〔《灵》〕黄帝曰∶病而不得眠者,何气使然?岐伯曰∶卫气不得入于阴,常留于阳,留于阳则
阳气满,阳气满则阳跷盛,不得入于阴,则阴气虚,故目不瞑矣。又曰∶病目不得视者,何气使然?岐伯曰∶
卫气留于阴,不得行于阳,留于阴则阴气盛,阴气盛则阴跷满,不得入于阳则阳气虚,故目闭也。(大惑论)
足太阳有通项入于脑者,正属目本,名曰眼系,头目苦痛,取之在项中两筋间,入脑,乃别阴跷阳跷,
阴阳相交,阳入阴,阴出阳,交于目锐 。(以跷脉考之,当作“目内 ”。)阳气盛则 目,
阴气盛则瞑目。(寒热论)帝问曰∶夫邪气之客人也,或令人目不瞑不卧出者,何气使然?伯高曰∶卫
气者,昼日行于阳,夜行于阴,常从足少阴之分间,行于五脏六腑。今厥气客于五脏六腑,则卫气独卫
其外,行于阳不得入于阴。行于阳则阳气盛,阳气盛则阳跷陷,(“陷”当作“满”。)不得入于
阴,阴气虚,故目不瞑。黄帝曰∶治之奈何?伯高曰∶补其不足,泻其有余,调其虚实,以通其道,而去
其邪。饮以半夏汤一剂,阴阳已通,其卧立至。黄帝曰∶善。此所谓决渎壅塞,经络大通,阴阳和得者也。愿
闻其方?伯高曰∶其汤方,以流水千里以外者八升,扬之万遍,取其清五升煮之,炊以苇薪火沸,置秫米
一升,治半夏五合,徐炊令竭为一升半,去其渣,饮汁一小杯,日三,稍益,以知为度。故其病新发者,
覆杯则卧,汗出则已矣。久者,三饮而已也。(邪客篇按∶本草秫米即所谓糯米是也。)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
常行于阳,夜行于阴,故阳气尽则寐,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,其气不清则目瞑,故多卧矣。其肠胃小,皮肤滑以缓,分肉解则卫气之留于阳也久,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。(大惑篇)
〔海〕胆虚不眠,寒也,酸枣仁炒,竹叶汤调服。(《圣惠方》)胆实多睡,热也,酸枣仁生
用末,茶姜汁调服。(《济众方》一法酸枣仁一两生用,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。)
《灵枢经》记载:黄帝问道:患病后无法入睡,是什么气机导致的?岐伯回答:卫气不能进入阴分,常常停留在阳分。停留在阳分则阳气充盛,阳气充盛则阳跷脉旺盛;卫气不能进入阴分,则阴气虚弱,所以眼睛无法闭合(失眠)。又说道:患病后眼睛无法睁开视物,是什么气机导致的?岐伯回答:卫气停留在阴分,不能在阳分行使功能。停留在阴分则阴气充盛,阴气充盛则阴跷脉满实;卫气不能进入阳分则阳气虚弱,所以眼睛闭合(嗜睡)。(出自《大惑论》)
足太阳膀胱经有一条通路从项部进入脑部,正连接着眼球根部,称为“眼系”。如果头部和眼部剧烈疼痛,取穴在项部两筋之间,深入脑部,由此分别联系阴跷脉和阳跷脉。阴阳二气在此相交,阳气入阴,阴气出阳,交汇于目外角。(根据跷脉理论考证,此处原文当作“目内眦”)。阳气旺盛时眼睛睁开,阴气旺盛时眼睛闭合。(出自《寒热论》)
黄帝问道:邪气侵入人体,有的使人失眠不卧,是什么气机导致的?伯高回答:卫气,白天行于阳分,夜晚行于阴分,通常从足少阴肾经的分野间,运行于五脏六腑。现在厥逆之气客居于五脏六腑,导致卫气只能独自护卫体表,行于阳分而不能进入阴分。行于阳分则阳气充盛,阳气充盛则阳跷脉满实(注:“陷”字当为“满”字之误),不能进入阴分,阴气虚弱,所以眼睛无法闭合(失眠)。黄帝问道:如何治疗?伯高回答:补其不足,泻其有余,调节虚实,疏通其道,祛除邪气。服用半夏汤一剂,阴阳之气得以通畅,睡眠立刻就能恢复。黄帝说:好。这就是所谓的疏通沟渠壅塞,经络大通,阴阳调和的结果。请问具体的方子?伯高回答:该汤剂的煎煮方法,用流动千里之外的水八升,反复扬洒一万遍,取其清水五升来煮,用芦苇做燃料烧火至沸腾,放入秫米一升,炮制过的半夏五合,慢慢熬煮直到药液浓缩为一升半,去掉药渣,每次饮用一小杯,每天三次,逐渐增加剂量,以见效为度。如果是新发的病,放下杯子就能睡着,出汗就好了;病程久的,喝三次就好了。(出自《邪客篇》,按语:本草中提到的秫米就是所说的糯米。)
黄帝问道:人之所以多睡(嗜睡),是什么气机导致的?岐伯回答:这个人的肠胃较大且皮肤湿润,肌肉纹理致密不开泄。肠胃大则卫气停留的时间久,皮肤湿润则肌肉纹理不开泄,卫气运行迟缓。卫气,白天常行于阳分,夜晚行于阴分,所以阳气尽则入睡,阴气尽则醒来。因此,肠胃大则卫气在体内停留时间长,皮肤湿润、肌肉纹理不开泄则运行缓慢,留在阴分的时间久,其气不清爽则眼睛闭合(嗜睡),所以多睡。如果肠胃小,皮肤滑润舒缓,肌肉纹理开泄,则卫气在阳分停留的时间久,所以少睡(失眠倾向)。(出自《大惑篇》)
黄帝问道:如果不是正常的经脉规律,突然发生多睡的,是什么气机导致的?岐伯回答:邪气停留在上焦,上焦闭塞不通,刚吃过饭或喝过汤,卫气长时间停留在阴分而不能运行出来,所以突然多睡。
《海藏先生》记载:胆虚导致的失眠,属于寒证,用炒酸枣仁研末,竹叶汤调服。(出自《太平圣惠方》)胆实导致的嗜睡,属于热证,用生酸枣仁研末,茶水和姜汁调服。(出自《济众方》另一种方法:生酸枣仁一两,腊茶二两,用生姜汁涂抹后烤至微焦,捣碎过筛成末,每次服用二钱,用水七分盏,煎至六分,温服,不限时间。)
