Insomnia - Bu Mei

[Guest guest]

Taken from the group's files section:

 

9. BU MEI (Insomnia)

 

9.1. DEFINITION AND ORTHODOX EQUIVENLANTS

 

A condition of being unable to get normal sleep: difficult to get

into sleep, wake up in the middle of sleep and unable to get back to

sleep, wake up too early, wake up frequently, unable to sleep at all.

 

Neurosis and diseases with insomnia as the main symptom (such as

hypertension, dyspeptic insomnia and anaemic insomnia.

 

9.2. CAUSES AND PATHOLOGICAL MECHANISMS

 

· Anxiety and pensiveness and overwork cause heart and spleen

impairment: yin blood consumption and shortage of nutrient – heart

shen disturbance and irritability

· Coordination failure between yin and yang: deficient kidney

yin (long term illness and weak constitution etc) can not nourish

heart yang resulting in heart yang exuberance (discordance between

water and fire); or extreme emotion transforms into fire. Heart fire

flares and fail to coordinate with kidney water (discordance between

water and fire); heart fire disturb shen resulting in insomnia.

· Yin deficiency fire leads to liver yang disturbance:

emotional disorder causing liver qi stagnation and transformation

into fire; or yin deficient and yang exuberant. Fire disturbs heart

shen resulting in insomnia

· Heart and gallbladder qi deficiency: indecision and

susceptibility to fright leads to unstable heart shen

· Stomach qi disorder: improper diet and undigested food lead

to heat and phlegm formation which disturb heart shen

 

9.3. BIAN ZHENG LUN ZHI

 

Notes:

a. Insomnia is a condition marked by sleeping difficulties

b. Distinguish deficiency and excess syndromes

 

Deficiency: yin and blood deficiency in heart, spleen, liver and

kidney

Excess: liver fire dyspepsia (indigestion), phlegm and stomach

disorders

 

 

 

9.3.1. Excess Syndromes

 

Table 9.1. Bian Zheng Lun Zhi of Bu Mei - Excess Syndromes

 

Liver fire Phlegm and heat

Symptoms Insomnia, quick temper, irritable, loss of appetite,

thirst for drink, red eyes and bitter mouth, dark urine,

constipation, red tongue with yellow coating, wiry and rapid pulse

Insomnia, heavy feeling in head, stuffy chest with excessive

phlegm, aversion to food, eructation, acid regurgitation, nausea,

vexation and bitter mouth, blurred vision, yellow and greasy tongue

coating, slippery and rapid pulse

Main points for Bian Zheng Insomnia, quick temper, irritable,

red eyes and bitter mouth, wiry and rapid pulse Insomnia, excessive

phlegm, stuffy chest, aversion to food, acid regurgitation, yellow

and greasy tongue coating, slippery and rapid pulse

Orthodox equivalents Neurasthenic insomnia Dyspeptic insomnia

Pathological mechanisms Anger causes liver qi stagnation which

transforms into fire and disturbs heart shen Dyspepsia causes

accumulation of dampness and formation of phlegm. Phlegm generates

heat and disturbs heart shen

Principle of treatment Relieve liver stagnation and clear fire with

assistance to tranquillise shen Resolve phlegm and clear heat,

regulate stomach and pacify shen

Formula Long Dan Xie Gan Tang Wen Dan Tang (Er Chen Tang + zhu ru,

zhi shi)

Modifications 1. add fu shen, long gu, mu li2. chest and

hypochondriac distension and frequent sighing + yu jin, xiang fu

1. add huang lian, zhi zi to clear heart fire2.

palpitation + zhen zhu mu3. constipation, use Gun Tang

Wan (meng shi, chen xiang, da huang, huang qin)

 

 

 

9.3.2. Deficiency Syndromes

 

Table 9.1. Bian Zheng Lun Zhi of Bu Mei - Deficiency Syndromes

 

