〔大〕夫妇人小便出血者，由心主于血，血之行身通遍经络，循环脏腑，血性得寒则
凝涩，得热则流散，失其常经，溢渗入于胞内，故小便出血也。
〔薛〕妇人小便尿血，或因膏粱炙爆，或因醉饱入房，或因饮食劳役，或因六淫七
情，以致元气亏损，不能统摄归源。若因怒动肝火者，用加味逍遥散调送发灰。肝经风
热者，送子芩丸。久而血虚者，用八珍送发灰。若膏粱积热者，用清胃散加槐花、甘草。
房劳所伤者，用六君加柴胡、升麻。风热所伤者，用四君加防风、枳壳。凡久而亏损元
气者，用补中益气为主。郁结伤脾者，用济生归脾为主，一妇人尿血，因怒气寒热，或
头痛，或胁胀，此肝血虚而肝火盛，用加味逍遥散而血胀止，补中益气加蔓荆子而头痛
痊。后郁怒腹痛尿血，仍用前散，加龙胆草并归脾汤治之。将愈，又因饮食所伤，复作
心忡不宁，彻夜不寐，仍用前汤而痊。一妇人尿血，面黄体倦，饮食不甘，晡热作渴，
此脾胃气虚不能摄血归经，用补中益气以补胃气，用归脾汤以解郁结，更用加味逍遥散
以调养肝血而痊。一妇人小便出血，服四物、蒲黄之类，更加发热吐痰，加芩连之类，
又饮食少思，虚证蜂起，肝脉弦而数，脾脉弦而缓，此因肝经风热，为沉阴之剂，脾伤
不能统摄其血，发生诸脏而然也。余用补中益气汤、六味地黄丸而痊。
鹿茸散 （《大全》）治妇人劳损虚羸尿血。
鹿茸 当归 熟地黄 葵子 蒲黄 续断（各等分）
上为细末，酒调二钱，日三服。
发灰散 治小便尿血，或先尿而后血，或先血而后尿，亦远近之谓也。又治饮食忍小
便，或走马房劳，皆致脬转，脐下急痛不通。兼治肺疽心衄内崩，吐血一两口，或舌上血
出如针孔，若鼻衄吹内立已。
乱发烧灰（《本草》云∶能疗瘀血，通关格，利水道，破 瘕、痈疽、抓尿刺、下疰、
杂疮，疗脬转，通大小便，咳嗽，鼻衄。）
上一味，用米醋二合，汤少许，调服二钱，井华水调亦得。服药讫，即炒黑豆叶蹲
其上，则通。
生干地黄散 治妇人尿血不止。
生干地黄（二两） 柏叶 黄芩（各半两） 阿胶（炒成珠，一两）
上为粗末，每服三钱，水一盏，姜三片，煎七分，去滓温服。
当归散 治妇人小便出血，或时尿血。
当归 羚羊角（屑） 赤芍药（各半两） 生地黄（一两） 刺蓟叶（三分）
上为粗末，每服三钱，水煎去滓服。
又方
羚羊角（屑） 龙骨 当归 蒲黄（各一两） 生地黄（二两）
上为细末，粥饮调下二钱，食前服。
又方 以生地黄捣取汁，每服一小盏，日二服。
又方 以蒲黄末酒调二钱服之。水调亦可。
又方 以鹿角胶（二两，炙令黄。）以水一大盏，煎至半盏，去滓分为三服，食前服。
《补遗》∶小便出血，竹茹一大块，水煎服。
又方 川牛膝去芦，浓煎服。
又方 当归、白芷为末，米饮下二钱。
又方 催生如神散，童子小便和酒调下。
治妇人卒伤于热，尿血 陈总领云∶余顷在章贡时，年二十六，忽小便后出鲜血数
点，不胜惊骇，却全不疼，如是一月，如不饮酒则血少，骇不能止。偶有乡兵告以市医
张康者，常疗此疾，遂延之来，供一器清汁，云是草药，添少蜜解以水，两服而愈。既浓
酬之，遂询其药名，乃镜面草，一名螺靥草，其色青翠，所在石阶缝中有之。
【戴元礼】妇女出现小便出血的症状，是因为心主司血液的运行。血液在全身经络中通行，循环于脏腑之间。血液的性质是遇寒则凝结涩滞，遇热则流动散溢。若血液失去正常的运行轨道，渗入膀胱胞宫内部，就会导致小便出血。
【薛己】妇女小便尿血，可能是因为食用了肥甘厚味及油炸烧烤食物，也可能是因为醉酒后行房事，或因饮食不节和过度劳累，或因六淫（风、寒、暑、湿、燥、火）外邪和七情（喜、怒、忧、思、悲、恐、惊）内伤，导致元气亏损，无法统摄血液使其回归本源。如果是因愤怒引动肝火所致，可用加味逍遥散送服发灰。若是肝经风热所致，用子芩丸送服。病程长久导致血虚者，用八珍汤送服发灰。若是膏粱积热所致，用清胃散加槐花、甘草。因房劳损伤者，用六君子汤加柴胡、升麻。因风热所伤者，用四君子汤加防风、枳壳。凡是病程长久且亏损元气者，以补中益气汤为主治方。因郁结伤脾者，以济生归脾汤为主治方。
