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Sweating

The sweating can be classified into

(1) Generalised
(2) Localised


Generalised Sweating

This means sweating of the whole body especially of the trunk.
CAUSES:-

(1) Sometimes sweating in some viral fevers which is out of proportion to fever.
(2) Myocardial Infarction: - Profuse sweating out of proportion to chest pain. This often occurs in sleep. No functional sweating occurs during sleep.
(3) In Peptic ulcer patients when sweating occurs look for bleeding from the ulcer. Black vomiting or black loose stool may follow.
(4) In a diabetic patient hypoglycaemia should be thought of.
(5) In acute Abdomen especially in Acute Pancreatitis excessive sweating is out of proportion to abdominal pain.
(6) Acute renal colic produces excessive sweating.
(7) Drug reaction may cause excessive sweating.
(8) Obese persons may sweat more than others.
(9) A rapid loss of weight with excessive sweating during few weeks to few months should remind us of Hyperthyroidism.

Localised Sweating

This usually occurs in palms, soles, tip of the nose, moustache area, forehead & armpits. This may accompany with nausea and is also due to fear, anxiety and mild pain. This sweating usually stops during sleep. Following are some situations when this occurs: -

(1) Patient has giddiness and comes with local sweating because he/she has a fear that something wrong with his/her blood pressure.
(2) The patient having chest pain either due to chondritis or muscle sprain or splenic flexure syndrome, but he/she thinks of heart pain. Or if you say blood pressure is normal or get ECG done; may also result in sweating.
(3) The patient gets tingling and numbness of limbs because of some other reason, but he thinks it is due to paralysis.
(4) The patient gets slight pain in RIF, may be due to spasm of colon, he/she may think of appendicitis & the operation.

There are certain young patients who come for excessive sweating of palms & soles lasting for few months or few years. The cause is not known and so no satisfactory treatment. Tranquillizers may be tried. Tab. Reserpine or Belladona may be used, local talcum powder or antiperspirant can be of help. If nothing works and it becomes nuisance to the patient, Sympathectomy operation may be advised. Long term results of the operation are not satisfactory. Gustatory sweating occurs on face & scalp after