中者，脾胃也。脾统血，脾虚则不能摄血。脾化血，脾虚则不能运化。是皆血无所主，
脱陷妄行。其血色不甚鲜红，或紫或黑，此阳败而然，故多无热证。而或见恶心呕吐，宜理
中汤温补脾胃。中气得理，血自归经矣。
理中汤
理物汤 即理中，四物合剂。
黄土汤
白术 甘草 附子 地黄 阿胶 黄芩（各三两） 灶心黄土（半升）
水八升，煮取三升，分温三服。
《本事》治肠痔在腹内，有鼠奶出血方
白芜荑 贯众 野狼牙根 椿东引枝 槐东引枝（白皮者，各一分） 白 头（一个
，炙焦） 雄黄（半两） 皮（一分，炙焦）
上为末，腊月猪脂和为丸，如弹子大，绵裹纳下部，日三易。
附方∶
木耳（五钱）
浸一宿洗净，空心生食，禁茶汤半日许。如嫌淡，少加盐，三服必愈。但不能除根耳。
溲血有虚有实，实者下焦积热，血为热迫，尿血成淋。虚者房劳内作，血失统御，溺血
不已。亦有心脏有热。热乘于血，血渗小肠而尿血者，当参合脉证治之。
凡小便血出，成淋作痛，或杂尿而出者，从膀胱中来也。如血出不痛者为尿血，乃心热
移于小肠，血从精窍中来也。
《济生》小蓟饮子 治下焦结热之剂。
生地（四两） 小蓟根 滑石 通草 蒲黄（炒） 淡竹叶 藕节 当归 山
栀仁 甘草（炙，各半两）
上 咀，每服四钱，水一盏，煎八分，空心温服。一方有白茅根、阿胶。
鹿茸散 治下元虚惫，小便尿血，日夜不止之剂。
鹿茸（酒洗去毛，涂酥，炙令黄） 当归（焙） 生地黄（焙，各二两） 蒲黄（一合）
上为极细末，每服三钱匕，空心温酒调服，日二。一方炼蜜为丸，如梧子大，每服二十
如神散 治心脏有热，热乘于血之剂。
阿胶（蛤粉炒，一两） 山栀 车前子 黄芩 甘草（炙，各二钱半）
上为细末，每服半钱，或一钱。井华水调服，日三。此方合犀角地黄汤用之良。
发灰散
乱发烧存性为末，每服二钱，以醋二合、汤少许调服，或以侧柏叶汁调糯米粉，和丸梧
子大，汤服五十丸。
鹿角胶丸 治房事劳伤，小便出血。
鹿角（一两，炒成珠） 没药 油发灰（各六钱）
上为末，取白茅根汁打糊为丸，如梧子大。空心盐汤吞七八十丸。
中焦指脾胃。脾具有统摄血液的功能，脾气虚弱则无法固摄血液；脾负责化生血液，脾气虚弱则无法运化水谷精微以生成血液。这些情况都导致血液失去主宰，从而脱失下陷、妄行溢出。其血色不十分鲜红，或呈紫色或黑色，这是阳气衰败所致，因此大多没有热证表现。若出现恶心呕吐症状，适宜使用理中汤来温补脾胃。中焦之气得以调理，血液自然回归经脉。
黄土汤
白术、甘草、附子、地黄、阿胶、黄芩（各三两），灶心黄土（半升）。
用水八升，煮取三升药液，分三次温服。
《本事方》治疗肠痔位于腹内，伴有鼠奶状出血的方剂：
白芜荑、贯众、野狼牙根、椿树东向引枝、槐树东向引枝（选用白皮者，各一分）、白头（一个，炙至焦黑）、雄黄（半两）、[此处原文缺字，推测为某皮]（一分，炙至焦黑）。
以上药物研为细末，用腊月猪脂调和制成丸药，大小如弹子，用绵布包裹后纳入下部（肛门或阴道），每日更换三次。
附方：
木耳（五钱）
浸泡一夜洗净，空腹生吃，服药后半日内禁止饮用茶和汤。如果觉得味道淡，可加少许盐，服用三次必定痊愈。但只能治标，不能除根。
小便出血有虚证和实证之分。实证是下焦积热，血液被热邪逼迫，形成尿血并伴有淋涩疼痛。虚证多因房劳过度内伤所致，血液失去统摄控制，导致溺血不止。也有心脏有热的情况，热邪侵袭血液，血液渗入小肠而致尿血，治疗时应当结合脉象和症状综合诊治。
凡是小便出血，成淋且伴有疼痛，或者混杂在尿液中排出的，病源来自膀胱。如果出血但不疼痛，称为尿血，这是心热移注于小肠，血液从精窍（尿道）中排出的。
《济生方》小蓟饮子：治疗下焦结聚热邪的方剂。
生地（四两）、小蓟根、滑石、通草、蒲黄（炒制）、淡竹叶、藕节、当归、山栀仁、甘草（炙，各半两）。
以上药物切碎，每次服用四钱，加水一盏，煎至八分，空腹温服。另一版本方中含有白茅根、阿胶。
鹿茸散：治疗下元虚惫，小便尿血，日夜不止的方剂。
鹿茸（酒洗去毛，涂酥，炙至黄色）、当归（焙干）、生地黄（焙干，各二两）、蒲黄（一合）。
以上药物研为极细末，每次服用三钱匕，空腹用温酒调服，每日两次。另一版本用炼蜜制成丸药，大小如梧桐子，每次服用二十丸。
如神散：治疗心脏有热，热邪侵袭血液的方剂。
阿胶（蛤粉炒，一两）、山栀、车前子、黄芩、甘草（炙，各二钱半）。
以上药物研为细末，每次服用半钱或一钱，用井华水（清晨第一次汲取的井水）调服，每日三次。此方配合犀角地黄汤使用效果良好。
发灰散
将乱发烧存性后研为细末，每次服用二钱，用醋二合、少量开水调服；或者用侧柏叶汁调和糯米粉，制成如梧桐子大小的丸药，开水送服五十丸。
