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Observing Sweating to Diagnose Disease in Traditional Chinese Medicine

If sweating is normal in hot summer days, some people sweat profusely regardless of season—after eating, doing light tasks, or feeling slightly nervous. This may signal underlying diseases.
In medicine, hyperhidrosis is classified as generalized or localized.
Generalized Hyperhidrosis
Caused by febrile diseases, metabolic disorders, and psychological factors.
□ Hypoglycemia: can cause pallor, cold sweats, hand tremors.
□ Hyperthyroidism: patients exhibit heat intolerance and excessive sweating, along with increased appetite, weight loss despite eating more, frequent bowel movements, palpitations, and anxiety.
□ Diabetes: due to autonomic neuropathy, patients often have abnormal sweating, accompanied by polyphagia, polydipsia, polyuria, and weight loss.
□ Pheochromocytoma: common symptoms include profuse, paroxysmal sweating, sometimes continuous. Also associated with palpitations, hand tremors, cold extremities, and marked blood pressure elevation during episodes.
Additionally, hypertension patients and menopausal women may also experience excessive sweating.
Localized Hyperhidrosis:
□ Spontaneous sweating: daytime sweating, worse with activity, usually due to qi deficiency or yang deficiency. Can be adjusted with warming tonics.
□ Night sweating: sweating during sleep, stops upon waking, commonly seen in yin deficiency with fire excess or long-term illness, especially prevalent in tuberculosis patients.
□ Nasal sweating: sweat exudes from the bridge and sides of the nose during emotional excitement, mental stress, fatigue, or excessive talking. Common in allergic rhinitis patients or those with low immunity prone to colds.
□ Forehead sweating: sweat confined to the forehead, sometimes resembling steam from a steamer. Often seen in individuals with excessive yang energy or hyperactive digestive function.
□ Hemispheric sweating: sweating on one side of the body, while the other side is dry or barely sweaty. Common in young hypertensive encephalopathy, renal hypertension, stroke, hemiplegia, or paraplegia patients.
□ Mental labor sweating: sweating in the epigastrium and between the breasts, usually due to excessive worry, thought, fear, or fright damaging heart and spleen. Common in mentally exhausted intellectuals.
□ Perineal sweating: sweating confined to the perineum and external genitalia. Common in vulvitis, vaginitis, and other gynecological conditions, sometimes with foul odor.
□ Axillary osmidrosis: sweat with a fox-like odor due to abnormal secretion from apocrine glands in the axilla. More common in young and middle-aged adults, especially females.
□ Hemispheric head sweating: entire head divided by the nose into two halves—one side sweats, the other completely dry. Caused by post-illness sexual activity leading to dual deficiency of yin and yang, plus exposure to cold.
□ Palmar and plantar sweating: occurs during tension, excitement, or speaking in public, commonly starting in adolescence, mostly due to psychological suppression.
Additionally, “battle sweat” (shivering followed by sweating) in high fever patients and “exhaustion sweat” (profuse, uncontrollable sweating) at death’s door are critical warning signs indicating deteriorating condition—should be taken seriously.

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