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Urinary Bladder • 膀胱 Pangguang

In modern Chinese medicine, much like Western biomedicine, the Urinary Bladder tends to get short shrift. It collects and excretes the urine, and little more.

In classical Chinese medicine, however, it plays a much more prominent role. The Urinary Bladder assists with the task of driving our Dao (our path, our evolution), both as a human collective and as individuals. In the collective context, the Bladder has supported our evolution from hunched animals to upright, self-conscious beings. And in the personal context, the Bladder participates in the individual’s path of inner alchemy; this process is based on Qihua, the transformation of Jing-Essence into Qi, which is subsequently transformed into Shen-Spirit.

Jing is the most condensed, material state of Qi, and it is stored in the reservoir of the Lower Dantian. Just as water boils and vaporizes in a cauldron, Jing is steamed by the activity of Kidney, Bladder, Heart, and Mingmen energies to produce Qi. The Bladder’s role is to suction downward, like a tensing bow, which provides the force to propel Qi upward, like a released arrow, to the Middle Dantian, where it is further refined into Shen (light, consciousness, spirit) and stored in the Heart. In this way, the Bladder assists in forming a bridge between Heart Fire and Kidney Water.

In the process of sending Qi upward from the Lower Dantian, the Bladder also sends Qi to the surface, forming the Taiyang layer of the body. In animals, the Taiyang manifests as an exceptionally strong outer boundary, for they must be “all surface all the time” in order to protect themselves and their young in the wild. This makes for a warm and dense outer layer (often aided by a furry coat).

We clothed ones, on the other hand, have shunted much of our outer warmth into mental activity. (Note that the Bladder channel enters the brain.) We must don a second skin of clothing, but the cost is worthy of the prize: the inner light of consciousness. Nevertheless, we still require surface protection, and the Taiyang Bladder supplies that. In fortifying our outer boundary, the Bladder’s task is to defend against external pathogens and to make us feel safe and warm.

Perhaps surprisingly, since they’re seldom considered companions, the Lung and Bladder share a classic Yin/Yang relationship. They form both a clock pair and a hexagram pair. “Clock pair” means they reside on polar opposite sides of the organ clock—the Lung ushers in the Yang of the early morning (and thus springtime), while the Bladder introduces the Yin of late afternoon (and autumn). Both govern the skin: the Lung opening the boundaries to allow for the intake of nourishment and the expulsion of waste; and the Bladder closing those same boundaries to keep our vital fluid in and invaders out. The Lung’s hexagram (#11, Inter-coursing) says “yes”; the Bladder’s hexagram (#12, Separating) says “no.” The Bladder governs prenatal Qi, which flows upward; the Lung governs postnatal Qi, “raining” that Qi downward throughout the community of organ networks. The Lung is subject to the force of gravity; the Bladder, in a way, sits beyond the laws of physics.

The Bladder primarily belongs to the Water phase-element, pairing with the Kidney in the 5-system. Its secondary element is also Water, by virtue of its pairing with the Small Intestine to form the Taiyang layer in the 6-system. The Bladder also carries an association with Metal; when the circadian organ clock is placed over the entire year, the Bladder becomes the organ network of the seventh month (August), the first month of autumn in the Chinese calendar.

Let’s delve into some of the themes associated with the Bladder. We’ll explore its 5-Phase and 6-Conformation associations, before moving on to its corresponding tidal hexagram, earthly branch, animal, and more. At the end, we’ll consider a couple points on the Bladder channel, Kunlun (Bladder-60) and Zhiyin (Bladder-67).

FIVE PHASE ELEMENT • 五行 Wuxing

Water • 水 Shui

Qihua

• Neijing Chapter 8: “The Bladder is the official that guards the outer boundary of the country; the body fluids are stored here; Qi transformation is what comes out of it.”

• My interpretation of Qihua is that there are coarser and more refined versions. First, let’s look at a coarser version. On the physical plane, the Bladder oversees the steaming of the fluids it has received from the ureters. This steam rises, warming and moistening the body, and then it re-condenses as Jinye, the thin and thick fluids that lubricate the tissues of the body. In the process, the Bladder sends Qi to the surface (Taiyang) layer, and excretes the waste in the form of urine.

