Regulating Fluid Balance, Eliminating Liquid Waste


     The urinary tract consists of the kidneys and all the subsidiary organs and attendant vessels that serve them, including the ureters, bladder and urethra.  Providing energetic support for the kidneys are the adrenal glands, a secondary noble organ of the urinary system.
     The kidneys and urinary tract belong to the Natural Faculty, since they regulate fluid metabolism and produce liquid waste.  But the kidneys and adrenals also interface with the Vital Faculty and its energetic and circulatory functions.  And so, the kidneys and adrenals sit right underneath the posterior  end of the diaphragm, which divides the  sphere  of  the Vital Faculty in the  thoracic  cavity from that of the Natural Faculty in the abdomen.  The kidneys and adrenals are located in the small of the back, and control the lumbar spine.
     The main metabolic function of the kidneys is to produce the urine, and to regulate fluid and electrolyte balance.  The various attendant vessels channel, store and excrete the urine.
     As a waste product, urine is an important indicator of the overall metabolic balance of the organism, and the various imbalances and disorders that can occur therein.  Uroscopy, or the traditional art of urine analysis, is an important diagnostic technique in Greek Medicine.



     The kidneys are the principal organs of the urinary tract.  They are essential to life, and are therefore one of the most vital and important organs of the body.
     The primary functions of the kidneys are metabolic: to regulate body fluid metabolism and electrolyte balance, and to produce urine, the main liquid waste of the body.  And so, the kidneys belong to the Natural Faculty.
     In producing urine, or liquid waste, the kidneys are assisted by the liver, the principal organ of the Natural Faculty.  The liver sorts out the urinary humors as waste products of digestion and sends them to the kidneys for excretion.  In modern medicine, the liver produces urea, which it sends to the kidneys for excretion as uric acid in the urine.
     Uric acid, which colors the urine yellow, is Choleric or bilious in nature, and is originally a product of the liver.  The yellowness of the urine is a good indicator of the Innate Heat of the kidneys' urine metabolism.  The darker the shade of yellow, the greater is this metabolic heat, and the more wastes are being ripened and eliminated in the urine.  Conversely, paleness or transparency of the urine is a sign of coldness.
     In the kidneys, the metabolic balance between the Cardinal Fire and Water elements plays out in urine production and body fluid regulation.  Fire circulates, assimilates and metabolizes Water; Water cools down the organism and contains Fire, holding it in check.  Fire and Water drive body fluid metabolism.
     By what the kidneys pass off in the urine, we can tell a lot about what has been left behind in the organism.  The kidneys also pass off humoral excesses and superfluities in the urine. 
     For example, if the kidneys pass copious amounts of urine, we know that there must be a deficiency of remaining fluids, or a Dry condition prevailing in the organism.  Conversely, with oliguria, excessive fluids are retained, and a Wet condition prevails in the body.
     In both the above conditions, the urine is usually watery and pale, indicating a Cold condition of deficient metabolic heat, or Fire.  With oliguria, it is excessive Water drowning out Fire; with polyuria, it is a weak Fire unable to assimilate and metabolize Water.  The former condition is Phlegmatic, whereas the latter is Melancholic.
     The metabolic heat of the kidneys concocts the urine until it's ready for excretion.  Whatever humors or substances are being eliminated via the urine, their clarity is a sign that they've been properly concocted or ripened.  Cloudy urine indicates that the metabolic residues of some humor, often Cold, Wet and Phlegmatic in nature, hasn't been properly ripened by the kidneys' metabolic heat.
     The kidneys are much more than a simple eliminative organ; actually they sift and balance out fluids, electrolytes and wastes in a process of initial elimination and selective reabsorption.  The metabolic heat, or Fire principle working within the kidneys gives them the biological intelligence necessary to know which substances to eliminate and which to retain or reabsorb. 
     Like any other metabolic organ, the kidneys have  the Four Administering Virtues working within them:
     The Attractive Virtue draws wastes and superfluous humors from throughout the organism into the kidneys for elimination.
     The Digestive Virtue, working with the metabolic heat of the kidneys, sifts out the wastes and superfluities, preparing the urine for excretion. 
     The Retentive Virtue enables the kidneys and the urinary bladder to hold on  to  the urine  until the time is right for excretion.  Working with the metabolic heat of the kidneys,  the Retentive Virtue also reabsorbs what needs to be retained.
     The Expulsive Virtue enables the kidneys and urinary tract to eliminate the urine when the time is right.
     Most kidney and urinary tract disorders involve functional disturbances in one or more of these Four Administering Virtues.
     The kidneys are also closely connected with the heart and Vital Faculty, and have a strong vital function.  After leaving the heart via the abdominal aorta, one of the first places fresh arterial blood goes is to the kidneys to be filtered and purified.
     The vital function of the kidneys involves their role in regulating arterial blood pressure and vascular dynamics.  The heart influences arterial blood pressure through the force and volume of its contractions.  The kidneys regulate blood pressure by controlling the total fluid volume in the circulatory system.  And so, the kidneys are the target of several hormonal feedback mechanisms aimed at regulating blood fluid volume and vascular dynamics.
     The kidneys and heart form a mutual feedback loop.  Adequate vigor and vitality in the heart's contractions is necessary to send enough blood to the kidneys for filtration and urine production.  If the kidneys aren't doing their job properly, and are excreting too much urine, or too little, the heart's job is made harder.

