Written By Jun Heo(許浚, 1539~1615), Translated by Namil Kim, Wung Seok Cha et al., Published by Ministry of Health & Welfare (Korea)
16 Hematuria 尿血요혈
① In the Inner Classic (內經), it is said, “If heat moves to the urinary bladder from the uterus, it becomes the dribbling urinary block disease or hematuria.”
② Zhongjing (仲景) said, “If heat is in the lower energizer, it becomes hematuria.”
③ If blood drops are found in the urine and the patient feels pain or blood is mixed in the urine, it is from the urinary
bladder. If the patient bleeds but does not have pain, it indicates that heat moves from the heart to the small intestines and blood comes out through the orifice of essence.
④ If the blood comes out in urine without pain, it is hematuria, not a strangury disease. It is blood that comes out through the orifice of essence. That’s because heat moves from the heart to the small intestines. Add Gardeniae Fructus (梔子), Talcum (滑石), Achyranthis Radix, Scutellariae Radix (黃芩) and Coptidis Rhizoma (黃連) to a Four Substances
Decoction or use Hair Ash Powder, or Amber Powder.
⑤ If the blood comes out in urine, it is because heat hidden in the heart moves to the small intestines. Add Liriopis Tuber (麥門冬) to Eight Ingredient Rectify Powder [The prescription is mentioned in the chapter Urine] And decoct.
⑥ To treat hematuria, use an Clear Intestine Decoction, Clear Heat and Nourish yin Decoction, Cephalonoplosi Herba Pill, or Zingiberis and Honey Decoction or add Five Ingredients with Poria Powder [The prescription is mentioned in the chapter Cold] To a Four Substances Decoction and decoct it together. To treat hematuria caused by alcohol, use a Poria Regulate Blood Decoction. To treat hematuria caused by lust, use a Cervi Cornus Colla Pill or Kidney Qi Pill. [The prescription is mentioned in the chapter Deficiency Vexation]. To treat hematuria of old persons, use a Six Ingredients Rehmannia Pill. [The prescription is mentioned in the chapter Deficiency Vexation]. To treat hematuria of women, use Angelica Powder. To treat hematuria of children, use Instant Effect Powder.
⑦ When the patient has excessive heat, use an Angelica Coordinate Qi Decoction [prescription is mentioned later] in order to purge.
- Hair Ash Powder 髮灰散 발회산: ① It cures hematuria. Grind burnt hair into powder, add 2 don of this powder to 2 hop of vinegar and mix with boiled water before taking. You can also use Aqua Pura. ② A Hair Ash Pill also cures the same disease. Mix the ashes of burnt hair with Thujae Orientalis Folium (側柏葉) juice and waxy rice powder, knead them, and make pills as big as the seed of the royal foxglove tree. Take 50 pills with boiled water.
- Amber Powder 琥珀散 호박산: It cures hematuria. Grind Succinum into fine powder, mix 2 don of this powder to the decoction of Junci Medulla and Menthae Herba (薄荷).
- Clear Intestine Decoction 淸腸湯 청장탕: It cures hematuria. 7 pun of Angelica Gigantis Radix (當歸), Rehmanniae Radix Crudus (生地黃), Gardeniae Fructus (梔子) (stir-baked), Coptidis Rhizoma (黃連), Paeoniae Radix (赤芍藥), Phellodendri Cortex (黃柏), Dianthi Herba (瞿麥), Poria Sclerotium Rubra (赤茯苓), Akebiae Caulis (木通), Polygoni Avicularis Herba(萹蓄), Anemarrhenae Rhizoma (知母) and Liriopis Tuber (麥門冬) each, and 5 pun of Glycyrrhizae Radix (甘草). Mince these drugs to make 1 package, and decoct in water with 1 dan of Junci Medulla and 1 Mume Fructus Praeparatum (烏梅).
- Clear Heat and Nourish Yin Decoction 淸熱滋陰湯 청열자음탕: It cures hematuria and bloody stools. 1 don of Rehmanniae Radix Crudus (生地黃) ․ Liriopis Tuber (麥門冬) ․ Gardeniae Fructus (梔子) (stir-baked until it becomes black) each, 8 pun of Scrophulariae Radix (玄參) ․ Moutan Cortex (牧丹皮) each, 5 pun of Angelica Gigantis Radix (當歸) ․ Cnidii Rhizoma (川芎)․ Paeoniae Radix (赤芍藥), 3 pun of Anemarrhenae Rhizoma (知母) and Phellodendri Cortex (黃柏) (soaked in alcohol and stir-baked together), Atractylodis Rhizoma Alba (白朮), Citrus Unshius Pericarpium (陳皮), Glycyrrhizae Radix (甘草) each. Mince these drugs to make 1 package and decoct in water.
