Patient Li, a 53-year-old employee from Nanjing, visited the clinic for more than 10 years because he found blood in his semen, the amount of blood was sometimes more and sometimes less, irregular, and dark in color. He has been treated repeatedly by several hospitals, and most of the drugs to cool the blood and stop bleeding are ineffective. He has vague pain in the lower abdomen, normal urination, normal urination, slightly dry stool, dark tongue, fat tongue, white fur, and sunken pulse. The prescription is Angelica Sinensis and Paeoniae with addition and subtraction: Angelica Sinensis 15g, Rhizoma Chuanxiong 10g, Radix Paeoniae 10g, Radix Paeoniae 10g, Rhizoma Zeligae 20g, Poria 20g, Atractylodes Macrocephala 20g, Cumin 6g, Bulbus Fritillariae 10g, 7 doses with water decoction. At the second consultation, the patient complained of vague pain in the abdomen relieved, intercourse 1 time, semen color became lighter, stool regulation. The original formula was supplemented with Chuan Huai Niu Knee 10g each, 14 doses with water decoction. At the third consultation, the patient complained that the color of semen was basically normal, with occasional pain in the abdomen. The original formula was continued for 14 doses and all the symptoms were removed. Summary: Treatment of hematospermia should be combined with individual’s constitution and symptoms, and should not just cool the blood to stop bleeding, especially for patients with cold constitution, longer bleeding time and darker blood color. Because cooling and hemostatic drugs over time can also lead to local blood clotting and the formation of stasis, blockage of blood by siltation can lead to blood not following the meridians and overflowing into the sperm chamber, with blood following the sperm and leaving for this disease. In this case, the patient has been bleeding for a long time, which may be caused by physical condition or mistreatment, forming blood stasis. “Blood is not good for water”, and blood stasis will cause water metabolism disorder over time. The normal blood circulation path is broken and the bleeding disease – hematemesis – develops. Treatment should be based on invigorating the blood and promoting the flow of water, which is treated with the addition and subtraction of Angelica Paeoniae San. This formula is composed of Angelica sinensis, Paeonia lactiflora, Chuanxiong, Zexiong, Fu Ling and Atractylodes macrocephala, and has the effect of harmonizing the liver and spleen, invigorating blood and promoting dampness. This formula is for treating Liver and Spleen together, but mainly for treating Liver; it is also for treating Qi and Blood together, but mainly for treating Blood. This formula is intended for treating gynecological diseases, but many male diseases have obscure onset and are difficult to heal over time, which are manifested by the evidence of this formula, all have the opportunity to apply this formula. As a result, ten years of blood sperm was cured in one month. This formula is more suitable for patients with chronic vesiculitis, long-term hematospermia, those identified by TCM as blood stasis and water stoppage, and those with vague pain in the lower abdomen.