寶鑑Bogam

Formulas · Text · Donguibogam 東醫寶鑑

Dreams

Mong

한글  ·  Pinyin Meng

夢門

The ethereal and corporeal souls make dreams 魂魄爲夢

鄭康成曰, 口鼻之呼吸爲魂, 耳目之聰明爲魄. 以耳目與口鼻對言, 則口鼻爲陽, 耳目爲陰. 以耳目口鼻與藏府對言, 則耳目口鼻爲陽, 藏府爲陰. 故陽氣行陽分二十五度於身體之外, 則耳目口鼻皆受陽氣, 所以能知覺視聽動作而窹矣. 陽氣行陰分, 則耳目口鼻無陽氣運動, 所以不能知覺而寐矣.

Zheng Kangcheng says: the breathing of mouth and nose is the ethereal soul; the acuity of ear and eye is the corporeal soul. Set ear and eye against mouth and nose, and mouth and nose are Yang, ear and eye Yin. Set ear, eye, mouth, and nose against the viscera and bowels, and the four of them are Yang, the viscera and bowels Yin. Therefore when the Yang Qi travels its twenty-five circuits through the Yang aspect, outside the body, then ear, eye, mouth, and nose all receive the Yang Qi — and so one can perceive, see, hear, and move, and is awake. When the Yang Qi travels the Yin aspect, then ear, eye, mouth, and nose have no Yang Qi to move them — and so one cannot perceive, and sleeps.
Clinical note Sleep defined not as something the mind does but as something the Qi stops doing. When the Yang withdraws inward at dusk, the sense organs are simply no longer supplied — and awareness goes out with the supply. It is a mechanical account, and its usefulness is that it makes insomnia a circulation problem: something is keeping the Yang from going in, or keeping it from staying there.

Jeong Gangseong 鄭康成

The travel of Yang Qi makes waking and sleeping 陽氣之出入爲窹寐

靈樞曰, 衛氣之行, 晝行於陽, 則目張而窹, 夜行於陰, 則目瞑而寐.

The Numinous Pivot says: as for the travel of the defensive Qi — by day it travels the Yang, and the eyes open and one wakes; by night it travels the Yin, and the eyes close and one sleeps.
Clinical note Twenty characters that carry the whole chapter. Sleep is the defensive Qi coming in from the surface at dusk; waking is its going out again at dawn. Everything the chapter later says about insomnia follows from this single image — the person who cannot sleep is a person whose Qi will not come in, and the treatments divide according to why.

Yeongchu 靈樞

Depraved excess sets dreams going 淫邪發夢

黃帝問曰, 淫邪泮衍奈何. 岐伯對曰, 正邪從外襲內, 而未有定舍, 反淫于藏, 不得定處, 與榮衛俱行, 與魂魄飛揚, 使人臥不安而喜夢. 是以陰氣盛則夢涉大水而恐懼, 陽氣盛則夢大火而燔灼, 陰陽俱盛則夢相殺. 上盛則夢飛, 下盛則夢墮. 甚飢則夢取, 甚飽則夢與. 肝氣盛則夢怒, 肺氣盛則夢哭泣, 心氣盛則夢善笑恐畏, 脾氣盛則夢歌樂, 身體重不擧, 腎氣盛則夢腰脊兩解不屬.

The Yellow Emperor asked: how is it when depraved excess spreads and overflows? Qibo answered: an upright evil comes from without and invades within, and having no fixed lodging it floods instead into the viscera; finding no settled place, it travels along with the construction and defense and flies up with the ethereal and corporeal souls, so that a person lies uneasily and dreams much. Hence when the Yin Qi is exuberant, one dreams of wading great waters and is afraid; when the Yang Qi is exuberant, one dreams of a great fire scorching; when Yin and Yang are both exuberant, one dreams of mutual slaughter. Exuberance above brings dreams of flying; below, of falling. Extreme hunger brings dreams of taking; extreme fullness, of giving. Liver Qi exuberant, one dreams of anger; Lung Qi exuberant, of weeping; Heart Qi exuberant, of laughing readily and of dread; Spleen Qi exuberant, of singing and music, with the body heavy and unable to lift itself; Kidney Qi exuberant, of the lumbus and spine coming apart at the joint.
Clinical note The most famous passage in the chapter, and one of the oldest systematic dream catalogues in any medical literature. What makes it worth reading is the underlying claim: dreams are not messages but *readings* — the content reports on the state of the body, the way a pulse does. Hunger produces dreams of taking, fullness of giving; too much Qi above and you fly, too much below and you fall. Whatever one makes of the organ correspondences, that basic move — treating dream content as clinical data rather than as omen — is a remarkable thing to find in a text of this age.

