解）。
兼有小便不利者，分欲食与不欲食两种情况。
阳明病欲食，小便反不利，大便自调，其人骨节疼，翕翕如有热状，奄然发狂，濈然汗出而解，此为水不胜谷气，与汗共并，脉紧则愈（可用桂枝汤、羌活汤之类）。阳明病若中寒不能食，小便不利，手足濈然汗出，此欲作痼瘕，必大便初硬后溏，因为胃中冷水，谷肉不分故也（可用浓朴生姜甘草半夏人参汤、吴茱萸汤、理中汤之类）。
兼有心下痞。
汗出心下痞满有二证：其痞按之濡软不通且恶寒者，宜附子泻心汤；其痞按之硬引胁痛且身体不恶寒者，宜十枣汤（方论见痞门）。
兼有下利。
汗出下利，热不去，厥逆恶寒者，四逆汤；下利清谷者，通脉四逆汤；汗出下利有微热者，其脉数自愈，脉紧未愈；六七日后发热而利，其人汗出不止者死（俱见下利条）。
兼有吐利。
脉紧反汗出而咽痛吐利者，少阴病亡阳；吐利汗出手足厥冷脉微欲绝者，四逆汤；吐利止汗出而厥脉微欲绝者，通脉四逆加猪胆汁汤（俱见吐利条）。
海藏云：太阳自汗用桂枝汤，阳明自汗用白虎汤，少阴自汗用四逆汤。
阳明证身热、目痛、鼻干、不得卧、不恶寒而自汗，或恶热而尺寸俱浮者，白虎汤主之。伤寒尺寸脉俱长，自汗大出，身表如冰石，脉传至于里细而小，及疟疾但寒不热，其人动作如故，此为阳明传入少阴，戊合癸即夫传妇也，白虎加桂枝主之。然脉虽细小，当以迟疾别之，此证脉疾而非迟，故用此法（白虎加桂枝汤方见杂病疟门，如中暑自汗微恶寒者亦宜服之）。
活人书云：伤寒应发汗而动气在左，不可发汗，发汗则头眩、汗出、筋惕肉瞤，此为逆，难治。先服防风白术牡蛎散，次服建中汤。
防风白术牡蛎散：治发汗过多头眩、汗出、筋惕肉瞤。
防风、牡蛎（炒成粉）、白术（各等分）。上为细末，每服二钱，以酒调下，米饮亦得，日二三服。汗止后服小建中汤。
集验方云：伤寒汗多不止，取穴内庭（泻）、合谷（泻）、复溜（泻）。
似阳明外证。
太阳病吐后汗出，不恶寒发热，关上脉细数，曰小逆（吐后似阳明而关脉细）。太阳病发热汗出，不恶寒者为柔痉（柔痉似阳明而身反张）。发汗已身灼热者名风温。风温为病，脉浮汗出，身重多眠。
汗吐下后自汗。
二阳并病，太阳初得病时发其汗，汗先出不彻，因转属阳明，续自微汗出，不恶寒。若太阳证不罢者，不可下，下之为逆。如此可小发汗。设面色缘缘正赤者，阳气怫郁在表，当解之熏之。若发汗不彻，不足言阳气怫郁不得越，当汗不汗，其人躁烦，不知痛处，乍在腹中，乍在四肢，按之不可得，其人短气，但坐以汗出不彻故也。更发汗则愈。何以知汗出不彻？以脉涩故知也。（成无己注：太阳病未解传并入阳明而太阳证未罢者，名曰并病。续自微汗出，不恶寒，为太阳证罢，阳明证具也，法当下之。若太阳证未罢，为表未解，则不可下，当小发其汗。先解表也。阳明之脉循面，面色缘缘正赤者，阳气怫郁在表也，当解之熏之以取其汗。若发汗不彻者，不足言阳气怫郁，止是当汗不汗，阳气不得越散，邪无从出，拥甚于经，故躁烦也。邪循经行，则痛无常处，或在腹中，或在四肢，按之不可得，而短气，但责以汗出不彻，更发汗则愈。内经曰：诸过者切之，涩者阳气有余，为身热无汗，是以脉涩知阳气拥郁而汗出不彻。○凡经文言或言、若言、设言、假令者，皆更端之词，即成氏所谓或为之证也。○不彻不足言，正与可小字相反。○因太阳故当汗，因并阳明故当小发，先字最有次第，仲景之枢机也。）
下后不可更行桂枝汤。若汗出而喘，无大热者，与麻黄杏仁甘草石膏汤。
发汗后，不可更行桂枝汤。汗出而喘，无大热者，麻黄杏仁甘草石膏汤。
服桂枝大汗出，脉洪大者，仍与桂枝。若形如疟，日再发者，汗出必解，桂枝二麻黄一汤。
太阳病发汗后，大汗出，胃中干燥，不得眠，欲饮水者，少少与之，胃和则愈。若脉浮，小便不利，微热消渴者，五苓散。
伤寒五六日，呕而发热，柴胡证具，而以他药下之，柴胡证仍在者，复与柴胡汤。虽下之不为逆，必蒸蒸而振，发热汗出而解。
太阳病桂枝证，医反下之，利遂不止，脉促者，表未解也；喘而汗出者，葛根黄连黄芩汤主之。（成无己注：经言不宜下而便攻之，内虚热入，挟热遂利。桂枝证者，邪在表也，而反下之，虚其肠胃，为热所乘，遂利不上。邪在表则见阳脉，邪在里则见阴脉。下利脉微迟，邪在里也。促为阳盛，虽下利而脉促者，知表未解也。病有汗出而喘者，为自汗而喘也，即邪气外甚所致。喘而汗出者，为因喘而汗出也，即里热气逆所致。与葛根黄连黄芩汤以散表邪除里热。○清肌脉促有此证者，宜用此方。厥阴证脉促手足厥，即以当归四逆汤加吴茱萸主之。）
