Visceral agitation refers to the symptoms of women experiencing emotional distress, a desire to cry, or unpredictable laughing and crying.

This condition was first mentioned in Jingui Yaolue, where Zhongjing stated, "Women with visceral agitation, speaking of sadness and a desire to cry, as if acted upon by spirits, frequently yawning and stretching..."

bubble_chart Pattern Analysis

1. Constraining of Liver Qi︰Depression, prone to sadness and crying, unable to control oneself. Chest tightness and discomfort, frequent sighing, restlessness and unease, distending pain in both flanks, or possible menstrual irregularities, tongue texture pale red, thin white coating, wiry pulse. Mostly caused by emotional depression, the liver's failure to regulate and disperse, affecting the spirit, hence prone to sadness and crying, accompanied by signs of liver depression qi stagnation (chest tightness and discomfort, frequent sighing, distending pain in both flanks, wiry pulse). Treatment should focus on soothing the liver and regulating qi, nourishing the heart and tranquilizing the mind. The recommended formula is Peripatetic Powder combined with Licorice, Wheat and Jujube Decoction.
2. Hot Phlegm︰Prone to sadness and weeping, or even abnormal crying and laughing, stuffiness in chest, coughing up yellow phlegm, restlessness, bitter taste in mouth, thirst without desire to drink, yellow urine, dry stool, tongue texture red with yellow greasy coating, slippery and rapid pulse. Mostly caused by prolonged qi depression transforming into fire, which condenses fluids into phlegm, leading to phlegm-heat stagnation that disturbs the mind. Hence, prone to sadness and weeping, often accompanied by abnormal crying and laughing, along with signs of phlegm-heat stagnation (stuffiness in chest, coughing up yellow phlegm, restlessness, bitter taste in mouth, thirst without desire to drink, dry stool and dark urine, red tongue with yellow greasy coating, slippery and rapid pulse). Frequently manifests as abnormal crying and laughing. Treatment should focus on clearing heat and resolving phlegm, soothing the liver and regulating qi, using Gallbladder-Warming Decoction supplemented with liver-soothing and qi-regulating herbs.
3. Yin Deficiency with Yang Hyperactivity︰Prone to sorrow and weeping, or easily startled and suspicious, vexation and insomnia, afternoon facial flushing, dizziness and blurred vision, dry mouth and throat, scanty dark urine, red tongue with thin white dry coating, fine and rapid pulse. Mostly caused by constitutional yin deficiency, where yin fails to restrain yang, leading to hyperactive deficient yang affecting the heart-mind, hence the tendency to sorrow and weeping, being easily startled and suspicious, accompanied by dizziness and blurred vision, afternoon facial flushing, vexation and insomnia, dry mouth and throat, scanty dark urine, red tongue, fine rapid pulse and other signs of yin deficiency with yang hyperactivity. Its differentiation from constraining of liver qi visceral agitation and phlegm-heat stagnation visceral agitation lies in: yin deficiency with yang hyperactivity visceral agitation belongs to deficiency pattern, rooted in yin deficiency where yin fails to restrain yang, deficient fire flares upward affecting the heart-mind, thus manifesting a cluster of root deficiency and branch excess signs, whereas constraining of liver qi visceral agitation and phlegm-heat stagnation visceral agitation are both excess patterns. Treatment should focus on enriching yin and clearing heat, nourishing the heart and tranquilizing the mind, using Lily Bulb and Rehmannia Decoction combined with Licorice, Wheat and Jujube Decoction with modifications.

For the symptom of visceral agitation, it is essential to first differentiate between deficiency and excess. Excess pattern may arise from the constraining of liver qi or due to phlegm heat stagnation. When qi depression is predominant, symptoms include mental depression, chest tightness, and hypochondriac distension; when phlegm heat is predominant, symptoms include chest tightness, coughing up yellow phlegm, irritability, and a bitter taste in the mouth. Deficiency pattern, on the other hand, is characterized by yin deficiency with yang hyperactivity, and will invariably present with symptoms such as deficient irritability, tidal fever, and dry mouth and throat. Clinically, by starting with the differentiation of deficiency and excess, qi depression, and phlegm heat, one can clearly distinguish between them.

bubble_chart Documentation

1. Nyuke Jinglun．Prenatal symptoms: "Unexplained sadness is associated with lung disease, visceral agitation is the visceral agitation of the lungs. During pregnancy, the qi and blood are congested to nourish the fetus, so the body fluids cannot be fully moistened, and the lungs become dry. Dry lungs should be treated by nourishing the mother, hence the use of Liquorice Root Chinese Date to tonify the spleen. If Li Zhai uses Eight Precious Ingredients Decoction to tonify and nourish qi and blood, it truly supplements what the predecessors did not fully address."