• The more refined level of Qihua is the transformation of Jing into Qi, which is a core component of inner alchemical practices. As Water organs, the Bladder and Kidney govern Jing, our prenatal Essence. Jing is a state of Qi that is condensed into its most compressed form. The Kidney is tasked with suctioning down and storing this Essence and the Bladder pulls it further downward and seals it tightly in the Jing Palace (perineum). Then, at the appropriate times, the Bladder, as the Fu organ, directs the steamed Essence upward toward the Heart. Once it find its way to the Middle Dantian in the chest, Qi is further “stretched” into Shen, which is Qi in its most sublime, ethereal form.

• The upward-squeezing of Qi generates physical body warmth, especially along the spine; in traveling along the spine, light and heat move to the highest and outermost parts (Yang) of the body.

• According to Dr. Fruehauf, the Chinese name for the Bladder—Pangguang—carries the meaning of “double-light”; recall that, on the back of the body, the Bladder runs in double channels. This is an organ network that warms, stimulates, and illuminates.

• On account of its role in ushering warmth upward and outward, connecting to both the skin layer and the brain, the Bladder plays an important role in both the immune system (Weiqi) and mental functioning.

• Jade is a symbol for prenatal purity. Bladder types have jade-like skin: vibrant, translucent, pure.

Unity & connection, separation & boundary

• As a Water organ, there is a component of the Bladder that represents unity. Water is considered the first of the elements; in a sense, it is the closest to Wuji—the Dao-as-oneness. Water stands for the primordial ocean of existence, from which everything emerges and to which all returns. Access to this realm is part of the wisdom that (ideally) comes with age. As we mature, we recognize the importance of this ocean of unity, subsuming our strivings for individuation that marked our youth. The Bladder unifies Kidney and Heart, Fire and Water, via Qihua.

• The Water element also represents separation. Bodies of water can serve as boundaries dividing loved ones; icy roads and floods prevent us from travel; rainstorms cancel our picnics and games. Water’s corresponding season, Winter, is a time of “hunkering down,” a time of hibernation, inwardness, even isolation. Thus, the Bladder can manifest with heightened individuation; Bladder types can become overly haughty, aloof, and cold.

Urination

• Urination is a byproduct of Qihua; as steam is moved upward, impure fluids move downward and out of the body.

• Urine therapy often serves as a healing modality in traditional medicines. In fact, urine can serve as a trauma remedy (trauma being a piercing of the Taiyang layer). Skin, teeth, and immune function can all benefit from urine therapy.

• A person might urinate during episodes of fear (the emotion of the Water element), when their Taiyang boundary has been breached. In such instances, the Bladder’s capacity for protection and containment has been overwhelmed.

SIX CONFORMATIONS • 六經 Liujing

太陽 Taiyang

Outer boundary, warmth and safety

• Taiyang is the body’s outermost surface layer; a healthy Taiyang makes you feel warm and safe.

• The Bladder and Small Intestine form a tight seal from the outside world: Bladder from external wind and cold and Small Intestine from internal invasion (sealing off the digestive tract, the breakdown of which leads to leaky gut and its associated immune response).

• Taiyang’s physiology is Hanshui: “cold water.” The physiological effect is akin to the tightening we experience when doused with cold water. The surface becomes taut, closed, protective. Taiyang’s reality, however, is warming: to tighten the boundary is to enhance the insulation, to warm up the inner space. To feel cold is to have had one’s boundary penetrated; cold is fear, overwhelm, isolation, separation, over-intellectualization, iciness, brittleness.

• The Bladder channel covers the most surface area of any of the organs (spanning 67 points). It is the only organ channel to feature double channels (two on either side of the spine).

• An example of a “Taiyang cold water” treatment: alternating an extremely hot sauna room with freezing cold water, so as to open and close the pores repeatedly. Skin-brushing, especially along the Bladder channel, is another Taiyang approach.

• The outer boundary of animals is so strong that they need not wear clothes. (However, their Taiyang doesn’t illuminate consciousness for them.) “Jiebiao” is to resolve the surface, to fortify the exterior, to “let the wild animals run free.”

• The main ingredient in skin creams is often derived from animal urine (a connection between the anatomical bladder and our skin boundary); again, healthy Bladder types tend to have smooth, unblemished skin.

