Gallbladder depression with phlegm harassing is the pattern name given when the classical role of the gallbladder in deciding and judging is described as constrained, and phlegm is described as moving upward and disturbing what is above.
The recorded features are: being timid, easily startled and unable to settle on a decision; dizziness or a spinning sensation; a bitter taste in the mouth; nausea or vomiting; a sense of fullness and oppression in the chest and below the ribs; sighing; palpitations; disturbed sleep with unsettling dreams; irritability; a sensation of a lump in the throat that neither comes up nor goes down; a yellow, greasy tongue coating and a wiry, slippery pulse.
The gallbladder here is a functional role inside a descriptive system. The anatomical gallbladder has no part in deciding anything, and people who have had it removed do not become indecisive. Timidity and being easily startled are descriptions of temperament in the classical texts, not findings.
What shares the list: panic attacks and generalised anxiety; vestibular disorders such as benign paroxysmal positional vertigo, Meniere disease and vestibular migraine; reflux and bile reflux as causes of a bitter taste - together with many medicines, zinc deficiency, poor oral health and pregnancy; and insomnia, shift work, caffeine, alcohol and withdrawal from sedatives for the sleep picture.
Where description has to stop: sudden confusion, or a change in thinking and behaviour, is an emergency rather than a temperament, and in an older person the common causes are infection, low oxygen, low blood sugar and medicines; vertigo with sudden severe headache, double vision, slurred speech, facial droop, limb weakness or numbness, or an inability to stand, is treated as stroke until it is not; palpitations with chest pain or blackouts are assessed; and anxiety that arrives with weight loss, heat intolerance, tremor or a racing pulse at rest has a thyroid and a cardiac differential.
Whether the approaches aimed at freeing constrained gallbladder qi and transforming phlegm change any of these outcomes is not established. New or worsening anxiety with thoughts of harming oneself needs a person, not a pattern name.
胆郁痰扰是古典术语：文献归于胆的决断作用被描述为郁滞，同时痰被描述为随气上行、扰动清窍。
记载中的表现包括：胆怯易惊、遇事犹豫难决；头晕或视物旋转；口苦；恶心或呕吐；胸胁满闷；善太息；心悸；睡眠不安、多梦易醒；烦躁；咽中如有物梗，咯之不出、咽之不下；舌苔黄腻，脉弦滑。
这里的胆是描述体系中的功能角色：解剖学上的胆囊不参与任何决断，切除胆囊的人也不会变得犹豫不决。胆怯易惊在古典文献里是性情描述，不是所见。
共享这份清单的现代情况包括：惊恐发作与广泛性焦虑；前庭疾病如良性阵发性位置性眩晕、梅尼埃病与前庭性偏头痛；反流与胆汁反流是口苦的常见原因，此外还有多种药物、缺锌、口腔问题与妊娠；失眠、轮班、咖啡因、酒精与镇静药戒断则构成睡眠那一组。
描述必须停下的地方：突发的意识混乱或思维行为改变是急症而不是性情，老年人最常见的成因是感染、低氧、低血糖与药物；眩晕若伴突发剧烈头痛、复视、言语含糊、口角歪斜、肢体无力或麻木、不能站立，在排除之前按卒中处理；心悸伴胸痛或晕厥需要评估；焦虑若同时有体重下降、怕热、手抖或静息心率过快，有甲状腺与心脏的鉴别要查。
所谓疏利胆气、化痰之法是否改变上述任一种结局，未被证实。新出现或加重的焦虑若带有伤害自己的念头，需要的是一个活人，不是一个证名。
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