TCM Diagnoses and Treatments
Spontaneous Sweating + Night Sweating
Etiology & Pathology:
Etiology:
1) Spontaneous Sweating:
Interior & Exterior injuries
Def. : disharmonize of Ying & Wei
Yang Def.
Lung Qi def.
Excess: Liver fire
Interior heat
Damp heat
2) Night Sweating:
Yin Def. type of heat
(Qi Def. Yang Def. or Damp-heat)

Treatment for differentiation
Harmonize Ying & Wei
-- Gui Zhi
Clear Heat + expel fire
-- Long Dan Cao, Shi Gao
Clear the damp-heat
-- Ze Xie
Tonify Qi & consolidate superficial resistance
-- Huang Qi, Bai Zhu
Tonify Yin & Clear def. type of fire
-- Gui Ban, Bie Jia
Warm Yang Qi to stop sweating
-- Fu zi, Gui Zhi

Treatment
1) Disharmony between Ying & Wei
Signs & Symptoms:
– Main Sym. : sweating now &again, or sweating only at the head, foot or half of the body
– Concurrent sym.: aversion to wind, pain in whole body, slight fever, headache
– Tongue: normal body with thin white coating
– Pulse: floating & slow
• Treatment Protocol:
– Dispelling wind
– Regulating Ying & Wei

Formula:
Gui Zhi Bai Shao
Gui Zhi Tang
Sheng Jiang Da Zhao Gan Cao
Modifications:
Sweating
-- Long Gu, Mu li
Qi Def.
-- Huang Qi, Dang Shen
Yang Def.
-- Fu zi half body or local area sweating
-- Gan Mai Da Zao Tang sweating+ heaviness of body
-- Fang Feng, Dou Juan wind-heat attacking
-- Sang Ju Yin + xuan Shen, Yin Hua
Some insomnia patients: sweating after emotional change
-- Gui Zhi Jia Long Gu Mu Li Tang

Signs & Symptoms:
– Main Sym. : sweating & aversion to wind, sweating even more after activity.
– Concurrent sym.: Pale complexion, anorexia, lassitude & tending to have a cold
– Tongue: thin coating
– Pulse: thready & weak
• Treatment Protocol:
– Tonify Qi to consolidate superficial resistance

Formula:
Huang Qi Bai Zhu
Yu Ping Feng San
Fang Feng
Modifications: sweating
-- Fu Xiao Mai, Ru Dao Geng, Mu Li, Long Gu
Qi Def.
-- Dang Sheng, Huang Jing
Yin Def.
-- Mai Dong, Wu Wei Zi
Sweating on hands & feet: Sp Qi Def.
-- Huang Qi Jian Zhong Tang
( Huang Qi, Bai Shao, Gui Zhi, Zhi Gan Cao, Sheng Jiang, Da zhao, Yi Tang)

Signs & Symptoms:
– Main Sym. : Night sweating, sometime spontaneous sweating.
– Concurrent sym.: Insomnia, low fever, dysphoria with feverish sensation in the chest, palms & soles, thirsty.
– Tongue: red body with little coating
– Pulse: thready, rapid
• Treatment Protocol:
– Nourish Yin to reduce fire

Formula:
Dang Gui Shu Di
Huang Bai Huang Qin
Dang Gui Liu Huang Yin
Sheng Di Huang lian Huang Qi

Treatment
4) Interior Excess Fire
Caused by interior dampness, stagnated liver Qi
Signs & Symptoms:
– Main Sym. : Continuous sweating with greasy or yellow sweating, sometimes sweating only at head, or at hands and feet
– Concurrent sym.: Red face, thirsty like drinking cold water, fever , restlessness, constipation, brown urination
– Tongue: red tongue with thick yellow fur or yellow greasy fur
– Pulse: slippery & rapid or full
•
Treatment Protocol:
–
Clearing away st. heat, or eliminating damp-heat

Formula:
Shi Gao Zhi Mu
Zhi Zhi Sheng Gan Cao
Bai Hu Tang
Lu Geng Tian Hua Feng Xuan Sheng thirsty
-- Tian Hua Feng
Constipation:
-- Xiao Cheng Qi Tang
Damp-heat
-- Long Dan Xie Gan Tang
Lower limbs sweating
-- Niu Xi
Chest oppression or stuffiness & tightness sensation
-- Huang Lian, Hou Pu

Case History1
1. Male 67 years
Medical history: Patient always has spontaneous sweating in normal days, worse after activity. Even in winter, sweating on the head. Easy to get cold outside.
First visiting:
Main complain: Night sweating for 3 month
3 month ago, daily spontaneous sweating turn to night sweating. After waking up, the cover and clothing are all wet. Aversion to wind & cold. Oppressed feeling in the chest, palpitation, cold limbs, shortness of breath, overweight body type, dry skin, dry mouth…
Tongue: little dark of the body with little yellow coating
Pulse: deep & thready
TCM diagnose:
Yang Qi Def. + Yin Def..
Treatment protocol:
Tonify Yin & strengthen Yang Qi
Formula
Fu Xiao Mai 20, Huang Qi 20, Long Gu 30, Mu Li 30, Shan Yu Rou 15, Ru
Dao Geng 10, Shen Di 15, Shu Di 15, Huang Bai 10g , JIng Yin Zi 15, Qian Shi
10
,