脉浮数者，法当汗出而愈。若下之，身重心悸者，不可发汗，当自汗出乃解。所以然者，尺中脉微，此里虚，须表里实，津液自和，便自汗出愈。（成无己注：经云诸脉浮数，当发热而淅洒恶寒，言邪气在表也，是当汗出愈。若下之，身重心悸者，损其津液，虚其胃气。若身重心悸而尺脉实者，则下后里虚，邪气来虚传里也。今尺脉微，身重心悸者，知下后里虚，津液不足，邪气不传里，但在表也。然以津液不足，则不可发汗，须里气实，津液足，便自汗出而愈。○宜麻黄汤、桂枝加白术茯苓甘草汤、下后桂枝加芍药汤。）
太阳病当恶寒发热，今自汗出不恶寒发热，关上脉细数者，以医吐之过也（详发热）。
太阳病寸缓关浮尺弱，其人发热汗出恶寒，不呕，但心下痞者，此以医下之也。如不应下，病患不恶寒而渴者，此转属阳明，渴欲饮水，少少与之，宜五苓散。
伤寒大吐大下之，极虚复极汗出者，以其人外气怫郁，复与之水以发其汗，因得哕。所以然者，胃中寒冷故也（详哕）。
亡阳。
伤寒脉浮，医以火迫劫之，亡阳必惊狂，起卧不安者，桂枝去芍药加蜀漆牡蛎龙骨救逆汤主之。
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，桂枝加附子汤主之。
发汗多，若重发汗，亡其阳，谵语，脉短者死，脉自和者不死。（亡阳胃燥谵语者，脉短津液已绝，不可复治；脉自和为正气未衰，而犹可生也。○宜小柴胡加桂。）
脉阳微而汗出少者，为自和也；汗出多者为太过。阳脉实，因发其汗，出多者，亦为太过。太过为阳绝于里，亡津液，大便因硬也。
少阴病脉微，不可发汗，亡阳故也。阳已虚，尺脉弱涩者，复不可下之。（脉微为亡阳表虚，不可发汗；脉弱涩为亡阴里虚，复不可下，宜桂枝芍药炙甘草汤、四逆汤。）
病患脉阴阳俱紧，反汗出者，亡阳也，此属少阴，法当咽痛而复吐利（或用桂枝加干姜汤、四逆汤）。
盗汗。
盗汗者，谓睡而汗出也。方其睡熟，凑凑然出，觉则止而不复出矣。（睡则胃气行里，表中阳气不致，故津液得泄；觉则气行于表而汗止矣。）杂病盗汗责其阴虚，伤寒盗汗由邪气在半表半里使然也。若邪气在表，则又谓之自汗矣。经曰：“微盗汗出，反恶寒者，表未解也。”又阳明当作里实，而脉浮者，云必盗汗，是犹有表邪也。又三阳合病，目合则汗，是知盗汗邪在表里之间，而悉属和解明矣，非若自汗有表里虚实之别也。
太阳病脉浮动数，头痛发热，微盗汗出，反恶寒者，表未解也（详见结胸）。
阳明病脉浮而紧，必潮热发作有时，但浮者，必盗汗出（活人云：脉浮盗汗，黄芩汤或柴胡姜桂汤、桂枝茯苓白术汤）。
三阳合病，脉浮大上关上，但欲眠睡，目合则汗（成无己注：关脉以候少阳之气，太阳之脉浮，阳明之脉大，脉浮上关上，知三阳合病。胆热则睡。少阴病但欲眠睡，目合则无汗，以阴不得有汗。但欲眠睡，目合则汗，知三阳合病，胆有热也。小柴胡汤、泻心汤）。
张元素云：或谓此证俱属少阳，篇中亦可用小柴胡否？答曰：可用。夫三阳合病，其邪发见于脉也，浮者太阳也，大者阳明也，上关上者少阳也。但欲眠睡，目合则汗，此胆有热，脉证相符，故出于少阳篇下。盖浮脉无证不可汗，大脉无证不可下，浮大之脉俱上关，知三阳合病而热在胆也。然胆居在半表半里，用小柴胡亦当。
(Attached: Night sweats, Head sweat, Hand and foot sweat, Anhidrosis, Inability to sweat)
Wei Qi (Defensive Qi), which protects the skin, fills the interstices (Cou Li), and secures body fluids to prevent their reckless discharge, fails to guard the exterior when invaded by pathogenic factors. Consequently, body fluids leak recklessly. However, this moist sweating occurs spontaneously without the use of