Hemosperm is both a TCM name and a symptom that can occur in adult males of any age, but is particularly common in middle-aged and young adults. Its main manifestation is blood in semen, which may be accompanied by frequent, urgent and painful urination. In mild cases, only red cells in the semen are found through microscopic examination, while in severe cases, blood in the semen can be seen visually by the naked eye, which is also known as “hematospermia”. This disease is commonly found in patients with acute and chronic vesiculitis in modern medicine. The author has been using Chinese herbal medicine for more than 2 years to treat hematospermia with good results, and has accumulated some experience and experience, which I will elaborate here, hoping to share with my colleagues. 1, the etiology of hematospermia pathogenesis —– early blood heat, disease long more stasis blood hematosperm first discussed in the Sui dynasty Chao Yuan Fang’s “source of diseases,” which said: “the kidney collects essence, essence, the blood into it. Deficiency labor is born seven injuries six extreme, qi and blood are injured, the kidney family partial deficiency, can not hide the essence, so the essence of blood also out. Influenced by this view, some experts and scholars have long believed that Yin deficiency and fire and Qi deficiency is the main pathogenesis of blood sperm, and therefore often use medicine to nourish Yin and lower fire, and supplement Qi. However, according to the author’s clinical experience, the pathogenesis of blood sperm is more common with blood heat forcing blood to move and blood blockage and blood not returning to the meridian, while yin deficiency and fire and qi deficiency are relatively uncommon. There are three reasons for this: firstly, from the age structure, patients with hematospermia are mainly young and strong, with a strong constitution and easy to generate heat and fire. Secondly, from the viewpoint of dietary structure, patients with hematospermia have a preference for spicy, hot and dry products, which on the one hand can directly help the internal production of heat; on the other hand, dryness and heat can easily damage the spleen and stomach transport function, the evil of water and dampness is generated internally, depression and heat, damp heat is injected, and if spleen qi is damaged, then qi does not take blood. Lastly, patients with hematospermia mostly have emotional factors such as impatience and sentimentality, which can cause qi rebellion and qi depression and fire. These three causes can either cause the disease alone or together, thus causing heat to enter the seminal chamber, damaging the blood channels, forcing the blood to move delicately, and the blood to follow the semen, resulting in hematospermia, which is mainly caused by blood heat. If the disease is mismanaged, the condition will be prolonged, and the silt, bad blood, dead blood will block the seminal chamber, or the Qi deficiency will not be fixed, or the Yin deficiency will be internally heated, and the blood will lose its normal path and become stubborn hematospermia, the development of the disease at this stage is mainly based on blood stasis, and can be mixed with Qi deficiency, Yin deficiency, etc. Based on the above etiology and pathogenesis, in the author’s opinion, blood sperm is mainly based on blood heat and blood stasis. The main clinical manifestations include bright red semen, pain in the lower abdomen and perineum during ejaculation, hypersexuality, impatience and irritability, yellow urine, frequent urination, dry and bitter mouth, red tongue, yellow fur, and stringiness of the pulse. Clinical manifestations include: dark red or black semen, or with blood, blood clots, etc. There may be pain and discomfort in the lower abdomen, perineum and testicles, purple and dark tongue, or petechiae, thin white coating, and astringent pulse. The two types of blood heat and blood stasis are used as the outline, and the factors of yin deficiency and qi deficiency are considered in conjunction with the specific condition to replace the four types of evidence, i.e., lower jiao damp-heat, yin deficiency and fire, spleen and kidney deficiency, and blood stasis and internal nodules; or the six types of evidence, i.e., deficiency of kidney essence, yin deficiency and blood heat, kidney deficiency and blood heat, blood stasis and internal nodules, yin deficiency and fire, and lower jiao damp-heat. In this way, we can keep it simple and clear for clinical identification. In terms of treatment, according to the theory of TCM that the method follows the evidence and the formula comes from the method, blood sperm should follow the principle of treating from “blood”, mainly cooling the blood to stop bleeding and activating blood stasis, supplemented by clearing heat and dampness, nourishing yin and lowering fire, and benefiting kidney and spleen. In accordance with the principle and method of prescription, the clinical efficacy is remarkable, see the analysis of two groups of prescriptions and case examples. 3.1 Self-designed formula1 Composition: 15g of water hyacinth, 20g of raw earth, 15g of white foxglove, 10g of cypress leaf, 10g of cyperus root, 15g of artichoke, 10g of raw elm, 10g of gardenia, 10g of cypress, 10g of Zhi Mu, 10g of dandan bark, 6g of raw licorice. Modern pharmacological research shows that: Buffalo horn has significantly shortened the bleeding time, reduced capillary permeability and enhanced the phagocytosis of reticuloendothelial system; ground elm contains ground elm alkaloids have astringent and hemostatic, anti-pathogenic microbial effects; raw ground contains ground yellow and alkaloids, which can elevate platelets and white blood cells, as well as anti-inflammatory, antibacterial and immunosuppressive effects. Radix Rehmanniae, Phellodendron, Radix Bupleurum, Artichoke, and Danpi are the subject herbs, while Radix Bupleurum also has the effect of diuretic and laxative to strengthen the effect of cooling the blood, and pharmacological studies in Chinese medicine found that these herbs have different degrees of hemostatic, antibacterial, anti-inflammatory, and anti-allergic effects [7, 8]; Gardenia, Phellodendron, and Zhi Mu clear heat and dampness in the lower jiao as auxiliary herbs, and pharmacological studies in Chinese medicine concluded that these three herbs have cooling, antipyretic, anti-inflammatory, and enhancing The pharmacological study of Chinese medicine concluded that these three herbs have the ability to lower temperature, relieve heat, anti-inflammatory and enhance phagocytosis of leukocytes. The herbs are used together to cool the blood and stop bleeding, clear heat and dampness. This formula is often used in cases of blood-heat in the early stage of hematospermia and has been used with great success. 