经曰∶阳明，胃脉也。胃者，六腑之海，其气亦下行，阳明逆，不得从其道，故不得卧也。
又曰∶胃不和则卧不安。夫人身之卫气，昼则行于阳，夜则行于阴。阳主动，阴主静，寤则
魂魄志意散于腑脏，发于耳目，动于肢体而为人身指使之用；寐则神气各归五官，而为默运
之妙矣。若脾胃气盛，则脏腑调和，水谷之精，各各融化，以为平和之气。若胃气一逆，则
气血不得其宜，脏腑不得其所，不寐之症，由此生焉，当用四君、远志、酸枣仁。肝肾虚热
者，六味丸。心血不足者，真珠母丸。思虑过度者，归脾汤。精神短乏者，人参养荣汤。病
后余热者，酸枣仁汤。胆虚不得眠者，人参竹叶汤。肝火不宁者，加味小柴胡汤。振悸不得眠
者，四君、生姜、酸枣仁。夜啼惊哭不寐，各详别症，当参求之。
治验
一小儿患疮溃后，饮食少思，倦怠不寐，先用四君、茯神、当归、陈皮，饮食顿加，乃佐以
八珍散为末，时服钱许，渐得寐。又因惊汗出，发热不寐，用异功散加柴胡、山栀，汗热顿
止；仍服四君、八珍之药得寐。后又饮食停滞，腹痛吐痰，不寐汗出，用六君、柴胡、升麻
、山楂而安。
一小儿十四岁，勤于功课，彻夜不寐，饮食无味，早间用补中益气汤，午后用异功散，饮食
渐有味，夜稍得寐，仍用补中益气汤、八味汤而愈。毕姻后不寐，兼遗精盗汗，用补中益气汤、
六味地黄丸而愈。
一小儿痢后，不食少寐，或兼盗汗，先用异功散加升麻、当归，饮食渐进，佐以补中益气汤
，稍得寐。四年后，因用心记诵，患自汗不寐，饮食甚少，用补中益气汤、加味异功散而愈
。
一女子十七岁，丧母过哀不寐，发热或寒热，此脾血虚而火动也，用加味逍遥散、加味归脾
汤治之寻愈。后因饮食怒气，不寐腹痛，先用六君、柴胡、升麻而痛止，仍用前二药而得寐
。
仲景酸枣汤 治虚劳虚烦不得眠。
酸枣仁（炒，一钱） 甘草 知母（炒） 茯苓 芎 生姜（各五分）
上水煎服。
本事鳖甲丸 治胆虚不得眠，四肢无力。
鳖甲 酸枣仁（炒） 羌活 黄 （炒） 牛膝（酒炒） 人参（各一两） 五味子
上为末，炼蜜丸梧子大。每服三四十丸，温酒下。
《圣惠》治骨蒸劳热，烦心不得眠，用酸枣仁三钱，水煎熟，下地黄汁一蛤蜊，食之。
本事真珠母丸 治肝胆二经，因虚内受风邪，卧则魂散而不守，状若惊悸。
真珠（三分，另研细） 当归 熟地黄（各一两半） 人参 酸枣仁（炒） 柏子仁（各一两） 犀角 茯神
沉香 龙齿（各半两）
上为末，炼蜜丸小豆大，辰砂为衣。每服二十丸，白汤下，日午夜卧各一服。
人参竹叶汤 治虚烦不得寐。
人参 竹叶 甘草（各二钱） 半夏 小麦 麦门冬（各一钱半）
上每服二三钱，姜二片，粳米一撮，水煎服。
四君子汤
六君子汤
加味归脾汤
加味逍遥散
五味异功散（五方见内钓）
补中益气汤（方见虚羸）
人参养荣汤（方见自汗）
加味小柴胡汤（方见痉症）
八珍散（十全大补去黄 、肉桂）
六味地黄丸（方见肾脏）
《黄帝内经》说：阳明经，是胃的经脉。胃，是六腑的大海，其气机也是向下运行的。如果阳明经的气机逆乱，不能顺着正常的通道运行，就会导致无法入睡。
又说：胃气不和，就会睡眠不安。人体内的卫气，白天运行于阳分（体表及六腑），夜晚运行于阴分（体内及五脏）。阳主动，阴主静。清醒时，人的魂魄、志意散布在脏腑，表现于耳目，活动于肢体，从而发挥指挥人体的作用；睡眠时，神气各自回归五官，产生默默运转的奇妙功效。如果脾胃之气旺盛，则脏腑调和，水谷的精微物质能够充分消化转化，形成平和之气。如果胃气一旦上逆，则气血失调，脏腑功能紊乱，不寐（失眠）的症状便由此产生，此时应当使用四君子汤（补气基础方）、远志、酸枣仁。如果是肝肾虚热者，使用六味地黄丸。心血不足者，使用真珠母丸。思虑过度者，使用归脾汤。精神短少匮乏者，使用人参养荣汤。病后有余热者，使用酸枣仁汤。胆气虚弱导致不得眠者，使用人参竹叶汤。肝火旺盛导致心神不宁者，使用加味小柴胡汤。出现震颤心悸导致不得眠者，使用四君子汤、生姜、酸枣仁。小儿夜啼、惊哭、不寐，需根据其他具体症状详细辨别，应当参考求治。
