〔海〕太阳自汗桂枝汤。阳明自汗白虎汤。少阴自汗四逆汤。阳明症,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,此症脉疾而非迟,故用此法。(白虎加桂枝汤方见疟。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。
〔成〕或汗出发润,与其出如油,或大如贯珠着身,出而不流,皆为不治之症。
〔《集》〕伤寒汗多不止∶内庭(泻) 合谷(泻) 复溜(泻)
二阳并病,潮热谵语,而手足 汗出者;阳明病,短气腹满,而手足 然汗出者,俱宜大
承气汤。(方论见潮热。)阳明病,不能食,小便不利,手足 然汗出者,胃冷欲作痼瘕,必大便
初硬后溏。(论见自汗。)
【海藏】太阳经自汗用桂枝汤。阳明经自汗用白虎汤。少阴经自汗用四逆汤。阳明病证,身体发热,眼睛疼痛,鼻子干燥,无法安卧,不恶寒而自汗,或者恶热,且寸脉尺脉都浮大的,用白虎汤主治。伤寒病寸脉尺脉都长,自汗大量流出,身体表面像冰石一样冷,脉象传入到里部,变得细小,以及疟疾病只有寒战没有发热的,其人动作如常,这是阳明病传入少阴经,戊(胃)合癸(肾),即夫传妇的关系,用白虎加桂枝汤主治。然而脉象虽然细小,应当以脉率快慢来辨别,此症脉率疾速而非迟缓,所以用这种方法。(白虎加桂枝汤方见疟疾章节。如果是中暑导致自汗且轻微恶寒的,也适宜服用。)
《活人书》伤寒病应当发汗,但如果动气在左侧,不可发汗,如果发汗则会导致头晕目眩、出汗、筋脉跳动肌肉抽搐,这属于逆证,难以治疗。先服用防风白术牡蛎散,再服用小建中汤。
防风白术牡蛎散 治疗发汗过多,头晕目眩、出汗、筋脉跳动肌肉抽搐。
防风 牡蛎(炒成粉) 白术(各等分)
以上药物研为细末,每次服用二钱,用酒调服,米饮也可以,每天二三次。汗止后服用小建中汤。
【成无己】有的汗出后头发湿润,或者汗出如油,或者汗珠大如串珠附着在身上,流出但不流淌,这些都是不治之症。
【《医宗金鉴》】伤寒汗多不止:针刺内庭穴(泻法) 合谷穴(泻法) 复溜穴(泻法)
两阳经并病,出现潮热谵语,且手足微微出汗的;阳明病,呼吸短促腹部胀满,且手足持续出汗的,都适宜用大承气汤。(方论见潮热章节。)阳明病,不能进食,小便不利,手足持续出汗的,是胃寒想要形成顽固积聚,必定是大便起初干硬后来稀溏。(论述见自汗章节。)
[Hai Zang] For spontaneous sweating in the Taiyang (Greater Yang) channel, Guizhi Tang (Cinnamon Twig Decoction) is used. For spontaneous sweating in the Yangming (Yang Brightness) channel, Baihu Tang (White Tiger Decoction) is used. For spontaneous sweating in the Shaoyin (Lesser Yin) channel, Sini Tang (Frigid Four Decoction) is used. In Yangming disease syndrome, characterized by fever, eye pain, nasal dryness, inability to sleep, absence of aversion to cold with spontaneous sweating, or aversion to heat with floating pulses at both the cun (inch) and chi (foot) positions, Baihu Tang (White Tiger Decoction) is the primary treatment. In cold damage disease, if both cun and chi pulses are long, with profuse spontaneous sweating, a body surface as cold as ice stones, and the pulse transmission reaching the interior becoming fine and small, as well as in malaria presenting only with chills without fever where the patient's movements remain normal, this indicates the transmission from Yangming to Shaoyin. This corresponds to the combination of Wu (Stomach Earth) and Gui (Kidney Water), representing the husband transmitting to the wife; Baizhu Jia Guizhi Tang (White Tiger plus Cinnamon Twig Decoction) should be administered. However, although the pulse is fine, it must be distinguished by its speed; since this condition presents with a rapid rather than slow pulse, this method is employed. (Baizhu Jia Guizhi Tang formula is seen in the Malaria section. If spontaneous sweating accompanied by slight aversion to cold occurs due to heatstroke, it is also suitable for administration.)
From *Huo Ren Shu* (The Book that Saves Lives): In cold damage disease, sweating should be induced; however, if there is "moving qi" on the left side, sweating should not be induced. Inducing sweating will result in dizziness, sweating, twitching of tendons, and tremors of muscles. This constitutes a counter-indication and is difficult to treat. First, administer Fangfeng Baizhu Muli San (Saposhnikovia, Atractylodes, and Oyster Shell Powder); subsequently, administer Jianzhong Tang (Build the Middle Decoction).
Fangfeng Baizhu Muli San: Treats excessive sweating leading to dizziness, sweating, tendon twitching, and muscle tremors.
Fangfeng (Radix Saposhnikoviae), Muli (Ostreae Concha, stir-fried to powder), Baizhu (Rhizoma Atractylodis Macrocephalae) in equal parts.
Grind into a fine powder. Take two qian per dose, mixed with wine or rice water. Administer two to three times daily. After sweating ceases, administer Xiao Jianzhong Tang (Minor Build the Middle Decoction).
[Cheng Wuji] Cases where hair becomes wet after sweating, or sweat flows like oil, or sweat beads form large pearls adhering to the body but do not flow, are all considered incurable conditions.
From *Yi Zong Jin Jian* (Golden Mirror of Medical Tradition): For excessive sweating in cold damage that does not stop: Needle Neiting (ST44) using the reducing method; Hegu (LI4) using the reducing method; Fuliou (KI7) using the reducing method.
When two Yang channels are diseased simultaneously, presenting with tidal fever and delirious speech, along with slight sweating of the hands and feet; or in Yangming disease, presenting with shortness of breath, abdominal fullness, and continuous sweating of the hands and feet, Da Chengqi Tang (Major Order the Qi Decoction) is appropriate for both. (Formula discussion is found in the Tidal Fever section.) In Yangming disease, if the patient cannot eat, has difficulty urinating, and exhibits continuous sweating of the hands and feet, this indicates stomach cold intending to form a stubborn accumulation (gu jia), resulting in stools that are initially hard and later loose. (Discussion is found in the Spontaneous Sweating section.)