汗出发润及如油,或大如贯珠,着身出而不流者死。
发湿温汗,名曰重 死。乃人素有湿,因而中暑,暑温相搏。
自汗属太阴脾经,脾之真气随汗而泄,复以热药汗之,两热相攻,热旺脾
脱,口不能言,而耳聋身不知痛,身青面变而死,有白虎加苍术,救其在表里
者,可保十死一生。
睡中出,曰盗汗。
盗汗,邪气在半表半里也。
睡则卫气行于里,乘表中阳气不密,故自汗,觉则气散于表,故汗止。
头汗,邪热内蓄不得越,蒸于阳经,且头汗为里虚表实,玄府不开则阳气上
蒸于头。头汗则五脏枯干,心包络中空虚,至此则津液竭也,切勿下之,下之则
肠胃真气大泄,津液外亡,故曰重虚,凡头汗忌下。
一表也,头汗,往来寒热,宜柴胡桂枝干姜汤。
一半表半里,头汗,名曰阳微结则阳气衰而肠胃燥,大便秘结矣,宜小柴
胡,次与脾约丸润之。
又有胸胁满微结,小便不利,呕而渴,但头汗,往来寒热,及微恶寒、手足冷、
大便硬,脉细,亦是也。
一里也,头汗,名曰纯阴结,不热但烦渴,便秘不通,宜大柴胡下之,不热者,热在内。
热入血室,头汗,谵语,宜小柴胡加生地黄。
瘀热在里,渴而小便不利,发黄,头汗,宜茵陈五苓散。
阳明病,心下懊 ,宜栀子豆豉汤,吐其胸胃之邪也。
水结胸,头汗,心下紧满,宜小半夏加茯苓。
寒湿相搏,头汗,欲得被覆向火。
阳明被火。
虚烦。
汗出后头发湿润如油,或者汗珠大如串珠,附着在身上却不流淌的,属于死证。
头发潮湿且伴有温热之汗,称为“重”(zhòng),也是死证。这是因为人体素来有湿邪,又因中暑,导致暑热与湿邪相互搏结。
自汗属于太阴脾经病变,脾脏的真气随着汗液外泄,如果再使用发汗的热药,两股热邪相互攻伐,热势亢盛导致脾气脱失,患者口不能言,耳聋且身体不知疼痛,面色青黑改变而死亡。这种情况可用白虎加苍术汤,救治表里同病者,或许能保住十分之一的生机。
睡眠中出汗,称为盗汗。
盗汗,是邪气位于半表半里的表现。
睡眠时卫气运行于体内,乘表中阳气不固密,所以自然出汗;醒来时气散于体表,所以汗止。
头汗,是邪热内蓄无法发散,蒸腾于阳经所致。而且头汗属于里虚表实,玄府(汗孔)不开则阳气上蒸于头部。出现头汗说明五脏津液枯干,心包络中空虚,至此津液已竭,切勿使用泻下法,否则肠胃真气大量泄失,津液外亡,所以称为“重虚”,凡是头汗都忌用泻下法。
属于表证兼见头汗、寒热往来,宜用柴胡桂枝干姜汤。
属于一半表半里证兼见头汗,称为“阳微结”,此时阳气衰微而肠胃干燥,大便秘结,宜用小柴胡汤,随后给予脾约丸以润燥。
又有胸胁胀满轻微痞结,小便不利,呕吐且口渴,仅头部出汗,寒热往来,以及轻微恶寒、手足冷、大便硬、脉细,也属于此类。
属于里证兼见头汗,称为“纯阴结”,无发热但烦躁口渴,便秘不通,宜用大柴胡汤泻下,若无发热,是因为热邪在内。
热入血室,出现头汗、谵语,宜用小柴胡汤加生地黄。
瘀热在里,口渴且小便不利,发黄,头汗,宜用茵陈五苓散。
阳明病,心中烦闷懊恼,宜用栀子豉汤,以吐出胸胃之邪。
水饮结聚于胸,出现头汗,心下紧满,宜用小半夏加茯苓汤。
寒湿相互搏结,出现头汗,想要盖被子靠近火源取暖。
阳明病误用火疗。
虚烦。
If sweat causes the hair to become moist and oily, or if the sweat droplets are as large as beads strung together, adhering to the body without flowing off, death ensues.
