经曰∶膀胱者，州都之官，津液藏焉，气化则能出矣。
又曰∶膀者言其横于前阴之旁，以通水也。胱者，言其质之薄而明也。合而言之，以其由虚而实，旁通水
道，通身虚松，可以蓄水，渐渍而渗入胞中，胞满而溺出也。
\r膀胱图\p04-a41a20.bmp\r
又曰∶膀胱当十九椎居肾之下，大肠之前，有下口，无上口，当脐上一寸水分穴处为小肠下口，乃膀胱上
际，水液由此别回肠，随气泌渗而入，其出其入，皆由
气化，入气不化，则水归大肠而为泄泻，出气不化，则闭塞下窍而为癃肿。后世诸书，有言其有上口无下口，
有言上下俱有口者，皆非。
《难经》曰∶膀胱重九两二铢，纵广九寸，盛溺九升九合，口广二寸半。
又曰∶足太阳经膀胱。
又曰∶是经多血少气。
又曰∶申时气血注于膀胱。
《灵枢》曰∶膀胱在小腹之内。
又曰∶鼻孔在外，膀胱漏泄。
《难经》曰∶膀胱以虚受水，为津液之腑，有上口而无下口，得气海之气，施化则溲便注泻，气海之气不
足，则秘涩不通。
经曰∶水液自小肠泌别汁，渗入膀胱之中，胞气化之而为尿，以泄出也。
东垣曰∶膀胱虽为津液之腑，至于受盛津液，则又有胞，而居膀胱之中。
《类纂》曰∶膀胱者，胞之室也。
经曰∶水泉不止者，膀胱不藏也。得守者生，失守者死。
《甲乙经》曰∶膀者，横也。胱者，广也。言其体横广而短也。
经曰∶膀胱胀者，小腹满而气癃。
又曰∶厥气客于膀胱，则梦游行。
又曰∶膀胱有热则淋闭，膀胱不约为遗溺。（溺，音尿，谓睡中遗尿也。）
又曰∶膀胱，津液之府，水注由之，然足三焦脉实，约下焦而不通，足三焦脉虚，不约下焦则遗溺也。膀
胱，又名足三焦也。
又曰∶是动病则冲头痛，目似脱，项似拔，脊病腰似折，髀不可以曲， 如结， 如裂，是为踝厥，是主筋。
又曰∶所生病者，痔，疟，狂，颠疾，头囟顶痛，目黄泪出鼽衄，项背、腰尻、 、脚背痛，小指不用。
盛者人迎大再倍于寸口，虚者人迎反小于寸口也。
足太阳膀胱引经药歌∶
申膀泽（泻）滑（石）茵陈（肉）桂，猪（苓白）茯（苓）羌（活）麻（黄黄）柏蔓（荆子）亲，行下大
黄并（白）术泽， （本）
羌防己檗同因。
膀胱实热，小便赤涩。虚寒，小便数，或漏精，精冷浓稠如米泔。
《灵枢》曰∶肾应骨，密理浓皮者，三焦膀胱浓，粗理薄皮者，三焦膀胱薄，疏腠理者，三焦膀胱缓，皮
急而无毫毛者，三焦膀胱急，毫毛美而粗者，三焦膀胱直，稀毫毛者，三焦膀胱结也。
又曰∶膀胱病者，小腹偏肿而痛，以手按之，即欲小便而不得，肩上热，若脉陷及足小指外廉，胫、踝后皆热。
《入门》曰∶膀胱病者热结下焦，小腹苦满，胞转小便不利，令人发狂。冷则湿痰上溢而为多唾，小便淋
漓或遗尿。
又曰∶膀胱虚则小便不禁，宜既济丸，加减八味丸，倍山萸，加乌药、益智、故纸。实则小便不通，宜益
元散、葵子汤、（葵子、赤茯苓、枳实、木通、黄芩、甘草、猪苓、车前子、瞿麦、滑石、姜引。《济生》）
五苓散，膀胱主药也。
《内经》曰∶膀胱不利为癃，不约为遗尿。
又曰∶遗尿狂言，目反直视，为膀胱绝也。
又曰∶膀胱之脉为足太阳，其终也，戴眼反折螈 ，其色白，绝汗乃出，绝汗出则死矣。
经曰∶太阳司天，寒淫所胜，则病心澹澹大动，是寒伤心也。
又曰∶肿胀水肿有十种之分，腹急肢瘦，为膀胱水。
补∶橘核、龙骨、益智仁、续断、菖蒲。
泻∶芒硝、泽泻、滑石、车前子。
温∶茴香、乌药。
凉∶生地、甘草梢、黄柏。
引经报使∶ 本、羌活上行，黄柏下行。
《黄帝内经》说：膀胱是州都之官，津液在此储藏，经过气化作用才能排出。
又说：膀，是指它横位于前阴旁边，用来通利水道。胱，是指它的质地薄而透明。合起来说，因为它由空虚变为充实，旁通水道，全身虚松，能够蓄水，逐渐浸润并渗入胞中，胞充满后尿液就排出了。
[膀胱图]
