（附面热、面寒）
阳虚则恶寒，用参 之类，甚者加附子少许，以行参 之气。一妇人恶寒，用苦参、
一钱为末，齑水调服。探吐之后，用川芎、南星、苍术、酒炒黄芩为末，
白汤下。冬月，芩减半，加姜汁调，曲煮糊丸。虚劳，冬月恶寒之甚，气实者可利，亦宜
解表，柴胡、干葛。恶寒久病，亦用解郁。
戴云∶凡背恶寒甚者，脉浮大而无力者，是阳虚也。
面热火起，寒郁热，面寒退胃热。
〔附录〕《内经》云∶面热者，手阳明病，阳明经气盛有余，则身以前皆热。此经多血多
则风热上行，诸阳皆会于头，故面热也。先以承气汤加黄连、犀角，彻其本热，次以升麻
附方
升麻加黄连汤
升麻 葛根（各一钱） 白芷（七分） 甘草（炙） 白芍（五分） 黄连（酒炒） 川芎（三分） 荆芥
薄荷（一分） 生犀（三分）
上作一服，水煎。升麻汤加黄连，治面热。加附子，治面寒。
升麻附子汤 治阳明经本虚气不足，则身以前皆寒，故面寒。
升麻 葛根（一钱） 白芷 黄 （七分） 甘草（炙） 草豆蔻 人参（二分） 附子（炮，七分） 益
智（三分）
上作一服，连须葱白同煎服。
承气汤 见痢类。
自汗属气虚、血虚、湿、阳虚、痰。东垣有法有方，人参、黄 ，少佐桂枝。
虚，附子亦可少用，须小便煮。火气上蒸胃中之湿，亦能汗，凉膈散主之。痰症亦有汗，
自汗，大忌生姜，以其开腠理故也。
〔附录〕或问湿之与汗，为阴乎，为阳乎？曰∶西南，坤土也，在人则为脾胃也。人之犹
天地之雨也，阴滋其湿则为露，露为雨也。阴湿下行，地之气也。汗多则亡阳，阳去则阴胜
。甚则寒中。湿胜则音声如从瓮中出，言其壅也，不出也，以明其湿审矣。《内经》曰∶“
外寒”，虽见热中，蒸蒸为汗，终传大寒，知始为热中。表虚亡阳，不任外寒，终传寒中
成痹寒矣。色以候天，脉以候地。形者，乃候地之阴阳也，故以脉气候之，皆有形无形之
见者也。又云∶“心之所藏，在内者为血，发外者为汗”。盖汗乃心之液，而自汗之证，未有不
由心肾俱虚而得之者。故阴虚阳必凑，发热而自汗；阳虚阴必乘，发厥而自汗。故阴阳偏
附方
玉屏风散 治自汗。
防风 黄 （各一两） 白术（二两）
上每服三钱，水一钟半，姜三片，煎服。
大补黄 汤 治自汗，虚弱之人可服。
黄 （蜜炙） 防风 川芎 山茱萸肉 当归 白术（炒） 肉桂 甘草（炙） 五味 人参
（各一两） 白茯苓（一两半） 熟地黄（二两） 肉苁蓉
上每服五钱，姜三片，枣一枚，水煎服。
调卫汤 治湿胜自汗，补卫气虚弱，表虚不任风寒。
麻黄根 黄 （各一钱） 羌活（七分） 生甘草 归梢 生黄芩 半夏（各五分） 麦门冬 生地
黄（各三分） 猪苓（二分） 苏木 红花（各二分） 五味（七个）
上作一服，水煎热服。
温粉
牡蛎 麦皮 麻黄根 本 糯米 防风 白芷
上为末。周身扑之。
又方
何首乌末。津调封脐，妙。
黄 建中汤
黄 肉桂（各三两） 甘草（二两） 白芍药（六两）
每服五钱，姜三片，枣一个，入饧少许，水煎服。
凉膈散
连翘（一两） 山栀 大黄 黄芩 薄荷叶（各半两） 甘草（一两半） 朴硝（一分）
上以水煎服。
（附面热、面寒）
阳气虚弱就会怕冷，用人参之类药物，严重的加少许附子，以通行人参之气。有一位妇女怕冷，用苦参一钱研为末，用醋水调服。探吐之后，再用川芎、天南星、苍术、酒炒黄芩研为末，用白开水送下。冬季时，黄芩用量减半，加姜汁调和，用曲煮成糊状制成丸剂。虚劳病，冬季特别怕冷的，气实的人可以通利大便，也应当解表，用柴胡、干葛。怕冷日久不愈的病，也用解郁的方法。
戴元礼说：凡是背部特别怕冷的，脉象浮大而无力的，这是阳气虚弱。
面部发热如火起，是寒气郁结导致的热；面部发凉退去热度，是胃中有热。
〔附录〕《内经》说：面部发热，是手阳明大肠经的病变，阳明经气盛有余，则身体前部都发热。这条经脉多血多气，风热上行，所有阳经都汇聚于头部，所以面部发热。先用承气汤加黄连、犀角，清除根本的热邪，其次用升麻……
附方
升麻加黄连汤
升麻、葛根（各一钱）、白芷（七分）、甘草（炙）、白芍（五分）、黄连（酒炒）、川芎（三分）、荆芥、薄荷（一分）、生犀角（三分）。
以上为一服的量，用水煎煮。升麻汤加黄连，治疗面部发热。加附子，治疗面部发凉。
升麻附子汤 治疗阳明经本虚气不足，则身体前部都发凉，所以面部发凉。
升麻、葛根（一钱）、白芷、黄芪（七分）、甘草（炙）、草豆蔻、人参（二分）、附子（炮制，七分）、益智仁（三分）。
以上为一服的量，连须葱白一起煎煮服用。
承气汤 见痢疾类。
自汗属于气虚、血虚、湿邪、阳虚、痰饮。李东垣有方法有方剂，用人参、黄芪，少佐桂枝。
