Formulas · Text · Donguibogam 東醫寶鑑

The Bladder

Banggwangbu

한글 방광부 · Pinyin Pang Guang Fu

The official of the provincial capital — a hollow that holds nine seung nine hop, with an upper mouth and no lower one, that empties only when the qi of the sea of qi transforms what it holds

膀胱腑

The fifth bowel chapter. The bladder is the bowel of fluids, and its form is its whole doctrine: it has an upper mouth and no lower one, so what goes in can come out only by transformation — when the qi of the sea of qi acts on it the urine pours, and when that qi is short the bladder binds. Dongwon adds that the bladder is a room, and the 胞 inside it is what actually holds the water. The bladder is read from the nostrils and from the skin, together with the three burners it shares a channel with; its disease is a swollen lower belly that wants to urinate and cannot, with heat on the shoulder and the outside of the little toe; and the Suwen's two words for it — 癃, dribbling, when it does not open, and 遺尿, wetting, when it does not hold — are the two formulas of the treatment section, a pill to hold and a decoction to open. The signs of its end are the eyes rolled back, the body arched and the expiring sweat; and the seventeen simples are nine to cool the bladder and eight to warm it.

11.1 The Form of the Bladder 膀胱形象

11.1.1

Source원문

膀胱, 以虛受水, 爲津液之府. 有上口而無下口, 得氣海之氣施化, 則溲便注瀉. 氣海之氣不足, 則秘澁不通.

Translation영역

The bladder receives water by being hollow, and is the bowel of fluids. It has an upper mouth and no lower one; when it gets the qi of the sea of qi to act and transform, the urine pours out; when the qi of the sea of qi is insufficient, it binds and does not pass.

Clinical note임상 주석

無下口 — no lower mouth. The tradition did not know the urethra as an opening of the bladder, and so urine had to leave by 氣化, transformation by qi. The claim is anatomically wrong and physiologically half right: the bladder does not empty by gravity, and the treatment that follows from it — supplement the qi for retention — is still used.

Donguibogam · Banggwang

11.1.2

Source원문

上口廣二寸半, 中廣九寸, 盛尿九升九合, 重九兩二銖. 《難經》

Translation영역

Its upper mouth is two and a half chon around, its middle nine chon around; it holds nine seung nine hop of urine and weighs nine nyang two su.

Nangyeong 難經

11.2 The Position of the Bladder 膀胱部位

11.2.1

Source원문

膀胱在小腹之內. 《靈樞》

Translation영역

The bladder is within the lower abdomen.

Yeongchu 靈樞

11.2.2

Source원문

中極二穴, 膀胱之募, 在臍下四寸. 在背則膀胱兪, 在脊第十九顀下兩傍, 此膀胱部位也. 《銅人》

Translation영역

The point Junggeuk (中極, CV3) is the bladder's alarm point, four chon below the navel; on the back, Banggwangsu (膀胱兪, BL28) is on either side below the nineteenth vertebra. These are the bladder's territory.

Clinical note임상 주석

Junggeuk, one chon below Gwanwon — the small intestine's alarm point at 9.2.3 — and the lowest of the midline points before the pubis. The Urine chapter needles it for retention, and the Essence chapter's 3.18 moxaed it for seminal loss.

Dongin 銅人

11.3 What the Bladder Passes and Receives 膀胱傳受

11.3.1

Source원문

水液自小腸泌別汁, 渗入膀胱之中, 胞氣化之而爲尿, 以泄出也. 《內經》

Translation영역

The fluid parted off from the juice in the small intestine seeps into the bladder, the qi of the 胞 transforms it into urine, and it is discharged.

Clinical note임상 주석

The Small Intestine chapter's 9.3 from the other end: what the gate of the rail sends to the bladder becomes urine there. 胞 in this passage is the bladder's inner sac, as 11.3.2 explains — not the uterus of the Uterus chapter, though the graph is the same.

Naegyeong 內經

11.3.2

Source원문

膀胱雖爲津液之府, 至於受盛津液, 則又有胞而居膀胱之中. 類纂曰, 膀胱者, 胞之室也. 《東垣》

Translation영역

Though the bladder is the bowel of fluids, as for actually receiving and holding the fluids, there is further a 胞 that sits within the bladder. The Yuchan says: the bladder is the 胞's chamber.

Clinical note임상 주석

A sac inside the sac — Dongwon's way of reconciling the Nanjing's bladder with no lower mouth and the plain fact that urine comes out. The bladder is the room and the 胞 the vessel in it, and 11.5.3's 胞轉, the twisted 胞, is that inner vessel turned so it cannot empty.

Dongwon 東垣

11.4 The Outer Signs of the Bladder 膀胱外候

11.4.1

Source원문

鼻孔在外, 膀胱漏泄. 《靈樞》

Translation영역

Where the nostrils show outward, the bladder leaks.

Clinical note임상 주석

Flared, upturned nostrils for a bladder that cannot hold — the Lingshu's oddest correspondence, and the Large Intestine chapter's 10.4.1 read the same nose for the bowel. Two orifices at the top for two outlets at the bottom.

Yeongchu 靈樞

11.4.2

Source원문

腎應骨. 密理厚皮者, 三焦膀胱厚. 麤理薄皮者, 三焦膀胱薄. 疎腠理者, 三焦膀胱緩. 皮急而無毫毛者, 三焦膀胱急. 毫毛美而麤者, 三焦膀胱直. 稀毫毛者, 三焦膀胱結也. 《靈樞》

Translation영역

The kidney answers to the bones. Fine grain and thick skin mean the three burners and bladder are thick; coarse grain and thin skin, thin. Loose interstices mean they are slack; tight skin without fine hair, tense; fine hair that is handsome and coarse, straight; sparse fine hair, knotted.

