Bladder

Abbreviation: BL. One of the six bowels; the organ in the smaller abdomen that stores and discharges urine. The bladder stands in exterior-interior relationship with the kidney. Plain Questions (素问 sù wèn, líng lán mì diǎn lùn) states, The bladder holds the office of river island (or Regional Rectifier), stores fluid, and by qì transformation lets it out.

Bladder Functions

The Bladder Stores and Discharges Urine (膀胱贮尿、排尿 páng guāng zhù niào、pái niào)

Urine is produced by the qì transformation function of the kidney. It runs into the bladder. Here, it is temporarily held by the retentive power of bladder qì, and periodically released by its qì transformation function.

The Sù Wèn states, The bladder holds the office of the River Island (Regional Rectifier); it stores fluids, which are released by qì transformation 膀胱者, 州都之官, 津液藏焉 páng guāng zhě, zhōu dū zhī guān, jīn yè cáng yān). For this reason, the bladder is also called the house of water (‍水之府 shuǐ zhī fǔ). Since the bladder is subordinate to the kidney, the action of the bladder is understood to be reliant on kidney qì.

• Pathologies of the bladder’s function of storing and discharging urine result either from bladder qì vacuity or from inhibited bladder qì transformation. The Sù Wèn (Chapter 23) sums this up as follows: When the bladder is inhibited, there is dribbling urination; when it fails to retain, there is enuresis (膀胱不利为癃, 不约为遗尿 páng guāng bù lì wéi lóng, bù yuē wéi yí niào).
• Failure to discharge urine: When bladder qì transformation is inhibited, this manifests in such signs as (a) painful urination, which, as a disease, is referred to as strangury; (b) inhibited urination, which means inability to achieve a full stream of urine; and (c) dribbling urinary block, that is, dribbling urination or, in severe cases, almost complete stoppage of urine. This is most commonly attributed to bladder damp-heat (see below).
• Failure to retain urine: Failure to retain urine is usually referred to as bladder retention failure and is attributable to bladder qì vacuity. It manifests as enuresis, which is the involuntary loss of urine during sleep or else as urinary incontinence, the involuntary loss of urine day or night. This is attributed to insecurity of kidney qì and is treated as such.

The Bladder Channel (膀胱经 páng guāng jīng)

The channel associated with the bladder is the foot greater yáng (tài yáng) bladder channel.

Bladder Patterns

For fuller information than is given below, follow the pattern links. See kidney and bladder pattern identification.

Bladder damp-heat (膀胱湿热 páng guāng shī rè): This is the most common bladder pattern. It manifests in frequent urination, urinary urgency, short voidings of yellow urine, scorching pain on urination, turbid urine, bloody urine, passing of stones in the urine, lumbar pain, smaller abdominal distension and pain, heat effusion, and thirst. The tongue is red with a slimy yellow fur. The pulse is slippery and rapid or soggy and rapid. Note that painful dribbling urination constitutes strangury. When caused by damp-heat, it is called damp-heat strangury.