巢氏云∶鼻乃肺之窍，皮毛腠理，乃肺之主。此因风邪客于肺，而鼻塞不利者，宜用消风散
，或用葱白七茎入油，腻粉少许，擂摊绢帛上，掌中护温贴囟门。因惊仆气散，血无所羁而
鼻衄者，用异功散加柴胡、山栀。左脸青而兼赤者，先用柴胡清肝散；后用地黄丸。右脸赤
，乃肺大肠实热也，用泻白散。鼻色赤，乃脾胃实热也，用泻黄散；微赤，乃脾经虚热也，
用异功散加升麻、柴胡；色深黄，用济生犀角地黄汤，后用杨氏地黄丸；淡白色，用六君子
汤。颏间色赤，用四物汤加山栀；赤甚，用五淋散；小便赤色，用六味丸、补中益气汤。唇
色白，用六君子汤；久不愈，用麦门冬饮子。若初病元气未亏，乳食如常，发热壮热，二便
秘结，作渴饮水，卧不露睛者，悉属形病俱实，当治邪气。若病久元气以亏，食少发热，口
干饮汤，呕吐泄泻，肢体畏寒，卧而露睛者，悉属形病俱虚，当补正气为要。
治验
一小儿咳嗽，恶心，鼻塞流涕，右腮青白，此乃脾肺气虚，而外邪所乘也，先用惺惺散，咳
嗽顿愈。但饮食不思，手足指冷，用六君子少加升麻，一剂而痊。
一小儿潮热鼻衄，烦渴便秘，气促咳嗽，右腮色赤，此肺与大肠有热也，用柴胡饮子，一服
诸症顿退。后因惊复作，微搐顿闷，此肝脾气血虚也，用四君子加芎、归、钩藤钩而愈。
一小儿遍身生疥，挖鼻出血，因肝脾有热，用四味肥儿丸而愈。后食炙 ，鼻血复出，疮疥
复发，先用清胃散二剂，又用四味肥儿丸，月余而痊。
一小儿鼻衄滞颐，作渴时汗，乃胃经实热也，先用泻黄散，二服而滞颐止，又用四味肥儿丸
，数服而鼻血愈。后鼻不时作痒，发渴便血，用圣济犀角地黄汤四剂，母子并服，别令儿童
更服四味肥儿丸，月余而愈。
一小儿鼻衄，发热作渴，右腮色青。余谓肝火乘脾。先用加味逍遥散，母子并服，热渴渐止
。另用五味异功散少加柴胡、升麻，与子服之而愈。
一小儿鼻衄，服止血之剂，反见便血，右腮色黄或赤，此脾气虚热，不能统血也，用补中
益气汤，又用五味异功散加柴胡、升麻而愈。
一小儿鼻衄，久不愈，四肢倦怠，饮食少思，恶风寒，此脾肺虚也，先用五味异功散，而鼻
血止，又用补中益气汤，而不畏风寒，继用四君，少加柴胡、升麻而痊愈。
一小儿鼻衄，两颏赤。余谓∶禀赋肾气不足，虚火上炎也。不信。别服清热凉血之药，病益
甚。余用地黄丸果效。毕姻后，虚症悉至，用八珍渴、地黄丸料寻愈。
一小儿鼻衄作渴，喘嗽面赤，此心火刑肺金也。用人参平肺散及地黄丸料加五味子、麦门冬
煎服，而痊。
杨氏地黄散 治荣中有热，肺壅鼻衄。
生地黄 赤芍药 当归身 川芎（各等分）
上每服二、三钱，水煎熟，入蒲黄少许；春夏衄入地黄汁、蒲黄各少许；秋冬衄，用车前草
汁少许。
麦门冬饮子 治吐血久不愈者。
五味子（十粒） 麦门冬（去心） 黄 （各一钱） 当归身 人参 生地黄（各五分）
上水煎服。
补中益气汤（方见虚羸）
清胃散
异功散（二方见内钓，即五味异功散）
人参平肺散（方见咳嗽）
柴胡清肝散（方见热症）
泻白散（方见肺脏）
泻黄散（方见脾脏）
犀角地黄汤（即圣济犀角地黄汤，方见便血脏血）
五淋散（方见五淋）
四君子汤（方见内钓）
八珍汤（即四君、四物二汤合服也，四君见天钓，四物见急惊）
四物汤（方见急惊）
惺惺散
柴胡饮子（二方见热症）
四味肥儿丸（方见呕吐）
加味逍遥散（方见内钓）
六味地黄丸（方见肾脏）
Niao Yuanfang stated: The nose is the orifice of the Lung, and the skin, hair, and interstices are governed by the Lung. When nasal congestion and obstruction occur due to wind-pathogen lodging in the Lung, Xiaofeng San (Wind-Expelling Powder) should be used. Alternatively, seven stalks of scallion white parts can be boiled in oil with a small amount of calomel, ground, spread on silk fabric, warmed in the palm, and applied to the fontanelle. For epistaxis caused by fright and falling leading to scattered Qi and uncontrolled blood flow, Yigong San (Extraordinary Efficacy Powder) added with Chaihu (Bupleurum Root) and Zhizi (Gardenia Fruit) should be used. If the left cheek is blue-green and red, use Chaihu Qinggan San (Bupleurum Liver-Clearing Powder) first, followed by Dihuang Wan (Rehmannia Pill). Redness on the right cheek indicates excess heat in the Lung and Large Intestine; Xiebai San (Draining White Powder) should be used. Redness of the nose indicates excess heat in the Spleen and Stomach; Xiehuang San (Draining Yellow Powder) should be used. Slight redness indicates deficiency heat in the Spleen meridian; Yigong San added with Shengma (Cimicifuga Rhizome) and Chaihu should be used. Deep yellow color indicates heat requiring Jisheng Xijiao Dihuang Tang (Jisheng Rhinohorn and Rehmannia Decoction), followed by Yangshi Dihuang Wan (Yang's Rehmannia Pill). Pale white color indicates Liu Junzi Tang (Six Gentlemen Decoction). Redness between the chin indicates Siwu Tang (Four Substances Decoction) added with Zhizi; severe redness requires Wulin San (Five Strangury Powder); dark red urine requires Liuyi Wan (Six-Ingredient Pill) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). White lips indicate Liu Junzi Tang; if persistent, Maidong Yinzi (Ophiopogon Drink) should be used. If the disease is recent, Yuanqi (Primal Qi) is not depleted, milk and food intake are normal, fever is high, bowel movements and urination are constipated, thirst with drinking occurs, and eyes do not open during sleep, these are signs of both form and disease being excess; pathogenic factors should be treated. If the disease has been long-standing, Yuanqi is depleted, appetite is poor with fever, dry mouth desires warm drinks, vomiting and diarrhea occur, limbs feel cold, and eyes remain open during sleep, these are signs of both form and disease being deficiency; tonifying healthy Qi is essential.
