Can’t Sleep All Night and Sleeping Pills Don’t Work? Doctor Zhang Xichun Cures Insomnia by Strengthening the Spleen and Stomach
Search terms this page answers: can’t sleep / insomnia / awake all night / sleeping pills don’t work / heat in the chest / no desire to eat / dry, bound stools
Medical terms: insomnia (bu mei) · liver blood deficiency (gan xue bu zu) · liver wood invading spleen earth (gan mu ke pi tu) · stomach qi failing to descend (wei qi bu jiang) · deficiency of both heart and spleen (xin pi liang xu)
Opening: a 66-year-old official who tried every sleeping pill and still could not sleep
During the Republican era, an elderly gentleman of 66 lived in Tianjin. He held a high official post — yet one thing had begun to torment him unbearably: he could not sleep. It started mildly in winter, and he paid it little attention. By spring the illness suddenly turned fierce: for several nights in a row he lay awake the whole night through. He tried every sleeping pill there was — and none of them did a thing. He grew thin, his spirit collapsed, and his family was frantic with worry.
💬 Note from Doctor Luo: Insomnia is enormously common today — especially among people who carry too many cares and think too much. This patient’s underlying cause is almost exactly the same as that of today’s office workers, which is why this case is especially worth telling.
Who was the patient? The president’s younger brother — who wrote his way into insomnia
The patient was Xu Youmei (徐友梅), the younger brother of Xu Shichang, President of the Republic of China, and at the time he held the post of daoyin (道尹) — a local administrative official of the Republican era, restructured from the Qing dynasty’s guanchashi posts. He lived at Xiaosongdao Street, District One, Tianjin. In a few strokes, Doctor Zhang Xichun set down his identity, his work and his age with complete clarity.
💬 Note from Doctor Luo: In Chinese medicine, you treat the whole person in his full context — age, position, work, and way of life all have to be taken into account before you can dig out the true cause. An official worries over countless affairs; that inevitably wears on the heart and spirit. At 66, his body was in decline. And he fell ill in spring — and spring corresponds to the liver. You see — the clues to the cause were already lined up one by one.
How did the illness come about? The old gentleman was deeply fond of poetry and often formed poetry clubs with his friends. To weigh a single word or phrase, he would mull it over day after day, silently draining his heart blood. On one side, the cares of office; on the other, the effort of composing verse — squeezed from both directions, his blood was gradually burned dry. And so insomnia arrived.
The symptoms: not just sleeplessness — a blocked stomach and dry bowels too
Doctor Zhang Xichun recorded the symptoms in remarkable detail: his spirit was exhausted, far worse than before; he constantly felt heat in his chest; he had no appetite — and if he forced himself to eat a little more, the food simply lodged in his stomach and refused to move downward; his stools were dry — so dry that he had to rely on medicine to move his bowels at all. On taking the pulse: the left pulse was floating and wiry (fu xian), the right pulse wiry and hard, at five beats per breath.
💬 Note from Doctor Luo: The phrase “no appetite for food” (lan yu yin shi) is extremely important. The sleeplessness is only one expression. The blocked stomach, the dry stools, the heat in the chest — these are all melons on a single vine. Doctor Zhang Xichun never treated insomnia by staring only at the word “sleep.”
The diagnostic highlight: the hun (spirit-soul) had no home to rest in, so sleep would not come
What does a floating, wiry left pulse mean? Liver blood deficiency (gan xue bu zu). Day after day of draining the heart spirit and heart blood had consumed the blood of the heart and liver severely. Blood is yin; when yin is insufficient, yang floats upward, and liver fire rises. Chinese medicine teaches that “the hun dwells in the liver” — the liver stores blood, and at night the hun goes into the liver to rest. Now the liver blood was depleted and fire had arisen: the hun had nowhere to return (hun wu suo gui). With no place for the spirit to rest at night, of course a person cannot sleep; and after a sleepless night, of course he has no energy during the day.
💬 Note from Doctor Luo: This is a very important principle of Chinese medicine: when liver blood is deficient, the liver cannot store blood and the hun has nowhere to return. Seen through Chinese medicine, insomnia is often not “the brain refuses to sleep” — it is “the hun has no place to land.”
