经曰∶阳之汗,以天地之雨名之。又曰∶阳加于阴谓之汗。又曰∶心为汗。夫心之所藏,在内者为血,在外
者为汗。盖汗乃心之液,而自汗之证,未有不由心肾两虚而得之者。然阴虚阳必凑之,故发热而自汗,阳虚阴必凑
之,故发厥而自汗。是皆阴阳偏胜所致也。
小儿脏腑娇嫩,肤腠未密,或重衣浓被,致五内生热,热搏于心,故心液不能自藏而额汗出也。额为心之位,
宜收敛心气,团参汤。
大病后气血两虚,津液自汗,或潮热,或寒热,发过之后身凉。自汗日久,令人黄瘦,失治则变蒸疳,宜黄
固真汤。
睡中汗出,醒来则止。此心虚盗汗,宜敛心气、养心血,用团参汤。
睡中遍身有汗,觉来久不干者,此食积盗汗,脾冷所致。益黄散。
脾虚泄泻,自汗后而遍身冷,有时遇泻则无汗,不泻则有汗。此为大虚之候,急当补脾,理中汤;待泻止,
黄固真汤
凡自汗上至胸,下至脐,此胃虚也。当补胃,四君子汤加黄 。
肺虚自汗,面白唇白,六脉无力。盖因久嗽脾虚,故令自汗。四君子汤加麦冬、五味。
伤风自汗,宜实表,桂枝汤;伤寒汗出,自头至颈而止者,欲发黄也,茵陈汤。如有实热在内,烦躁汗出不
止者,胃实也,宜集成沆瀣丹微下之。
诸汗服药久不止者,用五倍子一个研细末,醋和作一小饼,贴肚脐,以带扎之,效。
《黄帝内经》说:阳气之汗,可以用天地间的雨水来命名。又说:阳气作用于阴液,就形成汗。还说:心主管汗。心中所藏之物,在体内是血,在体外则是汗。大概汗是心的体液,而自汗的病症,没有不是由于心和肾两虚而导致的。然而阴虚则阳气必会凑合其上,所以出现发热并自汗;阳虚则阴气必会凑合于内,所以出现四肢厥冷并自汗。这些都是阴阳偏盛所致。
小儿脏腑娇嫩,皮肤腠理不致密,如果穿衣过厚、盖被过暖,导致五脏内生热邪,热邪搏结于心,因此心液不能自行固藏而从额头出汗。额头是心所主的部位,应当收敛心气,使用团参汤。
大病之后气血两虚,津液外泄导致自汗,或者出现潮热,或者出现寒热往来,发作过后身体转凉。自汗日久,使人面色萎黄消瘦,若失治则会演变为疳积,宜用黄芪固真汤。
睡眠中出汗,醒来后汗止。这是心虚导致的盗汗,应当收敛心气、滋养心血,使用团参汤。
睡眠中全身出汗,醒来后很久不干者,这是食积导致的盗汗,由脾寒引起。使用益黄散。
脾虚泄泻,自汗后全身发冷,有时遇到腹泻时无汗,不腹泻时则有汗。这是大虚的证候,急当补脾,使用理中汤;待腹泻停止后,再使用黄芪固真汤。
凡是自汗从胸部向上至胸,向下至肚脐,这是胃虚的表现。应当补胃,使用四君子汤加黄芪。
肺虚自汗,面色苍白,嘴唇苍白,六脉无力。这是因为久咳导致脾虚,从而引起自汗。使用四君子汤加麦冬、五味子。
伤风引起的自汗,应当实表,使用桂枝汤;伤寒引起的汗出,仅从头到颈部为止,这是将要发黄的症状,使用茵陈汤。如果体内有实热,烦躁且汗出不止,这是胃实,宜用集成沆瀣丹轻微攻下。
各种汗症服药久治不止的,用一个五倍子研成细末,用醋调和做成一个小饼,贴在肚脐上,用带子扎紧,有效。
The *Yellow Emperor's Inner Canon* states: The sweat of Yang can be named after the rain of heaven and earth. It also states: When Yang acts upon Yin, it is called sweat. Furthermore, it states: The Heart governs sweat. What the Heart stores internally is blood, while what manifests externally is sweat. Sweat is essentially the fluid of the Heart. Cases of spontaneous sweating (Zihan) invariably arise from deficiency of both the Heart and Kidney. However, when Yin is deficient, Yang inevitably converges upon it, resulting in fever accompanied by spontaneous sweating; when Yang is deficient, Yin inevitably converges within, resulting in cold extremities (Jue) accompanied by spontaneous sweating. These are all caused by an excess of either Yin or Yang.
Children have delicate Zang-Fu organs and loose skin pores. If dressed too heavily or covered with thick quilts, heat may generate internally within the five Zang organs. This heat combats with the Heart, causing the Heart fluid to fail in self-retention, leading to sweating on the forehead. The forehead is the domain of the Heart; thus, one should converge Heart Qi using Tuanshen Tang.
After a severe illness, both Qi and Blood are deficient, leading to spontaneous sweating due to leakage of body fluids, tidal fever, or alternating chills and fever, followed by cooling of the body after the episode. Prolonged spontaneous sweating causes sallow complexion and emaciation; if untreated, it may transform into infantile malnutrition (Gan syndrome). Huanggu Zhen Tang is indicated.
Sweating during sleep that ceases upon waking is盗汗 (Dao Han, night sweats) due to Heart deficiency. One should converge Heart Qi and nourish Heart Blood using Tuanshen Tang.
Whole-body sweating during sleep that remains wet for a long time after waking is盗汗 (Dao Han, night sweats) due to food retention, caused by Spleen cold. Yihuang San is indicated.
In cases of Spleen deficiency with diarrhea, spontaneous sweating is followed by whole-body coldness. Sometimes there is no sweating during diarrhea, but sweating occurs when not having diarrhea. This indicates a state of great deficiency; immediate tonification of the Spleen is required using Lizhong Tang. After diarrhea stops, Huanggu Zhen Tang should be used.
Spontaneous sweating extending from the chest upwards to the upper chest and downwards to the navel indicates Stomach deficiency. The Stomach should be tonified using Sijunzi Tang added with Huangqi.
Lung deficiency with spontaneous sweating presents with pale face and lips, and weak pulses in all six positions. This is often due to prolonged coughing leading to Spleen deficiency, which in turn causes spontaneous sweating. Sijunzi Tang added with Maidong and Wuweizi is indicated.
For spontaneous sweating due to wind-cold injury, the exterior should be secured using Guizhi Tang. For sweating due to cold damage, where sweat is limited from head to neck, jaundice is likely to develop; Yinchen Tang is indicated. If there is excess heat internally causing restlessness and incessant sweating, this indicates Stomach excess; Jicheng Hangxie Dan should be used to mildly purge.
For various sweating conditions that do not cease despite prolonged medication, grind one Wubeizi (Chinese Gall) into fine powder, mix with vinegar to form a small cake, apply to the umbilicus, and secure with a belt. This is effective.