Yeongchu 靈樞

又曰, 厥氣客于心則夢見丘山烟火, 客于肺則夢飛揚, 見金鐵之寄物, 客于肝則夢山林樹木, 客于脾則夢見丘陵大澤ㆍ壞屋風雨, 客于腎則夢臨淵沒居水中, 客于膀胱則夢遊行, 客于胃則夢飮食, 客于大腸則夢田野, 客于小腸則夢聚邑街衢, 客于膽則夢鬪訟自刳, 客于陰器則夢接內, 客于項則夢斬首, 客于脛則夢行走而不能前, 及居深地窌苑中.

And further: when reverting Qi lodges in the Heart, one dreams of hills and mountains with smoke and fire; in the Lung, of flying up, and of seeing objects of metal and iron; in the Liver, of mountain forests and trees; in the Spleen, of hills and great marshes, of ruined houses and wind and rain; in the Kidney, of standing at an abyss and sinking down into water; in the Bladder, of wandering about; in the Stomach, of eating and drinking; in the Large Intestine, of fields and open country; in the Small Intestine, of crowded towns and thoroughfares; in the Gallbladder, of quarrels and lawsuits and of cutting oneself open; in the genitals, of intercourse; in the nape, of being beheaded; in the shins, of walking and running and being unable to go forward, and of dwelling in deep pits and enclosures.
Clinical note Fifteen sites and fifteen dreams. Some read as free association from the organ's function — the Stomach dreaming of food, the Large Intestine of open fields — and some are stranger and better: the Gallbladder, which the tradition assigns decisiveness, dreaming of lawsuits and self-cutting; the shins dreaming of running and getting nowhere. That last one has been dreamt by nearly everyone, and the chapter files it under the legs rather than under anxiety, which is either a category error or a rather good observation about where the sensation originates.

Yeongchu 靈樞

Vacuity and repletion of the five viscera make dreams 五藏虛實爲夢

肝氣虛則夢見菌香生草, 實則夢伏樹下不敢起. 心氣虛則夢救火陽物, 實則夢燔灼. 脾氣虛則夢飮食不足, 實則夢築垣盖屋. 肺氣虛則夢見白物ㆍ見人斬血藉藉, 實則夢見兵戰. 腎氣虛則夢見舟船溺人, 實則夢伏水中若有畏恐. 《內經》

When the Liver Qi is vacuous, one dreams of fragrant fungus and living grasses; replete, one dreams of lying beneath a tree and not daring to rise. When the Heart Qi is vacuous, one dreams of putting out fires and of Yang things; replete, one dreams of burning and scorching. When the Spleen Qi is vacuous, one dreams of food and drink being insufficient; replete, one dreams of building walls and roofing houses. When the Lung Qi is vacuous, one dreams of white things, and of seeing people cut down with blood everywhere; replete, one dreams of soldiers at war. When the Kidney Qi is vacuous, one dreams of boats and of people drowning; replete, one dreams of lying submerged in water as though in dread.
Clinical note The same five organs as the previous section, now doubled — each with a vacuity dream and a repletion dream, and the pairs are constructed with real care. The vacuous Spleen dreams there is not enough to eat; the replete Spleen dreams of building walls. The vacuous Heart dreams of *putting out* fires; the replete Heart dreams of burning. Read as a whole, the table proposes that a dream's emotional direction — lack or excess, fleeing or doing — is the diagnostic signal, and its imagery merely the organ's vocabulary.

Naegyeong 內經

Vacuity vexation without sleep 虛煩不睡

靈樞曰, 黃帝問曰, 人之目不瞑不臥者, 何氣使然. 伯高對曰, 衛氣晝日行於陽, 夜行於陰, 常從足少陰之分間, 行於五藏六府. 今厥氣客於藏府, 則衛氣獨衛其外, 不得入於陰. 行於陽則陽氣盛, 陽氣盛則陽蹻陷, 不得入於陰, 陰氣虛, 故目不瞑. 飮以半夏湯一劑, 陰陽已通, 其臥立至. 其方以流水千里外者八升, 揚之萬遍, 取其淸五升煮之, 炊以葦薪火, 沸置秫米一升ㆍ治半夏五合, 徐炊令竭爲一升半, 去其渣, 飮汁一小盃, 日三, 稍益, 以知爲度. 其病新發者, 覆盃則臥, 汗出則已矣. 久者, 三飮而已也.

