寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

The Sweating Method

Han

한글 한  ·  Pinyin Han

Summer is the season for sweating — and everything turns on how much, how fast, and how far down it reaches

汗

The shortest of the three method chapters and the most exacting about degree. Summer is the season for sweating, and the day has its season too: before noon is the yang division and sweating belongs there, so the rule is that one cannot sweat too early. What follows is almost entirely about measure. The sweat should come damp and even over hands and feet for about an hour, not pouring like water; the covering should be light above the waist and heavy below it, because a sweat that breaks on the chest and never reaches the soles leaves the disease unresolved. If three doses bring no sweat at all, the case is fatal. There is a method for forcing one without medicine — a fire laid on the ground, silkworm droppings and leaves spread over it, the patient laid on a mat above — and the source that gives it says in the same breath never to do it twice, because it shortens life. The chapter is equally clear about who must not be sweated: anyone with open sores, anyone bleeding from the nose or elsewhere, and the lesser yin patient who only wants to sleep. It ends with eleven simples, most of them ordinary kitchen and roadside plants, and a note that sweat and blood are the same substance under two names.

7.1 Summer Is the Season for Sweating 夏宜汗

7.1.1
Source원문

仲景大法, 夏宜汗. 《傷寒論》

Translation영역
Zhongjing's great rule: in summer, sweating is the method.
Clinical note임상 주석
The second of the three seasonal rules. In summer the qi is at the surface and the pores are open, so a treatment that works outward goes with the season rather than against it. Spring for ejecting at To 6.1, autumn for purging at Ha 8.1, and summer here — the three methods laid out across the year.

Sanghannon 傷寒論

7.2 In Sweating There Is No Such Thing as Too Early 汗無太早

7.2.1
Source원문

凡汗俱宜午時前發汗, 午後陰分不宜. 故曰, 汗不太早, 汗不厭早. 緊急則不拘晨夜, 以衣被覆首裹足向火, 服藥, 緩緩得汗. 令手足濈遍爲佳. 《入門》

Translation영역
In sweating generally, the sweat should be effused before the o hour; after noon is the yin division and it is not fitting. Therefore it is said: sweating is not too early, and sweating is not troubled by earliness. Where the case is urgent, morning and night do not bind: cover the head and wrap the feet with clothes and bedding, turn toward the fire, take the medicine, and obtain the sweat slowly. It is best when the hands and feet are damp all over.
Clinical note임상 주석
The mirror of the Purging chapter's rule at 8.2. Sweating belongs to the yang half of the day and purging to the yin half, so one is done early and the other late. 手足濈遍 — the hands and feet damp all over — is the endpoint, and the chapter returns to it at 7.3. A sweat that has reached the extremities has reached everywhere.

Immun 入門

7.2.2
Source원문

早者, 非預早之早, 乃早晩之早也. 謂當日午以前, 爲陽之分當發汗. 午後陰之分也, 不當發汗. 故曰, 汗無太早, 汗不厭早, 是謂善攻. 《東垣》

Translation영역
Early does not mean the earliness of anticipating; it means early as against late in the day. That is, before noon of the same day is the yang division and sweat should be effused; after noon is the yin division and sweat should not be effused. Therefore it is said: in sweating there is no such thing as too early, and sweating is not troubled by earliness — this is what is called attacking well.
Clinical note임상 주석
The same gloss the Purging chapter gives for 晩, applied to 早, and for the same reason: the word is about the hour of the day, not about how soon in the illness. 善攻, attacking well, against the Purging chapter's 善守, guarding well. The pairing is deliberate — sweating drives out, purging holds back.

Dongwon 東垣

7.3 The Method of Effusing Sweat 發汗法

7.3.1
Source원문

凡發汗, 欲令手足俱周濈濈然, 一時許爲佳, 不欲如水淋漓. 服湯中病卽已, 不必盡劑. 然發汗須如常覆腰以上, 厚衣覆腰以下. 盖腰以上淋漓, 而腰以下至足心微潤, 病終不解. 令腰脚間, 須令汗氣周遍爲度. 《得效》

Translation영역
In effusing sweat generally, one wishes the hands and feet to be damp and even all over, for about one watch, and does not wish it pouring like water. When the decoction taken has met the disease, stop; it is not necessary to finish the dose. But in effusing sweat, cover above the waist as usual and cover below the waist with heavy clothing. For if above the waist it pours while from the waist down to the soles of the feet it is only faintly moist, the disease is in the end not resolved. Between the lumbus and the legs, the sweat qi must be made to reach all over, and that is the measure.
Clinical note임상 주석
The most practical passage in the chapter. Three things are specified: the sweat should be damp and even rather than pouring, it should last about two hours, and it must reach the soles. The covering instruction follows from the last: heavier below the waist than above, because the legs sweat last and a sweat that stops at the chest has not done its work. That runs against instinct — the natural thing is to pile blankets on the torso. 不必盡劑 — no need to finish the dose — is the same titration the other two method chapters apply.

