〔大〕产后小便出血者，因血气虚而热乘之，血得热则流散，渗于胞内，故血随小
便出。
〔薛〕一产妇尿血，面黄，胁胀少食，此肝木乘脾土也。用加味逍遥、补中益气兼
服而愈。后为怀抱不乐，食少体倦，惊悸无寐，血仍作，用加味归脾汤二十余剂，将愈。
惑于众论，服犀角地黄汤，诸证复作，仍服前汤而愈。
治小便利血方。
乱发（汤洗垢腻净）
上烧研为末，米饮调服方寸匕。
又方 用滑石（研） 发灰（等分） 每服一钱，地黄汁调下。
崔氏方 疗产后血渗入大小肠。
蜜（一大合） 车前草（捣汁，一升）
上相和煎沸，分两服。
《补遗》方 治产后小便出血。
川牛膝（去芦） 水煎服。
又方
生地黄汁（半升） 生姜自然汁（半合）
上相和服之。
〔薛〕产后便血，或饮食起居，或六淫七情，以致元气亏损，阳络外伤。治法∶若
因膏粱积热，用加味清胃散。若因醇酒湿毒，葛花解酲汤。若因怒动肝火，六君加芍药、柴
胡、芎、归。若因郁结伤脾，加味归脾汤。若因思虑伤心，妙香散。若因大肠风热，四物
加侧柏、荆、防、枳壳、槐花。若因大肠血热，四物加芩、连。若因肠胃虚弱，六君加
升麻、柴胡。若因肠胃虚寒，六君加肉蔻、木香。若因元气下陷，补中益气加茯苓、半夏。
若因气虚，用六君、升麻。若因血虚，用四物。气血俱虚，用八珍，俱加柴胡、升麻。大
凡病久或元气虚弱，见病百端，皆因脾胃亏损，内真寒而外假热，但用六君子或补中益
气加炮姜，温补脾气，诸证悉退。若四肢畏冷，属阳气虚寒，急加附子。病因多端，当
临证制宜，庶无误矣。一产妇粪后下血，诸药不应，饮食少思，肢体倦怠，此中气虚弱，
用补中益气加吴茱、炒黄连五分，四剂顿止。但怔忡、少寐，盗汗未止，用归脾汤治之而
痊。一妇人但怒便血，寒热口苦，或胸胁胀痛，或小腹痞闷，此木乘土。用六君加山
栀、柴胡而愈。又用补中益气、加味逍遥二药而不复作。一妇人久下血，在粪前，属
脾胃虚寒，元气下陷。用补中益气汤加连、炒吴茱一钱，数剂稍缓。乃加生吴茱五分，数
剂而愈。 一妇人产后便血，口干饮汤，胸胁膨满，小腹闷坠，内热晡热，饮食不甘，体
倦面黄，日晡则赤，洒淅恶寒，此脾肺气虚。先用六君加炮姜、木香，诸证渐愈。用补中
益气，将愈。用归脾汤全愈。后饮食失节，劳役兼怒气，发热血崩，夜间热甚，谵语不绝，
此热入血室。用加味小柴胡二剂而热退，用补中益气而血止，用逍遥散、归脾汤调理而康。
【大】产后出现小便出血的症状，是因为气血虚弱，热邪趁机侵袭。血液受热则流动散乱，渗入膀胱内部，因此血液随着小便排出。
【薛】有一位产妇出现尿血症状，面色萎黄，胁肋部胀满，食欲减退，这是肝木克制脾土的表现。采用加味逍遥散与补中益气汤交替服用而痊愈。后来因为心情抑郁不乐，导致食欲不振、身体疲倦、惊恐心悸、无法入睡，血证再次发作，使用加味归脾汤服用二十多剂，病情即将好转。但因受众人议论迷惑，改服犀角地黄汤，导致各种症状复发，随后重新服用之前的方剂才痊愈。
治疗小便带血的方剂。
乱发（用热水洗净污垢油腻）
将上述药物烧成灰并研为细末，用米汤调服一方寸匕。
另一个方子：使用滑石（研细）、发灰（两者等量）。每次服用一钱，用地黄汁送服。
崔氏方：治疗产后血液渗入大小肠。
蜂蜜（一大合） 车前草（捣取汁液，一升）
将两者混合煎至沸腾，分两次服用。
《补遗》方：治疗产后小便出血。
川牛膝（去除芦头）
用水煎煮后服用。
另一个方子：
生地黄汁（半升） 生姜自然汁（半合）
将两者混合服用。
【薛】产后大便下血，可能由于饮食起居不当，或六淫（风、寒、暑、湿、燥、火）七情（喜、怒、忧、思、悲、恐、惊）的影响，导致元气亏损，阳络受到外伤。治疗方法：如果是因为膏粱厚味积热，使用加味清胃散。如果是因为醇酒湿毒，使用葛花解酲汤。如果是因为愤怒引发肝火，使用六君子汤加入芍药、柴胡、川芎、当归。如果是因为郁结损伤脾脏，使用加味归脾汤。如果是因为思虑过度损伤心脏，使用妙香散。如果是因为大肠风热，使用四物汤加入侧柏叶、荆芥、防风、枳壳、槐花。如果是因为大肠血热，使用四物汤加入黄芩、黄连。如果是因为肠胃虚弱，使用六君子汤加入升麻、柴胡。如果是因为肠胃虚寒，使用六君子汤加入肉豆蔻、木香。如果是因为元气下陷，使用补中益气汤加入茯苓、半夏。如果是因为气虚，使用六君子汤、升麻。如果是因为血虚，使用四物汤。气血俱虚，使用八珍汤，均加入柴胡、升麻。大凡病程长久或元气虚弱，表现出各种病症，都是因为脾胃亏损，内里是真寒而外表是假热，只需用六君子汤或补中益气汤加入炮姜，温补脾气，各种症状都会消退。如果四肢畏冷，属于阳气虚寒，急需加入附子。病因多种多样，应当根据临床具体情况灵活处理，这样才不会出错。
一位产妇在排便后下血，服用多种药物无效，饮食减少，肢体倦怠，这是中气虚弱所致，使用补中益气汤加入吴茱萸、炒黄连五分，服用四剂后立刻止血。但仍有怔忡、睡眠少、盗汗未止的情况，使用归脾汤治疗而痊愈。
一位妇人只要发怒就便血，伴有寒热往来、口苦，有时胸胁胀痛，有时小腹痞闷，这是肝木乘克脾土的表现。使用六君子汤加入山栀、柴胡而痊愈。后来又服用补中益气汤和加味逍遥散两种药物，疾病不再复发。
一位妇人长期便血，且血在粪便之前排出，属于脾胃虚寒，元气下陷。使用补中益气汤加入黄连、炒吴茱萸一钱，服用数剂后症状稍缓。接着加入生吴茱萸五分，服用数剂后痊愈。
