〔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。血液的特性是遇寒则凝滞涩结，遇热则流动散溢。若血液失去正常的运行轨道，溢出并渗入膀胱（胞），就会导致小便出血。
【薛己】妇女小便尿血，可能是因为长期食用肥甘厚味及煎炸烧烤食物，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，可用加味逍遥散调服发灰。若是肝经风热所致，用子芩丸送服。病程日久导致血虚者，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。凡是病程日久且元气亏损者，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交替、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，头痛痊愈。后来因郁怒导致腹痛尿血，仍用前一方，加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安、彻夜失眠，仍用前方治愈。
另一位妇人尿血，面色萎黄、身体疲倦、饮食无味、下午发热口渴，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，反而更加发热吐痰；服用黄芩、黄连等清热药后，又出现食欲不振，各种虚证蜂拥而起。诊见肝脉弦数，脾脉弦缓，这是因为肝经有风热，却误用沉阴（寒凉滋腻）之剂，损伤了脾胃，导致脾胃不能统摄血液，进而引发各脏病变所致。我使用补中益气汤、六味地黄丸而治愈。
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，无论是先尿后血，还是先血后尿，都适用。也可治疗因憋忍小便，或纵欲过度，导致膀胱气化不利（脬转），脐下急痛不通的情况。兼治肺疽、心衄、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，加少许热水，调服二钱，用井华水（清晨第一次打的井水）调服也可以。服药后，立即蹲在炒热的黑豆叶上，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，每次取三钱，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，每次取三钱，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，每次服用一小盏，每日两次。
又一方：用蒲黄末，酒调服二钱。用水调服也可以。
又一方：用鹿角胶（二两，炙至黄色），加水一大盏，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，惊吓导致症状无法停止。偶然有乡兵告知市中有位叫张康的医生常治此疾，于是请他来，提供了一器清汁，说是草药，加少许蜂蜜和水稀释，服两次即愈。事后重金酬谢，询问其药名，原来是镜面草，又名螺靥草，颜色青翠，各地石阶缝中都有生长。”
[ Dai Yuanli ] When women experience hematuria (bleeding from the urinary tract), 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 pathway, overflows, and infiltrates into the bladder (uterus/bladder area), hematuria occurs.
[ Xue Ji ] Women suffering from hematuria may be caused by long-term consumption of rich, greasy, fried, or roasted foods; sexual intercourse after drunkenness or full meals; improper diet and overwork; or invasion by the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) and emotional disturbances (Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright). These factors deplete Yuan Qi (Original Qi), causing it to fail in controlling and retaining blood within its vessels. If caused by anger stirring up Liver Fire, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) taken with Fa Hui (Ashed Hair). If due to Wind-Heat in the Liver Meridian, use Zi Qin Wan (Fritillaria Pill). For chronic cases resulting in Blood Deficiency, use Ba Zhen Tang (Eight Treasure Decoction) taken with Fa Hui. For heat accumulation from rich foods, use Qing Wei San (Stomach Clearing Powder) plus Huai Hua (Sophora Flower) and Gan Cao (Licorice Root). For injury due to sexual exhaustion, use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Chai Hu (Bupleurum Root) and Sheng Ma (Cimicifuga Rhizome). For injury due to Wind-Heat, use Si Jun Zi Tang (Four Gentlemen Decoction) plus Fang Feng (Saposhnikovia Root) and Zhi Ke (Aurantium Fruit). For chronic cases with depleted Yuan Qi, prioritize Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For Spleen injury due to constraint/stagnation, prioritize Ji Sheng Gui Pi Tang (Accumulated Life Restore the Spleen Decoction).
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 stagnation and distension ceased. Headache was cured using Bu Zhong Yi Qi Tang plus Man Jing Zi (Vernonia Seed). Later, abdominal pain and hematuria occurred due to depression and anger; the previous formula was used again, plus Long Dan Cao (Gentian Root) and Gui Pi Tang (Restore the Spleen Decoction). As she was recovering, dietary injury caused palpitations and insomnia all night; the previous decoction cured her.
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. 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, leading to recovery.
Case 3: A woman with hematuria took Si Wu Tang (Four Substances Decoction) and Pu Huang (Typha Pollen), which exacerbated fever and phlegm vomiting. Taking Huang Qin (Scutellaria Root) and Huang Lian (Coptis Rhizome) led to loss of appetite and various deficiency syndromes. The Liver pulse was wiry and rapid; the Spleen pulse was wiry and moderate. This was due to Wind-Heat in the Liver Meridian, mismanaged with heavy Yin (cold/cloying) agents that injured the Spleen, causing it to lose control over blood and affecting other organs. I cured her using Bu Zhong Yi Qi Tang and Liu Wei Di Huang Wan (Six Ingredient Pill with Rehmannia).
