October 11, 2011

Huáng Lián assists sleep- A case by Huáng Huáng (黄煌)


One early morning last week as I had just turned on my cell phone, I received information about a patient from northern Jiāng Sū province that had suffered with insomnia. He had been here nine months previously for a formula and had taken seven packages. He recently returned, and after taking one package had completely recovered. This was quite remarkable!!

Now that he had finished his formula, he was asking how this was dealt with.

He was a forty year old male that was suffering with severe insomnia which started last year in December. He found it difficult to sleep for the entire night, and had repeatedly taken western medications all to no avail.

The formula he was given consisted of the following;

Huáng Lián 5g, Ròu Guì 10g, Zhì Fù Zǐ 10g, Gān Jiāng 10g, Shēng Gān Cǎo 5g.

This is Jiāo Tài Wán combined with Sì Nì Tāng. Now why would, these formulas be considered for this case? Let’s take a look at this patient. The man had a strong, robust physique; his skin was a dark color, he had no trouble eating, and his stools lacked shape. Now although he felt cold on the inside, he suffered from agitation and insomnia. This is what the ancients called ‘non-interaction of the heart and kidneys’, which is the ‘tried and true’ Jiāo Tài Wán formula pattern. Sì Nì Tāng harmonizes the body, and Huáng Lián and Ròu Guì treat the disease.

Huáng Lián is beneficial for insomnia. The Huáng Lián in Huáng Lián Ē Jiāo Tāng is used to treat “vexation in the heart, with an inability to sleep”. Huáng Lián Tāng uses equal parts Huáng Lián and Ròu Guì along with (Rén) Shēn, (Bàn) Xià, (Shēng) Jiāng, (Dà) Zǎo, and (Gān) Cǎo to treat “heat in the chest, evil qi in the stomach, abdominal pain, and a desire to vomit”. The heat in the chest is commonly expressed as heart vexation with an inability to sleep. Jiāo Tài Wán only contains two medicinals, Huáng Lián and Ròu Guì and is originally from the Míng dynasties ‘Comprehensive Medicine According to Master Han’ (韩氏医通, Hán Shì Yī Tōng). The author Hán Fēi-Xiá said;
“brew numerous times, add honey, take on an empty stomach, and this will instantly bring forth the interaction between the heart and kidneys”.

Yú Tīng-Hóng (余听鸿) had written about a patient from Zhè Jiāng County that had suffered with an inability to sleep the entire night for many years. He had taken over two hundred spirit calming, blood nourishing formulas which offered him no relief. The famous Mèng Hé physician Mǎ Shěng-Sān (马省三) prescribed;

Huáng Lián 8 fēn, Shān Zhī 3 qián, Zhū Dǎn Zhī 1 qián (mix fried), decocted. That night he slept soundly.

In the past, I have given patients equal parts powdered Huáng Lián and Ròu Guì infused in boiling water, and taken prior to going to sleep. This has indeed helped with sleep difficulties.

However, Huáng Lián is bitter and cold, and many people are unable to take it. Huáng Lián’s strength by itself is quite weak, and it is incapable of treating all stubborn cases of insomnia. Nevertheless, we always want to select the corresponding formula according to the body constitution. For example, with a red, oily facial complexion, heat vexation, headaches, and constipation, we can use Sān Huáng Xiè Xīn Tāng. With pale skin, red lips, red tongue, and heart vexation, me may use Huáng Lián Ē Jiāo Tāng. In a thin patient with dark lips, abdominal pain and insomnia, Huáng Lián Tāng may be used. With dry retching, epigastric focal distension, and mouth ulcers, we use Bàn Xià Xiè Xīn Tāng. With strong pain in the back and nape, diarrhea, chest oppression, vexation, palpitations, and insomnia, use Gé Gēn Qín Lián Tāng.

Originally, because Huáng Lián and Ròu Guì were combined with Sì Nì Tāng, we know that it is applicable in cases of a cold body with a hot disease. This is commonly seen in strong, robust men with a yellowish-dark skin color, and insomnia. After taking these medicinals, not only will insomnia improve, but enduring cases of abdominal pain and diarrhea, can be ameliorated.

This case was taken from Huáng Huáng's great classical formulas blog.  The original case can be found here.

4 comments:

Ren- Lady Of The Arts said...

I have found TCM to be extremely helpful with insomnia issues i've had in the past- In Toronto I was prescribed powder that was mixed with hot water and more recently a different (smelling) powder that was mixed with cold water- both seems to work after short periods of time, prior to all medications being finished.

tcmchina said...

Nice to see you blogging. Blogspot has been blocked here in China (for as long as I can remember). Ive been aware of Huangs forum posts for awhile but never get the chance to read them much. Anyways, great to see you making an effort to share his stuff and the fruits of your hard work and study! - Eric

Anonymous said...

Thanks for the fantastic cases on your blog. I found you through reading a couple of articles you've published in the Lantern. I've only been in practice for a year and am eager to get as much of a foundation in the classics as I can. There is so little translated for non-chinese speakers that I think you doing us a real service. Thanks - Aaron

Eran Even said...

@Irena-Happy to hear you had some positive results from the herbs. They can taste quite nasty, but can certainly have profound effects on the system.

@Eric- Thanks for checking out the blog. Happy to hear that the great Chinese firewall has eased slightly. You guys are doing some great work over on your site as well. Thanks for the link.

@Aaron- Thanks for checking out the blog as well. Much appreciated. The fact that there is little in the way of case studies being translated into English is exactly why I started the blog. I've slowed down a bit recently as I'm working on a pretty large project, but hopefully I'll get a chance to put more up soon. Thanks again for reading!!

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