产妇分娩既已亡血，而又多汗，极危证也。盖汗者，心之液，荣于内为血，发于外为汗。血液属
阴，阴亡阳亦随之而走，故曰脱汗亡阳。其用药与他证不同，但血块作痛， 、术又未可遽加。如倦
甚 汗出，形色又脱，速灌加参生化汤，倍参以救危急，毋拘块痛，俟汗止再去参服之。经曰∶阳
气者，精则养神，柔则养筋。多汗不止，必发柔痉。气血俱虚，当用十全大补汤。不应，加附子。予
谓无块痛者，当用之。此证若服参、 重剂，而汗多不止，及头汗出不至腰足，难治。
自汗不止，皆由劳伤心神，不能镇守其液，治当健脾胃，散水谷之精以归肺，益其营卫，而虚血
归源，灌溉四旁，不使妄行于外而为汗也。亦用加参生化汤或麻黄根汤，并间用黄 、五味煎汤送六
味丸。《医通》云∶因外感多汗者，黄 建中汤治之。
盗汗者，睡中汗出，醒来即止，犹盗贼之瞰人睡而盗之，谓之盗汗，非自汗可比。此因亡血阴虚，
阳气偏盛。《内经》云∶阳加于阴则发汗。治当兼用血分药品。《杂病》虽有当归六黄汤，然寒而腻
膈，又不可治产后之盗汗也，宜止汗散主之。头汗者，或因湿热，或因瘀血，当审虚实治之。
半身汗出，昔人用二陈合四物，治多不效，以血药助阴，闭滞经络也。此属气血不充而有寒痰留滞，
非大补气血兼行经豁痰不效，宜十全大补、人参养荣加星、半、川乌。若肥人，多加豁痰行气药。
如瘦人，乃气血本枯，夭之征也。
麻黄根汤 治产后虚极，自汗不止。
人参（一钱或二钱） 当归（二钱） 黄 （一钱五分，蜜炙） 麻黄根 牡蛎（ ） 麦冬（
去心） 浮麦（各一钱） 桂枝（五分） 炙草（四分）
水煎服。如无块痛，加土炒白术一钱，熟地三钱。手足冷，加熟附子一片，炮姜四分。渴，加去心麦
冬一钱，五味子十粒。恶风寒，加防风五分。肥人，加竹沥一小盏，生姜汁半茶匙，以清痰火。并间服
六味丸七、八十丸，用炙黄 、五味子煎汤送下。
黄 建中汤（附小建中汤，内补建中汤。）
桂枝（三钱） 白芍（六钱，炒） 炙草（二钱） 黄 （一钱五分，蜜炙） 胶饴（一合）
生姜（五片） 大枣（四枚，劈）
上开乃古方分两，后人多有减用者，桂枝一钱，白芍二钱，炙草七分，胶饴三钱，姜三片，枣二枚。
《千金》多人参二钱。桂枝汤者，和营表药也，倍芍药加胶饴，便能创建中气，故名小建中汤。以芍药
之酸，敛护营血；胶饴之甘，培养中土。能治风木乘脾，寒热腹痛。再更加炙黄 ，即黄 建中汤，
治虚劳感寒，发热自汗。以黄 实卫气，使营卫脏腑俱和，而受益多矣。《千金》于小建中方加入
当归，名曰内补建中，其调和中外之力可知。
止汗散 治产后盗汗。
人参（二钱） 麻黄根（一钱五分） 当归（酒洗） 熟地（各三钱。如有块痛不用） 黄连（
五分，炒） 浮麦（一钱）
水煎服。一方用牡蛎末五钱，炒小麦麸八两。二味兼服三五钱，猪肉汁调服。
人参养荣汤 治心脾虚寒，荣血不足，寝汗发热。
人参 黄 （蜜酒炙） 炙草 白术（土炒） 茯苓 陈皮 熟地 当归（酒拌。各一钱） 芍
药（一钱五分，炒） 肉桂（八分） 远志（五分，甘草水制，去骨净，取肉） 五味子（七分，炒，捶碎）
姜三片，枣二枚，水煎服。（二陈合四物名八物。因不用，故不录方。）
加参生化汤（见本卷晕厥门。） 六味丸（见上卷诸痛门，附六味地黄汤下。） 十全大
补汤（见上卷胎不长养门。）
产妇在分娩后已经失血，如果又出现多汗的症状，这是极其危险的证候。因为汗是心的体液，在体内运行化为血液，从体表发出则为汗。血液属于阴液，阴液亡失，阳气也会随之脱散，所以称为“脱汗”和“亡阳”。治疗此证的用药与其他病证不同，但如果伴有血块引起的疼痛，干姜、白术等药又不可贸然使用。如果患者极度疲倦且大汗淋漓，面色神态衰败，应立即灌服加参生化汤，加倍人参用量以挽救危急局面，不要拘泥于血块疼痛的问题，等到汗止后再去除人参服用。《内经》说：“阳气，精微部分滋养精神，柔和部分滋养筋脉。”如果多汗不止，必然会导致柔痉（筋脉拘急挛缩）。若气血俱虚，应当使用十全大补汤。如果无效，加入附子。我认为如果没有血块疼痛者，应当使用此方。此证如果服用重剂量的参、芪后，汗出仍不止，或者仅头部出汗而不到腰足，则难以治疗。
自汗不止，都是由于劳损心神，不能固摄津液所致，治疗应当健运脾胃，散布水谷精微以输送至肺，补益营卫之气，使虚损之血回归本源，灌溉四肢百骸，不使其妄行于体外成为汗液。也可使用加参生化汤或麻黄根汤，并间歇使用黄芪、五味子煎汤送服六味丸。《医通》说：因外感导致多汗的，用黄芪建中汤治疗。
盗汗，是指睡眠中出汗，醒来即止，如同盗贼趁人熟睡时偷窃一样，所以叫盗汗，这与自汗不可同日而语。这是因为失血导致阴虚，阳气相对偏盛。《内经》说：“阳气加于阴分就会发汗。”治疗应当兼用血分药物。《杂病》书中虽有当归六黄汤，但该方寒凉且滋腻碍胃，不适合治疗产后的盗汗，宜用止汗散为主治方。头汗，可能是因为湿热，也可能是因为瘀血，应当辨别虚实进行治疗。
半身出汗，古人曾用二陈汤合四物汤治疗，但大多无效，因为血药助长阴气，导致经络闭滞。这属于气血不足且有寒痰留滞，如果不大补气血兼以疏通经络、豁除痰浊，是不会见效的，宜用十全大补汤或人参养荣汤加天南星、半夏、川乌。如果是肥胖之人，多加豁痰行气的药物。如果是瘦人，则是气血本已枯竭，是夭折的征兆。
麻黄根汤：治疗产后极度虚弱，自汗不止。
配方：人参（一钱或二钱）、当归（二钱）、黄芪（一钱五分，蜜炙）、麻黄根、牡蛎（适量）、麦冬（去心）、浮小麦（各一钱）、桂枝（五分）、炙甘草（四分）。
用法：水煎服。如果没有血块疼痛，加土炒白术一钱、熟地黄三钱。手足冰冷，加熟附子一片、炮姜四分。口渴，加去心麦冬一钱、五味子十粒。恶风畏寒，加防风五分。肥胖之人，加竹沥一小盏、生姜汁半茶匙，以清化痰火。并间歇服用六味丸七、八十丸，用炙黄芪、五味子煎汤送下。
黄芪建中汤（附小建中汤、内补建中汤）：
配方：桂枝（三钱）、白芍（六钱，炒）、炙甘草（二钱）、黄芪（一钱五分，蜜炙）、胶饴（一合）、生姜（五片）、大枣（四枚，劈开）。
注：以上为古方分量，后人多有减少使用的情况，如桂枝一钱，白芍二钱，炙甘草七分，胶饴三钱，姜三片，枣二枚。《千金方》常加入人参二钱。桂枝汤是和营卫解表的方剂，加倍芍药并加入胶饴，便能建立中气，所以名叫小建中汤。利用芍药的酸味，收敛保护营血；利用胶饴的甘味，培养中焦脾胃。能治疗肝木乘脾引起的寒热腹痛。再增加炙黄芪，即为黄芪建中汤，治疗虚劳感受寒邪，发热自汗。利用黄芪充实卫气，使营卫脏腑都调和，从而受益更多。《千金方》在小建中汤中加入当归，名叫内补建中汤，其调和内外的力量可想而知。