治疗案例：
有一个小孩患疮疡溃烂后，饮食减少且缺乏食欲，倦怠乏力且无法入睡。先用四君子汤、茯神、当归、陈皮，饮食立刻增加，随后配合服用八珍散制成的粉末，每次服用一钱左右，逐渐能够入睡。后来又因受惊吓而出汗，发热且无法入睡，使用异功散加柴胡、山栀，汗出和发热立即停止；继续服用四君子汤、八珍散的药物而得以入睡。之后又因饮食停滞，腹痛吐痰，不寐且出汗，使用六君子汤、柴胡、升麻、山楂而痊愈。
有一个十四岁的小孩，勤于功课，彻夜无法入睡，饮食无味。早上服用补中益气汤，午后服用异功散，饮食逐渐有了味道，夜间稍能入睡，仍然服用补中益气汤、八味地黄丸而痊愈。结婚后出现不寐，兼有遗精和盗汗，使用补中益气汤、六味地黄丸而痊愈。
有一个小孩患痢疾后，不吃东西且睡眠少，有时兼有盗汗。先用异功散加升麻、当归，饮食逐渐进步，配合服用补中益气汤，稍能入睡。四年后，因为用心记诵书籍，患上自汗且不寐，饮食很少，使用补中益气汤、加味异功散而痊愈。
有一个十七岁的女子，因丧母过于悲伤而导致不寐，发热或寒热往来，这是脾血虚而虚火内动所致，使用加味逍遥散、加味归脾汤治疗，不久痊愈。后来因为饮食不当和生气，出现不寐和腹痛，先用六君子汤、柴胡、升麻使疼痛停止，仍用前两种药物而得以入睡。
仲景酸枣仁汤：治疗虚劳导致的虚烦不得眠。
酸枣仁（炒，一钱） 甘草 知母（炒） 茯苓 川芎 生姜（各五分）
以上药材用水煎服。
《本事方》鳖甲丸：治疗胆虚导致不得眠，四肢无力。
鳖甲 酸枣仁（炒） 羌活 黄芪（炒） 牛膝（酒炒） 人参（各一两） 五味子
以上制成粉末，用炼蜜做成梧桐子大小的丸药。每次服用三四十丸，温酒送下。
《圣惠方》治疗骨蒸劳热，心烦不得眠，用酸枣仁三钱，水煎熟，加入地黄汁一蛤蜊的量，食用。
《本事方》真珠母丸：治疗肝胆二经因虚内受风邪，睡觉时魂散而不守舍，症状如同惊悸。
真珠（三分，另研细） 当归 熟地黄（各一两半） 人参 酸枣仁（炒） 柏子仁（各一两） 犀角 茯神 沉香 龙齿（各半两）
以上制成粉末，用炼蜜做成小豆大小的丸药，以辰砂为衣。每次服用二十丸，白开水送下，半夜和睡前各服一次。
人参竹叶汤：治疗虚烦不得寐。
人参 竹叶 甘草（各二钱） 半夏 小麦 麦门冬（各一钱半）
以上每次取二三钱，加姜两片，粳米一撮，水煎服。
四君子汤
六君子汤
加味归脾汤
加味逍遥散
五味异功散（五方见内钓）
补中益气汤（方见虚羸）
人参养荣汤（方见自汗）
加味小柴胡汤（方见痉症）
八珍散（十全大补汤去掉黄芪、肉桂）
六味地黄丸（方见肾脏）
As stated in the *Huangdi Neijing* (Yellow Emperor's Inner Canon): The Yangming channel is the stomach meridian. The stomach is the sea of the six fu organs, and its qi also descends. If the qi of Yangming rebels and cannot follow its proper pathway, one will be unable to sleep.