diaphoretic agents. Wind-stroke causes fever and spontaneous sweating; dampness-stroke causes sweating, aversion to wind, and thirst; severe wind-dampness causes profuse sweating and a damp sensation. Both wind and summerheat-dampness as pathogens lead to spontaneous sweating. Only cold pathogens injure Ying Qi (Nutritive Qi) without injuring Wei Qi, thereby closing the skin and interstices tightly, resulting in no sweating. Initially, although there is no sweating, if the pathogen transmits inward and transforms into heat, Ying and Wei Qi flow freely, the interstices open, and spontaneous sweating occurs.
Spontaneous sweating also distinguishes between exterior and interior syndromes, and deficiency and excess syndromes. If sweating is accompanied by aversion to wind or slight aversion to cold, it indicates that the exterior syndrome has not resolved, and dispersing methods are appropriate. If sweating leaks incessantly with aversion to wind, or if aversion to cold appears after sweating therapy, it indicates exterior deficiency, and warming methods are appropriate. These situations involve pathogens remaining at the exterior. If sweating occurs without aversion to wind or cold, it indicates that the exterior syndrome has resolved and the pathology is interior; purgation will cure it. For example, Yangming disease with fever and sweating indicates heat venting outward; and Yangming disease with fever and profuse sweating requires urgent purgation. Although spontaneous sweating is a common symptom, if sweat is like oil or beads sticking to the body without flowing, it is considered incurable. A favorable sign occurs only when the hands, feet, and entire body become uniformly moist, and after a moment, sweating stops and the body cools down.
