丹溪曰∶盗汗属血虚阴虚,乃阳蒸阴分而液出者为盗汗,故阴虚阳必凑,发热而盗汗,阴虚
火炎者,法当补肾,所谓壮水之主,以制阳光是也。
平人脉虚细微者,善盗汗也。尺脉虚浮或滑涩,为盗汗。脉濡者为有盗汗,阴阳俱虚也。
东垣云∶盗汗者,寐中而通身出汗如浴,觉来方知,是属阴虚,荣血之所主也,宜补阴
降火,当归六黄汤
之类是也;若虚寒者,只以黄 六一汤。盗汗发热,因阴虚,用四物汤加黄柏;兼气虚,加人
参、黄 、白术。小儿盗汗不用治,盖血未足也。
当归六黄汤 治盗汗之圣药。
当归 生地黄 熟地黄 黄连 黄芩 黄柏(各一钱) 黄 (蜜炙,二钱)
上水二盏,煎八分服。或加甘草、浮麦、麻黄根。
黄 六一汤 治阴阳俱虚而盗汗。
黄 (蜜炙,六钱) 甘草(炙,一钱) 水二盏,煎一盏服。
黄 汤 治虚盗汗。
黄 (蜜炙) 人参 甘草(炙) 白扁豆(炒) 白术(炒) 白茯苓 陈皮 半夏(制)
山药 干葛(各等分)
每服八钱,水二盏,煎一盏,温服。
神效麦麸汤 治心气盗汗。
麦麸(炒黄色,一钱) 防风 白术(炒) 牡蛎(制) 黄 (蜜炙。各钱半)
水二盏,枣二枚,煎八分,调辰砂妙香散,极效。
辰砂妙香散 治盗汗,补气血,安心神。
大补阴丸 治盗汗。(方见虚损门)
玉屏风散 治自汗、盗汗俱效。(方见自汗门。)
白苓汤 治虚盗汗。
黄 (炙) 防风 白茯苓 白术(各一钱) 麻黄根 甘草 牡蛎(各五分) 小麦(五粒)
上水盏半,煎八分,食远服。
麦煎散 治营卫不调,夜多盗汗,四肢烦痛,肌肉消瘦。
知母 石膏 甘草(炙) 滑石 地骨皮 杏仁(去皮尖) 赤芍药 葶苈 人参 白茯苓 麻黄银(各等分)
上为末,每服二钱,浮麦煎汤,食远调服。
石斛散 治阴虚盗汗。
柴胡 防风 五味子 小草 远志(去心) 黄 (炙) 官桂 石斛 白术(炒) 甘草(炙) 茯苓(各等分)
上每服七钱,水二盏,煎八分,食前温服。
生地黄煎 治阴火盗汗。
生地黄 当归 黄 (炙) 黄连 黄芩 甘草(炙) 麻黄根 黄柏 浮小麦(各一钱)
水二盏,煎八分,温服。
术茯汤 治脾虚盗汗。
白术(三钱) 白茯苓(二钱)
上水盏半,姜三片、枣二枚,煎八分,调妙香散,至夜温服。
参苓散 治睡中汗出。
酸枣仁(炒去衣) 人参 白茯苓(各等分)
上为细末,每服三钱,食远米饮调下。大人小儿皆可服。
龙胆散 治盗汗有热。
龙胆草 防风(各等分)
上为细末,每服一钱,温米饮调下,临卧服。
防风散 治盗汗不止。
防风(一两) 人参(半两) 川芎(四钱)
上为细末,每服三钱,临卧米汤调下。
正气散 治盗汗。
黄柏(炒) 知母(炒。各二钱) 甘草(炙,六分)
上水盏半,煎八分,热服。
四白散 治男妇血虚发热,夜多盗汗,羸瘦,脚痛不能行。
白术 白扁豆 白茯苓 白豆蔻 浓朴(姜汁炒) 黄 (各七分) 藿香 益智仁 人参
半夏 陈皮 乌药 甘草 芍药(各五分) 檀香 沉香(各一分)
上水二盏,姜三片、枣二枚,煎八分,食前温服。
椒目散 治盗汗日久不止。
椒目 麻黄根(各等分)
上为细末,每服一钱,食后无灰酒调下。
白术散 治盗汗极验。
白术(半斤,切成小块,用浮麦一升,水一斗,煮干,如白术尚硬,又加水,者烂取起,
切片焙干,去麦)
上为末,每服三钱。别用浮麦煎汤,食远调服。
治盗汗歌曰∶睡中有汗醒时知,熟煮猪筒骨最宜。浓汁热调平胃散,清晨一服夜应稀。
朱丹溪说:盗汗属于血虚和阴虚,是由于阳气蒸腾阴分,导致津液外泄而形成的盗汗,所以阴虚时阳气必然凑集,出现发热并伴有盗汗;若是阴虚火旺的情况,治疗法则应当补肾,这就是所说的“壮水之主,以制约阳光”的道理。
普通人脉象虚、细、微的,容易患盗汗。尺部脉象虚浮或滑涩的,也是盗汗的表现。脉象濡软的,说明有盗汗,这是阴阳两虚的缘故。
