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The *Ling Shu* (Spiritual Pivot) in the chapter "Da Huo Lun" (Discussion on Great Confusion) states: When Wei Qi (Defensive Qi) cannot enter the Yin aspect, it remains constantly in the Yang aspect. Remaining in the Yang aspect causes Yang Qi to be full; when Yang Qi is full, the Yang Qiao vessel becomes vigorous. Inability to enter the Yin aspect leads to deficiency of Yin Qi, thus resulting in inability to close the eyes (insomnia). When Wei Qi remains in the Yin aspect and fails to circulate in the Yang aspect, remaining in Yin causes Yin Qi to be full; when Yin Qi is full, the Yin Qiao vessel becomes full. Inability to enter the Yang aspect leads to deficiency of Yang Qi, thus resulting in closed eyes (hypersomnia). The chapter "Han Re Bing Lun" (Discussion on Cold-Heat Diseases) in the *Ling Shu* states: There are pathways from the Foot Taiyang Bladder Meridian that pass through the neck into the brain, directly connecting to the root of the eye, named "Eye System". For severe pain in the head and eyes, select points located between the two tendons in the middle of the neck. Upon entering the brain, these pathways branch off. The Yin Qiao and Yang Qiao vessels intersect; Yang enters Yin, and Yin exits Yang, intersecting at the inner canthus of the eye. When Yang Qi is excessive, the eyes remain open; when Yin Qi is excessive, the eyes close for sleep. The *Nan Jing* (Classic of Difficult Issues), Chapter 46, states: Why do the elderly sleep but not rest deeply, while the young sleep soundly without waking? The answer is: The classics state that the young have abundant blood and Qi, smooth muscles, and unobstructed Qi channels, so the circulation of Ying Qi (Nutritive Qi) and Wei Qi does not deviate from normal patterns. Thus, they are energetic during the day and sleep deeply at night. The elderly have declining blood and Qi, non-smooth muscles, and sluggish channels for Ying and Wei Qi circulation, thus lacking energy during the day and unable to sleep peacefully at night. Hence, we understand the cause of insomnia in the elderly. Haizang (Zhang Yuansu) stated: Deficiency of the Gallbladder causing insomnia is due to Cold. Processed (fried) Sour Jujube Seed powder should be taken with Bamboo Leaf Decoction. Excess in the Gallbladder causing hypersomnia is due to Heat. Raw Sour Jujube Seed powder should be taken with Ginger and Tea Juice.

In the *Su Wen* (Basic Questions), the Yellow Emperor asked: Why do some people feel uneasy when lying down? Qibo answered: Injury to the Zang organs and deviation of Jing Essence lead to restless sleep; thus, one cannot escape the influence of disease to sleep peacefully. Qiang Huo Sheng Shi Tang (Notopterygium Decoction for Overcoming Dampness) treats restlessness and frequent fright during sleep, where pathogenic factors reside in the Shaoyang and Jueyin meridians. All patients with water diseases (edema) cannot lie flat; lying flat induces fright, and fright exacerbates coughing.

