Shifted bladder

Urinary stoppage or frequent voiding of small amounts of urine occurring in the seventh or eighth month of pregnancy; attributable to qì vacuity or kidney vacuity.

Patterns

Qi vacuity (气虚 qì xū) shifted bladder is marked by urinary stoppage or frequent voidings of small amounts of urine, pain and distension in the smaller abdomen, and fidgetiness. General signs include bright-white facial complexion, lassitude of essence-spirit, heavy-headedness and dizziness, shortness of breath, laziness to speak, ungratifying defecation, pale tongue with thick white fur, and a moderate vacuous slippery pulse.

Medicinal therapy: Supplement qì, upbear the fall, and raise the fetus. Use Qì-Boosting Urine-Abducting Decoction (益气导尿汤 yì qì dǎo niào tāng).

Kidney vacuity (肾虚 shèn xū) shifted bladder is characterized by frequent inhibited urination that may gradually turn into urinary stoppage. There is distension, fullness, and pain in the abdomen, and fidgetiness. General signs include fear of cold and cold limbs, limp aching lumbus and legs, pale tongue with thin moist tongue fur, and a forceless slippery sunken pulse.

Medicinal therapy: Warm the kidney and support yáng; transform qì (promote qì transformation) and move water. Use Golden Cabinet Kidney Qì Pill (金匮肾气丸 jīn guì shèn qì wán) minus aconite (Aconiti Radix Lateralis Praeparata, 附子 fù zǐ) and moutan (Moutan Cortex, 牡丹皮 mǔ dān pí), and plus morinda (Morindae Officinalis Radix, 巴戟天 bā jǐ tiān) and cuscuta (Cuscutae Semen, 菟丝子 tù sī zǐ).

Acumoxatherapy: Base treatment on back transport points and CV. Main points: Needle CV-6 (Sea of Qì, 气海 qì hǎi), bilateral BL-28 (Bladder Transport, 膀胱俞 páng guāng shù), bilateral SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán); moxa CV-4 (Pass Head, 关元 guān yuán). Supporting points: GV-14 (Great Hammer, 大椎 dà zhuī) and bilateral ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ). Apply a strong stimulus and retain needles for 15–20 minutes, rotating every 1–2 minutes. Moxa after needling. For qì vacuity, add BL-20 (Spleen Transport, 脾俞 pí shù). For kidney vacuity, add BL-23 (Kidney Transport, 肾俞 shèn shù) and KI-3 (Great Ravine, 太溪 tài xī).

Etymology

Chin 转 zhuǎn, turn, rotate, pass on; 胞 bāo, bladder, uterus. Essential Prescriptions of the Golden Cabinet (金匮要略 jīn guì yào lüè) describes this condition as being caused by twisting of the bladder connector, where tie, 系 xì, is believed to refer to the urethra. Essential Rhymes for Patterns and Treatment (证治要诀 zhèng zhì yào jué) says that the condition is so named because as the fetus grows it forces downward close to the bladder and the bladder is forced to the side.