Moderate Sweating Has an Important Adjunctive Role in Treating Many Chronic Diseases

Many famous Chinese medical works emphasize that, besides taking the medicine, one should induce moderate sweating. For example, Guizhi Tang in the Shanghan Lun requires "warm covering to induce sweating"—that is, covering up with a blanket to sweat. Under the "Wuling San" entry in the Jingui Yaolue, it is likewise stressed that the patient should "drink much warm water" (drink more boiled water) and that the illness resolves with sweating. The Waike Zhengzhi Quansheng Ji also enjoins patients to "take the medicine with yellow rice wine, cover up drunk, and induce sweat" (author's note: this must not be applied rigidly; for example, liver patients should not use wine, and ginger decoction or ginger-scallion decoction should be used instead to assist sweating). For many Chinese medicines, physicians require patients to "take with yellow rice wine" or "take with good wine" or "take with ginger decoction"—first, to induce sweating, and second, to help the medicine's dispersing action.

In Chinese medicine, sweat glands are the body's couli (interstices and skin texture). Once a person falls ill, the couli easily becomes closed, which produces a whole series of symptoms; and because the couli is blocked, the pathogenic evil loses one route out through the sweat glands, so the body is slow to recover. For such patients, inducing sweating alongside medication is quite necessary. So, beyond taking the medicine, letting the patient sweat a little helps recovery.

But more sweating is not always better. Only certain patients with severe couli blockage need a thorough sweat to relieve the condition; most chronic patients need only, as Zhang Zhongjing put it in the Shanghan Lun, "a faint suggestion of sweating"—that is, a slight amount of perspiration appearing on the skin surface, not a heavy drenching sweat. A heavy drenching sweat may not be a major problem for a healthy person, whose resistance is strong and whom pathogens cannot easily invade. But for the frail it is another matter; to sweat into the wind is especially likely to cause trouble.

Since sweat glands are a channel between the body and the outside world, they both expel pathogens and let pathogens in. When a person sweats profusely, the couli gape wide, and external evils such as wind, cold, dampness, dryness, and fire easily invade through the sweat glands. So after a drenching sweat the patient not only fails to recover but may worsen. In the past, an old Chinese physician training an apprentice would paddle him if the apprentice sweated a patient too strongly.

Many people do not know how to use fever-reducing medicines, whether Chinese or Western. Many antipyretics work by helping the person sweat; once the sweat comes, the fever recedes. But if the patient sweats profusely, then—sorry—the fever may have receded temporarily, but the illness worsens after a while. Especially in children, the elderly, and frail chronic patients, all sorts of troubles follow a thorough sweat.

This is the same principle by which mild diarrhea can detoxify while severe diarrhea can kill. So in treating illness one must emphasize moderate sweating; if too much sweat comes, one should powder the skin to prevent further heavy sweating. This, too, was taught by Zhang Zhongjing over two thousand years ago.

Chinese medicine is actually quite simple and quite reasonable; regrettably, through the dynasties, Chinese medical books have talked of mysteries and the Way, blowing herbal medicine's curative powers more and more abstruse, so that ordinary people cannot understand it and cannot cooperate with the physician's regulation. As the saying goes, "using his own muddle to make others clear." Many physicians themselves do not understand the principles of Chinese medicine; how could they explain them clearly to the patient?