论曰老人卧而不寐，少壮寐而不寤者何也，少壮者，血气盛，肌肉滑，气道通。营卫之
行，不失于常。故昼日精，夜不寤也。老人血气衰，肌肉不滑，营卫之道涩，故昼日不能精
夜不得寐也。虚劳之人，气血衰少，营卫不足，肌肉不滑，其不得眠之理。与老人同，盖
劳为病也。
治虚劳不得眠，虚烦不宁。酸枣仁汤方
酸枣仁（去皮微炒五两） 知母（焙） 干姜（炮） 白茯苓（去黑皮） 芎 （各一
两） 甘草
上六味，粗捣筛。每五钱匕。水一盏半，煎至一盏，去滓空腹分温二服。如人行四五里，
相次服之。亦可加桂心一两。
治虚劳烦躁不得眠，茯苓汤方
白茯苓（去黑皮） 人参（各二两） 麦门冬（去心焙） 陈橘皮（去白焙） 杏仁（汤
浸去皮尖双仁炒） 紫苏（微炒各一两） 酸枣仁（炒五两）
上七味，粗捣筛。每五钱匕，水一盏半，生姜半分拍碎，煎至一盏，去滓空腹分温二服。
相次服之。
治虚劳烦不得睡，胁下气逆，人参汤方
人参（二两） 酸枣仁（微炒去皮五两） 白术 陈橘皮（去白焙） 五味子（焙） 茯
神（去
上七味，粗捣筛，每服三钱匕，以水一盏半，生姜一分拍碎，煎至七分。去滓空腹温服。
日再。
治营卫俱伤，虚烦不得眠，半夏汤方
半夏（汤洗七遍去滑） 白茯苓（去黑皮各三分） 酸枣仁（汤浸去皮炒二两） 麦门
冬（去
炒） 人参（各半两
上一十味，粗捣筛，每五钱匕，先以东流水二盏，煮秫米一合，令蟹目沸，即下药。入
生姜半分拍碎，煎至一盏，去滓空心分温二服，相次服之。
治虚劳不得眠，黄 汤方
黄 （锉炒） 桂（去粗皮） 芍药（各三分） 甘草（炙锉） 当归（炙） 人参（各
半两） 干
上七味，粗捣筛，每服五钱匕，以水一盏半，入粳米一合，枣二枚劈破。煎至一盏，去
滓空腹分温二服，相次服之。
治虚劳惊恐不安，夜不得眠，桔梗汤方
桔梗（炒锉三分） 半夏（汤洗七遍去滑姜汁炒一两一分） 白术（三分） 甘草（炙
锉一分）
上七味，粗捣筛，每服三钱匕，以水一盏，入生姜半分拍碎，煎至七分，去滓下饴糖一
分，空腹温服，夜卧再煎服。
治虚劳烦扰，气奔胸中，不得眠，酸枣仁汤方
酸枣仁（汤浸去皮炒别研） 石膏（各一两） 桂（去粗皮） 人参（各半两） 甘草
（炙锉一
上七味，粗捣筛，每服五钱匕，水一盏半，入生姜半分拍碎，煎至一盏，去滓空腹分温
二服，相次服之，夜卧再煎服。
治虚劳气满不得眠，手足疼痛，茯苓汤方
白茯苓（去黑皮） 桂（去粗皮） 干姜（炮） 甘草（炙锉） 芍药 食茱萸（各半
两） 熟干
上七味。粗捣筛，每服五钱匕，以水一盏半，入枣两枚去核，煎至一盏，去滓空腹温服
日再。
治虚劳烦躁，不得睡，茯神汤方
茯神（去木） 人参（各一两） 酸枣仁（炒去皮别研五两）
上三味，粗捣筛，每服三钱匕，以水一盏，入生姜半分拍碎，煎至七分，去滓空腹温服。
日二夜一。
治虚劳发烦不得眠，半夏汤方
半夏（汤洗去滑七遍炒干二两） 白茯苓（去黑皮四两） 糯米（炒黄一合）
上三味，粗捣筛，每服五钱匕，以东流水一盏半，生姜半分拍碎，煎至一盏，去滓空腹
温服日二。
治虚劳烦躁，夜不得眠，少气， 微热，口干减食，麦门冬汤方。
麦门冬（去心焙） 前胡（去芦头） 人参 黄 （锉炒各半两）
上四味粗捣筛，每服五钱匕，以水一盏半，入生姜半分拍碎，小麦半合，煎至八分，去
滓温服，不计时。
治虚劳昼夜不得眠，短气食饮不下，或大病后虚热痰冷，橘皮汤方
陈橘皮（去白焙一两） 芎 （一分半） 甘草（炙锉一分） 半夏（汤洗去滑炒半两）
上四味，粗捣筛，每服五钱匕，以东流水一盏半，入生姜半分拍碎，生竹茹少许。煎至
八分，去滓温服，夜卧再煎服。
治虚烦不得睡眠，鳖甲丸方
鳖甲（去裙 醋炙） 酸枣仁（炒） 羌活（去芦头） 黄 （锉炒） 附子（炮裂去
皮脐） 柴
母（焙） 五味子（炒
上一十一味，捣罗为末，炼蜜为丸，如梧桐子大，每服二十丸，暖酒下。
治虚劳热气乘心，忧惧不安，不得眠睡，麦门冬汤方
麦门冬（去心焙一两半） 榆白皮（锉） 苦参 黄连（去须） 地骨皮 黄芩（去黑
心） 龙
上七味，粗捣筛，每服五钱匕，水一盏半，煎至七分，去滓入地黄汁半合，食后顿服。
治不得睡，酸枣仁煎方
酸枣仁（去皮五两炒捣筛只取末二两半） 乳香（研二两） 蜜（四两） 牛黄（别研
入一分）
上六味，用酒半升，和蜜等一处，慢火煎如稀饧。每服一匙头，温酒调下，腹空时服。
治虚劳烦闷，不得眠睡，酸枣仁丸方
酸枣仁（炒） 地榆叶（各半两）
