Sweating

Sweating

Sweat is essentially water from the Qi level. When blood is deficient, Qi becomes overheated, causing the body’s water to evaporate and manifest as sweat. However, if sweat only appears on the head while the rest of the body remains dry, this indicates that Yang Qi is trapped internally and surges downward to produce sweat. In such cases, Xiao Chai Hu Tang can be used to release the stagnation, allowing sweat to spread throughout the body and restore balance. Excessive, profuse sweating, on the other hand, arises from blood deficiency combined with excess Qi, resulting in boiling over and excessive perspiration; in these situations, Bai Hu Tang supplemented with Dang Gui, Pu Huang, and Chan Tui is appropriate. When hands and feet sweat profusely, it often signifies that there may be blood stasis or food accumulation in the stomach, as the limbs correspond to the central region of the body where heat tends to accumulate. Therefore, excessive sweating in the extremities is usually due to stagnation of heat in the middle burner. In such cases, Yu Zhu San combined with Zhi Ke and Hou Pu can be used to address the underlying issue, thereby eliminating the stagnation and stopping the excessive sweating. Nighttime spontaneous sweating occurs because during sleep, Qi returns to the blood level, and if blood is insufficient, Qi has nowhere to go, leading to leakage and subsequent sweating. In these cases, Dang Gui Liu Huang Tang is recommended, or Di Gu Pi San supplemented with Zao Ren, Zhi Mu, Fu Ling, Wu Wei Zi, Huang Qi, and Huang Bai can also be used.

All of the above discussions pertain to conditions arising from blood deficiency and internal Yin deficiency, where Yang Qi is suppressed and unable to rise. There are also cases of dual deficiency of Yin and Yang, characterized by spontaneous or nocturnal sweating; in such instances, Gui Pi Tang supplemented with Mai Dong and Wu Wei Zi, or Dang Gui Liu Huang Tang supplemented with Fu Zi, are suitable options.

Furthermore, there are cases of massive sweating accompanied by Yang collapse. In general diseases, Yang collapse alone indicates Yin deficiency, whereas in blood-related conditions, massive sweating with Yang collapse implies both Yin and Yang deficiency. Without large doses of Shen Fu Tang to restore Yang, it is impossible to reverse the situation; subsequently, Du Shen Tang should be administered to nourish both Qi and Yin, ultimately leading to recovery.

This discussion on sweating in blood-related conditions differs from that of other illnesses. For more detailed information, refer to the section on sweating, fever, and heat.

[Commentary] In blood-related conditions, sweating is often caused by blood deficiency and Qi overheating, with Yang Qi being suppressed and unable to rise. Treatment methods include resolving stagnation, promoting Qi circulation, breaking up blockages, and clearing heat. Commonly used formulas include Xiao Chai Hu Tang, Bai Hu Tang supplemented with Dang Gui, Pu Huang, and Chan Tui, Yu Zhu San supplemented with Zhi Ke and Hou Pu, and Dang Gui Liu Huang Tang with modifications, all of which can achieve the desired effects. For cases of dual deficiency of Yin and Yang, Gui Pi Tang supplemented with Mai Dong and Wu Wei Zi is recommended. For cases of massive sweating with Yang collapse, large doses of Shen Fu Tang should be administered immediately to restore Yang, followed by Du Shen Tang to replenish Qi and Yin, thereby achieving recovery.