如果是阴虚，附子也可以少量使用，必须用小便煮过。火气上蒸胃中的湿邪，也能导致出汗，主方用凉膈散。痰证也有出汗，
自汗，大忌生姜，因为生姜会开泄腠理的缘故。
〔附录〕有人问：湿与汗，属阴还是属阳？回答说：西南方，是坤土，在人体对应脾胃。人的汗液犹如天地间的雨。阴滋生了湿气就成为露，露聚集成为雨。阴湿下行，是地气的作用。汗出过多则亡阳，阳气离去则阴胜。严重则导致中焦寒盛。湿邪胜则声音像从瓮中发出，说明气机壅滞，不能通畅，以此明确湿邪的诊断。《内经》说：“外寒”，虽然见到内热，蒸蒸出汗，最终传变为大寒，知道起初是内热。表虚亡阳，不耐受外寒，最终传变为寒中，形成痹症和寒证。通过面色观察天时的变化，通过脉象观察地气的变化。形体，是用来观察地之阴阳的，所以用脉象气候来候察，都有有形无形的表现。又说：“心所藏的东西，在内的是血，发于外的就是汗”。大概汗是心的体液，而自汗的病症，没有不是由心肾俱虚而得的。所以阴虚则阳必凑集，发热而自汗；阳虚则阴必乘袭，发厥而自汗。所以阴阳偏……
附方
玉屏风散 治疗自汗。
防风、黄芪（各一两）、白术（二两）。
以上每次服用三钱，水一钟半，生姜三片，煎服。
大补黄芪汤 治疗自汗，虚弱之人可服用。
黄芪（蜜炙）、防风、川芎、山茱萸肉、当归、白术（炒）、肉桂、甘草（炙）、五味子、人参（各一两）、白茯苓（一两半）、熟地黄（二两）、肉苁蓉。
以上每次服用五钱，生姜三片，大枣一枚，水煎服。
调卫汤 治疗湿胜导致的自汗，补卫气虚弱，表虚不耐风寒。
麻黄根、黄芪（各一钱）、羌活（七分）、生甘草、归梢、生黄芩、半夏（各五分）、麦门冬、生地黄（各三分）、猪苓（二分）、苏木、红花（各二分）、五味子（七个）。
以上为一服的量，水煎热服。
温粉
牡蛎、麦麸、麻黄根、藁本、糯米、防风、白芷。
以上研为末。周身扑洒。
又一方
何首乌末。用唾液调和封贴肚脐，效果奇妙。
(Attached: Facial Heat and Facial Cold)
Yang deficiency leads to aversion to cold. Use herbs such as Renshen (Radix Ginseng); in severe cases, add a small amount of Fuzi (Radix Aconiti Lateralis Preparata) to promote the Qi-moving action of Renshen. A woman suffering from aversion to cold was treated with Kushen (Cortex Phellodendri), one qian ground into powder, mixed with vinegar water for oral administration. After inducing vomiting, she was given a mixture of Chuanxiong (Rhizoma Chuanxiong), Nanting (Rhizoma Arisaematis), Cangzhu (Rhizoma Atractylodis Chinensis), and Huangqin (Radix Scutellariae) stir-fried with wine, ground into powder, and taken with warm water. In winter, the dosage of Huangqin is halved, mixed with ginger juice, and formed into pills using a paste made from fermented grain. For Xu Lao (Consumptive Disease), if aversion to cold is severe in winter, patients with excess Qi may benefit from purgatives, but exterior-releasing methods are also appropriate, using Chaihu (Radix Bupleuri) and Gange (Radix Puerariae). For chronic aversion to cold, methods to resolve depression are also employed.