上二味，捣罗为末，炼蜜和丸，如梧桐子大，每服三十丸，糯米饮下。
治虚劳烦闷，不得眠睡方
上取酸枣仁，不拘多少，炒令香熟，捣罗为散，每服三钱匕，用水一盏，煎取六分热呷
[Discussion]
Why do the elderly lie down but fail to sleep, while the young and vigorous sleep without waking? This is because the young and vigorous possess abundant Qi and Blood, smooth muscles, and unobstructed Qi channels. The circulation of Ying (Nutritive) Qi and Wei (Defensive) Qi does not deviate from normal patterns. Therefore, they are energetic during the day and sleep soundly at night. In contrast, the elderly have declining Qi and Blood, non-smooth muscles, and sluggish pathways for Ying and Wei Qi circulation. Consequently, they lack energy during the day and cannot sleep at night. Patients with Xu Lao (Deficiency Consumption) suffer from deficient Qi and Blood, insufficient Ying and Wei Qi, and non-smooth muscles. The mechanism of their insomnia is similar to that of the elderly, arising essentially from disease caused by overexertion or chronic depletion.
Suan Zao Ren Tang (Ziziphus Decoction) for treating insomnia due to Xu Lao, characterized by empty vexation and restlessness:
Suan Zao Ren (Ziziphi Spinosae Semen, husked, lightly stir-fried, 5 liang), Zhi Mu (Anemarrhenae Rhizoma, roasted), Gan Jiang (Zingiberis Rhizoma, processed), Bai Fu Ling (Poria, black skin removed), Xiong Qiong (Ligustici Chuanxiong Rhizoma, each 1 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma).
The above six herbs are coarsely crushed and sieved. For each dose, take 5 qian bi (approx. 5-10g depending on measure) of the powder, add 1.5 zhan (approx. 300ml) of water, decoct until 1 zhan remains, remove the dregs, and take warm in two divided doses on an empty stomach. If possible, administer sequentially with an interval equivalent to walking 4-5 li. Guixin (Cinnamomi Ramulus) 1 liang may be added.