李东垣说:盗汗是指睡眠中全身出汗如洗澡一般,醒来后才发觉,这属于阴虚,是营血所主的问题,适宜采用补阴降火的方法,当归六黄汤(Danggui Liuhuang Tang, Cinnamon Twig and Six-Huang Decoction)之类的方剂就是适用的;如果是虚寒体质,只用黄芪六一汤(Huangqi Liuyi Tang, Astragalus and Licorice Decoction)。盗汗发热,因阴虚引起,可用四物汤(Sini Tang, Four-Substance Decoction)加黄柏;兼有气虚的,加入人参、黄芪、白术。小儿盗汗不需要特别治疗,因为小儿气血尚未充足。
当归六黄汤是治疗盗汗的神效药物。
组成:当归、生地黄、熟地黄、黄连、黄芩、黄柏(各一钱),黄芪(蜜炙,二钱)。
用法:用水二盏,煎至八分,服用。也可以加入甘草、浮小麦、麻黄根。
黄芪六一汤治疗阴阳俱虚引起的盗汗。
组成:黄芪(蜜炙,六钱),甘草(炙,一钱)。
用法:用水二盏,煎至一盏,服用。
黄芪汤治疗虚证盗汗。
组成:黄芪(蜜炙)、人参、甘草(炙)、白扁豆(炒)、白术(炒)、白茯苓、陈皮、半夏(制)、山药、干葛(各等分)。
用法:每次服用八钱,用水二盏,煎至一盏,温服。
神效麦麸汤治疗心气不足引起的盗汗。
组成:麦麸(炒至黄色,一钱),防风、白术(炒)、牡蛎(制)、黄芪(蜜炙,各钱半)。
用法:用水二盏,大枣二枚,煎至八分,调入辰砂妙香散(Chensha Miaoxiang San, Cinnabar and Miraculous Fragrance Powder),效果极佳。
辰砂妙香散治疗盗汗,补益气血,安定心神。(具体方剂见虚损门章节)
白苓汤治疗虚证盗汗。
组成:黄芪(炙)、防风、白茯苓、白术(各一钱),麻黄根、甘草、牡蛎(各五分),小麦(五粒)。
用法:用水一盏半,煎至八分,饭后稍久服用。
麦煎散治疗营卫不调,夜间多盗汗,四肢烦痛,肌肉消瘦。
组成:知母、石膏、甘草(炙)、滑石、地骨皮、杏仁(去皮尖)、赤芍药、葶苈子、人参、白茯苓、麻黄银(各等分)。
用法:以上药材研为细末,每次服用二钱,用浮小麦煎汤,在饭后稍久时调服。
石斛散治疗阴虚盗汗。
组成:柴胡、防风、五味子、小草、远志(去心)、黄芪(炙)、官桂、石斛、白术(炒)、甘草(炙)、茯苓(各等分)。
用法:每次服用七钱,用水二盏,煎至八分,饭前温服。
生地黄煎治疗阴火引起的盗汗。
组成:生地黄、当归、黄芪(炙)、黄连、黄芩、甘草(炙)、麻黄根、黄柏、浮小麦(各一钱)。
用法:用水二盏,煎至八分,温服。
术茯汤治疗脾虚盗汗。
组成:白术(三钱),白茯苓(二钱)。
用法:用水一盏半,生姜三片、大枣二枚,煎至八分,调入妙香散,至夜晚温服。
参苓散治疗睡中出汗。
组成:酸枣仁(炒去衣)、人参、白茯苓(各等分)。
用法:以上研为细末,每次服用三钱,在饭后稍久时用米饮调下。大人小孩都可以服用。
龙胆散治疗盗汗伴有热象。
组成:龙胆草、防风(各等分)。
用法:以上研为细末,每次服用一钱,用温米饮调下,临睡前服用。
防风散治疗盗汗不止。
组成:防风(一两),人参(半两),川芎(四钱)。
用法:以上研为细末,每次服用三钱,临睡前用米汤调下。
正气散治疗盗汗。
组成:黄柏(炒)、知母(炒,各二钱),甘草(炙,六分)。
用法:用水一盏半,煎至八分,热服。
四白散治疗男女血虚发热,夜间多盗汗,身体消瘦,脚痛不能行走。
组成:白术、白扁豆、白茯苓、白豆蔻、浓朴(姜汁炒)、黄芪(各七分),藿香、益智仁、人参、半夏、陈皮、乌药、甘草、芍药(各五分),檀香、沉香(各一分)。
用法:用水二盏,生姜三片、大枣二枚,煎至八分,饭前温服。
椒目散治疗盗汗日久不止。
组成:椒目、麻黄根(各等分)。
用法:以上研为细末,每次服用一钱,饭后用无灰酒调下。
白术散治疗盗汗极为灵验。
组成:白术(半斤,切成小块,用浮小麦一升,水一斗,煮至水干,如果白术还硬,再加水,煮烂后取出,切片焙干,去掉小麦)。
用法:以上研为细末,每次服用三钱。另外用浮小麦煎汤,在饭后稍久时调服。
治疗盗汗的歌诀说:睡觉中有汗醒来才知晓,熟煮猪筒骨最为适宜。用浓汁热调平胃散(Pingwei San, Peaceful Stomach Powder),清晨服用一次,夜间出汗就会减少。