The Numinous Pivot says: the Yellow Emperor asked — when a person's eyes will not close and they cannot lie down, what Qi brings this about? Bogao answered: the defensive Qi travels the Yang by day and the Yin by night, always passing from the division of the foot lesser-Yin to circulate through the five viscera and six bowels. Now when reverting Qi lodges in the viscera and bowels, the defensive Qi guards only the outside and cannot enter the Yin. Traveling the Yang, the Yang Qi becomes exuberant; the Yang Qi exuberant, the Yang springing vessel is overwhelmed and it still cannot enter the Yin; the Yin Qi being vacuous, the eyes will not close. Give a dose of Banha-tang: Yin and Yang are opened through, and sleep arrives at once. The method: take eight doe of water that has flowed from a thousand li away, stir it ten thousand times, take five doe of the clear part and boil it, kindling the fire with reed stalks; when it boils, put in one doe of glutinous millet and five hop of prepared pinellia, and cook slowly until reduced to a doe and a half. Remove the dregs and drink one small cup of the liquid, three times a day, increasing a little, until the effect is felt. Where the illness is newly arisen, one turns the cup over and lies down; sweat comes and it is finished. Where it is long-standing, three drinkings and it is done.
Clinical note The oldest insomnia prescription in the canon, and its mechanism is stated with unusual clarity: the defensive Qi is stuck outside and cannot get in, so the eyes will not close. Two ingredients answer it — millet and pinellia — but the preparation is a ritual in itself: water carried from a thousand li away, stirred ten thousand times, the clear part decanted, a fire of reed stalks. Whatever that accomplished pharmacologically, it accomplished something else as well: a patient who has watched all this done has been given an hour of attention before the first cup. 'Turn the cup over and lie down' is the finest promise in the chapter.

Yeongchu 靈樞

虛煩者, 心胸煩擾而不寧也. 內經曰, 陰虛則內熱. 今之虛煩, 多是陰虛生內熱所致. 是故傷寒吐下後, 及霍亂吐瀉後, 津液枯竭, 多有虛煩之證. 《醫鑑》 ○身不覺熱, 頭目昏疼, 口乾咽燥而不渴, 淸淸不寐, 皆虛煩也. 《三因》 ○大病後, 虛煩不睡, 溫膽湯主之. 甚者益元散 方見暑門, 加朱砂ㆍ牛黃服之. 《入門》 ○不寐有二種. 大病後虛弱, 及年高人陽衰不寐者, 六君子湯 方見痰門, 加酸棗仁(炒)ㆍ黃芪. 如痰在膽經, 神不歸舍而不寐者, 溫膽湯, 加南星ㆍ酸棗仁(炒). 《醫鑑》

Vacuity vexation is a restless disquiet in the heart and chest that will not settle. The Inner Classic says: when the Yin is vacuous there is internal heat. The vacuity vexation of our day is mostly brought about by Yin vacuity engendering internal heat. Thus after cold damage has been vomited and purged, and after the vomiting and diarrhea of sudden turmoil, the fluids are dried and exhausted, and there is often the vacuity vexation pattern (Uigam 醫鑑). — The body is not felt to be hot; the head and eyes are clouded and aching; the mouth is dry and the throat parched yet there is no thirst; and one lies clear-headed and sleepless — all of this is vacuity vexation (Samin 三因). — After a great illness, with vacuity vexation and no sleep, Ondam-tang 溫膽湯 governs it; in severe cases, Igwon-san — formula in the Summerheat chapter — with cinnabar and ox bezoar added (Immun 入門). — Sleeplessness is of two kinds. Where it follows a great illness with weakness, or where an aged person's Yang has waned: Yukgunja-tang 六君子湯 — formula in the Phlegm chapter — with dry-fried sour jujube seed and astragalus added. Where phlegm is in the gallbladder channel and the spirit does not return to its dwelling: Ondam-tang with arisaema and dry-fried sour jujube seed added. (Uigam 醫鑑)
Clinical note The Samin's description is worth committing to memory, because it is exactly how patients describe this: no fever they can feel, a heavy aching head, a dry mouth that does not actually want water, and lying there wide awake and clear-headed. That last phrase — 淸淸不寐, clear and clear and sleepless — captures the particular alertness of the depleted insomniac better than any modern term. And the two-kinds division at the end is still the working fork: is this emptiness after illness, or phlegm keeping the spirit from settling?