Body heat, sweating, and aversion to cold belong to the exterior syndrome.
When a patient suffers from chronic spontaneous sweating, it is because the Ying Qi is harmonious but disharmonious with the exterior, due to the failure of Wei Qi to harmonize with Ying Qi. Ying Qi circulates within the vessels, while Wei Qi circulates outside them. Re-inducing sweating at this stage will restore harmony between Ying and Wei Qi. Guizhi Tang (Cinnamon Twig Decoction) should be used. (Wind injures Wei Qi, Cold injures Ying Qi. When Wei Qi is affected by wind but Ying Qi remains unaffected, it is called "Ying Qi is harmonious." Once Wei Qi is occupied by pathogens, it cannot harmonize with Ying Qi nor protect the skin and interstices, leading to chronic spontaneous sweating. Administering Guizhi Tang dissipates wind pathogens and harmonizes Ying and Wei Qi, leading to recovery. See the Taiyang Disease section for details.) If accompanied by stiffness and pain in the neck and back, Guizhi Jia Gegen Tang (Guizhi Tang with Pueraria Decoction) is indicated (for neck stiffness). If accompanied by painful joints, inability to flex and extend, and dysuria, Gancao Fuzi Tang (Licorice and Aconite Decoction) is indicated (see discussion on wind-dampness with fever).
If sweating leaks incessantly with aversion to cold after inducing sweat, Guizhi Fuzi Tang (Guizhi Tang with Aconite Decoction) is indicated (see subsequent sections). If sweating is accompanied by thirst, Wuling San (Five-Ingredient Powder with Poria) is indicated; if there is no thirst, Lingzhi Jiangzhong Tang (Poria, Ginger, and Licorice Decoction) is indicated.
The *Liuren Shu* states: For wind-stroke with spontaneous sweating, Guizhi Tang must be used with caution. Suppose a patient with wind-stroke and spontaneous sweating presents with a floating and weak pulse. If Guizhi Tang is administered and the patient develops irritability without the typical Guizhi Tang signs, it should not be taken again. If wind-stroke with spontaneous sweating is accompanied by frequent urination, Guizhi Tang must absolutely not be given. Furthermore, in Taiyang disease with spontaneous sweating, stiff limbs difficult to flex and extend, and difficulty in urination, Fuzi (Aconite) may be added to Guizhi Tang. If urination is frequent, Guizhi Fuzi Tang is strictly contraindicated; Shaoyao Gancao Tang (Peony and Licorice Decoction) should be used instead. If Guizhi Fuzi Tang is mistakenly used to attack the exterior, causing dry throat, irritability, cold limbs, and vomiting, Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction) should be given to restore Yang Qi. Once the limbs warm up, Shaoyao Gancao Tang should be administered to relieve leg cramps.
Zhao noted that post-sweating leakage with difficulty in urination resembles spontaneous sweating with frequent urination. Zhang Zhongjing repeated a chapter Q&A to clarify this distinction. The first case describes Taiyang disease where excessive sweating led to leakage, aversion to wind, difficulty in urination, and slight stiffness of the four limbs, treated with Guizhi Fuzi Tang. This was caused by excessive sweating medication, not spontaneous sweating. Aversion to wind indicates residual pathogens; difficulty in urination and limb stiffness indicate loss of body fluids and lack of nourishment to the sinews. This is Yang collapse from excessive sweating, with exterior deficiency and meridian qi pathology carrying exterior pathogens, not interior. Thus, Fuzi warms the meridians, Guizhi releases the exterior, and Shaoyao nourishes blood and relaxes sinews.
