Seattle Institute of Oriental Medicine

Translations: Modern Masters

Professor Liu ShiChang's Experience on the Treatment of Insomnia

Professor Liu Shi Chang's Experience on the Treatment of Insomnia

Xin Zhong Yi, New Journal of Traditional Chinese Medicine, 1995, Volume 27, No. 9. Pages 12-13.

In this 1 1/2 page article, Dr. Liu Shi Chang outlines four common patterns he has seen in patient's with insomnia. These four patterns are Heart and Spleen Dual Deficiency, Phlegm Turbidity Obstruction, Binding Depression of Liver Qi, and Yin Vacuity Fire. For each pattern, he gives a brief explanation of the general symptoms, tells which people you are likely to see with these patterns, and gives a common formula and herbs you might use to treat them. Following this, he gives a representative case study using this formula. Someone could get most of the grist from this article by only translating the case studies. One exception to this is Dr. Chang does give a nice description following the case studies, of the patho-mechanisms at work in each case. Also, at the end of the general herbs listed for each pattern, he gives a few extra herb variations to use if certain additional symptoms are present.

In his treatments, Dr. Chang uses one bag of herbs per day, often decocted into one bowl full of liquid. The herb dosages for most of the individual herbs are between 9-15g. His treatments in all four cases follow a similar pattern. He gives herbs after the first examination, and then the patient comes back to the clinic about 4 days later. At this time, the formula is either slightly modified, changing 2 or 3 herbs, or it is left alone. The patient then comes back in for a third treatment four more days later, is much improved, and is given an unspecified variation of this same formula to take for a month. In all cases, there was complete recovery.

These are the summary descriptions for each case where Dr. Chang explains the pathomechanism and pertinent details of the case. In case #1 the patient was a 52 year old man, who had abdominal pain for 20 years, and has had insomnia for the previous year before seeking treatment. Dr. Chang explains that according to this case, the patient had stomach disease for over 20 years, spleen and stomach transformation and engendering are insufficient. Therefore, the heart is unable to be nourished and this causes insomnia, and Gui Pi Tang was prescribed.

Wen Dan Tang was used in the Phlegm Turbidity case. According to this case, excessive drinking, smoking, and eating improper foods led to phlegm turbidity. With this, the clear qi is unable to ascend, causing the qi mechanism to be disordered and counterflow, and there is harassment of the heart spirit. Because of this, there is dizziness, and insomnia with excessive dreaming.

For the Binding Depression of Liver Qi case, a Xiao Yao San variation was used. This patient is a menopausal woman, and her condition was due to her essence and qi being gradually lost. This caused her blood and qi to not flow smoothly, and liver qi to not course properly, eventually disrupting her heart spirit.

The Yin Vacuity Fire case is a 65 year old man. His condition was brought about through aging and his body waning, and he has high blood pressure, and a long history of arteriosclerosis. His yin and essence were depleted, so that deficiency fire flared upward, causing his insomnia. He was given a combination of Suan Zao Ren Tang, and Huang Lian E Jiao Tang, and he was cured. Although the only herb in his prescription that is in Huang Lian E Jiao Tang was Huang Lian, and no others. Suan Zao Ren contained all of its usual ingredients, except Chuan Xiong, and about 6 other herbs were added to the formula.

In this article, Dr. Chang gives concise descriptions of these four patterns of insomnia, and his cases are good examples of how he uses these formulas. The Chinese is well suited to 1st or 2nd year students, as most of the vocabulary will be familiar.

Chris Steckler