脉
汗脉浮虚，或涩，或濡，软大洪散，渴饮无余。脉大而虚，
浮而软者，汗。在寸为自汗，在尺为盗汗。伤寒脉阴阳俱紧，当无汗。若自汗者，曰亡阳，不治。
证
夫汗者，心之液也。心动则惕惕然而汗出也。有自汗者，有盗汗者。自汗者，不因发散而自然出也；盗
汗者，睡而汗出，及觉则不出矣。自汗之症，未有不由心肾俱虚而得者。故阴虚阳必凑，发热而盗汗；阳
虚阴必乘，发厥而自汗。此阴阳偏胜之所致也。丹溪曰∶自汗属气虚，属痰与湿；盗汗属阴虚，相火炽盛。其
伤寒、伤暑、伤风、伤湿、痰嗽等自汗，各载本门。其无病而汗常自出，与病后多汗，皆属表虚卫气不固，荣
血泄漏，宜黄 建中汤加浮麦煎，黄 六一汤或玉屏风散。或身温而常出冷汗，或身冷而汗亦冷，
别无他病，并属本证。凡汗出发润，一不治也；汗出如油，二不治也；汗凝如珠，三不治也。
治
治内伤及一切虚损之症，自汗不休，总用补中益气汤，少加附子、麻黄根、小麦，其效捷如影响。但
升麻、柴胡，俱用蜜水拌炒，以杀其升发涌汗之性。又欲其引参 等药至肌表，故不可缺也。
如左寸脉浮洪而自汗者，心火炎也，本方倍参 ，加麦门冬、五味子、黄连各五分。如左关脉浮弦而自汗者，
挟风邪也，本方加桂枝、芍药。若无阴虚，只用桂枝汤亦可。左尺脉浮洪无力而自汗者，水亏火盛也，本方
加黄柏、知母各五分，熟地黄一钱，壮水之剂以制阳光。如右寸脉浮洪，或伏而滑，此挟痰也，根据本方加知
母、贝母、天花粉各八分。如右关脉浮洪无力而自汗者，此脾元怯弱也，只根据本方倍参 。右尺脉洪数无力
而自汗者，或盗汗，相火挟心火之势，而凌伐肺金也，宜当归六黄汤。
方
玉屏风散 治自汗腠理不密，易感风寒。
防风（一两） 黄 （一两） 白术（二两）
一方加浮小麦、茯苓、牡蛎、麻黄根、甘草。
上锉一剂，生姜一片，水二钟，煎一钟，空心温服。
黄 汤 治元气虚弱自汗。
黄 （二钱二分） 当归（一钱二分） 生地（一钱五分） 天门冬（一钱五分） 麦门
冬（一钱） 五味子（七分） 防风（五分） 白茯苓（一钱五分） 麻黄根（一钱） 甘草（八
分） 浮小麦（一撮，炒）
上锉一剂，水煎温服。
黄 建中汤 治内虚挟外感自汗。又补诸虚不足，羸乏少力，大益荣卫。
黄 （二钱） 肉桂（二钱） 白芍药（三钱） 甘草（炙，三钱）
上锉一剂，姜一片，枣二枚，水煎服。
镇液丹（思恒兄传）〔批〕（按此方治自汗之剂） 防风（一两，炒） 黄 （二两，蜜
炙） 白术（一两，略炒） 中桂（一两） 芍药（一两，酒炒） 大附子（二两，面裹煨，去
皮、脐，童便浸炒）
上为末，酒糊为丸。每服五十丸，空心温酒下。
当归六黄汤 治盗汗之圣药也。
当归（一钱） 黄 （一钱） 生地黄（一钱） 熟地黄（一钱） 黄柏（炒，七分） 黄
连（炒，七分） 黄芩（炒，七分）
上锉一剂，水煎，临卧服。
黄 六一汤〔批〕（按此方治盗汗之剂） 治虚人盗汗。
黄 （六两） 甘草（一两，各用蜜炙十数次，出火毒）
上锉，每剂一两，水煎，空心服。
独胜散 治自汗盗汗。
用五倍子为末，津唾调，填满脐中，以绢帛缚定，一宿即止。或加枯矾末，尤妙。
白龙汤〔批〕（按此方治自汗盗汗兼治之剂） 治六脉芤动微紧，男子失精，女子梦交及自汗盗汗等症。
桂枝（三钱） 白芍药（三钱） 甘草（炙，三钱） 龙骨（ ，三钱） 牡蛎（三钱）
上锉一剂，水煎温服，加枣子一个同煎尤好。
一人血气大虚，形体羸瘦，大汗如雨不止，命在须臾，诸医弗
效。以十全大补汤倍用参 ，以童便制附子，一剂即效，服不数剂，全安。
脉象
汗证的脉象多见浮虚，或涩，或濡，或软大洪散，伴有口渴且饮水后仍不解渴。脉象大而虚、浮而软的，主汗证。脉象见于寸部为自汗，见于尺部为盗汗。伤寒病中，若阴阳脉俱紧，应当无汗。如果出现自汗，称为亡阳，属于难治之症。
证候
汗是心的体液。心神动荡时，人会感到惊恐不安并出汗。汗证分为自汗和盗汗两种。自汗是指不因发汗治疗而自然出汗；盗汗是指睡眠时出汗，醒来后汗止。自汗的病症，没有不是由心肾两虚引起的。因此，阴虚则阳气偏亢，出现发热和盗汗；阳虚则阴气乘虚而入，出现四肢厥冷和自汗。这是阴阳偏盛所致。朱丹溪说：自汗属于气虚，属于痰湿；盗汗属于阴虚，相火炽盛。至于因伤寒、伤暑、伤风、伤湿、痰嗽等引起的自汗，分别记载在各自的门类中。如果没有患病而经常自汗，以及病后多汗，都属于表虚卫气不固，营血泄漏所致，适宜用黄芪建中汤加浮小麦煎服，或用黄芪六一汤或玉屏风散。如果身体温暖却常出冷汗，或者身体寒冷且汗也冷，没有其他疾病，都归属于本证。凡是汗出后头发湿润，是一不治；汗出如油，是二不治；汗凝如珠，是三不治。