又说：膀胱位于第十九椎骨下方，肾脏之下，大肠之前，有下口而没有上口。当脐上一寸的水分穴处是小肠的下口，也就是膀胱的上际，水液由此与回肠分开，随着气机泌渗而入，其出入过程都由气化主导。如果入的气不能气化，水就会归入大肠导致泄泻；如果出的气不能气化，就会闭塞下窍导致癃闭肿胀。后世许多书籍，有的说它有上口无下口，有的说上下都有口，这些说法都不正确。
《难经》说：膀胱重九两二铢，纵长九寸，横宽九寸，能盛装尿液九升九合，口部宽度二寸半。
又说：这条经脉多血少气。
又说：申时气血注入膀胱。
《灵枢》说：膀胱位于小腹之内。
又说：鼻孔在外，若膀胱漏泄（指精气外泄）。
《难经》说：膀胱以虚空状态接受水液，作为津液之腑，有上口而无下口，得到气海之气的作用，施化则小便排泄通畅；如果气海之气不足，就会秘涩不通。
经文说：水液从小肠分别清浊的汁液，渗入膀胱之中，通过胞的气化作用变成尿液，从而排泄出来。
李东垣说：膀胱虽然是津液之腑，但在接受和盛装津液方面，还有一个“胞”存在，且位于膀胱之中。
经文说：水泉不止（指小便失禁），是膀胱不能固藏的表现。能守住正气者生，失去守御者死。
《甲乙经》说：膀，意为横。胱，意为广。形容其形体横广而短。
经文说：膀胱胀满，表现为小腹胀满且气机阻滞不通。
又说：厥逆之气客居于膀胱，则梦中会梦见游行。
又说：膀胱有热则导致淋证和闭证，膀胱约束无力则导致遗尿。（溺，音同尿，指睡梦中遗尿。）
又说：膀胱是津液之府，水流由此经过。然而足三焦脉实，约束下焦但气机不通；足三焦脉虚，不约束下焦则导致遗尿。膀胱，又名足三焦。
又说：本经发生变动产生的病症，会出现冲头痛，眼睛像要脱出，颈部像被拔起，脊柱疼痛腰部像折断，大腿不能弯曲，腘窝拘急像打结，身体疼痛像撕裂，这称为踝厥，本经主司筋的功能。
又说：本经所生的疾病，包括痔疾、疟疾、狂病、癫疾，头囟顶部疼痛，目黄流泪，鼻渊鼻衄，项背、腰尻、髀、脚背痛，小指不能活动。
实证时人迎脉比寸口脉大二倍，虚证时人迎脉反而小于寸口脉。
足太阳膀胱经引经药歌诀：
申时膀胱用泽泻、滑石、茵陈、肉桂，猪苓、白茯苓、羌活、麻黄、黄柏、蔓荆子为亲，下行可用大黄和白术、泽泻，藁本、羌活、防己、黄柏原因相同。
膀胱实热，表现为小便赤红涩痛。虚寒，表现为小便频数，或漏精，精液冷而浓稠如米泔水。
《灵枢》说：肾对应骨骼，纹理致密皮肤厚实的人，三焦和膀胱也厚；纹理粗糙皮肤薄的人，三焦和膀胱也薄；腠理疏朗的人，三焦和膀胱弛缓；皮肤紧绷且无毫毛的人，三焦和膀胱紧急；毫毛美观粗长者，三焦和膀胱正直；毫毛稀疏的人，三焦和膀胱郁结。
又说：膀胱患病，表现为小腹偏侧肿胀且疼痛，用手按压，就想小便却排不出，肩上发热，或者脉搏陷下以及足小指外侧、小腿、脚踝后方皆发热。
《医宗入门》说：膀胱病如果是热结在下焦，小腹部苦于胀满，胞转导致小便不利，使人发狂。如果是冷证，则湿痰上溢导致多唾，小便淋漓或遗尿。
又说：膀胱虚则小便不禁，适宜用既济丸、加减八味丸，重用山茱萸，加乌药、益智仁、补骨脂。实则小便不通，适宜用益元散、葵子汤（葵子、赤茯苓、枳实、木通、黄芩、甘草、猪苓、车前子、瞿麦、滑石，生姜为引。出自《济生方》）、五苓散，其中五苓散是治疗膀胱的主药。
又说：膀胱的经脉是足太阳经，当其终绝时，出现戴眼反折抽搐，面色苍白，绝汗流出，绝汗流出则死亡。
经文说：太阳司天之年，寒气过胜，则发病为心中悸动不安，这是寒气伤心所致。
又说：肿胀水肿分为十种，腹部紧急四肢消瘦，属于膀胱水。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The Bladder is the official of the "State Capital" (Zhou Du), where body fluids are stored; only through Qi transformation can they be excreted.
