Last time we talk about aversion to cold and fever in the four diagnostic methods of TCM, which is a fresh imaging for you to understand part of the Chinese culture. And this time, we will go on our travel about sweating in TCM.

 

In modern medicine, sweating is a kind of physiological manifestation. It is a kind of secretion from body, and is the garbage of body. Similar in TCM, we think that sweating is an important way to keep the balance between yin and yang. It is transformed from body fluid by yang qi and excretes from the sweat pores. Normally sweat has the functions of regulating ying qi and wei qi and moistening the skin. Under pathological conditions, sweating becomes abnormal due to the invasion of pathogenic factors and imbalance between yin and yang inside the body. In TCM, we pay much attention to the quantity, location, time and feature of sweating so to help make syndrome differentiation. Thereby TCM doctors like to ask the quantity of sweating, the location, the time and the feature of sweating so to gather the information. Now, let us talk about them one by one.

 

Ⅰ.No sweating

This situation is usually caused by exogenous pathogenic cold or deficiency of yin, blood, body fluid and yang qi.

⑴ No sweating in exterior syndrome: This condition is often seen in exterior syndrome of excess type due to exogenous pathogenic cold. Since the cold tends to stagnate and contract, the muscular interstices become tense and the sweat pores are closed up, consequently there is no sweat. The companying symptoms may be serious aversion to cold, mild fever and superficial and tense pulse, etc.

 

⑵ No sweating in interior syndrome: This condition is often seen in interior syndrome due to deficiency of blood, body fluid and yang. If there are symptoms such as pale tongue and lips, it is caused by blood deficiency. That’s because the sweat is generated from blood, if the blood is deficient, it will be impossible to produce sweat. If there are other symptoms such as dry skin, dry mouth and dry stool, absence of sweat is caused by deficiency of body fluid. That’s because the sweat is transformed from part of the body fluid, if the body fluid is dry, there is no enough fluid to be transformed into sweat. If there are some symptoms such as aversion to cold and cold limbs, absence of sweat is caused by yang deficiency, as production of sweat is not only related to the quantity of body fluid and blood, but also the evaporating energy of yang qi. If yang qi is deficient, it will not be strong enough to evaporate the body fluid.

 

Ⅱ.Sweating

Sweating here indexes to the abnormal pathological situation. It can be caused by pathogenic wind, or wind-heat invading the exterior portion, or exuberance of endogenous heat, or interior heat due to yin deficiency, or weakness of wei qi due to qi deficiency, or exhaustion of yang qi, or excretion of body fluid due to sudden loss of yang qi.

 

⑴ Sweating in exterior syndrome: This situation can be seen in exterior syndrome of deficient type due to external pathogenic wind, or exterior heat syndrome due to exogenous wind heat and diseases due to weakness of wei qi complicated by exogenous wind attack. The characteristics of pathogenic wind are open and leak, while the characteristics of heat are flaring up and dispersing. Attack by wind and heat, the muscular interstices become loose and sweat excretes. Sweat tends to excrete if wei qi is weak and the muscular interstices are loose. If accompanied by fever, aversion to wind and superficial and slowed-down pulse, it is differentiated as exterior syndrome of deficiency type; if accompanied by high fever, mild aversion to cold, sore throat and superficial and rapid pulse, it is differentiated as exterior heat syndrome.

                                                    ( to be continued…)

 

Exogenous pathogenic cold                        外感寒邪（wai gan han xie）

Exterior excessive syndrome                      表实证(biao shi zheng)

Superficial and tense pulse                         浮紧脉(fu jin mai)

Interior syndrome                                       里证(li zheng)

Blood deficiency                                           血虚(xue xu)

Evaporating energy                                     蒸腾(zheng teng)

Wind-heat invading the exterior portion      风热袭表(feng re xi biao)

Exuberance of endogenous heat                 邪热炽盛(xie re chi sheng)

Exhaustion of yangqi,                                  阳气耗伤(yang qi hao shang)

Excretion of body fluid                                 津液外泄(jin ye wai xie)

Sudden loss of yangqi.                                阳气暴脱(yang qi bao tuo)

Exterior deficient syndrome                        表虚证(biao xu zheng)

Exogenous wind heat                                 外感风热(wai gan feng re)

Superficial and slowed-down pulse              浮缓脉(fu huan mai)

Exterior heat syndrome.                             表热证(biao re zheng)

 

1. Lufen Wang, Zhaoguo Li, Bai Bao, Dianostics of Traditional Chinese Medicine, Publishing House of Shanghai University of traditional Chinese medicine.

 

2. Wenfeng Zhu, Diagnostics of Traditional Chinese Medicine, Shanghai Science and Technology Publishing House

 

3.Yanfu Zuo, The New Century Chinese-English Dictionary of Traditional Chinese Medicine, People’s Military Medical Press.

 

   （Yanting Guan, Translation Section）