How does the wisdom of Donguibogam translate into modern medicine? Frequent urination, urinary urgency, and nocturia are diagnosed in modern medicine as representative symptoms of overactive bladder. Translating the Donguibogam concepts of deficiency cold, qi deficiency failing to contain fluids, and deficiency of both lung and kidney into the language of modern science makes everything much clearer.
First, deficiency cold can be linked to a state where the sensory nerve of the urinary bladder becomes excessively sensitive. When the sympathetic nerve becomes excessively activated in cold environments or stressful situations, the detrusor urinae muscle contracts, causing one to feel an excessive urge even when only a small amount of urine has collected. It is much like how the skin reacts more sensitively to the cold. Endocrinologically, in women, hormonal changes around menopause can thin the bladder mucosa and heighten sensitivity. Cold qi can also lead to reduced blood circulation, hindering oxygen supply to the tissues surrounding the urinary bladder and triggering inflammatory responses.
Qi deficiency failing to contain fluids is closely related to the weakening of the pelvic floor muscle. When the pelvic floor muscle weakens due to childbirth, aging, obesity, and other factors, the ability to properly support and control the urinary bladder and urethra declines. These muscles serve to hold the urinary bladder firmly just like our qi, and when that strength diminishes, the urinary bladder's capacity to store urine decreases, making it difficult to hold urine when the urge strikes. In addition, an imbalance in neurotransmitters that regulate the contraction and relaxation of the urinary bladder, such as acetylcholine, can trigger hyperreactive bladder responses. In particular, when the C-fiber nerve associated with pain or inflammation is activated, the urinary bladder can react sensitively even to minor stimuli.
Deficiency of both lung and kidney can be interpreted as a decline in the body's overall ability to maintain homeostasis. The kidneys are core organs that regulate fluid and electrolyte balance in our body. When kidney function declines, urine concentration ability drops, which can increase urine volume or worsen nocturia due to abnormal antidiuretic hormone secretion. While the lungs are not directly connected to urinary bladder function, Korean medicine considers them to govern qi, exerting a major influence on general physical condition and immunity. From a modern medical perspective, generalized fatigue such as chronic stress, anxiety, sleep deprivation, and autonomic nervous system imbalance have been identified as significant factors that aggravate urinary bladder hypersensitivity. All of these factors interact in a complex manner, causing the urinary bladder to react abnormally sensitively and leading to discomfort that interferes with daily life. Sometimes, these symptoms may be a sign of various underlying diseases such as urinary tract infection, diabetes, or neurological disorders, so be sure to consult a specialist if the symptoms persist.
