The Gallbladder is classified both as a Fu and as an extraordinary bowel, as it both stores and secretes bile. As the reservoir for Heat and Dampness in the body, the Gall Bladder is responsible for absorbing excesses from the Liver. One of the functions of the Liver in Chinese medicine is to create smooth flow, specifically of Qi, Blood, digestion, and emotion. Liver depression means lack of free flow, and its specific cause is unfulfilled desires. Depression of free flow creates Heat (specifically, depressive Heat), and excess Heat can be dumped into the Gall Bladder. Gall Bladder dysfunction characterized by Heat is thought of in Chinese medicine as arising from prolonged stagnation, leading to resentment and festering anger (the festering quality arises from Dampness, produced by the Spleen).
An imbalance arising from vacuity of Gall Bladder function, as compared to those of excess described above, is the pattern of Gall Bladder timidity. The Gall Bladder engenders the capacity for courage and bravery. In the West, we speak of having gall to express this quality. Weakness in Gall Bladder function may manifest with a tendency towards fear and timidity. While the Liver is responsible for planning and organizing, the Gall Bladder is responsible for decisiveness and execution. Inability to act may be tied to a Gall Bladder imbalance.
The Gall Bladder also governs the right side of the body. This is simply due to its physical location alongside the Liver under the right ribcage, and therefore the preponderance of its energy on that side of the body. Using this metaphor, the Heart governs the left side of the body (there are other metaphors of left / right tropism in Chinese medicine, including Yang / Yin and Liver / Lung). Multiple symptoms occurring on the right side of the body often reflects a Gall Bladder dysfunction. Some of the most common of these include right-sided shoulder pain, hip pain, knee pain, and sciatica. These areas are traversed by the Gall Bladder channel.
Finally, the law of midday-midnight is important with relation to Gall Bladder function. This theory of Chinese medicine outlines a biorhythm for all of the organ systems. Beginning with the Lungs at 3:00 AM, Qi flows through each of the channels and organs during a two hour (referred to a Chinese hour) time period (the time shifts one hour forward during Daylight Savings Time). This order is Lung – Large Intestine – Stomach – Spleen – Heart – Small Intestine – Bladder – Kidney – Pericardium – Triple Heater – Gall Bladder – Liver. Gall Bladder time is 11:00 PM to 1:00 AM. This means that the Gall Bladder has the greatest amount of Qi in it at this time, and so excesses may manifest then. Gall Bladder symptoms which commonly manifest during this period are insomnia, anxiety, and digestive dysfunction.
The law of midday-midnight asserts that Gall Bladder deficiencies will manifest during the opposite hour, 11:00 AM to 1:00 PM, which is the time of its lowest energy. This is also Heart time. The midday-midnight theory illustrates the relationship between the Gall Bladder and the Heart. The right / left tropism described above also reflects this relationship. In addition, the Gall Bladder acts as a protector of the Heart. The Heart is protected by the Gall Bladder, and the Gall Bladder is protected by the appendix. They are affected by excess Heat and Dampness in ascending order of biological importance, with the Heart obviously appearing at the end as it is considered to be the ruler of the body. It is very common clinically to see people who have their appendix out as a teenager, their Gall Bladder out as an adult, and then to suffer from Heart disease and an eventual Heart attack later in life. This illustrates the concept in Chinese medicine that illness occurs as a gradual progression over the course of one’s life. When the symptomatic expression of one illness is removed without properly treating its root, then symptoms will simply manifest elsewhere at a later date. Without a model which connects these events, they are seen as different illnesses. Symptom chasing occurs, possibly over the course of years, without ever addressing the underlying cause.