Summary

As distinct from the Western medical concept of urinary bladder, this concept from traditional Chinese medicine is more a way of describing a set of interrelated functions than an anatomical organ. The bladder system in TCM has many other functions besides transformation and excretion. In TCM, the bladder is paired with the kidney, and the kidneys are the root of life, which makes it one of the most important energy systems in TCM. The kidneys store the deepest level of energy (the jing or essence), and are the root of all yin and yang in the body.

The Functions of the Bladder

• The Bladder is a Yang (Fu) organ; its paired Yin (Zang) organ is the Kidney. Both are associated with the element of water and the emotion of fear. As opposed to western medicine, where the bladder’s function is the storage and excretion of urine, the bladder in traditional Chinese medicine has extended functions, including how fluids are transformed during urine production.
• Fluids are still sent from the small intestine to the bladder for storage, but the bladder’s capabilities are dependent on the kidney Yang. If the kidney is yang deficient, the bladder may not have the sufficient qi and heat to transform fluids properly into urine. This could result in overly clear urine that must be excreted more frequently.

Classification

• Fu Organ

The TCM Bladder Functions

• The function of the Bladder is to receive, store and excrete urine. Therefore, Bladder malfunction causes urinary problems.
• The Bladder also participates in urine creation, but it is Kidney Yang that supplies the necessary Qi and Heat for this performance. The Bladder’s role in urine creation is called the ‘Qi transformation of Body Fluids’ by the Bladder.

Main Symptoms

Difficult urination, a feeling of heaviness of the hypogastrium, pale urine and incontinence etc,.

Patterns of Disharmony

1. Damp-Cold in the Bladder

• This pattern is distinguished by the presence of Cold and Dampness in the Bladder. The Coldness and Dampness obstruct the passages of Fluids in the Lower Burner (下焦)and interfere with the Bladder functions. The urgent and difficult urination as well as the feeling of heaviness are typical of Dampness.

2. Bladder Deficiency and Cold

• This pattern is similar to Kidney Yang Deficiency or Kidney Qi not Firm, except with more Bladder related symptoms. It can derive from Kidney Yang Deficiency like it can be a precursor for it, both patterns are intrinsically linked. This is because the Bladder derives its Qi from Kidney Yang to transform Fluids. If Kidney Yang is deficient, it cannot perform this function properly and many Fluids Bladder symptoms follow. The Fluids tend to leak out, leading to frequent urination, incontinence, enuresis or nocturia.

3. Damp-Heat in the Bladder

• This is an Excess Heat and Dampness pattern which obstructs the smooth flow of Fluids in the Lower Burner. The obstruction gives rise to difficult urination, urgent urination and turbid urine. The Heat causes burning and other Heat sensations. In extreme cases, Dampness can materialize into urinary stones.

4. Bladder Deficiency with Cold

• Bladder Deficiency with Cold is a pattern of disharmony in Chinese Medicine. Bladder Deficiency with Cold gives rise to such diverse symptoms as urine the color of rice water (grey and cloudy), disorientation, forgetfulness and incontinence. In the case of Bladder Deficiency with Cold patients tend to exhibit deep (Chen) or weak (Ruo) pulses as well as a pale tongue with thin white coating. Bladder Deficiency with Cold is thought to sometimes induce conditions such as uterine prolapse, autonomic dystonia or enuresis.