Fire syndrome caused by liver stagnation | Phlegm-heat harassment | Fire Syndrome caused by yin deficiency | Deficiencies of the heart and spleen | Deficiencies of the heart and gallbladder

Sleep pattern: difficulty falling asleep, nightmares, or unable to go to sleep at all.

Accompanying signs: irritability, bloodshot eyes, headache, 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.

Analysis: this type of insomnia usually occurs after emotional outbreaks such as depression or anger, and is also common in menopausal women. Stagnation of the liver creates fire and invades upwards to the head region. The fire belongs to a yang pathogen which disturbs the body's qi so that it cannot move inward, thus hindering the sleep process. Moreover, even when individuals are asleep the pathogens keep irritating the shen (spirit), resulting in frequent and confused dreaming. When the liver fire is too strong, there will be irritability, bloodshot eyes and a bitter taste in the mouth. The excess of liver can suppress the stomach leading to a lack of appetite, and if the fire also irritates the organ, then thirst will develop. Other signs like yellowish tongue fur refer to overheated stomach, taut and rapid pulse indicates liver fire.

Therapeutic principle: to soothe the liver, reduce the fire and calm the spirit.

Sample prescription: Modified Gentain Liver-Purging Decoction (long dan xie gan tang)

In the prescription, the gentian root, skullcap root and gardenia fruit soothe the liver and reduce the fire; water-plantain root, akebia stem and plantain seed further clear the damp-heat in the liver meridian; the bupleurum root smoothes the qi flow of the liver and gallbladder, and also enable other ingredients to work on specific meridians; the angelica root and rhemannia root promote blood production to ensure nourishment inside the body; the poria and fossil bone suppress the over-active spirit; while the liquorice root harmonizes the middle burner and acts as buffer.

In cases if there is obvious sighing, chest tightness, and rib discomfort, then add the following to enhance the regulating function of the liver.

In cases where there is poor appetite, belching and gastric fullness, then add the following to promote harmony between the liver and stomach.

Insomnia prescription