Uigam 醫鑑 · Samin 三因 · Immun 入門

The ethereal soul departs and one cannot sleep 魂離不睡

四明董生患神氣不寧, 每臥則魂魄飛揚, 覺身在床而神魂離體, 驚悸多魘, 通夕無寐, 更醫不效. 許學士診之曰, 以脉言之, 肝藏受邪, 非心病也. 平人肝不受邪, 臥則魂歸於肝, 神靜而得寐. 今肝氣因虛, 邪氣襲之. 肝藏魂者也, 肝有邪則魂不得歸, 是以臥則魂飛揚若離體也. 肝主怒, 故小怒則劇. 遂處以眞珠母丸ㆍ獨活湯二方以贈, 服一月而病悉除. 《本事方》

Dong of Siming suffered from spirit and Qi unquiet: whenever he lay down, the ethereal and corporeal souls flew up, and he felt his body on the bed while spirit and soul left it — startled and palpitating, much oppressed by nightmares, and through the whole night without sleep. He changed physicians without effect. Scholar Xu examined him and said: speaking by the pulse, the Liver viscus has received an evil; this is not a Heart illness. In a well person the Liver receives no evil, so on lying down the ethereal soul returns to the Liver, the spirit is still, and sleep comes. Now the Liver Qi has gone vacuous and an evil Qi has invaded it. The Liver is what stores the ethereal soul; the Liver having an evil, the soul cannot return — hence on lying down it flies up as though leaving the body. The Liver governs anger, and so with a little anger it worsens. He then prescribed Jinjumo-hwan and Dokhwal-tang 獨活湯, giving both; a month's taking, and the illness was entirely removed.
Clinical note A case report of what modern sleep medicine would file under hypnagogic dissociation or sleep paralysis — the body felt to be on the bed while awareness seems to depart it — described in 1132 with enough precision that it is unmistakable. Xu's diagnostic move is the interesting part: he rules out the Heart on the pulse and locates it in the Liver, on the doctrine that the ethereal soul lodges in the Liver at night and cannot do so if something else is occupying it. The confirming detail he offers is behavioral: it gets worse when the patient is even slightly angry. Note on modern practice: recurrent sleep paralysis and dissociative experiences at sleep onset merit medical assessment, including for narcolepsy.

Bonsabang 本事方

眞珠母丸, 治神魂不寧, 驚悸不得睡. 眞珠母 七錢半, 熟地黃ㆍ當歸 各一兩半, 人參ㆍ酸棗仁(炒)ㆍ柏子仁ㆍ犀角ㆍ白茯神 各一兩, 沈香ㆍ龍齒 各五錢. 右爲末, 蜜丸梧子大, 朱砂爲衣, 每四五十丸, 薄荷湯下, 日二服. 此方眞珠母爲君, 龍齒佐之. 眞珠母入肝經爲第一, 龍齒與肝同類也. 龍齒ㆍ虎睛, 人皆以爲鎭心藥, 殊不知龍齒安魂, 虎睛定魄. 龍能變化, 故魂遊而不定. 虎能專靜, 故魄止而有守. 若魄不寧者宜用虎睛, 魂飛揚者宜用龍齒. 《本事》

Jinjumo-hwan treats spirit and ethereal soul unquiet, with palpitations and inability to sleep. Mother-of-pearl 7.5 don; prepared rehmannia and Korean angelica, 1.5 nyang each; ginseng, dry-fried sour jujube seed, arborvitae seed, rhinoceros horn, and hostwood poria, 1 nyang each; aquilaria and fossilized tooth, 5 don each. Powder the above and bind with honey into pills the size of parasol-tree seeds, coated with cinnabar; take 40–50 pills with a mint decoction, twice daily. In this formula mother-of-pearl is sovereign and fossilized tooth assists it. Mother-of-pearl entering the Liver channel is first among medicinals; fossilized tooth is of the same kind as the Liver. Fossilized tooth and tiger's eye are taken by everyone for settling the Heart, but they do not realize that fossilized tooth quiets the ethereal soul while tiger's eye settles the corporeal soul. The dragon is able to transform, and so the ethereal soul roams and will not stay; the tiger is able to be wholly still, and so the corporeal soul halts and keeps watch. Where the corporeal soul is unquiet, use tiger's eye; where the ethereal soul flies up, use fossilized tooth.
Clinical note **Recorded as text: rhinoceros horn is from a critically endangered species protected under CITES, tiger parts likewise, and cinnabar is a mercury sulfide — none are used, and this formula cannot be prepared as written.** What is preserved here is the commentary, which is the finest piece of reasoning about mineral sedatives in the classical literature: dragon and tiger are chosen not for potency but for *character*. The dragon transforms and moves, so its bone answers the soul that roams; the tiger holds perfectly still, so its eye answers the soul that will not keep watch. Sympathetic logic, stated with unusual self-awareness about what it is doing.