The second case describes a floating pulse indicating deficiency, spontaneous sweating, slight aversion to cold due to Yang deficiency failing to defend the exterior, frequent urination due to lower jiao deficiency-cold failing to control water, irritability due to Yin deficiency and blood shortage, and leg cramps due to blood depletion failing to nourish sinews. This condition involves simultaneous exterior and interior deficiency from the onset, with no exterior Yang signs, so Guizhi Tang is contraindicated. Mistakenly using Guizhi Tang to attack the exterior would cause further sweating, leading to cold limbs, dry throat, irritability, and vomiting. Cold limbs result from Yang collapse and failure of Yin-Yang connection; dry throat from fluid scarcity; irritability and vomiting from cold obstruction above. Ganjiang (Dried Ginger) warms the interior and restores Yang; Gancao and Shaoyao replenish blood lost to sweating, restoring Yin-Yang deficiency. After legs extend, if delirium occurs, it is due to prior fluid loss from sweating and frequent urination combined with the drying nature of Ganjiang, causing Yangming internal binding. Although not full excess, Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction) should be used sparingly.
Tracing back, Shaoyao Gancao Tang is specifically for treating calf cramps after reversal of cold limbs and warming of feet, not for treating floating pulse, spontaneous sweating, and frequent urination. The *Liuren Shu* claims it treats these symptoms and errors after Guizhi Tang. I question how such symptoms match Zhongjing's formulas. Upon reflection: ordinary people might think using Ganjiang for spontaneous sweating and frequent urination without diarrhea leads to dryness and delirium, later requiring cold herbs like Mangxiao and Dahuang, seeming out of order. Patients blame doctors for using hot/drying herbs first and cooling ones later. However, Zhongjing’s intent is not to fear Ganjiang’s heat but to address righteous Qi deficiency. Strengthening righteous Qi eliminates pathogens. For simultaneous exterior-interior deficiency, one must first restore righteous Qi using Ganjiang, Shaoyao, and Gancao. Once righteous Qi is restored and internally solid, even if stomach dryness and delirium occur due to internal binding, Dahuang and Mangxiao can lubricate and remove the binding without damaging righteous Qi. This sequence—hot then cold, tonifying then purging—seems reverse but is actually smooth, demonstrating Zhongjing’s brilliance. Scholars should apply this principle rather than blaming patients.
In summer heatstroke with spontaneous sweating, body heat, aversion to cold, weak pulse, thirst, and cold feet, Baihu Jia Renshen Tang (White Tiger plus Ginseng Decoction) is indicated (see Summerheat section).
Body heat, sweating, and absence of aversion to cold belong to the interior syndrome, representing the fundamental Yangming syndrome.
Q: What are the external manifestations of Yangming? A: Body heat, spontaneous sweating, absence of aversion to cold, and aversion to heat. (Da Chengqi Tang)
Q: Why does a patient feel aversion to cold on the first day without fever? A: The initial aversion to cold will cease spontaneously, followed by spontaneous sweating and aversion to heat.
Q: Why does aversion to cold cease? A: Yangming belongs to Earth in the center, receiving all things without further transmission. Initial aversion to cold ceases by the second day, confirming Yangming disease.
When cold damage transfers to Yangming, the patient has slight continuous sweating. (Wind-stroke causes sweating, cold damage does not; only upon entering Yangming does sweating occur, hence "Yangming disease typically involves profuse sweating.")
If accompanied by hard stool and delirium, purgation is indicated.
Sweating, body heat, absence of aversion to cold, hard stool, and delirium require Chengqi Tang (see Delirium section). Yangming disease with fever and profuse sweating requires urgent purgation with Da Chengqi Tang (Major Order the Qi Decoction).
Xu recorded a case of cold damage with eye pain, nasal dryness, insomnia, constipation, and large pulses in all positions for several days. Overnight sweating occurred. I advised immediate purgation with Dachaihu Tang (Major Bupleurum Decoction). The physician objected, citing depleted fluids and recommending honey suppositories. I insisted on Dachaihu Tang, citing Zhongjing’s profound method. Two doses cured the patient. Critics argue that purging spontaneous sweating depletes fluids further, or that purging early in Shaoyin/Yangming dryness harms Yin. These doubts arise from misreading Zhongjing. "Urgent purgation" implies acting before fluids are fully depleted, preventing the need for suppositories. If understood clearly, there is no doubt; otherwise, suppositories are safer.