曾有一位妇人尿血，伴有因怒气引起的寒热往来、头痛或胁肋胀满，这是肝血虚而肝火盛的表现，使用加味逍遥散后血胀停止，再用补中益气汤加蔓荆子使头痛痊愈。后来因郁怒导致腹痛尿血，仍用前一方，加入龙胆草并配合归脾汤治疗。即将痊愈时，又因饮食不当导致心慌不宁、彻夜失眠，仍用前一方治愈。
另一位妇人尿血，面色萎黄、身体疲倦、饮食无味、午后发热口渴，这是脾胃气虚不能摄血归经的表现，用补中益气汤来补益胃气，用归脾汤来解郁结，再用加味逍遥汤来调养肝血，从而痊愈。
还有一位妇人小便出血，服用四物汤、蒲黄等药物后，反而加重了发热吐痰的症状；再服用黄芩、黄连等清热药后，又出现食欲减退、各种虚证蜂拥而至的情况。诊见肝脉弦数，脾脉弦缓，这是因为肝经风热，误用沉阴寒凉之剂，损伤脾气，导致脾不能统摄血液，进而引发诸脏病变所致。我使用补中益气汤、六味地黄丸治愈。
鹿茸散（出自《妇人大全良方》）：治疗妇人因劳损虚弱羸瘦导致的尿血。
药材：鹿茸、当归、熟地黄、冬葵子、蒲黄、续断（各等分）。
制法用法：研为细末，用酒调服二钱，每日三次。
发灰散：治疗小便尿血，或者先排尿后出血，或者先出血后排尿，这指的是出血部位远近的不同。也治疗因憋忍小便，或纵欲房劳，导致膀胱气化不利（脬转），脐下急痛不通畅。兼治肺疽、心衄（鼻出血）、内崩、吐血一两口，或舌上出血如针孔状，以及鼻衄，吹入鼻腔即可立止。
药材：乱发烧灰（《本草纲目》记载：能治疗瘀血，通关格，利水道，破除癥瘕、痈疽、抓尿刺、下疰、杂疮，治疗膀胱气化不利，通大小便，咳嗽，鼻衄。）
制法用法：单味药，用米醋二合，少许热水，调服二钱，用井华水（清晨第一次打的井水）调服也可以。服药完毕后，立即炒热黑豆叶蹲在上面熏蒸，尿液即可通畅。
生干地黄散：治疗妇人尿血不止。
药材：生干地黄（二两）、侧柏叶、黄芩（各半两）、阿胶（炒至珠状，一两）。
制法用法：研为粗末，每次服三钱，加水一盏，生姜三片，煎至七分，去渣温服。
当归散：治疗妇人小便出血，或偶尔尿血。
药材：当归、羚羊角（屑）、赤芍药（各半两）、生地黄（一两）、刺蓟叶（三分）。
制法用法：研为粗末，每次服三钱，水煎去渣服用。
又一方：
药材：羚羊角（屑）、龙骨、当归、蒲黄（各一两）、生地黄（二两）。
制法用法：研为细末，用米粥汁调下二钱，饭前服用。
又一方：将生地黄捣取汁液，每次服一小盏，每日两次。
又一方：将蒲黄末用酒调服二钱。用水调服也可以。
又一方：将鹿角胶（二两，炙至黄色），用水一大盏，煎至半盏，去渣分为三份，饭前服用。
又一方：川牛膝去芦头，浓煎服用。
又一方：催生如神散，用童子小便和酒调下。
治疗妇人突然受热损伤导致的尿血：陈总领说：“我以前在章贡任职时，二十六岁，忽然在小便后流出几点鲜血，非常惊恐，但完全不疼痛。这样持续了一个月，如果不饮酒则血量较少，惊吓导致症状不能停止。偶然有乡兵告知市中有位叫张康的医生常治此病，于是请他来诊治。他提供一器清汁，说是草药，加少许蜂蜜和水稀释，服用两次即愈。我丰厚地酬谢了他，并询问药名，原来是镜面草，又名螺靥草，颜色青翠，各地石阶缝隙中都有生长。”
[Dai Yuanli] When women experience hematuria (blood in urine), it is because the Heart governs blood. Blood circulates throughout the meridians and viscera. The nature of blood is to coagulate and become stagnant when cold, and to flow and scatter when hot. If blood loses its normal course and渗 (seeps) into the bladder and uterus, hematuria occurs.
