二症或因饮食起居失养，或因六淫七情失宜，以致脾胃亏损，不能生发统摄，气血乖违，行
失常道。若先因经水断绝，后至四肢浮肿，小便不通，血化为水，名曰血分，宜用椒仁丸治
之。若先小便不利，后至身面浮肿，经水不通，水化为血，名曰水分，宜用葶苈丸治之。此
属形气不足，邪淫隧道，必用此药以宣导其邪，而佐以辅补元气，庶使药力有所仗而行，则
邪自不能容，而真气亦不至于复伤矣。
治验
一妇人月经不调，晡热内热，饮食少思，肌体消瘦，小便频数，服济阴丸，月经不行，四肢
浮肿，小便不通。余曰∶此血分也。朝用椒仁丸，夕用归脾汤渐愈，乃以人参丸代椒仁丸，
两月余将愈。专用归脾汤，五十余剂而痊。
一 妇月经不调，小便短少，或用清热分利之剂，小便不利，三月余身面浮肿，月经不通。
余曰∶此水分也。遂朝用葶苈丸，夕用归脾汤渐愈，乃用人参丸间服而愈。已上二症，作脾
虚水气，用分利等药而殁者多矣。惜哉!
妇人小便尿血，或因膏粱炙 ，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。
治验
一妇人尿血，因怒气寒热，或头痛，或胁胀，用加味逍遥，诸症稍愈，惟头痛，此阳气虚，
用补中益气加蔓荆子而痊。后郁怒，小腹内 痛，次日尿血热甚，仍用前散加龙胆草并归脾
汤，将愈，因饮食所伤，血仍作，彻夜不寐，心忡不宁，此脾血尚虚，用前汤而痊。
一妇人尿血，久用寒凉止血药，面色痿黄，肢体倦怠，饮食不甘，晡热作渴三年矣，此前药
复伤脾胃，元气下陷而不能摄血也。盖病久郁结伤脾，用补中益气以补元气，用归脾汤以解
脾郁，使血归经。更用加味逍遥以调养肝血，不月诸症渐愈，三月而痊。
这两种病症，有的因为饮食起居调养不当，有的因为六淫（风、寒、暑、湿、燥、火）和七情（喜、怒、忧、思、悲、恐、惊）失调，导致脾胃受损，无法生发和统摄气血，使得气血运行失常。如果先出现月经停止，随后四肢浮肿、小便不通，这是血液转化为水液，称为“血分”，适宜使用椒仁丸治疗。如果先出现小便不利，随后身体面部浮肿、月经不通，这是水液转化为血液，称为“水分”，适宜使用葶苈丸治疗。这属于形体元气不足，邪气侵入经络隧道，必须用这些药物来宣通疏导邪气，并辅以补益元气，使药力有所依托而发挥作用，这样邪气自然无法存留，真气也不会再次受到损伤。
医案记录：
一位妇女月经不调，傍晚发热及体内发热，食欲减退，身体消瘦，小便频数，服用济阴丸后，月经停止，四肢浮肿，小便不通。我说：“这是血分病。”早晨服用椒仁丸，晚上服用归脾汤，病情逐渐好转，后来用人参丸替代椒仁丸，两个多月后即将痊愈。专门使用归脾汤，五十多剂后痊愈。
另一位妇女月经不调，小便短少，有人使用清热利湿的药物，导致小便更加不利，三个多月后身体面部浮肿，月经不通。我说：“这是水分病。”于是早晨服用葶苈丸，晚上服用归脾汤，病情逐渐好转，后来间歇性服用人参丸而痊愈。以上两种病症，被诊断为脾虚水气，使用分利等药物治疗而死亡的很多，可惜啊！
妇女小便尿血，有的因为食用肥甘厚味或烧烤食物，有的因为醉酒饱食后行房事，有的因为饮食劳累，有的因为六淫七情，导致元气亏损，不能统摄血液回归本源。如果是因愤怒引动肝火引起的，用加味逍遥散调送发灰（头发烧成的炭）。肝经风热引起的，送服子芩丸（黄芩丸）。久病导致血虚的，用八珍汤送服发灰。如果是肥甘厚味积热引起的，用清胃散加槐花、甘草。房劳损伤引起的，用六君子汤加柴胡、升麻。风热损伤引起的，用四君子汤加防风、枳壳。凡是久病亏损元气的，以补中益气为主。郁结伤脾引起的，以济生归脾汤为主。
医案记录：
一位妇女尿血，因愤怒伴有寒热症状，有时头痛，有时胁肋胀满，使用加味逍遥散，各种症状稍有好转，只有头痛未愈，这是因为阳气虚弱，使用补中益气汤加蔓荆子而痊愈。后来因郁怒，小腹内部疼痛，第二天尿血且热象严重，仍然使用前方的散剂加龙胆草并配合归脾汤，病情将愈，但因饮食所伤，出血再次发作，彻夜不眠，心慌不安，这是因为脾血依然虚弱，使用前面的方剂而痊愈。
另一位妇女尿血，长期使用寒凉止血药，面色萎黄，肢体倦怠，饮食无味，傍晚发热口渴三年了，这是之前的药物再次损伤脾胃，元气下陷而不能摄血所致。因为久病郁结伤脾，使用补中益气汤来补益元气，使用归脾汤来解除脾郁，使血液回归经脉。再用加味逍遥散来调养肝血，不到一个月各种症状逐渐好转，三个月后痊愈。
These two conditions may arise from improper diet and lifestyle, or from disharmony of the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and Seven Emotions (Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright), leading to Spleen-Stomach deficiency. This impairs their ability to generate and control Qi and Blood, causing them to deviate from their normal pathways. If menstruation ceases first, followed by edema of the limbs and urinary retention, where blood transforms into water, it is termed "Blood Division" (Xue Fen). It should be treated with Jiaoren Wan (Pepper Kernel Pill). If urinary difficulty occurs first, followed by facial and bodily edema and amenorrhea, where water transforms into blood, it is termed "Water Division" (Shui Fen). It should be treated with Tingli Wan (Descurainia Seed Pill). These cases belong to insufficiency of form and Qi, with pathogenic factors invading the meridians and collaterals. It is necessary to use these medicines to vent and guide out the pathogens, assisted by tonifying primordial Qi. This ensures that the medicinal force has support to act, so that pathogens cannot remain, and True Qi will not be further injured.
