Huanglian Wendan Decoction for the treatment of insomnia

Nowadays, people are faced with various pressures and diseases in life, and are prone to insomnia. Generally speaking, many people choose traditional Chinese medicine for treatment when facing insomnia. Because insomnia is closely related to liver and gallbladder qi stagnation, and gallbladder and stomach disharmony. Huanglian Wendan Decoction is a traditional Chinese medicine prescription that can treat insomnia symptoms. It has a good effect on regulating liver and gallbladder qi stagnation and gallbladder and stomach disharmony.

Wen Dan Tang comes from "Qian Jin Yao Fang" (Prescriptions for Emergencies). There are variations in the "Sanyin Fang", there is the "Zhengzhi Zhunsheng" which has the "Shiwei Wendan Decoction", and there is the "Liuyin Tiaobian" which has the "Huanglian Wendan Decoction". I often use a modified version of Wen Dan Tang to treat insomnia caused by phlegm-heat disturbing the heart, heart deficiency and timidity, gallbladder qi stagnation, and stomach disharmony.

"Suwen Linglan Secret Classic" says: "All eleven organs depend on the gallbladder." The gallbladder belongs to Jia wood and is the official of the center. It is responsible for making decisions, regulating emotions, defending against and eliminating adverse mental stimulation, maintaining the normal operation of qi and blood, and ensuring the coordination of the internal organs. The function of making decisions depends on courage. If one is courageous, one can make decisions and the eleven internal organs will be at peace. If one is timid, one cannot make decisions and the eleven internal organs will be disturbed. People with weak bodies and weak qi, or those with excessive emotions, or irregular diet and daily life, which damage the middle burner, can all lose their courage. Deficiency of gallbladder qi and abnormal secretion of qi will affect the digestion and absorption of food and cause the heart to lose nourishment. The heart and courage are connected, the courage is weak, the courage is indecisive, the mind is easily frightened, and the person is often in a state of worry and fear. The gallbladder is the house of purity, likes gentleness and is responsible for growth and development. If it is abnormal, the wood will be blocked and the stomach qi will be unharmonious, which will then turn into heat and produce phlegm. The liver and gallbladder qi are stagnant, the spleen and stomach ascend and descend out of order, and wood stagnation turns into fire. The accumulation of moisture in the earth is the source of phlegm and heat. The phlegm and heat combine to disturb the mind and cause insomnia. The gallbladder likes quietness and cannot tolerate evil disturbances. If external evil invades, or if diet and emotions are out of balance, the evil will invade the gallbladder, causing the gallbladder qi to stagnate and lose its clarity and tranquility. It causes poor liver secretion, poor circulation of qi and blood, disorder of spirit and insomnia; or it causes gallbladder depression and phlegm disturbance, restlessness and insomnia.

Wen Dan Tang has the functions of clearing away the gallbladder qi, harmonizing the stomach, regulating qi and resolving phlegm, and raising the clear and lowering the turbid. The prescription does not contain any strong tonic or attacking ingredients, but rather a mild and neutral agent that regulates the body's yin and yang, qi and blood, and the functions of internal organs, restoring the gallbladder's mild and neutral nature. Wen Dan Tang has the characteristics of resolving phlegm without drying out, and clearing away heat without causing cold. It can be used flexibly according to the clinical manifestations of insomnia.

1. Phlegm-heat disturbs the heart and causes insomnia

Symptoms: Insomnia, difficulty falling asleep, chest tightness and irritability, dizziness, vomiting and sputum, poor appetite, yellow and greasy tongue coating, and slippery and rapid pulse.

Phlegm and old food are blocked in the body and accumulate and turn into heat. The phlegm-heat disturbs the heart and causes insomnia. The phlegm and turbidity go up and obscure the clear orifices, causing dizziness. The qi flow is not smooth and the stomach fails to harmonize and descend, causing vomiting of phlegm and poor appetite. The treatment is to clear away heat and resolve phlegm, harmonize the middle and calm the mind.