Lurong San (Deer Horn Powder) [from *Da Quan*]: Treats hematuria in women due to consumptive weakness and debility.
Ingredients: Lurong (Deer Horn), Danggui (Angelica Sinensis), Shudihuang (Prepared Rehmannia), Kuizi (Abelmoschus Seeds), Puhuang (Typha Pollen), Xuduan (Dipsacus Root) (equal parts).
Preparation: Grind into fine powder. Take 2 qian mixed with wine, three times daily.
Fahui San (Ashed Hair Powder): Treats hematuria, whether blood appears after urine or urine after blood. It also treats "Pao Zhuan" (bladder retention/spasm) and urgent lower abdominal pain caused by holding urine or excessive sexual activity. It treats Lung abscess, heart bleeding, internal rupture, spitting up one or two mouthfuls of blood, tongue bleeding like needle pricks, and epistaxis (nosebleed); blowing the powder into the nose stops it immediately.
Ingredient: Luansha Fahui (Ashed disordered hair) [Compendium notes: treats blood stasis, opens blockages, promotes urination, breaks masses/abscesses, treats urinary retention, promotes bowel/urinary movement, cough, epistaxis].
Preparation: Single ingredient. Mix 2 qian with 2 he of rice vinegar and a little hot water. Can also be taken with Jinghua Water (first drawn well water). After taking, squat over stir-fried black soybean leaves to promote urination.
Sheng Gan Dihuang San (Raw Dried Rehmannia Powder): Treats persistent hematuria in women.
Ingredients: Sheng Gan Dihuang (Raw Dried Rehmannia, 2 liang), Baiye (Cacumen Platycladi), Huangqin (Scutellaria Root, each 0.5 liang), Ejiao (Donkey-hide Gelatin, fried until bubbling, 1 liang).
Preparation: Coarse powder. Take 3 qian per dose with 1 sheng of water and 3 slices of ginger. Decoct to 0.7 sheng, strain, and take warm.
Danggui San (Angelica Powder): Treats hematuria or intermittent blood in urine in women.
Ingredients: Danggui (Angelica Sinensis), Lingyangjiao (Antelope Horn, powdered), Chi Shaoyao (Red Peony Root, each 0.5 liang), Shengdihuang (Raw Rehmannia, 1 liang), Cijiye (Leaf of Carthamus/Saflower plant? Note: Ci Ji usually refers to Carthamus tinctorius leaf or similar thistle, here likely specific local herb), Cijiye (Thistle Leaf, 0.3 qian).
Preparation: Coarse powder. Take 3 qian per dose, decoct in water, strain, and take.
Another Formula:
Ingredients: Lingyangjiao (Antelope Horn, powdered), Longgu (Fossilized Bones), Danggui (Angelica Sinensis), Puhuang (Typha Pollen, each 1 liang), Shengdihuang (Raw Rehmannia, 2 liang).
Preparation: Fine powder. Take 2 qian mixed with millet gruel water, before meals.
Another Formula: Crush raw Rehmannia to extract juice. Take one small cup per dose, twice daily.
Another Formula: Take 2 qian of Puhuang powder mixed with wine. Water can also be used.
Another Formula: Use Lu Jiao Jiao (Deer Horn Gelatin, 2 liang, roasted yellow). Decoct in 1 large sheng of water until reduced to half a sheng. Strain and divide into three doses, before meals.
*Supplement*: For hematuria, decoct a large piece of Zhu Ru (Bamboo Shavings) in water and drink.
Another Formula: Decoct thickly Chuan Niuxi (Achyranthes Bidentata Root, de-rhizomed) and drink.
Another Formula: Make Danggui (Angelica Sinensis) and Baizhi (Angelica Dahurica) into powder. Take 2 qian with millet drink.
Another Formula: Cu Sheng Ru Shen San (Delivery-like-God Powder). Take mixed with child's urine and wine.
Treatment for sudden heat injury causing hematuria in women: Commander Chen stated: "When I was in Zhanggong at age twenty-six, I suddenly noticed a few drops of bright red blood after urination. I was terrified, though there was no pain. This persisted for a month. If I did not drink alcohol, the bleeding was less, but the fear prevented cessation. A local soldier told me of a city doctor named Zhang Kang who often treated this. I invited him. He provided a vessel of clear liquid, saying it was a herbal medicine, diluted with a little honey and water. Two doses cured me. I rewarded him heavily and asked the name. It was Jingmian Cao (Mirror-leaved Herb), also known as Luoye Cao (Snail-face Herb). It is green and grows in cracks of stone steps everywhere."