And why was the right pulse wiry and hard? When a person’s liver blood is deficient and liver fire runs high, the first organs affected are the spleen and stomach — in Chinese medicine this is called liver wood invading spleen earth (gan mu ke pi tu). The stomach works properly only when its qi descends. Now liver fire had disturbed the spleen and stomach, the stomach yin was insufficient, food could not be digested and the stomach qi could not descend — so it piled up in the stomach, and further down it dragged on the intestines, and the stools became bound. So whenever you see liver blood deficiency and liver fire, you must always think: the spleen and stomach are affected too.
Breaking down the formula: the first herb for insomnia was yam, to strengthen the spleen and stomach
Doctor Zhang Xichun’s strategy was to clear liver fire, nourish liver blood, generate liver blood, and send the stomach qi downward — he called this “knowing the stomach yin” (that is, nourishing yin). But when the formula appeared, many people were taken aback: the very first herb was sheng huai shan yao (raw Huai Chinese yam), 30 g (one liang) — a generous dose.
💬 Note from Doctor Luo: Most doctors treating insomnia start with herbs that nourish the blood and settle the spirit. Doctor Zhang Xichun would not do that — he first regulated the spleen, opening the formula with 30 g of raw Huai yam. That is the mark of a true master! In the Republican era, the first name in Chinese medicine was Doctor Zhang Xichun; he mostly saw patients whom Western medicine could not cure, and everything he wrote was clinical experience.
Can Huai yam really cure insomnia? Doctor Luo Dalun told a true story of his own: an elder in his family developed senile depression — convinced he had a brain tumor or stomach cancer, frightened day and night, unable to sleep at night, unable to eat, thin as a skeleton. When it was finally discovered that he had a pituitary tumor and he had it surgically removed, the insomnia continued; during his hospital stay he paced the corridor in the middle of the night, frightening the duty doctor into a cold sweat. Doctor Luo first gave him Zhu Sha An Shen Wan (Cinnabar Spirit-Settling Pill) and Tian Wang Bu Xin Wan (Heavenly King Heart-Tonifying Pill), and then told him: every day at noon, take two spoonfuls of Huai yam powder in hot water. He kept at it for more than two years — and the insomnia was completely cured, his body fully recovered, his complexion bright with a white luster like polished jade. At family gatherings everyone said he looked like a different man.
💬 Note from Doctor Luo: The greatest truth is the simplest. Most people give up on their own health — someone who practices Baduanjin every day will of course be transformed after two years; half a year of Huai yam powder changes the constitution markedly, and a full year transforms a person entirely. Fix on one sound principle and persist — that is the only way to truly change your constitution. This approach I used for my elder came straight from Doctor Zhang Xichun’s book.
The second half of the formula is where the real subtlety lies. Doctor Zhang Xichun explained it himself: the Neijing contains few insomnia formulas, but one of them is Ban Xia Shu Mi Tang (Pinellia and Sorghum Decoction) — pinellia (ban xia) sends the stomach qi downward, while shu mi (the sorghum of today, cooked until thick and sticky) tonifies and harmonizes the spleen and stomach — harmonizing the middle burner while sending the stomach qi down. Hence the saying: “When the stomach is not at peace, one cannot lie down in peace (wei bu he ze wo bu an).” Doctor Zhang Xichun used Huai yam paired with raw hematite (sheng zhe shi) — the yam tonifies the spleen and stomach, the hematite moves downward — precisely the method of Ban Xia Shu Mi Tang.
Next came gou qi zi (wolfberry), 24 g (eight qian) to tonify the essence of the liver and kidney; paired with xuan shen (figwort root) and bei sha shen (north adenophora root) to nourish yin — when kidney yin is sufficient, liver yin is sufficient; white peony (bai shao) with licorice (gan cao) forms Shao Yao Gan Cao Tang (Peony and Licorice Decoction), generating yin from sour and sweet flavors. These herbs together nourish the yin of the liver and kidney. Chao suan zao ren (dry-fried sour jujube seed), 12 g (four qian), was added specifically to nourish liver blood.
