This is one of the 12 organ systems in Chinese medicine.

The information below is intended to enhance and expand your experience of the Bladder podcast (linked here when it is ready) but can of course be used on its own to understand your treatment at Watershed Wellness more deeply.

Bladder organ system overview #

The Bladder is known as 膀胱 páng guāng in Chinese.

Of the twelve organ systems, the Bladder is probably the one whose Chinese medicine version differs most sharply from the one you already know. In conventional terms it is a storage sac, and not much is asked of it. In Chinese medicine it governs the entire back surface of the body, it is the longest channel we have, and it carries responsibilities that reach from the eyes to the little toe.

In Chinese medicine, some of the major functions of the Bladder organ system are:

• Storing the fluids of the body, and transforming them so that what needs to leave can leave and what needs to be kept is kept
• Governing the surface of the body along with the Lung, which makes it central to how we meet cold, wind and the changing of seasons
• Regulating the back, the spine and the muscles running alongside it, which is why so much back and neck treatment happens on this channel
• Carrying access points to every other organ system along its course, so that the Bladder channel can be used to reach organs far from the bladder itself
• A close relationship with the Kidney, its paired organ, and through the Kidney with the brain, the marrow and the deepest reserves of the body

Let’s dig in a bit more using the various structures and symbols associated with the Bladder.

The Bladder acupuncture channel #

The Bladder channel is the longest in the body, with 67 points. It is very likely the channel you have had needled most, whether or not anyone told you its name.

It begins at the inner corner of the eye, runs up across the forehead and over the top of the head, then descends the back of the head and neck. From there it does something no other channel does: it splits into four parallel streams running down the back, two on either side of the spine. Those four lines travel the whole length of the back, converge behind the knee, continue down the calf behind the outer ankle, and end at the outer corner of the little toenail.

The doubling is written into the name. 胱 guāng contains 光, light, and one reading of 膀胱 in the classical tradition is a channel that carries light upward from below in a double stream. This is not the only reading available, but it is the one that explains why the channel is built the way it is.

Because it touches nearly everything, the Bladder channel treats nearly everything. Most obviously, it is the primary channel for back pain of every kind, from the neck to the sacrum, and for sciatic pain down the back of the leg. Less obviously, the inner branches carry a series of points that give access to each of the other organ systems, so a treatment aimed at the Liver or the Lung may well be given on your back.

Phase Element – Water #

The five phases, also known as the five elements or five phase elements, is one of the most common symbolic systems used in Chinese medicine. The five phases are Fire, Earth, Metal, Water and Wood. Each phase has its own basic character and series of associations, all of which can be used to understand human health, as well as other aspects of reality.

The Bladder is one of two Water organ systems, the other being the Kidney. Because this is the first time we are discussing Water, it is worth spending a moment on the phase itself, and everything said here applies to the Kidney as well.

Water is the deepest and most inward of the five phases. It belongs to winter, to the north, to the dark, and to the parts of us that are furthest from view: the bones, the marrow, the reserves we draw on when everything else is spent. Where Fire rises, Water sinks and gathers. Where Fire is bright and quick, Water is still and patient and slow to change.

Water is also the phase most associated with what we inherit. The reserves a person is born with, their baseline constitution and capacity – all are governed by water. This is why Water and its two organ systems come up so often when we are talking about aging, about depletion after a long illness, and about the fear that tends to accompany both. Fear is the emotion that belongs to Water, and it is worth saying that fear here does not mean cowardice. It means the whole family of responses to what is genuinely deep and genuinely uncertain. Fear is deeply human, even (and maybe especially) when it causes problems in our bodies and experience.

Six Conformations – Tàiyáng #

The six conformations is a system of diagnosis that divides the twelve organ systems into six synergistic pairs. There are a variety of ways to parse the information contained in this system, which is chiefly used when diagnosing and treating infectious conditions such as colds and flus, but has utility beyond that use.

Tàiyáng translates to greater Yang. The Bladder shares this conformation with 小腸 Xiǎo Cháng / Small Intestine, and together they form the outermost layer of the body, the first thing a cold or a wind or a sudden chill actually meets.

Taiyang is described as needing to open. When it opens properly, the surface communicates with the world: we sweat when we should, our temperature regulates, and fluids move through the bladder as they ought to. When it opens too much, we sweat without cause and run a fever. When it fails to open, the surface shuts: body aches, stiffness in the neck and upper back, chills, and difficulty passing urine, all at the same time and all from the same cause.

This is why an acupuncturist may ask about your urination when you come in with a stiff neck and the beginnings of a cold. In this system those are not two problems. They are one conformation not doing its job.

Huángdì Nèijīng – Chapter 8 – The Regional Rectifier #

One of the most important books in Chinese medicine is the Huángdì Nèijīng or Yellow Emperor’s Inner Classic. In Chapter 8 of that text, all of the organ systems are described using language that relates to the operation of a country or state. This is a common way of symbolically discussing physiology and pathology in ancient Chinese texts.

In the text, this translation by Paul Unschuld, it is said of the Bladder,

“The urinary bladder is the official functioning as regional rectifier. The body liquids are stored in it.”

The regional rectifier was an official responsible for a whole territory rather than a single function, which fits an organ whose channel covers the entire back of the body.