Dai Yuanli stated: When there is severe aversion to cold in the back, accompanied by a floating, large, and forceless pulse, this indicates Yang deficiency.
Facial heat rising like fire is due to cold stagnation generating heat; facial cold resulting from the retreat of heat indicates stomach heat.
[Appendix] The *Neijing* states: Facial heat is a disease of the Hand-Yangming Large Intestine Meridian. When the Qi of the Yangming meridian is excessive, the anterior part of the body becomes hot. This meridian is rich in blood and Qi; wind-heat ascends, and all Yang meridians converge at the head, hence facial heat. First, use Chengqi Tang (Major Order the Qi Decoction) added with Huanglian (Rhizoma Coptidis) and Xijiao (Cornu Rhinocerotis) to clear the root heat; subsequently, use Shengma...
Supplementary Formulas
Shengma Jia Huanglian Tang (Cimicifuga Decoction with Coptis)
Shengma (Rhizoma Cimicifugae), Gegen (Radix Puerariae) (each 1 qian), Baizhi (Radix Angelicae Dahuricae) (7 fen), Gancao (Radix Glycyrrhizae Preparated), Shaoyao (Radix Paeoniae Alba) (5 fen), Huanglian (Rhizoma Coptidis stir-fried with wine), Chuanxiong (Rhizoma Chuanxiong) (3 fen), Jingjie (Herba Schizonepetae), Bohe (Herba Menthae) (1 fen), Shengxi (Cornu Rhinocerotis) (3 fen).
Take as one dose, decoct in water. Shengma Tang with Huanglian treats facial heat. With Fuzi added, it treats facial cold.
Shengma Fuzi Tang (Cimicifuga and Aconite Decoction)
Treats deficiency of the Yangming meridian with insufficient Qi, leading to cold in the anterior body and thus facial cold.
Shengma (Rhizoma Cimicifugae), Gegen (Radix Puerariae) (1 qian), Baizhi (Radix Angelicae Dahuricae), Huangqi (Radix Astragali) (7 fen), Gancao (Radix Glycyrrhizae Preparated), Caodoukou (Semen Cardamomi Rotundum), Renshen (Radix Ginseng) (2 fen), Fuzi (Radix Aconiti Lateralis Preparata, processed) (7 fen), Yizhi (Fructus Alpiniae Oxyphyllae) (3 fen).
Take as one dose, decoct together with scallion whites including roots.
Chengqi Tang (Major Order the Qi Decoction) See Dysentery category.
Zihan (Spontaneous Sweating) belongs to Qi deficiency, Blood deficiency, Dampness, Yang deficiency, and Phlegm. Li Dongyuan had methods and formulas: use Renshen (Radix Ginseng) and Huangqi (Radix Astragali), with a small addition of Guizhi (Ramulus Cinnamomi).
If Yin deficiency, Fuzi (Radix Aconiti Lateralis Preparata) can be used in small amounts, but must be boiled in urine. Fire Qi steaming upward from dampness in the stomach can also cause sweating; the primary formula is Liangge San (Cool the Diaphragm Powder). Phlegm syndromes also involve sweating.
For spontaneous sweating, Ginger (Shengjiang) is strictly contraindicated because it opens the Couli (pores).