If accompanied by floating-tight pulse and bitter taste, sweating and acupuncture are contraindicated; harmonization is required.
Yangming disease with floating-tight pulse, dry throat, bitter taste, abdominal fullness, panting, fever, sweating, aversion to heat, and heaviness. Sweating causes mental confusion and delirium; moxibustion causes fright and insomnia. Purging empties the stomach, allowing rebellious Qi to disturb the chest, causing inner restlessness and tongue coating. Zhiizi Chi Tang (Gardenia and Fermented Soybean Decoction) is indicated. If thirst and dry mouth/tongue occur, Baihu Jia Renshen Tang is indicated. If floating pulse, fever, thirst, and dysuria occur, Zhuling Tang (Polyporus Decoction) is indicated. (Note: Floating/fever/bitter taste indicates exterior pathogen; tight pulse/sweating/abdominal fullness/no aversion to cold indicates interior pathogen. Simultaneous exterior-interior pathogens require harmonization.)
If accompanied by dysuria, distinguish between appetite present and absent.
Yangming disease with appetite, abnormal dysuria, normal stool, joint pain, feeling of heat, sudden madness, and continuous sweating resolves as Water fails to overcome Grain Qi, merging with sweat; tight pulse indicates recovery (use Guizhi Tang or Qianghuo Tang). Yangming disease with cold invasion, anorexia, dysuria, and continuous hand/foot sweating suggests impending mass formation; stool will be initially hard then loose due to cold water in the stomach mixing poorly with food (use Houpo Shengjiang Gancao Banxia Renshen Tang, Wuzhuyu Tang, or Lizhong Tang).
If accompanied by epigastric fullness (Pi):
Epigastric fullness with sweating has two patterns: soft/fullness with aversion to cold requires Fuzi Xiexin Tang; hard/fullness with rib pain and no aversion to cold requires Shizao Tang (Ten Jujube Decoction).
If accompanied by diarrhea:
Sweating, diarrhea, persistent heat, cold limbs, and aversion to cold require Sini Tang (Frigid Extremities Decoction). Clear undigested stool requires Tongmai Sini Tang (Pulse-Restoring Frigid Extremities Decoction). Sweating, diarrhea, slight heat with rapid pulse indicates self-healing; tight pulse indicates unresolved. Fever and diarrhea after six-seven days with incessant sweating indicate death (see Diarrhea section).
If accompanied by vomiting and diarrhea:
Tight pulse, sweating, sore throat, vomiting, and diarrhea indicate Shaoyin disease with Yang collapse. Vomiting, diarrhea, sweating, cold limbs, and faint pulse require Sini Tang. Cessation of vomiting/diarrhea with sweating, cold limbs, and faint pulse requires Tongmai Sini Tang plus Porcine Bile (see Vomiting/Diarrhea section).
Haizang stated: Taiyang spontaneous sweating uses Guizhi Tang; Yangming spontaneous sweating uses Baihu Tang; Shaoyin spontaneous sweating uses Sini Tang.
Yangming syndrome with body heat, eye/nasal pain, insomnia, no aversion to cold, spontaneous sweating, or aversion to heat with floating chi/cun pulses is treated with Baihu Tang. Cold damage with long pulses, profuse sweating, cold body surface, and thin interior pulses, or malaria with chills only, is Yangming transmitting to Shaoyin; Baihu Jia Guizhi Tang is indicated. Pulse speed distinguishes this case (fast, not slow). (See Malaria section; also suitable for summerheat with slight aversion to cold.)
*Liuren Shu* states: If moving Qi is on the left during attempted sweating in cold damage, do not sweat, as it causes dizziness, sweating, and muscle twitching (adverse reaction). First use Fangfeng Baizhu Muli San (Saposhnikovia, Atractylodes, and Oyster Shell Powder), then Jianzhong Tang.