• A core Taiyang remedy is Guizhi Tang boiled in alcohol. Alcohol—water infused with fire—is a prenatal Essence. A small amount of alcohol can fortify the Taiyang; however, an over-abundance of alcohol wears away at our Essence. (The Neijing warns that inebriated sexual intercourse is particularly detrimental to health.)

• Bladder points #60 (Kunlun) and #62 (Shenmai) reference mountains in the Pamir range that served as China’s natural barrier from the northern invaders, echoing Taiyang’s outer defense function.

Taiyang Disease

• Taiyang Disease is cold invasion of the body’s outermost defense. The problem is cold, and the patient feels cold. The pores are either frozen open or frozen shut.

• Treat Taiyang Disease with diaphoretic methods, the foremost herbs of which are Mahuang and Guizhi. Purge the cold (via diaphoretic) and fortify Kidney Essence (so Bladder can circulate this to the surface).

• The Bladder and Small Intestine channels meet in the neck; one of the main symptoms of Taiyang Disease is a stiff neck.

TIDAL HEXAGRAM • 消息卦 Xiaoxi gua

否 Pi • Hexagram #12: “Separation”

Separation

• The character 否 Pi features a mouth, out of which comes “no.” (This is the same character we see so frequently in the Shanghan lun—an obstruction, or “glomus,” typically located in the epigastrium. The Earth realm is saying “no” to incoming food.)

• An ancient script for Pi portrays a bird flying to heaven; it is separating from the earth. We see this theme of flight in the Bladder’s soaring to the lofty realms of spirit/mind/consciousness; the channel’s coverage of the inner aspect of the wings region (upper back); and Bladder-58 Feiyang’s theme of “flitting and fluttering.”

• The hexagram itself consists of three yang lines over three yin lines: the trigram Heaven over the trigram Earth. Heavenly Yang will only continue to rise, while earthly Yin wants to keep sinking, resulting in separation. (Compare this with lung’s hexagram #11, “Inter-course,” which is shown below hexagram #12.)

• Hexagram #12 reflects the Jing-to-Shen process, with Jing-Essence as the lower, earthly trigram and the upper trigram representing the circulation of warmth to the highest and outermost part of the body.

• Urination can be seen as the separation of the (downward-moving) impure and the (upward-moving) pure.

• In “saying no,” hexagram #12 is strengthening the boundary.

Fertility

• The ability to say no might make one more fertile; celibacy (or at least infrequent sexual release) stores Jing, rendering it more potent. Pangguang might be considered a foremost organ network for fertility treatment.

• Dr. Fruehauf considers the perineum is the executor muscle of hexagram #12.

• Ghenghis Khan lived out a Bladder story, invading boundaries, inflicting trauma, and impregnating the victims.

EARTHLY BRANCH • 地支 Dizhi

申 Shen • 7th month

Squeezing upward: the evolution of consciousness

• 申 Shen can be translated as “to erect” or “to stretch upward.”

• An oracle script of Shen (shown) depicts hands squeezing a substance upward, echoing the movement of Yangqi up the spine. Indeed, the Bladder holds the spine erect.

• The Bladder can be viewed through the lens of the evolutionary process of humans “growing” a neocortex by pushing kundalini energy upward, pumping substances normally underground to the highest reaches of the body. This process echoes the activity of plants shunting their root energies upward to manifest seed-formation.

• Shu points, the Bladder points along the spine, assist in the Jing-to-Shen movement.

• Urination, straightness of spine, and Taiyang defense are all side-effects of this primary function of the Bladder: the evolution of consciousness.

Yin gains

• In the month roughly spanning August 5th-Sept. 5th, the first month of autumn in the Chinese calendar, the climate is typically still steamy, yet energetically, we’re contracting, cooling.

• After stretching heavenward during spring and summer, plants now start to return to earth, weighed down by their bounty.

Death & sorrow

• Fall is a time for grief, which is triggered by the dying process pervading all facets of the natural world.

• Grief is linked with respiratory function, which makes sense, given the close relationship of the Bladder and Lung.

Boundaries

• An ancient saying: “In the seventh month, repair the walls.” Outwardly, fortify yourself against the coming cold of fall and winter; inwardly, reinforce your boundaries in order to ward off pathogens.