Zhu Danxi stated: Night sweats belong to blood deficiency and yin deficiency. They occur when yang steams the yin portion, causing fluids to leak out; thus, when yin is deficient, yang inevitably converges, leading to fever accompanied by night sweats. In cases of yin deficiency with flaming fire, the treatment principle should be to tonify the kidney. This is what is referred to as "strengthening the master of water to control the sunlight."
In ordinary people, a pulse that is empty, fine, and minute indicates a predisposition to night sweats. A pulse at the chi position that is empty and floating, or slippery and choppy, also signifies night sweats. A soggy pulse indicates the presence of night sweats, which is due to the deficiency of both yin and yang.
Li Dongyuan stated: Night sweats refer to sweating all over the body like bathing during sleep, only realizing it upon waking. This belongs to yin deficiency and is governed by nutritive blood. It is appropriate to use methods that tonify yin and descend fire, such as Danggui Liuhuang Tang (Cinnamon Twig and Six-Huang Decoction). If the condition is characterized by deficiency-cold, only Huangqi Liuyi Tang (Astragalus and Licorice Decoction) should be used. For night sweats with fever caused by yin deficiency, Siwu Tang (Four-Substance Decoction) can be used with added Huangbai (Phellodendri Cortex); if qi deficiency is also present, add Renshen (Ginseng Radix), Huangqi (Astragali Radix), and Baizhu (Atractylodis Macrocephalae Rhizoma). Night sweats in children do not require specific treatment, as their blood has not yet fully developed.
Danggui Liuhuang Tang is a miraculous medicine for treating night sweats.
