"There are many possible causes. It could be a deficiency in nutritive qi, leading to a malnourished heart and a restless mind. It could also be excessive fire-heat disturbing the mind, or perhaps a sudden fright that has left your spirit unsettled.

Furthermore, the heart is closely related to organs like the liver, gallbladder, spleen, stomach, and kidneys. Therefore, insomnia is often caused by an imbalance of yin and yang or a disharmony of qi and blood, originating from pathologies in other organs."

Li Xu saw how anxious Deng Haiyang was and reassured him, "Your condition isn’t severe, but it is prone to recurring.

Treatment is a process. More importantly, you need to try to relax in your daily life. ’Sleep when it’s time to sleep, and try not to overthink things.’

I know you’ll say you can’t control your racing thoughts, but that’s precisely what we’re going to address with medication and lifestyle adjustments."

After a moment of thought, Li Xu wrote out a prescription.

Fried Sour Jujube Seeds, Lophatherum leaf, Poria Cocos, Chuan Xiong, Zhimu, and licorice.

He also instructed Deng Haiyang to return for a follow-up appointment after taking the medicine, predicting that his insomnia would significantly improve within a few weeks.

Li Xu explained, "I’ve prescribed a formula based on Sour Jujube Seeds Soup, with the addition of Lophatherum leaf.

Sour Jujube Seeds are the core of this formula. They have a sour, astringent taste and a neutral nature. They function to nourish the heart and liver, calm the spirit, and restrain sweating. They are particularly effective for treating irritability and insomnia caused by heart and liver blood deficiency.

Their sour and bitter properties induce purgation, which can drain stagnant heat from the heart and mind, allowing heart-fire to descend and bringing a cooling sensation to the brain.

Zhimu assists in clearing heat. It can nourish yin and descend fire. Paired with Sour Jujube Seeds, it more effectively clears heat and alleviates restlessness.

And licorice serves to harmonize the properties of the other herbs, ensuring they work together synergistically without being too extreme."

"Chuan Xiong in this formula is acrid, diffusive, and ascending. It invigorates blood and moves qi, which helps promote the circulation of qi and blood in the head.

Poria Cocos, on the other hand, is bland, percolating, and descending. It promotes urination, leaches out dampness, strengthens the spleen, and calms the spirit.

When combined, they coordinate the body’s ascending and descending functions of qi, allowing qi and blood to flow smoothly and stabilizing the mind.

As for the Lophatherum leaf I specially added, its nature is sweet, bland, and slightly cold. It has the effect of dispelling heat with its potent coldness, clearing the heart, and relaxing the spleen. It is particularly adept at treating vexing heat in the upper jiao.

It assists the Sour Jujube Seeds, enhancing their therapeutic effects of clearing the heart, alleviating restlessness, calming the spirit, and aiding sleep."

After listening to Li Xu’s explanation, Deng Haiyang’s doubts vanished.

He thanked him and left with the medicine Song Sisi handed him.

Soon, another patient arrived.

This patient was a woman in her sixties named Zhang Shuhua.

She leaned on a cane and moved slowly, each step appearing to take a great deal of effort. Her face was pale, and she looked very weak.

As soon as Zhang Shuhua sat down, she let out a long sigh.

"Doctor, I’ve had this illness for twenty years now."

She spoke slowly. "I was diagnosed with heart disease twenty years ago. I’ve been seeing doctors at the hospital and taking a lot of medication ever since. The drugs only provide temporary relief for the palpitations and shortness of breath; the symptoms come right back if I stop taking them. The doctors recommended surgery, but I’m getting old, and I’m worried about the outcome and the side effects of the drugs."

After a pause, she continued describing her current symptoms. "Now, I have palpitations and shortness of breath all day, and I suffer from chronic insomnia at night. I can’t sleep well at all.

My head is always dizzy and feels full and numb, with a dull ache that’s not quite pain. I also feel a hot, swollen sensation inside my ears, and my face goes numb from time to time.

My chest has a constant stabbing pain, and I can feel the muscles inside twitching randomly.

I sweat profusely. The slightest movement makes me break out in a sweat.

My knees are both painful and cold, and I always feel like something is burrowing or crawling along my spine.

Different parts of my body twitch at random times, and my limbs feel numb.

Now I have to use a cane whenever I go out, otherwise I can’t walk at all."