I often modify the Huanglian Wendan Decoction (Coptis chinensis, Pinellia ternata, Tangerine peel, Poria cocos, Licorice root, Ginger, Rhizoma Anemarrhenae, Citrus aurantium) from the "Six Causes Treatise".

2. Guilty and timid insomnia

Symptoms: Frequent dreams and easy awakening, palpitations and timidity, restlessness, fatigue and shortness of breath, pale and fat tongue, and thin and stringy pulse. The heart controls the spirit, and the gallbladder controls decision-making. If the heart and gallbladder are weak and timid, the spirit will not be nourished, the heart and spirit cannot be restrained, and the courage will find it difficult to make decisions. This will lead to frequent dreams, easy startling, palpitations, timidity, and restlessness. If the heart qi is weak, one will feel tired and short of breath. Treatment is to invigorate Qi and warm the gallbladder, and calm the mind and tranquilize the nerves.

I often modify the Ten-Ingredient Warming Gallbladder Decoction (processed Pinellia, stir-fried Citrus aurantium, dried tangerine peel, Poria, Ziziphus jujuba seed, Polygala tenuifolia, Rehmannia root, ginseng, Schisandra chinensis, roasted Licorice root, ginger, and jujube) from "The Standard of Diagnosis and Treatment".

3. Insomnia due to gallbladder qi stagnation

Symptoms: Insomnia, frequent dreams, chest tightness and sighing, distension and fullness in the ribs, irritability, poor appetite and belching, thin tongue coating and wiry pulse. If the gallbladder qi is blocked, the liver loses its order, and the soul is distracted, then there will be insomnia and frequent dreams; if the qi flow is not smooth, there will be chest tightness and sighing, fullness and distension in the ribs, and restlessness; if the gallbladder qi is rebellious and invades the spleen and stomach, there will be poor appetite and belching. Treatment is to promote bile secretion, soothe the liver, resolve phlegm and calm the mind.

I often use Wen Dan Tang combined with Sini San (Bupleurum, Peony, Citrus aurantium, Licorice) or Chaihu Shugan San (Bupleurum, Peony, Chuanxiong, Cyperus rotundus, Citrus aurantium, Tangerine peel, Licorice) to modify the formula.

4. Insomnia due to stomach disharmony

Symptoms: restless sleep, tossing and turning, chest and abdominal fullness, loss of appetite, nausea and vomiting, belching and acid regurgitation, undigested stool, thick and greasy tongue coating, and slippery pulse. Improper eating and drinking will cause stagnation of old food, disharmony of the stomach, upward flow of foul air, and disturbance of the mind, which will cause insomnia and tossing and turning. If the ascending and descending pivot is blocked, there will be fullness and stuffiness in the chest and abdomen, nausea and vomiting. If food cannot be digested and the spleen and stomach are damaged, there will be loss of appetite, belching, acid regurgitation, and undigested stool. The treatment is to strengthen the spleen and stomach, digest food and calm the mind.

I often use Wen Dan Tang combined with Ban Xia Shu Mi Tang (Pinellia ternata and sorghum rice) and add some flavors to it.

Common addition and subtraction

Blood deficiency: Angelica sinensis, Rehmannia glutinosa, and Lycium barbarum.

Liver heat: Cortex Moutan, Gardenia jasminoides, and Scutellaria baicalensis.

Heart fire: Coptis chinensis, lotus seed core, bamboo leaves.

Qi deficiency: Codonopsis pilosula, Astragalus membranaceus, and Atractylodes macrocepha

Yin deficiency: Cornus officinalis, Rehmannia glutinosa, and lily.

Deficiency-heat: Anemarrhena asphodeloides and Phellodendron chinense.

Guide the fire back to its origin: add cinnamon and Achyranthes bidentata.

Indigestion: Jiao Sanxian, Houpo, Jiao Areca, and Shujun.