• The seventh month is the time to put clothes on, reflecting the Bladder’s evolutionary role in diverting our Taiyang energy from solely outer protection to illumination of consciousness.

Individuation & unity

• By the seventh month, plant life has become mature, defined, separated (just as humans have, by adulthood, distinguished themselves as distinct individuals); at this time of year, however, the upward-reaching, individuating momentum of vegetation is beginning to return to the earth, under the weight of the fully-expressed fruits and flowers (echoing the human process of realizing the importance of the undifferentiated ocean of being, as we age).

Back & north

• As a Yang meridian, the Bladder is found on the back of the body. As a Water organ, it corresponds with the direction north (emperors and sages are said to face south—toward the sun—with their backs to the north). At this time of year, the cold is (at least energetically) starting to hit our backs more strongly from the north.

Late afternoon

• Pangguang’s time of day is 3-5p.m (Rifu).

Seasonal nodes: Liqiu & Chushu

• These periods are “Beginning of Fall” and “End of Heat,” both of which point to the momentum of Yin energies.

ANIMAL • 生肖 Shengxiao

Monkey • 猴 Hou

Evolution & cultivation

• The monkey’s posture is half-way between standing erect and on-all-fours. They use tools, develop language, and form complex social structures...and yet will throw their poop at you at the zoo. The monkey represents the evolutionary process.

• Monkeys are animals that behave like people. For instance, they are known to mourn the death of a troop member.

• “Taming the monkey mind” is a common phrase in meditative spiritual paths.

Humor & immaturity

• Monkeys have been commonly used as entertainment. In Monkey Junction, NC, for instance, monkeys were featured by gas station owners to attract customers in the 1930s. Similarly, 19th-century organ grinders would often partner up with white-headed capuchin monkeys to do tricks and attract attention.

• Lighthearted “monkey business” provides a healthy counterpoint to the seriousness of the seventh month of the year (roughly August 5th-Sept. 5th), historically a time marking the end of summer and the start of preparation for the harshness of winter.

• A pathological Bladder type might not be able to take anything seriously. They might lack the discipline necessary for their own spiritual cultivation. Or they might be excessively serious—rigid in mind and body, with a stiff spine, making them brittle and aloof.

Protection

• Vassals ruled the outlying kingdoms of early China like “monkey-kings” personifying the Taiyang defense role. These enfiefed officers were known as Zhuhou (“the wild ones in the outer reaches of the country”). You’ll remember that the Neijing referred to the Bladder as “the official that guards the outer boundary of the country.” Note that a group of monkeys is called a “troop,” suggesting a martial assembly.

• Monkeys have often been depicted as soldiers and henchmen in popular culture, as in the Chinese animated film Havoc in Heaven, which features the Monkey King and his army; L. Frank Baum’s Land of Oz books, which includes the Wicked Witch’s troop of flying monkeys; Michael Crichton’s Congo; and all the way back to the 5th century B.C.E. with the Ramayana, whose hero Rama was aided by the Monkey King Sugriva and his army of monkeys.

Urination

• The monkey is often associated with urination. Squirrel monkeys, night monkeys, and howler monkeys, for instance, engage in “urine-washing”: rubbing their tail and skin with their own urine to mark territory. The tufted capuchin monkey rubs urine on its hands and feet to attract mates and reduce stress.

• An episode of The Simpsons features the “Urine Monkey” that pees on Krusty the Clown’s head.

STELLAR CONSTELLATIONS • 宿 Xiu

翼 Yi & 軫 Zhen

• The Bladder’s two stellar constellations are Yi (“Wings of the Phoenix”) and Zhen (“Feathered Tail of the Phoenix”).

• The phoenix represents the cultivated soul returning to the heaven realm, reflecting the Bladder’s function as a heavenly organ and echoing the heavenward-flying bird of the ancient script for Pi (hexagram #12).

WATERWAY • 净水 Jingshui

清 Qing

• Qing is translated as “pure” or “clear.” It refers to the waters bubbling forth from Mt. Kunlun (which is the name for Bladder-60, discussed below). These waters are both pristine and also infused with the lunar milkiness of jade. It’s thought that a healthy man’s sperm ought to have Qing’s milky quality, while a healthy person’s urine should exhibit its clearness.