Yin deficiency fire Heart and spleen deficiency Heart

and gallbladder qi deficiency

Symptoms Insomnia and vexation, palpitation, dizziness,

tinnitus, amnesia, lower back and knee aches, oneirogmus (wet

dreams), hot feeling at 5 centres, dry mouth, red tongue with little

coating, thready and rapid pulse Insomnia with excessive

dreams and waken up easily, palpitation, amnesia, dizziness,

tiredness and listlessness, poor appetite, dull complexion, pale

tongue with thin coating, weak and thready pulse Insomnia or

excessive dreams, susceptible to fright and waken up easily, timid,

panic easily, palpitation, short of breath, tiredness, clear and

excessive urination, pale tongue, wiry and thready pulse

Main points for Bian Zheng Insomnia and vexation, lower back and

knee aches, oneirogmus, hot feeling at 5 centres, dry mouth, red

tongue with little coating Insomnia with excessive dreams and

waken up easily, palpitation, amnesia, tiredness, poor appetite, pale

tongue, weak pulse Insomnia or excessive dreams, susceptible to

fright and waken up easily, timid, palpitation, panic easily

Orthodox equivalents Hypertensive insomnia Anaemic insomnia

Neurasthenic insomnia

Pathological mechanisms Deficient kidney yin fails to coordinate with

heart and liver. Liver and heart deficiency fire disturbs shen Heart

and spleen deficiency, blood fails to nourish heart and heart fails

to store shen Heart qi deficiency causes unstable shen and

gallbladder qi deficiency causes susceptibility to fright and panic

Principle of treatment Nourish yin to reduce fire; nourish heart to

pacify shen Tonify heart and spleen to generate qi and blood

Improve qi to conquer fright and pacify shen

Formula Huang Lian E Jiao Tang (huang lian, e jiao, huang qi, bai

shao, ji zi huang) Gui Pi Tang An Shen Ding Zhi Wan

Modifications Flushed face with sever dizziness and tinnitus + ci

shi, mu li 1. severe blood deficiency + shu di huang, bai

shao, e jiao2. severe insomnia + wu wei zi, bai zi ren, he huan hua,

ye jiao teng, long gu, mu li3. slippery and greasy tongue with poor

appetite and stuffy epigastrium + ban xia, chen pi, hou po Blood

deficiency leading to yang floating with vexation, use Suan Zao Ren

Tang

 

 

8.4. DISCUSSIONS

 

a. Compare Xin Ji (palpitation) syndromes and Bu Mei (insomnia)

syndromes from the standpoint of the Bian Zheng Lun Zhi.

b. Explain the importance of shen in Xin Ji and Bu Mei from the

point of view of TCM the pathological mechanisms.

 

 

 

 

APPENDIX 1: DUO MEI (Lethargy or Sleepiness)

 

1. Definition: feeling sleepy all the time day and night. Can be

waken up but back to sleep again soon after. Sleepiness in the course

of febrile diseases and other chronic disease is not included in this

discussion.

2. Main causes: dampness, spleen qi deficiency and spleen yang

deficiency

3. General pathological mechanism: yin exuberance with yang

deficiency.

4. Bian Zheng Lun Zhi

 

a. Damp and phlegm prevalence

 

· Pathological mechanism: Dampness and phlegm accumulation and

spleen yang suppression. Shen is suppressed.

· Symptoms: Happens in damp, wet and rainy seasons or

overweight individuals. Sleepiness with heavy feeling in the body,

stuffy chest, poor appetite, white and greasy tongue coating, soggy

pulse

· Principle of treatment: dry dampness and invigorate spleen

· Formula and modifications: Ping Wei San + huo xiang, pei lan

yi yi ren, ban xia, dan nan xing

 

b. Spleen deficiency

 

· Pathological mechanism: middle qi deficiency and spleen

weakness cause weak and delayed transport functions, qi unable to

maintain shen

· Symptoms: sleepiness and tiredness after eating, normal

tongue and pulse

· Principle of treatment: supplement middle qi and strengthen

spleen

· Formula and modifications: Liu Jun Zi Tang + mai ya, shan

zha, shen qu

 

c. Yang deficiency

 

· Pathological mechanism: deficient middle yang unable to

maintain shen

· Symptoms: happens after major illness or in old age,

sleepiness with poor appetite, aversion to cold with cold limbs,

spontaneous sweating, lack of vitality, indolence of speech, weak

pulse

· Principle of treatment: warm yang and tonify qi

· Formula and modifications: middle yang deficiency, use Li

Zhong Tang; middle qi collapsing, use Bu Zhong Yi Qi Tang

 

5. Discussions

 

a. Describe the TCM treatments for Duo Mei.

 

APPENDIX 2 JIAN WANG (Amnesia)

 

1. Definition: memory loss or failure in remembering and

memorising due to brain power declination

2. Main causes and pathological mechanism: heart and spleen

weakness and deficient kidney essence. Anxiety, worry and pensiveness

impair heart and spleen and cause blood deficiency. Sexual

hyperactivity causes losses of kidney essence and failures in

nourishing the brain.

3. Bian Zheng Lun Zhi

 

a. Spleen impairment by anxiety and worry

 

· Symptoms: amnesia, insomnia, palpitation, poor appetite, lack

of vitality

· Principle of treatment: tonify and nourish heart and spleen

· Formula and modifications: Gui Pi Tang

 

b. Kidney essence consumption

 

· Symptoms: amnesia, lower back aches and weakness,

spermatorrhoea and immature ejaculation, red tongue and thready and

rapid pulse (yin deficiency) or pale tongue and deep and thready

pulse (yin and yang deficiency)

· Principle of treatment: tonify kidney yin and yang and

replenish essence

· Formula and modifications: yin deficiency, use Liu Wei Di

Huang Wan + suan zao ren, wu wei zi, yuan zhi, shi chang pu; yin and

yang deficiency; use Liu Wei Di Huang Wan + rou cong rong, ba ji

tian, lu jiao jiao, zi he che

 

4. Discussions

 

a. Describe the causes, pathological mechanisms and TCM treatments

for Jian Wang.

 

Attilio

[Guest guest]

These are excellent notes Atttilio. I don't suppose you have a list of

translations for the list of notes in the files?

 

Jackie

[Guest guest]

No i don't, but i suppose i can make one and post it in the files

section.

 

Attilio

 

Chinese Medicine , " jackie "

<Jackie@N...> wrote:

> These are excellent notes Atttilio. I don't suppose you have a list

of

> translations for the list of notes in the files?

>

> Jackie

[Guest guest]

No i don't, but i suppose i can make one and post it in the files

section.

 

 

That would be wonderful for those not yet familiar with the Chinese names -

I didn't really know where to start, and they look very informative.

 

Jackie