It further states: "Bang" refers to its horizontal position beside the external genitalia, facilitating the passage of water. "Guang" refers to its thin and transparent texture. Taken together, it transitions from emptiness to fullness, connecting laterally with the water pathways. Being loose and hollow throughout, it can store water, which gradually infiltrates and permeates into the "Pao" (Bladder Sac/Urinary Bladder proper). When the Pao is full, urine is discharged.
[Diagram of the Bladder]
It also states: The Bladder is located below the nineteenth vertebra, beneath the Kidneys and anterior to the Large Intestine. It has a lower orifice but no upper orifice. The lower orifice of the Small Intestine is at the Shuifen acupoint (CV9), one cun above the umbilicus, which serves as the upper boundary of the Bladder. Body fluids separate from the ileum here, entering via Qi-mediated secretion and permeation. Their entry and exit are governed by Qi transformation. If the incoming Qi fails to transform, water returns to the Large Intestine causing diarrhea; if the outgoing Qi fails to transform, the lower orifices become blocked leading to strangury and swelling. Later texts claiming it has an upper orifice but no lower, or both, are incorrect.
The *Nan Jing* (Classic of Difficult Issues) states: The Bladder weighs nine taels and two zhu, measures nine inches in length and width, holds nine sheng and nine he of urine, and its orifice is two and a half cun wide.
It further states: The Foot-Taiyang Bladder Meridian belongs to the Bladder.
It states: This meridian contains abundant blood but scarce Qi.
It states: At Shen hour (3-5 PM), Qi and Blood flow into the Bladder.
The *Ling Shu* (Spiritual Pivot) states: The Bladder is within the lower abdomen.
It states: If the nostrils are external and the Bladder leaks (referring to leakage of essence/fluids).
The *Nan Jing* states: The Bladder receives water in a state of emptiness, serving as the Fu organ of body fluids. It has an upper orifice but no lower orifice. Receiving the Qi of the Qi Sea (Qihai), it facilitates transformation and excretion of urine; if the Qi of the Qi Sea is insufficient, obstruction and difficulty urinating occur.
The classics state: Fluids from the Small Intestine, separated into clear and turbid parts, seep into the Bladder. Through the Qi transformation of the Pao, they become urine and are excreted.
Li Dongyuan stated: Although the Bladder is the Fu organ of body fluids, regarding the reception and containment of these fluids, there exists a "Pao" situated within the Bladder.
The *Lei Zuan* states: The Bladder is the chamber of the Pao.
The classics state: Unremitting discharge of urine indicates that the Bladder cannot retain fluids. Survival depends on maintaining this function; loss leads to death.
The *Jia Yi Jing* states: "Bang" means horizontal. "Guang" means broad. Describing its shape as broad, short, and horizontal.
The classics state: Bladder distension manifests as fullness in the lower abdomen and Qi stagnation.
It further states: If Jue Qi invades the Bladder, dreams of traveling occur.
It states: Heat in the Bladder causes strangury and retention; lack of constraint in the Bladder causes enuresis. ("Niao" sounds like "urine," referring to bedwetting during sleep.)