Fangfeng Baizhu Muli San treats excessive sweating, dizziness, and twitching. Equal parts Saposhnikovia Root, Atractylodes Macrocephala Rhizome, and Calcined Oyster Shell. Take 2 qian with wine or rice drink, 2-3 times daily. After sweating stops, take Xiao Jianzhong Tang.
Jiyi Fang states: For excessive sweating in cold damage, needle Neiting (X), Hegu (X), and Fuliu (X).
Resembling Yangming External Syndrome:
Taiyang disease with post-vomit sweating, no aversion to cold, fever, and fine-rapid Guan pulse is minor deviation (resembles Yangming but Guan is fine). Taiyang fever, sweating, no aversion to cold is Rou Jing (Soft Spasm, resembles Yangming but with opisthotonos). Post-sweating burning heat is Feng Wen (Wind Warmth): floating pulse, sweating, heaviness, somnolence.
Post-sweat/vomit/purge spontaneous sweating:
Two-Yang concurrent disease: Initial Taiyang sweating incomplete leads to Yangming transfer, continuous slight sweating, no aversion to cold. If Taiyang signs persist, do not purge; use mild sweating. Persistent red face indicates stagnant Yang Qi at the exterior; resolve via fumigation. Incomplete sweating causes irritability, unknown pain location, shortness of breath. Check for choppy pulse to confirm incomplete sweating. (Cheng Wuji commentary: Concurrent disease involves Taiyang not resolving while transferring to Yangming. Slight sweating/no aversion to cold means Taiyang is gone, Yangming is present; purge. If Taiyang persists, exterior is unresolved; mild sweating first. Red face indicates Yang stagnation; fumigate. Choppy pulse confirms Yang stagnation and incomplete sweating.)
After purgation, do not use Guizhi Tang. If sweating, panting, and no high heat occur, use Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction).
Post-sweating, do not use Guizhi Tang. If sweating, panting, and no high heat occur, use Mahuang Xingren Gancao Shigao Tang.
After Guizhi Tang, if massive sweating and洪大 pulse occur, continue Guizhi Tang. If resembling malaria with twice-daily episodes, sweating resolves it; use Guizhi Er Mahuang Yi Tang (Guizhi Twice, Ephedra One Decoction).
Taiyang post-sweating massive sweating, dry stomach, insomnia, thirst: give small amounts of water. If floating pulse, dysuria, slight fever, and thirst occur, use Wuling San.
Cold damage day five-six, vomiting, fever, Chaihu signs persist after mistaken purgation: re-administer Chaihu Tang. Shivering and sweating will resolve it.
Taiyang Guizhi syndrome mistakenly purged leads to diarrhea. Rapid pulse indicates unresolved exterior; panting and sweating require Ge Gen Huang Lian Huang Qin Tang (Kudzu, Coptis, and Scutellaria Decoction). (Cheng Wuji commentary: Purging exterior pathogen causes interior heat diarrhea. Rapid pulse indicates exterior still unresolved despite diarrhea. Panting+sweating indicates interior heat/rebellious Qi; this formula clears exterior and interior heat.)
Floating-rapid pulse indicates sweating will cure. If purged, heavy body and palpitations indicate no sweating; spontaneous sweating will cure. Choppy Chi pulse indicates interior deficiency; restore interior/exterior balance and fluids for spontaneous curing. (Cheng Wuji commentary: Floating-rapid pulse indicates exterior pathogen needing sweating. Purging damages fluids/stomach Qi. Choppy Chi pulse confirms interior deficiency without interior pathogen transmission. Restore fluids for spontaneous cure. Use Mahuang Tang, Guizhi Jia Baizhu Fuling Gancao Tang, or Xiashi Guizhi Jia Shaoyao Tang.)
Taiyang should have aversion to cold/fever; now sweating without aversion, fine-rapid Guan pulse indicates error of vomiting (see Fever).