止汗散：治疗产后盗汗。
配方：人参（二钱）、麻黄根（一钱五分）、当归（酒洗）、熟地黄（各三钱。如有血块疼痛则不用）、黄连（五分，炒）、浮小麦（一钱）。
用法：水煎服。另一方案用牡蛎末五钱、炒小麦麸八两。两味药混合服用三、五钱，用猪肉汁调服。
人参养荣汤：治疗心脾虚寒，营血不足，夜间出汗发热。
配方：人参、黄芪（蜜酒炙）、炙甘草、白术（土炒）、茯苓、陈皮、熟地黄、当归（酒拌，各一钱）、白芍（一钱五分，炒）、肉桂（八分）、远志（五分，甘草水制，去骨净取肉）、五味子（七分，炒，捶碎）。
用法：生姜三片，大枣二枚，水煎服。（二陈汤合四物汤名为八物汤，因未在此处列出，故不录方。）
After childbirth, if a woman has already lost blood and subsequently experiences excessive sweating, this is an extremely critical condition. Sweat is the fluid of the Heart; within the interior it transforms into blood, and at the exterior it emerges as sweat. Blood belongs to Yin. When Yin is exhausted, Yang also departs with it; hence this is termed "sweat of collapse" (Tuo Han) and "collapse of Yang" (Wang Yang). The medication for this condition differs from other syndromes. If pain caused by blood stasis clots is present, drugs such as dried ginger (Ganjiang) and Atractylodes macrocephala Rhizome (Baizhu) should not be hastily added. If the patient is extremely fatigued with profuse sweating and a depleted appearance, Jishen Shenghua Decoction (Decoction for Generating New Blood with Ginseng) should be administered immediately, with the dosage of Ginseng Radix et Rhizoma (Renshen) doubled to rescue the critical situation. Do not be constrained by the presence of clot pain; wait until the sweating stops before removing the Ginseng. The Classic says: "The Yang Qi, in its refined aspect, nourishes the Spirit; in its soft aspect, it nourishes the sinews." If sweating continues excessively, it will inevitably lead to flaccid rigidity (Rou Jing). If both Qi and Blood are deficient, Shiquan Dabu Decoction (Decoction for Great Tonification of Ten Powers) should be used. If there is no improvement, add Prepared Aconite Lateralis Radix Preparata (Fuzi). I suggest that for those without clot pain, this formula should be used. If, after administering heavy doses of Ginseng and Astragalus Membranaceus Radix (Huangqi), sweating remains profuse, or if sweating is confined only to the head and does not reach the waist and feet, the condition is difficult to treat.
Continuous spontaneous sweating is caused by mental fatigue damaging the Heart Spirit, which fails to secure the fluids. Treatment should focus on strengthening the Spleen and Stomach, distributing the essence of food and water to the Lung, tonifying Ying and Wei, and causing the deficient blood to return to its source, irrigating the four extremities, preventing it from leaking out as sweat. One may also use Jishen