Perspiration Syndrome

SYMPTOMS AND SIGNS: Perspiration syndrome is called Han Zheng in Chinese medicine. Han Zheng means hidrosis (profuse perspiration) due to the loss of Yin-Yang balance and disharmony of Yin Qi (nourishing Qi) and Wei Qi (defending Qi). Continuously sweating, worse after any activity or work, is called Zi Han (spontaneous perspiration); sweating which occurs during sleep, stops after waking up, is called Dao Han (night perspiration); involuntary profuse sweating, or greasy sweating with cold limbs and weak breath, is called Tua Han (exhaustive perspiration); sweating with alternate fever and chills, or aversion to cold, is called Zhan Han (shivering perspiration); or sweating in yellow color is called Huang Han (yellow perspiration). 

ETIOLOGY AND PATHOLOGY: Perspiring in hot weather, after hot drinks, or during laborious work, is the normal physical reaction. If perspiration occurs at a time when a normal person does not perspire, such as spontaneous sweating, night sweating, and other abnormal sweating, then they classify to the Han Zheng (perspiration syndrome). Traditionally, Chinese medicine considers that "The body fluid of the heart is sweat", and that "Sweat is that Yang works on Yin" (From Shu Wen Plain Questions). So, any excessive or deficient status of Yin and Yang, or disharmony of Yin Qi (nourishing Qi) and Wei Qi (defending Qi) will cause a perspiration syndrome. The following are the most common factors and pathogenic changes during perspiration: 

  1. Disharmony of lung defending Qi: defending Qi of lung plays a fundamental function to protect the body surface by adjusting the pores of the skin. If wind factor or other pathogenic factors attack the lungs, or deficiency of lung Qi, it will cause the disharmony of Yin and Wei (nourishing Qi and defending Qi), causing perspiration. 
  2. Interior fire due to Yin deficiency; mostly kidney Yin deficiency flames up to disturb the heart, thereby losing its function to control perspiration. 
  3. Yang deficiency creates a loss of function of strengthening and protecting the Yin, thereby creating abnormal perspiration. 
  4. Damp-heat obstructs the liver and gallbladder due to irregular or fatty foods, or due to the dysfunction of spleen and stomach, or from exogenous damp factor. Yellow perspiration will show up.
  5. The fighting between the normal Qi and pathogenic factors in febrile diseases usually shows profuse perspiration after high fever and chills. 

DIFFERENTIATIONS: 

1. Spontaneous Perspiration:

(1). Perspiration due to the disharmony of Yin and Wei (nourishing Qi and defending Qi): 

Indications: Perspiration, aversion to wind, general sourness, sensitive to cold or hot. It is often seen among people of surface deficient types who catch wind cold or wind heat, or among people who often have insomnia, which makes the perspiration worse when there are some strong emotions. Slow pulse, white and thin tongue coating. 

Treatment & Formulas: Harmonize the Yin-Wei (nourishing Qi and defending Qi). 

Products:

    • Gui Zhi Tang (Cinnamon Combination, Item No. 2156): This is a very famous formula from Shang Han Lun (The Treatise on Febrile Diseases). It is the first choice formula for spontaneous perspiration due to the disharmony of Yin and Wei; so it is very good for wind cold attacking the surface of human body. 
    • Gui Zhi Jia Long Gu Mu Li Tang (Cinnamon and Dragon Bone Combination, Item No. 2163): This is a very good formula for spontaneous sweating due to wind factor, at the same time, showing symptoms of insomnia, palpitation, nervousness. 

(2). Perspiration due to the Deficiency of Lung Qi: 

Indications: Spontaneous sweating, aversion to cold, worse after any activities. It is usually seen in chronic patients with weak bodies. They usually are easily chilled, averse to wind and cold, pale complexion, thready and weak pulse. 

Treatment & Formulas: Tonify the Qi and strengthen the exterior defensive system of body. 

Products:

    • Yu Pin Feng San (The Jade Screen Powder): This is a very good formula to strengthen the exterior defensive system so as to treat the spontaneous sweating due to defensive Qi deficiency. Its ingredients are as follows: 
      • Huang Qi (Astragalus, Item No. 1074): 38%
      • Bai Zhu (White Atractylodes, Item No. 1051): 31%
      • Fang Feng (Siler, Item No. 1098): 31%
      • Bu Zhong Yi Qi Tang (Ginseng and Astragalus Combination, Item No. 2225): This is a strong Qi tonic formula by its promoting functions of spleen and stomach, so the lung Qi can be strengthened by getting the Qi supplies from the spleen and stomach. 

