The function of the gallbladder described in Donguibogam is a fascinating concept that encompasses both the modern medical gallbladder and neuropsychiatric functions.
In modern medicine, the gallbladder is an organ that concentrates and stores bile produced by the liver, releasing it into the small intestine when food passes from the stomach to assist in fat digestion. When we experience severe stress, our autonomic nervous system loses its balance. In particular, excessive activation of the sympathetic nerve can cause spasms in the sphincter of Oddi, which regulates bile secretion, thereby obstructing the flow of bile.
When this occurs, bile cannot discharge properly and refluxes upward into the stomach or even reaches the esophagus, which is the primary reason one notices a bitter taste in the oral cavity upon waking in the morning. Because bile is strongly alkaline, it irritates the esophagus and gastric mucosa, causing discomfort and leading to dyspepsia, bloating, nausea, and epigastric pain. This serves as an exact modern interpretation of the phrases in Donguibogam: gallbladder disease causes a bitter mouth (膽病則口苦), fullness beneath the heart (心下滿), and frequent vomiting (善嘔).
Hypochondriac pain can also manifest due to gallbladder distension from cholestasis, increased pressure in the bile duct, or muscle tension triggered by stress. In particular, the gut-brain axis is a key concept showing the intimate connection between the digestive system and the brain. Cortisol, a stress hormone, affects digestive fluid secretion and intestinal motility, which in turn influences bile secretion and flow. Chronic stress also impairs the function of the vagus nerve, diminishing its ability to regulate gallbladder contraction and bile evacuation.
The aspect related to decisiveness can also be explained through modern neuroscience. Chronic stress adversely affects the function of the frontal lobe, the region responsible for decision-making and problem-solving. A persistent state of tension depletes the brain's cognitive resources and impairs emotional regulation, making even minor decisions difficult. This closely mirrors the philosophical insight in Donguibogam that the gallbladder governs decision-making. Ultimately, modern stress and the resulting disruption of the autonomic nervous system can obstruct bile flow, trigger digestive issues, and even shake our mental decisiveness.