LANDMARK

昆仑山 Kunlun Shan

• The Kunlun Mountain range was the mythical paradise of Daoism. King Mu of the Zhou Dynasty was said to be its first visitor. There, he discovered the Jade Palace of Huangdi and met Xi Wang Mu, the “Spirit Mother of the West.”

• Kunlun is part of the Pamir range that served as a natural barrier against northern invaders, a physical manifestation of the Bladder’s Taiyang function.

COSMIC VIBRATION

夷則 Yize

• Yize can be translated as “the law of (or against) the northern barbarians,” and evokes Mt. Shen of the Pamir range, which, like Kunlun, served as the natural barrier against the invaders from the north. The Great Wall was an extension of this natural barrier.

• Yize points to the fact that in the seventh month, nature is vibrating with severity, tightness, and control, as it turns its attention toward preparations for winter. And yet, for health’s sake, there is the need for humor and relaxation or else we won’t be resourced enough for the winter ahead. This need might be personified by the high-priest who is able to be let go of orthodoxy and keep those around him engaged through lightheartedness.

PATHOLOGY

When the Bladder is out of balance, disharmonies may manifest within the themes below. (I’ve included a few examples of pathologies within each theme.)

Taiyang Disease

• Cold invasion: feeling cold, aversion to cold, high fever, floating pulse, and a stiff neck

• Trauma (any shattering of boundaries)

• Inability to say “no,” to decline, or to assert boundaries

• Propensity to fright, fear, panic, palpitations

• Blotchy skin

• Alcoholism

Eyes, head & spine

• Back and neck conditions

• Headaches

• Eye and vision problems

Leakage (or the opposite—inappropriate retention)

• Excess urination or foamy urine; enuresis; dribbling urine

• Irregular menstruation

• Miscarriage

• Uterine prolapse

• Diarrhea or constipation

• Hemorrhoids

• Edema

• Epistaxis

• Sweating disorders

Reproductive organs

• Dysmenorrhea; leukorrhea

• Infertility; impotence

• Ovarian and prostate cancers

• Difficult labor, breech position

• Urinary tract infections

Maturation/Evolution

• Lack of maturity; acting childish/selfish even in advanced age

• Failing to recognize the importance of the ocean of unity; disinclination for spiritual cultivation

• Being overly serious; difficulty enjoying lighthearted “monkey business”

Shen

• Confusion, dizziness, foggy-headedness

• Anxiety, mania, insomnia, depression

• Obsession with purging/detox

Jing

• Thin and clear ejaculation; premature ejaculation

• Thick and turbid urine

• Weakness/flaccidity/coldness/numbness of the lower body (lumbus, pelvis, legs, and feet)

Let’s close this exploration by looking at a couple points on the Bladder channel, Kunlun (Bladder-60) and Zhiyin (Bladder-67):

Bladder-60

昆侖 Kunlun “Ladder to the Sky”

Point Category:
Jing-river & Fire point of the Bladder channel; Ma Danyang Heavenly Star point

Location:
Behind the ankle joint, in the depression between the prominence of the lateral malleolus and the Achilles tendon. (Deadman)

Physiology & Pathology:

The Taiyang Bladder channel traverses the head and back, the most Yang areas of the body. Kunlun, the Fire point, clears excess wind, fire, and Yang (often the branch-manifestations of rising Liver energy) from the upper part of the body, treating such conditions as headache (especially occipital, in combination with Houxi, SI-3), eye pathologies, nosebleed, toothache, lockjaw, and epilepsy.

Kunlun also corresponds with the spine (see the section below for elaboration on this). It is a pivotal point for spinal problems from the neck down to the coccyx. It’s specifically indicated for heart pain radiating through to the back. Kunlun can be through-needled with Taixi (KD-3) for deficiency-induced lumbar pain. Ma Danyang recommended Kunlun for painful cramping of the lumbus and sacrum. The point’s ability to release tension and pain extends down the legs to the heel.

Kunlun can also address reproductive issues. Like Zhiyin (BL-67), Kunlun can promote labor, hasten prolonged labor, control pain, and promote the expulsion of the placenta. It is contraindicated when these results are not desired.