治法
治疗内伤及一切虚损病症，自汗不止，总用补中益气汤，少量加入附子、麻黄根、小麦，效果迅速显著。但升麻、柴胡必须用蜜水拌炒，以消除其升发涌汗的性质。又希望它们能引导人参等药物到达肌表，所以不可省略。
如果左寸脉浮洪且自汗，是心火炎上，在本方中加倍人参用量，加入麦门冬、五味子、黄连各五分。如果左关脉浮弦且自汗，是挟有风邪，在本方中加入桂枝、芍药。如果没有阴虚，只用桂枝汤也可以。左尺脉浮洪无力且自汗，是水亏火盛，在本方中加入黄柏、知母各五分，熟地黄一钱，使用壮水制火的方剂。如果右寸脉浮洪，或伏而滑，这是挟痰，根据本方加入知母、贝母、天花粉各八分。如果右关脉浮洪无力且自汗，这是脾元怯弱，只根据本方加倍人参用量。右尺脉洪数无力且自汗，或者是盗汗，是相火挟带心火之势，凌犯肺金，适宜用当归六黄汤。
方剂
玉屏风散 治疗自汗腠理不密，容易感受风寒。
防风（一两） 黄芪（一两） 白术（二两）
一方加浮小麦、茯苓、牡蛎、麻黄根、甘草。
以上锉成粗末为一剂，生姜一片，水两钟，煎至一钟，空腹温服。
黄芪汤 治疗元气虚弱导致的自汗。
黄芪（二钱二分） 当归（一钱二分） 生地（一钱五分） 天门冬（一钱五分） 麦门冬（一钱） 五味子（七分） 防风（五分） 白茯苓（一钱五分） 麻黄根（一钱） 甘草（八分） 浮小麦（一撮，炒）
以上锉成粗末为一剂，水煎温服。
黄芪建中汤 治疗内虚挟外感导致的自汗。又补益诸虚不足，身体瘦弱乏力，大补荣卫。
黄芪（二钱） 肉桂（二钱） 白芍药（三钱） 甘草（炙，三钱）
以上锉成粗末为一剂，姜一片，枣二枚，水煎服。
镇液丹（思恒兄传）[批注]（按此方是治疗自汗的药剂）
防风（一两，炒） 黄芪（二两，蜜炙） 白术（一两，略炒） 中桂（一两） 芍药（一两，酒炒） 大附子（二两，面裹煨，去皮、脐，童便浸炒）
以上研为细末，酒糊制作成丸。每次服用五十丸，空腹温酒送下。
当归六黄汤 治疗盗汗的圣药。
当归（一钱） 黄芪（一钱） 生地黄（一钱） 熟地黄（一钱） 黄柏（炒，七分） 黄连（炒，七分） 黄芩（炒，七分）
以上锉成粗末为一剂，水煎，临睡前服用。
黄芪六一汤[批注]（按此方是治疗盗汗的药剂） 治疗虚人盗汗。
黄芪（六两） 甘草（一两，各用蜜炙十数次，去火毒）
以上锉碎，每剂取一两，水煎，空腹服用。
独胜散 治疗自汗盗汗。
用五倍子研为细末，用唾液调和，填满肚脐，用绢帛绑紧固定，一夜即可停止。或者加入枯矾末，效果更好。
白龙汤[批注]（按此方是治疗自汗盗汗兼治的药剂） 治疗六脉芤动微紧，男子失精，女子梦交及自汗盗汗等症状。
桂枝（三钱） 白芍药（三钱） 甘草（炙，三钱） 龙骨（ ，三钱） 牡蛎（三钱）
以上锉成粗末为一剂，水煎温服，加枣子一个同煎更好。
有一人气血大虚，形体瘦弱，大汗如雨不止，生命垂危，众医无效。用十全大补汤加倍用人参，用童便炮制附子，一剂即见效，服用不到几剂，完全康复。
Pulse
The pulse in sweating disorders is often floating and deficient, or choppy, or soggy, or soft, large, surging, and scattered, accompanied by thirst that is not relieved by drinking. A pulse that is large and deficient, or floating and soft, indicates sweating. When the pulse is felt at the cun (inch) position, it indicates spontaneous sweating; when felt at the chi (cubit) position, it indicates night sweating. In cold damage diseases, if both yin and yang pulses are tight, there should be no sweating. If spontaneous sweating occurs, it is called collapse of yang (Wang Yang), which is difficult to treat.
