while the signs and symptoms of this disorder are manifold, the basic mechanism is simple: disharmony between the gallbladder and stomach with phlegm-heat.

phlegm in the stomach leads to focal distention, copious sputum, a greasy tongue coating, and a slippery pulse. heat in the gallbladder gives rise to a bitter taste in the mouth, a yellow tongue coating, and either a rapid, slippery or a rapid, wiry pulse.

phlegm-heat in these organs causes constraint which interferes with the rising of the clear yang and manifests as dizziness or vertigo. at the same time, the turbid yin rises in rebellion and manifests as nausea or vomiting. phlegm-heat disturbs the chest and heart and causes irritability, insomnia, palpitations, and anxiety. in very severe cases this can lead to seizures. the heat in the stomach may also cause indeterminate gnawing hunger.