〔仲〕虚劳虚烦不得眠，酸枣汤主之。
酸枣仁（二升） 甘草（一两） 知母 茯苓 芎 （各二两。一方加生姜二两）
上以水八升，煮酸枣仁得六升，纳诸药煮取三升，分温三服。
〔《本》〕治胆虚不得眠，四肢无力，鳖甲丸。
鳖甲 酸枣仁 羌活 牛膝 黄 人参 五味子（各等分）
上为细末，炼蜜杵为丸，如桐子大。每服三四十丸，温酒送下。
〔《圣》〕治骨蒸劳，烦心不得眠。用酸枣仁一两，水一大盏半，研绞取汁，下米二合，煮
粥候熟，下地黄汁一合，更煮过，不计时服之。
〔《素》〕帝曰∶人有卧而有所不安者，何也？岐伯曰∶藏有所伤，及精有所寄之则安，故人不
能悬其病也。（精有所寄之则安，《太素》作“精有所倚则卧不安”是也。）
〔海〕胡洽治振悸不得眠。人参、白术、茯苓、甘草、生姜、酸枣仁，六物煮服。
〔《本》〕真珠母丸治肝经因虚，内受风邪，卧则宽散而不收，状若惊悸。
珠母（三分，研细用碾） 当归 熟地（各一两半） 人参 酸枣仁 柏子仁 犀角 茯苓（各一两）
沉香 龙齿（各半钱）
上为细末，炼蜜为丸，如桐子大。辰砂为衣，每服四五十丸，金银薄荷汤下，日午后卧服。
独活汤
独活 羌活 人参 前胡 细辛 半夏 五味子 沙参 白茯苓 酸枣仁 甘草（各一两）
上为粗末，每服四大钱，水一盏半，姜三片，乌梅半个，同煎至七分，去渣，不拘时候。
绍兴癸丑，予待次四明，有董生者，患神气不宁，每卧则魂飞扬，觉身在床，而神魂离体，惊悸多
魇，通夕无寐，更医不效。予为诊视，询之曰∶医作何病治？董曰∶众皆以为心病。予曰∶以脉言之，
肝经受邪，非心病也。肝气因虚，邪气袭之，肝藏魂者也，游魂为变。平人肝不受邪，卧则魂归于肝，
神静而得寐。今肝有邪，魂不得归，是以卧则魂飞扬若离体也。肝主怒，故小怒则剧。董欣然曰∶前
此未之闻，虽未服药，已觉沉 去体矣，愿求治之。予曰∶公且持此说，与众医议所治之方而徐质之。
阅旬日，复至云∶医遍议古今方，无与病相对者。故予处此二方以赠，服一月而病悉除。此方用真
珠母为君，龙齿佐之，真珠母入肝经为第一，龙齿与肝同类也。龙齿虎睛，今人例以为镇心药，殊不
知龙齿安魂，虎睛定魄，各言其类也。盖东方苍龙木也，属肝而藏魂，西方白虎金也，属肺而藏魄。
龙能变化，故魂游而不定。虎能专静，故魄止而有守。予谓治魄不宁者，宜以虎睛，治魂飞扬者，宜
以龙齿，万物有成理而不失，在夫人达之而已。
〔垣〕羌活胜湿汤加柴胡，治卧而多惊，邪在少阳厥阴也。（方见腰痛）诸水病者，故不得卧，
卧则惊，惊则咳甚也。（全文见水肿。）
《内经》半夏汤治不得卧，乃去饮之剂也。（方见前阴阳条。）
〔无〕温胆汤 治大病后，虚烦不得眠，兼治惊悸。（方见惊悸。）
〔丹〕烦不得眠，六乙散加牛黄服之。（即益元散。）
〔子和〕一富家妇人，伤思虑过甚，二年不得寐，无药可疗，其夫求戴人治之。戴人曰∶两
手脉俱缓，此脾受邪也，脾主思故也。乃与其夫议以怒激之，多取其财，饮酒数日，不处一法而去。
其妇大怒汗出，是夜困眠，如此者八九日不寤，自是食进，其脉得平。（此因胆虚不能制脾之思
虑而不寐，今激之怒，胆复制脾故得寐也。）
〔《素》〕阳明者，胃脉也，胃者六腑之海，其气亦下行，阳明逆，不得从其道，故不得卧也。
《下经》曰∶胃不和则卧不安，此之谓也。（逆调论）
喘不得卧，以喘法治之。
厥不得卧，以香港脚法求之。
〔《素》〕帝曰∶人之不能偃卧者，何也？岐伯曰∶肺者藏之盖也，肺气盛则肺大，肺大则
不得偃卧。
〔《撮》〕胆寒不得卧∶窍阴（一分，补之灸。）
〔《甲》〕惊不得眠，善 ，水气上下，五脏游气也，阴交主之。不得卧，浮 主之。
[Zhang Zhongjing] In deficiency consumption (Xu Lao), mental deficiency and vexation lead to insomnia; Suan Zao Ren Tang (Sour Jujube Decoction) is the primary treatment.