[Appendix] Someone asked: Are Dampness and Sweat Yin or Yang? The answer is: The southwest corresponds to Kun Earth, which in the human body corresponds to the Spleen and Stomach. Human sweat is like rain between heaven and earth. Yin nourishing dampness becomes dew; dew accumulates to become rain. Yin-dampness descends, representing Earth Qi. Excessive sweating leads to loss of Yang; when Yang departs, Yin prevails. Severe cases lead to Cold in the Middle. Dampness prevailing causes the voice to sound as if coming from an urn, indicating obstruction and lack of flow, clarifying the diagnosis of Dampness. The *Neijing* says: "External cold," although internal heat is seen with steaming sweat, it ultimately transmits to Great Cold, knowing that it began as Internal Heat. Exterior deficiency with loss of Yang cannot withstand external cold, ultimately transmitting to Cold in the Middle, forming Bi syndrome and Cold patterns. Complexion observes Heaven's changes; pulse observes Earth's changes. Form is used to observe the Yin and Yang of Earth, so pulse and climate observations reveal both form and formless manifestations. It also says: "What the Heart stores internally is Blood; what emerges externally is Sweat." Sweat is the fluid of the Heart. Spontaneous sweating syndromes invariably result from dual deficiency of Heart and Kidney. Thus, Yin deficiency leads to Yang encroachment, causing fever and spontaneous sweating; Yang deficiency leads to Yin invasion, causing syncope and spontaneous sweating. Therefore, Yin and Yang imbalance...
Supplementary Formulas
Yupingfeng San (Jade Windscreen Powder)
Treats spontaneous sweating.
Fangfeng (Radix Saposhnikoviae), Huangqi (Radix Astragali) (each 1 liang), Baizhu (Rhizoma Atractylodis Macrocephalae) (2 liang).
Take 3 qian per dose, with 1.5 zhong of water and 3 slices of ginger, decoct and take.
Da Bu Huangqi Tang (Great Tonification with Astragalus Decoction)
Treats spontaneous sweating; suitable for weak individuals.
Huangqi (Radix Astragali honey-fried), Fangfeng (Radix Saposhnikoviae), Chuanxiong (Rhizoma Chuanxiong), Shanzhuyu (Fructus Corni), Danggui (Radix Angelicae Sinensis), Baizhu (Rhizoma Atractylodis Macrocephalae stir-fried), Rougui (Cortex Cinnamomi), Gancao (Radix Glycyrrhizae Preparated), Wuweizi (Fructus Schisandrae), Renshen (Radix Ginseng) (each 1 liang), Baifuling (Poria) (1.5 liang), Shudihuang (Radix Rehmanniae Preparata) (2 liang), Roushouyu (Caulis Cistanches).
Take 5 qian per dose, with 3 slices of ginger and 1 jujube, decoct in water and take.
Tiaowei Tang (Regulate Defense Decoction)
Treats spontaneous sweating due to Dampness prevailing, tonifies deficient Wei Qi, and addresses exterior deficiency unable to withstand wind-cold.
Mahuanggen (Radix Ephedrae), Huangqi (Radix Astragali) (each 1 qian), Qianghuo (Rhizoma et Radix Notopterygii) (7 fen), Sheng Gancao (Radix Glycyrrhizae), Guishao (Ramulus Cinnamomi), Sheng Huangqin (Radix Scutellariae), Banxia (Rhizoma Pinelliae) (each 5 fen), Maimendong (Radix Ophiopogonis), Sheng Dihuang (Radix Rehmanniae) (each 3 fen), Zhuling (Polyporus) (2 fen), Sumu (Lignum Sappan), Honghua (Flos Carthami) (each 2 fen), Wuweizi (Fructus Schisandrae) (7 berries).
Take as one dose, decoct in water and take hot.
Wen Fen (Warm Powder)
Muli (Concha Ostreae), Maibai (Triticum Vulgare Bran), Mahuanggen (Radix Ephedrae), Bencao (Rhizoma Ligustici Wallichii), Nuomi (Oryza Sativa Glutinosa), Fangfeng (Radix Saposhnikoviae), Baizhi (Radix Angelicae Dahuricae).
Grind into powder. Dust over the entire body.
Another Prescription
Heshouwu (Radix Polygoni Multiflori Preparata) powder. Mix with saliva and apply to the umbilicus; effective.
Huangqi Jianzhong Tang (Astragalus and Middle-Tonifying Decoction)
Huangqi (Radix Astragali), Rougui (Cortex Cinnamomi) (each 3 liang), Gancao (Radix Glycyrrhizae) (2 liang), Baishaoyao (Radix Paeoniae Alba) (6 liang).
Take 5 qian per dose, with 3 slices of ginger, 1 jujube, and a little maltose, decoct in water and take.
Liangge San (Cool the Diaphragm Powder)
Lianqiao (Fructus Forsythiae) (1 liang), Shanzhi (Fructus Gardeniae), Dahuang (Radix et Rhizoma Rhei), Huangqin (Radix Scutellariae), Boheye (Folium Menthae) (each 0.5 liang), Gancao (Radix Glycyrrhizae) (1.5 liang), Puxiao (Natrii Sulfas) (1 fen).
Decoct in water and take.