Introduction: 3 Herb Pairs for Treating "Hypersomnia"

Polygonatum odoratum, Akebia quinata

【Indications and Applications】

Drowsiness.

【Clinical Experience】

Chen Yufeng's Experience: The symptom of drowsiness is often caused by phlegm-dampness.

The etiology is internal obstruction by phlegm-dampness, with the spleen constrained by dampness and clear yang failing to ascend, leading to drowsiness. In clinical practice, methods to fortify the spleen and resolve dampness are commonly used.

Master Chen often uses Polygonatum odoratum 25g and Akebia quinata 10g, decocted in water for oral administration to treat hypersomnia, achieving excellent results each time. "Treating dampness without promoting urination is not the proper treatment."

Akebia quinata is used to promote urination and eliminate dampness, while Polygonatum odoratum nourishes the yin of the spleen and stomach. The combination of these two herbs removes dampness without harming the body's vital energy, nourishes yin without retaining pathogenic factors, and balances attack and tonification. It both purges and tonifies, and tonifies while purging, making it effective in treating hypersomnia. [Guo Chenglin, Examples of Professor Chen Yufeng's Medication Experience, Jilin Journal of Traditional Chinese Medicine, 1987; (1):4]

Semen Ziziphi Spinosae, Tea Leaves

Regulating yin and yang, opening the orifices and awakening the spirit. Used for hypersomnia syndrome attributed to liver depression and gallbladder heat.

Liu Xianlin's experience: Suanzaoren (sour jujube seed) nourishes the heart and regulates the liver, while tea clears the gallbladder, opens the orifices, and awakens the spirit. The formula Suanzaoren Tea Powder regulates yin and yang, opens the orifices, and awakens the spirit.

Used for hypersomnia, with symptoms including constant drowsiness day and night, waking when called but falling back asleep, mental fatigue and lethargy, inability to control oneself, fullness and discomfort in the chest and hypochondrium, bitter taste in the mouth, thin yellow tongue coating, and wiry-thin pulse, attributed to liver depression and gallbladder heat.

Take equal amounts of sour jujube kernel and tea leaves, grind them into fine powder. Take 6g each time, three times daily, with tea water. (From "Summary of Liu Xianlin's Academic Experience")

Acorus tatarinowii, Solanum nigrum

Excessive sleepiness.

[Experience and Insights]

Zhang Qiming's Experience: During the Mid-Autumn Festival in 1972, a male patient surnamed Liu was introduced to me by a friend. He reported that since a traumatic brain injury in 1968, he had experienced memory decline, frequent dizziness, excessive sleepiness, and a constant state of drowsiness throughout the day. In severe cases, he would even fall asleep while walking. It had been four years, and despite seeking various treatments without significant improvement, he came to me for help.

The patient presented with a thick, greasy tongue coating and a deep, soggy pulse. Based on the theory of dampness encumbering the spleen and clouding the clear orifices, I treated him with methods to fortify the spleen, drain dampness, and open the orifices for over a month, but no significant improvement was observed.

Considering his history of trauma, I then modified and administered Tongqiao Huoxue Tang (Orifice-Unblocking and Blood-Activating Decoction). However, there was still no significant improvement.

At a loss for what to do, I suddenly recalled that black nightshade has the effect of "relieving fatigue and reducing sleepiness," so I prescribed a decoction of 1 liang of black nightshade with a small amount of 3 qian of sweetflag rhizome for treatment.

After one week of treatment, significant improvement was observed. The patient was then instructed to brew the decoction as tea and drink it whenever thirsty. After one month, the patient reported a substantial reduction in dizziness and decreased sleepiness. The treatment was continued for another two months, after which all symptoms disappeared, and the patient returned to normal. Since then, whenever encountering cases of excessive sleepiness, this formula has been applied, often yielding remarkable results.

This condition of excessive sleepiness is related to the Heart and Spleen meridians. The Heart governs the mind, while the Spleen governs the transformation and transportation of fluids. When dampness fails to transform, it generates heat, and the combination of dampness and heat clouds the clear orifices, leading to excessive sleepiness. Although this case had a history of external injury, it was unrelated to blood stasis.

Sweetflag rhizome, with its pungent and warm properties, can open the orifices and resolve phlegm, making it a key herb for regulating the Heart and Spleen. It has the ability to uplift the spirit and open the orifices. Black nightshade, with its bitter, sweet, and cold nature, has the power to detoxify and promote diuresis. Therefore, the combination of these two herbs can effectively treat excessive sleepiness caused by damp-heat clouding the clear orifices.