鹿角胶丸：治疗房事劳伤，小便出血。
鹿角（一两，炒至成珠状）、没药、油发灰（各六钱）。
以上药物研为细末，取白茅根汁打糊制成丸药，大小如梧桐子。空腹用盐汤吞服七八十丸。
The "Middle" refers to the Spleen and Stomach. The Spleen governs the containment of blood; when Spleen Qi is deficient, it fails to control the blood. The Spleen transforms nutrients into blood; when Spleen Qi is deficient, it fails to transport and transform, thereby failing to generate blood. In all these cases, blood loses its master, leading to collapse, sinking, and reckless bleeding. The color of the blood is not bright red but may be purple or black, which is due to the failure of Yang Qi; therefore, there are usually no signs of heat syndromes. If symptoms such as nausea and vomiting appear, Lizhong Tang (Regulate the Middle Decoction) should be used to warm and tonify the Spleen and Stomach. Once the Qi of the Middle Jiao is regulated, the blood will naturally return to its vessels.
Lizhong Tang
Li Wu Tang: A combination of Lizhong Tang and Siwu Tang.
Huangtu Tang (Yellow Earth Decoction)
Baizhu (Atractylodis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata), Dihuang (Rehmanniae Radix), Ejiao (Colla Corii Asini), Huangqin (Scutellariae Radix) (each 3 liang), Zaoxin Huangtu (Caulis Cinnamomi Cum Terra / Hearth Earth) (0.5 sheng).
Add 8 sheng of water, boil to obtain 3 sheng of decoction, divide into three doses, and take warm.
From *Ben Shi Fang* (Formulas of Great Reliance): Formula for treating intestinal hemorrhoids located within the abdomen, accompanied by bleeding resembling a mouse's teat.
Bai Wuyi (Chukunthi Fructus), Guanzhong (Cyathulae Rhizoma), Ye Langya Gen (Sibiricne Spirea Root), Chun Dong Yin Zhi (Toona Sinensis Branch Growing Eastward), Huai Dong Yin Zhi (Melia Toosendan Branch Growing Eastward, using white bark) (each 1 fen), Bai Tou (Allii Fistulosi Bulbus) (one bulb, roasted until charred), Xionghuang (Realgar) (0.5 liang), [Text missing, likely Pi] (1 fen, roasted until charred).
