多寐者,阳虚阴盛之病。《灵枢》曰∶足太阳有通项入于脑者,正属目本,名曰眼系。在项中两筋间,
入脑,乃别阳跷阴跷,阴阳相交。阳入阴,阴出阳,交于目内 。阳气盛则 目,阴气盛则瞑目。心神昏浊,
不能自主,脾气困顿,食已即倦,皆能致之。欲清心神,如麦冬、石菖蒲、芽茶、南烛之属。欲醒脾困,
六君子汤加砂仁。身重脉缓,多寐,湿胜也。平胃散加防风、白术。神倦肢惰,嗜卧,气弱也。人参益气汤。
长夏倦午,四肢不收,脾肺气弱而伤暑也。清暑益气汤。病后身热好眠,余邪未清,正气未复也。沈氏葳蕤汤。
胆实口苦,嗜寐,少阳经热也。生枣
仁一两,研末,茶清调服。狐惑症,病后肠胃空虚,三虫求食,食人喉为惑,上唇生疮,食人肛为狐,下唇
生疮。四肢沉重,默默多眠。黄连犀角汤,治惑桃仁汤。风温症身热脉浮自汗,体重多眠,鼻鼾,语言难出,
治在少阴厥阴,不可发汗。葳蕤汤去麻、羌。热症得汗后,脉沉细,身冷喜卧,四逆汤。少阴症欲寐,从本病
治。
〔脾虚〕六君子汤 见一卷中风。
〔除湿〕平胃散 术 朴 陈 草
〔气弱〕人参益气汤 黄 (钱半) 人参 防风 升麻(各七分) 生地 白芍(各五分) 炙草(三分)
肉桂(二分) 五味(二十粒)
〔暑倦〕清暑益气汤 见一卷暑。
〔病后〕沈氏葳蕤汤 葳蕤 茯苓 枣仁 石膏(各一钱) 人参(七分)
〔狐惑〕黄连犀角汤 黄连 犀角 乌梅 木香 桃仁(各一钱)
〔狐惑〕治惑桃仁汤 桃仁 生槐子(研) 艾叶(各二钱)
〔热症〕四逆汤 见一卷暑。
〔风温〕葳蕤汤 见一卷温。
Duomi (Hypersomnia) is a disease characterized by deficiency of Yang and excess of Yin. The *Ling Shu* states: There are pathways in the Foot-Taiyang Bladder Meridian that pass through the nape into the brain, directly connecting to the root of the eye, known as the Eye System. Located between the two tendons in the nape, entering the brain, it diverges to connect with the Yang Qiao and Yin Qiao vessels, where Yin and Yang Qi intersect. Yang enters Yin, and Yin emerges from Yang, intersecting at the inner canthus of the eye. When Yang Qi is abundant, the eyes open; when Yin Qi is abundant, the eyes close. A confused and turbid state of the Heart Spirit (Shen), unable to exercise self-control, or a sluggish Spleen Qi leading to fatigue immediately after eating, can all cause hypersomnia. To clear and awaken the Heart Spirit, herbs such as Ophiopogonis Radix (Maidong), Acori Tatarinowii Rhizoma (Shichangpu), young tea leaves, and Myrti Fructus (Nanzhu) may be used. To rouse the sluggish Spleen, Liu Jun Zi Tang (Six Gentlemen Decoction) with Amomi Fructus Rotundus (Sharen) is indicated. Heaviness of the body, slow pulse, and hypersomnia indicate excessive Dampness; Ping Wei San (Peace the Stomach Powder) with Saposhnikoviae Radix (Fangfeng) and Atractylodis Macrocephalae Rhizoma (Baizhu) is prescribed. Mental fatigue, flaccidity of the limbs, and a desire to lie down indicate Qi deficiency; Ren Shen Yi Qi Tang (Ginseng Decoction for Boosting Qi) is used. Fatigue in the afternoon during the late summer season, with limbs failing to move freely, indicates weakness of Spleen and Lung Qi complicated by Summerheat injury; Qing Shu Yi Qi Tang (Decoction for Clearing Summerheat and Boosting Qi) is applied. Post-illness fever accompanied by a preference for sleep indicates lingering pathogenic factors and incomplete recovery of healthy Qi; Shen Shi Rui Yu Tang (Shen's Polygonatum Decoction) is used. Gallbladder excess heat causing bitter taste and somnolence indicates Heat in the Shaoyang Meridian; one liang of raw Ziziphi Spinosae Semen (Suanzaoren), powdered and taken with clear tea water, is