Shibiao San for Spontaneous Sweating Due to Yang Deficiency

"Shibiao San" (Exterior-Solidating Powder) comes from the Yilue Liushu (Six Books on Medical Outlines). The formula consists of prepared aconite (Fuzi, stir-fried) 1 liang 5 qian (45 g), dong quai (Danggui) 3 liang (90 g), schisandra berry (Wuweizi) 1 liang 5 qian (45 g), and light wheat (Fuxiaomai) 9 qian (27 g). Grind the above into a powder, decoct with jujube (Dazao) water, and remove the dregs. Take warm, twice daily. It is now mostly used as a decoction; the adult dose for one packet is: aconite 9 g, dong quai 10 g, schisandra 9 g, light wheat 6 g, jujube 5 pieces, decocted in water, taken twice daily.

This formula has the action of supporting yang and stopping sweating. It is indicated for spontaneous sweating due to yang deficiency, in patients with a fine pulse. In this formula, aconite supports yang and bolsters fire; dong quai nourishes and activates blood; schisandra astringes sweating and secures the exterior; light wheat is a medicinal commonly used in TCM to stop sweating. When these medicines are used together, they achieve the effect of supporting yang and stopping sweating.

Spontaneous sweating due to yang deficiency is what we colloquially call cold sweating: the patient's hands and feet are cold and he is averse to cold, yet sweating does not cease, and the urine is clear and copious. Western medicine has no corresponding treatment for this condition, but TCM has a symptomatic approach. This disease is common in weak patients with chronic illness; some cancer patients develop this symptom after surgery and chemoradiotherapy. The author has encountered such patients in clinical practice; for them, using Yupingfeng Granules or Guizhi Tang is not markedly effective, but this formula produces an immediate effect.