Ingredients: Danggui (Angelicae Sinensis Radix), Shengdihuang (Rehmanniae Radix Recens), Shudihuang (Rehmanniae Radix Preparata), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex) (each 1 qian), Huangqi (Astragali Radix, honey-fried, 2 qian).
Preparation: Use two cups of water, decoct until eight-tenths remain, and take orally. One may also add Gancao (Glycyrrhizae Radix et Rhizoma), Fumai (Tritici Fructus Immaturus), and Mahuanggen (Ephedrae Radix et Rhizoma).
Huangqi Liuyi Tang treats night sweats caused by deficiency of both yin and yang.
Ingredients: Huangqi (Astragali Radix, honey-fried, 6 qian), Gancao (Glycyrrhizae Radix et Rhizoma, fried, 1 qian).
Preparation: Use two cups of water, decoct until one cup remains, and take orally.
Huangqi Tang treats deficiency-type night sweats.
Ingredients: Huangqi (Astragali Radix, honey-fried), Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix et Rhizoma, fried), Baibian Dou (Lablab Semen Album), Baizhu (Atractylodis Macrocephalae Rhizoma, fried), Baifuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma Preparatum), Shanyao (Dioscoreae Rhizoma), Gange (Puerariae Radix) (each equal parts).
Preparation: Take 8 qian per dose, use two cups of water, decoct until one cup remains, and take warm.
Shenxiao Maifou Tang treats night sweats caused by heart qi deficiency.
Ingredients: Maifou (Tritici Fructus, stir-fried until yellow, 1 qian), Fangfeng (Saposhnikoviae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, fried), Muli (Ostreae Concha, prepared), Huangqi (Astragali Radix, honey-fried, each 1.5 qian).
Preparation: Use two cups of water and two jujubes, decoct until eight-tenths remain, then mix with Chensha Miaoxiang San (Cinnabar and Miraculous Fragrance Powder). The effect is excellent.
Chensha Miaoxiang San treats night sweats, tonifies qi and blood, and calms the spirit. (See the Deficiency Damage section for the formula.)
Dabuyin Wan treats night sweats. (See the Deficiency Damage section for the formula.)
Yupingfeng San is effective for both spontaneous sweating and night sweats. (See the Spontaneous Sweating section for the formula.)
Bailing Tang treats deficiency-type night sweats.
Ingredients: Huangqi (Astragali Radix, fried), Fangfeng (Saposhnikoviae Radix), Baifuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 1 qian), Mahuanggen (Ephedrae Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Muli (Ostreae Concha) (each 0.5 qian), Xiaomai (Tritici Fructus, 5 grains).
Preparation: Use one and a half cups of water, decoct until eight-tenths remain, and take well after meals.
Maijian San treats disharmony of ying and wei, frequent night sweats at night, painful limbs, and emaciation.
Ingredients: Zhimu (Anemarrhenae Rhizoma), Shigao (Gypsum Fibrosum), Gancao (Glycyrrhizae Radix et Rhizoma, fried), Huashi (Talcum), Digupi (Lycii Cortex), Xingren (Armeniacae Semen Amarum, skin and tip removed), Chi Shaoyao (Paeoniae Radix Rubra), Tingli (Descurainiae Semen seu Lepidii Semen), Renshen (Ginseng Radix), Baifuling (Poria), Mahuangyin (Ephedrae Herba) (each equal parts).
Preparation: Grind into fine powder. Take 2 qian per dose, mix with decoction of Fumai (Tritici Fructus Immaturus), and take well after meals.
Shihu San treats yin deficiency night sweats.
Ingredients: Chaihu (Bupleuri Radix), Fangfeng (Saposhnikoviae Radix), Wuweizi (Schisandrae Chinensis Fructus), Xiaocao (Ophiopogonis Radix), Yuanzhi (Polygalae Radix, heart removed), Huangqi (Astragali Radix, fried), Guongui (Cinnamomi Ramulus), Shihu (Dendrobii Caulis), Baizhu (Atractylodis Macrocephalae Rhizoma, fried), Gancao (Glycyrrhizae Radix et Rhizoma, fried), Fuling (Poria) (each equal parts).