Bonsa 本事

Thought binds and one cannot sleep 思結不睡

一婦人因思慮過傷, 二年不得寐. 戴人曰, 兩手脉俱緩, 此脾受邪也, 脾主思故也. 與其夫議, 以怒激之. 多取財, 飮酒數日, 不處一方而去. 其婦大怒汗出, 是夜困臥, 如此者八九日不窹. 自是食進, 其脉得平. 此因膽虛不能制脾之思慮而不寐, 今激之以怒, 怒屬肝木, 木能克土, 脾之思慮解矣.

A woman, from thought and worry carried past all injury, went two years without sleep. Master Dai said: the pulses of both hands are moderate and slack — this is the Spleen having received an evil, for the Spleen governs thought. He conferred with her husband and arranged to provoke her to anger: he took a great deal of her money, drank wine for several days, and left without prescribing a single formula. The woman flew into a great rage and broke into a sweat; that night she fell into an exhausted sleep, and slept so for eight or nine days without waking. From then on food went in and her pulse came level. This was a case where the Gallbladder was vacuous and could not restrain the Spleen's brooding, and so she could not sleep. Now, provoked to anger — and anger belongs to Liver Wood, and Wood can restrain Earth — the Spleen's brooding was resolved.
Clinical note The most famous case history in this chapter and one of the strangest in the canon: two years of insomnia from rumination, cured by a physician who took the patient's money, went drinking, and left without a prescription — having arranged the whole thing with her husband in advance. The theory is the five-phase cycle applied as therapy: Wood restrains Earth, so anger breaks the grip of overthinking. Whatever one makes of the mechanism, something recognizable is being described — a person locked in rumination, shaken out of it by a strong emotion, and sleeping at last. **The method is not one any modern practitioner should imitate: deceiving a patient and enlisting her family against her would be a serious ethical breach today, whatever the outcome.** It is preserved as a record of how the tradition thought emotions could be used against one another.

Bonsabang 本事方

Old and young do not sleep alike 老少之睡不同

黃帝問曰, 老人之不夜瞑, 少壯之不晝瞑者, 何氣使然. 岐伯答曰, 壯者之氣血盛, 其肌肉滑, 氣道通, 榮衛之行不失其常, 故晝精而夜瞑. 老者之氣血衰, 其肌肉枯, 氣道澁, 五藏之氣相搏, 其榮氣衰少而衛氣內代, 故晝不精而夜不眠. 《靈樞》

The Yellow Emperor asked: that the old do not close their eyes at night, and the young and vigorous do not close theirs by day — what Qi brings this about? Qibo answered: in the vigorous, the Qi and Blood are exuberant, the flesh is smooth, the Qi pathways pass through, and the travel of construction and defense does not lose its regularity — hence they are sharp by day and sleep at night. In the aged, the Qi and Blood have waned, the flesh is withered, the Qi pathways are rough, the Qi of the five viscera contend with one another, the construction Qi is waning and scant while the defense Qi takes its place within — hence they are not sharp by day and do not sleep at night.
Clinical note The classical account of age-related insomnia, and it gets the phenomenology right: the old sleep badly at night *and* are dull by day, which is one condition rather than two. The mechanism proposed — rough Qi pathways, construction waning while defense takes its place inside — is a way of saying that the daily rhythm has lost its amplitude at both ends. Modern sleep medicine describes the same flattening in different terms, and it is the reason that treating an older patient's insomnia by sedation alone tends to make the daytime worse.

Yeongchu 靈樞

傷寒及雜病多睡者, 陽虛陰盛也. 無睡者, 陰虛陽盛也. 喜明者屬陽, 元氣實也. 喜暗者屬陰, 元氣虛也. 睡向壁者屬陰, 元氣虛也. 睡向外者屬陽, 元氣實也. 《回春》 ○人臥則血歸於肝. 今血不靜, 臥不歸肝, 故驚悸而不得臥也. 《綱目》

In cold damage and in miscellaneous illness, one who sleeps much has Yang vacuous and Yin exuberant; one who does not sleep has Yin vacuous and Yang exuberant. One who likes the light belongs to Yang, the origin Qi being replete; one who likes the dark belongs to Yin, the origin Qi being vacuous. One who sleeps facing the wall belongs to Yin, the origin Qi being vacuous; one who sleeps facing outward belongs to Yang, the origin Qi being replete (Hoechun 回春). — When a person lies down, the Blood returns to the Liver. Now if the Blood is not still, then on lying down it does not return to the Liver — hence palpitations, and one cannot lie down. (Gangmok 綱目)
Clinical note Bedside signs that cost nothing to observe, and one of them is genuinely charming: which way the patient sleeps facing. Turned to the wall is read as Yin and depletion; turned outward as Yang and repletion. Whether or not the correspondence holds, the underlying instinct is sound — that how a person arranges themselves in bed, and whether they want the light or the dark, is information a clinician can use and rarely thinks to ask for.

