1. TCM Diagnoses and Treatments
Sweating
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)

3. Harmonize Ying & Wei Treatment for differentiation -- 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

4. 1) Disharmony between Ying & Wei
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

5. half body or local area sweating -- Gan Mai Da Zao Tang
Formula:
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
Gui Zhi Tang
Gui Zhi
Bai Shao
Sheng Jiang
Da Zhao
Gan Cao

6. 2) Lung Qi Def. & fail to protect body
Treatment
2) Lung Qi Def. & fail to protect body
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

7. Formula:
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)
Yu Ping Feng San
Huang Qi
Bai Zhu
Fang Feng

8. 3) Hyperactivity fire due to yin def.
Treatment
3) Hyperactivity fire due to yin def.
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

9. Modifications: Abundent sweating: -- Mu Li, Fu Xiao Mai, Ru Dao Geng
Formula:
Modifications:
Abundent sweating:
-- Mu Li, Fu Xiao Mai, Ru Dao Geng
Feverish sensation:
-- Yin Cai Hu, Bai Wei, Gui ban, Bie Jia
Yin Def.
-- Mai Wei Di Huang Wan
Dang Gui Liu Huang Yin
Dang Gui
Shu Di
Sheng Di
Huang lian
Huang Qi
Huang Bai
Huang Qin

10. 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

11. Modifications: thirsty -- Tian Hua Feng Constipation:
Formula:
Modifications:
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
Bai Hu Tang
Shi Gao
Zhi Mu
Lu Geng
Tian Hua Feng
Xuan Sheng
Zhi Zhi
Sheng Gan Cao

12. 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 ,

13. 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 ,

14. Liver & kidney yin def. Empty fire due to yin def. force fluid out
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 ,

15. 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

16. TCM Diagnoses and Treatments
Blood syndrome
TCM Diagnoses and Treatments
Blood does not follow normally within its vessels, but bleed from the muscle or skin.
Etiology & Pathology:
Main pathogenesis of bleeding:
1) Hyperactivity
2) Damage of Qi
3) Blood stasis

18. 1) Location Main Points for differentiation
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

19. Stop bleeding Main Points for therapeutic Principles
-- 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

20. 1) Nasal Bleeding (Epistaxis)
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

21. Modifications: Cooling blood to stop bleeding
Formula:
Modifications:
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
Sang Ju Yin
Sang Ye
Ju hua
Bo He
Lian Qiao
Jie Geng
Gan Cao
Lu Geng
Xin Ren

22. 1) Nasal Bleeding (Epistaxis)
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

23. Modifications: Cooling blood to stop bleeding
Formula:
Modifications:
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
Yu Nu Jian
Shi Gao
Zhi Mu
Mai Dong
Sheng Di
Niu Xi

24. 1) Nasal Bleeding (Epistaxis)
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

25. Modifications: Cooling blood to stop bleeding
Formula:
Modifications:
Cooling blood to stop bleeding
-- Bai Mao Geng, Pu Huang, Da Ji, Xiao Ji, Dan Pi, Ou Jie
Liver fire :
-- Xia Ku Cao, Qin Dai
Yin Def.
-- Xuan Sheng, Mai dong, Wu Wei Zi, Nu ZhengZi, Han Lian Cao
Long Dan Xie Gan Tang
Long Dan Cao
Huang Qin
Zhi Zi
Ze Xie
Mu Tong
Che Qian Zi
Cai Hu
Sheng di
Dang gui
Gan Cao

26. 1) Nasal Bleeding (Epistaxis)
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

27. Modifications: Stop bleeding -- Xian He Cao, Er Jiao, Pu Huang
Formula:
Modifications:
Stop bleeding
-- Xian He Cao, Er Jiao, Pu Huang
Gui Pi Tang
Dang Shen
Bai Zhu
Huang Qi
Fu Shen
Suan Zhao Ren
Yuan Zhi
Long Yan
Mu Xiang
Gan Cao
Dang Gui
Sheng Jiang
Da Zhao

28. Treatment 2) Bleeding Gums 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

29. Formula:
Modifications:
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)
Jia Wei Qin Wei San
Sheng Di
Dan Pi
Dang Gui
Huang Lian
Lian qiao
Shui Niu Jiao
Shen Ma
Gan Cao

30. 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

31. Formula:
Modifications:
Harmonize blood (stop bleeding, eliminate stasis, calm & nourish blood)
-- Di Yu, San Qi, Er Jiao
Nourish Yin
-- Mai Dong, Yu Zhu , Tian hua feng
Astringe
-- Lian zi
Qin Wei San
Sheng Di
Mu Dan Pi
Dang Gui
Huang Lian
Shen Ma

32. 3) Bleeding under the skin
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

33. Formula:
Modifications:
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
Xi Jiao Di Huang Tang
Hui Niu Jiao
Shen Di
Dan Pi
Chi Shao
Shi Gao
Zhi Mui
Zhi Zi
Ce Pai Ye
Gan Cao