论曰营卫之气,昼行于阳则寤,夜行于阴则寐。伤寒瘥后,脏腑皆虚,营卫出入,不能
循常,缘热邪未散,与阳气并,卫气独行于阳,不得入于阴,则阳实阴虚,故不得眠。
治伤寒发汗后,虚烦不得眠,剧者必反复颠倒,心中懊 。栀子豉汤方
栀子(十四枚) 香豉(四合)
上二味, 咀如麻豆大,每服三钱匕,水一盏,煎至七分,去滓温服,一二服得吐,止
后服。
治伤寒后虚烦不得眠,心中懊 。栀子乌梅汤方
栀子仁 甘草(炙) 黄芩(去黑心各半两) 乌梅(去核炒十四枚) 柴胡(去苗一
两)
上五味, 咀如麻豆大,每服四钱匕,水一盏半,生姜三片,豉五十粒,竹叶二七片,
同煎至七分,去滓温服。
治伤寒吐下后,心烦气乏,昼夜不得眠。酸枣仁汤方
酸枣仁(炒一两) 麦门冬(去心焙二两) 甘草(炙一两) 知母(切焙半两) 白
茯苓(去黑皮) 芎 干姜(炮各三两)
上七味, 咀如麻豆大,每服四钱匕,水一盏半,煎至一盏,去滓温服。
治伤寒后劳损,烦躁不得眠。酸枣仁甘草汤方
酸枣仁(微炒四两) 甘草(炙锉) 当归(切焙) 桂(去粗皮) 人参 白茯苓(去
黑皮) 石膏(碎) 芎 (各半两) 远志(去心一分)
上九味,粗捣筛,每服五钱匕,水一盏半,煎至一盏,去滓温服不拘时。
治伤寒汗后,虚烦不得眠睡,酸枣仁汤方
酸枣仁(微炒二两) 人参(一两) 石膏(碎半两) 赤茯苓(去黑皮三分) 桂(去
粗皮半两) 知母(切焙) 甘草(炙各半两)
上七味。粗捣筛。每服五钱匕。水一盏半。煎至八分。去滓温服不拘时。
治伤寒后余热未散。不得眠睡。酸枣仁黄芩汤方
酸枣仁(微炒二两) 黄芩(去黑心) 麦门冬(去心焙各半两) 远志(去心一分) 人
参(切一两) 桂(去粗皮三分) 茯神(去木一两) 甘草(炙半两) 萆 (一分)
上九味,粗捣筛,每服五钱匕,水一盏半,生姜五片,煎至一盏去滓,食前温服日再。
治伤寒后虚烦不得眠睡,呕逆。栀子仁汤方
栀子仁(一分) 芎 (半两) 酸枣仁(炒一两) 陈橘皮(去白炒) 人参 白茯
苓(去黑皮各半两) 豉(炒一分)
上七味,粗捣筛,每服三钱匕,水一大盏,生姜三片,煎至七分去滓,食前温服,日再。
治伤寒后虚劳不得眠,烦闷四肢乏力。人参汤方
人参(一两) 酸枣仁(微炒三两) 当归(切焙) 芎 (锉) 桂(去粗皮) 甘
草(炙锉) 柴胡(去苗) 赤茯苓(去黑皮) 石膏(碎各一两)
上九味,粗捣筛,每服五钱匕,水一盏半,生姜三片,煎至一盏,去滓食前温服。
治伤寒后虚劳,烦热惊悸,不得眠睡。柴胡汤方
柴胡(去苗半两) 酸枣仁(微炒二两) 远志(去心一分) 当归(切焙) 防风(去
叉) 甘草(炙锉) 茯神(去木) 猪苓(去黑皮) 桂(去粗皮) 黄 (锉) 人参 生
干地黄 芎 麦门冬(去心焙各半两)
上一十四味,粗捣筛,每服三钱匕,水一大盏,生姜三片,煎至七分去滓,空心温服日
再。
治伤寒后烦满,心神恍惚,不得眠卧。麦门冬茯苓饮方
麦门冬(去心焙) 赤茯苓(去黑皮) 知母(焙) 芎 酸枣仁(微炒) 陈橘皮
(去白炒) 槟榔(锉) 甘草(炙各一两)
上八味,粗捣筛,每服五钱匕,水一盏半,入生姜五片,煎至一盏,去滓温服日三。
治伤寒后虚烦客热,累夜不得眠睡,头痛眼疼迷闷。地骨皮饮方
地骨皮(洗) 麦门冬(去心各二两) 酸枣仁(炒三两)
上三味,粗捣筛,每服五钱匕,水一盏半,入生姜五片,煎至七分去滓,温服食后服。
治伤寒后胆冷不得睡。梅实丸方
梅实肉 大枣肉 酸枣仁(炒等分)
上三味,同捣成膏,丸如弹丸大,每服一丸,临卧含化服。
治大病后及虚劳不得眠。酸枣仁汤方
酸枣仁(炒) 榆皮(切各三两)
上二味,粗捣筛,每服三钱匕,水一盏,煎至七分,去滓温服。
Commentary states: Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) circulate in the Yang aspect during the day, resulting in wakefulness; they circulate in the Yin aspect at night, resulting in sleep. After recovery from Shanghan (Cold Damage disease), the Zang-Fu organs are all deficient. The entry and exit of Ying and Wei Qi cannot follow their normal course. Because the pathogenic heat has not yet dissipated, it combines with Yang Qi, causing Wei Qi to circulate alone in the Yang aspect without entering the Yin aspect. This results in an excess of Yang and a deficiency of Yin, hence insomnia.