It states: The Bladder is the mansion of body fluids, where water flows. However, if the Foot-Sanjiao meridian is excess, it constrains the Lower Jiao but lacks free flow; if deficient, it fails to constrain the Lower Jiao, leading to enuresis. The Bladder is also known as the Foot-Sanjiao.
It states: Disorders of motion in this meridian cause headache radiating upward, eyes feeling as if protruding, neck feeling as if pulled, back pain with waist feeling as if broken, inability to bend the thighs, cramping in the popliteal fossa like a knot, and tearing pain, termed An-Jue. This meridian governs the sinews.
It states: Diseases generated by this meridian include hemorrhoids, malaria, mania, epilepsy, pain in the vertex and fontanelle, yellow eyes with tearing, rhinorrhea, and epistaxis, pain in the nape, back, loins, sacrum, thighs, and soles of the feet, and dysfunction of the little toe.
In excess conditions, the Renying pulse is twice as large as the Cunkou pulse; in deficiency, the Renying pulse is smaller than the Cunkou pulse.
Song for Guiding Herbs of the Foot-Taiyang Bladder Meridian:
For Shen-hour Bladder issues, use Ze Xie, Hua Shi, Yin Chen, Rou Gui; Zhu Ling, Bai Fu Ling, Qiang Huo, Ma Huang, Huang Bo, Man Jing Zi are close allies. For descending action, Da Huang, Bai Zhu, and Ze Xie are used; Gao Ben, Qiang Huo, Fang Ji, and Huang Bo share similar reasons.
Excess-Heat in the Bladder presents with red, scanty, and painful urination. Deficiency-Cold presents with frequent urination, spermatorrhea, or cold, thick semen resembling rice wash water.
The *Ling Shu* states: The Kidney corresponds to bones. Those with dense skin and thick texture have thick San-Jiao and Bladder; those with coarse skin and thin texture have thin San-Jiao and Bladder; those with loose interstices have relaxed San-Jiao and Bladder; those with tight skin and no hair have urgent/tense San-Jiao and Bladder; those with beautiful, coarse hair have straight/unobstructed San-Jiao and Bladder; those with sparse hair have knotted/stagnant San-Jiao and Bladder.
It further states: In Bladder disease, there is unilateral swelling and pain in the lower abdomen. Pressing induces the urge to urinate but results in nothing. There is heat on the shoulder, or sunken pulses, and heat on the lateral aspect of the little toe, calf, and posterior ankle.
The *Ru Men* (Introduction to Medicine) states: Bladder disease due to Heat Knot in the Lower Jiao causes abdominal fullness, bladder torsion with difficult urination, and madness. Cold causes damp-phlegm to overflow upward, resulting in excessive salivation, dribbling urination, or enuresis.
It further states: Bladder deficiency leads to incontinence; treat with Ji Ji Wan or Jia Jian Ba Wei Wan, increasing Shan Yu, adding Wu Yao, Yi Zhi Ren, and Gu Zhi. Excess leads to urinary retention; treat with Yi Yuan San, Kui Zi Tang (Kui Zi, Chi Fu Ling, Zhi Shi, Mu Tong, Huang Qin, Gan Cao, Zhu Ling, Che Qian Zi, Qu Mai, Hua Shi, with Sheng Jiang as guide, from *Ji Sheng Fang*), or Wu Ling San. Wu Ling San is the principal formula for the Bladder.
The *Neijing* states: Difficulty in Bladder emptying is called Long; lack of constraint is called Enuresis.
It further states: Enuresis with delirium, eyes rolling back and staring fixedly, indicates Bladder exhaustion.
It states: The Bladder meridian is the Foot-Taiyang. At its termination, symptoms include staring upward, opisthotonos, convulsions, pale complexion, and sweating of absolute collapse. Death follows the appearance of absolute sweat.
The classics state: When Tai Yang governs the year and Cold prevails excessively, heart palpitations occur, indicating Cold injuring the Heart.
It further states: Edema is divided into ten types. Abdominal urgency with emaciated limbs characterizes Bladder Water.
Tonification herbs: Ju He, Long Gu, Yi Zhi Ren, Xu Duan, Chang Pu.
Draining herbs: Mang Xiao, Ze Xie, Hua Shi, Che Qian Zi.
Warming herbs: Hui Xiang, Wu Yao.
Cooling herbs: Sheng Di, Gan Cao Shao, Huang Bo.
Guiding and Messenger herbs: Gao Ben and Qiang Huo ascend; Huang Bo descends.