- Cephalonoplosi Herba Pill 小薊飮子 소계음자: It cures hematuria caused by heat accumulated in the lower energizer. 2 don of Nelumbinis Rhizomatis Nodus (藕節), 1 don of Angelica Gigantis Radix (當歸), 8 pun of Gardeniae Fructus (山梔仁), 5 pun of Cephalonoplosi Herba (小薊), Rehmanniae Radix Crudus (生地黃), Talcum (滑石), Tetrapanacis Medulla (通草), Typhae Pollen (蒲黃) each, and 3 pun of Glycyrrhizae Radix (甘草). Mince these drugs to make 1 package and decoct with 7 leaves of Phyllostachys Folium.
- Zingiberis and Honey Decoction 薑蜜湯 강밀탕: It cures bleeding through urine. 7 pieces of Zingiberis Rhizoma Crudus (生薑), half cup of honey l (蜜), and 1 handful of Imperatae Rhizoma (白茅根). Decoct these drugs in water.
- Poria Regulate Blood Decoction 茯苓調血湯 복령조혈탕: It treats bleeding through urine due to the overconsumption of alcohol and food made from flour, and sexual overindulgence. 1.5 don of Poria Sclerotium Rubra (which have red color) (赤茯苓). 7 pun of Paeoniae Radix (赤芍藥), Cnidii Rhizoma (川芎), Pinelliae Tube Fermentata (半夏麴) each. 5 pun of Angelicae Decursivae Radix (前胡), Bupleuri Radix (柴胡), Citri Unshius Pericarpium Immaturus (靑皮), Aruantii Fructus Immaturus (枳殼), Platycodonis Radix (桔梗), Mori Cortex (桑白皮), Imperatae Rhizoma (白茅根), Junci Medulla (燈心), Glycyrrhizae Radix (甘草) each. Mince these drugs to make 1 package and decoct in water with 5 pieces of Zingiberis Rhizoma Crudus (薑) and 2 spoons of honey l (蜜).
- Cervi Cornus Colla Pill 鹿角膠丸 녹각교환: It cures bleeding through urine due to sexual overindulgence. 1 nyang of Cervi Cornus Colla (stir-baked and made like a bead) (鹿角膠), and 6 don of Myrrha (沒藥) and Carbonisatus Crinis (油髮) (ashes) each. Grind these drugs in powder, knead with the juice of Imperatae Rhizoma (白茅根), and combine them to make pills as big as the seed of the royal foxglove tree. Take 70 pills with salt water on an empty stomach.
- Angelica Powder 當歸散 당귀산: It cures the hematuria of women. 2.5 don of Rehmanniae Radix Crudus (生地黃), 2 don of leaves of Cephalonoplosi Herba (小薊葉), and 1.5 don of Angelica Gigantis Radix (當歸), Antelopis Cornu (羚羊角) (cut and ground into powder) and Paeoniae Radix (赤芍藥) each. Mince these drugs to make 1 package and decoct in water.
- Instant Effect Powder 立效散 입효산: ① It cures hematuria in children. 1 don of Typhae Pollen (蒲黃), Rehmanniae Radix Crudus (生地黃), Poria Sclerotium Rubra (赤茯苓) and Glycyrrhizae Radix (甘草) each. Mince these drugs and decoct in water.[B073] ② Moreover, if you mix Augment Base Powder to the Decoction of Glycyrrhizae Radix (甘草) and Cimicifugae Rhizoma (升麻), it has a marvelous effect. [The prescription is mentioned in the chapter on Summer-heat].
17 Bloody Stool 便血 변혈
① In the Inner Classic (內經), it is said, “If yin is bound, the patient has 1 doe of bloody stool; if it is bound again, he/she has 2 doe of bloody stool, and if it is bound one more time, he/she has 3 doe of bloody stool.” In the Interpretation, it is said, “When yin is bound, yin-qi is lumped inside and cannot go outside. It cannot lead blood; therefore, the blood soaks into
the intestines and induces the bloody stool. The pulse is vacuous, rough, and the blood is lumped and cannot flow, thus it gushes out downward.” A Sanguisorba Calm Stomach Decoction and Fructify Yin Elixir are mainly
prescribed.
② In the Divine Pivot (靈樞), it is said, “If pathogenic qi is in the five viscera, the yin channels become irregular, and if yin channels are irregular, blood cannot flow.” If pathogenic qi enters the five viscera, the three yin channels lose their harmony and lump together. Therefore, blood cannot flow, so it stagnates and flows into the intestines and forms bloody stools.[B146] ③ Zhongjing (仲景) said, “If blood comes out after the stool, it indicates that this is distal bleeding, thus a Yellow Earth Decoction is mainly prescribed. If blood comes out before the stool, it indicates that this is proximal bleeding, thus Adzuki Bean and Angelica Powder is mainly used.”
