《大全》曰∶娠妇劳伤经络，有热在内，热乘于血，血得热则流溢，渗入于脬，故令尿血。
李氏曰∶胎漏自人门下血，尿血自尿门下血。妊娠尿血，属胞热者多，四物加山栀、发灰。又方，阿胶、熟
地。
慎斋按∶以上二条，序胎前尿血之证也。尿血易混于胎漏，得李氏一辨，已见分晰。但胎漏有无时频出，尿
血是热入膀胱，本心经有火，移小肠，渗入膀胱，溺时则下，不溺则不下，即是小便溺血，但属妊娠为异耳。
《产宝百问》曰∶肾者作强之官，技巧出焉，与膀胱为表里，男子藏精，女子系胞。妊娠小便淋者，肾虚
而膀胱有热也。肾虚不能制水，则小便数。客热膀胱，则水道涩而数，淋漓不宣，名曰子淋，地肤子汤主之。
陈良甫曰∶孕妇小便涩少，由气血聚养
胎元，不及敷荣渗道，遂使膀胱郁热，法当养血以荣渗道，利小便以导郁热，用归、芍调血，人参补气，麦冬清
肺，以滋肾水之源，滑石、通草利小便，以清郁滞，名安荣散。方内有滑石，乃重剂，恐致堕胎，若临月极妙。
若在七八月前，宜去此味，加石斛、山栀尤稳。
万密斋曰∶子淋之病，须分二证。一则妊母自病，一则子为母病。然妊母自病，又分二证∶或服食辛热，
因生内热者；或自汗自利，津液燥者。其子为母病，亦分二证∶或胎气热壅者，或胎形迫塞者。证既不同，治
亦有别。大抵热则清之，燥则润之，壅则通之，塞则行之，此治之之法也。
《妇人大全良方》说：孕妇因劳累损伤经络，体内有热，热气侵袭血液，血液受热则流动溢出，渗入膀胱，从而导致尿血。
李氏说：胎漏是从阴道出血，尿血是从尿道出血。妊娠期间尿血，多属于胞宫有热，可用四物汤加入山栀、发灰。另一个方子，用阿胶、熟地黄。
慎斋按语：以上两条，叙述了产前尿血的证候。尿血容易与胎漏混淆，经李氏一辨析，已经分辨清楚。但是胎漏有时频繁出血，尿血则是热邪进入膀胱，原本心经有火，移热于小肠，渗入膀胱，排尿时则下血，不排尿则不下血，这就是小便带血，只是发生在妊娠期有所不同罢了。
《产宝百问》说：肾是作强之官，技巧由此产生，与膀胱互为表里，男子藏精，女子系胞（子宫）。妊娠期间小便淋沥不畅，是肾虚而膀胱有热。肾虚不能制约水液，则小便频数。客热侵入膀胱，则水道涩滞且频数，淋漓不尽，名为子淋，用地肤子汤主治。
陈良甫说：孕妇小便涩少，是因为气血聚集以滋养胎元，没有余力去濡润渗道（泌尿通道），致使膀胱郁热。治法应当养血以濡润渗道，利小便以引导郁热，使用当归、白芍调血，人参补气，麦冬清肺，以滋补肾水的源头，滑石、通草利小便，以清除郁滞，名为安荣散。方中含有滑石，属于重剂，恐怕导致堕胎，如果在临产月分非常妙。如果在怀孕七八个月前，应该去掉这味药，加入石斛、山栀更为稳妥。
万密斋说：子淋的病，必须分为两种证候。一种是孕妇自身患病，一种是胎儿受母亲影响患病。然而孕妇自身患病，又分为两种证候：或者是服用辛热食物，因而产生内热；或者是自汗、自利，津液干燥。那胎儿受母亲影响患病，也分为两种证候：或者是胎气热邪壅盛，或者是胎体压迫阻塞。证候既然不同，治疗也有区别。大抵热证则清热，燥证则润燥，壅塞则通利，阻滞则行气，这是治疗的法则。
The *Daquan* (Complete Good Prescriptions for Women) states: When a pregnant woman suffers from exertion and injury to the meridians, with heat residing internally, the heat attacks the blood. Blood, when subjected to heat, flows and overflows, seeping into the bladder (Pangguang), thus causing hematuria (blood in urine).
Li states: Fetal leakage (Tailou) involves bleeding from the vagina, whereas hematuria involves bleeding from the urethra. In pregnancy, hematuria is mostly due to heat in the uterus (Baogong); Siwu Tang (Four Substances Decoction) added with Zhizi (Gardeniae Fructus) and Fahui (Carbonized Hair) is used. Another prescription uses Ejiao (Donkey-hide Gelatin) and Shudihuang (Prepared Rehmanniae Radix).
Shen Zhai notes: The above two passages describe the syndrome of antepartum hematuria. Hematuria can be easily confused with fetal leakage; Li’s differentiation has clarified this distinction. However, while fetal leakage may bleed intermittently or frequently, hematuria results from heat entering the bladder. Originally, there is fire in the Heart Meridian, which transfers to the Small Intestine, then seeps into the bladder. Blood is discharged during urination but not when voiding does not occur. This is essentially hematuria in the urine, differing only in that it occurs during pregnancy.
The *Chanbao Baiwen* (Hundred Questions on Childbirth Treasures) states: The Kidney (Shen) is the official of strength and vigor, where skills originate; it forms an interior-exterior relationship with the Bladder. In men, it stores essence; in women, it anchors the fetus (Bao). During pregnancy, dysuria (Linzheng) is caused by Kidney deficiency and heat in the Bladder. Kidney deficiency fails to control water, leading to frequent urination. Exogenous heat in the Bladder causes the water pathway to become obstructed and frequent, resulting in dribbling and incomplete emptying, named Zilin (pregnancy dysuria), treated primarily with Difuzi Tang (Kochia Seed Decoction).
Chen Liangfu states: Scanty and difficult urination in pregnant women occurs because Qi and Blood gather to nourish the Fetus Yuan, leaving insufficient resources to moisten the urinary pathways, thereby causing stagnant heat in the Bladder. The method should be to nourish Blood to moisten the pathways and promote urination to guide out stagnant heat. Use Danggui (Angelicae Sinensis Radix) and Shaoyao (Paeoniae Radix) to regulate Blood, Renshen (Ginseng Radix) to tonify Qi, Maidong (Ophiopogonis Tuber) to clear the Lung and nourish the source of Kidney Water, Huashi (Talcum) and Tongcao (Tetrapanacis Medulla) to promote urination and clear stagnation. This is named Anrong San (Anrong Powder). Since Huashi is a heavy/cold agent, it might induce abortion; it is excellent near term. If before the seventh or eighth month, remove this herb and add Shihu (Dendrobii Caulis) and Zhizi (Gardeniae Fructus) for greater safety.
Wan Muzhai states: Zilin must be differentiated into two syndromes. One is the mother being ill herself; the other is the fetus being affected by the mother. Regarding the mother being ill herself, it divides into two syndromes: either consuming pungent and hot foods, generating internal heat; or having spontaneous sweating and diarrhea, leading to dryness of body fluids. Regarding the fetus being affected by the mother, it also divides into two syndromes: either heat congestion in the fetal Qi, or physical obstruction by the fetus. Since the syndromes differ, the treatments also differ. Generally, heat is cleared, dryness is moistened, congestion is unblocked, and obstruction is moved. This is the method of treatment.