Insomnia is a common complaint. Physical causes f insomnia
are comparatively few. In most cases, insomnia is a psychophysiological disorder,
resulting mainly from the self-stimulation engendered y anxiety, worry, or depression.
Sleeping pills are routinely used for treating this disorder, but their continuous
use in chronic cases may cause adverse side or toxic effects. Herbal medicines
and acupuncture can be effectively used as alternative measures.
Etiology
and Pathogenesis
Insomnia is often caused by emotional or psychic disturbances.
Anxiety and anger make the Liver depressed, and the depressed Liver qi may be
transformed into fire, which interferes with the normal functions of the Heart.
Excessive anxiety may also impair the Heart (mind) and the Spleen, and insomnia
occurs due to inadequate supply of nutrients and blood to the Heart.
In the
aged and the patients suffering from chronic diseases, qi and blood are insufficient
to nourish the Heart, thus leading to palpitations and insomnia. Qi deficiency
may also involve the Heart and the Gallbladder, impairing one's sleep and making
one vulnerable to fright. Consumption of Kidney essence may break down the normal
balance between the Heart and the Kidneys, and incoordination between the Heart
and the Kidneys may also be manifested as insomnia.
Syndrome Differentiation
According
t the pathogenesis, insomnia can be classified into the following syndrome patterns:
1.
Depressed Liver with exuberant fire: Insomnia accompanied by irritability, irascibility,
thirst, yellow coating, and stringy, rapid pulse.
2. Incoordination of the
Heart and the Kidneys: Insomnia accompanied by dizziness, tinnitus, dryness in
the mouth, heat sensation in the palms and soles, palpitations, forgetfulness,
lumbar aching, reddened tongue, and thready, rapid pulse.
3. Deficiency f both
the Heart and the spleen: Dreamful sleep with early waking, palpitations, forgetfulness,
dizziness, lassitude, lack of strength, anorexia, pallid complexion, and thready,
weak pulse.
4. Deficiency of the Heart ad the Gallbladder: Dreamful sleep with
wakefulness, susceptibility to fright, and stringy, thready pulse.
Herbal Medication
1.
Depressed Liver with exuberant fire
Principle of treatment: To purge the Liver
of fire.
Formula of choice: Longdan Xiegan Tang (Decoction of Gentian to Purge
the Liver).
2. Incoordination of the Heart and the Kidneys
Principle of
treatment: To coordinate the Heart and the Kidneys.
Formula of choice: Liuwei
Dihuang Wan (Pill of Six Ingredients with Rehmannia) plus Rhizoma Coptidis (goldthread
rhizome) and Cortex Cinnamomi (cinnamon bark).
3. Deficiency of both the Heart
and the Spleen
Principle of treatment: to nourish the Heart and the Spleen.
Formula
of choice: Guipi Tang (Spleen-Invigorating Decoction).
4. Deficiency of the
Heart and the Gallbladder
Principle of treatment: To replenish qi and induce
tranquilization
Formula of choice: Anshen Wan (Tranquilizing Pill).
Patent
Medicines
1. Depresed Liver with exuberant fire: Longdan Xiegan Wan (Gentian
Pill to Purge the Liver).
2. Incoordination of the Heart and the Kidneys: Tianwang
Buxin Dan (Heavenly King's heart Tonic).
3. Deficiency of both the Heart and
the Spleen: Renshen Guipi Wan (Spleeninvigorating Pill with Ginseng).
4. Deficiency
of the Heart and the Gallbladder: Anshen Wan (Tranquilizing Pill).
Dr. Ming's
TCM Medical Center,
Hua Xi Xiao Yuan, Hutian Developing Area,
Huaihua city,
Hunan province
China