She also took out a stack of diagnostic reports from the municipal hospital.

Li Xu looked them over. She had been diagnosed with "rheumatic heart disease," and a hospital fluoroscopy showed that her heart was enlarged.

"Everyone says you’re a great doctor, so they told me to come and give it a try. I’ve been dragging this illness along for so long anyway, I’m treating this as a last resort."

In truth, Zhang Shuhua didn’t have much confidence.

Li Xu’s brow furrowed as he listened to Zhang Shuhua’s description.

The symptoms affected her entire body—from her head, face, chest, and back to her limbs, and from her internal organs to her skin—testifying to the complexity and severity of her condition.

"Ma’am, do you usually have a bitter taste in your mouth?"

Li Xu asked.

Zhang Shuhua nodded. "Yes, a bitter taste, especially when I get angry. My urine is also yellow."

Li Xu then asked her to stick out her tongue.

He saw that her tongue was pale, with smooth, peeled edges and no coating.

He then took her pulse. The pulse in the *guan* position on her right wrist was uniquely large and forceful, while her left pulse was deep and faint, with the *cun* position pulse being especially weak.

Li Xu withdrew his hand and pondered for a moment before saying to Zhang Shuhua, "Ma’am, your condition is indeed quite serious."

Hearing the word "serious," Zhang Shuhua wasn’t particularly surprised.

After all, many doctors had told her the same thing.

But Li Xu’s tone shifted. "However, serious doesn’t mean untreatable. Your illness can be managed with Chinese medicine. I can’t promise you a complete cure, but I can at least improve your quality of life."

"Huh?"

Zhang Shuhua was taken aback.

She had seen doctors in many different places.

Even some specialists hadn’t dared to give her such an assurance.

A glimmer of hope appeared. She asked, "Doctor, can it really be managed?"

"Ma’am, rest assured, I’ve been practicing medicine for a long time, and I have never lied to a patient. If I say it can be managed, I can do it. But you must also be mentally prepared. Your condition is chronic and persistent, so treatment will require time and patience."

"Your condition presents with numerous symptoms all over your body, but the core principle of treatment is to grasp the key issue and regulate it from the level of nutritive and defensive qi, as well as qi and blood."

Li Xu explained his therapeutic approach.

"The prescription I’m writing for you will be based on Chai Gui Jia Longgu Muli Tang as the main formula, combined with Gualou Bai Banxia Tang, and supplemented with some herbs that open the heart’s orifices."

"Chai Gui Jia Longgu Muli Tang is a formula primarily used to uplift the qi mechanism, harmonize nutritive and defensive qi, and stop sweating.

It can effectively alleviate your symptoms like palpitations, shortness of breath, numbness, muscle twitching, and joint pain. At the same time, it also calms the mind and spirit, helping to improve your sleep.

This formula can soothe the liver and resolve depression, and harmonize the nutritive and defensive qi, which will be very helpful in improving your systemic discomfort."

"As for the stabbing pain in your chest, in Chinese medicine, this is considered to be a result of phlegm-qi stagnation obstructing the chest yang.

I’m using Gualou Bai Banxia Tang, a formula that specifically targets chest and back pain with remarkable results.

Gualou can clear heat and transform phlegm, broaden the chest, and dissipate nodules.

Banxia, on the other hand, dries dampness, transforms phlegm, directs rebellious qi downward, and stops vomiting.

Used together, they can effectively relieve the stabbing pain in your chest."

"Additionally, I’ve added Acorus, Polygala Tenuifolia, and Poria Cocos to the formula.

These three herbs all have the effect of opening the heart’s orifices and strengthening cardiac activity.

Acorus can transform dampness and open the appetite, open the orifices, and tranquilize the spirit.

Polygala Tenuifolia can calm the spirit and improve intellect, expel phlegm, and open the orifices.

And Poria Cocos strengthens the spleen, leaches dampness, and calms the heart and spirit.

When combined, these herbs can better enhance heart function and improve your symptoms of palpitations and insomnia."

Li Xu finished writing the prescription and handed it to Song Sisi to have the herbs filled.

Then he instructed Zhang Shuhua, "Take this for one week, then come back for a follow-up. I will adjust the formula based on any changes in your symptoms. Remember to eat a light diet and maintain a relaxed mood while taking the medicine."