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Fear is similar to palpitations and fright, but it is essentially different from palpitations. Zhang Zihe stated: Fright arises from the unknown, whereas fear arises from awareness. Generally, fright occurs immediately upon hearing a loud noise, while fear manifests as an awareness that one is about to be caught by someone. It renders the patient unable to sit or lie down alone; they must have company to avoid feeling fearful. They may require a lamp at night, feeling fearful even in the absence of light. This describes the condition of fear.

There are four internal organs associated with fear:
First, the Kidney. The Classics state: "In the zang organs, it corresponds to the Kidney; in the emotions, it corresponds to Fear." It also states: "When essence and qi converge in the Kidney, fear arises." (See sections on Deficiency and Acupuncture.)
Second, the Liver and Gallbladder. The Classics state: "The Liver stores Blood; when Blood is insufficient, fear arises." Dai Ren (Zhang Zihe) said: "The Gallbladder represents courage; being frightened and afraid damages the Gallbladder." Generally, excess in the Liver and Gallbladder leads to anger and bravery, while deficiency leads to irritability and timidity. (See above for details.)
Third, the Stomach. The Classics state: "Stomach pathology leads to fear."
Fourth, the Heart. The Classics state: "If the Spirit is injured by fright, alarm, and overthinking, the Spirit is damaged, leading to fear and loss of self-control."

[Case by Zhu Danxi] Zhou Benxin, aged sixty, had robust physical constitution and Qi. Due to extreme fear, he fell ill in January. He felt uneasy in his heart, as if someone were chasing him. His sleep was restless at night, and he perceived flames rising behind both ears. Although he could eat and drink, he lost the sense of taste. His mouth was dry, yet he had no appetite. Using Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Rhizome), and Dang Gui Shen (Angelica Sinensis Root Tip) as the sovereign drugs, Chen Pi (Tangerine Peel) as the minister drug, and adding a small amount of salt-fried Huang Bo (Phellodendron Bark) and roasted Xuan Shen (Scrophularia Root), he recovered after decoction and administration, stabilizing after more than a month. (The Classics state: Fear injures the Kidney. Danxi used salt-fried Huang Bo and roasted Xuan Shen to guide Ren Shen and Dang Gui into the Foot-Shaoyin Kidney meridian collaterals to tonify the Kidney.)

[From *Bencao*] To treat Gallbladder deficiency characterized by frequent fear and dread, inability to lie down alone, a sensation as if being chased, and visual/ocular discomfort, use Ren Shen San (Ginseng Powder).
Ren Shen (Ginseng Root), Zhi Ke (Bitter Orange Fruit), Wu Wei Zi (Schisandra Berry), Gui Xin (Cinnamon Twig Heart), Gan Ju Hua (Chrysanthemum Flower), Fu Shen (Poria with Hostwood), Shan Zhu Yu (Cornus Fruit), Gou Qi Zi (Goji Berry) [each 3 fen]; Bai Zi Ren (Biota Seed), Shu Di (Prepared Rehmannia Root) [each 1 liang].
Grind into fine powder. Take 2 qian per dose, mixed with warm wine.

To treat Cold-Gallbladder-Deficiency presenting with vertigo, headache, mental fear and dread, inability to stay alone, and chest fullness, use Fu Shen San (Poria Powder).
Fu Shen (Poria with Hostwood) [1 liang]; Yuan Zhi (Polygala Root), Fang Feng (Saposhnikovia Root), Xi Xin (Asarum Root), Bai Zhu (Atractylodes Rhizome), Qian Hu (Peucedanum Root), Ren Shen (Ginseng Root), Gui Xin (Cinnamon Twig Heart), Shu Di (Prepared Rehmannia Root), Gan Ju Hua (Chrysanthemum Flower) [each 3 fen]; Zhi Ke (Bitter Orange Fruit) [0.5 liang].
Grind into powder. Take 3 qian per dose with 1 cup of water and 3 slices of fresh ginger, decoct until reduced to 60%, and take warm. Suitable for all ages.

To treat Gallbladder Deficiency causing dim vision, sore throat with frequent spitting, vertigo and dizziness, visual obstruction by colors, dreams of litigation, and facial color changes due to fear, use Bu Dan Fang Feng Tang (Tonify Gallbladder Saposhnikovia Decoction).
Fang Feng (Saposhnikovia Root) [1 qian]; Ren Shen (Ginseng Root) [7 fen]; Xi Xin (Asarum Root), Xiong (Ligusticum Chuanxiong Rhizome), Gan Cao (Licorice Root), Fu Ling (Poria), Du Huo (Angelica Pubescens Root), Qian Hu (Peucedanum Root) [each 8 fen].
Grind into coarse powder. Take 4 da qian per dose with 1.5 cups of water and 2 jujubes, decoct until reduced to 80%, strain, and take before meals.

Regarding Six Qi Transformation: Excessive fear belongs to Liver Wood deficiency. The Classics state: "Wood deficiency is called Wei He (Compliant Harmony). In the era of Wei He, diseases involve erratic movement and fear."

Acupuncture treatment for excessive fear according to the *Nei Jing* involves three approaches:
First, targeting the Kidney. The Classics say: "The Foot-Shaoyin Kidney Meridian... If Qi is deficient, there is excessive fear, and the heart feels alarmed as if someone is chasing them. For deficiency, apply tonification; for cold, retain the needle."
Second, targeting the Liver. The Classics state: "Liver deficiency causes blurred vision and deafness, and excessive fear as if someone is chasing them. Treat the Jueyin and Shaoyang meridians."
Third, targeting the Gallbladder. The Classics state: "Gallbladder disease presents with frequent sighing, bitter taste, vomiting of old fluids, palpitations in the epigastrium, and fear of being chased. Treat Yinlingquan (SP9)." It further states: "Frequent vomiting with bitter fluid, frequent sighing, mental restlessness, and fear of being chased indicate pathogenic factors in the Gallbladder and rebellious Qi in the Stomach. Leakage of Gallbladder juice causes bitter taste; rebellious Stomach Qi causes vomiting of bitter fluid, termed 'Vomiting Gallbladder.' Treat below Zusanli (ST36); if Stomach Qi rebels, close the Foot-Shaoyin blood collaterals to restrain Gallbladder rebellion, then regulate excess and deficiency to eliminate pathogens."

[From *Jia Yi Jing*] When the heart feels suspended, accompanied by sorrow and confusion, excessive fear, swelling inside the throat, heart alarm and fear as if chased, excessive salivation, asthma with shortness of breath, and rapid shallow breathing, Ran Gu (KI2) governs these symptoms. Palpitations with excessive fear and sadness are governed by Neiguan (PC6). (*Qian Jin Fang* suggests Quze (PC3)).