《灵枢》大惑篇黄帝曰∶人之多卧者，何气使然？岐伯曰∶此人肠胃大而皮肤湿，而分肉不解焉。
肠胃大则卫气留久，皮肤湿则分肉不解，其行迟。夫卫气者，
昼日常行于阳，夜行于阴，故阳气尽则卧，阴气尽则寤。故肠胃大则卫气行留久，皮肤湿分肉不解则
行迟。留于阴也久，其气不精则欲瞑，故多卧矣。其肠胃小，皮肤滑以缓，分肉解利，卫气之行于阳
也久，故少瞑焉。黄帝曰∶其非常经也，卒然多卧者，何气使然？岐伯曰∶邪气留于上焦，上焦闭而
不通，已食若饮汤，卫气留久于阴而不行，故卒然多卧焉。运气多睡，皆属内热。经云∶阳明司天之
政，初之气，阴始凝，气始肃，病中热善眠是也。酸枣仁一两，生用，腊茶二两，以生姜汁涂，炙微
焦，捣罗为末。每服二钱，水七分盏，煎六分，温服无时。灸法，无名指第二节尖一壮，屈手指取之。
东垣云∶脉缓怠惰嗜卧，四肢不收，或大便泄泻，此湿胜，从平胃散。又云∶怠惰嗜卧，有湿，
胃虚不能食，或沉困，或泄泻，加苍术，自汗加白术。食入则困倦，精神昏冒而欲睡者，脾虚弱也。
六君子汤加神曲、麦芽、山楂之属。四肢懒惰，
人参补气汤。丹溪云∶脾胃受湿，沉困无力，怠惰嗜卧者，半夏、白术。肥人是气虚，宜人参、二术、
半夏、甘草。（又云∶是湿，苍术、茯苓、滑石。）黑瘦人是热，黄芩、白术。饮食太过，转运不调，
枳实、白术。按∶人之虚实寒热，当审脉证定之，岂可以肥瘦为准，学人无以辞害意可也。
In the "Da Huo" (Great Dizziness/Confusion) chapter of the *Ling Shu* (Spiritual Pivot), the Yellow Emperor asked: What qi mechanism causes people to sleep excessively? Qibo replied: This type of person has large intestines and stomachs, and moist skin, leading to blockage in the muscle intervals (fen rou).
Because the intestines and stomach are large, Wei Qi (Defensive Qi) remains inside for a long time. Because the skin is moist, the muscle intervals are blocked, causing its movement to be slow. Wei Qi normally travels through the Yang aspects (exterior, six fu organs) during the day and through the Yin aspects (interior, five zang organs) at night. Therefore, when Yang qi is exhausted, one sleeps; when Yin qi is exhausted, one awakens. Thus, if the intestines and stomach are large, Wei Qi stays inside longer; if the skin is moist and muscle intervals are blocked, its movement is slow. Staying in the Yin aspect for a long time makes the qi less clear, leading to drowsiness, hence excessive sleeping. Conversely, if the intestines and stomach are small, the skin is smooth and relaxed, and the muscle intervals are open and unobstructed, Wei Qi travels in the Yang aspect for a long time, resulting in less sleep.
The Yellow Emperor then asked: If this is not a normal physiological pattern, but rather sudden onset of excessive sleeping, what qi mechanism causes it? Qibo replied: Pathogenic factors remain in the Upper Jiao (Upper Burner), causing it to be closed and obstructed. After eating or drinking soup, Wei Qi remains in the Yin aspect for a long time and cannot move outward, thus causing sudden excessive sleeping. According to the theory of Six Qi (Yun Qi), excessive sleep often belongs to internal heat. The classics state: "When Yangming governs the year, during the first phase of climate, Yin begins to condense, and the atmosphere becomes solemn/cold; the disease manifests as internal heat and a propensity to sleep."
Formula: Suan Zao Ren (Ziziphi Spinosae Semen), 1 liang, used raw; La Cha (Winter Tea), 2 liang, coated with fresh ginger juice, roasted until slightly scorched, pounded and sifted into powder. Take 2 qian per dose, with 7/10 of a cup of water, decoct to 6/10, and take warm at any time.
Moxibustion method: Apply one moxa cone (zhuang) to the tip of the second joint of the ring finger. Flex the finger to locate the point.
Li Dongyuan stated: A slow pulse, lethargy, propensity to sleep, flaccidity of the four limbs, or loose stools indicates excess dampness; use Ping Wei San (Calm the Stomach Powder). He also stated: Lethargy and propensity to sleep due to dampness, with weak stomach unable to digest food, heaviness, or diarrhea, should add Cang Zhu (Atractylodis Rhizoma); spontaneous sweating should add Bai Zhu (Atractylodis Macrocephalae Rhizoma). Feeling sleepy and mentally foggy after eating indicates Spleen deficiency; use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Shen Qu (Massa Medicata Fermentata), Mai Ya (Hordei Fructus Germinatus), and Shan Zha (Crataegi Fructus). Laziness of the four limbs calls for Ren Shen Bu Qi Tang (Ginseng Qi-Boosting Decoction).
Zhu Danxi stated: Dampness invading the Spleen and Stomach, causing heaviness, weakness, lethargy, and propensity to sleep, is treated with Ban Xia (Pinelliae Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma). Obese individuals usually have Qi deficiency, suitable for Ren Shen (Ginseng Radix), Cang Zhu/Bai Zhu, Ban Xia, and Gan Cao (Licorice Root). (He further noted: If due to dampness, use Cang Zhu, Fu Ling (Poria), and Hua Shi (Talcum)). Thin, dark-skinned individuals usually have Heat patterns, treated with Huang Qin (Scutellariae Radix) and Bai Zhu. Overeating leading to impaired transportation and transformation is treated with Zhi Shi (Aurantii Fructus Immaturus) and Bai Zhu.
Commentary: One must examine the pulse and symptoms to determine deficiency/excess and cold/heat patterns in individuals; one cannot rely solely on body constitution (fat/thin). Students of medicine should not let literal interpretations obscure the deeper meaning.