Insomnia is a
common complaint. Physical causes f insomnia are
comparatively few. In most cases, insomnia is a
psychophysiological disorder, resulting mainly from the
self-stimulation engendered y anxiety, worry, or depression.
Sleeping pills are routinely used for treating this
disorder, but their continuous use in chronic cases may
cause adverse side or toxic effects. Herbal medicines and
acupuncture can be effectively used as alternative measures.
Insomnia is often caused by emotional or psychic
disturbances. Anxiety and anger make the Liver depressed,
and the depressed Liver qi may be transformed into fire,
which interferes with the normal functions of the Heart.
Excessive anxiety may also impair the Heart (mind) and the
Spleen, and insomnia occurs due to inadequate supply of
nutrients and blood to the Heart.
In the aged and the patients suffering from chronic
diseases, qi and blood are insufficient to nourish the
Heart, thus leading to palpitations and insomnia. Qi
deficiency may also involve the Heart and the Gallbladder,
impairing one's sleep and making one vulnerable to fright.
Consumption of Kidney essence may break down the normal
balance between the Heart and the Kidneys, and
incoordination between the Heart and the Kidneys may also be
manifested as insomnia.
According t the pathogenesis, insomnia can be classified
into the following syndrome patterns:
1. Depressed Liver with exuberant fire: Insomnia
accompanied by irritability, irascibility, thirst, yellow
coating, and stringy, rapid pulse.
2. Incoordination of the Heart and the Kidneys: Insomnia
accompanied by dizziness, tinnitus, dryness in the mouth,
heat sensation in the palms and soles, palpitations,
forgetfulness, lumbar aching, reddened tongue, and thready,
3. Deficiency f both the Heart and the spleen: Dreamful
sleep with early waking, palpitations, forgetfulness,
dizziness, lassitude, lack of strength, anorexia, pallid
complexion, and thready, weak pulse.
4. Deficiency of the Heart ad the Gallbladder: Dreamful
sleep with wakefulness, susceptibility to fright, and
stringy, thready pulse.
1. Depressed Liver with exuberant fire
Principle of treatment: To purge the Liver of fire.
Formula of choice: Longdan Xiegan Tang (Decoction of
Gentian to Purge the Liver).
2. Incoordination of the Heart and the Kidneys
Principle of treatment: To coordinate the Heart and the
Formula of choice: Liuwei Dihuang Wan (Pill of Six
Ingredients with Rehmannia) plus Rhizoma Coptidis
(goldthread rhizome) and Cortex Cinnamomi (cinnamon bark).
3. Deficiency of both the Heart and the Spleen
Principle of treatment: to nourish the Heart and the
Formula of choice: Guipi Tang (Spleen-Invigorating
4. Deficiency of the Heart and the Gallbladder
Principle of treatment: To replenish qi and induce
Formula of choice: Anshen Wan (Tranquilizing Pill).
1. Depresed Liver with exuberant fire: Longdan Xiegan Wan
(Gentian Pill to Purge the Liver).
2. Incoordination of the Heart and the Kidneys: Tianwang
Buxin Dan (Heavenly King's heart Tonic).
3. Deficiency of both the Heart and the Spleen: Renshen
Guipi Wan (Spleeninvigorating Pill with Ginseng).
4. Deficiency of the Heart and the Gallbladder: Anshen
Wan (Tranquilizing Pill).