Grind the above ingredients into powder, mix with lard from the twelfth lunar month to form pills the size of a bullet, wrap in cotton, and insert into the lower orifice (anus or vagina), changing three times daily.
Supplementary Formula:
Mu'er (Wood Ear Mushroom) (5 qian).
Soak overnight, wash clean, and eat raw on an empty stomach. Avoid drinking tea or soup for about half a day after ingestion. If the taste is bland, add a little salt. Three doses will surely cure the symptom, though it cannot remove the root cause.
Hematuria (blood in urine) can be due to deficiency or excess syndromes. Excess syndromes involve accumulated heat in the Lower Jiao, where blood is forced by heat, resulting in hematuria with strangury (painful urination). Deficiency syndromes often arise from internal injury due to sexual exhaustion, causing blood to lose its control, leading to continuous urinary bleeding. There are also cases of heat in the Heart; when heat invades the blood, blood seeps into the Small Intestine causing hematuria. Treatment should be determined by integrating pulse and symptom analysis.
Generally, if blood exits with urine, forms strangury, and causes pain, or is mixed with urine, the source is the Bladder. If blood exits without pain, it is called hematuria, caused by Heart heat transferring to the Small Intestine, with blood exiting from the essence orifice (urethra).
Xiaoji Yinzi (Small Thistle Drink) from *Jisheng Fang*: A formula for treating constrained heat in the Lower Jiao.
Shengdi (Rehmanniae Radix) (4 liang), Xiaoji Gen (Cephalanoplis Radix), Huashi (Talcum), Tongcao (Tetrapanacis Medulla), Puhuang (Typhae Pollinis, stir-fried), Dan Zhuye (Lophatheri Herba), Ou Jie (Nelumbinis Node), Danggui (Angelicae Sinensis Radix), Shanzhiren (Gardeniae Semen), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) (each 0.5 liang).
Coarsely crush the ingredients. Take 4 qian per dose, add one cup of water, decoct to 0.8 cup, and take warm on an empty stomach. Another version includes Baimaogen (Imperatae Rhizoma) and Ejiao.
Lurong San (Deer Antler Powder): A formula for treating deficiency and exhaustion of the Lower Yuan, with hematuria continuing day and night.
Lurong (Cornu Cervi Pantotrichum, washed with wine, hair removed, coated with butter, roasted yellow), Danggui (Angelicae Sinensis Radix, baked), Shengdihuang (Rehmanniae Radix, baked) (each 2 liang), Puhuang (Typhae Pollinis) (1 he).
Grind into an extremely fine powder. Take 3 qianbi per dose, mix with warm wine, and take on an empty stomach, twice daily. Another version uses refined honey to make pills the size of wutong seeds, taking 20 pills per dose.
Rushen San (Miraculous God Powder): A formula for treating heat in the Heart invading the blood.
Ejiao (Colla Corii Asini, fried with clam powder) (1 liang), Shanzhi (Gardeniae Fructus), Cheqianzi (Plantaginis Semen), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) (each 2.5 qian).
Grind into a fine powder. Take 0.5 qian or 1 qian per dose, mixed with Jinghua Shui (first-drawn well water in the morning), three times daily. This formula works well when combined with Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction).
Fahui San (Hair Ash Powder)
Burn disordered hair until carbonized, grind into powder. Take 2 qian per dose, mixed with 2 he of vinegar and a little hot water. Alternatively, mix with juice of Ce Bai Ye (Biota Tops) and glutinous rice flour to form pills the size of wutong seeds, taken with water, 50 pills per dose.
Lu Jiao Jiao Wan (Deer Horn Gelatin Pills): For treating injury from sexual activity and hematuria.
Lu Jiao (Cornu Cervi, stir-fried until pearl-like), Moyao (Myrrha), You Fa Hui (Ash of oiled hair) (each 6 qian).
Grind into powder, use juice of Baimaogen (Imperatae Rhizoma) to make paste for pills the size of wutong seeds. Swallow 70-80 pills with salted water on an empty stomach.