In the *Ling Shu* chapter "Xie Ke Pian" (Chapter on Pathogenic Invasion), the Yellow Emperor asked: What Qi causes some people to be unable to close their eyes and sleep after pathogenic invasion? Bo Gao replied: When grains enter the stomach, their dregs, fluids, and Zong Qi (Gathering Qi) divide into three pathways. Thus, Zong Qi accumulates in the chest, emerges from the throat, penetrates the Heart vessels, and facilitates respiration. Ying Qi secretes fluids, injects them into the vessels, transforms them into Blood, nourishes the four extremities, and internally irrigates the five Zang and six Fu organs, corresponding to time cycles. Wei Qi emits its fierce, rapid, and slippery Qi, circulating first in the four extremities, intermuscular spaces, and skin without rest. It travels in the Yang aspect during the day and in the Yin aspect at night, usually passing through the divisions of the Foot Shaoyin Kidney Meridian to circulate among the five Zang and six Fu organs. Now, if Jue Qi (Rebellious Qi) lodges in the five Zang and six Fu organs, Wei Qi alone guards the exterior, traveling in the Yang aspect and unable to enter the Yin aspect. Traveling in Yang causes Yang Qi to be excessive; excess Yang Qi causes the Yang Qiao vessel to be full (note: "sunken" in text should be "full"). Unable to enter Yin, Yin deficiency results in inability to close the eyes. The Yellow Emperor said: Excellent. How to treat it? Bo Gao said: Tonify deficiency, drain excess, regulate emptiness and fullness, unblock the pathways, and eliminate pathogens. Administer one dose of Ban Xia Tang (Pinellia Decoction); once Yin and Yang are unblocked, sleep returns immediately. The Yellow Emperor said: Excellent. This is what is meant by dredging obstructions, achieving thorough meridian patency, and harmonizing Yin and Yang. Please explain the prescription. Bo Gao said: The decoction formula uses eight sheng of flowing water from a distance of a thousand li, stirred ten thousand times, taking five sheng of the clear water for boiling. Cook using reed fire. When boiling, add one sheng of Shu Mi (Glutinous Millet, known as Huang Mi in the North, used for brewing wine) and five he of prepared Ban Xia (Pinellia Tuber). Simmer slowly until reduced to one and a half sheng. Remove dregs. Drink one small cup, three times daily, gradually increasing the dose until efficacy is observed. For newly onset illness, sleep comes upon covering the cup with a lid, and sweating cures it. For chronic cases, three doses suffice. The *Su Wen* chapter "Ni Diao Lun" (Discussion on Reverse Regulation) states: The Yangming Meridian is the Stomach Meridian. The Stomach is the Sea of the Six Fu organs, and its Qi also descends. If Yangming Qi rebels and cannot follow its proper pathway, insomnia results. The *Xia Jing* states: "If the Stomach is disharmonious, sleep will be uneasy," which refers to this principle. The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) in the Xu Lao (Consumptive Disease) section mentions that for deficiency vexation and insomnia, Suan Zao Ren Tang (Sour Jujube Decoction) is the primary treatment. The *Ben Shi Fang* (Formulas of Ability) includes Bie Jia Wan (Turtle Shell Pill). The *Sheng Hui Fang* (Holy Benefit Formulas) treats bone-steaming, vexation, and insomnia using one liang of Sour Jujube Seed, one and a half da zhan of water, ground and squeezed for juice, added with two he of rice, cooked into porridge, then mixed with one he of Di Huang Juice (Rehmannia Juice), taken at any time. Hu Qia treated palpitations and tremors with insomnia using Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala Rhizome), Fu Ling (Poria), Gan Cao (Licorice Root), Sheng Jiang (Fresh Ginger), and Suan Zao Ren (Sour Jujube Seed) boiled together. (All above are Liver-tonifying formulas.) Wen Dan Tang (Warm the Gallbladder Decoction) treats deficiency vexation and insomnia after major illnesses. (Along with Ban Xia Tang from the *Nei Jing*, these are phlegm-fluid resolving formulas.) Liu Yi San (Six-to-One Powder) added with Niu Huang (Calculus Bovis) treats irritability and insomnia. Dai Yun stated: Insomnia has two types: one is weakness after illness or Yang deficiency in the elderly; the other is Phlegm in the Gallbladder Meridian causing the Spirit to lose its residence. For deficiency, use Liu Jun Zi Tang (Six Gentlemen Decoction) added with fried Suan Zao Ren and roasted Huang Qi (Astragalus Root), each one qian. For Phlegm, use Wen Dan Tang reducing Zhu Ru (Bamboo Shavings) by half, adding Nan Xing (Arisaema Cum Bile) and fried Suan Zao Ren, each one qian, taken with Qing Ling Dan. Generally, palpitations, forgetfulness, Zheng Chong (palpitations with anxiety), loss of will, and Wind of the Heart causing insomnia are all due to Gallbladder fluid flooding the Heart, leading to Heart Qi deficiency. If cooling the Heart agents are used excessively, Heart Fire becomes weaker, Phlegm-Saliva becomes more abundant, and the disease persists. The primary principle must be regulating Phlegm-Qi, using Dao Tan Tang (Guide Out Phlegm Decoction) added with Shi Chang Pu (Acorus Rhizome), half a qian. For dyspnea preventing lying down, treat according to dyspnea protocols. For Jue (cold extremities/reversal) preventing lying down, treat according to Hong Zhang (foot swelling/beriberi) protocols.