be affected.
As always in Chinese medicine, there is an interrelationship between body and Mind. On the one
hand, a deficiency of Blood or a pathogenic factor such as Fire may affect the Mind; on the other
hand, emotional stress affecting the Mind may cause a disharmony of the internal organs. In fact,
any disharmony of the internal organs, whether it is due to a Deficiency or an Excess, affects
Blood and Essence. Since the Essence and Qi are the root of the Mind (the "Three Treasures"),
the Mind has then no residence and insomnia may result. The "Simple Questions" in chapter 46
says: "When a person lies down and cannot sleep, [it means] the Yin organs are injured [so that]
the Essence has no residence and is not quiet and the person cannot sleep".1(276)
As far as sleep is concerned the Mind is not the only mental-spiritual faculty involved. The
Ethereal Soul (Hun) also plays an important role in the physiology and pathology of sleep and
the length and quality of sleep are related to its state (see Chapter 9). If the Ethereal Soul is well
rooted in the Liver (Liver-Bloo d or Liver-Yin), sleep is normal, sound and without too many
dreams. If Liver-Yin or Liver-Blood is deficient, the Ethereal Soul is deprived of its residence
and wanders off at night, causing a restless sleep with many tiring dreams. Tang Zong Hai says:
"At night during sleep the Ethereal Soul returns to the Liver; if the Ethereal Soul is not peaceful
there are a lot of dreams".2(277)
The Ethereal Soul is affected not only by a deficiency of the Liver, but also by any pathogenic
factor (such as Fire or Wind) agitating the Liver. The "Complete Book of Jing Yue" (1624) by
Zhang Jing Yue says: "Overexertion, worrying and excessive thinking injure Blood and fluids so
that the Mind and Ethereal Soul are deprived of residence and insomnia results".3(278) It also
says: "Worrying and excessive thinking injure the Spleen so that it cannot make Blood and
insomnia results".4(279)
When a patient complains of poor sleep we must ascertain that the condition is true insomnia and
not an inability to sleep well due to other external or temporary causes. For example, a sudden
change in weather, a bedroom which is too hot or too cold, drinking a lot of tea or coffee, an
emotional upset or worrying about something specific may all cause a person to sleep badly but
cannot be defined as "insomnia". In fact, once the above causes are removed, the person sleeps
well. Also, one cannot diagnose insomnia when sleep is disturbed by other conditions such as
asthma, a pain (e.g. shoulder, hip or back pain) or itching from a skin disease; in such cases,
sleep is restored once the relevant disease is treated successfully.
Finally, according to traditional Chinese views, the best sleeping position is lying on the right
side, with the legs slightly bent, the right arm bent and resting in front of the pillow, and the left
arm resting on the left thigh. According to these views, with this position the heart is in a high
position so that Blood can circulate freely, the liver is in a low position so that Blood can collect
there and root the Ethereal Soul to promote sleep, and the stomach and duodenum are in such a
position that facilitates the downward movement of food.