effective. The Hu Huo Syndrome (Chancroid/Ulceration syndrome), occurring after illness when the intestines and stomach are empty, involves three parasites seeking food. Erosion of the throat is called "Huo," causing sores on the upper lip; erosion of the anus is called "Hu," causing sores on the lower lip. Symptoms include heavy limbs, taciturnity, and excessive sleep. Huang Lian Xi Jiao Tang (Coptis and Rhinoceros Horn Decoction) treats "Huo," while Zhi Huo Tao Ren Tang (Tao Ren Decoction for Treating Hu Huo) treats "Hu." Wind-Warmth Syndrome presents with fever, floating pulse, spontaneous sweating, heaviness, hypersomnia, snoring, and difficulty speaking. The pathology involves the Shaoyin and Jueyin meridians; diaphoresis (sweating therapy) is contraindicated. Rui Yu Tang (Polygonatum Decoction) without Ephedrae Herba (Mahuang) and Saussureae Radix (Qianghuo) is used. After sweating in Heat Syndromes, if the pulse is deep and fine, the body is cold, and there is a preference for lying down, Si Ni Tang (Four Reversal Decoction) is indicated. For Shaoyin Syndrome presenting with a desire to sleep, treat according to the primary disease pattern.
[Spleen Deficiency] Liu Jun Zi Tang (Six Gentlemen Decoction) - See Vol. 1, Stroke.
[Expel Dampness] Ping Wei San (Peace the Stomach Powder): Baizhu (Atractylodis Macrocephalae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma).
[Qi Deficiency] Ren Shen Yi Qi Tang (Ginseng Decoction for Boosting Qi): Huangqi (Astragali Radix, 1.5 qian), Renshen (Panax Ginseng Radix et Rhizoma), Fangfeng (Saposhnikoviae Radix), Shengma (Cimicifugae Rhizoma, each 0.7 fen), Shengdi (Rehmanniae Radix), Baishao (Paeoniae Radix Alba, each 0.5 fen), Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma, 0.3 fen), Rougui (Cinnamomi Cortex, 0.2 fen), Wuweizi (Schisandrae Fructus, 20 grains).
[Summerheat Fatigue] Qing Shu Yi Qi Tang (Decoction for Clearing Summerheat and Boosting Qi) - See Vol. 1, Summerheat.
[Post-Illness] Shen Shi Rui Yu Tang (Shen's Polygonatum Decoction): Yuzhu (Polygonati Odorati Rhizoma), Fuling (Poria), Zaoren (Ziziphi Spinosae Semen), Shigao (Gypsum Fibrosum, each 1 qian), Renshen (Panax Ginseng Radix et Rhizoma, 0.7 fen).
[Hu Huo] Huang Lian Xi Jiao Tang (Coptis and Rhinoceros Horn Decoction): Huanglian (Coptidis Rhizoma), Xijiao (Rhinocerotis Cornu), Wumei (Mume Fructus), Muxiang (Aucklandiae Radix), Taoren (Persicae Semen, each 1 qian).
[Hu Huo] Zhi Huo Tao Ren Tang (Tao Ren Decoction for Treating Hu Huo): Taoren (Persicae Semen), Sheng Huaizi (Stemonae Radix, ground), Aiye (Artemisiae Argyi Folium, each 2 qian).
[Heat Syndrome] Si Ni Tang (Four Reversal Decoction) - See Vol. 1, Summerheat.
[Wind-Warmth] Rui Yu Tang (Polygonatum Decoction) - See Vol. 1, Warmth.