表兄赵××之妻，年近三旬，得不寐证，兼心中恒惊悸。
病因 因家中诸事皆其自理，劳心过度，因得不寐兼惊悸病。
证候 初苦不寐时，不过数日偶然，其过半夜犹能睡，继则常常如此，又继则彻夜不寐。一连
七八日困顿已极，仿佛若睡，陡觉心中怦怦而动，即暮然惊醒，醒后心犹怔忡，移时始定。
心常发热，呼吸似觉短气，懒于饮食，大便燥结，四五日始一行。其脉左部弦硬，右部近滑，重
诊不实，一息数近六至。
诊断 此因用心过度，心热耗血，更因热生痰之证也。为其血液因热暗耗，阴虚不能潜阳，是
以不寐，痰停心下，火畏水刑（心属火痰属水），是以惊悸。其呼吸觉短气者，上焦凝滞之痰碍气
之升降也。其大便燥结者，火盛血虚，肠中津液短也。此宜
治以利痰、滋阴、降胃、柔肝之剂，再以养心安神之品辅之。
处方 生赭石（八钱轧细） 大甘枸杞（八钱） 生怀地黄（八钱） 生怀山药（六钱）
栝蒌仁（六钱炒捣） 天冬（六钱） 生杭芍（五钱） 清半夏（四钱）
枣仁（四钱炒捣） 生远志（二钱） 茵陈（钱半） 甘草（钱半） 朱砂（二分研细）
药共十三味，将前十二味煎汤一大盅，送服朱砂末。
复诊 将药连服四剂，心中已不觉热，夜间可睡两点钟，惊悸已愈十之七八，气息亦较前
调顺，大便之燥结亦见愈，脉象左部稍见柔和，右部仍有滑象，至数稍缓，遂即原方略为加减
俾再服之。
处方 生赭石（八钱轧细） 大甘枸杞（八钱） 生怀地黄（八钱） 生怀山药（六钱）
龙眼肉（五钱） 栝蒌仁（五钱炒捣） 玄参（五钱） 生杭芍（五钱）
枣仁（四钱炒捣） 生远志（二钱） 甘草（二钱）
共煎汤一大盅，温服。
效果 将药连服六剂，彻夜安睡，诸病皆愈。
表兄赵××的妻子，年龄接近三十岁，患上了不寐证（失眠），同时心中经常感到惊悸。
病因 因为家中大小事务都由她独自料理，用心过度，因此导致了不寐兼惊悸的病证。
证候 起初苦于失眠时，不过是几天偶尔发生，过了半夜还能入睡；后来变成常常如此；再后来则彻夜无法入睡。一连七八天困顿到了极点，仿佛要睡着时，突然觉得心中怦怦跳动，随即猛然惊醒，醒来后心中仍怔忡不安，过了一段时间才平静下来。心中常发热，呼吸似乎觉得气短，懒得进食，大便干燥结硬，四五天才排便一次。其脉象左部弦硬，右部近滑，重按不实，一息跳动接近六次（数脉）。
诊断 这是因为用心过度，心热耗伤血液，并且因热生痰的证候。由于血液因热而暗中消耗，阴虚不能潜藏阳气，所以导致不寐；痰停于心下，火（心）畏惧水刑（痰属阴水），所以导致惊悸。感觉呼吸短气，是因为上焦凝滞的痰阻碍了气的升降。大便干燥结硬，是因为火盛血虚，肠道津液不足所致。此证适宜用利痰、滋阴、降胃、柔肝的方剂治疗，再辅以养心安神的药物。
处方 生赭石（八钱，轧细） 大甘枸杞（八钱） 生怀地黄（八钱） 生怀山药（六钱）
栝蒌仁（六钱，炒捣） 天冬（六钱） 生杭芍（五钱） 清半夏（四钱）
枣仁（四钱，炒捣） 生远志（二钱） 茵陈（一钱半） 甘草（一钱半） 朱砂（二分，研细）
药共十三味，将前十二味煎取一大盅汤，送服朱砂末。
复诊 将药连续服用四剂后，心中已不觉发热，夜间可睡两个小时，惊悸已痊愈十之七八，气息也较之前调顺，大便干燥结硬的情况也见好转，脉象左部稍见柔和，右部仍有滑象，至数稍缓，于是就在原方基础上略作加减，让患者继续服用。
处方 生赭石（八钱，轧细） 大甘枸杞（八钱） 生怀地黄（八钱） 生怀山药（六钱）
龙眼肉（五钱） 栝蒌仁（五钱，炒捣） 玄参（五钱） 生杭芍（五钱）
枣仁（四钱，炒捣） 生远志（二钱） 甘草（二钱）
共煎取一大盅汤，温服。
效果 将药连续服用六剂后，彻夜安睡，所有病证皆愈。
Cousin Zhao XX's wife, approaching thirty years of age, suffered from *Insomnia* (Bu Mei Zheng) accompanied by frequent palpitations and fright in the heart.