④ To treat bloody stools, use a stomach Wind Decoction. [The prescription is mentioned in the chapter on Feces.], Clear Organ Decoction, Sanguisorba and Amomum Decoction, Sanguisorba Powder, Forsythia Pill, Modified Four Substances Decoction, or Sophora Flower Powder. If the patient has excessive heat, use an Angelica Coordinate Qi Decoction. If the bloody stool is protracted and source qi sags down, use a Magnolia Bark Formula or Tonify the Center to Augment the qi Decoction. [The prescription is mentioned in the chapter on Internal Damage]. If the patient has internal damage due to food, use Calm Stomach Powder [the prescription is mentioned in the chapter on Internal Damage] with Aruantii Fructus Immaturus (枳殼), Sophorae Flos (槐花), Angelica Gigantis Radix (當歸), and Mume Fructus Praeparatum (烏梅). If the patient has a bloody stool due to alcoholic toxin, use a Wine Steamed Coptis Pill.
- Sanguisorba Calm Stomach Decoction 平胃地楡湯 평위지유탕: It cures the bloody stool caused by lumped yin. 1 don of Atractylodis Rhizoma (蒼朮), Cimicifugae Rhizoma (升麻) and Aconiti Lateralis Radix Preparata (附子) (wrapped with damp paper and baked) each, 7 pun of Sanguisorbae Radix (地楡), 5 pun of Puerariae Radix (葛根), Magnoliae Cortex (厚朴), Atractylodis Rhizoma Alba (白朮), Citrus Unshius Pericarpium (陳皮) and Poria Sclerotium Rubra (赤茯苓) each, and 3 pun of Zingiberis Rhizoma (乾薑), Angelica Gigantis Radix (當歸), Massa Medicata Fermentata (stir-baked), Paeoniae Radix Alba (白芍藥), Alpiniae Oxyphyllae Fructus, Ginseng Radix (人蔘) and Glycyrrhizae Radix (甘草) (baked) each. Mince these drugs to make 1 package and decoct in water with 3 pieces of Zingiberis Rhizoma Crudus (生薑) and 2 Zizyphi Fructus (大棗).
- Fructify Yin Elixir 結陰丹 결음단: It cures the bloody stool caused by lumped yin. 5 don of Aruantii Fructus Immaturus (枳殼), Clematidis Radix, Astragali Radix (黃芪), Citrus Unshius Pericarpium (陳皮), Cortex Toonae Sinensis, Polygoni Multiflori Radix, and Schizonepetae Spica (荊芥) each. Grind these drugs into powder and knead this powder with paste prepared with alcohol to make pills as big as the seed of the royal foxglove tree. Mix vinegar to a thin gruel made of old rice, and take 50~70 pills with this gruel.
- Yellow Earth Decoction 黃土湯 황토탕: It treats cases when blood comes out after the stool. 3 don of Yellow Terra in the fireplace, 1 don of Rehmanniae Radix Preparata (熟地黃), Atractylodis Rhizoma Alba (白朮) and Aconiti Lateralis Radix Preparata (附子) wrapped with damp paper, Asini Corii Colla (阿膠珠) and Scutellariae Radix (黃芩), and 1 don of Glycyrrhizae Radix (甘草). Mince these drugs to make 1 package and decoct in water.
- Adzuki Bean and Angelica Powder 赤小豆當歸散 적소두당귀산: It treats cases when blood comes out before the bloody stool. 5 nyang of Phaseoli Angularis Semen (赤小豆) (soaked in water until it sprouts and then dried in the sun), 1 nyang of Angelica Gigantis Radix (當歸). Pound these drugs and make into powder, mix 2 don of this powder in the upper water of millet gruel and take 3 times a day.
- Clear the Organs Decoction 淸臟湯 청장탕: It cures bleeding through the stool. 1 don of Rehmanniae Radix Crudus (生
地黃), 8 pun of Angelica Gigantis Radix (當歸) (washed with alcohol) and Sanguisorbae Radix (地楡) each, 7 pun of Scutellariae Radix (黃芩), Gardeniae Fructus (梔子) (stir-baked until it becomes black) and Phellodendri Cortex (黃柏) (stir-baked) each, 6 pun of Paeoniae Radix Alba (白芍藥), Coptidis Rhizoma (黃連), Thujae Orientalis Folium (側柏葉) and Asini Corii Colla (阿膠珠) each, and 5 pun of Cnidii Rhizoma (川芎) and Sophorae Fructus (stir-baked) each. Mince these drugs to make 1 package and decoct in water. - Sanguisorba and Amomum Decoction 楡砂湯 유사탕: It cures a bloody stool caused by lumped yin. 4 nyang of Sanguisorbae Radix (地楡), 7 Amomi Fructus (ground), 1.5 don of Glycyrrhizae Radix (甘草) (crude one) and 1 don of Glycyrrhizae Radix (甘草) (baked). Mince these drugs and decoct in water.