Fu Ling Tang (Poria Decoction) for treating irritability and insomnia due to Xu Lao:
Bai Fu Ling (Poria, black skin removed), Ren Shen (Panacis Ginseng Radix, each 2 liang), Mai Men Dong (Ophiopogonis Radix, heart removed, roasted), Chen Ju Pi (Citri Reticulatae Pericarpium, white pith removed, roasted), Xing Ren (Armeniacae Semen Amarum, soaked in hot water, husked and tips removed, double-kernelled ones stir-fried), Zi Su Ye (Perillae Folium, lightly stir-fried, each 1 liang), Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried, 5 liang).
The above seven herbs are coarsely crushed and sieved. For each dose, take 5 qian bi, add 1.5 zhan of water and half a qian bi of crushed fresh Sheng Jiang (Zingiberis Rhizoma Recens), decoct until 1 zhan remains, remove the dregs, and take warm in two divided doses on an empty stomach. Administer sequentially.
Ren Shen Tang (Ginseng Decoction) for treating irritability and difficulty sleeping due to Xu Lao, accompanied by rebellious Qi under the hypochondrium:
Ren Shen (Panacis Ginseng Radix, 2 liang), Suan Zao Ren (Ziziphi Spinosae Semen, lightly stir-fried, husked, 5 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chen Ju Pi (Citri Reticulatae Pericarpium, white pith removed, roasted), Wu Wei Zi (Schisandrae Fructus, roasted), Fu Shen (Poria with Hostwood, wood removed).
The above seven herbs are coarsely crushed and sieved. For each dose, take 3 qian bi, add 1.5 zhan of water and one fen of crushed fresh Sheng Jiang (Zingiberis Rhizoma Recens), decoct until 0.7 zhan remains, remove the dregs, and take warm on an empty stomach. Twice daily.
Ban Xia Tang (Pinellia Decoction) for treating injury to both Ying and Wei, empty vexation, and insomnia:
Ban Xia (Pinelliae Rhizoma, washed seven times in hot water to remove acridity), Bai Fu Ling (Poria, black skin removed, each 3 fen), Suan Zao Ren (Ziziphi Spinosae Semen, soaked in water, husked, stir-fried, 2 liang), Mai Men Dong (Ophiopogonis Radix, heart removed, roasted), Ren Shen (Panacis Ginseng Radix, each 0.5 liang), Zhi Shi (Aurantii Fructus Immaturus, bran-fried), Huang Qin (Scutellariae Radix, black heart removed), Jie Geng (Platycodonis Radix, radix stem removed), Da Zao (Ziziphi Jujubae Fructus, split), Sheng Jiang (Zingiberis Rhizoma Recens, sliced).
The above ten herbs are coarsely crushed and sieved. For each dose, take 5 qian bi. First, boil 2 zhan of running water from the east with 1 he of Shu Mi (Sorghum Vulgare), until bubbles appear like crab eyes. Then add the herbs. Add half a qian bi of crushed fresh Sheng Jiang (Zingiberis Rhizoma Recens), decoct until 1 zhan remains, remove the dregs, and take warm in two divided doses on an empty stomach. Administer sequentially.
Huang Qi Tang (Astragalus Decoction) for treating insomnia due to Xu Lao:
Huang Qi (Astragali Radix, cut into pieces, stir-fried), Gui Zhi (Cinnamomi Ramulus, outer bark removed), Shao Yao (Paeoniae Radix Alba, each 3 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, cut into pieces), Dang Gui (Angelicae Sinensis Radix, honey-fried), Ren Shen (Panacis Ginseng Radix, each 0.5 liang), Gan Jiang (Zingiberis Rhizoma, processed).
The above seven herbs are coarsely crushed and sieved. For each dose, take 5 qian bi, add 1.5 zhan of water, 1 he of Jing Mi (Oryza Sativa Japonica Group), and two Da Zao (Ziziphi Jujubae Fructus) split open. Decoct until 1 zhan remains, remove the dregs, and take warm in two divided doses on an empty stomach. Administer sequentially.
Jie Geng Tang (Platycodon Decoction) for treating fright and insecurity due to Xu Lao, and inability to sleep at night:
Jie Geng (Platycodonis Radix, stir-fried, cut into pieces, 3 fen), Ban Xia (Pinelliae Rhizoma, washed seven times in hot water to remove acridity, stir-fried with Jiang Zhi [Zingiberis Rhizoma juice], 1 liang 1 fen), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, cut into pieces, 1 fen).