Clinical note임상 주석

The bladder and the three burners judged together, from the skin's grain and body hair — because they share the greater yang and the kidney, and the Lingshu treats them as one system of water. The Three Burners chapter will say why.

Yeongchu 靈樞

11.5 The Patterns of Bladder Disease 膀胱病證

11.5.1

Source원문

膀胱病者, 小腹偏腫而痛, 以手按之, 卽欲小便而不得, 肩上熱, 若脈陷, 及足小指外廉, 脛踝後皆熱. 《靈樞》

Translation영역

In bladder disease the lower abdomen is swollen to one side and painful; pressed with the hand, one wants at once to urinate and cannot; there is heat on the shoulder, or the vessel there is sunken, and the outer edge of the little toe and the back of the shin and ankle are all hot.

Clinical note임상 주석

A full bladder that cannot empty, with heat along the bladder channel — shoulder, little toe, back of the ankle. The Lingshu reads the organ on its channel's course, which runs down the whole back of the body to the outside of the foot.

Yeongchu 靈樞

11.5.2

Source원문

膀胱不利爲癃, 不約爲遺尿. 《內經》

Translation영역

Where the bladder does not pass freely there is dribbling; where it does not hold there is wetting.

Clinical note임상 주석

癃 and 遺尿 — retention and incontinence — the bladder's two failures in eight graphs, and the two formulas of 11.6 are one for each. The Urine chapter is this line at length.

Naegyeong 內經

11.5.3

Source원문

膀胱病者, 熱結下焦, 小腹苦滿, 胞轉, 小便不利, 令人發狂. 冷則濕痰上溢而爲多唾, 小便淋瀝, 或遺尿. 《入門》

Translation영역

In bladder disease, where heat binds in the lower burner, the lower abdomen suffers fullness, the 胞 twists, the urine does not pass, and it drives a person mad. Where it is cold, damp phlegm overflows upward and there is much spitting, the urine dribbles, or there is wetting.

Clinical note임상 주석

令人發狂 — it drives a person mad. The Immun's hot bladder is the Cold Damage chapter's blood amassment in the lower burner, where the patient raves; the cold one is the wet, dribbling bladder of the old. 胞轉, the twisted sac, is the tradition's name for acute retention.

Immun 入門

11.6 The Treatment of Bladder Disease 膀胱病治法

11.6.1

Source원문

膀胱虛, 則小便不禁, 宜旣濟丸ㆍ加減八味湯, 倍山茱萸, 加烏藥ㆍ益智仁ㆍ破故紙方見腎藏. 實, 則小便不通, 宜益元散方見暑門ㆍ葵子湯.

Translation영역

Where the bladder is vacuous the urine is not held — Already Crossed Pill and Modified Eight Ingredients Decoction with the cornus doubled and lindera, alpinia and psoralea added formula in the Kidney chapter are appropriate. Where it is replete the urine does not pass — Boost the Origin Powder formula in the Summerheat chapter and Mallow Seed Decoction.

Clinical note임상 주석

11.5.2's two failures with two formulas each. The empty bladder that leaks is warmed and held; the full bladder that will not open is cooled and drained. Gagampalmi-hwan's entry records its decoction form, and the additions here — lindera, alpinia, psoralea — are the Kidney chapter's warm astringents.

Donguibogam · Banggwang

11.6.2

Source원문

五苓散, 膀胱主藥也方見寒門.

Translation영역

Five Poria Powder is the governing medicine of the bladder formula in the Cold Damage chapter.

Clinical note임상 주석

Zhongjing's formula for the bladder that has water it cannot transform — and 11.1.1's reasoning is why cinnamon twig is in it: the qi that transforms the water has to be warmed before the four drainers can work.

Donguibogam · Banggwang

11.7 The Signs of the Bladder Expiring 膀胱絶候

11.7.1

Source원문

遺尿, 狂言, 目反直視, 此爲膀胱絶也.

Translation영역

Wetting, wild speech and the eyes rolled back and staring — this is the bladder expiring.

Junggyeong 仲景

11.7.2

Source원문

膀胱之脈, 爲足太陽. 其終也, 戴眼反折, 瘈瘲, 其色白, 絶汗乃出, 絶汗出則死矣. 《內經》

Translation영역

The bladder's channel is the foot greater yang. Where it ends, the eyes roll up and the body arches back, there is convulsion, the colour is white, and the expiring sweat comes; when the expiring sweat has come, death.

Clinical note임상 주석

戴眼反折 — eyes rolled up, back arched: opisthotonos, the greater yang's end. The Qi chapter's 4.25 gave the expiring sweat as the general sign; this is the channel it belongs to.

Naegyeong 內經

11.8 Simple Medicinals 單方

11.8.1

Source원문

凡十七種.

Translation영역

Seventeen kinds in all.

Clinical note임상 주석

Seventeen simples, and they sort by 11.5.3's hot and cold. Nine to cool and open — alisma, stephania, pyrrosia, kochia, dianthus, arborvitae seed, clematis, bushcherry kernel, phellodendron — and eight to warm and move — fennel, green tangerine peel, lindera, zanthoxylum seed, pig's kidney, evodia, kelp and raw fish. The kelp entry is a recipe: four nyang boiled soft with three scallion stalks, dressed with ginger, pepper and salt.

Donguibogam · Banggwang

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Inner Landscape, Volume 3, The Bladder chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.