By: Steven Clavey

(Thanks Steve for this case and the one’s that follow. Please check out his journal, The Lantern)

Insomnia: Case number 12, by Xu Shu-Wei

A local notable named Chen, when he first became sick, had fever, floating pulse and spontaneous perspiration. The doctor used Ma Huang Tang to cause sweating, but the fever became severe, Chen could not get to sleep, his head was heavy, there were palpitations and he complained of a restless cooped-up feeling. The mistake was insisting on a strong diaphoretic formula when the condition was [not cold invasion but rather] a wind invasion — zhong feng. Zhong-Jing says:

Tai Yang illness: after using diaphoresis the sweat is heavy, there is parched dryness in the Stomach and insomnia. The patient desires to drink water — give him a little at a time: this will cause the Stomach qi to harmonise and he will be cured. [Clause 71]“

I first used Zhu Ling Tang (Polyporus Decoction) followed by herbs like Dang Gui (Angelica Polymorpha, Radix), Shou Di (Rehmanniae Glutinosae Conquitae, Radix), Mai Men Dong (Ophiopogonis Japonici, Tuber), Bai Shao (Paeoniae Lactiflora, Radix) and Wu Mei (Pruni Mume, Fructus) as a soup to sip.

The sweat stopped and he recovered.

Xu’s Discussion:
The Huang Di Zhen Jing (The Yellow Emperor’s Classic of Needling — ie the Ling Shu) says:

Protective wei qi travels the surface yang during the day, but at night it moves to the internal yin. If it cannot move into the yin internally it will wander ceaselessly outside. This external movement makes the yang full, and this fullness makes the Yang Qiao channel surfeited and unable to transfer into yin. Weakened yin means inability to get to sleep [because the quiet settling of yin is reduced] (Ling Shu Chapter 80).”

In this case the jin and ye fluids are exhausted internally [because of the over-sweating of the treatment], the fluids of the Stomach are parched dry [because the sweating drained the Earth flesh]; the malady concentrated in yang, with no refuge for yin — the symptoms are as we have seen.
Thus Dang Gui and Shou Di are used to tonify blood, while [the sourness of Bai Shao and] Wu Mei are used to contract yin. This stopped the sweating and the patient naturally recovered.