My Empirical Formula for Treating Hematuria
Hematuria is a common clinical symptom of various kidney and urinary tract diseases. In clinical practice I often have to manage patients' hematuria and have gradually formed my own experience with medication. My basic formula for treating hematuria is quite simple: plantain herb (cheqiancao) 20 g, yerbadentia/echpta (hanliancao) 20 g, brake herb (fengweicao) 20 g, and small thistle (xiaoji) 20 g. One dose daily, decocted in water and taken two to three times a day, or decocted into a tea taken as a beverage.
These four herbs all have diuretic and hemostatic effects; used together they promote diuresis, stop bleeding, and exert antibacterial and anti-inflammatory effects. They have good efficacy for hematuria due to urinary stones and for hematuria before and after surgery for kidney or urinary tract tumors.
This formula was developed on the basis of Er Cao Dan (Two Herbs Elixir), which consists of equal parts of plantain herb (cheqiancao) and yerbadentia (hanliancao). Er Cao Dan comes from the Chishui Xuanzhu and is specifically indicated for urinary bleeding (niaoxue); the famous physician Shi Jinmo also liked to use this herb pair.
The brake herb (Pteris multifida, fengweicao) is a commonly used folk herb with hemostatic and analgesic effects. I have written a separate article introducing this folk herb; see my article The Brake Herb (Fengweicao): A Hemostatic Commonly Used in Cancer Patients, so I will not repeat it here. Small thistle (Cirsium, xiaoji) cools blood and stops bleeding, and promotes diuresis and relieves stranguria. Thus, adding these two herbs to Er Cao Dan makes the treatment of hematuria even more effective.
Hematuria patients sometimes also have foamy urine. If foamy urine is present, it is mostly caused by secondary acute nephritis; in that case add motherwort (yimucao) 20–30 g to the above formula. Usually after 3–5 days of medication, the foamy urine disappears. Patients with urinary tract stones may also have painful urination during hematuria; when using this formula they still need to add some stone-dissolving and stranguria-relieving herbs, such as chicken gizzard lining (jineijin) 30 g, coin grass (jinqiancao) 15 g and spora lygodii (haijinsha) 15 g. But severe kidney stones may not be resolved quickly with Chinese medicine; this formula should be combined with lithotripsy surgery.
In summer and autumn, some urinary tract disease patients, besides hematuria, also have difficulty urinating; severe cases cannot pass a single drop of urine. Before taking this formula, such patients may drink large amounts of honeysuckle flower distillate (jinyinhua lu). In my home province of Hubei, honeysuckle distillate is a common drink in supermarkets, available in both sugared and sugar-free versions; patients may choose according to their taste and situation, and diabetics should choose the sugar-free kind. Honeysuckle distillate is very effective in promoting urination; patients with scant, dark urine or even complete anuria can generally urinate freely after drinking large amounts. But honeysuckle distillate alone is difficult to treat hematuria; once urination is free, the above formula should still be taken.