For treating insomnia caused by deficiency-heat vexation after sweating therapy for Shanghan, where severe cases involve tossing and turning and mental restlessness (Xin Zhong Ao Nao): Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction).
Zhizi (Fruit of Gardeniae, fourteen seeds) Xiangchi (Fermented Soybeans, four he)
The above two ingredients are chopped like hemp or bean seeds. Each dose is three qian bi (approx. 3-5 grams), boiled in one sheng (approx. 200ml) of water until reduced to seven-tenths. Strain and take warm. If vomiting occurs after one or two doses, discontinue further administration.
For treating insomnia and mental restlessness (Xin Zhong Ao Nao) due to deficiency-heat after Shanghan: Zhizi Wumei Tang (Gardenia and Mume Fruit Decoction).
Zhizi Ren (Seed of Gardeniae) Gancao (Radix Glycyrrhizae Preparata, half liang each) Huangqin (Radix Scutellariae, heart removed, half liang each) Wumei (Fructus Mume, pitted and stir-fried, fourteen seeds) Chaihu (Radix Bupleuri, sprouts removed, one liang)
The above five ingredients are chopped like hemp or bean seeds. Each dose is four qian bi, boiled in one and a half sheng of water with three slices of Shengjiang (Rhizoma Zingiberis Recens), fifty grains of Chi (Fermented Soybeans), and fourteen leaves of Zhuye (Leaf of Bambusa). Reduce to seven-tenths, strain, and take warm.
For treating irritability, qi deficiency, and inability to sleep day and night after emesis or purgation in Shanghan: Suanzaoren Tang (Sour Jujube Seed Decoction).
Suanzaoren (Semen Ziziphi Spinosae, stir-fried, one liang) Maimendong (Radix Ophiopogonis, core removed and baked, two liang) Gancao (Radix Glycyrrhizae Preparata, one liang) Zhimu (Rhizoma Anemarrhenae, cut and baked, half liang) Baifuling (Poria Cocos, black skin removed) Xiong (Rhizoma Chuanxiong) Ganjiang (Rhizoma Zingiberis Preparatum, three liang each)
The above seven ingredients are chopped like hemp or bean seeds. Each dose is four qian bi, boiled in one and a half sheng of water until reduced to one sheng. Strain and take warm.
For treating irritability and insomnia due to fatigue damage after Shanghan: Suanzaoren Gancao Tang (Sour Jujube Seed and Licorice Decoction).
