I Can Hear the Heart's Voice of Traditional Chinese Medicine

Chapter 102: Insomnia Syndrome (Part 2)


The normal activities of the human body involve the rising of yin and the descending of yang. If this regular pattern is disrupted, it is very difficult to correct.

Therefore, insomnia is a stubborn issue.

When treating it, this pathological phenomenon of yin-yang inversion should be reversed to restore the normal physiological state, which will improve sleep.

However, although insomnia has to do with the disconnection between the heart and the kidneys, it is also closely related to the liver, which stores blood.

The Inner Canon's chapter on the five organs states: "When people sleep, the blood returns to the liver," and Medical Introduction also mentions: "When people move, blood circulates through the meridians, and when still, blood returns to the liver."

Hence the saying, "If one cannot sleep at midnight, it is because the blood does not return to the liver," meaning that the inability to sleep at midnight is related to blood not returning to the liver.

The etiology and mechanism of insomnia are also related to yin-yang, qi-blood, nutrient-defense, and fluids.

Overall, the formation of insomnia is caused by an imbalance of yin and yang.

For example, excessive mental or physical labor, blood loss after childbirth, or blood loss due to other reasons, can all cause insomnia because they either injure the qi or blood.

The treatment should facilitate the interaction between the heart and kidneys and remove vexing heat.

Zhou Xinming seemed curious about his condition and asked, "Dr. Lu, what's going on with me? I can't sleep the whole night, night after night. In the short term, it's nothing, but over time, I feel like I'm about to die, wanting to sleep but unable to, and not sleeping makes me very tired."

After taking his pulse, Lu Xuan explained, "Traditional Chinese medicine believes that if the rules of yin and yang transformation are disrupted, it can lead to insomnia, which is what you refer to as neurasthenia.

Many causes can lead to insomnia, as the Complete Works of Jingyue states: 'Though the symptoms of insomnia vary, understanding the concepts of evil and righteousness can sum them up. Sleep depends on yin, and the spirit is its master. If the spirit is at peace, sleep ensues; if not, one cannot sleep. The disturbance can either come from evil qi or a deficiency in nutrient qi.'"

The heart governs the spirit, making it the primary site of insomnia.

Any factor that can affect the heart and mind can cause insomnia, such as a deficiency in nutrient qi causing the heart to lose its nourishment, or excessive heat disturbing the heart, or sudden shock unsettling the heart's spirit, which are common causes of insomnia.

The heart is also closely related to other organs like the liver, gallbladder, spleen, stomach, and kidneys. The occurrence of insomnia is also closely related to disorders in these organs.

Whether it is due to the heart losing nourishment, excessive heat disturbing the heart, or the heart's spirit being unsettled, most cases are due to imbalances of yin and yang and disharmony of qi and blood caused by other organ disorders."

Zhou Xinming only partially understood, but he grasped something when Lu Xuan mentioned qi and blood, so he asked, "Dr. Lu, is my condition serious?"

Seeing Zhou Xinming's worried expression, Lu Xuan chuckled and said, "It's not serious, but insomnia can easily recur, so you shouldn't overthink things. Go to sleep when it's time.

Of course, that's easier said than done, and changing a habit of worrying isn't something that can be done overnight."

Hearing this, Zhou Xinming looked as if he had found a confidant and said wistfully, "Isn't that true? I don't want to think about everything, but whenever I lie in bed, my mind goes out of control with all sorts of random thoughts. By the time I realize it, half an hour or even an hour has passed, making it even harder to sleep.

I honestly had no choice; someone recommended you online, so I registered with you, thinking Dr. Lu might have a way to let me get a good night's sleep."

Lu Xuan smiled and replied, "In that case, I'll prescribe you some medicine. Take it home and use it. When it's finished, you can come back for a follow-up. Your situation isn't too serious; after a few weeks, your insomnia should improve significantly."

"Thank you, Dr. Lu."

Lu Xuan smiled and wrote the prescription: 30 grams of roasted jujube seed, 30 grams of bland bamboo leaves, 9 grams of Fuling, 9 grams of Chuanxiong, 9 grams of Anemarrhena, and 4.5 grams of licorice.

After writing it down, he handed the medical records to Su Kenan for registration.

When Zhou Xinming scanned the payment receipt, seeing Lu Xuan and the others curious, Lu Xuan also smiled and explained, "Jujube Seed Soup with bamboo leaves. The sour-bitter Jujube Seed in the formula is the main ingredient, to drain the pent-up heat from the heart and brain.

