Sweating TCM Diagnoses and Treatments Spontaneous Sweating + Night Sweating Etiology & Pathology:...

SweatingSweating

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 heat2) Night Sweating:

Yin Def. type of heat(Qi Def. Yang Def. or Damp-heat)

Treatment for differentiationTreatment for differentiation

Harmonize Ying & WeiHarmonize Ying & Wei

-- Gui Zhi-- Gui Zhi

Clear Heat + expel fireClear Heat + expel fire

-- Long Dan Cao, Shi Gao-- Long Dan Cao, Shi Gao

Clear the damp-heatClear the damp-heat

-- Ze Xie-- Ze Xie

Tonify Qi & consolidate superficial resistanceTonify Qi & consolidate superficial resistance

-- Huang Qi, Bai Zhu-- Huang Qi, Bai Zhu

Tonify Yin & Clear def. type of fireTonify Yin & Clear def. type of fire

-- Gui Ban, Bie Jia-- Gui Ban, Bie Jia

Warm Yang Qi to stop sweatingWarm Yang Qi to stop sweating

-- Fu zi, Gui Zhi-- Fu zi, Gui Zhi

TreatmentTreatment 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:

Modifications:Sweating

-- Long Gu, Mu liQi Def.

-- Huang Qi, Dang ShenYang Def.

-- Fu zihalf body or local area sweating

-- Gan Mai Da Zao Tangsweating+ heaviness of body

-- Fang Feng, Dou Juanwind-heat attacking

-- Sang Ju Yin + xuan Shen, Yin HuaSome 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

TreatmentTreatment 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


– Tonify Qi to consolidate superficial resistance

Formula:

Modifications:sweating

-- Fu Xiao Mai, Ru Dao Geng, Mu Li, Long GuQi Def.

-- Dang Sheng, Huang JingYin Def.

-- Mai Dong, Wu Wei ZiSweating 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

TreatmentTreatment 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


– Nourish Yin to reduce fire

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

TreatmentTreatment 4) Interior Excess Fire

Caused by interior dampness, stagnated liver QiSigns & 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


– Clearing away st. heat, or eliminating damp-heat

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

Case History1

1. Male 67 years Medical history: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: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: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

Blood syndromeBlood 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 Qi3) Blood stasis

Main Points for differentiationMain Points for differentiation

1) Location1) Location

Nose bleeding: Lu. St. or Liv. Nose bleeding: Lu. St. or Liv.

2) Def. & Excess2) Def. & Excess

Yin def. Qi Def. Excess FireYin def. Qi Def. Excess Fire

3) Coexistence of two or more syndromes3) Coexistence of two or more syndromes

Cold & Heat

Exterior & Interior

Qi Stag. & Blood Stasis

Qi Def. & Blood Stasis

Main Points for therapeutic PrinciplesMain Points for therapeutic Principles

Stop bleedingStop bleeding-- -- Bai Ji, San Qi, Ai Ye, Pu Huang, Ou Jie, Xian He Cao, Bai Ji, San Qi, Ai Ye, Pu Huang, Ou Jie, Xian He Cao,

Eliminating blood stasisEliminating blood stasis-- -- Chuan Xiong, Ru Xiang, Mo Yao, Er Zhu, San Ling, Dan 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 Sheng, Ji Xue Teng, Tao Ren, Hong Hua, Shui Zhi, Di Bie Chong, Yan Hu Suo, Chuan san Jia, Ze Lan, Wang Bu Liu XingSuo, Chuan san Jia, Ze Lan, Wang Bu Liu Xing

Cool bloodCool blood -- -- Da Ji, Xiao Ji, Di Yu, Bai Mao Geng, Huai Hua, Ce Bai Ye, Da Ji, Xiao Ji, Di Yu, Bai Mao Geng, Huai Hua, Ce Bai Ye,

Qian CaoQian Cao, ,

Tonify def. and bloodTonify def. and blood -- -- Dang Gui, Shu Di, He shou wu, Bai Shao, E Jiao, Long Yan Dang Gui, Shu Di, He shou wu, Bai Shao, E Jiao, Long Yan

rourou

TreatmentTreatment 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


– Clearing Lung heat– 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


B) Excess of st. heatSigns & 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


– Clearing stomach heat– 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


C) Liver Fire UpSigns & 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


– Clearing away liver fire– Cooling blood to stop bleeding

Formula:

Modifications:

Cooling blood to stop bleeding -- Bai Mao Geng, Pu Huang, Da Ji, Xiao Ji,

Dan Pi, Ou JieLiver fire :

-- Xia Ku Cao, Qin DaiYin 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


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


– Tonify Qi to hold the blood

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

TreatmentTreatment 2) Bleeding Gums

A) Stomach-HeatSigns & 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


– Clear St.-heat– Cool blood to stop bleeding

Formula:

Modifications:

Harmonize blood (stop bleeding, eliminate stasis, calm & nourish blood)

-- Da Ji, Xiao Ji, San Qi, Bai ShaoSwollen gum

-- Jin Yin Hua, Pu Gong Yin, Zi Hua Di DingThirsty

-- Shi Gao, Zhi Mu, Tian Hua FengSt. 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

TreatmentTreatment 2) Bleeding Gums

B) Stomach-Yin Def. with empty-heatSigns & 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


– Nourish St. – Yin– Clear Empty heat– Cool blood to stop bleeding

Formula:

Modifications:


-- Di Yu, San Qi, Er JiaoNourish Yin

-- Mai Dong, Yu Zhu , Tian hua fengAstringe

-- Lian zi

Qin Wei San

Sheng Di Mu Dan Pi Dang Gui Huang Lian Shen Ma

TreatmentTreatment 3) Bleeding under the skin

A) Blood heatSigns & 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


– Expel poison– Clear away heat– Cool blood to stop bleeding

Formula:

Modifications:


-- Qian Cao Geng, Di Yu, Gou Qi ZiAstringe

-- Shan Zhu YuAbdomen pain + hematochezia

-- Mai Dong, Yu Zhu , Tian hua fengBlood 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

Sweating TCM Diagnoses and Treatments Spontaneous Sweating + Night Sweating Etiology & Pathology:...

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