[Xue Ji] Women's hematuria may be caused by consuming rich, greasy, fried, or roasted foods; by sexual intercourse after drunkenness or full meals; by improper diet and overwork; or by external pathogens of the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and internal injuries of the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright). These lead to a deficiency of Primordial Qi (Yuan Qi), which fails to control and retain blood within its vessels. If caused by anger stirring Liver Fire, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) administered with Fa Hui (Scorched Hair Ash). If caused by Wind-Heat in the Liver Meridian, use Zi Qin Wan (Zi Qin Pill). If prolonged illness leads to Blood deficiency, use Ba Zhen Tang (Eight Treasures Decoction) administered with Fa Hui. If caused by accumulation of heat from rich food, use Qing Wei San (Clear Stomach Powder) added with Huai Hua (Sophora Flower) and Gan Cao (Licorice Root). If injured by sexual exhaustion, use Liu Jun Zi Tang (Six Gentlemen Decoction) added with Chai Hu (Bupleurum Root) and Sheng Ma (Cimicifuga Rhizome). If injured by Wind-Heat, use Si Jun Zi Tang (Four Gentlemen Decoction) added with Fang Feng (Saposhnikovia Root) and Zhi Ke (Aurantii Fructus). For those whose condition has persisted and depleted Primordial Qi, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is the primary treatment. For those injured by stagnation damaging the Spleen, Ji Sheng Gui Pi Tang (Ji Sheng's Restore the Spleen Decoction) is the primary treatment.
Case 1: A woman had hematuria accompanied by alternating chills and fever due to anger, headache, or hypochondriac distension. This indicated Liver Blood deficiency with exuberant Liver Fire. After using Jia Wei Xiao Yao San, the blood and distension stopped. Then, Bu Zhong Yi Qi Tang added with Man Jing Zi (Vitex Fruit) cured the headache. Later, she experienced abdominal pain and hematuria due to depression and anger; the previous powder was used again, added with Long Dan Cao (Gentian Root) and combined with Gui Pi Tang. As she was recovering, dietary injury caused palpitations, restlessness, and insomnia all night; the previous decoction cured her again.
Case 2: Another woman had hematuria, sallow complexion, fatigue, poor appetite, afternoon tidal fever, and thirst. This indicated Spleen and Stomach Qi deficiency failing to control blood return to the vessels. Bu Zhong Yi Qi Tang was used to tonify Stomach Qi, Gui Pi Tang to resolve stagnation, and Jia Wei Xiao Yao Tang to nourish Liver Blood, resulting in recovery.
Case 3: A woman with hematuria took Si Wu Tang (Four Substances Decoction) and Pu Huang (Typha Pollen), which aggravated fever and phlegm vomiting. She then took Huang Qin (Scutellaria Root) and Huang Lian (Coptis Rhizome), leading to loss of appetite and various deficiency symptoms arising. Her Liver pulse was wiry and rapid, and her Spleen pulse was wiry and slow. This was due to Wind-Heat in the Liver Meridian, where heavy, yin-cold medicines damaged the Spleen, causing it to fail in controlling blood, thereby affecting all organs. I treated her with Bu Zhong Yi Qi Tang and Liu Wei Di Huang Wan (Six Ingredient Pill with Rehmannia), resulting in recovery.
Lurong San (Deer Horn Powder) [from *Da Quan*]: Treats hematuria in women due to consumptive disease and emaciation.
Ingredients: Lurong (Antler of Deer, *Cornu Cervi Pantotrichum*), Danggui (Angelica Sinensis Root), Shudihuang (Prepared Rehmannia Root), Kuizi (Okra Seed, *Abelmoschi Semen*), Puhuang (Typha Pollen), Xuduan (Dipsacus Root, *Radix Dipsaci*) (equal parts).
