阳气自动而之静，则寐。阴气自静而之动，则寤。不寐者，病在阳不交阴也。《灵枢》曰∶卫气日行于
阳，夜行于阴，厥气客于脏腑，则卫气行于阳，不得入于阴。行于阳则阳气盛，阳气盛则阳跷满，不得入于阴
则阴气虚，故目不瞑。卫气留于阴，不得行于阳。留于阴则阴气盛，阴气盛则阴跷满，不得行于阳则阳气虚，
故目闭。《素问》曰∶阴虚故目不瞑，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，
其卧立至。盖不寐多由思虑劳神，惊忧怒火，气郁生涎，用半夏汤。半夏除痰而利小便，秫米益阴而利大肠，
则阴阳交通而得卧也。又曰∶胃不和则卧不安，盖胃气主降，若痰火阻痹，则烦扰不寐也。宜橘红、茯苓、
石斛、半夏、炙草、枳实、楂肉、神曲之属。又曰∶卧则喘者，是水气之客也，此水停心下，不得眠。宜茯苓
甘草汤。若夫心血不足，或神不守舍，宜归脾汤、琥珀养心丹。由肝虚受邪，梦中惊悸，魂不守舍。先服独活汤，
后服珍珠母丸。《纲目》曰∶人卧则血归于肝。今血不静，卧不归肝，故惊悸不得卧也。由营卫俱虚，神魂失
守，七福饮，或大补元煎。由胆火郁热，口苦神烦，温胆汤加丹皮、山栀、钩藤、桑叶。由肾阴久亏，孤阳
浮越，六味汤加淡菜、龟胶、五味子。由心火焦烦，津干口渴，宜补心
丹。由惊恐伤神，心虚不安，养心汤，定志丸。由思虑伤脾，脾血亏损，经年不寐，归芍六君子汤，或益气安
神汤。由胆虚不眠，定志丸加熟枣仁，或炒枣仁一两，研末，酒调服。由心胆俱怯，触事易惊，十味温胆汤。
由病后虚烦不眠，竹叶石膏汤，茯苓补心汤。由虚劳烦热不寐，金匮酸枣仁汤，或枣半汤。由高年血衰不寐，
圣愈汤。有喘不得寐者，苏子竹茹汤。经曰∶肺者脏之盖也。肺气盛，则肺大不能偃卧。有卧易惊醒者，鳖甲
羌活丸。有通宵不寐者，安卧如神汤。有烦不得寐，服药不效者，栀豉汤下朱砂安神丸。有病久余热不止，遗
精不寐者，六味丸加炒枣仁、五味子。病后及吐下后，与溃疡不得眠者，属胆虚。人参、茯神、枣仁、陈皮、
麦冬、龙眼为主。有火脉数，加知母、黄连、竹茹。心烦，加炒山栀。《医通》曰∶凡妇人肥盛，多郁，不
得眠者吐之，从郁结痰火治。温胆汤，用猪胆汁炒半夏曲，加柴胡、熟枣仁。凡怔忡惊恐健忘，癫狂失志不寐，
皆由痰涎沃心，以致心气不足。若凉心之剂太过，则心火愈微，痰涎愈盛，惟以理痰顺气，养心安神，为第一
义。导痰汤加茯神、人参、石菖蒲。
阳气由动转为静，人便入睡。阴气由静转为动，人便醒来。不寐（失眠）的病症，在于阳不能交合于阴。《灵枢》说：卫气白天运行于阳分，夜晚运行于阴分。如果厥逆之气客居于脏腑，卫气就会停留在阳分，无法进入阴分。卫气行于阳分则阳气盛，阳气盛则阳跷脉满盛，无法进入阴分则阴气虚，所以眼睛睁着睡不着。卫气滞留于阴分，无法运行于阳分。滞留于阴分则阴气盛，阴气盛则阴跷脉满盛，无法运行于阳分则阳气虚，所以眼睛闭着却睡不沉（或指嗜睡）。《素问》说：阴虚导致眼睛睁着睡不着，应当补其不足，泻其有余，调和虚实，疏通其道并祛除邪气。饮用半夏汤，睡眠立刻就能恢复。大概不寐多因思虑劳神、惊忧怒火，导致气郁生痰涎，适用半夏汤。半夏能除痰并通利小便，秫米能益阴并通利大肠，这样阴阳交通便能安睡。又说：胃不和则卧不安，因为胃气主降，若被痰火阻滞痹塞，就会烦扰不寐。适宜用橘红、茯苓、石斛、半夏、炙甘草、枳实、山楂肉、神曲这类药物。又说：躺下就喘息的，是水气侵犯所致，这是水饮停聚在心下，导致无法安眠。适宜用茯苓甘草汤。如果是心血不足，或者神志不守舍，适宜用归脾汤、琥珀养心丹。如果是因肝虚受邪，梦中惊悸，魂不守舍。先服用独活汤，后服用珍珠母丸。《本草纲目》说：人躺下时血液回归肝脏。现在血液不宁静，躺下时不归肝，所以惊悸不得安睡。如果是营卫俱虚，神魂失守，可用七福饮，或大补元煎。如果是胆火郁热，口苦神烦，用温胆汤加牡丹皮、山栀、钩藤、桑叶。如果是肾阴久亏，孤阳浮越，用六味地黄汤加淡菜、龟胶、五味子。如果是心火焦灼烦闷，津液干枯口渴，适宜用补心丹。如果是惊恐伤神，心虚不安，用养心汤、定志丸。如果是思虑伤脾，脾血亏损，常年不寐，用归芍六君子汤，或益气安神汤。如果是胆虚不眠，用定志丸加熟枣仁，或炒枣仁一两，研成末，酒调服。如果是心胆俱怯，遇事易惊，用十味温胆汤。如果是病后虚烦不眠，用竹叶石膏汤、茯苓补心汤。如果是虚劳烦热不寐，用金匮酸枣仁汤，或枣半汤。如果是年老血衰不寐，用圣愈汤。如果有喘息不能安睡的，用苏子竹茹汤。经书说：肺是五脏的华盖。肺气盛，则肺大不能仰卧。有睡觉容易惊醒的，用鳖甲羌活丸。有通宵不寐的，用安卧如神汤。有烦躁不得安睡，服药无效的，用栀豉汤送服朱砂安神丸。有病久余热不止，遗精不寐的，用六味丸加炒枣仁、五味子。病后及吐下之后，以及溃疡患者不得安眠的，属于胆虚。以人参、茯神、枣仁、陈皮、麦冬、龙眼为主药。如果有火象且脉数，加知母、黄连、竹茹。心烦，加炒山栀。《医宗金鉴·医通》说：凡是妇人形体肥胖，多抑郁，不得安眠的，应当吐之，从郁结痰火治疗。用温胆汤，用猪胆汁炒半夏曲，加柴胡、熟枣仁。凡是怔忡、惊恐、健忘、癫狂、失志不寐，都是由痰涎壅盛于心，导致心气不足。如果凉心之剂太过，则心火更微弱，痰涎更旺盛，只有以理痰顺气、养心安神为第一要义。用导痰汤加茯神、人参、石菖蒲。
When Yang Qi transitions from movement to stillness, sleep occurs. When Yin Qi transitions from stillness to movement, wakefulness occurs. Insomnia (Bu Mei) is a disease where Yang fails to interact with Yin. The *Ling Shu* states: Wei Qi (Defensive Qi) travels in the Yang channels during the day and in the Yin organs at night. If Jue Qi (Rebellious Qi) lodges in the Zang-Fu organs, Wei Qi remains in the Yang channels and cannot enter the Yin. Traveling in Yang causes Yang Qi to become excessive; when Yang Qi is excessive, the Yang Qiao vessel becomes full, and inability to enter Yin causes Yin Qi to be deficient, thus the eyes remain open without sleep. If Wei Qi stays in Yin and cannot travel to Yang, staying in Yin causes Yin Qi to become excessive; when Yin Qi is excessive, the Yin Qiao vessel becomes full, and inability to travel to Yang causes Yang Qi to be deficient, thus the eyes are closed but sleep is not deep (or refers to hypersomnia). The *Su Wen* states: Yin deficiency