Syndrome
Sweat is the fluid of the Heart. When the Heart spirit agitates, one feels palpitations and sweats. Sweating disorders are divided into spontaneous sweating and night sweating. Spontaneous sweating refers to sweating naturally without the use of diaphoretic treatment; night sweating refers to sweating during sleep, which stops upon waking. The syndrome of spontaneous sweating arises invariably from deficiency of both the Heart and Kidney. Therefore, yin deficiency leads to yang encroachment, causing fever and night sweating; yang deficiency allows yin to prevail, causing cold extremities and spontaneous sweating. This results from the excess of either yin or yang. Zhu Danxi stated: Spontaneous sweating belongs to qi deficiency and phlegm-dampness; night sweating belongs to yin deficiency with flourishing ministerial fire. As for spontaneous sweating caused by cold damage, summerheat injury, wind strike, dampness injury, or phlegm cough, these are recorded in their respective sections. Spontaneous sweating in healthy individuals or excessive sweating after illness all belong to exterior deficiency with insecure Wei Qi and leakage of Ying Blood. Suitable treatments include Huangqi Jianzhong Tang (Astragalus Decoction to Establish and Enrich the Middle) added with Fumai (Floating Wheat), Huangqi Liuyi Tang (Astragalus Six-to-One Powder), or Yupingfeng San (Jade Windscreen Powder). If the body is warm but constantly emits cold sweat, or the body is cold and the sweat is also cold, with no other diseases, they all belong to this syndrome. Any case where sweat wets the hair upon emission is the first untreatable condition; sweat like oil is the second; sweat congealing like beads is the third.