Case History2
1. Male 35 years
First visiting:
Main complain: Spontaneous sweating on head for 10 years
Pale complexion, lassitude, thirsty and prefer to have a drink, continuously sweating upper neck, worse on day time, also worse after meal and activity.
Patient has been treated by Yang Qi & Yin def. for years but no working.
Tongue: stasis purple color on both sides of tongue body with yellow greasy coating
Pulse: weak
TCM diagnose:
Yin blood stasis after long illness, Wei Qi Def. fail to protect the body
Treatment protocol:
Move blood stasis, tonify Qi to stop sweating
Formula
Xue Fu Zhu Yu Tang
Tao Ren 6, Hong Hua 6, Dang Gui 10, Sheng Di 12, Chi Shao 10, Niu Xi 10,
Chuan Xiong 5, Zhi Ke 6, Jie Geng 5, Zhi Gan Cao 3, Huang Qi 15, Fu Xiao Mai
30, Ru Dao Geng 30
X 14 Bags
,

Case History3
Female 27 y
First visiting:
Main complains: spontaneous sweating & night sweating for half of year
Patient just procreated a baby half of year before. Since that time, patient started sweating, short of breath on activity, continuously sweating, bad sleeping, sweating can even wet the clothing when in the sleep. Lower back pain, two hands joints & lower limbs feel numbness & ache in the morning.
Pale complexions.
Tongue: reddish tongue body with white coating.
Pulse: empty & thready
TCM diagnose:
Liver & kidney yin def. Empty fire due to yin def. force fluid out
Treatment protocol:
Nourish Liver & kid, tonify yin to stop sweating
Formula
Dang Gui 10, bai shao 10, shu di huang 15, shan yao 10, wu wei zi
6, di gu pi 10, dan pi 10, sha sheng 10, mai dong 10, ze xie 10
,

Second visiting:
Main complains: Spontaneous sweating lower back pain & night sweating were gone. Hands & joints pain
& numbness reduced.
However, patient started feeling feverish & irritability at 4 – 6 o’clock in every morning, following with sweating on the chest & back. Panting.
Tongue: reddish body with thin slight yellow & dry fur
Treatment protocol:
Tonify Liver blood, stop sweating
Bai Shao 30, He shou wu 30, shan Yao 15, Qian Shi 10, Jing Yin Zi
10, Long Dan Cao 6, Shen Gan Cao 6

Main Points for differentiation
1) Location
Nose bleeding: Lu. St. or Liv.
2) Def. & Excess
Yin def. Qi Def. Excess Fire
3) Coexistence of two or more syndromes
Cold & Heat
Exterior & Interior
Qi Stag. & Blood Stasis
Qi Def. & Blood Stasis

Main Points for therapeutic Principles
Stop bleeding
-Bai Ji, San Qi, Ai Ye, Pu Huang, Ou Jie, Xian He Cao,
Eliminating blood stasis
-Chuan Xiong, Ru Xiang, Mo Yao, Er Zhu, San Ling, Dan Sheng, Ji
Xue Teng, Tao Ren, Hong Hua, Shui Zhi, Di Bie Chong, Yan Hu Suo,
Chuan san Jia, Ze Lan, Wang Bu Liu Xing
Cool blood
-Da Ji, Xiao Ji, Di Yu, Bai Mao Geng, Huai Hua, Ce Bai Ye, Qian
Cao ,
Tonify def. and blood
-Dang Gui, Shu Di, He shou wu, Bai Shao, E Jiao, Long Yan rou

Treatment
1) Nasal Bleeding (Epistaxis)
A). Evil-heat attacking Lu.
Signs & Symptoms:
– Main Sym. : Dry nose & nasal bleeding
– Concurrent sym.: fever, dry mouth & throat, cough with little sputum
–
Tongue: red body with thin yellowish coating
– Pulse: rapid
• Treatment Protocol:
–
Clearing Lung heat
–
Cooling blood to stop bleeding

Formula:
Sang Ye
Gan Cao
Ju hua
Lu Geng
Sang Ju Yin
Bo He Lian Qiao
Xin Ren
Cooling blood to stop bleeding
-- Dan Pi, Bai Mao Geng, Ce Bai Ye
Lu. Heat without exterior sym.:
-- Huang Qin, Zhi Zi (- Jie Geng, Bo He)
Yin Def.
-- Xuan Sheng, Mai dong, Shen Di
Constipation
-- Da Huang, Gua Lou
Sore throat
-- Niu Pang Zi
Jie Geng