Taiyang slow Cun, floating Guan, weak Chi with fever, sweating, aversion to cold, no vomiting, but epigastric fullness indicates error of purgation. If no purgation needed but patient has thirst, it transfers to Yangming; give small water or Wuling San.
Severe vomiting/purging causing extreme deficiency and massive sweating, followed by water-induced sweating and hiccups, indicates cold stomach (see Hiccups).
Yang Collapse:
Cold damage floating pulse, fire coercion causes Yang collapse with惊狂 (panic/madness), restlessness. Gui Zhi Qu Shaoyao Jia Shu Ki Mu Li Long Gu Jiu Ni Tang (Guizhi Tang minus Peony plus Schizonepeta, Oyster Shell, Dragon Bone, Rescue Decoction) is indicated.
Taiyang excessive sweating causes leakage, aversion to cold, dysuria, limb stiffness. Guizhi Jia Fuzi Tang (Guizhi Tang with Aconite Decoction) is indicated.
Excessive sweating or re-sweating causes Yang collapse, delirium. Short pulse indicates death; harmonious pulse indicates survival. (Short pulse: fluid exhaustion, untreatable; Harmonious: righteous Qi intact, treatable. Use Xiaochaihu Jia Guizhi.)
Yang pulse micro with little sweating indicates harmony; profuse sweating indicates excess. Solid Yang pulse with excessive sweating causes Yang isolation and fluid loss, leading to hard stool.
Shaoyin micro pulse prohibits sweating (Yang collapse). Weak-choppy Chi pulse prohibits purgation (Yin deficiency). Use Guizhi Shaoyao Gancao Tang or Sini Tang.
Patient with tight Yin-Yang pulses but sweating indicates Yang collapse, belonging to Shaoyin, likely with sore throat, vomiting, diarrhea (use Guizhi Jia Ganjiang Tang or Sini Tang).
Night Sweats:
Night sweats occur during sleep and stop upon waking. (Sleep moves Qi inward, releasing fluids; waking moves Qi outward, stopping sweat.) Miscellaneous disease night sweats indicate Yin deficiency; cold damage night sweats indicate pathogens in half-exterior/half-interior. Exterior pathogens cause spontaneous sweating. Text says: "Slight night sweating with aversion to cold indicates unresolved exterior." Yangming interior excess with floating pulse indicates residual exterior pathogen. Three-Yang concurrent disease with sweating upon closing eyes indicates pathogens between exterior/interior, requiring harmonization, unlike spontaneous sweating which has clear exterior/interior/deficiency/excess distinctions.
Taiyang floating-numerous pulse, headache, fever, slight night sweating, aversion to cold: exterior unresolved (see Phlegm-Rheum).
Yangming floating-tight pulse with tidal fever; floating pulse alone indicates night sweating (*Liuren Shu*: Huangqin Tang, Chaihu Jianggui Tang, or Guizhi Fuling Baizhu Tang).
Three-Yang concurrent disease: floating-large pulse at Guan, somnolence, sweating upon closing eyes. (Cheng Wuji: Guan pulse monitors Shaoyang. Taiyang floats, Yangming is large. Floating-large at Guan indicates Three-Yang concurrent disease with Gallbladder heat causing somnolence and sweating. Shaoyin somnolence has no sweating. Use Xiaochaihu Tang or Xiexin Tang.)
Zhang Yuansu: Can Xiaochaihu Tang be used for Shaoyang-like symptoms? Yes. Three-Yang concurrent disease shows Taiyang (floating), Yangming (large), Shaoyang (Guan). Somnolence and eye-closing sweat indicate Gallbladder heat. Since Gallbladder is half-exterior/half-interior, Xiaochaihu Tang is appropriate.
Head Sweat:
The head is the meeting point of all Yang meridians. Heat steaming Yang causes head-only sweating. Three-Yin meridians do not reach the head, so they do not cause head sweating. Whole-body sweating is called "Heat Venting"; head-only sweating with no body sweat indicates heat...