Insomnia - fire syndrome caused by liver stagnation
Sleep pattern: difficulty falling asleep, frequent nightmares, even unable to fall asleep all the night.
Accompanying signs: irritability, bloodshot eyes, distending feeling on head, dizziness, ear ringing, bitter taste in the mouth, thirst, poor appetite, yellowish urine and constipation; the tongue is red and covered by yellow fur, the pulse is taut and rapid.
Pathogenesis: this type of insomnia usually occurs after emotional outbreaks such as depression or anger, and is also common in menopausal women. Emotional distress leads to qi stagnation of the liver, which makes the body generates fire and then travels upwards to the head region. The fire belongs to a yang pathogen, it disturbs yang to move inward (yin) at night, and thus hinders the sleep process. Moreover, eventhough individuals are asleep, the fire pathogen keeps irritating the spirit, resulting in frequent dreaming. Irritability, bloodshot eyes and a bitter taste in the mouth are all due to liver fire. A hyperactive liver can suppress the stomach leading to a lack of appetite, and if the fire also irritates the stomach, then thirst will develop. Other signs like yellowish urine, constipation, red tongue with yellow fur, the taut and rapid pulse are indications of excess fire.
Therapeutic aims: soothe liver, purge fire, calm heart and spirit
Sample prescription: Modified Gentain Root Liver Purging Decoction (long dan xie gan tang)
In the prescription, the gentian root, skullcap root and gardenia fruit soothe the liver and purge the fire; water-plantain rhizome, akebia stem and plantain seed induce urination and clear heat; the bupleurum root soothes the liver and facilitates gallbladder functioning; the angelica root and rhemannia root enrich blood and nourish yin; the poria and fossil bone suppress the over-active spirit and calm the heart; while the liquorice root harmonizes the middle burner and acts as buffer.
In cases if the individuals experienced sighing, chest tightness, and ribside discomfort, then add the following herbs to enhance the regulating function of the liver.
In cases if the individuals experienced poor appetite, belching and hiccups, then add the following herbs to promote the harmony between the liver and stomach.
Accompanying signs: irritability, bloodshot eyes, distending feeling on head, dizziness, ear ringing, bitter taste in the mouth, thirst, poor appetite, yellowish urine and constipation; the tongue is red and covered by yellow fur, the pulse is taut and rapid.
Pathogenesis: this type of insomnia usually occurs after emotional outbreaks such as depression or anger, and is also common in menopausal women. Emotional distress leads to qi stagnation of the liver, which makes the body generates fire and then travels upwards to the head region. The fire belongs to a yang pathogen, it disturbs yang to move inward (yin) at night, and thus hinders the sleep process. Moreover, eventhough individuals are asleep, the fire pathogen keeps irritating the spirit, resulting in frequent dreaming. Irritability, bloodshot eyes and a bitter taste in the mouth are all due to liver fire. A hyperactive liver can suppress the stomach leading to a lack of appetite, and if the fire also irritates the stomach, then thirst will develop. Other signs like yellowish urine, constipation, red tongue with yellow fur, the taut and rapid pulse are indications of excess fire.
Therapeutic aims: soothe liver, purge fire, calm heart and spirit
Sample prescription: Modified Gentain Root Liver Purging Decoction (long dan xie gan tang)
| long dan cao | Chinese gentian root | Radix Gentianae |
| chai hu | bupleurum root | Radix Bupleuri |
| huang qin | baical skullcap root | Radix Scutellariae |
| zhi zi | gardenia fruit | Fructus Gardeniae |
| ze xie | oriental water-plantain rhizome | Rhizoma Alismatis |
| che qian zi | plantain seed | Semen Plantaginis |
| mu tong | akebia stem | Caulis Akebiae |
| dang gui | angelica root | Radix Angelicae Sinensis |
| sheng di | rhemannia root | Radix Rehmanniae |
| fu shen | poria with pine | Poria with pini |
| long gu | fossil bone | Os Draconis |
| gan cao | liquorice root | Radix Glycyrrhizae |
In the prescription, the gentian root, skullcap root and gardenia fruit soothe the liver and purge the fire; water-plantain rhizome, akebia stem and plantain seed induce urination and clear heat; the bupleurum root soothes the liver and facilitates gallbladder functioning; the angelica root and rhemannia root enrich blood and nourish yin; the poria and fossil bone suppress the over-active spirit and calm the heart; while the liquorice root harmonizes the middle burner and acts as buffer.
In cases if the individuals experienced sighing, chest tightness, and ribside discomfort, then add the following herbs to enhance the regulating function of the liver.
| yu jin | turmeric root-tuber | Radix Curcumae |
| xiang fu | nutgrass rhizome | Rhizoma Cyperi |
| bai shao | white peony root | Radix Paeoniae Alba |
In cases if the individuals experienced poor appetite, belching and hiccups, then add the following herbs to promote the harmony between the liver and stomach.
| fo shou | finger citron fruit | Fructus Citri Sarcodactylis |
| xiang yuan | medical citron fruit | Fructus Citri |
| zhi ke | submature bitter orange | Fructus Citri Aurantii |
| Insomnia | Fire syndrome caused by liver stagnation Phlegm-heat harassment Fire syndrome caused by yin deficiency Deficiencies of heart and spleen Qi deficiency of heart and gallbladder |
