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Hematuria (blood in urine) results from the obstruction of essence flow leading to abnormal blood formation, where blood fails to remain within the vessels and exits through the urine. However, its root cause lies in the decline of Kidney Qi and the flourishing of ministerial fire; treatment should focus on clearing the Kidney.
The method for clearing the Kidney involves tonifying the Spleen and Lung to generate Kidney Water, thereby naturally calming the fire, allowing both essence and blood to return to their proper locations.
Using Si Jun Zi Tang (Four Gentlemen Decoction) added with Tong Cao (Akebia Caulis) and Xiang Fu (Cyperus Rhizome) regulates Qi and strengthens essence.
For chronic hematuria that does not heal, caused by Yang sinking into Yin, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is indicated.

Clinical Case:
A patient suffered from hematuria due to insufficiency of Spleen Yin. Shu Di Huang (Prepared Rehmannia Root) was used to nourish Yin.
Since Yin insufficiency allows Liver Wood to overact upon Spleen Earth, weakening it, Gan Cao (Licorice Root) and Bai Shao (White Peony Root) were used to drain the excessive Liver Wood within the Spleen Earth, while Suan Zao Ren (Ziziphus Seed) and Yuan Zhi (Polygala Root) were used to support the mother of Spleen Earth (Heart/Shen); this unblocks the pathways of ascending and descending, preventing stagnation by pathogenic factors.
Mai Dong (Ophiopogon Tuber) and Tian Dong (Asparagus Tuber) were used to clear and moisten the Lung, as when the Lung descends, the Spleen can naturally ascend.
If aromatic and drying herbs such as Chen Pi (Tangerine Peel), Ban Xia (Pinellia Tuber), Bai Zhu (Atractylodes Rhizome), and Fu Ling (Poria) are used, they will hinder Yin and are unsuitable.

Epistaxis (nosebleed) is a heat syndrome of the Yangming channel.
The Yangming channel flanks the nose; intense heat causes blood to rise upward. Treatment should aim at clearing heat.
If epistaxis flows profusely and persists despite various medications, take Sheng Di Huang (Rehmannia Root), Bo He (Mint), Ou Jie (Lotus Node), Ce Bai Ye (Biota Tops), and Bai Mao Gen (Imperata Rhizome), each 1 qian, along with 5 qian of Sheng Jiang (Fresh Ginger). Crush and extract the juice to obtain one bowl, then grind Jing Mo (Beijing Ink) into it and administer orally.
If the blood fills a basin and appears pale, this prescription is ineffective; instead, Da Fu Zi (Prepared Aconite Lateral Root) 5 qian should be decocted in water to yield one cup, mixed with half a cup of Sheng Jiang Zhi (Ginger Juice) and Tong Bian (Child's Urine).
If epistaxis persists, An Shen Wan (Calming the Spirit Pills) administered two or three times without success requires Chen Xiang (Aquilaria Wood) powder 2 qian and Shan Zhi (Gardenia Fruit) powder 5 qian, taken with wine.
If epistaxis still does not stop, donkey dung burned until carbonized (preserving properties), ground into powder, and insufflated into the nasal cavity, stops bleeding immediately.

In Taiyang Cold Damage disease, if blood comes from the nose, it is because Taiyang governs the exterior, and the Lung governs the skin and hair, which also belong to the exterior. The nose is the orifice of the Lung; when exterior heat is intense, blood escapes from these external orifices.
Cold-natured drugs can only drain excess fire but cannot drain deficient fire.
If there is no pathology in the five zang organs, but merely Kidney deficiency causing virtual fire to move, cold-natured drugs should be used to nourish Yin and descend fire.
However, if Spleen deficiency leads to sinking of middle Qi and rising of yin-fire, using cold-natured drugs again will cause the rootless fire to blaze more fiercely, resulting in sore throat and hoarseness; how could one avoid critical danger?