If the hair is wet with warm sweat, it is termed *Chong* (Heavy/Severe), which also indicates a fatal condition. This occurs when a person previously had dampness in their constitution and subsequently contracted summerheat, causing summerheat and dampness to contend with each other.
Spontaneous sweating belongs to the Taiyin Spleen Meridian. The true Qi of the spleen escapes with the sweat. If hot diaphoretic medicines are then administered, the two heats attack each other; excessive heat leads to the collapse of Spleen Qi, resulting in an inability to speak, deafness, insensitivity of the body to pain, a bluish complexion, and death. In cases where both exterior and interior are affected, Baihu Jia Cangzhu Tang (White Tiger plus Atractylodis Rhizoma Decoction) may be used to rescue the patient, offering perhaps one chance in ten of survival.
Sweating during sleep is termed Night Sweats (Daohan).
Night sweats indicate that pathogenic factors are located at the Half-Exterior and Half-Interior.
During sleep, Wei Qi (Defensive Qi) travels inside the body. Taking advantage of the lack of solidity in the Yang Qi at the exterior and interior boundaries, spontaneous sweating occurs. Upon waking, Qi disperses to the exterior, so sweating stops.
Head sweating results from internal accumulation of pathogenic heat that cannot vent, steaming upwards into the Yang meridians. Furthermore, head sweating signifies Interior Deficiency and Exterior Excess. When the Xuanfu (pores) do not open, Yang Qi steams upward to the head. The appearance of head sweating indicates that the fluids of the Five Zang Organs are dried up and the Pericardium Collateral is hollow and empty; at this stage, body fluids are exhausted. Purging methods must strictly be avoided. If purging is used, the true Qi of the intestines and stomach will be severely depleted, and fluids will escape externally, hence it is called "Double Deficiency." All cases of head sweating contraindicate purging.
In cases of Exterior syndrome accompanied by head sweating and alternating chills and fever, Chaihu Guizhi Ganjiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction) is indicated.
In cases of Half-Exterior and Half-Interior syndrome accompanied by head sweating, termed "Yang Mild Obstruction," Yang Qi is declining while the intestines and stomach are dry, leading to constipation. Xiao Chaihu Tang (Minor Bupleurum Decoction) should be administered first, followed by Pi Yue Wan (Splee Restriction Pill) to moisten dryness.
There are also cases presenting with fullness and slight obstruction in the chest and hypochondrium, difficulty in urination, vomiting with thirst, only head sweating, alternating chills and fever, slight aversion to cold, cold hands and feet, hard stools, and a fine pulse; these also belong to this category.
In cases of Interior syndrome accompanied by head sweating, termed "Pure Yin Obstruction," there is no fever but there is irritability and thirst, along with constipation. Da Chaihu Tang (Major Bupleurum Decoction) should be used to purge. If there is no fever, it is because the heat is located internally.
When Heat enters the Blood Chamber, manifesting as head sweating and delirious speech, Xiao Chaihu Tang Sheng Dihuang Tang (Minor Bupleurum Decoction with Rehmanniae Radix) is indicated.
When Stagnant Heat resides in the interior, manifesting as thirst, difficulty in urination, jaundice, and head sweating, Yinchin Wuling San (Artemisiae Scopariae and Five-Ingredient Powder with Poria) is indicated.
In Yangming Disease, if there is oppression and restlessness in the epigastrium, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) is indicated to expel pathogenic factors from the chest and stomach.
When Water obstructs the Chest, manifesting as head sweating and tight fullness in the epigastrium, Xiaobanxia Jia Fuling Tang (Minor Pinellia Decoction plus Poria) is indicated.
When Cold and Dampness contend, manifesting as head sweating, the patient desires to cover themselves and face fire for warmth.
Yangming disease treated incorrectly with Fire therapy.
Empty irritability.