心气虚，则小肠不能制而血流；脾气弱，则大肠无移荫而血下。故二便出血，当实之心脾二经。
血气虚而热乘之，故血随小便而出，血热则流，故渗入胞内，用发炭、滑石末、地黄汁调下。
面黄胁胀少食，此肝木乘脾土也。加味逍遥散。（补二十一）
惊悸不寐，加味归脾汤。（补三）
大便下血，缘六淫七情，致伤元气。阳络外伤而然也。
肠胃虚弱，六君子汤加升麻、柴胡，若虚寒，去升柴加肉果；如怒动肝火，加当归、白芍，去升麻。
膏粱积热，四物汤加丹皮、山楂。（补七）
大肠风热，四物汤加荆芥、防风。（同上）
大肠血热，四物汤加丹皮、槐米。（同上）
肾虚无约束也，都气饮。（补二十四）
脾肾不足，补中益气汤。（补六）
脾肾虚寒，八味丸。（补四十六）
非肺气虚而不能约制，即肾气竭而虚热移于膀胱也。
气虚不能制，人参、黄 、桑螵蛸、鹿茸、牡蛎、赤石脂。
脾肾虚寒，七味丸。（补三十一）
尿脬破损，猪、羊胞煎汤，入人参、黄 、当归、熟地、陈皮、茯苓、桃仁，于极饥时饮之，然须急治，缓则不能
成功也。又补脬饮，用生黄丝绢一尺，煎碎，白牡丹根皮、白及各一钱，俱为末，水一碗，同煮至绢烂如饧，空心顿服。
服时不得作声，作声则不效。
膀胱阴虚，补中益气汤加山茱萸、山药、桑螵蛸，以补肺肾，则小便自不淋沥。（补六）
心气虚弱，则小肠失去制约功能而导致血液外溢；脾气虚弱，则大肠缺乏滋养而致便血。因此，大小便出血，应当补益心和脾两经。
气血亏虚且受热邪侵袭，所以血液随小便排出；血分有热则血流妄行，故血液渗入胞宫（此处指下焦血室），可用发炭、滑石末、地黄汁调服。
面色萎黄、胁肋胀满、食欲不振，这是肝木乘克脾土的表现。选用加味逍遥散。（补二十一）
大便下血，源于六淫（风、寒、暑、湿、燥、火）和七情（喜、怒、忧、思、悲、恐、惊）致病，损伤元气。这是由于阳络（体表或上部的脉络）受到外伤所致。
肠胃虚弱，用六君子汤加升麻、柴胡；若属虚寒证，去掉升麻、柴胡，加入肉豆蔻；如因愤怒引动肝火，加入当归、白芍，去掉升麻。
若非肺气虚弱导致不能约制，即是肾气衰竭，虚热转移至膀胱所致。
尿脬（膀胱）破损，用猪或羊的膀胱煎汤，加入人参、黄芪、当归、熟地黄、陈皮、茯苓、桃仁，在极度饥饿时服用，但必须紧急治疗，拖延则难以成功。另有补脬饮，用生黄丝绢一尺，煎碎，配伍白牡丹根皮、白及各一钱，均研为细末，用水一碗，同煮至丝绢烂如糖浆状，空腹顿服。
服药时不得出声，出声则无效。
If the Heart Qi is deficient, the Small Intestine loses its controlling function, leading to blood extravasation; if the Spleen Qi is weak, the Large Intestine lacks nourishment and support, resulting in hematochezia. Therefore, for bleeding from both bowels and urine, one should tonify the Heart and Spleen meridians.
When Qi and Blood are deficient and invaded by Heat, blood follows the urine out; since Blood-Heat causes turbulent flow, blood infiltrates the Bao (uterus/lower jiao blood chamber). Use Fa Tan (Charred Hair), powder of Talcum (Hua Shi), and juice of Rehmanniae Radix (Di Huang) mixed and taken orally.
Sallow complexion, distension in the hypochondrium, and poor appetite indicate Liver Wood overacting on Spleen Earth. Use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). (Supplement 21)
For palpitations due to fright and insomnia, use Jiawei Guipi Tang (Modified Tonify the Spleen Decoction). (Supplement 3)
Hematochezia arises from pathogenic factors of the Six Exogenous Pathogens (Liu Yin) or emotional disturbances of the Seven Emotions (Qi Qing), damaging the Primordial Qi. This results from external injury to the Yang Collaterals.
For weakness of the Stomach and Intestines, use Liujunzi Tang (Six Gentlemen Decoction) with Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix); if it is a deficiency-cold pattern, remove Sheng Ma and Chai Hu and add Rou Dou Kou (Myristicae Semen); if anger stirs Liver Fire, add Dang Gui (Angelicae Sinensis Radix) and Bai Shao (Paeoniae Radix Alba), and remove Sheng Ma.
For heat accumulation from rich and greasy food, use Siwu Tang (Four Substances Decoction) with Mu Dan Pi (Moutan Cortex) and Shan Zha (Crataegi Fructus). (Supplement 7)
For Wind-Heat in the Large Intestine, use Siwu Tang (Four Substances Decoction) with Jing Jie (Schizonepetae Herba) and Fang Feng (Saposhnikoviae Radix). (Same as above)
For Blood-Heat in the Large Intestine, use Siwu Tang (Four Substances Decoction) with Mu Dan Pi (Moutan Cortex) and Huai Mi (Sophorae Flos). (Same as above)
Kidney deficiency fails to provide constraint and control; use Duqi Yin (Duqi Decoction). (Supplement 24)
Deficiency of Spleen and Kidney; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). (Supplement 6)
Deficiency-cold of Spleen and Kidney; use Bawei Wan (Eight-Ingredient Pill). (Supplement 46)
This is either due to Lung Qi deficiency failing to exert control, or Kidney Qi exhaustion where Deficient Heat shifts to the Bladder.
When Qi is deficient and cannot control retention, use Ren Shen (Ginseng Radix et Rhizoma), Huang Qi (Astragali Radix), Sang Piao Xiao (Mantis Ootheca), Lu Rong (Cornu Cervi Pantotrichum), Mu Li (Concha Ostreae), and Chi Shi Zhi (Halloysit Rubra).
Deficiency-cold of Spleen and Kidney; use Qiwei Wan (Seven-Ingredient Pill). (Supplement 31)
Rupture of the Niao Pao (Urinary Bladder): Decoct pig or sheep bladders in water, add Ren Shen (Ginseng Radix et Rhizoma), Huang Qi (Astragali Radix), Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Prepared Rehmanniae Radix), Chen Pi (Citri Reticulatae Pericarpium), Fu Ling (Poria), and Tao Ren (Persicae Semen). Drink this when extremely hungry. However, urgent treatment is required; delay will render success impossible. Another prescription, BUPAO YIN (Bladder-Reinforcing Decoction), uses one chi of raw yellow silk gauze, boiled until broken down, combined with Bai Mudan Genpi (Moutan Cortex Radicis) and Bai Ji (Bletillae Rhizoma), each one qian, all ground into powder. Boil with one bowl of water together until the silk rots like syrup. Take orally in one dose on an empty stomach. Do not make any sound while taking it; making sound renders it ineffective.
Yin deficiency of the Bladder: Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Shan Zhu Yu (Corni Fructus), Shan Yao (Dioscoreae Rhizoma), and Sang Piao Xiao (Mantis Ootheca) to tonify the Lungs and Kidneys, so that urinary dribbling will naturally cease. (Supplement 6)