The Chinese line carries one more clause that most English translations leave out, and it is the important one: 氣化則能出矣, roughly, “and when qi transforms them, then they can leave.” Storage is not the whole office. The Bladder holds, and only an active transformation lets anything out. So in Chinese medicine, difficulty with urination is not read as a plumbing problem but as a failure of that transformation, and treatment aims at restoring it rather than at forcing anything through.

Organ clock – 3pm – 5pm #

Mid to late afternoon. The light is past its peak but has not started to go, and on a clear day this is when it is at its most defined, with edges and shadows crisper than they were at noon.

For most people this is also the part of the day when the morning’s momentum has run out and the evening has not yet arrived. It is a good time to stop starting things and begin closing them, to drink water, and to move: a short walk in this window does more for the rest of the day than the same walk does at any other hour.

Organ clock – August #

Note : The lunisolar Chinese calendar doesn’t match up perfectly with the months of the Gregorian calendar. I’m using the closest month on the Gregorian calendar that makes sense.

August looks like high summer and is in fact the turn. We are six weeks past the solstice, the days have been shortening the entire time, and by the end of the month the change is impossible to miss. The Chinese agricultural calendar names this directly: 立秋 Lìqiū, the Start of Autumn, falls in the first third of August, and the five-day period that follows it is called 涼風至, the cool winds arrive.

Anyone who has spent an August on the North Coast knows that particular first cool wind on the back of the neck, often weeks before anything else has changed. That is the Bladder’s month announcing itself, and the back of the neck is exactly where this channel meets the weather.

In the plant world this is the month of refinement rather than growth. Nothing much is getting bigger. Everything is pushing what it gathered in spring and early summer into fruit and seed, concentrating it, making it worth harvesting. That is a useful image for what this time of year asks of us: not more, but better, and a clear-eyed decision about what is worth carrying forward.

Organ clock – The Monkey #

Every organ system is related to an “Earthly Branch” which is one of the pieces of the ancient Chinese calendar system. To make those symbols easier to relate to, the Chinese associated each with one of the 12 zodiac animals from Chinese astrology.

The Bladder is related to the Monkey, and the Monkey is the only primate in the Chinese zodiac. It stands in for us – for human beings. That alone tells you something about how seriously this system takes the Bladder: of all twelve organs, this is the one given our own animal family.

The monkey is also, in most traditions, the figure of transition. It stands between walking on four legs and walking on two, which is a fair description of what the Bladder channel does mechanically. It runs the length of the spine and holds us upright, and an upright spine is the precondition for nearly everything else we do.

And there is the monkey mind. The restless, chattering, unstoppable analysis that anyone who has tried to sit quietly has met. In this system that is not a character flaw; it is what the Bladder looks like when its energy is not settling where it belongs.

Organ clock – Hexagram 12 #

The Yijing / I Ching is one of the most ancient Chinese texts. It contains 64 hexagrams and their interpretation and was used anciently, and is still used today, for divination purposes. Each hexagram is composed of 6 lines, either broken (yin lines) or solid (yang lines) or a combination of the two, meaning each has a unique type of yin/yang balance.

There are 12 special hexagrams called “tidal hexagrams” that are arrayed around the organ clock depicting the relative balance and relationship of yin and yang throughout the cycle of 12 months. The Bladder’s is Hexagram 12, Pǐ 否, three yang lines above and three yin lines below. It is usually translated as Obstruction, Standstill, or Stagnation.

The image is Heaven above and Earth below, each moving away from the other, and so not meeting. Wilhelm translates the line simply: “Heaven and earth do not unite.”

Two things make this a good fit. The first is clinical: a surface that has shut, with nothing passing through it, is precisely the Taiyang failure described above. The second is that Hexagram 12 is the exact inverse of Hexagram 11, Tài, which belongs to the Lung and is the picture of heaven and earth in full communication. The two sit at opposite ends of the same axis, and the human being is the one thing standing between them that can join them.

The Bladder in clinic #

Like most organ systems, and the channels they are connected to, the Bladder channel and organ can be used in a variety of ways in the clinic. In fact it is reductive, and inappropriate, to say that one organ system or channel “treats such and such condition,” as though that is the sum total of its impact. That said, there are general principles worth naming that will help you understand this organ system more deeply.

1. Pain and dysfunction anywhere along the back, which is to say most of the back: neck stiffness, upper back tension between the shoulder blades, low back pain, sacral pain, and sciatic pain down the back of the leg.
2. The early stage of colds and flus, particularly the presentation with chills, body aches and a stiff neck. This is Taiyang failing to open, and it is one of the situations where Chinese medicine is fastest.
3. Urinary symptoms of many kinds, including urgency, difficulty, incomplete emptying and irritation. Note that the classical approach here often warms and relaxes rather than clearing heat, which surprises people.
4. Access to other organ systems through the points along the inner lines of the back, which is why a treatment for something apparently unrelated may be given face down.
5. Problems of the eyes, since the channel begins at the inner corner of the eye.
6. Longer-term work on posture, spinal flexibility and the effects of aging, where the traditional approach leans on movement practices such as qigong and yoga as much as on treatment.

Acupuncture & Herbs #

Bladder 40 Wěi Zhōng (acupuncture point)

Guìzhī – Cinnamomum cassia (herb)