Clinical Records:
A woman suffered from irregular menstruation, afternoon fever, internal heat, poor appetite, emaciation, and frequent urination. After taking Ji Yin Wan (Nourishing Yin Pill), her menstruation ceased, accompanied by limb edema and urinary retention. I said, "This is Blood Division." In the morning, she took Jiaoren Wan; in the evening, Guipi Tang (Restore the Spleen Decoction). Her condition gradually improved. Later, Ren Shen Wan (Ginseng Pill) replaced Jiaoren Wan. After more than two months, she was nearly cured. Using only Guipi Tang for over fifty doses resulted in complete recovery.
Another woman had irregular menstruation and scanty urine. Someone administered clearing-heat and promoting-diuresis agents, which worsened her urinary difficulty. After three months, she developed facial and bodily edema and amenorrhea. I said, "This is Water Division." Thus, in the morning she took Tingli Wan; in the evening, Guipi Tang. Her condition gradually improved. Later, she intermittently took Ren Shen Wan and recovered. Regarding the above two cases, many died after being diagnosed as Spleen-deficiency with Water-Qi and treated with diuretic agents. How regrettable!
Women experiencing hematuria may suffer this due to rich, greasy, or roasted foods, sexual activity after drunkenness or full meals, dietary labor, or the Six Evils and Seven Emotions. These lead to Yuan Qi (Primordial Qi) deficiency, failing to control blood and return it to its source. If caused by anger stirring Liver Fire, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) taken with Fa Hui (Hair Ash). If caused by Wind-Heat in the Liver Meridian, take Ziqin Wan (Scutellaria Pill). For chronic blood deficiency, use Bazhen Tang (Eight Treasures Decoction) with Fa Hui. If caused by accumulation of heat from rich foods, use Qingwei San (Clear Stomach Powder) plus Huaihua (Sophora Flower) and Gancao (Licorice Root). For injuries from sexual exhaustion, use Liujun Zi Tang (Six Gentlemen Decoction) plus Chaihu (Bupleurum Root) and Shengma (Cimicifuga Rhizome). For injuries from Wind-Heat, use Sijun Zi Tang (Four Gentlemen Decoction) plus Fangfeng (Saposhnikovia Root) and Zhike (Aurantii Fructus Immaturus). For chronic Yuan Qi depletion, prioritize Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). For Spleen injury due to constraint and stagnation, prioritize Jisheng Guipi Tang (Guipi Decoction for Saving Lives).
Clinical Records:
A woman had hematuria, alternating chills and fever due to anger, sometimes headache, sometimes hypochondriac distension. She used Jiawei Xiaoyao San; symptoms improved slightly, but headache persisted. This indicated Yang Qi deficiency. She was cured using Buzhong Yiqi Tang plus Manjingzi (Vernonia Seed). Later, due to depression and anger, she experienced internal lower abdominal pain. The next day, severe hematuria with heat occurred. She again used the previous powder plus Longdancao (Gentiana Root) combined with Guipi Tang. As she was recovering, dietary injury caused bleeding to recur. She suffered insomnia all night and palpitations. This indicated remaining Spleen-Blood deficiency. She was cured using the aforementioned decoction.
Another woman had hematuria. Long-term use of cold-natured hemostatic drugs led to sallow complexion, limb fatigue, lack of taste for food, and afternoon fever with thirst for three years. This was because previous medications re-injured the Spleen and Stomach, causing Yuan Qi to sink and fail to control blood. Since long-standing illness leads to constraint injuring the Spleen, she used Buzhong Yiqi Tang to tonify Yuan Qi, and Guipi Tang to resolve Spleen constraint, allowing blood to return to the vessels. Additionally, Jiawei Xiaoyao San was used to nourish Liver Blood. Within a month, symptoms gradually improved, and she recovered in three months.