Hoechun 回春 · Gangmok 綱目

Clouded sinking with much sleep 昏沈多睡

傷寒之邪傳入陰則多眠, 昏昏閉目者, 陰主闔也. 黙黙不欲言者, 陰主靜也. 太陽證已解而多眠者, 不必藥也. 陽明證熱伏於裏而多眠者, 宜小柴胡湯 方見寒門. 少陰之證, 脉微細但欲寐, 盖窹則行陽, 寐則行陰, 必從足少陰始, 故少陰病但欲寐, 宜茯苓四逆湯 方見寒門, 以益陰回陽. 或熱病得汗後, 脉沈細, 身冷喜臥, 昏沈不省, 亦急與之令四肢溫. 不爾, 有熟睡而死者. 惟汗下後酣眠者, 爲正氣已復, 不必藥也.

When the evil of cold damage is transmitted into the Yin there is much sleeping. That one is clouded and keeps the eyes shut is because Yin governs closing; that one is silent and does not wish to speak is because Yin governs stillness. Where the greater-Yang pattern has already resolved and there is much sleeping, no medicine is needed. Where the Yang-brightness pattern has heat lying hidden within and there is much sleeping, Sosiho-tang 小柴胡湯 — formula in the Cold Damage chapter — is appropriate. In the lesser-Yin pattern the pulse is faint and fine and one only desires sleep — for waking travels the Yang and sleeping the Yin, always beginning from the foot lesser-Yin; hence in lesser-Yin disease one only desires sleep, and Bokryeongsayeok-tang — formula in the Cold Damage chapter — is appropriate, to boost the Yin and return the Yang. Or where, after sweating has been obtained in a heat illness, the pulse is sunken and fine, the body cold, one is glad to lie down, and is clouded and unaware — this too must be given urgently, to warm the four limbs. Otherwise there are those who sleep soundly and die. Only where one sleeps deeply after sweating or purging is it the upright Qi already restored, and no medicine is needed.
Clinical note The most clinically serious passage in the chapter, and it turns on a distinction any clinician still has to make: after an acute illness, is this person sleeping because they are recovering, or because they are sinking? The chapter gives the answer in signs — a pulse gone sunken and fine, a cold body, unawareness — and states the stakes without softening them: **there are those who sleep soundly and die.** In modern terms this is the difference between convalescent rest and deteriorating consciousness, and the instruction to warm the limbs urgently is the right instinct even where the pharmacology is not.

Donguibogam · Mong

The body heavy and inclined to lie down 身重嗜臥

黃帝曰, 人之多臥者何氣使然. 岐伯曰, 此人腸胃大, 皮膚濕而分肉不解焉. 腸胃大則衛氣留久, 皮膚濕則分肉不解, 其行遲. 夫衛氣者, 晝行於陽, 夜行於陰, 故陽氣盡則寐, 陰氣盡則寤. 故腸胃大則衛氣行留久, 皮膚濕分肉不解則行遲, 留於陰也久, 其氣不精則目瞑, 故多臥矣. 《靈樞》 ○怠惰嗜臥者, 脾胃有濕也, 宜平胃散 方見內傷. 身重者, 濕也. 《東垣》

The Yellow Emperor said: when a person lies down much, what Qi brings it about? Qibo said: in such a person the intestines and stomach are large, the skin is damp, and the divisions of the flesh do not open. The intestines and stomach being large, the defensive Qi lingers long; the skin being damp and the flesh divisions not opening, its travel is slow. Now the defensive Qi travels the Yang by day and the Yin by night, so that when the Yang Qi is spent one sleeps, and when the Yin Qi is spent one wakes. Therefore where the intestines and stomach are large the defensive Qi lingers long in its travel, and where the skin is damp and the flesh does not open it travels slowly; lingering long in the Yin, its Qi is not sharp and the eyes close — hence much lying down (Yeongchu 靈樞). — One who is indolent and inclined to lie down has damp in the Spleen and Stomach: Pyeongwi-san 平胃散 — formula in the Internal Damage chapter —. Heaviness of the body is damp. (Dongwon 東垣)
Clinical note Hypersomnia explained as a transit problem: the defensive Qi moves slowly through a damp, heavy body and so lingers too long on the Yin side of its circuit. What the description actually picks out is a recognizable type — heavy-set, sluggish, always wanting to lie down — and the treatment is not stimulation but drying. That is the chapter's consistent instinct with excess sleep: the person is not short of energy so much as wading through something.

