Main Signs and Symptoms
There appears to be no cause (i.e. no worries, no stress). She generally wakes around midnight to urinate and is then unable to go back to sleep, ‘tossing and turning until morning’. As a result she feels she has no energy and is very lethargic during the day. On examination she had pale complexion, eyes lacking spirit, slim build and poor muscle development.
Pulse: deep, thready and choppy
Tongue: pale with purple spots
Diagnosis and Treatment
Insomnia due to Blood stasis; insufficient Qi and Blood to fill the Channels and Vessels to maintain normal movement of the Qi and Blood.
Tao Hong Si Wu Wan (Persica, Carthamus & Dang-gui Combination)
After one week there was significant improvement. She continued to improve over next three weeks while taking the formula. After one month her sleep had returned to normal.
Blood stasis is a common pathodynamic underlying insomnia, especially in middle aged and elderly patients. Generally, such patients are readily subject to Blood stasis due to declining Yang Qi, and deficiency of the Qi and Blood due to declining Stomach Qi. Lack of normal movement of the Blood, together with deficiency of the Blood affects the Spirit in the Heart, depriving it of sufficient Blood to become ‘anchored’, thus preventing it from settling at night time. This leads to disruption of normal sleep patterns, as in this patient’s case. Therefore, in order to rapidly restore normal sleep, a twofold approach to treatment was adopted: nourish the Blood and also activate the Blood to dispel stasis. This approach shows how to calm the Spirit and help it settle without the use any specific herbs that nourish the Heart and calm the Spirit. It should also be noted that this type of problem is common in women of menopausal age with declining ovarian function. The formula Tao Hong Si Wu Wan has a specific action on the organs of the lower Jiao in women, including the ovary.