Deukhyo 得效

7.4 Slow and Urgent in Effusing Sweat 發汗緩急

7.4.1
Source원문

凡發汗溫服湯藥. 其方雖言日三服, 若病劇不解, 當促其間, 可半日中盡三服. 若與病相阻, 卽便有所覺. 重病者, 一日一夜, 當晬時觀之. 如服一劑病證猶在, 則當復作本湯服之. 至有不肯汗出, 服三劑乃解. 若汗不出者, 死病也. 《仲景》

Translation영역
In effusing sweat, the decoction is taken warm. Though the formula says three doses a day, if the disease is severe and does not resolve, the intervals should be shortened and the three doses may be finished within half a day. If it meets and checks the disease, that is felt at once. In grave cases watch through a full day and night, a whole cycle. If after one preparation the pattern remains, the same decoction should be made again and taken. There are cases where the sweat will not come and three preparations are taken before it resolves. But where the sweat does not come out, it is a fatal disease.
Clinical note임상 주석
若汗不出者, 死病也 — where the sweat does not come out, it is a fatal disease. That is the chapter's prognostic line, and it corresponds to something real: in severe febrile illness an inability to sweat marks circulatory failure. 晬時, a whole cycle, is the full twenty-four hours, and the instruction to watch that long before concluding is a caution against giving up too soon.

Junggyeong 仲景

7.4.2
Source원문

汗證, 詳見寒門.

Translation영역
The sweating patterns are treated in fuller detail in the Cold Damage chapter.

Donguibogam · Han

7.5 Forcing Sweat by Steaming 蒸劫發汗

7.5.1
Source원문

蒸法, 以薪火燒地, 良久, 掃除去火, 以水洒之. 取蚕沙ㆍ柏葉ㆍ桃葉ㆍ糠ㆍ麩, 皆可用相和, 鋪燒地上, 可側手厚. 上鋪草席, 令病人臥溫覆之, 夏月只布單覆之, 汗移時立至. 竢周身至脚心自汗漐漐, 乃用溫粉方見津液撲止汗. 最得力者, 蚕沙ㆍ桃葉ㆍ柏葉也, 無蚕沙亦得. 此極急則可, 愼莫再作, 促壽也. 《得效》

Translation영역
The steaming method: burn a fire of firewood on the ground, and after a good while sweep away the fire and sprinkle the ground with water. Take silkworm droppings, arborvitae leaf, peach leaf, rice bran and wheat bran — all of them may be used — mix them together and spread them on the burnt ground to the thickness of a hand on edge. Spread a straw mat on top, have the patient lie on it and cover them warmly; in summer cover only with a single cloth. The sweat arrives at once within the hour. Wait until the whole body down to the soles of the feet sweats freely of itself, then use warming powder formula in the Fluids chapter dusted on to stop the sweat. Most effective are silkworm droppings, peach leaf and arborvitae leaf; without silkworm droppings it still works. This may be done where the case is extremely urgent, but take care never to do it a second time — it shortens life.
Clinical note임상 주석
A method with no medicine in it: ground heated by fire, damped, strewn with leaves and bran, and the patient laid on a mat above it. What it produces is a sauna, and the sweat is said to come within the hour. 竢周身至脚心自汗 — wait until the whole body down to the soles sweats — applies the same endpoint as 7.3. The soles are the test. 愼莫再作, 促壽也 — never do it twice, it shortens life — is given in the same breath as the method, which is characteristic of these three chapters. The technique is set down and the limit set down with it. **Forced hyperthermia causes dehydration, electrolyte loss and cardiovascular collapse, and is dangerous in the elderly, the frail and the febrile.**

Deukhyo 得效

7.6 Hurrying the Sweat Shortens Life 促汗夭壽

7.6.1
Source원문

詳見寒門.