The above four herbs are coarsely crushed and sieved. For each dose, take 3 qian bi, add 1 zhan of water and half a qian bi of crushed fresh Sheng Jiang (Zingiberis Rhizoma Recens), decoct until 0.7 zhan remains. Remove the dregs, add Yi Tang (Maltose), and take warm on an empty stomach. Decoct again and take before bedtime.
Suan Zao Ren Tang (Ziziphus Decoction) for treating restlessness and Qi rushing to the chest due to Xu Lao, leading to insomnia:
Suan Zao Ren (Ziziphi Spinosae Semen, soaked in water, husked, stir-fried, separately ground into powder), Shi Gao (Gypsum Fibrosum, each 1 liang), Gui Zhi (Cinnamomi Ramulus, outer bark removed), Ren Shen (Panacis Ginseng Radix, each 0.5 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, cut into pieces, 1 fen).
The above seven herbs are coarsely crushed and sieved. For each dose, take 5 qian bi, add 1.5 zhan of water and half a qian bi of crushed fresh Sheng Jiang (Zingiberis Rhizoma Recens), decoct until 1 zhan remains, remove the dregs, and take warm in two divided doses on an empty stomach. Administer sequentially, and decoct again to take before bedtime.
Fu Ling Tang (Poria Decoction) for treating fullness of Qi and insomnia due to Xu Lao, accompanied by pain in the hands and feet:
Bai Fu Ling (Poria, black skin removed), Gui Zhi (Cinnamomi Ramulus, outer bark removed), Gan Jiang (Zingiberis Rhizoma, processed), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, cut into pieces), Shao Yao (Paeoniae Radix Alba), Shi Zhu Yu (Canellae Cortex, each 0.5 liang), Shu Di Huang (Rehmanniae Radix Praeparata).
The above seven herbs are coarsely crushed and sieved. For each dose, take 5 qian bi, add 1.5 zhan of water and two Da Zao (Ziziphi Jujubae Fructus) with pits removed. Decoct until 1 zhan remains, remove the dregs, and take warm on an empty stomach. Twice daily.
Fu Shen Tang (Poria with Hostwood Decoction) for treating irritability and insomnia due to Xu Lao:
Fu Shen (Poria with Hostwood, wood removed), Ren Shen (Panacis Ginseng Radix, each 1 liang), Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried, husked, separately ground into powder, 5 liang).
The above three herbs are coarsely crushed and sieved. For each dose, take 3 qian bi, add 1 zhan of water and half a qian bi of crushed fresh Sheng Jiang (Zingiberis Rhizoma Recens), decoct until 0.7 zhan remains, remove the dregs, and take warm on an empty stomach. Twice daily, once at night.
Ban Xia Tang (Pinellia Decoction) for treating feverish irritability and insomnia due to Xu Lao:
Ban Xia (Pinelliae Rhizoma, washed in hot water to remove acridity, seven times, stir-dried, 2 liang), Bai Fu Ling (Poria, black skin removed, 4 liang), Nuo Mi (Oryza Sativa Glutinosa, stir-fried until yellow, 1 he).
The above three herbs are coarsely crushed and sieved. For each dose, take 5 qian bi, add 1.5 zhan of running water from the east and half a qian bi of crushed fresh Sheng Jiang (Zingiberis Rhizoma Recens), decoct until 1 zhan remains, remove the dregs, and take warm on an empty stomach. Twice daily.
Mai Men Dong Tang (Ophiopogon Decoction) for treating irritability, insomnia at night, shortness of breath, slight fever, dry mouth, and reduced appetite due to Xu Lao:
Mai Men Dong (Ophiopogonis Radix, heart removed, roasted), Qian Hu (Peucedani Radix, radix stem removed), Ren Shen (Panacis Ginseng Radix), Huang Qi (Astragali Radix, cut into pieces, stir-fried, each 0.5 liang).