- Sanguisorba Powder 地楡散 지유산: It cures protracted dysentry. 5 don of Sanguisorbae Radix (地楡) and Selaginellae
Herba (卷柏). Mince these drugs, put them in porcelain, boil 10 times, and take it warm. - Forsythia Pill 連殼丸 연각환: ① It cures dysentry caused by internal damage. This drug loosens up the lumped collateral vessels. Mince 2 nyang of Coptidis Rhizoma (黃連) and Aruantii Fructus Immaturus (枳殼) each, stir-bake it with 4 nyang of Sophorae Flos (槐花), then pick out the Sophorae Flos (槐花) and throw away. Grind these drugs into powder, knead with steamed rice cake, and make pills as big as the seed of the royal foxglove tree. Take 50~70 pills with boiled water.[B146] ② This is the same prescription with the Bitter Orange Decoction in the Orthodox Transmission of Medicine (正傳). Mince 5 don and decoct in water.
- Modified Four Substances Decoction 加減四物湯 가감사물탕: It cures the bloody stool and also intestinal wind. 1 don of Thujae Orientalis Folium (側柏葉), Rehmanniae Radix Crudus (生地黃), Angelica Gigantis Radix (當歸) and Cnidii Rhizoma (川芎) each, and 5 pun of Aruantii Fructus Immaturus (枳殼), Schizonepetae Spica (荊芥), Sophorae Flos (槐花) (stir-baked) and Glycyrrhizae Radix (甘草) (baked) each. Mince these drugs to make 1 package and decoct with 3 pieces of Zingiberis Rhizoma Crudus (生薑) and 1 Mume Fructus Praeparatum (烏梅).
- Sophora Flower Powder 槐花散 괴화산: It treats cases where dampness persists in the intestines and stomach, which causes the patient to feel distention, fullness and dysentry. 2 don of Sophorae Flos (槐花) (stir-baked), 1 don of Atractylodis Rhizoma (蒼朮), Magnoliae Cortex (厚朴), Citrus Unshius Pericarpium (陳皮), Angelica Gigantis Radix (當歸) and Aruantii Fructus Immaturus (枳殼) each, and 5 pun of Mume Fructus Praeparatum (烏梅) and Glycyrrhizae Radix (甘草) (baked) each. Mince these drugs to make 1 package and decoct in water.
- Angelica Coordinate Qi Decoction 當歸承氣湯 당귀승기탕: It cures the bloody stool caused by excessive heat. 2 don of Angelica Gigantis Radix (當歸), 8 pun of Magnoliae Cortex (厚朴), Ponciri Fructus Immaturus and Rhei Radix et Rhizoma (大黃) each, and 7 pun of Natrii Sulfas (芒硝). Mince these drugs and decoct in water.
- Magnolia Bark Formula 厚朴煎 후박전: It cures the bloody stool and all kinds of vaginal discharge. 5 nyang of Magnoliae Cortex (厚朴) and Zingiberis Rhizoma Crudus (生薑) (pound together and stir-bake until they become yellow) each, and 1 nyang of Atractylodis Rhizoma Alba (白朮), Massa Medicata Fermentata (神麴), Hordei Fructus Germinatus (麥芽) and Schisandrae Fructus (五味子) each. Grind these drugs into powder, knead with paste made from water, and make pills as big as the seed of the royal foxglove tree. Take 100 pills with thin rice gruel. The spleen and stomach do not contain blood originally. However, if the intestines become thin due to a qi deficiency, blood from nutrient and defense qi soak into the intestines, which causes vaginal bleeding. Magnoliae Cortex (厚朴) makes the intestines and stomach thicker, Hordei Fructus Germinatus (麥芽) helps in the digestion of alcohol and food, Atractylodis Rhizoma Alba (白朮) leads water, therefore blood cannot be produced. This prescription has a very marvelous effect.
- Wine Steamed Coptis Pill 酒蒸黃連丸 주증황련환: It treats bloody stools due to the accumulation of heat caused by alcoholic toxins and scorching heat in the anus. Grind 4 nyang of Coptidis Rhizoma (黃連) (minced, soaked in alcohol overnight, and dried in the sun) into powder, knead with paste made from millet, and make pills as big as the seed of
the royal foxglove tree. Take 30~50 pills with boiled water.