Translation영역
Treated in fuller detail in the Cold Damage chapter.
Clinical note임상 주석
A heading kept with a cross-reference only, and the chapter keeps it because the warning belongs in the sequence: after the method of forcing a sweat at 7.5 comes the section saying what forcing costs. The Purging chapter has 下多亡陰 in the same position and the Vomiting chapter 不可吐證. Each of the three methods is followed immediately by its price.

Donguibogam · Han

7.7 Patterns for Which Sweating May Be Used 可汗證

7.7.1
Source원문

內經曰, 其在皮者, 汗而發之. 又曰, 其在表者, 漬形以爲汗.

Translation영역
The Neijing says: what is in the skin, sweat it and effuse it. It also says: what is in the exterior, soak the form to make a sweat.
Clinical note임상 주석
The two lines the method rests on, and the second licenses the steaming method at 7.5. 漬形, soaking the form, means bathing or steaming the body rather than giving a medicine. The Vomiting chapter's foundation at 6.3 is the companion sentence — what is high, let it overflow. Both come from the same passage of the Suwen, which assigns a direction of exit to each location of disease.

Naegyeong 內經

7.7.2
Source원문

凡中風, 傷寒, 諸雜病, 有表證, 皆可汗之.

Translation영역
In wind stroke, cold damage and all the miscellaneous diseases, wherever there is an exterior pattern, sweating may be used.

Donguibogam · Han

7.7.3
Source원문

麻黃湯ㆍ桂枝湯, 治傷寒表證可汗. 方幷見傷寒

Translation영역
Ephedra Decoction and Cinnamon Twig Decoction treat exterior patterns in cold damage where sweating may be used. both formulas in the Cold Damage chapter

Donguibogam · Han

7.7.4
Source원문

小續命湯ㆍ通氣驅風湯, 治中風表證可汗. 方幷見中風

Translation영역
Minor Prolong Life Decoction and Free the Qi and Expel Wind Decoction treat exterior patterns in wind stroke where sweating may be used. both formulas in the Wind chapter

Donguibogam · Han

7.7.5
Source원문

葛根解肌湯ㆍ升麻葛根湯, 治四時傷寒瘟疫. 方幷見傷寒

Translation영역
Pueraria Resolve the Flesh Decoction and Cimicifuga and Pueraria Decoction treat cold damage and epidemic pestilence in all four seasons. both formulas in the Cold Damage chapter

Donguibogam · Han

7.7.6
Source원문

羌活冲和湯, 治四時傷風, 傷寒, 疫癘, 及感冒諸證, 皆可汗. 方見傷寒

Translation영역
Notopterygium Harmonize the Centre Decoction treats wind damage, cold damage, pestilence and all patterns of common contraction in the four seasons, and in all of them sweating may be used. formula in the Cold Damage chapter
Clinical note임상 주석
Every formula in this section is sent elsewhere — to the Cold Damage chapter or the Wind chapter. Unlike the Vomiting and Purging chapters, which carry their own formularies, this one holds no prescriptions of its own beyond the simples at 7.11. What that leaves is a chapter about method rather than about medicines, which is why its sections on degree and timing are so much fuller than its list of what to give.

Donguibogam · Han

7.8 Patterns for Which Sweating May Not Be Used 不可汗證

7.8.1
Source원문

瘡家, 雖有身痛, 不可發汗, 發汗則成痓. 《仲景》

Translation영역
In one who has sores, though there be body pain, sweat may not be effused; effusing sweat brings on rigidity.
Clinical note임상 주석
痓, rigidity, is the arched-back spasm the Dampness chapter describes at 3.8.8 as following a wound, and which modern medicine calls tetanus. The prohibition is exact in its reasoning even if not in its mechanism: a patient with open sores who is further depleted by sweating is at risk, and the association between wounds and tetanic spasm was well observed.

Junggyeong 仲景

7.8.2
Source원문

鼻衄者, 不可發汗, 凡失血皆同. 盖血與汗異名而同類. 故奪血者無汗, 奪汗者無血. 今血妄行爲熱所逼, 若更發其汗, 則反助熱邪, 重竭津液, 必變凶證. 故不可汗也. 《仲景》

Translation영역
In one with nosebleed, sweat may not be effused, and it is the same in all loss of blood. Blood and sweat are different in name and the same in kind. Therefore one whose blood is taken has no sweat, and one whose sweat is taken has no blood. Now where the blood moves recklessly, driven by heat, if the sweat is further effused it assists the heat evil instead and doubly exhausts the fluids, and it must change into an ominous pattern. Therefore sweating may not be used.
Clinical note임상 주석
血與汗異名而同類 — blood and sweat are different in name and the same in kind — is the sentence this prohibition rests on, and it is the chapter's most-quoted line. 奪血者無汗, 奪汗者無血 follows from it as a rule of practice: a patient who has lost blood cannot spare sweat, and one who has sweated heavily cannot spare blood. The Vomiting chapter bars the same patients from its method at 6.10.2.