Adrenal Glands

     Energetically supporting the kidneys and their vital function are the adrenal glands, which sit right on top of each kidney.  In addition to stimulating the vital function of the kidneys, the adrenal glands also stimulate the heart.  Through the adrenal glands, the vital connection between the heart and kidneys and the whole energetic system of the body is strengthened.
     The adrenal glands also play a key role in the  vital energetic response of the organism to stress, physical activity and exertion, and in the immune response.  Undue stress, fatigue, or immunological challenges to the organism will exhaust the adrenal glands, and also the vital functioning of the kidneys and the entire urinary tract.
     In coping with the vital energetic needs of the organism and the demands of stress, the adrenal glands have two parts:
     The medulla, whose function is vital and energetic;
     The cortex, whose function is  nutritive.
     The adrenal medulla secretes adrenaline, which mediates the active, energetic, short term "fight, fright, flight" response to stress.  The heartbeat and pulse rate quicken, and blood is diverted to the limbs and periphery.  The sympathetic nervous system, which mobilizes the body for action, is stimulated at the expense of the parasympathetic nervous system and the vegetative functions.
     The adrenal cortex secretes adrenocortical hormones, which enrich the blood with additional minerals and carbohydrates to help the organism meet the nutritive demands of long term stress.  They also exert a restorative and antiinflammatory effect, and favor the retention of valuable minerals and electrolytes by the kidneys. 
     In their general action, nature and temperament, the medulla is Choleric and the cortex is Sanguine.  To have healthy adrenal glands, these two halves must be balanced.  The inherent strength and resiliency of the adrenals underlies the strength and resiliency of the urinary function and the whole organism, as well as supporting a healthy and robust male sexual function.
     When the body gets chronically or extremely fatigued and exhausted, the kidneys and adrenal glands get extremely devitalized.  The chief signs and symptoms are:  pain and weakness in the lower back, loins, thighs, knees and lower body; urinary weakness and debility; polyuria and nocturia; and impotence and male sexual dysfunction.

Relationships of the Kidneys and Adrenals to Other Organs

     The kidneys and adrenals are the principal organs of the urinary tract.  All the vital principles - the Vital Force, Innate Heat, Thymos and Radical Moisture - are first received by the kidneys and adrenals and then distributed to their attendant vessels, principally the urinary bladder.  Immunity is also conferred from the kidneys and adrenals outwards, whereas infectious challenges to the urinary tract usually proceed from the more peripheral and superficial attendant vessels inwards. 
     In men, the kidneys, adrenals and urinary tract have a very close relationship, both functionally and anatomically, with the male reproductive system.  For this reason, they are often referred to together as the male genitourinary tract.  The male sexual function is only as strong, robust and resilient as the kidneys and adrenal glands.
     By stimulating the sympathetic nervous system, the adrenal glands and their adrenaline promote mental clarity and alertness.  The brain fatigues more easily when the adrenal glands are exhausted. 
     Of the sense organs, the adrenals have a strong relationship with the eyes, or Visual Faculty.  Strong adrenals support visual clarity and healthy eye function, and visual fatigue, blurriness and eyestrain set in when the kidneys and adrenals get tired.  Degenerative changes like cataracts have been linked to those of the kidneys and adrenals, particularly a decline in their Radical Moisture.
     The adrenals secrete adrenaline, which stimulates the heart beat and circulation through the Sympathetic nervous system.  By exhausting the adrenals, chronic stress is also a big contributor to heart disease.
     Sitting right below the diaphragm, or breathing muscle, the kidneys and adrenals have a close relationship with the lungs and respiratory function.  If the kidneys and adrenals are strong, respiration will be deep and profound.  If the kidneys and adrenals are weak or exhausted, respiration will be shallow and feeble; in addition, there may often be a weak, chronic consumptive cough or asthmatic condition, which is often congenital. 
     By regulating body fluids through excretion, the kidneys have a close relationship with the lungs and skin, which also release moisture.  If the kidneys aren't eliminating sufficient fluids, superfluous phlegm and moisture can back up into the lungs, causing coughing and congestion.  Hypofunctioning kidneys can also cause the skin to sweat too easily and profusely, in an effort to eliminate the fluids and toxins that the kidneys aren't excreting.
     The kidneys and adrenals govern the low back, hips, thighs and loins, and knees.  Pain or weakness in these areas is often associated with exhausted or devitalized kidneys and adrenals.  In addition, the kidneys have a close relationship with the soles of the feet.  If the feet get cold or wet, those with weak kidneys will urinate a lot.  Those with weak kidneys and adrenals often suffer from cold hands and feet.