💬 Note from Doctor Luo: The famous Ming dynasty physician Miao Xiyong (缪希雍) once treated a postpartum patient who could not sleep after losing too much blood in childbirth — he used a large dose of dry-fried sour jujube seed, with the famous saying: “To nourish the blood, you must use suan zao ren (sour jujube seed).” It is said that after taking the medicine the woman slept continuously for days, and when she woke her complexion was rosy and more beautiful than usual. So even today, when insomnia is treated with powdered dry-fried sour jujube seed, what is being nourished is precisely the liver blood.
The formula also contained sheng mai ya (raw malt) — to spread and lift the liver qi — and yin chen (oriental wormwood seedling) — the tender young sprout of artemisia that appears in early spring, which spreads the liver qi, soothes the liver, and disperses the heat of the liver and gallbladder. Doctor Zhang Xichun held that yin chen’s nature is close to chai hu (bupleurum), but for people who are frail and yin-deficient, chai hu disperses too forcefully, so yin chen can be used in its place — its action is gentler. Paired with raw malt, it unknots the bound liver qi, and the pathogenic fire naturally disperses. A little sheng ji nei jin (raw chicken gizzard lining) was added to transform stasis and open the appetite, helping the stomach qi descend. The formula both rises and falls: raw hematite sends things down, raw malt and yin chen lift things up — a very complete prescription.
The course of treatment: two doses showed effect, three more brought peaceful sleep
How did the medicine work? After two doses, he could already sleep two to three hours a night, the heat in his chest was gone, and his appetite had slightly increased. His stools were still a little sluggish, but the pulse was no longer so wiry and hard. Seeing the effect, Doctor Zhang Xichun decisively changed the formula: raw Huai yam 30 g (one liang), raw hematite 18 g (six qian) — still the method of Ban Xia Shu Mi Tang, tonifying the spleen and stomach, supporting the upright qi and sending the stomach qi down — with wolfberry, figwort root, north adenophora root, sour jujube seed, white peony and licorice unchanged, the group devoted to regulating the liver. He removed the raw malt and added two new herbs — long yan rou (longan fruit), 9 g (three qian), and yuan zhi (polygala root), 4.5 g (one and a half qian).
💬 Note from Doctor Luo: Longan fruit tonifies spleen qi, nourishes heart blood and calms the spirit — an herb that tonifies both heart and spleen at once, especially suited to insomnia from thinking too much day after day and exhausting the heart blood. Yuan zhi is generally regarded as settling the spirit and linking the heart and kidney, treating palpitations, insomnia and dream-disturbed sleep from heart-kidney disharmony; Doctor Zhang Xichun added his own insight — yuan zhi is sour in flavor, so it can astringe liver fire, and at the same time it enters the stomach channel to help digestion — one herb, several uses.
Three more doses, and the result: at night he slept peacefully as if normal, his appetite surged back, and his bowels moved freely — only the pulse was still a little wiry and hard. Doctor Zhang Xichun’s instruction: increase the longan fruit to 24 g (eight qian) and continue for several more doses to consolidate the cure.
The narrator’s closing note: five doses, and the whole “machine” was regulated
A patient whom no sleeping pill could help — Doctor Zhang Xichun resolved it in five doses. And he did not simply settle the spirit and let the man sleep, then call it done. What he actually did was: regulate the spleen and stomach so eating returned to normal; send the stomach qi down so the bowels moved freely; nourish liver blood, nourish liver yin, spread the liver qi, so the hun returned to its home — regulating the whole machine of the body from the top down, and the insomnia cured itself along the way.
💬 Note from Doctor Luo: This is the hallmark of Doctor Zhang Xichun’s practice — thorough consideration, accurate diagnosis, every aspect attended to. When treating insomnia, do not fixate on the two words “settle the spirit.” Ask yourself first: is my spleen and stomach well? Is my liver blood sufficient? Do my bowels move freely? Regulate all of these, and sleep usually follows as naturally as water finding its own level.
Adapted from Doctor Luo Dalun’s commentary on Doctor Zhang Xichun’s case records, from Records of Chinese Medicine with Western Reference (《医学衷中参西录》).