尿血者，精不通行而成血，血不归经而入便，然其原在肾气衰而火旺，治当清肾。清肾
之法，补脾益肺以生水则火自平，而精血各归其所矣。用四君加木通、香附，则气理而精旺矣。
尿血久不愈，阳陷于阴者，补中益气汤。
验案
一人尿血，此脾阴不足也，用熟地以补其阴，阴不足则肝木乘脾而土弱；用甘草、白芍
泻土中之木，枣仁、远志扶土之母；以通其升
降之道，不为邪气所郁；用麦冬、天冬以清肺，盖肺能降，脾自能升也。若陈、半、术、苓
香燥之味，有碍乎阴，不宜。
鼻血，阳明热证也。阳明经挟鼻，热甚故血上行也。治宜清之。
鼻血涌出，诸药不止，生地、薄荷、藕节、柏叶、茅根各一钱，生姜五钱，捣汁一碗，
磨京墨服。血来盈盆色淡者，此药不效，须用大附子便制五钱，水煎一盅，加姜汁半杯、童便一
衄血，安神丸二、三次不止，用沉香末二钱、山栀末五钱酒服。
衄血不止，用驴屎烧存性，研末吹鼻立止。
太阳伤寒，血出于鼻者，盖太阳主表，肺主皮毛，亦属表，鼻为肺窍，表气热甚，故其
于表之窍。寒凉泻火之有余，不能泻火之不足，若五脏无病，只肾虚火动，应用寒凉，滋阴
降火；若脾虚下陷，阴火上升，复用寒凉，则无根之火愈炽，而喉痛咽哑之病作矣，危亡其能免乎？
尿血，是由于精气运行不畅导致血液生成异常，血液不能循行于经脉而从小便排出。然而其根本原因在于肾气衰弱而相火旺盛，治疗应当清补肾阴。
清补肾阴的方法，是通过补益脾脏和肺脏以滋生肾水，这样虚火自然平息，精与血就能各自回归其正常位置。
使用四君子汤加入木通、香附，可以使气机调理顺畅，精气充盛。
如果尿血日久不愈，属于阳气下陷于阴分的，使用补中益气汤。
验案：
有一人患尿血，这是脾阴不足所致，使用熟地黄来滋补脾阴。
因为阴液不足，会导致肝木克制脾土，使脾气虚弱；
因此使用甘草、白芍来泻除脾土中过盛的肝木之气，使用酸枣仁、远志来扶助脾土之母（即心火/心神，此处指通过安神以助脾运）；
以此疏通升降的气机之道，防止被邪气郁滞；
使用麦冬、天冬来清润肺脏，因为肺能肃降，脾脏自然能够升清。
如果使用陈皮、半夏、白术、茯苓等香燥的药物，会损伤阴液，不宜使用。
鼻出血，属于阳明经的热证。
阳明经挟持鼻部，热势炽盛所以血液向上溢出。
治疗应当清热。
如果鼻血涌出不止，服用各种药物无效，取生地黄、薄荷、藕节、侧柏叶、白茅根各一钱，生姜五钱，捣烂取汁一碗，研磨京墨后服用。
如果流出的血充满盆且颜色淡红，此药无效，必须使用大附子（经过炮制）五钱，加水煎煮至一盅，加入姜汁半杯、童便（儿童尿液）一同服用。
如果鼻衄不止，使用安神丸二到三次仍不止血，使用沉香末二钱、山栀末五钱，用酒送服。
如果鼻衄仍然不止，使用驴屎烧至存性（保留药性），研成粉末吹入鼻腔，立即可止血。
太阳伤寒病，出现鼻出血的，是因为太阳主表，肺主皮毛，也属于表证，鼻是肺的窍道，体表热气炽盛，所以血液从体表的窍道溢出。
寒凉药物只能泻除有余的火邪，不能泻除不足的虚火。
如果五脏没有病变，仅仅是肾虚导致虚火上动，应当应用寒凉药物滋阴降火；
如果是脾虚导致中气下陷，阴火上升，再使用寒凉药物，那么无根之火会更加炽盛，喉痛、声音嘶哑等疾病就会发作，危亡难道能避免吗？
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?