Insomnia / Neurasthenia

SYMPTOMS AND SIGNS: Insomnia is a common symptom, indicating that a person has difficulty getting normal sleep. Insomnia includes: difficulty sleeping, unrestful sleep, or waking up throughout the night; or difficulty getting to sleep again after waking up in the middle of the night; or in serious cases, a person can not fall asleep for the whole night. Insomnia is usually accompanied with headache, dizziness, palpitation, forgetfulness, or nervous and worried emotions. It is mostly seen in neurasthenia, or during menopause.

ETIOLOGY AND PATHOLOGY: Insomnia is usually caused by the following factors:

  1. Upward disturbance of liver fire due to unstable emotions
  2. Retention of phlegm-heat due to gastric indigestion, or food stagnation in stomach
  3. Flaming up of heart fire due to insufficiency of kidney Yin or essence
  4. Qi and blood deficiency due to the first reason which cause the spleen and stomach to not function well
  5. Uncertainty of mind caused by the deficiency of heart and gallbladder, the latter is supposed to control emotions and build up one's confidence.

DIFFERENTIATIONS: 

1. Insomnia Due To The Excessive Liver Fire:

Indications: Difficulty falling asleep, easily angered, restlessness, poor appetite, thirsty and likes to drink, red eyes, bitter mouth, yellow urine, constipation, red tongue, yellow coating, wiry and rapid pulse. 

Treatment & Formulas: Clear the liver fire so as to soothe the spirit.

Products:

    • Long Dan Xie Gan Tang (Gentiana Combination, Item No. 2267): It treats insomnia with strong excessive liver fire combined with dampness. 
    • Yi Gan San (Bupleurum Formula, Item No. 2105): This regulates the liver Qi and harmonizes liver with spleen. 
    • Jia Wei Xiao Yao San (Bupleurum and Paeonia Formula, Item No. 2068): It harmonizes the liver and spleen, clear the deficient liver fire. It is a very good formula for women during menopausal period, or elderly with symptoms of the indications. 

2. Insomnia Due To The Upward Phlegm-Heat:

Indications: Difficulty getting to sleep, heavy and tight feeling of head, dizziness, profuse sputum,oppression and fullness in the chest, anorexia, poor appetite, acid regurgitation, vomiting, restlessness, bitter mouth, yellow greasy tongue coating, slippery and rapid pulse. 

Treatment & Formula: Clear heat and resolve phlegm, soothe the stomach and calm the spirit. 

Products:

    • Wen Dan Tang (Bamboo and Hoelen Combination Item No. 2228), or combine with Shan Huang Xie Xin Tang (Colitis and Rhubarb
      Combination, Item No. 2026) if internal heat is strong

3. Insomnia Due To The Up Flaming of Heart Fire:

Indications: Difficulty getting to sleep, or waking up easily during the night, dream sleep, palpitation, dizziness, tinnitus, forgetfulness, hot sensations of the four palms, especially during the night, or night sweating, soreness and weakness at lumbar regions, dry mouth, red tongue, scanty coating, thready and rapid pulse. 

Treatment & Formulas: Tonify the heart and kidney Yin, clear the heart fire so as to tranquilize the mind. 

Products:

    • Tian Wang Bu Xin Dan (Ginseng and Zizyphus Formula, Item No. 2055): This is a very good formula for insomnia due to the heart fire caused by the deficient kidney and heart Yin. 
    • Lian Zhi Qing Xin Yin (Lotus Seed Combination, Item No. 2254): This is a very effective for those symptoms caused by emotional or mental reasons. It clears the heart fire, harmonizes the liver (the organ supposed to control all emotions) and spleen (the organ which is easily attacked by the liver). In clinic, it is used to treat anxiety, heavy mental work, exhaustion, injured spleen and lungs,
      excessive much wine or sexual injuries, frequent urination, nocturnal emissions,  leukorrhea, neurosis, heart distress diabetes, etc. 

4. Insomnia Due To The Deficiency of Heart and Spleen:

Indications: Dream sleep, easily woken up during the night, palpitation, forgetfulness, dizziness and blurry vision, general fatigue, tastelessness, poor appetite, pale and dull face, pale tongue, thin coating, thready and weak pulse. 

Treatment & Formulas: Promote the functions of spleen and heart so as to tonify the Qi and blood, and soothe the mind. 

Products:

    • Gui Pi Tang (Ginseng and Longan Combination, Item No. 2261 ): This is a very good formula to treat insomnia due to the deficiency of heart and spleen. 
    • Ren Shen Yang Rong Tang (Ginseng Nutritive Combination, Item No. 2007): It tonifies the spleen and stomach, nourishes the heart and tranquilize the spirit. 
    • Shi Quan Da Bu Tang (Ginseng and Tang-kuei Ten Combination, Item No. 2015): It tonifies the Qi and blood so as to nourish the head which is supposed to be the house of spirit (mind).

5. Insomnia Due To The Qi and Blood Deficiency of Heart and Gallbladder:

Indications: Insomnia, dream sleep, easily woken up by fearful emotions, lack of confidence, palpitation, always in worry and fearful emotions, easily frightened by unrespected matters, shortness of breath, frequent and profuse urination, pale tongue, wiry and thready pulse. 

Treatment & Formulas: Tonify the Qi and tranquilize the spirit

Products:

    • Suan Zao Ren Tang (Zizyphus Combination, Item No. 2251): It is a very good formula to treat insomnia due to the Qi and blood deficiency of heart and liver. 
    • Tian Wang Bu Xin Dan (Ginseng and Zizyphus Formula, Item No. 2055): It is often used for mental exhaustion, emotional instability, spermatorrhea, amnesia, insomnia, etc. caused by the Qi and blood deficiency of heart. 
    • Dang Gui Liu Huang Tang (Dang-kuei and Six Yellow Combination, Item No. 2231 ): It tonifies the liver Yin and blood (liver is connected with gallbladder, and is the mother of heart according to the theory of the Five Element) clears the liver deficient fire so as to tranquilize the mind arid sedate fearful emotions. 

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