Suanzaoren (Semen Ziziphi Spinosae, slightly stir-fried, four liang) Gancao (Radix Glycyrrhizae Preparata, prepared and crushed) Danggui (Radix Angelicae Sinensis, cut and baked) Gui (Ramulus Cinnamomi, coarse bark removed) Renshen (Radix Ginseng) Baifuling (Poria Cocos, black skin removed) Shigao (Gypsum Fibrosum, crushed) Xiong (Rhizoma Chuanxiong, half liang each) Yuanzhi (Radix Polygalae, core removed, one fen)
The above nine ingredients are coarsely pounded and sieved. Each dose is five qian bi, boiled in one and a half sheng of water until reduced to one sheng. Strain and take warm at any time.
For treating insomnia due to deficiency-heat vexation after sweating in Shanghan: Suanzaoren Tang (Sour Jujube Seed Decoction).
Suanzaoren (Semen Ziziphi Spinosae, slightly stir-fried, two liang) Renshen (Radix Ginseng, one liang) Shigao (Gypsum Fibrosum, crushed, half liang) Chifuling (Poria Cocos with Porii Cortex, black skin removed, three qian) Gui (Ramulus Cinnamomi, coarse bark removed, half liang) Zhimu (Rhizoma Anemarrhenae, cut and baked) Gancao (Radix Glycyrrhizae Preparata, half liang each)
The above seven ingredients are coarsely pounded and sieved. Each dose is five qian bi. Boil in one and a half sheng of water until reduced to eight-tenths. Strain and take warm at any time.
For treating insomnia due to residual heat after Shanghan: Suanzaoren Huangqin Tang (Sour Jujube Seed and Scutellaria Decoction).
Suanzaoren (Semen Ziziphi Spinosae, slightly stir-fried, two liang) Huangqin (Radix Scutellariae, heart removed) Maimendong (Radix Ophiopogonis, core removed and baked, half liang each) Yuanzhi (Radix Polygalae, core removed, one fen) Renshen (Radix Ginseng, cut, one liang) Gui (Ramulus Cinnamomi, coarse bark removed, three qian) Fushen (Poria Cocos with Pinus Root, wood removed, one liang) Gancao (Radix Glycyrrhizae Preparata, half liang) Bi (Herba Dictamni Radicis, one fen)
The above nine ingredients are coarsely pounded and sieved. Each dose is five qian bi, boiled in one and a half sheng of water with five slices of Shengjiang (Rhizoma Zingiberis Recens) until reduced to one sheng. Strain and take warm before meals, twice daily.
For treating insomnia accompanied by nausea and regurgitation due to deficiency-heat vexation after Shanghan: Zhiren Tang (Gardenia Seed Decoction).
Zhiren (Seed of Gardeniae, one fen) Xiong (Rhizoma Chuanxiong, half liang) Suanzaoren (Semen Ziziphi Spinosae, stir-fried, one liang) Chenjupi (Pericarpium Citri Reticulatae, white pith removed and stir-fried) Renshen (Radix Ginseng) Baifuling (Poria Cocos, black skin removed, half liang each) Chi (Fermented Soybeans, stir-fried, one fen)
The above seven ingredients are coarsely pounded and sieved. Each dose is three qian bi, boiled in a large sheng of water with three slices of Shengjiang (Rhizoma Zingiberis Recens) until reduced to seven-tenths. Strain and take warm before meals, twice daily.
For treating insomnia, chest stuffiness, and limb weakness due to deficiency-fatigue after Shanghan: Renshen Tang (Ginseng Decoction).
Renshen (Radix Ginseng, one liang) Suanzaoren (Semen Ziziphi Spinosae, slightly stir-fried, three liang) Danggui (Radix Angelicae Sinensis, cut and baked) Xiong (Rhizoma Chuanxiong, crushed) Gui (Ramulus Cinnamomi, coarse bark removed) Gancao (Radix Glycyrrhizae Preparata, prepared and crushed) Chaihu (Radix Bupleuri, sprouts removed) Chifuling (Poria Cocos with Porii Cortex, black skin removed) Shigao (Gypsum Fibrosum, crushed, one liang each)
The above nine ingredients are coarsely pounded and sieved. Each dose is five qian bi, boiled in one and a half sheng of water with three slices of Shengjiang (Rhizoma Zingiberis Recens) until reduced to one sheng. Strain and take warm before meals.