Anemarrhena is used to cool, licorice to harmonize; Chuanxiong's pungency ascends, Fuling's bland nature drains downwards. Together, they coordinate the ascending and descending functions. Adding a dose of bland bamboo leaves, known for its great cold to remove heat, clears the mind, calms the spleen, treats upper burner heat, and remarkably complements the Jujube Seed to achieve mutually reinforcing effects on insomnia."

Even though Zhou Xinming didn't understand much, hearing Lu Xuan's explanation made him feel confident in Dr. Lu's abilities, and he repeatedly thanked him before getting up and leaving the consultation room.

Zhou Xinming had just left the consultation room when a female patient with a cane walked in.

Wang Suyan sat down in front of Lu Xuan and, after introducing herself, began to talk about her condition.

It turned out Wang Suyan had been suffering from heart disease for twenty years, always having symptoms of heart palpitations, shortness of breath, and long-term insomnia.

Recently, she's experienced head heaviness, undefined headaches, ear heat swelling, facial numbness, stabbing chest pain, perceived muscle twitching, excessive sweating, knee pain and cold sensation, spine tingling, occasional spasms throughout the body, numb limbs, occasional mobility issues, and needing a cane when going out.

An X-ray showed an enlarged heart, and Western medicine diagnosed it as rheumatic heart disease.

While taking her pulse, Lu Xuan asked, "Does your mouth taste bitter?"

"Bitter, and..."

Wang Suyan thought for a moment and said, "Especially when I get angry, the bitterness is overwhelming. Also, my urine is quite yellow."

"Your tongue."

Wang Suyan stuck out her tongue for Lu Xuan to see.

The right-hand pulse is tense, the left is submerged and weak, particularly weak at the left cubit, with a pale tongue and glossy edges.

Lu Xuan frowned slightly.

From head to torso, to limbs throughout her whole body, from internal organs to skin, from inside to outside, Wang Suyan was almost covered in symptoms of all sizes.

Wang Suyan had seen many doctors over the years and been to the hospital countless times, where she became accustomed to doctors frowning. Seeing this, she sighed: "Dr. Lu, is my heart disease very serious?

Actually, I've been to the hospital many times, and I've taken various medications that ease the discomfort a little, but once I stop, the symptoms return immediately. Surgical treatment is not guaranteed to work, and many medications for rheumatic heart disease have significant side effects, so I'm wary of taking them often.

My mother heard about you from somewhere and suggested I come and try. Since the hospital couldn't do much, I decided to treat a dead horse as if it were alive and give it a try.

But now seeing Dr. Lu frowning too, I suppose my condition must be very serious."

Hearing this, Lu Xuan reassured her, "I'll be honest with you – your condition and symptoms are indeed widespread, internal and external, but severe doesn't mean untreatable. Taking Chinese medicine can still help to adjust, but before taking it, I also can't guarantee it will definitely work."

Wang Suyan, having lost hope, was overjoyed to hear that Chinese medicine could help: "Dr. Lu, are you serious?"

"As a doctor, I don't see the need to deceive you about these things; if it really can't be cured, wouldn't it ruin my reputation?" Lu Xuan said seriously.

"Then, Dr. Lu, what's the situation with my disease? What medicine should I take?" Wang Suyan asked curiously.

Although Ji Xiuwen had not taken Wang Suyan's pulse, he was curious about her description and instinctively looked at Lu Xuan.

Lu Xuan hadn't intended to say much, but seeing both Wang Suyan and Ji Xiuwen curious, he thought for a moment and said, "The treatment of rheumatic heart disease should focus on major aspects, adjusting nutrient-defense qi and blood.

Chai Gui plus Dragon Bone and Oyster Soup raises the qi mechanism, harmonizes nutrient-defense qi and blood, stops sweating, and can alleviate heart palpitations, shortness of breath, numbness, muscle twitching, and joint pain. It also has a calming effect to aid sleep.

Chest and back pain are major indications for Mongolian Snakegourd Fruit and Pinellia Soup, while Acorus, Polygala, and Fuling open the heart orifices and enhance cardiac activity."

"Try taking this medicine for a week to see if there is any improvement."

Lu Xuan then looked at Ji Xiuwen and said, "Add Ms. Wang to the group."

"I'm also in the group, so if you have any questions, you can consult there. I'll reply when I see them."

"Okay, okay, I'll join the group right away."

Hearing about a patient group, Wang Suyan's eyes lit up. Living far away, it took about forty minutes to drive over here. Joining the group would make it easier to consult if anything came up.

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