Junggyeong 仲景

7.8.3
Source원문

傷寒少陰證, 欲寐但厥者, 忌强發汗. 發汗則必動其血, 九竅出血不治. 《仲景》

Translation영역
In the lesser yin pattern of cold damage, where the patient only wishes to sleep and the limbs are reverse-cold, forcing a sweat is to be avoided. Effusing sweat must stir the blood, and bleeding from the nine orifices cannot be treated.
Clinical note임상 주석
欲寐但厥 — only wishing to sleep, with cold limbs — is the lesser yin presentation, and it describes a patient whose yang is already failing. Sweating such a patient drives out what little remains. 九竅出血, bleeding from the nine orifices, is disseminated bleeding and the chapter calls it untreatable. **Drowsiness with cold extremities in a febrile illness indicates circulatory failure and is a medical emergency.**

Junggyeong 仲景

7.9 Sweating Much Destroys the Yang 汗多亡陽

7.9.1
Source원문

大汗傷氣. 《得效》

Translation영역
Heavy sweating damages the qi.

Deukhyo 得效

7.9.2
Source원문

汗者, 本所以助陽也. 若陽受陰邪, 寒結無形, 須當發去陰邪, 以復陽氣. 陰邪旣去, 而復汗之, 則反傷陽也. 經曰, 重陽必陰. 故陽氣自亡, 汗多亡陽, 此之謂也. 《東垣》

Translation영역
Sweating is fundamentally the means of assisting the yang. Where the yang has received a yin evil and cold has bound without form, the yin evil must be effused away so that the yang qi may be restored. But where the yin evil has already gone and sweating is done again, on the contrary the yang is damaged. The classic says: doubled yang must become yin. Hence the yang qi is destroyed of itself, and sweating much destroying the yang means this.
Clinical note임상 주석
The exact counterpart of the Purging chapter's argument at 8.5.2, with yang and yin exchanged. Sweating protects the yang by removing what oppresses it; continuing after the evil is gone takes the yang itself. 寒結無形 — cold bound without form — is the reason this method suits an exterior pattern and purging does not. What has form is taken out below; what has none is driven out through the skin. The Purging chapter's test at 8.3.2 turns on the same distinction. **Profuse sweating causes dehydration and electrolyte loss, and is dangerous in the elderly and the frail.**

Dongwon 東垣

7.10 Resolving the Flesh 解肌

7.10.1
Source원문

解肌, 謂微汗也. 《入門》

Translation영역
Resolving the flesh means a slight sweat.
Clinical note임상 주석
A term defined in four graphs. 解肌 is the gentler half of this method — a sweat raised at the level of the flesh rather than driven from the interior — and it is what most exterior patterns actually call for. The distinction matters because the formulas differ: ephedra effuses, pueraria resolves.

Immun 入門

7.10.2
Source원문

大抵解肌, 葛根第一, 柴胡次之. 《綱目》

Translation영역
In resolving the flesh generally, pueraria is first and bupleurum next.
Clinical note임상 주석
Pueraria first because it reaches the yang brightness where the flesh is thickest, bupleurum next because it works at the lesser yang between exterior and interior. The simples section confirms it at 7.11.4, where pueraria is credited with resolving the flesh and bringing out the yang brightness sweat.

Gangmok 綱目

7.11 Simple Medicinals 單方

7.11.1
Source원문

石膏 解肌, 出毒汗. 碎取一兩煎服, 發陽明經汗. 《本草》 《丹心》

Translation영역
Gypsum (石膏): Resolves the flesh and brings out a toxic sweat. Break it up, take 1 nyang, decoct and take, and it effuses the sweat of the yang brightness channel.
Clinical note임상 주석
出毒汗 — bringing out a toxic sweat — is a phrase used of medicinals that clear heat while opening the surface. Gypsum is cold and heavy and would not be expected to sweat anyone; what it does is cool the yang brightness so that the surface can open.

