秦子曰∶不得卧之证，诸经皆有，主热者多。在外感门，有表热、里热、半表半里热、
有气分热、血分热，有余热未尽，汗下太过诸条。在杂症门，则里热多而无表热者也。今注
【表热不得卧之症】发热身痛，无汗烦热，不得卧，太阳经表热症也。目痛鼻干，身大
热，不得卧，阳明经表热症也。时寒时热，寒热往来，不得卧，少阳经表热症也。
【表热不得卧之因】风寒伤于太阳，郁而发热，则烦热不得卧。风寒伤于阳明，郁而发
热，则烦躁不得卧。风寒伤于少阳，郁而发热，则懊 不得卧。
【表热不得卧之脉】人迎浮紧，太阳表热，右关洪长，阳明表热，左关浮弦，少阳表热
【表热不得卧之治】太阳表热，不得卧而无汗者，冬月，北方人麻桂汤，南方人，羌
活汤。阳明表热不得卧，干葛升麻汤。少阳表热不得卧，小柴胡汤。
麻桂汤
羌活汤
干葛升麻汤
小柴胡汤 上四方俱见伤寒门。
【里热不得卧之症】身热汗出，渴而引饮，小便不利，太阳经里热也。烦渴消水，
口燥唇焦，大便坚结，阳明经里热也。寒热口苦，胁痛干呕，少阳经里热也
【里热不得卧之因】太阳失用解表，则传膀胱之本；阳明失用解表，则传阳明之里；少
阳失用解表，则传少阳之里。邪热传里，则烦躁不得卧矣。
【里热不得卧之脉】左尺沉数，太阳里热，右关沉数，阳明里热，左关弦数，少阳里热
【里热不得卧之治】太阳里热，冬月五苓散，家秘用木通羌活汤。阳明里热，白虎汤。
有下症者，承气汤下之。少阳里热，家秘黄芩汤。
五苓散
猪苓 泽泻 白术 肉桂 白茯苓
白虎汤
知母 石膏 粳米 甘草
承气汤
枳壳 浓朴 大黄
家秘木通羌活汤
木通 桔梗 羌活 荆芥
家秘黄芩汤
黄芩 山栀 柴胡 甘草
Qin Zi said: The syndrome of inability to sleep (Bude Wo) can occur in all meridians, but it is predominantly caused by heat. In the category of external contraction diseases, there are patterns of exterior heat, interior heat, half-exterior half-interior heat, Qi-level heat, Blood-level heat, residual heat not yet exhausted, and excessive sweating or purgation. In the category of miscellaneous diseases, however, it is mostly interior heat without exterior heat. Now, annotations follow.
[Symptoms of Inability to Sleep due to Exterior Heat] Fever with body pain, absence of sweat, and vexatious heat leading to inability to sleep constitute the exterior heat syndrome of the Taiyang Meridian. Eye pain, nasal dryness, high fever, and inability to sleep constitute the exterior heat syndrome of the Yangming Meridian. Alternating chills and fever, with inability to sleep, constitutes the exterior heat syndrome of the Shaoyang Meridian.
[Etiology of Inability to Sleep due to Exterior Heat] When wind-cold invades the Taiyang Meridian and stagnates causing fever, it results in vexatious heat and inability to sleep. When wind-cold invades the Yangming Meridian and stagnates causing fever, it results in restlessness and inability to sleep. When wind-cold invades the Shaoyang Meridian and stagnates causing fever, it results in inner restlessness (Ao Nao) and inability to sleep.
[Pulse Signs of Inability to Sleep due to Exterior Heat] A floating and tight pulse at the Renying point indicates Taiyang exterior heat; a surging and long pulse at the right Guan position indicates Yangming exterior heat; a floating and wiry pulse at the left Guan position indicates Shaoyang exterior heat.
[Treatment for Inability to Sleep due to Exterior Heat] For Taiyang exterior heat with inability to sleep and no sweat: in winter, people in the North use Magui Tang (Cinnamon Twig and Ephedra Decoction), while people in the South use Qianghuo Tang (Notopterygium Decoction). For Yangming exterior heat with inability to sleep, use Gange Shengma Tang (Pueraria and Cimicifuga Decoction). For Shaoyang exterior heat with inability to sleep, use Xiaochaihu Tang (Minor Bupleurum Decoction).
Magui Tang
Qianghuo Tang
Gange Shengma Tang
Xiaochaihu Tang The above four formulas are all found in the External Contraction section.
[Symptoms of Inability to Sleep due to Interior Heat] Body heat with sweating, thirst with desire to drink, and difficult urination indicate interior heat of the Taiyang Meridian. Vexatious thirst consuming fluids, dry mouth and scorched lips, and hard, bound stool indicate interior heat of the Yangming Meridian. Alternating chills and fever, bitter taste, hypochondriac pain, and dry retching indicate interior heat of the Shaoyang Meridian.
[Etiology of Inability to Sleep due to Interior Heat] If the Taiyang Meridian fails to utilize exterior-releasing treatment, the pathogen transmits to the root organ of the Bladder; if the Yangming Meridian fails to utilize exterior-releasing treatment, the pathogen transmits to the interior of Yangming; if the Shaoyang Meridian fails to utilize exterior-releasing treatment, the pathogen transmits to the interior of Shaoyang. When evil-heat transmits to the interior, it causes restlessness and inability to sleep.
[Pulse Signs of Inability to Sleep due to Interior Heat] A deep and rapid pulse at the left Chi position indicates Taiyang interior heat; a deep and rapid pulse at the right Guan position indicates Yangming interior heat; a wiry and rapid pulse at the left Guan position indicates Shaoyang interior heat.
[Treatment for Inability to Sleep due to Interior Heat] For Taiyang interior heat, use Wuling San (Five-Ingredient Powder with Poria) in winter; the family secret formula uses Mutong Qianghuo Tang (Akebia and Notopterygium Decoction). For Yangming interior heat, use Baihu Tang (White Tiger Decoction). If there are signs suitable for purgation, use Chengqi Tang (Order the Qi Decoction) to purge. For Shaoyang interior heat, the family secret formula uses Huangqin Tang (Scutellaria Decoction).
Wuling San
Polyporus (Zhu Ling), Alisma (Zexie), Atractylodes Macrocephala (Baizhu), Cinnamon Bark (Rougui), Poria (Baifuling)
Baihu Tang
Anemarrhena (Zhimu), Gypsum (Shigao), Rice (Jingmi), Licorice (Gancao)
Chengqi Tang
Citrus Aurantium (Zhiqiao), Magnolia Officinalis (Nongpu), Rhubarb (Dahuang)
Family Secret Mutong Qianghuo Tang
Akebia (Mutong), Platycodon (Jiegeng), Notopterygium (Qianghuo), Schizonepeta (Jingjie)
Family Secret Huangqin Tang
Scutellaria Baicalensis (Huangqin), Gardenia (Shanzhi), Bupleurum (Chaihu), Licorice (Gancao)