Conditions of the Kidneys and Urinary Tract

     Urinary disorders can be broadly differentiated according to the principles of humor and temperament, with the nature of the disorder providing the key as to how to treat it.  Urinary disorders of a common temperament or type will have a common character to their signs and symptoms, and recurring themes.
     The basic urinary signs associated with the Four Basic Qualities are as follows:
     Hot:  Generally, the hotter the condition, the darker the urine color will be.  Hot urine can also be burning.
     Cold:  Generally, the colder the condition, the paler the urine color will be. 
     Dry:  Generally, a dry temperament shows up as thin urine.  If dryness and dehydration are severe, the urine volume will also be reduced, as the body is trying to conserve fluids.
     Wet:  Generally, a wet temperament shows up as thick urine.  If the wetness is so severe that the body is overflowing with excess Water, there will tend to be copious or frequent urination, as in diabetes.  Otherwise, edema and water retention are associated with oliguria, or deficient urination.
     Although numerous variations and complexities of urinary conditions and their signs and symptoms exist, the basic urinary signs of the Four Temperaments are as follows:
     Sanguine:  bright yellow (warm) and thick (moist)
     Choleric:  dark yellow (hot) and thin (dry)
     Melancholic:  pale or clear (cold) and thin (dry)
     Phlegmatic:  pale or clear (cold) and thick (wet)
     Cloudy or turbid urine can indicate insufficient metabolic heat to properly ripen the urinary wastes.

     Choleric conditions of the kidneys and urinary tract generally involve acute or severe infection, irritation, inflammation or cyst formation.  The more serious Choleric conditions involve the kidneys themselves.  The signs and symptoms of a Choleric urinary tract infection will often be acute or vehement.
     Choleric urinary conditions can also involve hot, bilious pathologies of the liver, which will turn the urine a deep, dark yellow or brownish color.  The kidneys must assume the added toxic burden of a bilious liver.
     Choleric urinary tract infections can also be chronic or recurring, involving aesthenic deficiency heat and dryness.  The Radical Moisture and the nutritive integrity of the bladder and its delicate mucosa are consumed, creating chronic irritation and inflammation.  This condition can often be quite latent and asymptomatic until triggered or aggravated by certain diuretics or genitourinary tonics, usually of a heating or stimulating nature; such medicines are contraindicated in these conditions.
     Basic urinary signs:  Dark yellow urine, which may have a reddish or brownish tint.  The urine texture will be thin.  The urine can feel hot or burning if the heat is severe.  If dryness is severe, the urine volume will be reduced.

     Sanguine conditions usually involve urinary putrefaction and the accumulation of excess heat and moisture in the bladder - the basic urinary tract infection.  They can also involve the urinary manifestations or complications of metabolic excesses affecting the blood, which is, of course, a much more serious condition.
     Diabetes melitus is a condition in which excess sugar and the Sanguine sweet taste builds up in the blood and spills over into the urine.  In addition to all the other complications of diabetes, there will be frequent copious urination and great thirst.  The sweet taste is Wet in temperament, and all this excess moisture spills over into the urine.
     Uric acid diathesis is a predisposition to build up too much uric acid in the blood, and usually affects those of a Sanguine temperament.  Associated with uremia and gout, it also has urinary signs and symptoms: urinary weakness or debility, chronic irritation and inflammation of the urinary passages, and a chronic itching or pruritis in the groin area.  Uric acid is a breakdown product of protein metabolism, and these conditions are associated with the overconsumption of protein-rich foods.
     Basic Sanguine urinary signs:  Bright yellow urine with thick texture and viscosity.  With urinary debility, there may be frequent, copious or dribbling urination.