It is also said: "When the stomach is not harmonious, sleep is uneasy." In the human body, the Wei Qi (Defensive Qi) travels through the Yang aspects during the day and through the Yin aspects at night. Yang governs movement, while Yin governs stillness. When awake, the Hun (Ethereal Soul), Po (Corporeal Soul), Zhi (Will), and Yi (Intellect) are dispersed among the zang-fu organs, manifesting in the eyes and ears, and moving within the limbs, thereby serving as the commander of the body. When asleep, the Shen (Spirit) returns to the five orifices, producing the subtle miracle of silent operation. If the Qi of the Spleen and Stomach is vigorous, the zang-fu organs are harmonized, and the essence from food and drink is thoroughly transformed into peaceful Qi. However, if the Stomach Qi rebels even slightly, the Qi and Blood become disordered, and the zang-fu organs lose their proper residence, giving rise to symptoms of insomnia (Bu Mei). In such cases, Si Jun Zi Tang (Four Gentlemen Decoction), Yuan Zhi (Polygala Root), and Suan Zao Ren (Ziziphus Seed) should be used. For cases of deficiency-heat in the Liver and Kidney, Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) is indicated. For cases of insufficient Heart Blood, Zhen Zhu Mu Wan (Pearl Shell Pill) is indicated. For cases of excessive mental worry, Gui Pi Tang (Restore the Spleen Decoction) is indicated. For cases of deficient spirit and energy, Ren Shen Yang Rong Tang (Ginseng Nourishing the Nutritive Qi Decoction) is indicated. For residual heat after illness, Suan Zao Ren Tang (Ziziphus Decoction) is indicated. For inability to sleep due to Gallbladder deficiency, Ren Shen Zhu Ye Tang (Ginseng and Bamboo Leaf Decoction) is indicated. For restlessness due to Liver Fire, Jia Wei Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction) is indicated. For tremors, palpitations, and inability to sleep, Si Jun Zi Tang, Sheng Jiang (Fresh Ginger), and Suan Zao Ren are used. For infantile nocturnal crying, fright, and insomnia, each specific symptom must be examined in detail for appropriate treatment.
Clinical Cases:
A child suffered from ulcerated sores, leading to poor appetite, fatigue, and insomnia. Initially, Si Jun Zi Tang, Fu Shen (Poria with Hostwood), Dang Gui (Angelica Sinensis), and Chen Pi (Tangerine Peel) were administered. Appetite immediately improved. Subsequently, Ba Zhen San (Eight Treasure Powder) was taken in powder form, about one qian per dose, gradually allowing the child to sleep. Later, due to fright causing sweating, fever, and insomnia, Yi Gong San (Yi Gong Powder) was modified with Chai Hu (Bupleurum) and Shan Zhi (Gardenia Fruit). The sweating and fever ceased immediately; continuing with Si Jun Zi Tang and Ba Zhen San allowed the child to sleep. Later, due to food stagnation causing abdominal pain, phlegm vomiting, insomnia, and sweating, Liu Jun Zi Tang (Six Gentlemen Decoction) was modified with Chai Hu, Sheng Ma (Cimicifuga Rhizome), and Shan Zha (Hawthorn Fruit), resulting in recovery.
A fourteen-year-old child, diligent in studies, suffered from all-night insomnia and loss of taste in food. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was administered in the morning, and Yi Gong San in the afternoon. Food gradually regained flavor, and slight sleep occurred at night. Continued use of Bu Zhong Yi Qi Tang and Ba Wei Di Huang Wan (Eight-Ingredient Pill of Rehmannia) led to recovery. After marriage, insomnia accompanied by seminal emission and night sweats occurred. Treatment with Bu Zhong Yi Qi Tang and Liu Wei Di Huang Wan resulted in recovery.