Etymology/Mythology/History:

• 昆 Kun can be translated as “elder brother”; “descendants”; “posterity”; “multitudes, together, unity.” It features a sun over Bi (“to compare, compete”). It can thus mean “the place that is brightest”—relevant, given that this is the “channel of dual light.”

• 侖 Lun is “discussion, reflection, consideration, thought.” When the cart radical is added, Lun becomes 輪 Lun (“wheel”). The spine is described as a “water-wheel” by Daoists: Kunlun represents a water-wheel to the sky that you can climb to reach a place of brightness (unity of consciousness). It describes Jing-Qi-Shen transformation, and the clarity and brightness it engenders.

• Kunlun is a Chinese mountain range. It’s unclear whether the modern Kunlun is identical with the mythical Kunlun. The range has traditionally served as a barrier to the harsh Siberian winds—and invaders—of the north. It’s considered the original “great wall of China.” (Note that Shenshan is a mountain within the Kunlun range; this mountain figures in to the etymological word-field of Shenmai, Bladder-62.)

• Kunlun is central to the Bladder channel’s myth of ascent and protection. Kunlun is the mountain that serves as the “ladder to the sky.” It corresponds with the spine, up which Bladder-propelled Qi rises. On the other hand, the Kunlun’s role as a guardian-wall corresponds with the Bladder’s function of preventing pathogens from invading the body’s surface.

Bladder-67

至陰 Zhiyin “Utmost Yin”

Point Category:
Jing-well & Metal point of the Bladder channel

Location:
On the dorsal aspect of the little toe, at the junction of lines drawn along the lateral border of the nail and the base of the nail, approximately 0.1 cun from the corner of the nail. (Deadman)

Physiology & Pathology:

As we’ve established, the Bladder is the functional administrator of the Kidney, and thus works within the realm of Water. The Water organs downwardly suction Jing, seal it in, and transform it (via Qihua, the by-product of which is urine), so that it can rise as Qi up the spine in the microcosmic orbit.

When a fetus’s head is turned downward, this is a symbol of Jing strength in the mother—the baby’s head is suctioned downward via the anterior aspect of the microcosmic orbit. Breech positioning suggests a Jing leakage in the mother. Zhiyin’s most renowned action is the turning of breech babies (usually with moxa, starting in the 34th week), but we can also employ the point for delayed, prolonged, or difficult labor, as well as for expelling a retained placenta. Furthermore, we can consider Zhiyin for any need for turning in life—for those who have reached a dead-end, and need to create a shift.

Zhiyin can also treat disorders (especially of the acute variety) at the opposite end of the channel—the head. It is indicated for vertex and occipital headache, neck pain, nasal congestion, nosebleed, eye pain, and tinnitus and deafness.

Lastly, Zhiyin is one of the few distal points on the Bladder channel used for urinary disorders, specifically pain and difficulty urinating.

Etymology/Mythology/History:

• 陰 Yin is the feminine principle; it connotes darkness, the moon, water, interiority, that which is hidden; it is the negative charge. It also refers to genitalia.

• 至 Zhi is “to arrive at, reach”; “extreme, extremely, very.” It indicates the superlative degree, the utmost—the point at which there must be a turning back (as from Yin to Yang, or Yang to Yin). Zhiyin is the last point on the Bladder channel, where Yang becomes Yin.

• Suwen 61: “The Kidney is the Zhiyin of the body, and Zhiyin is Shengshui (‘abundant Water’).”

• Suwen 81: “The ancestral temple of Water: this is to accumulate Water/Essence…It is called utmost Yin; Zhiyin is the Jing of the Kidney.”

• The Kidney, Sanjiao, and Bladder serve as the ocean of the body: they gather and store a deep reservoir of Essence that evaporates upward, without depleting the source. The Kidney is in charge of pulling inward, and the Sanjiao (hexagram #2) maximizes the drawing-in effect. The Bladder is “the officer of the island between the two streams” (the perineum); Jingqi is suctioned downward to the perineum (pelvic floor) and the Bladder ensures that it doesn’t leak out. This action of the sealing the very bottom (the Yinnest part of the torso) allows for proper Qihua and the resulting ascent up the microcosmic orbit. So, we might consider using Zhiyin to prevent leakage and bringing water/energy back into circulation.