Shenghua Decoction or Mahuanggen Tang (Ephedrae Caulis Decoction), and intermittently administer decoctions of Astragalus Membranaceus Radix (Huangqi) and Schisandra Chinensis Fructus (Wuweizi) to deliver Liuwei Wan (Six-Ingredient Pill with Rehmannia). The *Yitong* states: For excessive sweating due to external contraction, Huangqi Jianzhong Tang (Astragalus Decoction to Establish the Middle) is indicated.
Night sweats refer to sweating during sleep that ceases upon waking, likened to a thief stealing while one sleeps; thus it is called night sweat (Dao Han), which cannot be compared to spontaneous sweating. This is due to blood loss leading to Yin deficiency and relatively hyperactive Yang. The *Neijing* states: "When Yang acts upon Yin, sweat is produced." Treatment should incorporate herbs acting on the Blood level. Although Danggui Liuhuang Tang (Angelica Hexane Yellow Decoction) exists in texts on miscellaneous diseases, its cold and cloying nature makes it unsuitable for postpartum night sweats; Zhihan San (Sweat-Stopping Powder) is appropriate as the primary treatment. Head sweating may be due to damp-heat or blood stasis; one must differentiate excess and deficiency to treat accordingly.
Hemihidrosis (sweating on only half of the body) was previously treated with Erchen Tang combined with Siwu Tang, but often with little effect, because blood-tonifying herbs aid Yin and cause obstruction of the collaterals. This syndrome belongs to insufficiency of Qi and Blood with retention of cold phlegm. Without substantial tonification of Qi and Blood combined with unblocking the collaterals and resolving phlegm, efficacy will not be achieved. Shiquan Dabu Decoction or Renshen Yangrong Tang (Ginseng Decoction to Nourish the Ying) should be used, adding Arisaema Cum Bile (Banxia) and Aconitum Carmichaelii Radix Preparata (Chuanwu). For obese individuals, add more phlegm-resolving and Qi-moving herbs. For thin individuals, this indicates inherent exhaustion of Qi and Blood, a sign of premature death.
Mahuanggen Tang (Ephedrae Caulis Decoction): Treats extreme deficiency after childbirth with continuous spontaneous sweating.
Ingredients: Ginseng Radix et Rhizoma (Renshen) (1 qian or 2 qian), Angelica Sinensis Radix (Danggui) (2 qian), Astragalus Membranaceus Radix (Huangqi) (1.5 qian, honey-fried), Ephedrae Caulis (Mahuanggen), Oyster Shell (Muli) (appropriate amount), Ophiopogon Japonicus Tuber (Maidong) (decocted after removing heart), Floating Wheat (Fumai) (each 1 qian), Cinnamon Twig (Guizhi) (0.5 qian), Honey-fried Licorice Root (Zhigancao) (0.4 qian).
