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The process of diagnosing a morbid condition as a disease pattern of the gallbladder.

Physiology Recap

The gallbladder stands in external-internal relationship with the liver. It discharges bile. It governs decision-making. Its channel is the foot lesser yáng (shào yáng) channel.

Gallbladder Signs

The main gallbladder signs are yellowing of the body and eyes, indecision, gallbladder timidity, and alternating cold and heat.

Yellowing of the body and eyes (身目发黄 shēn mù fā huāng) is a sign of jaundice due to damp-heat or cold-damp affecting the liver and gallbladder. A bright coloration like tangerines is attributed to damp-heat, while a dull coloration is attributed to cold-damp.

Indecision (遇事不决 yù shì bù jué): Inability to make decisions. It is attributed to the gallbladder’s governance of decision-making. It is seen in gallbladder qì vacuity.

Gallbladder timidity (胆怯 dǎn qiè): Also called gallbladder timidity and susceptibility to fright (胆怯易惊 dǎn qiè yì jīng) and qì timidity (气怯 qì qiè). Shyness, fearfulness, and lack of courage resulting from a disturbance of the gallbladder’s governance of decision-making. It is often accompanied by susceptibility to fear and fright, heart vexation, unquiet sleep or insomnia, and profuse dreaming or nightmares. It is observed in gallbladder qì vacuity and in liver-gallbladder patterns involving heat.

Connotations of Gall

English-speaking and Chinese culture traditionally attached psychological qualities to the gallbladder and bile. In modern English, we use gall to mean boldness or effrontery. In Chinese, the word for gallbladder is used to mean courage or boldness: someone who has great courage or boldness, is said to be 大胆 dà dǎn, big gallbladder. This cultural notion may be related to the Chinese medical concept of the gallbladder governing decision and resoluteness.

The terms gallbladder cold (胆寒 dǎn hán) and gallbladder vacuity (胆虚 dǎn xū) often appear in pathological descriptions. Though they appear to be pattern names, they are explained as being virtually synonymous with gallbladder timidity. Gallbladder cold is understood to involve insufficiency of gallbladder qì, since it is not associated with cold signs and is commonly associated with heat. Wēn dǎn tāng (温胆汤 Gallbladder-Warming Decoction) is one formula used to treat this.

Alternating cold and heat (寒热往来 hán rè wǎng lái), that is, alternating aversion to cold and heat effusion, occurs in malarial disease and lesser yáng (shào yáng) disease. Remember that the foot lesser yáng (shào yáng) channel is associated with the gallbladder.

Gallbladder Patterns

Simple Patterns

Depressed gallbladder and harassing phlegm (胆郁痰扰 dǎn yù tán rǎo): Fright palpitation; insomnia; dizziness; bitter taste in the mouth; nausea; oppression in the chest distension in the rib-side. It usually stems from affect-mind excesses causing qì depression that engenders phlegm and transforms into fire.

Combined Patterns

Liver-gallbladder damp-heat (肝胆湿热 gān dǎn shī rè): Distending pain in the rib-side, aversion to food, abdominal distension, yellowing of the body and eyes, genital itch with signs of damp-heat. It results from contraction of external or internal dampness combining with heat.

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