Suan Zao Ren (Ziziphi Spinosae Semen, two sheng) Gan Cao (Glycyrrhizae Radix et Rhizoma, one liang) Zhi Mu (Anemarrhenae Rhizoma) Fu Ling (Poria) Xiong (Chuanxiong Rhizoma) (each two liang. Another version adds Sheng Jiang [Zingiberis Rhizoma Recens], two liang).
Take eight sheng of water, boil Suan Zao Ren until six sheng remain, then add the other herbs and boil to obtain three sheng of decoction. Divide into three doses and take warm.
[Ben Cao] Treats insomnia due to Gallbladder deficiency and weakness in the four limbs; Bie Jia Wan (Tartar Turtle Shell Pill) is used.
Bie Jia (Testudinis Carapax et Plastrum) Suan Zao Ren Zuo Yang Qiang Huo (Notopterygii Rhizoma et Radix) Niu Xi (Achyranthis Bidentatae Radix) Huang Qin (Scutellariae Radix) Ren Shen (Ginseng Radix) Wu Wei Zi (Schisandrae Fructus) (each equal parts).
Grind into fine powder, mix with refined honey, and make pills the size of tung tree seeds. Take 30-40 pills per dose, washed down with warm wine.
[Sheng Ji Zong Lu] Treats bone-steaming labor heat, vexation, and insomnia. Use one liang of Suan Zao Ren, one and a half large bowls of water, grind and squeeze to extract juice. Add two he of rice, cook into porridge. When ripe, add one he of Di Huang (Rehmanniae Radix) juice, boil again, and take at any time.
[Su Wen - Yellow Emperor's Inner Canon] The Yellow Emperor asked: Why do some people feel uneasy when lying down? Qi Bo answered: If the zang organs are injured, and if the jing essence has nowhere to rely upon, there is no peace; thus, humans cannot be separated from their diseases. (The phrase "if the jing essence has somewhere to rely upon, there is peace" in Tai Su is correctly interpreted as "if the jing essence has nowhere to rely upon, sleep is uneasy.")
[Hai Zang] Hu Qia treats palpitations and insomnia due to fright. Ren Shen Bai Zhu Poria Gan Cao Sheng Jiang Suan Zao Ren (six herbs) are boiled and taken.
[Ben Cao] Zhen Zhu Mu Wan (Pearl Mother Pill) treats Liver channel deficiency with internal wind pathogen invasion. During sleep, the Liver qi becomes loose and fails to consolidate, presenting symptoms similar to palpitations.
Zhen Zhu Mu (Margaritifera Ostrea, three fen, finely ground) Dang Gui (Angelicae Sinensis Radix) Shu Di Huang (Prepared Rehmanniae Radix) (each one and a half liang) Ren Shen Suan Zao Ren Bai Zi Ren (Platycladi Semen) Xi Jiao (Rhinocerotis Cornu) Poria (each one liang) Chen Xiang (Aquilariae Lignum) Long Chi (Dent Draconis) (each half qian).
Grind into fine powder, mix with refined honey, and make pills the size of tung tree seeds. Coat with Cinnabar (Zhu Sha). Take 40-50 pills per dose, washed down with Yin Jin Bo He Tang (Silver Mint Decoction), taken in the afternoon or before sleep.
Du Huo Tang (Angelicae Pubescentis Decoction)
Du Huo (Angelicae Pubescentis Radix) Qiang Huo Nong Shen Qian Hu (Peucedani Radix) Xi Xin (Asari Radix et Rhizoma) Ban Xia (Pinelliae Rhizoma) Wu Wei Zi Sha Shen (Glehniae Radix) Bai Fu Ling Suan Zao Ren Gan Cao (each one liang).
Grind into coarse powder. Take four da qian per dose, with one and a half bowls of water, three slices of Sheng Jiang, and half a Mei Zi (Prunus mume), decoct until three-tenths remains, remove dregs, and take at any time.