Treatment
For internal injury and all deficiency syndromes with incessant spontaneous sweating, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is generally used, with small additions of Fuzi (Prepared Aconite Root), Mahuanggen (Ephedra Root), and Xiaomai (Wheat), yielding rapid effects. However, Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) must be stir-fried with honey water to mitigate their ascending and inducing-sweat properties. They are indispensable because they guide herbs such as Renshen (Ginseng Radix et Rhizoma) to the muscle layer.
If the left cun pulse is floating and surging with spontaneous sweating, it indicates flaming Heart Fire; double the dosage of Renshen in the base formula and add Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), and Huanglian (Coptidis Rhizoma), each 5 fen. If the left guan pulse is floating and wiry with spontaneous sweating, it indicates invasion by Wind Pathogen; add Guizhi (Cinnamomi Ramulus) and Shaoyao (Paeoniae Radix) to the base formula. If there is no yin deficiency, Guizhi Tang (Cinnamon Twig Decoction) alone may suffice. If the left chi pulse is floating, surging, and forceless with spontaneous sweating, it indicates Water Deficiency with Fire Excess; add Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma), each 5 fen, and Shudihuang (Rehmanniae Radix Preparata) 1 qian, using a formula to nourish Water to control Fire. If the right cun pulse is floating and surging, or deep and slippery, it indicates Phlegm; according to the base formula, add Zhimu, Beimu (Fritillariae Bulbus), and Tianguafen (Trichosanthis Radix), each 8 fen. If the right guan pulse is floating, surging, and forceless with spontaneous sweating, it indicates Spleen Yuan weakness; simply double the dosage of Renshen in the base formula. If the right chi pulse is surging, rapid, and forceless with spontaneous sweating, or night sweating, it indicates Ministerial Fire riding on the momentum of Heart Fire to invade Lung Metal; Danggui Liu Huang Tang (Angelica Hexa-Huang Decoction) is suitable.
Formulas
Yupingfeng San (Jade Windscreen Powder) treats spontaneous sweating due to loose interstices, making one susceptible to Wind-Cold.
Fangfeng (Saposhnikoviae Radix) (1 liang), Huangqi (Astragali Radix) (1 liang), Baizhu (Atractylodis Macrocephalae Rhizoma) (2 liang).
Another prescription adds Fumai (Floating Wheat), Fuling (Poria), Muli (Ostreae Concha), Mahuanggen (Ephedrae Radix et Rhizoma), and Gancao (Glycyrrhizae Radix et Rhizoma).
Grind into coarse powder for one dose. Add one slice of Shengjiang (Zingiberis Rhizoma Recens), two zhong of water, decoct to one zhong, and take warm on an empty stomach.
Huangqi Tang (Astragalus Decoction) treats spontaneous sweating due to weak Primordial Qi.
Huangqi (Astragali Radix) (2.2 qian), Danggui (Angelicae Sinensis Radix) (1.2 qian), Shengdi (Rehmanniae Radix) (1.5 qian), Tiantaimen Dong (Asparagi Radix) (1.5 qian), Maidong (Ophiopogonis Radix) (1 qian), Wuweizi (Schisandrae Fructus) (0.7 qian), Fangfeng (Saposhnikoviae Radix) (0.5 qian), Bai Fuling (Poria cum Pinodia) (1.5 qian), Mahuanggen (Ephedrae Radix et Rhizoma) (1 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (0.8 qian), Fumai (Floating Wheat) (a pinch, stir-fried).