A child suffering from dysentery had no appetite and little sleep, sometimes accompanied by night sweats. Yi Gong San modified with Sheng Ma and Dang Gui was used first, gradually improving diet. This was supplemented with Bu Zhong Yi Qi Tang, allowing slight sleep. Four years later, due to intense mental effort in memorization, spontaneous sweating and insomnia developed with very little food intake. Treatment with Bu Zhong Yi Qi Tang and Jia Wei Yi Gong San (Modified Yi Gong Powder) led to recovery.
A seventeen-year-old girl suffered from insomnia due to excessive grief over her mother's death, with fever or alternating chills and fever. This was diagnosed as Spleen Blood deficiency with stirring fire. Treatment with Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) and Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction) led to quick recovery. Later, due to improper diet and anger, insomnia and abdominal pain occurred. Liu Jun Zi Tang modified with Chai Hu and Sheng Ma stopped the pain first, followed by the previous two formulas to restore sleep.
Zhongjing's Suan Zao Ren Tang: Treats deficiency labor with vexation and inability to sleep.
Suan Zao Ren (Stir-fried, 1 qian), Gan Cao (Licorice Root), Zhi Mu (Stir-fried), Fu Ling (Poria), Xiong (Ligusticum Chuanxiong Rhizome), Sheng Jiang (Fresh Ginger) (each 0.5 qian).
Decoct in water and take orally.
Ben Shi Fang's Bie Jia Wan (Turtle Shell Pill): Treats Gallbladder deficiency causing insomnia and weakness in the four limbs.
Bie Jia (Turtle Shell), Suan Zao Ren (Stir-fried), Qiang Huo (Notopterygium Rhizome), Huang Qi (Stir-fried), Niu Xi (Achyranthes Root, wine-fried), Ren Shen (Ginseng Root) (each 1 liang), Wu Wei Zi (Schisandra Berry).
Grind into powder, make pills with refined honey the size of wutong seeds. Take 30–40 pills per dose, washed down with warm wine.
Sheng Hui Fang: Treats bone-steaming consumption fever, vexation, and inability to sleep. Use 3 qian of Suan Zao Ren, decoct in water until cooked, add one clam-shell amount of Di Huang Juice (Rehmannia Juice), and consume.
Ben Shi Fang's Zhen Zhu Mu Wan (Pearl Shell Pill): Treats Wind-Evil invading internally due to deficiency in the Liver and Gallbladder channels, where the Hun scatters during sleep and fails to reside, resembling palpitations.
Zhen Zhu (Pearl, 3 fen, ground separately into fine powder), Dang Gui (Angelica Sinensis Root), Shu Di Huang (Prepared Rehmannia Root) (each 1.5 liang), Ren Shen, Suan Zao Ren (Stir-fried), Bai Zi Ren (Biota Seed) (each 1 liang), Xi Jiao (Rhinoceros Horn), Fu Shen, Chen Xiang (Aquilaria Wood), Long Chi (Dragon Teeth/Fossilized Bones) (each 0.5 liang).
Grind into powder, make pills with refined honey the size of adzuki beans, coated with Chen Sha (Cinnabar). Take 20 pills per dose, washed down with plain boiled water, once at midnight and once before bed.
Ren Shen Zhu Ye Tang: Treats deficiency vexation and inability to sleep.
Ren Shen, Zhu Ye (Bamboo Leaf), Gan Cao (each 2 qian), Ban Xia (Pinellia Tuber), Xiao Mai (Wheat), Mai Men Dong (Ophiopogon Tuber) (each 1.5 qian).
Take 2–3 qian per dose, add 2 slices of ginger and a pinch of Jing Mi (Rice Grain), decoct in water, and take orally.
Si Jun Zi Tang (Four Gentlemen Decoction)
Liu Jun Zi Tang (Six Gentlemen Decoction)
Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction)
Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder)
Wu Wei Yi Gong San (Five-Ingredient Yi Gong Powder) (See Nei Diao for formulas)
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) (See Xu Lei for formula)
Ren Shen Yang Rong Tang (Ginseng Nourishing the Nutritive Qi Decoction) (See Zi Han for formula)
Jia Wei Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction) (See Jing Zheng for formula)
Ba Zhen San (Eight Treasure Powder) (Shi Quan Da Bu Decoction minus Huang Qi and Rou Gui)
Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) (See Shen Zang for formula)