不寐之故，属心血不足，有热所致。故仲淳曰∶治不寐当以养阴血，清心火为要。然亦有因肝经血
虚，气滞而不寐者，则当疏肝养血。有因胸膈痰壅，气逆而不寐者，则当涤痰降气。有因病后血少，
或劳症阴虚而不寐者，则当滋阴养
目。此尚大略，然虚实不齐，神而明之，存乎其人耳。
加减补心丹
生地 白芍 丹皮 枣仁〔养血。〕麦冬〔同竹叶以清心。〕茯神 远志 石斛〔安
神。〕加竹叶 圆肉调服朱砂末。有痰加竹沥，心火甚者加犀角、黄连，虚者加人参。
此方养血、清心、安神，宗仲淳法甚效，随症加减治之。
一妇患阴虚火症，彻夜不眠者两月，饮食俱废，形体日消，皆谓不治。仲淳诊视，许以可救。盖
此病虽属虚，幸脏腑无损，心经虽有火，不至灼肺。况久病脉调，身不发热，岂有他虞。多服补阴收敛
之剂，自然水升火降而愈。用生脉散加茯苓、枣仁、远志、当归、生地大剂投之。因虚甚气怯，佐以琥
珀、辰砂、金、银器之类，约百余剂而瘳。
健忘者，为事有始无终，言语不知首尾；怔忡者，心中惕惕。动而不宁，无时而作；惊悸者、外有
所触，心中跳动，因惊而作。三症皆属心血不足，通宜天王补心、归脾之属治之。然亦有挟火挟痰所致。
如挟火者，则天王补心加减，如犀角、黄连之属；挟痰者，或天王补心加减，如竺黄、竹沥之属。或温胆
汤治之。
天王补心丹 归脾汤〔俱见虚劳。〕
此二方通治健忘、怔忡、惊悸之剂，加减用之。
六味汤〔见虚劳。〕
宜加莲心 圆肉 枣仁 麦冬 辰砂之属。如因心肾不交而健忘者，或加黄连、官
桂，〔连、桂同用，能使心肾交于顷刻。〕或加茯神、沉香。〔二味名朱雀丸，并治惊悸。〕
此方因肾虚火旺，而致怔忡者宜之。
温胆汤〔即二陈汤，加枳实、竹茹、麦冬。〕治痰饮浮于心胞，而致健忘、怔忡、惊悸者。
本方倍茯苓，宜加天竺黄、竹沥。
丹溪曰∶惊则神出于舍，舍空而痰涎聚于胞络之间，是因惊而痰聚也。亦宜本方加豁痰、安神之剂。
The cause of insomnia belongs to insufficient Heart Blood, caused by heat. Therefore, Zhongchun said: The treatment of insomnia should focus on nourishing Yin and Blood, and clearing Heart Fire. However, there are also cases due to Liver channel Blood deficiency with Qi stagnation causing insomnia, in which case one should soothe the Liver and nourish Blood. There are cases due to phlegm turbidity obstructing the chest and diaphragm with rebellious Qi causing insomnia, in which case one should eliminate phlegm and direct Qi downward. There are cases due to blood deficiency after illness or Yin deficiency from consumptive diseases causing insomnia, in which case one should nourish Yin and benefit the eyes. This is merely a general outline; however, since deficiency and excess vary, divine understanding depends on the practitioner.
Modified Buxin Dan (Nourish Heart Decoction)
Shengdi Huang (Rehmanniae Radix Preparata), Baishao (Paeoniae Radix Alba), Danpi (Moutan Cortex), Zaoren (Ziziphi Spinosomi Semen) [Nourishes Blood.] Maidong (Ophiopogonis Radix) [Together with Zhuye (Bambusae Folium) clears Heart.] Fushen (Poria cum Radix et Lignum), Yuanzhi (Polygalae Radix), Shihu (Dendrobii Caulis) [Calms Spirit.] Add Zhuye (Bambusae Folium) and Yuanyuan (Dimocarpus Longan Arillus) to mix with Zhusha Mo (Cinnabar Powder). If there is phlegm, add Zhuli (Phyllostachys Nigra Juice); if Heart Fire is severe, add Xijiao (Rhinocerotis Cornu) and Huanglian (Coptidis Rhizoma); if deficient, add Renshen (Ginseng Radix et Rhizoma).