[Lingshu] The Yellow Emperor asked: What qi causes a patient to be unable to sleep? Qibo replied: When Wei Qi (Defensive Qi) cannot enter the Yin aspect, it remains constantly in the Yang aspect. Remaining in the Yang aspect leads to an excess of Yang Qi; when Yang Qi is excessive, the Yang Qiao vessel becomes full. Inability to enter the Yin aspect results in deficiency of Yin Qi, thus causing the eyes to remain open (insomnia). It also states: What qi causes a patient to be unable to open their eyes and see? Qibo replied: When Wei Qi remains in the Yin aspect and cannot circulate in the Yang aspect, remaining in the Yin aspect leads to an excess of Yin Qi; when Yin Qi is excessive, the Yin Qiao vessel becomes full. Inability to enter the Yang aspect results in deficiency of Yang Qi, thus causing the eyes to close (hypersomnia). (From "Da Huo Lun")
The Foot-Taiyang Bladder Meridian has a pathway entering the brain from the nape, directly connecting to the root of the eye, named the Eye System (Yan Xi). If there is severe pain in the head and eyes, treatment points are located between the two tendons in the middle of the nape, entering the brain, where they diverge to connect with the Yin Qiao and Yang Qiao vessels. Yin and Yang intersect here; Yang enters Yin, and Yin exits Yang, intersecting at the outer canthus of the eye. (According to the study of the Qiao vessels, this should read "inner canthus of the eye".) When Yang Qi is excessive, the eyes are open; when Yin Qi is excessive, the eyes are closed. (From "Han Re Lun")
The Emperor asked: When pathogenic factors invade the human body, why does it cause some people to be unable to sleep or lie down? Bo Gao replied: Wei Qi (Defensive Qi) circulates in the Yang aspect during the day and in the Yin aspect at night, usually passing through the branches of the Foot-Shaoyin Kidney Meridian to circulate among the Zang-Fu organs. Now, if Jue Qi (Rebellious Qi) lodges in the Zang-Fu organs, Wei Qi can only guard the exterior, circulating in the Yang aspect and unable to enter the Yin aspect. Circulating in the Yang aspect leads to excess of Yang Qi; when Yang Qi is excessive, the Yang Qiao vessel becomes full ("Xian" [sunken/depressed] should be "Man" [full]). Unable to enter the Yin aspect, Yin Qi becomes deficient, thus causing the eyes to remain open (insomnia). The Emperor asked: How should it be treated? Bo Gao replied: Tonify the deficiency, drain the excess, regulate the deficiency and excess, unblock the pathways, and eliminate the pathogen. Administer one dose of Banxia Tang (Pinellia Decoction); once the Yin and Yang are unblocked, sleep will return immediately. The Emperor said: Excellent. This is what is meant by dredging obstructions, unblocking the meridians extensively, and harmonizing Yin and Yang. I wish to hear the prescription. Bo Gao replied: For the decoction, use eight sheng of flowing water from a distance of a thousand