Preparation: Take 7 qian per dose, use two cups of water, decoct until eight-tenths remain, and take warm before meals.
Shengdihuang Jian treats night sweats caused by yin fire.
Ingredients: Shengdihuang (Rehmanniae Radix Recens), Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Radix, fried), Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, fried), Mahuanggen (Ephedrae Radix et Rhizoma), Huangbai (Phellodendri Cortex), Fuxiaomai (Tritici Fructus Immaturus) (each 1 qian).
Preparation: Use two cups of water, decoct until eight-tenths remain, and take warm.
Shufu Tang treats spleen deficiency night sweats.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma, 3 qian), Baifuling (Poria, 2 qian).
Preparation: Use one and a half cups of water, three slices of ginger, and two jujubes, decoct until eight-tenths remain, then mix with Miaoxiang San, and take warm at night.
Shenling San treats sweating during sleep.
Ingredients: Suanzaoren (Ziziphi Spinosae Semen, stir-fried and husked), Renshen (Ginseng Radix), Baifuling (Poria) (each equal parts).
Preparation: Grind into fine powder. Take 3 qian per dose, mix with rice drink, and take well after meals. Suitable for both adults and children.
Longdan San treats night sweats with heat.
Ingredients: Longdancao (Gentianae Radix), Fangfeng (Saposhnikoviae Radix) (each equal parts).
Preparation: Grind into fine powder. Take 1 qian per dose, mix with warm rice drink, and take before bed.
Fangfeng San treats persistent night sweats.
Ingredients: Fangfeng (Saposhnikoviae Radix, 1 liang), Renshen (Ginseng Radix, 0.5 liang), Chuanxiong (Ligustici Chuanxiong Rhizoma, 4 qian).
Preparation: Grind into fine powder. Take 3 qian per dose, mix with rice soup, and take before bed.
Zhengqi San treats night sweats.
Ingredients: Huangbai (Phellodendri Cortex, stir-fried), Zhimu (Anemarrhenae Rhizoma, stir-fried, each 2 qian), Gancao (Glycyrrhizae Radix et Rhizoma, fried, 0.6 qian).
Preparation: Use one and a half cups of water, decoct until eight-tenths remain, and take hot.
Sibai San treats blood deficiency fever in men and women, frequent night sweats at night, emaciation, and leg pain preventing walking.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma), Baibian Dou (Lablab Semen Album), Baifuling (Poria), Baidoukou (Amomi Fructus Rotundus), Nongpo (Magnoliae Officinalis Cortex, stir-fried with ginger juice), Huangqi (Astragali Radix) (each 0.7 fen), Huoxiang (Agastaches Herba), Yizhiren (Alpiniae Oxyphyllae Fructus), Renshen (Ginseng Radix), Banxia (Pinelliae Rhizoma Preparatum), Chenpi (Citri Reticulatae Pericarpium), Wuyao (Linderae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Shaoyao (Paeoniae Radix) (each 0.5 fen), Tanxiang (Santalum Album Lignum), Chenxiang (Aquilariae Lignum Resinatum) (each 0.1 fen).
Preparation: Use two cups of water, three slices of ginger, and two jujubes, decoct until eight-tenths remain, and take warm before meals.
Jiaomu San treats long-standing persistent night sweats.
Ingredients: Jiaomu (Zanthoxyli Semen), Mahuanggen (Ephedrae Radix et Rhizoma) (each equal parts).
Preparation: Grind into fine powder. Take 1 qian per dose, mix with non-intoxicating wine, and take after meals.
Baizhu San is extremely effective for treating night sweats.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma, 0.5 jin, cut into small pieces, boiled with 1 sheng of Fumai and 1 dou of water until dry; if still hard, add more water and boil until soft, then remove, slice, and dry).
Preparation: Grind into powder. Take 3 qian per dose. Separately decoct Fumai in water, mix, and take well after meals.
The song for treating night sweats states: "Sweat during sleep, known upon waking; boiled pork marrow bones are best. Mix Pingwei San with thick broth and take hot; one dose in the morning will reduce night sweat."