Grind into coarse powder for one dose, decoct with water, and take warm.
Huangqi Jianzhong Tang (Astragalus Decoction to Establish and Enrich the Middle) treats spontaneous sweating due to interior deficiency with exterior pathogen invasion. It also tonifies various deficiencies, emaciation, and lack of strength, greatly benefiting Ying and Wei.
Huangqi (Astragali Radix) (2 qian), Rougui (Cinnamomi Cortex) (2 qian), Baishaoyao (Paeoniae Radix Alba) (3 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (stir-baked, 3 qian).
Grind into coarse powder for one dose. Add one slice of ginger and two dates, decoct with water, and take.
Zhenye Dan (Liquid-Calming Pill) (Passed by Brother Siheng) [Commentary] (This formula treats spontaneous sweating).
Fangfeng (Saposhnikoviae Radix) (1 liang, stir-fried), Huangqi (Astragali Radix) (2 liang, honey-stir-fried), Baizhu (Atractylodis Macrocephalae Rhizoma) (1 liang, slightly stir-fried), Zhonggui (Cinnamomi Cortex) (1 liang), Shaoyao (Paeoniae Radix) (1 liang, wine-stir-fried), Dafuzi (Aconiti Lateralis Radix Preparata) (2 liang, wrapped in flour and baked, peel and navel removed, stir-fried in child's urine).
Grind into fine powder, make pills with wine paste. Take 50 pills per dose, down with warm wine on an empty stomach.
Danggui Liu Huang Tang (Angelica Hexa-Huang Decoction) is the sacred medicine for treating night sweating.
Danggui (Angelicae Sinensis Radix) (1 qian), Huangqi (Astragali Radix) (1 qian), Shengdihuang (Rehmanniae Radix) (1 qian), Shudihuang (Rehmanniae Radix Preparata) (1 qian), Huangbai (Phellodendri Cortex) (stir-fried, 0.7 qian), Huanglian (Coptidis Rhizoma) (stir-fried, 0.7 qian), Huangqin (Scutellariae Radix) (stir-fried, 0.7 qian).
Grind into coarse powder for one dose, decoct with water, and take before retiring.
Huangqi Liuyi Tang [Commentary] (This formula treats night sweating) treats night sweating in deficient persons.
Huangqi (Astragali Radix) (6 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (1 liang, both stir-baked with honey more than ten times to remove fire toxicity).
Grind, take 1 liang per dose, decoct with water, and take on an empty stomach.
Dusheng San (Single Victory Powder) treats spontaneous and night sweating.
Use Wubeizi (Galla Chinensis) ground into powder, mixed with saliva, filled into the umbilicus, bound tightly with silk cloth. It stops within one night. Adding Kufan (Alumen) powder is even better.
Bailong Tang (White Dragon Decoction) [Commentary] (This formula treats both spontaneous and night sweating). Treats conditions where all six pulses are hollow, moving, slight, and tight, seminal emission in men, dream intercourse in women, and spontaneous/night sweating.
Guizhi (Cinnamomi Ramulus) (3 qian), Baishaoyao (Paeoniae Radix Alba) (3 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (stir-baked, 3 qian), Longgu (Fossilia Ossis Mastodi) ( , 3 qian), Muli (Ostreae Concha) (3 qian).
Grind into coarse powder for one dose, decoct with water, and take warm. Adding one date for simultaneous decoction is especially good.
A patient with severe deficiency of Qi and Blood, emaciated body, and continuous profuse sweating like rain, whose life was in imminent danger, found no relief from various physicians. Using Shiquan Dabu Tang (Ten Complete Tonifying Decoction) with doubled Renshen (Ginseng Radix et Rhizoma) and Fuzi (Prepared Aconite Root) processed with child's urine, efficacy was seen after one dose. After taking only a few doses, full recovery was achieved.