For treating insomnia with irritability, heat, palpitations, and fright due to deficiency-fatigue after Shanghan: Chaihu Tang (Bupleurum Decoction).
Chaihu (Radix Bupleuri, sprouts removed, half liang) Suanzaoren (Semen Ziziphi Spinosae, slightly stir-fried, two liang) Yuanzhi (Radix Polygalae, core removed, one fen) Danggui (Radix Angelicae Sinensis, cut and baked) Fangfeng (Radix Saposhnikoviae, twigs removed) Gancao (Radix Glycyrrhizae Preparata, prepared and crushed) Fushen (Poria Cocos with Pinus Root, wood removed) Zhuling (Polyporus, black skin removed) Gui (Ramulus Cinnamomi, coarse bark removed) Huangqi (Radix Astragali, crushed) Renshen (Radix Ginseng) Shengdihuang (Radix Rehmanniae Recens) Shenggan Dihuang (Radix Rehmanniae Preparata) Xiong (Rhizoma Chuanxiong) Maimendong (Radix Ophiopogonis, core removed and baked, half liang each)
The above fourteen ingredients are coarsely pounded and sieved. Each dose is three qian bi, boiled in a large sheng of water with three slices of Shengjiang (Rhizoma Zingiberis Recens) until reduced to seven-tenths. Strain and take warm on an empty stomach, twice daily.
For treating insomnia with irritability, fullness, and mental confusion after Shanghan: Maimendong Fuling Yin (Ophiopogon and Poria Drink).
Maimendong (Radix Ophiopogonis, core removed and baked) Chifuling (Poria Cocos with Porii Cortex, black skin removed) Zhimu (Rhizoma Anemarrhenae, baked) Xiong (Rhizoma Chuanxiong) Suanzaoren (Semen Ziziphi Spinosae, slightly stir-fried) Chenjupi (Pericarpium Citri Reticulatae, white pith removed and stir-fried) Binglang (Semen Arecae, crushed) Gancao (Radix Glycyrrhizae Preparata, one liang each)
The above eight ingredients are coarsely pounded and sieved. Each dose is five qian bi, boiled in one and a half sheng of water with five slices of Shengjiang (Rhizoma Zingiberis Recens) until reduced to one sheng. Strain and take warm, three times daily.
For treating insomnia due to deficiency-heat and external pathogens after Shanghan, characterized by consecutive nights of sleeplessness, headache, eye pain, and dizziness: Digupi Yin (Dogwood Root Bark Drink).
Digupi (Cortex Lycii, washed) Maimendong (Radix Ophiopogonis, core removed, two liang each) Suanzaoren (Semen Ziziphi Spinosae, stir-fried, three liang)
The above three ingredients are coarsely pounded and sieved. Each dose is five qian bi, boiled in one and a half sheng of water with five slices of Shengjiang (Rhizoma Zingiberis Recens) until reduced to seven-tenths. Strain and take warm after meals.
For treating insomnia due to Gallbladder cold after Shanghan: Meishi Wan (Plum Fruit Pill).
Meishi Rou (Flesh of Fructus Mume) Dazao Rou (Flesh of Fructus Jujubae) Suanzaoren (Semen Ziziphi Spinosae, stir-fried, equal parts)
The above three ingredients are pounded together into a paste and formed into pills the size of quail eggs. Take one pill at bedtime, allowing it to dissolve in the mouth.
For treating insomnia after major illness and deficiency-fatigue: Suanzaoren Tang (Sour Jujube Seed Decoction).
Suanzaoren (Semen Ziziphi Spinosae, stir-fried) Yupi (Cortex Ulmi, cut, three liang each)
The above two ingredients are coarsely pounded and sieved. Each dose is three qian bi, boiled in one sheng of water until reduced to seven-tenths. Strain and take warm.