bubble_chart Concept

Expiry sweating, which refers to profuse sweating that occurs during the critical stage of a disease, is characterized by continuous, dripping sweat resembling beads or oil.

This condition is referred to in the Suwen, Jutong Lun, and Lingshu, in chapters such as "Five Prohibitions," as "great sweating," "expiry sweating," "leaking sweating," "collapse sweating," and "sweating that cannot be stopped." The Song Dynasty Leizheng Huorenshu records "incessant deficient sweating," while the Yuan Dynasty's "Shiyi De Xiao Li" also describes "incessant sweating." The Qing Dynasty Zabing Yuanliu Xizhu further refers to it as "great sweating." These terms share significant clinical relevance.

bubble_chart Pattern Analysis

1. Deficiency of Both Qi and Yin︰The main symptoms include profuse sweating that does not stop, sweat that is hot and sticky, or oily sweating, body heat, warm hands and feet, thirst with a preference for cold drinks, coarse breathing, physical fatigue and mental fatigue, dry and red lips and tongue, and a weak, rapid pulse or a thin, rapid, and feeble pulse. Suwen. Jutong Lun states: "When there is heat, the striae and interstice open, the nutrient and defense qi circulate, and sweating is profuse, thus qi is dissipated... When there is exhaustion, there is panting and sweating, both internal and external qi are dissipated, thus qi is depleted." It points out that abnormal exuberance of yin or yang imbalance, especially the abnormal exuberance of yin or yang imbalance of the heart, as well as nutrient-defense disharmony, can cause the striae and interstice to open and discharge, leading to incessant sweating. Lingshu. Jueqi also states: "In cases of fluid collapse, the striae and interstice open, and sweating is profuse." This type of sweating indicates a severe tendency of disease, which is the phenomenon of "yin exhaustion." It is often characterized by sweating that does not stop, sweat that is hot and thick, or oily sweating, body heat, warm hands and feet, dry and red lips and tongue, and a weak, rapid pulse or a thin, rapid, and feeble pulse. Treatment should focus on tonifying qi to stabilize collapse and nourishing yin to generate fluids. The recommended formula is Pulse-Reinforcing Powder with added Cornus officinalis, etc.
2. Yang Qi on the Verge of Collapse︰The main manifestations are great dripping sweating, sweat like beads, clear and cool, fear of cold and curling up in bed, cold limbs, listlessness, pale complexion, weak breathing, thirst with a preference for hot drinks, moist tongue, and a faint or floating, rapid, and hollow pulse. Lingshu-Jingmai states: "When the six yang qi are exhausted, yin and yang separate. Upon separation, the striae and interstices open, and expiry sweating occurs." In cases of prolonged or severe illness, the yang qi is excessively depleted, especially the heart yang, which fails to restrain yin, leading to the separation of yin and yang and the scattering of yang qi outward, resulting in profuse sweating. This profuse sweating indicates a critical tendency of the disease and is referred to as "yang exhaustion." Its characteristics include great dripping sweating, cold limbs, listlessness and fatigue, a faint pulse on the verge of disappearing, etc. Treatment should focus on tonifying yang to stabilize collapse and restoring yang to save from collapse. The recommended formula is Ginseng and Aconite Decoction supplemented with fossil bone, oyster shell, etc.

Both the impending collapse of qi and yin and the impending escape of yang qi, along with expiry sweating, are critical symptoms and signs of collapse. Due to severe high fever, profuse sweating, severe vomiting and diarrhea, massive blood loss, or prolonged illness depleting yin, there is a serious deficiency of yin fluids, leading to the exhaustion of yin, which causes yang qi to have nothing to adhere to and thus scatter and escape. The collapse of yang then prevents the generation of yin fluids, leading to their exhaustion. Therefore, the critical conditions of impending collapse of qi and yin and the impending escape of yang qi appear, but these two conditions often occur sequentially, with only a difference in the order and predominance. Key points of differentiation: in addition to the various critical symptoms of the primary disease, there are also unique symptoms of the impending collapse of qi and yin and the impending escape of yang qi.

The symptom of expiry sweating can appear in both the impending collapse of qi and yin and the impending escape of yang qi, but it is essential to continuously monitor the changes in the condition and take appropriate measures. Once the collapse is alleviated, treatment should also be based on the specific symptoms and signs through pattern identification.

bubble_chart Documentation

1. Suwen-Zhenyao Jingzhong Lun: "The taiyang channels, at their end, cause the eyes to stare upward and the body to arch backward in spasm and convulsion, the complexion turns white, expiry sweating emerges, and upon its emergence, death occurs."
2. Leizheng Zhicai Volume 2: "Jia Yan Yu Shi further divides it into upper collapse, lower collapse, and both upper and lower collapse. Now, examining this condition in detail, it is always due to the instability of the yin-yang pivot. For example, in upper collapse, there is panting without continuity, profuse sweating leading to yang exhaustion, mental confusion, and the separation of the soul and spirit, which is yang collapse; in lower collapse, there is menorrhagia without cessation, severe diarrhea leading to yin exhaustion, frequent intercourse, and great loss of essence, which is yin collapse. In cases of both upper and lower collapse, there are symptoms like fainting from stroke, snoring nasal sounds, expiry sweating, enuresis, and incontinence, which is the collapse of both yin and yang."
3. Linzheng Zhinan Yi'an Volume 3: "Collapse refers to the sudden escape of yang qi, the separation of yin and yang, oily sweating, feeble pulses on six positions of the wrist pulse, and acute symptoms, which are then named as collapse."