This formula nourishes Blood, clears Heart, and calms the Spirit. Following Zhongchun's method, it is very effective; modify according to symptoms for treatment.
A woman suffered from Yin deficiency with Fire syndrome, unable to sleep all night for two months. Her diet was rejected, and her body wasted away daily; all said she was incurable. Zhongchun examined her and promised she could be saved. Although this disease belongs to deficiency, fortunately the Zang-Fu organs were undamaged. Although there was Fire in the Heart channel, it did not scorch the Lung. Moreover, the pulse was harmonious after long illness, and the body had no fever; how could there be other worries? Taking more agents that tonify Yin and astringe will naturally cause Water to ascend and Fire to descend, leading to recovery. Use Shengmai San (Generate Pulse Powder) with added Fuling (Poria), Zaoren (Ziziphi Spinosomi Semen), Yuanzhi (Polygalae Radix), Danggui (Angelicae Sinensis Radix), and Shengdi Huang (Rehmanniae Radix Preparata) in large doses. Due to extreme deficiency and timid Qi, assist with Hupo (Succinum), Chensha (Cinnabaris), Gold, Silver vessels, etc. After about a hundred doses, she recovered.
Forgetfulness (Jianwang) refers to starting things but not finishing them, speaking without knowing beginning or end. Palpitations (Zhongchong) refer to a fearful feeling in the heart, moving and restless, occurring at any time. Startled palpitations (Jingji) refer to trembling in the heart triggered by external stimuli, arising from fright. All three conditions belong to insufficient Heart Blood, generally treated with Tianwang Buxin Dan (Emperor of Heaven's Special Formula to Tonify the Heart) or Guipi Tang (Restore the Spleen Decoction). However, some are caused by accompanying Fire or Phlegm. If accompanied by Fire, modify Tianwang Buxin Dan with agents like Xijiao (Rhinocerotis Cornu) or Huanglian (Coptidis Rhizoma); if accompanied by Phlegm, modify Tianwang Buxin Dan with agents like Zhuhuang (Hippuris Fragrans Spadix) or Zhuli (Phyllostachys Nigra Juice). Or treat with Wendan Tang (Warm the Gallbladder Decoction).
Tianwang Buxin Dan (Emperor of Heaven's Special Formula to Tonify the Heart), Guipi Tang (Restore the Spleen Decoction) [Both seen in Xu Lao (Consumptive Disease).]
These two formulas generally treat forgetfulness, palpitations, and startled palpitations; use with modifications.
Liuwei Wan (Six-Ingredient Pill with Rehmannia) [Seen in Xu Lao (Consumptive Disease).]
Should add Lianxin (Nelumbinis Plumula), Yuanyuan (Dimocarpus Longan Arillus), Zaoren (Ziziphi Spinosomi Semen), Maidong (Ophiopogonis Radix), Chensha (Cinnabaris). If forgetfulness is due to non-interaction between Heart and Kidney, optionally add Huanglian (Coptidis Rhizoma) and Guigui (Cinnamomi Ramulus). [Using Lian and Gui together can cause Heart and Kidney to interact instantly.] Or add Fushen (Poria cum Radix et Lignum) and Chenxiang (Aquilariae Resina). [These two ingredients form Zhuque Wan (Vermilion Bird Pill), treating both palpitations and startled palpitations.]
This formula is suitable for palpitations caused by Kidney deficiency with hyperactive Fire.
Wendan Tang (Warm the Gallbladder Decoction) [Is Erchen Tang (Two-Aged Decoction) plus Zhishi (Aurantii Fructus Immaturus), Zhuru (Bambusae Caulis in Taeniae), and Maidong (Ophiopogonis Radix).] Treats phlegm-fluids floating around the Pericardium causing forgetfulness, palpitations, and startled palpitations.
Double the Fuling (Poria) in this base formula, and should add Tianzhuhuang (Calami Tiphosa) and Zhuli (Phyllostachys Nigra Juice).
Danxi said: Fright causes the Spirit to leave its residence; when the residence is empty, phlegm-saliva gathers between the collateral channels. Thus, fright causes phlegm accumulation. One should also use this base formula plus agents that resolve phlegm and calm the Spirit.