The above four herbs are coarsely crushed and sieved. For each dose, take 5 qian bi, add 1.5 zhan of water and half a qian bi of crushed fresh Sheng Jiang (Zingiberis Rhizoma Recens) and half a he of Xiao Mai (Tritici Fructus), decoct until 0.8 zhan remains, remove the dregs, and take warm. Time is not restricted.
Ju Pi Tang (Citrus Peel Decoction) for treating insomnia day and night, shortness of breath, inability to eat or drink due to Xu Lao, or deficiency heat and phlegm-cold after severe illness:
Chen Ju Pi (Citri Reticulatae Pericarpium, white pith removed, roasted, 1 liang), Xiong Qiong (Ligustici Chuanxiong Rhizoma, 1.5 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, cut into pieces, 1 fen), Ban Xia (Pinelliae Rhizoma, washed in hot water to remove acridity, stir-fried, 0.5 liang).
The above four herbs are coarsely crushed and sieved. For each dose, take 5 qian bi, add 1.5 zhan of running water from the east, half a qian bi of crushed fresh Sheng Jiang (Zingiberis Rhizoma Recens), and a small amount of Sheng Zhu Ru (Bambusae Caulis in Taenia). Decoct until 0.8 zhan remains, remove the dregs, and take warm. Decoct again and take before bedtime.
Bie Jia Wan (Softshell Turtle Pill) for treating empty vexation and inability to sleep:
Bie Jia (Testudinis Carapax et Plastrum, skirt edge removed, vinegar-fried), Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried), Qiang Huo (Notopterygii Rhizoma et Radix, radix stem removed), Huang Qi (Astragali Radix, cut into pieces, stir-fried), Fu Zi (Aconiti Lateralis Radix Praeparata, cracked, processed, skin and umbilicus removed), Chai Hu (Bupleuri Radix), Zhi Mu (Anemarrhenae Rhizoma, roasted), Wu Wei Zi (Schisandrae Fructus, stir-fried).
The above eleven herbs are pounded and sifted into fine powder. Honey is refined to make pills the size of wutong seeds. Take 20 pills per dose, swallowed with warm wine.
Mai Men Dong Tang (Ophiopogon Decoction) for treating heat qi invading the Heart, anxiety, fear, and insomnia due to Xu Lao:
Mai Men Dong (Ophiopogonis Radix, heart removed, roasted, 1.5 liang), Yu Bai Pi (Ulmaceae Cortex, cut into pieces), Ku Shen (Sophorae Flavescentis Radix), Huang Lian (Coptidis Rhizoma, whiskers removed), Di Gu Pi (Lycii Cortex), Huang Qin (Scutellariae Radix, black heart removed), Long Dan (Gentianae Radix).
The above seven herbs are coarsely crushed and sieved. For each dose, take 5 qian bi, add 1.5 zhan of water, decoct until 0.7 zhan remains, remove the dregs, add 0.5 he of Di Huang Zhi (Rehmanniae Juice), and take all at once after meals.
Suan Zao Ren Jian (Ziziphus Decoction Paste) for treating inability to sleep:
Suan Zao Ren (Ziziphi Spinosae Semen, husked, 5 liang, stir-fried, pounded and sieved, taking only the powder, 2.5 liang), Ru Xiang (Olibanum, ground, 2 liang), Mi (Honey, 4 liang), Niu Huang (Bovis Calculus, separately ground, 1 fen).
The above six ingredients are mixed with half sheng of wine and honey, then slowly boiled over low heat until resembling thin maltose. Take one spoonful per dose, dissolved in warm wine, taken on an empty stomach.
Suan Zao Ren Wan (Ziziphus Pill) for treating irritability and insomnia due to Xu Lao:
Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried), Di Yu Ye (Sanguisorbae Folium, each 0.5 liang).
The above two herbs are pounded and sifted into fine powder. Honey is refined to mix and form pills the size of wutong seeds. Take 30 pills per dose, swallowed with Nuo Mi Yin (Glutinous Rice Drink).
Formula for treating irritability and insomnia due to Xu Lao:
Take Suan Zao Ren (Ziziphi Spinosae Semen), any quantity, stir-fry until fragrant and cooked thoroughly, pound and sift into a powder. For each dose, take 3 qian bi, add 1 zhan of water, decoct until 0.6 zhan remains, and sip warm.