leads to open eyes without sleep; one should tonify the deficiency, drain the excess, regulate deficiency and excess, unblock the pathways, and eliminate the pathogen. Drinking Banxia Tang (Pinellia Decoction) results in immediate sleep. Generally, insomnia often arises from overthinking and mental labor, or fright, worry, anger, and fire, leading to Qi stagnation generating phlegm-fluids; Banxia Tang is indicated. Banxia (Pinelliae Rhizoma) eliminates phlegm and promotes urination, while Shumi (Sorghum Vulgare Semen) nourishes Yin and promotes bowel movements, allowing Yin and Yang to communicate for sleep. It is also said: "If the Stomach is disharmonious, sleep is uneasy," because Stomach Qi governs descending; if obstructed by Phlegm-Fire, it causes restlessness and insomnia. Suitable herbs include Juhong (Citri Reticulatae Pericarpium Rubrum), Fuling (Poria), Shihu (Dendrobii Caulis), Banxia (Pinelliae Rhizoma), Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata), Zhishi (Aurantii Fructus Immaturus), Zharonrou (Crataegi Fructus), and Shenqu (Massa Medicata Fermentata). It is also said: "Wheezing upon lying down indicates invasion by Water Qi," where water retention below the Heart prevents sleep; Fuling Gancao Tang (Poria and Licorice Decoction) is suitable. If Heart Blood is insufficient or the Spirit does not reside in its abode, Guipi Tang (Restore the Spleen Decoction) or Hupo Yangxin Dan (Amber Nourishing Heart Pill) are indicated. If Liver deficiency allows pathogenic invasion, causing dreams of fright and palpitations with the Soul not residing properly, first administer Duhuo Tang (Angelicae Pubescentis Decoction), followed by Zhenzhumu Wan (Mother-of-Pearl Pill). The *Bencao Gangmu* states: "When people lie down, blood returns to the Liver." Now, if blood is restless and does not return to the Liver upon lying down, it causes fright, palpitations, and inability to sleep. If Ying (Nutritive) and Wei (Defensive) Qi are both deficient, and the Hun and Shen lose their residence, Qifu Yin (Seven Blessings Infusion) or Dabu Yuanjian (Great Tonification of the Source Decoction) may be used. If Gallbladder Fire is stagnant and hot, causing bitter taste and mental agitation, Wendan Tang (Warm the Gallbladder Decoction) added with Mudanpi (Moutan Cortex), Shanzhi (Gardeniae Fructus), Gouteng (Uncariae Ramulus cum Uncis), and Sangye (Mori Folium) is appropriate. If Kidney Yin has been deficient for a long time, causing solitary Yang to float upward, Liuwei Tang (Six-Ingredient Decoction) added with Dancai (Porphyra), Guijiao (Colla Corii Asini), and Wuweizi (Schisandrae Fructus) is indicated. If Heart Fire causes scorching agitation, dry fluids, and thirst, Buxin Dan (Nourish Heart Pill) is suitable. If fright and terror injure the Spirit, causing Heart deficiency and insecurity, Yangxin Tang (Nourish Heart Decoction) and Dingzhi Wan (Calm the Mind Pill) are used. If overthinking injures the Spleen, depleting Spleen Blood and causing chronic insomnia, Guishao Liujunzi Tang (Guizhi, Shaoyao, and Six-Gentlemen Decoction) or Yiqi Anshen Tang (Tonify Qi and Calm Spirit Decoction) are appropriate. For Gallbladder