In the year Gui Chou of Shaoxing, while I was waiting for an appointment in Siming, a scholar named Dong suffered from spirit unrest. Whenever he slept, his hun soul seemed to fly away; he felt his body was in bed but his spirit had left it. He experienced frequent fright, palpitations, and nightmares, unable to sleep all night. Multiple doctors failed to cure him. I examined him and asked, "How are you being treated?" Dong said, "Everyone considers it a Heart disease." I said, "Judging by the pulse, this is a Liver channel pathogen, not a Heart disease. The Liver qi is deficient, allowing pathogens to invade. The Liver stores the hun soul. In healthy individuals, when the Liver is free of pathogens, the hun returns to the Liver during sleep, the spirit calms, and sleep occurs. Now, because the Liver has pathogens, the hun cannot return, so during sleep the hun flies about as if leaving the body. The Liver governs anger, so slight anger exacerbates the condition." Dong happily said, "I have never heard this before. Although I haven't taken medicine yet, I already feel the heaviness leaving my body. I wish to seek treatment." I said, "Hold onto this theory and discuss the prescription with other doctors to verify it." Ten days later, he returned saying, "Doctors discussed ancient and modern prescriptions, none matched the illness." So I gave him these two prescriptions. After one month of use, the illness was completely cured. This prescription uses Zhen Zhu Mu as the sovereign herb, with Long Chi as the assistant. Zhen Zhu Mu enters the Liver channel first; Long Chi is similar to the Liver. People usually consider Long Chi and Hu Jing (Tiger Eye) as heart-calming agents, not knowing that Long Chi calms the hun and Hu Jing stabilizes the po, each corresponding to its category. The Eastern Azure Dragon belongs to Wood, corresponds to the Liver, and stores the hun; the Western White Tiger belongs to Metal, corresponds to the Lung, and stores the po. The Dragon can transform, so the hun wanders and is unstable; the Tiger is steadfast, so the po stops and has control. I say that for treating unstable po, one should use Tiger Eye; for treating flying hun, one should use Dragon Teeth. All things have inherent principles that do not fail; it depends on people to understand them.
[Li Dongyuan] Qiang Huo Sheng Shi Tang (Notopterygium and Angelica Decoction to Overcome Dampness) added with Chai Hu (Bupleuri Radix) treats insomnia with frequent fright, where the pathogen is in the Shaoyang and Jueyin channels. (Prescription see Low Back Pain chapter.) For various edema conditions, one cannot lie flat; lying down causes fright, and fright worsens coughing. (Full text see Edema chapter.)
Ban Xia Tang (Pinellia Decoction) in Nei Jing treats insomnia; it is a formula to eliminate phlegm-fluid retention. (Prescription see Yin-Yang section above.)
[Chen Wuce] Wen Dan Tang (Warm the Gallbladder Decoction) treats insomnia with vexation after severe illness, and also treats fright and palpitations. (Prescription see Fright and Palpitations chapter.)
[Zhu Danxi] For vexation and insomnia, Liu Yi San (Six-to-One Powder) added with Niu Huang (Calculus Bovis) is taken. (This is Yi Yuan San.)
[Zhang Hezi] A wealthy woman, having overthought and worried excessively, could not sleep for two years. No medicine worked. Her husband sought treatment from Dai Ren (Zhang Hezi). Dai Ren said, "Both wrists' pulses are slow; this indicates the Spleen is affected by pathogens, as the Spleen governs thought." He discussed with her husband to provoke anger. He took much money, made her drink alcohol for several days, and left without prescribing any method. The woman became extremely angry and sweated. That night she slept deeply. This repeated for eight or nine days until she woke up refreshed. Her appetite improved, and her pulse normalized. (This was insomnia caused by Gallbladder deficiency failing to control Spleen overthinking; by provoking anger, the Gallbladder re-controlled the Spleen, allowing sleep.)
[Su Wen] Yangming is the Stomach meridian. The Stomach is the sea of the six fu organs, and its qi also descends. If Yangming qi rebels and does not follow its pathway, one cannot lie down.
Xia Jing says: "If the Stomach is not harmonious, sleep will be uneasy," which refers to this. (From Ni Diao Lun)
For dyspnea preventing lying down, treat according to dyspnea methods.
For jue syndrome preventing lying down, seek treatment according to hong xie (foot disease/gout) methods.
[Su Wen] The Yellow Emperor asked: Why can some people not lie on their backs? Qi Bo answered: The Lung is the canopy of the zang organs. If Lung qi is excessive, the Lung becomes enlarged. If the Lung is enlarged, one cannot lie on the back.
[Cuo Yixue] Insomnia due to Gallbladder cold: Qiao Yin (GB45) point (one fen, tonifying method with moxibustion).
[Jia Yi Jing) Insomnia due to fright, prone to convulsions, caused by water qi moving up and down and wandering qi of the five zang organs; governed by Yin Jiao (CV7) point. Inability to lie down; governed by Fu Xu (BL62) point.