一位妇人产后便血，口干想喝汤水，胸胁膨满，小腹闷坠感，内有发热及傍晚发热，饮食无味，身体疲倦面色萎黄，每天下午脸色发红，怕冷如洒冷水般颤抖，这是脾肺气虚。先用六君子汤加入炮姜、木香，各种症状逐渐好转。再用补中益气汤，病情即将痊愈。最后用归脾汤完全治愈。后来因饮食不节制，劳累兼有怒气，引发发热和血崩，夜间发热严重，胡言乱语不停，这是热入血室。使用加味小柴胡汤两剂后热退，使用补中益气汤后血止，使用逍遥散、归脾汤调理后康复。
[Da] Postpartum hematuria (blood in urine) occurs due to deficiency of Qi and Blood, allowing Heat pathogen to invade. When Blood is affected by Heat, it flows and scatters, seeping into the bladder interior; thus, blood is discharged with the urine.
[Xue] A postpartum woman presented with hematuria, sallow complexion, distension in the hypochondrium, and poor appetite. This indicates Liver Wood overacting on Spleen Earth. She was cured by alternating administration of Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Later, due to emotional depression, she developed poor appetite, physical fatigue, palpitations, insomnia, and recurrent bleeding. After taking Jiawei Guipi Tang (Modified Restore the Spleen Decoction) for more than twenty doses, her condition was nearly resolved. However, confused by conflicting opinions, she took Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction), causing all symptoms to recur. She was subsequently cured by resuming the previous prescription.
Prescription for treating hematuria:
Fa (Human Hair) (Wash thoroughly with hot water to remove dirt and grease).
Burn the above material, grind into powder, and take one fangcun bi (a square-inch measure) mixed with rice water.
Another prescription: Use Huashi (Talcum) (ground) and Fa Hui (Hair Ash) in equal parts. Take one qian per dose, administered with Sheng Dihuang Zhi (Fresh Rehmannia Juice).
Cui Shi's Prescription: Treats postpartum blood infiltrating the large and small intestines.
Mi (Honey) (one da he) Cheqian Cao (Plantago Leaf) (crushed to extract juice, one sheng).
Mix and boil until bubbling, then divide into two doses.
"Buyi" Prescription: Treats postpartum hematuria.
Chuan Niuxi (Achyranthes Root) (remove the radicle).
Decoct in water and take.
Another prescription:
Sheng Dihuang Zhi (Fresh Rehmannia Juice) (half sheng) Shengjiang Ziran Zhi (Fresh Ginger Juice) (half he).
Mix and take.
