Lecture on Sweating in Traditional Chinese Medicine (TCM)

Introduction

Normal Sweating: People often think their sweating pattern is normal. Some sweat excessively, while others barely sweat at all.
Sweating is related to the regulation of various body systems, including spleen and heart health.

Sweat and the Heart: Sweat is considered to belong to the heart and is a refined essence from the blood. Excessive sweating can damage heart-related fluids.
Sweat and the Spleen: Adjusting the spleen can help regulate sweating.
Sweat and Yin/Yang Balance: A balance between Yin and Yang in the body is crucial for proper sweating.

Wei and Ying: Normal sweat is produced by the interaction between the Wei (defensive Qi) and Ying (nutritive Qi).
Heat Exchange: Sweat helps in the body’s heat exchange with the external environment.
Sweating Triggers: Normal sweat occurs in response to heat, exercise, spicy food, or emotional strain.

Types of Abnormal Sweat:
- Excessive sweating without a clear trigger.
- Night sweating, leading to loss of valuable Yin essence (Thief Sweating).
- Cold sweat and its associations with Yang deficiency or insubstantial phlegm.
- Sweating due to internal heat or blood deficiency.
Causes and Patterns:
- Qi deficiency: Leads to spontaneous sweating or sweat with light exertion.
- Full Heat: Excess heat in organs can lead to excessive sweating.
- Yin deficiency: Leads to night sweats, exacerbating the Yin deficiency.
- Damp Heat: Can also cause night sweats (often more common than Yin deficiency night sweats).

Half Body Sweat: Often associated with wind obstructions, such as wind stroke.
Heart Sweat: Excessive emotion affecting the heart, sometimes involving heart blood deficiency or heart heat.
Yin Sweat: In the genital region, often linked to liver channel issues or damp heat.
Hand and Feet Sweat: Potentially linked to the liver or spleen and stomach dampness.

Wind Cold Exterior Invasion: Sweating due to a weak Wei Qi.
Internal Replete Heat: Excess heat in any organ can lead to sweating.
Damp Heat on Qi Level: Lower Jiao damp heat often involves the liver and gallbladder.
Vacuity Sweat: Qi, Yang, Yin, or dual heart and spleen vacuity can lead to different sweating patterns.
Expiry Sweat: Terminal sweating due to deeply compromised Yin or Yang.

Wind Cold Exterior Deficiency (Taiyang Pattern): Harmonize Ying and Wei using herbs like Guizhi.
Blood Nourishment: Dual vacuity of heart and spleen requires strengthening the spleen to produce more blood.
Diaphoresis: For promoting sweat in cases of sweat block due to Yang or Wei disorders.
Herbs: Mahuang and caffeine as diaphoretics.

Observation: Noting the moisture level of a patient’s skin can provide insights into their internal state.
Differentiating Causes: Proper identification of the underlying pattern causing abnormal sweating is crucial for effective treatment.