Library

The *Classic of Internal Medicine* states: Regulating sleep and diet should precede medical treatment. This is precisely the theory of "treating disease before it arises" advocated by the sages. Since the physical form has already been subjected to external stimuli such as sounds and colors, if one cannot eat peacefully, essence and qi cannot be generated; if one cannot sleep peacefully, blood and spirit cannot be nourished. Therefore, when various diseases reach a critical stage, it is essential first to inquire whether the patient can consume liquid porridge, thereby verifying whether the stomach qi is exhausted or intact; observing whether their wakefulness and sleep are normal, thereby inspecting whether their mental state is tranquil. Inability to eat with little sleep is a pathological condition, just as excessive eating with lethargy is also a pathological condition. Those who wish to preserve health and prevent disease must surely exercise caution regarding sleep and diet.

Regarding conditions of inability to eat, there are cases where cold damage (*Shanghan*) causes fullness in the epigastrium, nausea, vomiting, and even regurgitation of food; cases where stagnant qi causes pain that hinders eating; cases where phlegm accumulation prevents the容纳 (acceptance) of food; cases where food is eaten but immediately vomited back up; cases where excessive worry and fear cause qi depression and loss of appetite; pregnant women experiencing morning sickness due to fetal formation; cases where heat exists in the spleen and stomach while cold resides in the epigastrium, causing hunger without desire to eat; cases of inherent spleen and stomach deficiency failing to transport and transform effectively; cases where fire fails to generate earth, leaving no means to cook and decompose food; cases of middle qi deficiency after severe illness, leading to aversion to the smell of food; and cases of dryness and atrophy in the epigastrium preventing even spoonfuls of food from entering. Generally speaking, sudden inability to eat due to overeating belongs to excess syndromes (*Shi*), while gradual inability to eat starting from reduced intake belongs to deficiency syndromes (*Xu*).

Regarding conditions of excessive eating, there are cases where fire hides in the yin aspect, stomach heat digests grain well, or heat transfers from the large intestine to the stomach, and from the stomach to the gallbladder. Excessive eating with emaciation is called "food mass" (*Shi Xia*), also known as "breath accumulation" (*Xi Ben*). There are cases where cold damage pathogens enter the zang organs, causing cold limbs and diarrhea; although they should not be able to eat, they suddenly can, which is called "removal of the center" (*Chu Zhong*). There are cases of wind-stroke where liver wood qi becomes excessive and overacts on spleen earth; the spleen earth, being overacted upon, seeks assistance and results in increased eating. When one zang organ is deficient, there is often a specific craving for a certain taste, such as craving sour foods during pregnancy due to liver deficiency. Parasitic accumulation may cause cravings for tea leaves, raw rice, mud, charcoal, or paper. After an illness, extreme stomach deficiency may lead to feeling full yet quickly hungry again. Generally, easy digestion despite large intake is attributed to the fire of the Yangming channel; difficulty digesting food is attributed to the deficiency of the Taiyin channel.

Regarding conditions of insomnia, if mental labor and worry deplete yin blood, causing wakefulness and inability to sleep, the pathology lies in the Heart. If spirit and qi are weak, accompanied by paranoia, palpitations, timidity, and loneliness without sleep, the pathology lies in the Liver and Gallbladder. If water qi rebels upward, causing wheezing, coughing with sound, and inability to lie flat, the pathology lies in the Lung. If caused by fright, with spirit wandering and the heart residence empty, allowing phlegm to enter due to deficiency, resulting in delirium and insomnia, the pathology lies in the Pericardium Collateral. If qi and blood are insufficient, causing post-illness vexation, leading to light sleep and frequent waking, the pathology lies in the Spleen. If Yangming fu-organ disease from cold damage involves dry feces internally, causing intense heat and restless sleep, the pathology lies in the Stomach. In elderly individuals, qi deficiency and blood reduction lead to increasingly rough muscles, lack of vitality during the day, and inability to sleep at night; the pathology lies in Ying and Wei. Thus, insomnia caused by the Heart, Spleen, Liver, Gallbladder, Ying, and Wei mostly belongs to deficiency. Insomnia caused by the Lung, Stomach, Pericardium, and Collaterals mostly belongs to excess.

Regarding conditions of hypersomnia, if liver qi is heated or turbid fire disturbs the spirit, causing long sleep and short wakefulness, it is due to heat. If the pulse is slow and sluggish, limbs are flaccid, body is heavy with diarrhea and hypersomnia, it is due to dampness. If the head feels heavy, body is hot, and consciousness is clouded, it belongs to wind. If following overwork, hemorrhage, or dysentery, the spirit has not recovered but deep sleep ensues, it belongs to deficiency. If a person has innate abundance, with large intestines/stomach and tight skin, the largeness means Wei qi stays in the yin aspect for a long time; the tightness means Wei qi moves slowly in the yang aspect. Being both long and slow, Wei qi fails to reach the exterior, resulting in hypersomnia, which belongs to yang failing to overcome yin. If drowsiness, mental fog, and yawning occur immediately after eating, it is due to spleen fatigue or combined damp-heat. However, when cold damage pathogens enter the Shaoyin channel, the pulse is faint and fine, and there is only a desire to sleep. Therefore, clear-mindedness with peaceful sleep is the norm for humans; exhaustion with hypersomnia is the pathology of the sick. The above items cover the manifestations of sleep and diet imbalance. Once other symptoms are clarified, treatment methods can be extended accordingly. However, these are established for existing diseases. Regarding preventive regulation before disease onset, there are numerous discussions among health preservation experts. I endorse the words of Zhang Tongchu: "In terms of dietary moderation, reduce fullness and accept emptiness; therefore, eat only when hungry, stop before becoming fully satisfied, leaving some void." Regarding sleeping methods, calm the mind first, then close the eyes. Calming the mind is the method of "stopping"; closing the eyes is the method of "observing." Only by mastering these two can one discuss health preservation. Yet, there are those in the world who have no discipline in sleep and diet, indulging in alcohol despite satiety and seeking sexual gratification despite fatigue. This is inviting disease rather than having disease invite them. Thus, Zhuangzi said, "What is to be feared in humans occurs between the bedclothes and the dining table," which is truly so.