Treatment
1) Nasal Bleeding (Epistaxis)
B) Excess of st. heat
Signs & Symptoms:
– Main Sym. : Nasal bleeding with scarlet blood
– Concurrent sym.: Gum bleeding, dry mouth, foul breath, restlessness, constipation or swelling & soreness of the gums
–
Tongue: red body with yellowish coating
– Pulse: rapid
• Treatment Protocol:
–
Clearing stomach heat
–
Cooling blood to stop bleeding

Formula:
Shi Gao Zhi Mu Mai Dong
Yu Nu Jian
Sheng Di
Cooling blood to stop bleeding
-- Da Ji, Xiao Ji, Ou Jie, Ce Bai Ye
Excess St. heat:
-- Huang Qin, Zhi Zi, Dan Pi
Yin Def.
-- Tian Hua Feng, Shi Hu, Yu Zu
Constipation
-- Da Huang, Gua Lou
Niu Xi

Treatment
1) Nasal Bleeding (Epistaxis)
C) Liver Fire Up
Signs & Symptoms:
– Main Sym. : Nasal bleeding , headache, blurred vision & bitter taste
– Concurrent sym.: red eyes, tinnitus, irritability & emotional changing,
– Tongue: red body with thin yellowish coating
– Pulse: taut & rapid
•
Treatment Protocol:
–
Clearing away liver fire
– Cooling blood to stop bleeding

Formula:
Long Dan Cao Huang Qin
Che Qian Zi Cai Hu
Long Dan Xie Gan Tang
Zhi Zi Ze Xie
Sheng di Dang gui
Mu Tong
Gan Cao

Treatment
1) Nasal Bleeding (Epistaxis)
D) Qi & Blood Def.
Signs & Symptoms:
– Main Sym. : Nasal bleeding with light red color, bleeding from gums & muscles
– Concurrent sym.: pale complexion, mental fatigue, lassitude, dizziness, palpitation
– Tongue: pale body
– Pulse: thready weak or hollow
•
Treatment Protocol:
–
Tonify Qi to hold the blood

Dang Shen
Long Yan
Bai Zhu
Gui Pi Tang
Huang Qi Fu Shen Suan Zhao Ren Yuan Zhi
Mu Xiang Gan Cao Dang Gui Sheng Jiang Da Zhao

A) Stomach-Heat
Signs & Symptoms:
– Main Sym. : scarlet bleeding, painful & swollen gums
– Concurrent sym.: frontal headache, foul breath, thirst,
– Tongue: red body with yellow fur
– Pulse: rapid, overflowing on the right middle postion
• Treatment Protocol:
– Clear St.-heat
– Cool blood to stop bleeding

Formula:
Sheng Di
Shen Ma
Dan Pi
Gan Cao
Jia Wei Qin Wei San
Dang Gui Huang Lian Lian qiao Shui Niu Jiao
Harmonize blood (stop bleeding, eliminate stasis, calm & nourish blood)
-- Da Ji, Xiao Ji, San Qi, Bai Shao
Swollen gum
-- Jin Yin Hua, Pu Gong Yin, Zi Hua Di Ding
Thirsty
-- Shi Gao, Zhi Mu, Tian Hua Feng
St. heat turn to St. Fire (constipation)
-- Xie Xing Tang ( Huang Lian, Huang Qin, Da Huang)

Treatment
2) Bleeding Gums
B) Stomach-Yin Def. with empty-heat
Signs & Symptoms:
– Main Sym. : slight bleeding from gums, swelling of gums
– Concurrent sym.: mental restlessness, gums diseased, loose tooth, hot sensations in the palms & soles.
– Tongue: red body with little fur
– Pulse: rapid, thready
• Treatment Protocol:
– Nourish St. – Yin
– Clear Empty heat
–
Cool blood to stop bleeding

Formula:
Sheng Di
Qin Wei San
Mu Dan Pi Dang Gui Huang Lian Shen Ma

Treatment
3) Bleeding under the skin
A) Blood heat
Signs & Symptoms:
– Main Sym. : Suddenly onset, purple spots or plague in skin
– Concurrent sym.: blood from other sites such as nose, intestines or bladder, mental restlessness, thirsty, constipation, fever at night.
– Tongue: red body without coating, red points all over
– Pulse: rapid & fine
• Treatment Protocol:
– Expel poison
– Clear away heat
–
Cool blood to stop bleeding

Formula:
Hui Niu Jiao Shen Di
Xi Jiao Di Huang Tang
Dan Pi Chi Shao
Zhi Zi Ce Pai Ye Gan Cao
Shi Gao Zhi Mui
Harmonize blood (stop bleeding, eliminate stasis, calm & nourish blood)
-- Qian Cao Geng, Di Yu, Gou Qi Zi
Astringe
-- Shan Zhu Yu
Abdomen pain + hematochezia
-- Mai Dong, Yu Zhu , Tian hua feng
Blood heat is very pronounced
-- Zi Cao