(3). Perspiration due to the Interior Heat: 

Indications: Profuse perspiration, thirsty, likes cold drinks, restlessness, flushed complexion, hot sensation of body, fever, soreness and pain of four limbs, or constipation. Red tongue, yellow tongue coating, big and forceful pulse. 

Treatment & Formulas: Clear the interior heat. 

Products:

    • Bai Hu Tang (White Tiger Formula): This is a typical formula to treat the interior heat at Yang-min stage, which shows pure fever and profuse perspiration. Its ingredients are the following:
      • Shi Gao (Gypsum, Item No. 1061): 38%
      • Zhi Mu (Anemarrhena, Item No. 1105): 16%
      • Gan Cao (licorice, Item No. 1072): 8%
      • Gen Mi (Rice): 38%
      • Zhu Ye Shi Gao Tang (Bamboo Leaves and Gypsum Combination, Item No. 2091 ): It clears the interior heat and strengthens the Yin and Qi at the same time since the heat is always very Yin and Qi consuming. 

2. Night Perspiration:

(1). Night Perspiration due to the Deficiency of Heart Blood: 

Indications: Profuse perspiration occurs during sleep, stops after waking up, palpitation, insomnia, pale face, shortness of breath, fatigue, pale tongue, thin coating, weak pulse. 

Treatment & Formulas: Tonify the heart blood so as to stop perspiration. 

Products:

    • Gui Pi Tang (Ginseng and Longan Combination, Item No. 2261 ): This is a very good formula as a blood tonic by its promoting functions for spleen and heart. 
    • Ren Shen Yang Rong Tang (Ginseng Nutritive Combination, Item No. 2007): Its functions are very similar to Gui Pi Tang (Item No. 2261).

 (2). Perspiration due to the Yin Deficient Fire: 

Indications: Night sweating, tidal fever (fever at a specific time, such as night or afternoon), restlessness, insomnia, nervousness, hot sensation of the souls and palms, thin body type, irregular menstruation for women, emission during dream state in men, red tongue, scanty tongue coating, wiry, thready and rapid pulse. 

Treatment & Formulas: Tonifies the Yin to reduce the deficient fire. 

Products:

    • Dang Gui Liu Huang Tang (Tang- kuei and Six Yellow Combination, Item 2231): This is a strong formula for symptoms due to Yin deficiency. It tonifies the Yin, at the same time, it clears the deficient heat or fire. 
    • Zhi Po Ba Wei Wan (Anemarrhena, Phellodendron and Rehmannia Formula, Item No. 2123): This treats the night sweating due to kidney Yin deficiency. 

3. Exhaustive Perspiration:

Indications: Sudden profuse perspiration, occurs during acute or serious diseases, exhaustion, weak breath and body, cold limbs, weak or unclear pulse, or big and forceless pulse, rigidity of tongue without moisture. 

Treatment & Formulas: Strongly tonifies the Qi and Yang so as to build up the normal energy. 

Products:

    • Ren Shen (Ginseng Radix, Item No.1321) combined with Fu Zi (Baked Aconitum Radix, Item No. 1294): These are two strong herbs to build up the exhaustive Qi and Yang. Long Gu (Draconis Os, Item No. 1247) and Mu Li (Concha ostrea, or Oyster Shell, Item No. 1093) may be added if there is a strong and continuous perspiration. 

4. Yellow Perspiration:

indications: Sweating yellowish color, bitter taste and sticky sensation in mouth, thirsty, but does not like to drink, poor appetite, fullness or pain at hypochondriac region, or edema, scanty urine, fever, restlessness, yellow and greasy tongue coating, wiry and slippery pulse. 

Treatment & Formula: Clears the heat and eliminates the damp factor. 

Products:

    • Yin Chen Wu Ling San (Capillaris and Hoelen Five Formula, Item No. 2143): This is a very good formula to treat the damp heat at lower or middle burner by its cooling and diuretic function. 

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