The Bladder Official is known as the Official Who Controls the Storage of Water. In Western medical terms, this organ collects the urine excreted by the Kidneys. During urination, the muscles of the Bladder contract, opening the sphincter to allow the urine to flow out via the urethra. Excess water, sugars, soluble toxic wastes, and other compounds are contained in the urine are eventually eliminated in this process.

Our bodies are approximately 60% water. As the Controller of the Storage of Water, this Official's job is to ensure that the correct amount of fluids are, in fact, in the correct locations so that every organ, function and system - physically, mentally, and spiritually - has the appropriate lubrication to allow for smooth movement, flexibility, cleansing, and growth.

The Physical Level

If the Bladder is failing, there may be physical water retention resulting in edema, swelling, and bloating. At the other extreme, there may be dehydration resulting in symptoms such as dry skin and hair, overheating, dry eyes, brittleness of bones, insufficient synovial fluid and resultant stiff joints, insufficient digestive fluids and sexual secretions – to name a few.

The Bladder is the longest meridian in the body, extending from the medial canthus of the eye, over the head, down the back of the neck, the back, posterior aspect of the leg, down to the ankle, to the foot and ending at the lateral nail point of the little toe. Essentially, the entire body is its home and symptoms can arise anywhere along its pathway.

Even more devastating than the physical examples of imbalance listed above are imbalances of this Official at the level of the mind and spirit.

The Mental Level

Water, at the level of the mind, refers to its fluidity, its flow of ideas, thoughts, attitudes, and conceptions. In nature, Water innately is able to appropriately take the form of a clear lake, a raging ocean, a subtle mist, or a frozen glacier. In imbalance, we lose this adaptability. We are no longer appropriate in our reactions. Our mind loses its appropriate control. We no longer know when to be still and quiet, or when strength and force are needed.

When the mind becomes dry, we tend to become stubborn, narrow, fixed and brittle in our thinking – attached to beliefs and concepts, without the ability to release what is old, toxic, and stale. Without the ability to "go with the flow", we lose our ability to adapt and change. We may age, but without the wisdom, fairness, and expanded awareness gleaned from a lifetime of varied experiences, we cease to grow into true elders. Like a plant devoid of sufficient water, we dry out. We cannot age with grace. Rather, we become curmudgeons – irritable, hard, and inflexible. We lose the quality of water, which innately finds its way through, over, or under whatever stands in its path. Water yields to every protrusion and fills every crevice, taking the shape of whatever contains it.

At the opposite extreme, an imbalance in the Bladder Official could result in a mind that is out of control, racing, awash in thoughts, words, and ideas. To make matters worse, as a sick Bladder allows for retention of toxins, the torrent of thoughts becomes polluted, confused, and delusional. As the emotion associated with the Water element is fear, the thoughts become terrifying.

A healthy mind, as pertains to the Bladder Official, is secure in the knowledge that it contains a reservoir of mental strength and endurance on which to draw. It is capable of analysis, concentration, study, memorization, as well as having the capacity to be in a meditative state – empty, able to witness the movement of itself from a place of quiet non-attachment.

The Spirit Level

At the spirit level, the Water element manifests will, ambition, determination, perseverance, and resolve. These qualities arise from having a full reserve, under the dominion of the Official of the Storage of Water. Winter, the season associated with the Water element, is the coldest and darkest of seasons. Cold and darkness preserve and store. Winter is about containment and accumulation of reserves in the seed state, recharging of life's "batteries", providing the security of knowing that, whatever comes, we have the inner resources to meet it appropriately – with neither too much nor too little expenditure of our energy.

Few things disturb our spiritual well being more than feeling we have nothing in reserve. It is akin to having no money in the bank. Every ring of the phone or knock at the door seems a threat from some person or agency to which we owe a debt. When we perceive a lack in our internal "bank", it is as if we have no "cushion" - nothing on which to draw. It is as if it is winter when nothing is growing and we have stored nothing away. We feel we have little or no energy at any level, often accompanied with a sense of internal panic and raciness, and feel unable to meet life on its terms. We may freeze in fear or thrash about, but in either case, we live in fear, imagining ourselves alone, isolated, beyond help, and facing a terrifying future. Everything and everyone seems a threat. We often wish to hide, often needing to rest or sleep – a longing for the hibernation that we sense could restore our reserves. We become preoccupied with self-preservation and, as our resources diminish still further, our will to live diminishes correspondingly.

In the opposite extreme, a sick Bladder Official can manifest with a lack of fear. This is not a true and healthy expression of courage in appropriate circumstances, but a false bravado and an escape from the real fear, which lurks in the muddy and terrifying waters below. The more fear that lies within often manifests a correspondingly outer display of fearlessness and a tough protective exterior. This could manifest behaviorally as an extreme in the practice of martial arts, body building, collecting of guns, ammunition, and other weapons, being part of a violent gang or group, and engaging in dangerous sports and activities.

The Points

Each of the points on the Urinary Bladder meridian will, in its own specific way, assist in the functioning and healing of this Official. Each of the points has a name, translated from the Chinese characters, which suggests the unique gifts it can bring to the patient in need. For examples of points on this meridian, see "Spirits of the Points: The Bladder Official" Parts I and II (Acupuncture Today, April and June 2005).

We would tend to treat points on the Bladder meridian only if, through traditional methods of diagnosis: assessing odor, color, sound, and emotion, Water was determined to be the patient's primary elemental imbalance or "Causative Factor" (aka "CF"). Diagnostically, a Water CF will manifest a putrid odor, the color blue lateral to the eyes, the vocal sound of groaning, and an excess or lack of fear.

Though the point names of every meridian sound inviting, in this tradition, we trust that, generally, nature has provided the most appropriate and effective points on the meridians which correspond to the patient's CF. However, points on the outer Bladder line on the back are exceptions to the above guideline and may be conjoined, for their spiritual connotations, with treatment of any element. Further, in treating a Water CF, we would treat points on both Water Officials: Bladder and Kidney, thus giving support to the whole of the element.

The Questions

The following questions are useful for self-observation and can be appropriately modified to inquire as to the state of a patient's Bladder Official. It is important to remember that a problem or symptom in this Official does not necessarily make anyone a Water Causative Factor, nor does it mean that the Bladder is the major problem.

Any symptom can come from imbalance in any element, as imbalance spreads from one Official and Element to the next. We determine the source of the trouble, the CF, only through odor, color, sound and emotion. Yet, if you suspect a problem in a patient's Water element and specifically with the Bladder Official, here are some questions to consider in assessing its state:

1. When have you felt out of control?
2. When have you felt you had nothing in reserve?
3. When have you just wanted to hide?
4. When have you projected a tough exterior?
5. When have you been frozen with fear?
6. When have you babbled uncontrollably?
7. When have you acted heroically?
8. When have you had faith in the face of adversity or danger?
9. When have you been able to witness, from a quiet and empty state, the movement of the exterior world, your physical body, your own mind?

Professor Neil R. Gumenick, M.Ac. (UK), L.Ac., Dipl. Ac. is Founder and Director of The Institute of Classical Five-Element Acupuncture Inc., which offers post-graduate training to licensed acupuncturists, physicians, and students of Oriental Medicine. He has been in practice for 33 years, is a Professor at Emperor's College of Traditional Oriental Medicine, and has taught throughout the US and Canada. He can be reached at his website, www.5elements.com, by email at nrg@5elements.com, or at (310) 453-2235.