Etiology The disease arose because she managed all household affairs independently, leading to excessive mental exertion, which resulted in insomnia combined with palpitations.
Symptoms Initially, her insomnia occurred occasionally for a few days, yet she could still sleep after midnight. Subsequently, it became a frequent occurrence, and eventually, she experienced total sleeplessness throughout the night. For seven or eight consecutive days, she was extremely exhausted; just as she seemed about to fall asleep, she would suddenly feel her heart pounding (*Peng Peng*), waking up abruptly. After waking, her heart remained unsettled (*Zheng Chong*) for some time before stabilizing. She often felt heat in the heart, perceived shortness of breath, had a lack of appetite, and suffered from dry, hard stools, passing them only once every four or five days. Her pulse was wiry and stiff on the left side, near-slippery on the right side, empty upon heavy pressure, and rapid, beating nearly six times per breath.
Diagnosis This is a syndrome caused by excessive mental exertion, where heart-heat consumes blood, and phlegm is generated due to heat. Because blood is secretly consumed by heat, Yin deficiency fails to anchor Yang, resulting in insomnia. Phlegm stagnates below the heart; Fire (Heart) fears Water punishment (Phlegm belongs to Yin-Water), resulting in palpitations and fright. The sensation of shortness of breath is due to stagnant phlegm in the Upper Jiao obstructing the ascending and descending of Qi. The dry, hard stools are due to excess Fire and deficient Blood, leading to a shortage of fluids in the intestines. Treatment should employ agents that resolve phlegm, nourish Yin, descend Stomach Qi, and soften the Liver, supplemented by herbs that nourish the Heart and calm the Spirit.
Prescription Raw Hematite (Shi Zhe Shi, Ochre) [8 qian, finely ground]
Large sweet Goji Berry (Gou Qi Zi) [8 qian]
Raw Huai Rehmannia Root (Sheng Di Huang) [8 qian]
Raw Huai Chinese Yam (Shan Yao) [6 qian]
Trichosanthes Seed (Gua Lou Ren) [6 qian, stir-fried and crushed]
Asparagus Tuber (Tian Dong) [6 qian]
Raw Hang Peony Root (Bai Shao) [5 qian]
Prepared Pinellia Rhizome (Ban Xia) [4 qian]
Ziziphus Seed (Suan Zao Ren) [4 qian, stir-fried and crushed]
Raw Polygala Root (Yuan Zhi) [2 qian]
Artemisia Capillaris Herb (Yin Chen) [1.5 qian]
Licorice Root (Gan Cao) [1.5 qian]
Cinnabar (Zhu Sha) [0.02 qian, finely powdered]
There are thirteen ingredients in total. Decoct the first twelve ingredients in one large cup of water, and take the powder of Cinnabar with the decoction.
Second Visit After taking the medicine for four doses, the feeling of heat in the heart disappeared, she could sleep for two hours at night, and palpitations improved by seventy to eighty percent. Her breathing became smoother than before, and the dryness and hardness of her stools also improved. The pulse on the left side became slightly softer, while the right side remained slippery, though the rate slowed down slightly. Therefore, slight modifications were made to the original prescription for continued use.
Prescription Raw Hematite (Shi Zhe Shi, Ochre) [8 qian, finely ground]
Large sweet Goji Berry (Gou Qi Zi) [8 qian]
Raw Huai Rehmannia Root (Sheng Di Huang) [8 qian]
Raw Huai Chinese Yam (Shan Yao) [6 qian]
Longan Aril (Long Yan Rou) [5 qian]
Trichosanthes Seed (Gua Lou Ren) [5 qian, stir-fried and crushed]
Scrophularia Root (Xuan Shen) [5 qian]
Raw Hang Peony Root (Bai Shao) [5 qian]
Ziziphus Seed (Suan Zao Ren) [4 qian, stir-fried and crushed]
Raw Polygala Root (Yuan Zhi) [2 qian]
Licorice Root (Gan Cao) [2 qian]
Decoct together in one large cup of water and take warm.
Outcome After taking the medicine for six consecutive doses, she slept peacefully throughout the night, and all symptoms resolved.