li, throw it up ten thousand times, take five sheng of the clear water, boil it using reed fire until boiling, add one sheng of Shumi (Sorghum Rice) and five he of processed Banxia (Pinellia Rhizome), simmer slowly until reduced to one and a half sheng, remove the dregs, drink one small cup at a time, three times a day, gradually increasing the dose until the desired effect is achieved. For newly onset diseases, sleep comes as soon as the cup is put down, and sweating indicates recovery; for chronic cases, three doses are sufficient. (From "Xie Ke Pian"; Note: According to Materia Medica, Shumi refers to glutinous rice.)
The Emperor asked: What qi causes people to sleep excessively? Qibo replied: This person has large intestines and stomach, moist skin, and tight muscle interstices that do not separate. Large intestines and stomach mean Wei Qi stays longer; moist skin means muscle interstices do not separate, causing slow circulation. Wei Qi usually circulates in the Yang aspect during the day and in the Yin aspect at night; thus, when Yang Qi is exhausted, one sleeps, and when Yin Qi is exhausted, one wakes. Therefore, large intestines and stomach cause Wei Qi to stay longer; moist skin and tight muscle interstices cause slow movement, keeping it in the Yin aspect for a long time. If the Qi is not clear, the eyes close, leading to hypersomnia. Conversely, small intestines and stomach, smooth and relaxed skin, and separated muscle interstices allow Wei Qi to stay longer in the Yang aspect, leading to less sleep (tendency towards insomnia). (From "Da Huo Pian")
The Emperor asked: If it is not the normal meridian pattern, but sudden hypersomnia occurs, what qi causes this? Qibo replied: Pathogenic factors remain in the Upper Jiao (Upper Burner), which becomes blocked and unpatent. After eating or drinking soup, Wei Qi remains long in the Yin aspect and cannot exit, thus causing sudden hypersomnia. (From "Da Huo Pian")
[Haizang] Insomnia due to Gallbladder Deficiency is caused by Cold; stir-fried Suanzaoren (Ziziphus Seed) powder taken with Zhuye (Bamboo Leaf) decoction. (From *Taiping Shenghui Fang*) Hypersomnia due to Gallbladder Excess is caused by Heat; raw Suanzaoren (Ziziphus Seed) powder taken with tea and Ginger Juice. (From *Jizhong Fang*; Another method: One liang of raw Suanzaoren (Ziziphus Seed), two liang of La Cha (Aged Tea), coated with Ginger Juice and roasted until slightly scorched, pounded and sifted into powder. Take two qian per dose, decoct in seven-tenths of a cup of water until reduced to six-tenths, take warm, at any time.)