《难经》四十六难曰∶老人寤而不寐，少壮寐而不寤者，何也？然经言少壮者，
血气盛，肌肉滑，气道通，荣卫之行，不失其常，故昼日精，夜不寤。老人血气衰，
肌肉不滑，荣卫之道涩，故昼日不能精，夜不寐也。故知老人不得寐也。（宜八珍汤、归
脾汤之类。）虚劳虚烦不得眠者（宜仲景酸枣仁汤。）胆虚惊悸不寐者。（宜温胆汤、六君子汤
之类。）痰饮停中，烦惑不合目者。（宜内经半夏汤、导痰汤之类。）
八珍汤（见第十六）
归脾汤（见第五十八）
仲景酸枣仁汤 治虚劳虚烦不得眠。
酸枣仁（二升） 甘草（一两） 知母 茯苓 芎 （各二两。深师有生姜二两）
上五味，以水八升，煮酸枣仁得六升。内诸药，煮三升，分温三服。
温胆汤（见第二十）
六君子汤（见第十六）
内经半夏汤 治阴阳之气偏胜，不相和谐，阳不得入阴，故不瞑不寐。服此阴阳通，
卧可立至。黄帝所谓决渎壅塞，经络大通，阴阳和得者也。亦治痰气阻塞，阳不
入阴，成上证。大抵转动枢机，则阴阳自谐矣。其汤方以流水千里以外者八升，
扬之万遍，取其清五升煮之。炊以苇薪火，沸，置秫米一升。（秫米，北人谓之黄米，可以
酿酒，）治半夏五合。徐炊，令竭为一升半。去其滓，饮汁一小杯，日三。稍益，以
知为度。故其病新发者，覆杯则卧，汗出则已。久者，三饮而已也。
导痰汤（见第四十四）
The Sixty-Sixth Difficulty of the *Nan Jing* (Classic of Difficult Issues) asks: Why do the elderly remain awake but cannot sleep, while the young and vigorous sleep deeply but are hard to wake? The answer is: As stated in the classics, the young and vigorous possess abundant Qi and Blood, smooth muscles, unobstructed Qi pathways, and normal circulation of Ying (Nutritive Qi) and Wei (Defensive Qi). Therefore, they are energetic during the day and sleep soundly at night. The elderly have declining Qi and Blood, rough muscles, and sluggish channels for Ying and Qi circulation; thus, they lack energy during the day and cannot sleep at night. Hence, it is known that the elderly often suffer from insomnia. (Suitable formulas include Bazhen Tang [Eight Treasure Decoction] and Guipi Tang [Restore the Spleen Decoction].) For those suffering from deficiency exhaustion with empty vexation and inability to sleep, Zhongjing's Suanzaoren Tang (Sour Jujube Seed Decoction) is suitable. For those with gallbladder deficiency causing palpitations and fright leading to insomnia, Wendan Tang (Warm the Gallbladder Decoction) or Liujunzi Tang (Six Gentlemen Decoction) are suitable. For cases where phlegm-fluid retention in the middle jiao causes mental confusion and restlessness preventing eye closure, Banxia Tang (Pinellia Decoction) from the *Nei Jing* (Inner Canon) or Daotan Tang (Great Phlegm-Resolving Decoction) are suitable.
Bazhen Tang (See Volume 16)
Guipi Tang (See Volume 58)
Zhongjing's Suanzaoren Tang treats deficiency exhaustion characterized by empty vexation and insomnia.
Suanzaoren (Ziziphi Spinosae Semen, two sheng) Gancao (Glycyrrhizae Radix et Rhizoma, one liang) Zhi mu (Anemarrhenae Rhizoma) Fuling (Poria) Xiongqiong (Chuanxiong Rhizoma) (each two liang. The *Shenshi Fang* includes Shengjiang [Zingiberis Rhizoma Recens], two liang).
Take these five herbs, add eight sheng of water, and decoct the Suanzaoren until six sheng remain. Add the remaining herbs and decoct until three sheng remain. Divide into three warm doses.
Wendan Tang (See Volume 20)
Liujunzi Tang (See Volume 16)
*Nei Jing*'s Banxia Tang treats conditions where Yin and Yang Qi are imbalanced and disharmonious, such that Yang Qi cannot enter Yin, resulting in inability to close the eyes and insomnia. After taking this formula, Yin and Yang become connected, allowing immediate sleep upon lying down. This corresponds to Huangdi's concept of dredging obstructions, ensuring free flow of meridians, and achieving harmony between Yin and Yang. It also treats insomnia caused by phlegm-Qi obstruction preventing Yang from entering Yin. Generally, rotating the pivot mechanism allows Yin and Yang to harmonize naturally. The preparation method uses flowing water from a distance of a thousand li (eight sheng), agitated ten thousand times, taking five sheng of the clear liquid for decoction. Cook using reed fire. When boiling, add Shumi (Setaria italicae Semen, one sheng; known as Huangmi [Yellow Millet] in the north, used for brewing wine) and Zhibanxia (Prepared Pinelliae Rhizoma, five he). Simmer slowly until reduced to one and a half sheng. Strain the dregs. Drink one small cup per dose, three times daily. Gradually increase the dosage until therapeutic effect is achieved. For newly onset cases, sleep may occur immediately after finishing the bowl, accompanied by sweating which resolves the condition. For chronic cases, three doses are sufficient.
Daotan Tang (See Volume 44)