Insomnia (Bu Mei) and Its Treatments
Insomnia arises from multiple causes, each requiring specific (used in traditional contexts):
- Food stagnation requires digestive regulation (Xiao Dao)
- Fluid retention demands water drainage (Zhu Shui)
- Yin deficiency needs Yin nourishment (An Yin)
- Spleen weakness calls for spleen tonification (Bu Pi)
- Yang excess requires yang containment (Lian Yang)
Most cases involve excess patterns rather than deficiency patterns, requiring careful differentiation.
Case Record from Chengdong’s San Dao River
While studying at San Dao River in the east city, I encountered Mr. Li Xiangquan, a forty-year-old scholar repeatedly failing imperial examinations. An obsessive tea drinker, he consumed dozens of cups daily from dawn till dusk, finding joy in watching his tea kettle boil. Chronic tea consumption left him pale and appetite-impaired. Every early autumn, he suffered complete nighttime wakefulness with worsening thirst at dawn.
One day he brought medicinal pills to our school, along with roasted Sour Jujube Seeds (Suan Zao Ren) which he snacked on constantly. When questioned, he explained: “Doctors say these seeds calm the spirit (An Shen). The pills are Ginseng Guipi Pill (Ren Shen Gui Pi Wan) prescribed by Dr. Wang Ningtai, a Catholic practitioner who claims my insomnia stems from excessive mental exertion during studies.”
“Effective?” I inquired.
“Not particularly, but harmless,” he shrugged.
Upon examination, I detected a rapid and tight pulse. I explained: “Your insomnia stems from fluid retention (Shui Ting), not blood deficiency. Symptoms like palpitations when lying down, chest tightness, difficult urination, and persistent thirst indicate excess patterns. We need drainage, not tonics. Continued use of Guipi Pill might lead to dizziness, vomiting, and potentially edema in later years.”
“Exactly!” Li exclaimed. “Please treat me!”
I prescribed Fuling Drainage Decoction (Fu Dao Shui Tang), a fluid-regulating formula. Around 9 PM, he urinated five to six times successively. Falling asleep, he mumbled blissfully in dreams: “Such relief!” By morning, his bedding was soaked in urine resembling muddy water. Remarkably, his tea cravings diminished and appetite normalized thereafter. I prescribed long-term use of Six Gentlemen Pill (Liu Jun Wan) containing Ginseng (Ren Shen), Atractylodes (Bai Zhu), Poria (Fu Ling), Licorice (Gan Cao), Tangerine Peel (Chen Pi), and Pinellia (Ban Xia) to strengthen his spleen-stomach system. Li later became an enthusiastic advocate for this (used in traditional contexts).
(Note: Fuling Drainage Decoction belongs to traditional diuretic formulas. Six Gentlemen Pill, known as Liu Jun Zi Wan, is a classic spleen-tonifying formula.)
This translation preserves all original content while using standardized herb names with pinyin (without tones) for international readers. Medical terms remain technically accurate yet accessible to non-Chinese audiences
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