Usage: Decoct in water and drink. If there is no clot pain, add Earth-fried Atractylodes Macrocephala Rhizome (Baizhu) 1 qian and Prepared Rehmanniae Radix (Shudi) 3 qian. For cold hands and feet, add Prepared Aconiti Lateralis Radix (Fuzi) 1 slice and Prepared Zingiberis Rhizoma (Paojiang) 0.4 qian. For thirst, add Maidong 1 qian and Wuweizi 10 grains. For aversion to wind and cold, add Saposhnikoviae Radix (Fangfeng) 0.5 qian. For obese patients, add Bamboo Sap (Zhuli) 1 small cup and Ginger Juice (Shengjiangzhi) half tea spoon to clear phlegm-fire. Intermittently take 70-80 pills of Liuwei Wan, delivered with a decoction of Huangqi and Wuweizi.
Huangqi Jianzhong Tang (Astragalus Decoction to Establish the Middle) (Includes Xiaojianzhong Tang and Neibu Jianzhong Tang):
Ingredients: Cinnamon Twig (Guizhi) (3 qian), White Peony Root (Baishao) (6 qian, stir-fried), Honey-fried Licorice Root (Zhigancao) (2 qian), Astragalus Membranaceus Radix (Huangqi) (1.5 qian, honey-fried), Malt Sugar (Jiaoyi) (1 he), Fresh Ginger (Shengjiang) (5 slices), Jujube (Dazao) (4 pieces, split).
Note: The above are ancient dosages; later practitioners often reduced them, e.g., Guizhi 1 qian, Baishao 2 qian, Zhigancao 0.7 qian, Jiaoyi 3 qian, Ginger 3 slices, Jujube 2 pieces. The *Qianjin Fang* often adds Ginseng Radix et Rhizoma (Renshen) 2 qian. Guizhi Tang harmonizes the Ying and Wei levels; doubling Baishao and adding Jiaoyi establishes the Middle Qi, hence it is named Xiaojianzhong Tang. The sourness of Baishao astringes and protects Ying Blood; the sweetness of Jiaoyi nourishes the Middle Earth. It treats Liver Wood overacting on Spleen causing alternating chills and fever with abdominal pain. Adding Honey-fried Astragalus Membranaceus Radix (Huangqi) creates Huangqi Jianzhong Tang, treating deficiency-wasting conditions complicated by cold invasion, fever, and spontaneous sweating. Huangqi consolidates Wei Qi, harmonizing Ying, Wei, and Zang-Fu, thereby increasing benefits. The *Qianjin Fang* adds Angelica Sinensis Radix (Danggui) to Xiaojianzhong Tang, naming it Neibu Jianzhong Tang, demonstrating its power to harmonize interior and exterior.
Zhihan San (Sweat-Stopping Powder): Treats postpartum night sweats.
Ingredients: Ginseng Radix et Rhizoma (Renshen) (2 qian), Ephedrae Caulis (Mahuanggen) (1.5 qian), Angelica Sinensis Radix (Danggui) (wine-washed), Prepared Rehmanniae Radix (Shudi) (each 3 qian; omit if clot pain is present), Coptis Chinensis Rhizoma (Huanglian) (0.5 qian, stir-fried), Floating Wheat (Fumai) (1 qian).
Usage: Decoct in water and drink. Another prescription uses Oyster Shell (Muli) powder 5 qian and Stir-fried Wheat Bran (Xiaomai Fu) 8 liang. Take 3-5 qian of these two mixed together, taken with pork broth.
Renshen Yangrong Tang (Ginseng Decoction to Nourish the Ying): Treats Heart and Spleen deficiency-cold, insufficient Ying Blood, night sweats, and fever.
Ingredients: Ginseng Radix et Rhizoma (Renshen), Astragalus Membranaceus Radix (Huangqi) (honey-wine fried), Honey-fried Licorice Root (Zhigancao), Atractylodes Macrocephala Rhizome (Baizhu) (earth-fried), Poria (Fuling), Tangerine Peel (Chenpi), Prepared Rehmanniae Radix (Shudi), Angelica Sinensis Radix (Danggui) (wine-mixed, each 1 qian), White Peony Root (Baishao) (1.5 qian, stir-fried), Cinnamon Bark (Rougui) (0.8 qian), Polygala Tenuifolia Radix (Yuanzhi) (0.5 qian, processed with Licorice water, bone removed, flesh taken), Schisandra Chinensis Fructus (Wuweizi) (0.7 qian, stir-fried and crushed).
Usage: Fresh Ginger (Shengjiang) 3 slices, Jujube (Dazao) 2 pieces, decoct in water and drink. (Erchen Tang combined with Siwu Tang is named Bawu Tang; since it is not included here, the formula is not recorded.)
Jishen Shenghua Tang (See Syncope Section in this volume).
Liuwei Wan (See Pain Section in previous volume, attached under Liuwadihuang Wan).
Shiquan Dabu Tang (See Fetal Malnutrition Section in previous volume).