Yeongchu 靈樞 · Dongwon 東垣

The method of lying down to sleep 寢睡法

臥宜側身屈膝, 益人心氣. 覺宜舒展, 則精神不散. 孔子寢不尸. ○不得晝眠, 令人失氣. ○暮臥常習閉口, 口開卽失氣, 且邪惡從口入成病. ○屈膝側臥, 益氣力, 勝正偃仰. 故曰, 睡不厭踧, 覺不厭舒. ○人臥一夜, 常作五度反覆, 逐更轉側. 《得效》 ○夜不安寢, 衾厚熱壅故也, 當急去之, 仍拭汗孔. 或薄而寒, 卽加之, 睡自穩也. ○飢而睡不安, 則宜少食. 飽而睡不安, 則宜啜茶, 少行坐. 《東垣》

In lying down one should turn on the side and bend the knees, which boosts a person's Heart Qi; on waking one should stretch out, and then the essence-spirit does not scatter. Confucius did not sleep like a corpse. — One must not sleep in the daytime; it makes a person lose Qi. — In lying down at evening, make a habit of keeping the mouth closed: with the mouth open one loses Qi, and evils enter by the mouth and become illness. — Lying on the side with the knees bent boosts the Qi and strength, better than lying flat on the back. Hence it is said: in sleeping do not tire of drawing in; in waking do not tire of stretching out. — In one night's lying a person should turn over about five times, shifting with each watch (Deukhyo 得效). — If the night's sleep is unquiet, it is because the bedding is thick and heat is dammed: remove it at once and wipe the sweat pores. Or if it is thin and one is cold, add to it — and the sleep settles of itself. — Hungry and unable to sleep, one should eat a little; full and unable to sleep, one should sip tea and walk or sit a while. (Dongwon 東垣)
Clinical note Sleep hygiene, four centuries early, and most of it survives contact with a modern sleep clinic. Side-lying with the knees drawn up; no daytime napping; turning over through the night rather than lying rigid; and the temperature rule stated as a rule — too hot, take a layer off and wipe the sweat; too cold, add one. The last pair is the most practical thing in the chapter: hungry and sleepless, eat a little; too full and sleepless, sip tea and move about before lying down again. Nothing here needs updating except the prohibition on naps.

Deukhyo 得效 · Dongwon 東垣

Warding off bad dreams 辟惡夢

夜夢惡不須說. 且以水面東, 持刀噀之, 呪曰, 惡夢着草木, 好夢成珠玉, 卽無咎矣. ○麝香久服, 不夢窹魘寐. 又將眞麝一劑, 安枕合中枕之, 除邪辟惡夢. ○蘇合香, 令人無夢魘, 或服或帶之. ○虎頭, 爲枕枕之, 辟惡夢, 除魘寐. ○羚羊角, 安心氣, 不令魘寐, 除邪氣驚夢. ○虛而多夢紛紜, 人參ㆍ龍骨加而用之. 《本草》

A bad dream in the night need not be spoken of. Rather, take water, face east, hold a knife and spray the water out, and say the charm: *let bad dreams cleave to grass and trees, let good dreams become pearls and jade* — and there will be no misfortune. — Musk taken long prevents dreams of oppression and nightmare; also, take a dose of true musk, set it inside the pillow and sleep on it, and it removes evils and wards off bad dreams. — Storax makes a person free of nightmare, whether taken internally or worn. — A tiger's head made into a pillow and slept upon wards off bad dreams and removes nightmare. — Antelope horn quiets the Heart Qi, prevents nightmare, and removes evil Qi and startling dreams. — Where one is vacuous and dreams much in confusion, ginseng and dragon bone are added and used.
Clinical note The chapter's last word on dreams belongs to charm rather than pharmacy, and the charm is a small piece of poetry — bad dreams to the grass and trees, good dreams into pearls and jade. It is also a coping instruction with something to it: *a bad dream need not be spoken of*, meaning do not rehearse it on waking. **Note on modern practice: musk and antelope horn come from protected species, and tiger parts from a critically endangered one; none are used, and these entries are recorded as text.** What remains usable is the final line — for the depleted patient whose nights are crowded with confused dreaming, add ginseng and dragon bone to whatever else is being given.