Preparation and Administration: Grind into fine powder. Mix with wine and take 2 qian, three times daily.
Fahui San (Scorched Hair Ash Powder): Treats hematuria, whether bleeding occurs before or after urination, indicating varying depths of the lesion. It also treats "Pao Zhuan" (bladder retention) and urgent pain below the umbilicus caused by holding urine or excessive sexual activity. It additionally treats lung abscesses, cardiac epistaxis, internal hemorrhage, vomiting one or two mouthfuls of blood, or bleeding from the tongue like needle holes, and epistaxis; blowing the powder into the nose stops it immediately.
Ingredient: Luanshao Fahui (Ash made from burning disordered hair) [According to *Bencao*: Treats blood stasis, clears obstruction, promotes urination, breaks masses/abscesses, treats urinary pricking, gonorrhea, miscellaneous sores, bladder retention, unblocks bowel and bladder movements, cough, and epistaxis.]
Preparation and Administration: Single ingredient. Mix with 2 he of rice vinegar and a little hot water, take 2 qian. Mixing with Jinghua Shui (well water drawn at dawn) is also acceptable. After taking the medicine, squat over scorched black bean leaves to promote urination.
Shenggan Dihuang San (Raw Dried Rehmannia Powder): Treats persistent hematuria in women.
Ingredients: Shenggan Dihuang (Raw Dried Rehmannia Root, 2 liang), Baiye (Biota Leaf, *Cacumen Biotaee*), Huangqin (Scutellaria Root, *Radix Scutellariae*) (each 0.5 liang), Ejiao (Donkey-hide Gelatin, *Colla Corii Asini*) (fried until bubbling, 1 liang).
Preparation and Administration: Grind into coarse powder. Take 3 qian per dose, add 1 sheng of water and 3 slices of ginger, decoct to 0.7 sheng, strain, and take warm.
Danggui San (Angelica Powder): Treats hematuria in women, occurring intermittently.
Ingredients: Danggui (Angelica Sinensis Root, *Radix Angelicae Sinensis*), Lingyangjiao (Antelope Horn, *Cornu Saigae Tataricae*, powdered), Chishaoyao (Red Peony Root, *Radix Paeoniae Rubra*) (each 0.5 liang), Shengdihuang (Raw Rehmannia Root, *Radix Rehmanniae Recens*), Cijiye (Thistle Leaf, *Folium Cirsii Japonici*) (0.3 fen).
Preparation and Administration: Grind into coarse powder. Take 3 qian per dose, decoct in water, strain, and take.
Another Formula:
Ingredients: Lingyangjiao (Antelope Horn, powdered), Longgu (Fossilized Mammoth Bone, *Os Mastodi Gigantis*), Danggui, Puhuang (each 1 liang), Shengdihuang (2 liang).
Preparation and Administration: Grind into fine powder. Take 2 qian mixed with millet gruel, before meals.
Another Formula: Crush raw Rehmannia root to extract juice. Take one small cup per dose, twice daily.
Another Formula: Take 2 qian of Puhuang powder mixed with wine. Water mixing is also acceptable.
Another Formula: Take 2 liang of Lu Jiao Jiao (Deer Antler Glue, *Colla Cornus Cervi*), roasted until yellow. Decoct in 1 large sheng of water until reduced to half a sheng. Strain and divide into three doses, taken before meals.
*Supplement*: For hematuria, decoct a large piece of Zhu Ru (Bamboo Shavings, *Caulis Bambusae in Taeniae*) in water and take.
Another Formula: Decoct thickly Chuan Niuxi (Cyathula Root, *Radix Cyathulae*) with the radicle removed.
Another Formula: Take Danggui and Baizhi (Angelica Dahurica Root) as powder, take 2 qian with rice drink.
Another Formula: Cui Sheng Rushen San (Divine-like Delivery Powder), mix with child's urine and wine, take.
Treatment for sudden heat injury causing hematuria in women: Commander Chen stated: "When I served in Zhanggong, at age twenty-six, I suddenly noticed a few drops of bright red blood after urination. I was terrified, but felt no pain. This lasted for a month. If I did not drink alcohol, the bleeding was less, but the fear prevented cessation. A local soldier informed me of a city doctor named Zhang Kang who often treated this ailment. I invited him. He provided a vessel of clear liquid, claiming it was herbal medicine, diluted with a little honey and water. Two doses cured me. I rewarded him generously and asked for the herb name. It was Jingmian Cao (Mirror Grass), also known as Luoye Cao. It is green and grows in stone crevices everywhere."