Common concerns
不寐
Waking at the same small hour night after night, then lying there until the birds, is one of the oldest complaints in the Chinese literature, written 不寐: not sleeping. The tradition does not ask how many hours you got. It asks which hour you woke, whether you were hot, and what your mind was doing, because those details sort into different pictures. Insomnia is the word most people arrive with; the tradition works with the hour.
不寐
The Chinese literature has been writing about people who cannot sleep for a little over two thousand years, and the striking thing about the early passages is what they choose to notice. Not the number of hours. The Neijing’s explanation is mechanical in its own terms: the body’s defensive qi, 卫气 wèi qì, is supposed to travel the outside of the body by day and turn inward at nightfall, and sleep is what happens when it does. When it cannot get in — because the inside is too hot, too full, or too empty to receive it — a person lies with their eyes open.
When defensive qi cannot enter the yin and lingers in the yang, the yang is full and the yin is empty, and so the eyes do not close.
The second early passage is shorter and more domestic. The Suwen puts it in six characters: when the stomach is not at ease, lying down is not at ease either, 胃不和则卧不安. Anyone who has gone to bed full and woken at two knows exactly what it means, and it is still the first thing a physician in our clinic asks about: what you ate, and when.
When the stomach is not in harmony, lying down is not peaceful.
By the Ming the subject had a chapter of its own. Zhang Jiebin’s Jingyue Quanshu of 1624 opens its discussion of 不寐 with a distinction we still use: sleeplessness is either because something is present that should not be — heat, food, phlegm, a mind that will not stop — or because something is missing that should be there, usually blood or yin. The first kind wakes you hot and busy. The second kind leaves you tired and awake at once, which is worse.
失眠
Most people who find this page have already been given, or have given themselves, a word for it: insomnia. It is a perfectly good word for a fact — that sleep is not happening — and a clinician where you live may have used it, possibly with a qualifier about falling asleep or staying asleep. We do not use it in a reading, and not out of squeamishness. The tradition has no equivalent, because it never grouped all sleeplessness under one name. It grouped it by what else was true of the person.
So the honest translation of the word you arrived with is not one Chinese term but a question: which kind? Cannot fall asleep, or fall asleep and wake? Wake hot, or wake cold? Wake with a racing mind, or with nothing in it at all? The answers are what a reading is built from, and they are the reason the thirty questions ask about your evening meal and the temperature of your feet before they ask about your sleep.
子午流注
The tradition keeps a clock. The 子午流注 zǐ wǔ liú zhù, the midnight-noon ebb and flow, assigns each two-hour watch of the day to one organ network, on the idea that qi runs through the networks in a fixed circuit. It is a metaphor rather than a mechanism, and we say so plainly, but it is a metaphor that turns out to be a useful sorting tool.
Three in the morning sits on the border between the first two, which is part of why it is the hour people name most. In the clinic we do not take the clock literally. We take it as a prompt: a person who wakes at one, hot, with a mind running through the day’s arguments is described differently from one who wakes at four, cold, with a heaviness in the chest, and the clock is simply the fastest way to start telling them apart.
辨证
Four pictures account for most of what we see. They overlap, and the reading’s job is to say which is underneath.
The tongue decides more of this than the story does, which is why a reading asks for one photograph taken in daylight. Red and peeled tips towards the first picture; pale and thin towards the second; a thick greasy coat towards the third. A person can rarely see this on themselves, and should not try to.
起居
The things that reliably make broken sleep heavier are dull, and everyone already knows them, so we will be brief. A large evening meal, and especially a late one. Alcohol, which the tradition reads as hot and damp and which sends people to sleep and then wakes them at two. Screens, which the tradition did not anticipate but would have filed under keeping the spirit 神 shén out in the yang when it should be going home. Lying in bed working out how to fix the night.
None of that is a promise, and we make none. It is the floor. A reading starts from the floor and adds the things that depend on which picture you are.
食
The kitchen has been asked about sleep for a long time, and its answers are modest. Two items from the shared-origin catalogue come up in almost every reading that names broken sleep, and both are already on this site.
Lotus seed: it joins the heart and the kidney, thickens the intestines and stomach, and secures the essence.
The same warning as everywhere on this site applies with more force here than usual: the foods for the hot, dry picture and the foods for the cold, tired one pull in opposite directions, and the complaint itself — awake at three — does not tell you which you are.
穴
The point the tradition pairs most often with a heart that will not settle is on the inside of the wrist, three finger-widths above the crease, between the two tendons: Neiguan, Pericardium 6, 内关, the Inner Gate. Its entry explains how to find it on your own arm. Held for a minute on each side before bed, with the out-breath, it is the one thing in this section that costs nothing and needs nobody.
It is pressure with a thumb, not a needle, and it is not a claim about outcomes. It is what a physician in our clinic would show you with her own hand if you were sitting across the desk.
慎
Everything else on this page still stands afterwards. The clock, the four pictures and the lotus seed will describe the nights accurately once the things above have been looked at; they are not a substitute for looking.
Questions
Because in its reading the hour is a clue to which picture you are carrying, not a coincidence. Waking hot at one with a busy mind, and waking cold at four with a heavy chest, are described differently and eased differently. The clock the tradition uses is a metaphor rather than a mechanism, but as a sorting question it has held up for a long time.
No. Insomnia is a Western word for a fact, that sleep is not happening. The tradition never grouped all sleeplessness under one name; it grouped it by what else was true of the person, mainly whether the body was too hot, too full or too empty at night. A reading names that picture rather than the word you arrived with.
It will tell you which of the tradition’s pictures your thirty answers and your tongue fit, in Chinese and in English, and what usually eases that picture — food, hours, one point. It will not tell you a cause in the Western sense, because it cannot see one, and it says so on its first page.
Eating late, drinking in the evening, and lying awake in bed. Those three account for more broken nights in our clinic notes than everything else combined, and a reading that named a beautiful pattern while you carried on doing all three would be a waste of your money.
The others
Broken sleep and an unsettled mind share most of the clinic notes they appear in. Long tiredness and unpredictable digestion share a spleen. Skin that flares and a head that aches both rise with heat. If more than one of the six is yours, read the nearest neighbour next, and notice how often the same picture is underneath both — that picture, rather than either complaint, is what a reading is written about.
Every page here hands over to the same three places: the five patterns, which are the pictures these complaints sort into; the food pages, where the shared-origin list is sorted by what each ingredient is traditionally understood to do; and the three points, which you can press with your own hands. All of it is free, and none of it needs anything from us first.
The reading
Every page in this section is written for everyone who arrives with the same complaint, which means it is written for nobody in particular. A reading is the opposite: thirty questions, one photograph of your tongue, and a document written in English for you alone by a physician licensed in China, sent within 48 hours.