Kidneys and Bladder

A Pale wet tongue, a bare root, a sticky coating at the back, a pulse that disappears at chi under deep pressure: which pattern of the Kidneys or Bladder do you read, and which finding separates the neighbours?

After this lesson you know where to read the Kidneys and Bladder (the root of the tongue and both chi) and what the root of the pulse is, you know the tongue and pulse of all patterns of the Kidneys and Bladder, you separate the Yin side from the Yang side and the Water from the Fire, you know what the tongue cannot separate and which tongues and pulses go to a doctor first, and you read an older person with nocturia and a cold back from finding to principle.

Schematic: Kidney-Yang deficiency. Pale, wet, Swollen.

Schematic: Water overflowing. Pale, Swollen, teeth marks, very wet, thin white coating.

Schematic: Kidney-Qi not firm, or Kidneys failing to receive Qi. Pale.

Schematic: Kidney-Yin deficiency with Empty-Heat. Red, little or no coating.

Schematic: Empty-Heat blazing. Red, bare, cracked, dry.

Schematic: Heart and Kidneys not harmonised. Red, redder tip, little coating.

Schematic: Damp-Heat in the Bladder. Red, sticky yellow on the root.

Schematic: Damp-Cold in the Bladder. Sticky white on the root.

Schematic: Bladder deficient and cold. Pale, moist.

Know by heart

Where you look and feel. The root of the tongue and both chi: left chi Kidney-Yin and Bladder, right chi Kidney-Yang (Ming Men). The root of the pulse is chi under deep pressure; mnemonic: the root is at the bottom, on the tongue at the back, at the pulse towards the elbow.
Two sides. Yang: Pale, wet, Swollen; deep and weak, especially at chi, often slow. Yin: little or no coating, normal in colour at first, Red with Empty-Heat; thin-rapid or floating-empty; mnemonic: wet and pale is cold, bare and red is warm.
Qi and Essence. Kidney-Qi not firm and Kidneys failing to receive Qi: Pale; deep, weak; leaking below or a breath that does not land. Essence deficiency: tongue and pulse follow the side that falls most short.
Something on top. Water overflowing: Pale, Swollen, wet, white coating; deep, weak, slow; little urine and oedema. Empty-Heat blazing: Red, bare, cracked; floating-empty and rapid; mnemonic: Yang empty, water rises; Yin empty, fire rises.
The Bladder. Damp-Heat: Red, sticky yellow on the root; slippery-rapid. Damp-Cold: sticky white on the root; slippery, slow. Deficient and cold: Pale, moist; deep, weak; mnemonic: yellow coating, dark urine; white coating, pale urine.
What the tongue does not separate. Kidney-Yang, Spleen-Yang, Water overflowing and Bladder deficient and cold give the same Pale, wet tongue. The urine, the stools, the oedema and the lower back decide.
Red flags. Night sweating with weight loss, oedema with breathlessness when lying flat, blood in the urine, fever with flank pain, sudden incontinence with back pain and a numb saddle area, a slow pulse with dizziness or fainting: see a doctor first.

The rest of this lesson is reference.

Three practice questions from this lesson

Where do you read the Kidneys on the tongue and at the pulse?

The root of the tongue and both chi
The centre of the tongue and right guan
The sides of the tongue and left guan

Answer: The root of the tongue and both chi. The root is the Lower Burner; left chi is Kidney-Yin, right chi Kidney-Yang or Ming Men. The centre and right guan are the Stomach, the sides and left guan the Liver.

What is the root of the pulse?

That it stays palpable at chi under deep pressure
That the pulse continues beyond chi towards the elbow
That the pulse is strongest at cun, under the index finger

Answer: That it stays palpable at chi under deep pressure. A pulse with a root still has reserve; that is why the Nan Jing calls chi the root of the tree. In someone seriously ill, a pulse with a root is a favourable sign.

Case. Woman of 68: cold lower back and knees, passes abundant clear urine twice a night, feels the cold, tired. Stools normal, no oedema. Her GP has checked glucose and heart. Tongue Pale, wet, Swollen; pulse deep and weak, both rear positions barely palpable. Which pattern?

Kidney-Yang deficiency
Kidney-Yin deficiency
Damp-Cold in the Bladder

Answer: Kidney-Yang deficiency. Cold and wet with a weak chi on both sides and abundant clear urine: the Fire of the Kidneys is going out. Damp-Cold gives a sticky white coating on the root and a slippery pulse.

The rest of this lesson

In the course you get the step-by-step explanation with illustrated tongues and animated pulse models, 16 case-based practice questions, 17 spaced-repetition flashcards, the pitfalls, the bridge to physiology and the visual trainer. This lesson belongs to module 4: Organ by organ.

Try two lessons free See Tongue and Pulse