[Xue] Postpartum hematochezia (blood in stool) may result from improper diet or lifestyle, or from Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) and Seven Emotions (Joy, Anger, Worry, Pensiveness, Sadness, Fright, Fear), leading to depletion of Yuan Qi and external injury to Yang Collaterals. Treatment methods: If caused by accumulation of heat from rich foods, use Jiawei Qingwei San (Modified Stomach-Clearing Powder). If caused by damp-toxin from alcohol, use Gegua Jiecheng Tang (Pueraria Flower Decoction to Resolve Intoxication). If caused by anger stirring Liver Fire, use Liujun Zi Tang (Six Gentlemen Decoction) added with Shaoyao (Peony), Chaihu (Bupleurum), Chuanxiong (Ligusticum), and Danggui (Angelica). If caused by stagnation injuring the Spleen, use Jiawei Guipi Tang (Modified Restore the Spleen Decoction). If caused by excessive thinking injuring the Heart, use Miaoxiang San (Wonderful Fragrance Powder). If caused by Wind-Heat in the Large Intestine, use Siwu Tang (Four Substances Decoction) added with Cebaiye (Biota Leaf), Jingjie (Schizonepeta), Fangfeng (Saposhnikovia), Zhike (Aurantii Fructus), and Huaihua (Sophora Flower). If caused by Blood-Heat in the Large Intestine, use Siwu Tang added with Huangqin (Scutellaria) and Huanglian (Coptis). If caused by weakness of the stomach and intestines, use Liujun Zi Tang added with Shengma (Cimicifuga) and Chaihu. If caused by deficiency-cold of the stomach and intestines, use Liujun Zi Tang added with Roudoukou (Myristica Seed) and Muxiang (Aucklandia). If caused by sinking of Yuan Qi, use Buzhong Yiqi Tang added with Fuling (Poria) and Banxia (Pinellia). If caused by Qi deficiency, use Liujun Zi Tang and Shengma. If caused by Blood deficiency, use Siwu Tang. For combined Qi and Blood deficiency, use Bazhen Tang (Eight Treasures Decoction), adding Chaihu and Shengma to both. Generally, for chronic illness or weak Yuan Qi presenting with various symptoms, the root cause is often Spleen-Stomach damage, manifesting as true cold internally and false heat externally. In such cases, only use Liujun Zi Tang or Buzhong Yiqi Tang added with Paojiang (Prepared Ginger) to warm and tonify Spleen Qi, after which all symptoms will recede. If there is aversion to cold in the four limbs, indicating Yang Qi deficiency and cold, add Fuzi (Aconite) urgently. Etiologies are diverse; clinical judgment must be applied flexibly to avoid errors.
One postpartum woman passed blood after defecation; various medicines failed. With reduced appetite and limb fatigue, this indicated deficiency of Middle Qi. She was treated with Buzhong Yiqi Tang added with Wuzhuyu (Evodia) and fried Huanglian (Coptis) [5 fen], stopping the bleeding abruptly after four doses. However, palpitations, scant sleep, and night sweats persisted; she was cured using Guipi Tang (Restore the Spleen Decoction).
One woman experienced hematochezia upon anger, accompanied by alternating chills and fever, bitter taste, sometimes chest/hypochondriac distension/pain, or abdominal fullness. This indicates Wood overacting on Earth. She was cured using Liujun Zi Tang added with Zhizi (Gardenia) and Chaihu. Subsequent use of Buzhong Yiqi Tang and Jiawei Xiaoyao San prevented recurrence.
One woman had long-term hematochezia, with blood appearing before stool, indicating deficiency-cold of Spleen-Stomach and sinking of Yuan Qi. She was treated with Buzhong Yiqi Tang added with Lian (likely Huanglian/Coptis) and fried Wuzhuyu [1 qian]; symptoms eased slightly after several doses. Then, raw Wuzhuyu [5 fen] was added, curing her after several doses.
One postpartum woman presented with hematochezia, dry mouth desiring soup, chest/hypochondriac distension, abdominal heaviness/dragging sensation, internal heat, afternoon tidal fever, poor appetite, physical fatigue, sallow complexion, redness of face in the afternoon, and aversion to cold with shivering. This indicates deficiency of Spleen and Lung Qi. Initially, Liujun Zi Tang added with Paojiang and Muxiang was used, gradually improving symptoms. Then Buzhong Yiqi Tang was used, nearing cure. Finally, Guipi Tang completely cured her. Later, due to irregular diet, labor, and anger, she developed fever and metrorrhagia (flooding), severe night fever, and continuous delirium. This indicates Heat entering the Blood Chamber. She was treated with Jiawei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction) for two doses to resolve the fever, then Buzhong Yiqi Tang to stop bleeding, and finally Xiaoyao San (Free and Easy Wanderer Powder) and Guipi Tang for regulation, resulting in recovery.