3.2 Self-designed Formula 2: Panax notoginseng powder 3g, peach kernel 10g, safflower 10g, cypress charcoal 10g, cyperus roots 10g, senghu cao 15g, red peony 10g, Chuanxianniu 15g, shanjia 5g, danshen 15g, yuanhu 10g, huangqi 15g, yujin 10g, roasted licorice 6g. In this formula, Panax notoginseng powder, safflower and peach kernel are used to activate blood circulation and remove blood stasis. The pharmacological study of Chinese medicine found that Panax notoginseng is mainly composed of saponins and flavonoid glycosides, which can constrict blood vessels, anti-inflammatory, analgesic, etc. Safflower and peach kernel can dilate blood vessels and inhibit thrombus formation [7]; considering the suspicion of stasis and heat for a long period of time, the use of Phellodendron charcoal, Radix Paeoniae, Salviae Miltiorrhizae, and Radix et Rhizoma Xi root to clear heat and cool blood to stop bleeding, which have the effect of improving microcirculation and anti-thrombosis. The herbal pharmacology study showed that the herb can raise the white blood cells and platelets, and the herb can shorten the clotting time, anti-inflammatory and anti-pathogenic microorganisms; Yuan Hu and Yu Jin can relieve pain by moving Qi and relieving depression, and Astragalus can replenish Qi and take in blood. The alkaloids contained in Astragalus saponins and alkaloids can enhance specific and non-specific immune functions, and have anti-viral and anti-aging effects; roasted licorice harmonizes all the medicines. The combination of all the medicines can activate the blood to stop bleeding, cool the blood, open the ligaments, and move the qi and replenish the qi as one. This formula is very effective in treating recalcitrant and episodic hematemesis. It can be seen from the above pharmacological research results that Chinese medicine is flexible in treating hematospermia, with complex components and a wide range of mechanisms of action, which may combine the antibacterial, anti-inflammatory, improving vascular permeability, regulating immunity, enhancing the function of platelets and coagulation factors, etc. of western medicine in one. Thus, there is a scientific basis for the significant efficacy of the Chinese herbal medicine compound in the treatment of hematospermia, but its exact mechanism of action needs to be studied in depth in the future. 4. Typical case example Case 1: Qin, 38 years old, a cadre. He was diagnosed with seminal vesiculitis and was given doxycycline, sparfloxacin and cephalosporin for 4 weeks. In July 2009, he came to our hospital for consultation and treatment. After detailed medical history, combined with the symptoms, pulse and tongue, he was diagnosed with blood-heat type of hematospermia, and was given 7 doses of the above-mentioned self-prepared formula for treatment. Case 2: Chen, 23 years old, reported suffering from “vesiculitis” for more than a year, has been transferred to Nanning, Hechi, Liuzhou and other places, by a number of hospitals, spending a total of more than 20,000 yuan, but Xiao Chen’s disease has not improved, the resulting economic burden and mental pressure, so that he almost lost confidence in treatment. In October 2008, he came to the male outpatient clinic, and the author, after patiently inquiring about his condition and treatment, combined with his tongue and pulse and other comprehensive analysis, identified him as hematospermia, a type of qi stagnation and blood stasis, and treated him with the above-mentioned self-prepared formula 2 for more than 2 months, and he was cured. 5. Matters that should be noted in the diagnosis and treatment of hematospermia 5.1 Pay attention to the medical history and necessary examinations, and make a clear diagnosis as far as possible Although the treatment of hematospermia in Chinese medicine has very good curative effect, it should not be done blindly and rashly, because after all, hematospermia is only a clinical symptom of some diseases. At present, it is generally believed that hematospermia is mainly seen in seminal vesiculitis, followed by prostatitis, etc. In clinical work, it is important to pay attention to the medical history, detailed physical examination, especially for recalcitrant hematospermia must be used with the help of modern medical physical and chemical examination to find the primary cause as far as possible, such as dilatation of seminal vesicles and ejaculatory ducts, seminal cysts, tumors, blood system diseases, and drug-resistant bacteria-based seminal vesicle infections, in order to treat the cause and prevent delays. In the early stage of the disease, blood-heat and solid evidence are the main causes, and the treatment is based on drugs that clear heat and cool blood to stop bleeding. In the chronic stage of the disease, blood stasis and qi and yin deficiency are common, i.e., mixed with deficiency and reality. This is also to re-emphasize the idea of simple typology in the treatment of hematospermia advocated by the author. The occurrence of hematospermia is closely related to physical constitution, dietary habits, and emotional factors. Therefore, it is important to prevent the disease before it occurs and to prevent changes in the disease. In the early stage of the disease, we should do more ideological work for the patients and tell them to maintain a relaxed mood and actively cooperate with the treatment; secondly, we should try to eat less spicy and thick food and give priority to a light diet; in addition, we should abstain from sexual desire and prohibit sexual intercourse in the acute stage. In the chronic stage of the disease, patients should be encouraged to moderate sexual intercourse, on the one hand, to keep the seminal tract open, to facilitate the discharge of the blood from the menstruation, on the other hand, you can observe the effect of treatment.