Boncho 本草 · Dansim 丹心

7.11.2
Source원문

麻黃 發表出汗. 根節能止汗. 麻黃無葱, 汗不發. 人參佐麻黃, 表實無汗者, 一服卽效. 《本草》 《入門》

Translation영역
Ephedra (麻黃): Effuses the exterior and brings out sweat. The root and nodes can stop sweat. Without scallion, ephedra does not effuse a sweat. With ginseng assisting ephedra, in one whose exterior is replete and who does not sweat, a single dose takes effect.
Clinical note임상 주석
The stem effuses sweat and the root stops it — one plant with opposite actions in its two parts, and the tradition keeps them as separate medicinals. The Fluids chapter uses the root for spontaneous sweating. 麻黃無葱, 汗不發 — without scallion, ephedra does not effuse a sweat — is the pairing rule, and scallion appears at 7.11.10 in its own right. **Ephedra contains ephedrine and is cardiovascularly active. It is restricted or prohibited in many jurisdictions.**

Boncho 本草 · Immun 入門

7.11.3
Source원문

水萍 發汗甚於麻黃. 治中風癱瘓, 熱毒. 卽風門去風丹, 是也. 取五錢, 水煎服. 《丹心》

Translation영역
Duckweed (水萍): Effuses sweat more strongly than ephedra. Treats wind stroke with paralysis and heat toxin. It is the Expel Wind Elixir of the Wind chapter. Take 5 don, decoct in water and take.
Clinical note임상 주석
發汗甚於麻黃 — effuses sweat more strongly than ephedra — is a striking claim for a plant that floats on ponds, and it is the chapter's one surprise among the simples.

Dansim 丹心

7.11.4
Source원문

葛根 能解肌, 出陽明經汗. 剉取一兩, 水煎服之. 《丹心》

Translation영역
Pueraria (葛根): Can resolve the flesh and bring out the sweat of the yang brightness channel. Cut up, take 1 nyang, decoct in water and take.

Dansim 丹心

7.11.5
Source원문

荊芥 發汗. 又治血風. 水煎服之. 《丹心》

Translation영역
Schizonepeta (荊芥): Effuses sweat, and also treats blood wind. Decoct in water and take.

Dansim 丹心

7.11.6
Source원문

薄荷 發毒汗. 又治風熱, 出汗. 《本草》

Translation영역
Mint (薄荷): Effuses a toxic sweat, and also treats wind heat and brings out sweat.

Boncho 本草

7.11.7
Source원문

紫蘇葉 發汗, 散表氣. 久汗不出, 加靑皮ㆍ紫蘇葉, 則汗卽出. 《本草》 《丹心》

Translation영역
Perilla leaf (紫蘇葉): Effuses sweat and scatters the exterior qi. Where the sweat has long not come, add green tangerine peel and perilla leaf, and the sweat comes at once.

Boncho 本草 · Dansim 丹心

7.11.8
Source원문

木賊 能發汗. 去節用之. 《丹心》

Translation영역
Horsetail (木賊): Can effuse sweat. Remove the nodes before using it.
Clinical note임상 주석
去節 — removing the nodes — echoes the ephedra entry, where the nodes are the part that stops sweat rather than effusing it. The same rule is applied to a different jointed stem.

Dansim 丹心

7.11.9
Source원문

忍冬草 能出汗. 《俗方》

Translation영역
Honeysuckle (忍冬草): Can bring out sweat.

Sokbang 俗方

7.11.10
Source원문

葱白 能發汗. 已上幷煮湯飮. 《本草》

Translation영역
Scallion white (葱白): Can effuse sweat. All the above are boiled into a decoction and drunk.

Boncho 本草

7.11.11
Source원문

淸酒 能發汗. 《俗方》

Translation영역
Clear wine (淸酒): Can effuse sweat.
Clinical note임상 주석
Eleven simples, and nine of them are ordinary plants from the kitchen garden or the roadside — scallion, mint, perilla leaf, schizonepeta, honeysuckle, horsetail, duckweed, pueraria, wine. Only gypsum and ephedra are pharmacy items. For a method whose whole difficulty lies in judging degree rather than in choosing a drug, that is consistent: the chapter spends its attention on how much sweat and how far it reaches, and takes the means for granted.

Sokbang 俗方

7.11.12
Source원문

當與津液門參看.

Translation영역
This should be read together with the chapter on fluids.
Clinical note임상 주석
The chapter ends by pointing elsewhere, as the Purging chapter does to the Stool chapter. Sweating as a method belongs here; sweat as a complaint — spontaneous sweating, night sweating, sweat that will not stop — belongs to the Fluids chapter.

Donguibogam · Han

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Miscellaneous Disorders, Volume 1, The Sweating Method chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.