     Phlegmatic conditions of the kidneys and urinary tract are those of coldness and a deficient metabolic heat, and the resulting buildup of excess moisture.  The urine will be pale or clear, indicating an insufficient heat and ripening of uric acid and other metabolic wastes for excretion.  The urine will be thick.
     The usual pattern in Phlegmatics is oliguria, or insufficient urination, allowing excess fluids and lymph to build up and stagnate in the organism.  But other conditions, like diabetes insipidus, in which copious amounts of clear, watery, tasteless urine are passed, are due to a deficient metabolic heat of the kidneys unable to reabsorb and remetabolize fluids back into the organism.   Associated with  a low output of antidiuretic hormone (ADH) by the pituitary, diabetes insipidus, especially with thin urine, is Melancholic.
     The moisture of the Phlegmatic temperament  and the Expulsive Virtue of its humor tend to make the bladder muscles and urinary sphincters too relaxed.  This can result in frequent urination, urinary dribbling, or poor bladder control.  Water sinks, and the accumulation of excess Phlegmatic fluids in the pelvis, groin and urinary tract can often cause moist, clammy skin and weeping, eczematous skin conditions in these areas.  The heaviness of excess phlegm and dampness can often cause a bearing down sensation in the groin and urinary tract, and weeping urination.
     White, cloudy urine often indicates a Phlegmatic condition of the urinary tract.  It indicates that the metabolic heat of the kidneys is insufficient to properly ripen humoral residues, especially phlegm.

     Melancholic conditions of the kidneys and urinary tract are many and diverse in their causes and clinical manifestations, and can be quite chronic and difficult to treat.  They can be grouped into several different categories, as follows:
     Chronic aesthenic or devitalized conditions of the kidneys, adrenals and urinary tract, usually associated with chronic prostration and fatigue.  Undue stress, fatigue or overwork will aggravate them or bring them on, whereas rest and regeneration will relieve or ameliorate them.
     Nervous, colicky, spasmodic or allergic conditions of the urinary tract involving imbalances, reversals or obstructions in the normal flow of functional energy through these organs.  These often have a strong psychosomatic component, and are aggravated by undue stress, worry, anxiety or inhibitions; in the male, these can often have a strong sexual component, affecting the genitourinary tract as a whole.  Ignoring or repressing the natural urge to urinate can also aggravate these conditions. 
     Conditions involving obstruction, blockage, stenosis (narrowing) or lithiasis (stones) affecting the urinary tract, as well as sand and gravel in the urine.  In men, an enlarged prostate is a Sanguine condition of excessive growth that produces a Melancholic condition of stenosis or constriction of the bladder and urinary passages.  To relieve the frequent urination and the nervous, colicky urinary symptoms that accompany this condition, the prostate must be shrunk, preferrably by natural means. 
     Arthritic or rheumatic conditions of the low back, pelvis, hips and knees, associated with chronic aesthenia and devitalization of the kidneys and urinary tract.
     Polyuria, nocturia or copious urination, letting go of too many fluids, resulting in a Dry condition in the organism.  A low metabolic heat of the kidneys unable to reabsorb and metabolize the needed fluids, plus a general devitalization of the kidneys and bladder and insufficient Vital Force to properly retain the fluids.
     The basic urinary signs of a Melancholic condition are pale, clear urine, indicating coldness and a low metabolic heat of the kidneys.  In addition, the urine is often thin, indicating dryness.

     Melancholic urinary conditions involving aesthenia, fatigue or devitalization of the kidneys and urinary tract often represent the final stage in a three step progression of pathology:
     Sanguine:  A simple urinary tract infection - putrefaction from excess heat, dampness and stagnation.
     Choleric:  Acute flareups or chronic heat starts to consume the Radical Moisture and compromise the nutritive integrity of the bladder and urinary mucosa, causing dryness and inflammatory changes.
     Melancholic:  Chronic urinary heat and irritation, and the resulting aesthenia of the urinary organs creates nervous, irritable, colicky, spasmodic, or allergic complications and poor urinary immunity.


Conclusion:  The Waters of Life

     The kidneys and urinary tract are the seat of the Water element in the human body.  For proper urinary health, we must keep these Waters of Life flowing smoothly.