Bonchō 本草

Simple medicinals 單方

鹿頭肉, 治煩悶多夢, 及夜夢見鬼物. 煮汁飮, 食其肉. ○安息香, 治婦人夜夢鬼交. 以雄黃合爲丸, 燒熏丹穴, 永斷. ○苦竹葉, 治虛煩不睡. 煮服之. ○小麥, 治煩熱少睡. 煮服之. ○酸棗仁, 睡多則生用, 不得睡則炒熟用之. ○楡白皮, 治不睡. 嵇公云, 楡令人瞑, 是也. 初生莢仁, 以作糜羹服之, 令人多睡. 《本草》

Deer head meat treats vexing oppression with much dreaming, and dreaming of ghostly things at night: boil it, drink the broth and eat the meat. — Benzoin treats a woman dreaming of intercourse with ghosts at night: combine it with realgar into pills, burn them and fume the lower parts, and it is ended for good. — Black bamboo leaf treats vacuity vexation with sleeplessness: boil and take it. — Wheat treats vexing heat with scant sleep: boil and take it. — Sour jujube seed: where sleep is excessive, use it raw; where one cannot sleep, dry-fry it thoroughly and use it. — Elm bark treats sleeplessness. Master Xi said that elm makes a person close the eyes — this is the case. The young pods and kernels made into gruel or soup and taken make a person sleep much.
Clinical note The sour jujube seed entry is the one every student learns, and it is the clearest statement in the whole materia medica of what processing does: the same seed, raw, is given for too much sleep — and dry-fried, for too little. One herb, opposite indications, the fire between them. Note on modern practice: realgar is an arsenic sulfide and is not used; the animal-derived entries are likewise recorded as text.

Bonchō 本草

林檎, 治不睡. 多食則令人好睡. ○木槿, 煮作飮服之, 令人得睡. ○蕨, 食之令人多睡. ○蓴, 常食令人嗜睡. ○烏梅, 治不眠. 作茶飮, 令得睡. 《本草》

Chinese apple treats sleeplessness: eaten in quantity it makes a person sleep well. — Rose of Sharon: boil it into a drink and take it, and it brings sleep. — Bracken: eaten, it makes a person sleep much. — Water shield: eaten regularly, it makes a person crave sleep. — Dark plum treats sleeplessness: drunk as a tea, it brings sleep.
Clinical note Five foods rather than five drugs — apple, hibiscus, bracken, water shield, and plum tea. This is the chapter at its most domestic, and the entries are worth reading as a set: everything here is something a household already had, prepared the way it would ordinarily be eaten. The tradition's first line against a bad night was not the pharmacy but the kitchen.

Bonchō 本草

沙參, 治多睡, 常欲眠. 煮服, 或作虀食之. ○通草, 療脾疸, 常欲眠. 煮服之. ○茶, 令人少睡. 溫服, 除好睡. ○苦菜及苦苣, 皆令不睡. 久食之少睡. ○伏翼, 取血滴目中, 令不睡. ○馬頭骨, 主喜眠. 作枕枕之, 令不睡. ○草決明子, 久服令人不睡. 《本草》

Adenophora treats much sleeping and a constant desire to doze: boil and take it, or make it into a seasoned dish and eat it. — Rice-paper plant treats spleen jaundice with a constant desire to doze: boil and take it. — Tea makes a person sleep less; taken warm, it removes the fondness for sleep. — Bitter herbs and bitter lettuce both prevent sleep; eaten over time they reduce it. — Bat: take its blood and drop it into the eyes, and one does not sleep. — Horse skull governs excessive sleeping: make it into a pillow and sleep on it, and one does not sleep. — Cassia seed, taken long, makes a person sleep less.
Clinical note The other half of the list, and its existence is the interesting thing: a *wake-promoting* materia medica, for the patient who sleeps too much. Tea appears here in one of its earliest medical listings, doing exactly what everyone still uses it for. Two textual notes: the Donguibogam, following the Uihak Immun and related sources, blends the identities of 通草 and 木通 — the plant intended in entries like this one is not always certain, and readers comparing editions should be aware of it. And on modern practice: the bat and horse-skull entries belong to their era and are recorded as text; nothing is dropped into anyone's eyes.

Bonchō 本草