deficiency insomnia, Dingzhi Wan added with Shu Zaoren (Prepared Ziziphus Seed) or Chao Zaoren (Stir-fried Ziziphus Seed) one liang, ground into powder and taken with wine, is used. For Heart and Gallbladder timidity causing easy fright upon encountering events, Shiwei Wendan Tang (Ten-Ingredient Warm the Gallbladder Decoction) is indicated. For post-illness empty irritability and insomnia, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) or Fuling Buxin Tang (Poria Nourishing Heart Decoction) are used. For consumptive fatigue with irritability, heat, and insomnia, Jin Gui Suanzaoren Tang (Acid Jujube Decoction from the Golden Cabinet) or Zaoban Tang (Jujube and Pinellia Decoction) are used. For elderly individuals with blood decline and insomnia, Shengyu Tang (Generate Vitality Decoction) is used. For those with wheezing preventing sleep, Suzi Zhuru Tang (Perilla Fruit and Bamboo Sap Decoction) is indicated. The Classics state: "The Lung is the canopy of the Zang organs." When Lung Qi is excessive, the Lung enlarges and prevents supine sleeping. For those who startle easily during sleep, Biejia Qianghuo Wan (Soft-shell Turtle Shell and Notopterygium Pill) is used. For those unable to sleep all night, Anwu Rushen Tang (Peaceful Sleep Like Divine Decoction) is used. For those with irritability preventing sleep who do not respond to medication, Zhichi Tang (Gardenia and Soybean Decoction) administered with Zhusha Anshen Wan (Cinnabar Calming Spirit Pill) is appropriate. For prolonged illness with lingering residual heat, seminal emission, and insomnia, Liuwei Wan (Six-Ingredient Pill) added with Chao Zaoren (Stir-fried Ziziphus Seed) and Wuweizi (Schisandrae Fructus) is used. After illness, or following vomiting and purging, as well as in ulcer patients unable to sleep, this belongs to Gallbladder deficiency. The main herbs are Renshen (Ginseng Radix et Rhizoma), Fushen (Poria with Pine Root), Zaoren (Ziziphus Seed), Chenpi (Citri Reticulatae Pericarpium), Maidong (Ophiopogonis Tuber), and Longyan (Longan Aril). If there is Fire with a rapid pulse, add Zhimu (Anemarrhenae Rhizoma), Huanglian (Coptidis Rhizoma), and Zhuru (Bambusae Caulis in Taeniam). For mental distress, add Chao Shanzhi (Stir-fried Gardeniae Fructus). The *Yitong* states: "For obese women with much depression who cannot sleep, induce vomiting, treating from stagnant constriction and Phlegm-Fire." Use Wendan Tang (Warm the Gallbladder Decoction), using Banxia Qu (Pinellia Fermented Paste) stir-fried with Pig Bile, added with Chaihu (Bupleuri Radix) and Shu Zaoren (Prepared Ziziphus Seed). Palpitations, fright, terror, forgetfulness, mania, loss of will, and insomnia are all caused by Phlegm-Saliva flooding the Heart, leading to Heart Qi deficiency. If Cold-Cooling agents for the Heart are used excessively, Heart Fire becomes weaker, and Phlegm-Saliva becomes more abundant. Only regulating Phlegm, smoothing Qi, and nourishing the Heart to calm the Spirit is the primary principle. Daotan Tang (Great Phlegm-Resolving Decoction) added with Fushen (Poria with Pine Root), Renshen (Ginseng Radix et Rhizoma), and Shichangpu (Acori Tatarinowii Rhizoma) is used.