Excessive fear refers to the sensation of fear arising without encountering any actual frightening events, ultimately leading to mental unease, such as symptoms akin to being pursued by someone.

bubble_chart Pattern Analysis

1. Kidney Essence Insufficiency︰Weakness and soreness in the waist and knees, listlessness, flusteredness, tendency to fear, seminal emission, night sweat, insomnia, vexation, scant tongue coating with a red tongue body, and thin weak pulse. Fear is associated with the kidney's emotion. If prolonged illness with seminal emission or excessive sexual activity depletes essential qi, internal deficiency manifests as a tendency to fear. Lingshu.Jingmai states: "The Kidney Foot-Shaoyin meridian... when qi is insufficient, there is a tendency to fear." The key points for clinical pattern differentiation are: a tendency to fear accompanied by weakness and soreness in the waist and knees, mental fatigue, vexation, night sweat, tidal fever, seminal emission, and a faint weak pulse, which are signs of kidney deficiency pattern. Treatment should focus on tonifying the kidney and replenishing essence. The prescription of choice is Six-Ingredient Rehmannia Decoction plus Milkwort Root and Barbary Wolfberry Fruit; for kidney yang deficiency, add Deer Horn and Cassia Bark.
2. Deficiency of Both Qi and Blood︰Fatigue, lack of strength, spontaneous sweating, shortness of breath, flusteredness, palpitation, easily frightened by events, dull complexion, pale tongue with thin coating, thready and weak pulse. The heart governs the spirit, and when the spirit loses nourishment due to blood and qi deficiency, it leads to frequent fear. Suwen. Sishici Nicong Lun: "Internal depletion of blood and qi causes frequent fear; excessive fear, in turn, easily injures the spirit." Lingshu. Benshen chapter: "Injury to the spirit results in self-loss through fear." The key points for clinical differentiation are: frequent fear accompanied by shortness of breath, spontaneous sweating, lack of strength, dull complexion, weak pulse, and other signs of qi weakness and blood deficiency. Treatment should focus on tonifying and replenishing qi and blood, with the prescription of Milkwort Root Pill combined with Eight Precious Ingredients Decoction. Although this pattern and the frequent fear due to kidney essence insufficiency both belong to deficiency patterns, and clinically may manifest as insufficient spirit, fatigue, lack of strength, dull complexion, weak pulse, and frequent fear, the frequent fear due to kidney essence insufficiency is primarily characterized by kidney deficiency symptoms, while the frequent fear due to qi and blood deficiency is mainly caused by the spirit losing nourishment. These are not difficult to differentiate. However, since essence, qi, and blood mutually transform, the frequent fear due to kidney essence insufficiency and that due to qi and blood deficiency can exist independently in clinical practice, or they may transform into each other or coexist.
3. Liver and Gallbladder Deficiency︰Discomfort in both flanks, indecisiveness when encountering situations, timidity and frequent fear, thin tongue coating with pale color, and weak pulse. The liver stores blood and houses the ethereal soul (魂). The ethereal soul moves with the spirit. If the body is inherently weak, essence fails to transform into qi, and the liver and gallbladder are insufficient, then the liver cannot store the ethereal soul, and the gallbladder loses its decisiveness, leading to frequent fear when facing situations. Zhubing Yuanhou Lun states: "Liver deficiency leads to fear... When the heart and liver are deficient and affected by wind pathogens, and gallbladder qi is weak, they are invaded by wind, causing fear as if being pursued." The key clinical distinguishing features are: frequent fear accompanied by discomfort in both flanks, a timid and fearful nature, and a tendency toward excessive worry and indecisiveness when encountering situations. The treatment should focus on tonifying the liver and gallbladder, with the formula choice being Bu Dan Fangfeng Tang (Supplement the Gallbladder Saposhnikovia Root Decoction).

bubble_chart Documentation

1. Suwen．Xuanming Wuqi Discussion: "The stomach is the counterflow of qi, causing hiccups and fear."
2. Yizong Jinjian．Zabing Heart Method: "Fear and inability to sleep alone, gallbladder qi deficiency and timidity are treated with Renshu, Bo Ren, Di Gou, Wei Yu, Gui, Shen, Ju, Ke, and wine for administration."