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Those with pain are classified as *xuelin* (blood strangury). Those without pain are termed *niaoxue* (hematuria). *Xuelin* is discussed separately in the section on strangury. The classics state: "Excessive sorrow causes the pericardium collaterals to be obstructed; obstruction of the pericardium collaterals leads to internal movement of yang qi, resulting in bleeding from below the heart and frequent hematuria." It also states: "Heat transferring from the uterus/bladder to the bladder causes urinary retention or hematuria." Thus, hematuria invariably originates from heat. Chen Wuyue attributed it to the stagnation of heart and kidney qi, failing to realize that the words of the sages are concise yet profound, where one example can illustrate ten. Although blood is primarily governed by the Heart, which of the other four Zang organs does not rely on blood for nourishment? Is the blood expelled in urine restricted only to cases of heart-kidney qi stagnation? By analogy, any blood from the five Zang organs that flows recklessly due to injury will seep into the bladder like bleeding from below the heart; similarly, heat from the five Zang organs will transmit to the Lower Jiao like heat transferring to the bladder. Why is this so? Lung Metal is the mother of Kidney Water, referred to as the "connected organ," and furthermore, the Lung regulates water passages, directing fluids downward to the Bladder. If lung injury causes reckless blood flow, upward rebellious Qi results in hematemesis. What if Qi does not rebel? Would it not descend via the water passages into the bladder? Its heat would undoubtedly reach the Kidneys and Bladder directly. Spleen Earth is the controlling element over Water; if water essence fails to distribute, damp-heat accumulates. Damp-heat sinks downward, damaging the water passages, harming both the Kidneys and Bladder. Damage to the Yin collaterals causes blood to scatter into the bladder. The Liver belongs to Yang, governing metabolism, free flow, and storing blood. The Kidney belongs to Yin Blood; if its closing function is insecure, blood inevitably seeps into the bladder. This aligns with the *Neijing*'s description of liver-injury blood depletion, where bleeding occurs frequently from both anterior and posterior orifices. Generally, hematuria, bloody strangury, and bloody stool differ only in the exit orifice (anterior vs. posterior), but their pathological origins are identical. Therefore, the treatment principle of distinguishing root and branch remains the same. Hemostatic and blood-resolving herbs number no more than a few dozen; the difference lies merely in the guiding and assistant herbs targeting specific meridians. Initially, use raw *Wuling San* combined with *Sini Tang*. If ineffective, and the patient has a history of sexual excess, this indicates deficiency. Use *Wuling San* combined with *Jiao'ai Tang*, swallowing *Lurong Wan*. Alternatively, use *Bawei Dihuang Wan*, *Luji Jiao Wan*, or *Chensha Miaoxiang San* combined with *Wuling San*, swallowing two types of pills. If urine is clear initially followed by a few drops of blood, add one qian of *Chishao Yao* to *Wuling San*. Discharge resembling red gravel without the pain of stone strangury also indicates deficiency. Use *Wuling San* combined with *Jiaoai Tang*, or *Wuling San* combined with *Chensha Miaoxiang San*, swallowing *Lurong Wan*, *Bawei Wan*, or *Luji Jiao Wan*. Dry gelatin roasted and powdered, taken with wine. *Luji Jiao* is particularly effective; take 1–2 liang per dose. Two qian of hair ash, administered with decoction of *Maogen* and *Cheqian Cao*. Four liang of *Danggui* boiled in three sheng of wine to yield one sheng, taken at once. Natural juice of *Jingmiancao* with one spoonful of raw honey. Decoct *Bazheng San* with *Mendong* and scallion. For painful, difficult urination, mix in powder of *Haijinsha*. Powder of calcined *Xiakucao* mixed with rice drink or cold water. Several he of natural *Cheqiancao* juice taken on an empty stomach. In excess patterns, purge using *Tiaowei Chengqi Tang* added with *Danggui*. The *Maijing* states: "Slippery pulse at the Chi position indicates excess Qi and Blood; irregular menstruation in women and hematuria in men should be treated with *Piaoxiao Jian* or *Dahuang Tang* to purge menstrual blood, followed by needle therapy at *Guanyuan* with reducing method." Cough with hematuria, emaciation, and a small, forceful pulse indicate adverse prognosis. Cough, hematuria, muscle wasting, and a surging pulse also indicate adverse prognosis.