interpretation and treatment of insomnia in traditional chinese medicine

Interpretation and treatment of insomnia in traditional Chinese medicine

What is insomnisa by TCM?

There are more people suffering from insomnia now. First, let's take a look at what insomnia is?

Sleep is about recognizing the mind and resting, as the body's qi and blood circulate on their own.

Insomnia, on the other hand, is a lack of awareness and unwillingness to rest. 

There are two aspects to this: active and passive. The active aspect is that people themselves do not want to rest, for example, when we are very tired but do not want to sleep, and there are things we want to do that have not been completed, so we force our consciousness to continue working, and even use various methods to stimulate our consciousness, such as hanging our heads, stabbing our thighs, etc., to keep our consciousness awake. This is the proactive aspect.

What we generally refer to as insomnia is passive insomnia, which means that one wants to sleep but cannot, and the consciousness cannot rest peacefully.

And the passive one can be divided into two types, one is physical and the other is emotional.

Emotionally, it refers to something happening in the heart, such as encountering something big, getting too excited, or being unable to let go of something, which can lead to insomnia. When this matter is over, or when you have a clear mind, insomnia will naturally improve. This is temporary. Of course, there are also people who often have a lot of thoughts in their minds, and when they encounter small things in their daily lives, they will have wild thoughts, which can lead to frequent insomnia. Or perhaps there is something that is weighing on one's mind and cannot be resolved, such as many women who have poor relationships with their loved ones or mother-in-law, which can lead to long-term depression and frequent insomnia.

Insomnia in the body is easy to treat, but insomnia in emotions is difficult to treat because it requires the individual to open up. There is a medicine that can treat emotional insomnia, and that is alcohol. Alcohol can be enchanting. When you get slightly drunk, you forget everything and fall asleep.

This is emotional, and the person who tied the bell still needs to untie it. The key is to open the knot in the heart, and the person will fall asleep.

Then we talk about the physical aspects.

What is the pathogenesis of insomnia? The human consciousness of the gods lies in the heart, and the heart governs the gods. To sleep, the consciousness of the gods needs to be hidden, the heart fire needs to descend, the kidney water needs to rise, the heart and kidney intersect, and the fire is hidden in the water. As soon as the heart and kidneys intersect, the consciousness of the gods is hidden, and the person falls asleep. If the heart and kidneys are not connected, if the heart fire is burning upwards and the kidney water is separated downwards, then a person cannot sleep. This is the pathogenesis of insomnia, and it only lies in one thing, which is heart kidney dysfunction.

Treatment of insomnia

So when we treat insomnia, we treat the intersection of heart and kidney.

There are four types of treatment methods here: upper, lower, inner, and outer, and the upper and lower are generally treated together, so there are only three types.

The upper and lower treatment method directly treats the heart and kidneys. Lower heart fire and increase kidney water.

There is a famous formula for treating insomnia called Jiaotai Wan, which only has two ingredients and uses Huanglian and Cinnamon. This is the principle behind it. Huanglian is used to reduce heart fire, while cinnamon is used to warm kidney water. If the heart fire decreases, the kidney water rises, the heart and kidney intersect, and yang enters yin, then the person will naturally sleep peacefully.

There is also a formula in the theory of typhoid fever, which is similar to this principle, and it is Gardenia and Soybean Soup. Gardenia, which looks like a heart, can clear the fire in the heart, while fermented black beans, which looks like a kidney, can nourish the kidney water. This is also the intersection of heart and kidney.

Both of these are for treating mild symptoms of insomnia. If insomnia persists for a long time, it is already very serious, and the effectiveness of these two is not enough.

At this point, we need to use another prescription from the Treatise on Cold Damage, which is Fuzi Xiexin Tang, to effectively lower heart fire and increase kidney water. Among them, Fuzi is used to warm the kidneys, while Rhubarb, Huanglian, and Huangqin are used to reduce heart fire. Do not boil the Sanhuang tea, just soak it in boiling water. Boil the aconite separately, and after boiling, it will hydrate with the Sanhuang tea. This is for treating severe insomnia.

This is the upper and lower treatment method, as well as the internal and external treatment.

Internally, it means treating from the middle. Sometimes the heart and kidneys cannot intersect, not because of the heart and kidneys themselves, but because the middle spleen and stomach cannot function properly, and the path between the heart and kidneys is blocked. At this time, it is necessary to treat the middle pathway. As the saying goes, if the stomach is not in harmony, one will feel restless and need to lower the stomach before the heart fire can be lowered.

There are also two formulas here, one of which is the formula in the Inner Canon. It is one of the thirteen formulas in the Inner Canon, Banxia Yangmi Tang, which uses two herbs: Banxia and Yangmi. Banxia lowers the stomach and Yangmi nourishes yin. Another one is Xiaochaihu Tang in the Treatise on Cold Damage. Chaihu clears the pathway, Banxia lowers the stomach, Huangqin lowers fire, and ginseng, ginger, grass, and jujube nourish the body. When the middle road is open and the stomach qi decreases, the heart fire naturally decreases. This is treated from the middle.

Then there is the external treatment, which is to treat from the peripheral qi and blood. This also includes two aspects.

One is the deficiency of qi and blood itself. If a person's qi and blood are insufficient, their mind and spirit cannot be nurtured, and their heart fire will naturally become inflamed. So many elderly people are prone to insomnia and sleep less because their qi and blood have already declined. At this moment, it is necessary to nourish qi and blood, and rest assured. There are also two prescriptions, one is Huanglian ass hide glue chicken yellow soup in the theory of typhoid, the other is Suanzaoren soup in the chapter of blood stasis, deficiency and fatigue in the Golden Chamber, both of which are for heart and blood.

There is another type, it is not a deficiency of qi and blood, but a disorder of the body's qi mechanism. This is mainly related to the environment. For example, a person who used to sleep well suddenly can't fall asleep in a new environment, such as going to a hotel or staying at a friend's house. Or people may not be able to sleep in a specific environment, such as a strong magnetic or electrical environment. This is because the human body's qi has been disturbed and the body has not yet reconciled with the qi of the environment.

The treatment method at this time is to straighten out the body's qi system. There is a formula called Cizhu Wan, which uses magnets, cinnabar, and sacred music. This is the method used. Magnets can adjust the body's qi, cinnabar can calm the mind, and Shenqu is used because both magnets and cinnabar are minerals, and Shenqu can protect the stomach.

There are basically so many treatment methods for insomnia, divided into four types: upper, lower, inner, and outer, which can be selected according to each person's situation. No matter how the medication or formula changes, it does not fall within the scope of these four.