bubble_chart Concept

The pattern of gallbladder qi deficiency refers to a series of symptoms and signs caused by gallbladder insufficiency with timidity, primarily characterized by timidity and palpitation due to fright. It is often caused by internal damage from the seven emotions or by qi deficiency affecting the gallbladder.

The main clinical manifestations include: timidity, severe palpitation, frequent fright, indecisiveness, restless sleep, dreamfulness, shortness of breath, lack of strength, or accompanied by dizziness, blurred vision, wiry and thin pulse, and pale red tongue texture.

The pattern of gallbladder qi deficiency is commonly seen in diseases such as "palpitation due to fright," "insomnia," "manic and depressive psychosis," "stagnation syndrome," and "syncope."

This syndrome should be differentiated from "heart-gallbladder non-tranquility syndrome" and "pattern of liver qi deficiency."

bubble_chart Differentiation and Treatment

The pattern of gallbladder qi deficiency can be seen in various diseases.

1. For example, in "palpitation due to fright," this syndrome manifests as dizziness with a desire to vomit, timidity and easy fright, restlessness, inability to sleep due to vexation, frequent sighing, blurred vision, dysphoria, excessive phlegm, poor appetite with nausea, a wiry and thin pulse, and a greasy tongue coating. It is caused by internal damage from the seven emotions, chaotic qi movement, and phlegm-heat disturbing upwards. The treatment aims to resolve phlegm, descend turbidity, warm the gallbladder, and calm the spirit. The formula used is Gallbladder-Warming Decoction(Qianjin Fang) with modifications.
2. In "insomnia," it manifests as insomnia with dreamfulness, easy fright and timidity, palpitations, shortness of breath, fatigue, clear and copious urine, a pale red tongue, and a wiry and thin pulse. The "Shenshi Zunsheng Shu·Insomnia" states: "Fear and timidity of the heart and gallbladder, easily startled upon contact, many inauspicious dreams, and inability to sleep due to vexation." It is due to a weak constitution, inherent gallbladder qi deficiency, or sudden fright. The treatment should tonify qi, calm fright, tranquilize the spirit, and calm the mind. The formulas selected are Spirit-Tranquillizing Mind-Stabilizing Pill(Yixue Xinwu) or Sour Jujube Decoction(Jingui Yaolue).
3. In "manic and depressive psychosis," it manifests as mental derangement, silence and dementia, fear and easy fright, incoherent speech, or insomnia with dysphoria, a red tongue with yellow coating, and a slippery and rapid pulse. This is due to excessive contemplation, gallbladder qi deficiency and timidity, unsettled heart spirit, and phlegm-qi depression transforming into heat. The treatment requires clearing heat, resolving phlegm, tranquilizing the spirit, and stabilizing the mind. The formula selected is Gallbladder-Warming Decoction with the addition of Magnetite, raw Hematite, Cinnabar, and other heavy sedatives to tranquilize the mind.
4. In "stagnation syndrome," it manifests as depressed mood, mental confusion, easy fright upon encountering events, frequent worry and crying, a pale red tongue, thin white coating, and a wiry and thin pulse. It is often caused by emotional frustration, liver qi depression affecting the gallbladder. The treatment should resolve depression, regulate qi, nourish the heart, and tranquilize the mind. The formula selected is Depression-Resolving Pill(Danxi Xinfa) combined with Licorice, Wheat and Jujube Decoction(Jingui Yaolue) with modifications.

If the pattern of gallbladder qi deficiency is left untreated for a long time, it often affects heart qi, leading to the pattern of qi deficiency in the heart and gallbladder, manifesting as severe palpitation due to fright. Since the gallbladder and liver are internally and externally related, gallbladder qi deficiency often develops into liver-gallbladder qi deficiency, presenting with symptoms such as dull pain under the ribs, muscle spasms, tinnitus, and deafness.

bubble_chart Differentiation of Similar Patterns

1. Pattern of liver qi deficiency and pattern of gallbladder qi deficiency: The liver governs the free flow of qi and is internally and externally related to the gallbladder. The pattern of gallbladder qi deficiency is often caused by the liver's failure to disperse and regulate, and both belong to qi deficiency, making them easily confused. However, liver qi deficiency is due to the stagnation of the seven emotions or develops on the basis of liver blood deficiency, presenting symptoms such as melancholy, reticence, fatigue, headache, hypochondriac pain, and blurred vision. On the other hand, gallbladder qi deficiency is mainly caused by emotional internal damage, presenting symptoms such as fearfulness, easy fright, insomnia, dreamfulness, or accompanied by dizziness and blurred vision, which are generally less severe, allowing for differentiation.
2. The syndrome of heart-gallbladder unrest and pattern of gallbladder qi deficiency: Both syndromes can present with emotional disturbances and sleep disturbances. The syndrome of heart-gallbladder unrest can be either excess or deficiency: it can be caused by heart qi deficiency affecting the gallbladder, or by gallbladder qi deficiency leading to heart qi deficiency, resulting in a deficiency pattern, presenting symptoms such as palpitations, confusion, and insomnia. There is also the case where phlegm-heat obstructs internally, gallbladder qi stagnates and transforms into fire, disturbing the heart spirit and leading to an excess pattern of heart-gallbladder unrest, presenting symptoms such as heart vexation, thirst, irritability, and a red tongue tip. The pattern of gallbladder qi deficiency is formed by gallbladder qi insufficiency, purely a deficiency pattern, presenting symptoms such as timidity, palpitations, dizziness, blurred vision, and insomnia dreamfulness. This is how they are distinguished.

bubble_chart Documentation

1. Zhangshi Yitong‧Fear: "Dizziness and fear, stringy and weak pulse, belonging to gallbladder deficiency, Six Gentlemen Decoction with Bupleurum, Saposhnikovia Root, Chinese Angelica, and also take modified Eight Flavor Pill. Gallbladder deficiency with dim vision, sore throat, frequent spitting, dizziness and blurred vision due to liver qi stagnation, dreaming of disputes, fear causing complexion changes, use Gallbladder-Tonifying Saposhnikovia Root Decoction."
2. Zhangshi Yitong‧Fright: "Frequent nightmares and enuresis during sleep, use Gallbladder-Tonifying Saposhnikovia Root Decoction with Notopterygium and Cinnamon Twig, this is lower energizer wind-cold, suitable for wind-dispelling herbs to regulate the meridians."