Case Records
A child presented with cough, nausea, nasal congestion, and runny nose, with a blue-white right cheek. This indicated deficiency of Qi in the Spleen and Lung with invasion by external pathogens. Xingxing San was administered first, resulting in immediate cessation of cough. However, due to lack of appetite and cold fingers/toes, Liu Junzi Tang with a small addition of Shengma cured him in one dose.
A child presented with tidal fever, epistaxis, irritability and thirst, constipation, shortness of breath, and cough, with a red right cheek. This indicated heat in the Lung and Large Intestine. Chaihu Yinzi cured all symptoms after one dose. Later, due to fright, symptoms recurred with mild convulsions and sudden oppression, indicating deficiency of Qi and Blood in the Liver and Spleen. Sizijunzi Tang added with Chuanxiong (Szechwan Lovage Rhizome), Danggui (Angelica Sinensis Root), and Gouteng (Uncaria Ramulus cum Uncis) cured him.
A child had generalized scabies and epistaxis from nose-picking, due to heat in the Liver and Spleen. Simi Fei'er Wan cured him. After eating roasted food, epistaxis and scabies recurred. Qingwei San for two doses, followed by Simi Fei'er Wan, cured him after more than a month.
A child presented with epistaxis, drooling (Zhiyi), thirst with sweating, indicating excess heat in the Stomach meridian. Xiehuang San stopped drooling after two doses; Simi Fei'er Wan stopped epistaxis after several doses. Later, frequent nasal itching, thirst, and bloody stool occurred. Shengji Xijiao Dihuang Tang for four doses, taken by both mother and child, along with Simi Fei'er Wan for the child, cured him after more than a month.
A child presented with epistaxis, fever, thirst, and a blue right cheek. I diagnosed Liver Fire invading the Spleen. Jiawei Xiaoyao San was administered to both mother and child, gradually stopping fever and thirst. Wuwei Yigong San added with Chaihu and Shengma given to the child cured him.
A child presented with epistaxis. After taking hemostatic agents, hematochezia appeared, with yellow or red right cheeks. This indicated deficiency heat in the Spleen failing to control blood. Buzhong Yiqi Tang, followed by Wuwei Yigong San added with Chaihu and Shengma, cured him.
A child presented with persistent epistaxis, limb fatigue, poor appetite, and aversion to wind and cold, indicating deficiency of the Spleen and Lung. Wuwei Yigong San stopped the bleeding; Buzhong Yiqi Tang resolved aversion to wind and cold; Sizijunzi Tang added with Chaihu and Shengma completed the cure.
A child presented with epistaxis and redness on both chins. I diagnosed insufficient congenital Kidney Qi causing deficient fire to flare upward. The parents disagreed and used heat-clearing and blood-cooling herbs, worsening the condition. Dihuang Wan proved effective. After marriage, deficiency symptoms fully manifested; Bazhen Tang and Dihuang Wan ingredients cured him.
A child presented with epistaxis, thirst, wheezing, cough, and red face, indicating Heart Fire punishing Lung Metal. Renshen Pingfei San and Dihuang Wan ingredients added with Wuweizi (Schisandra Fruit) and Maidong (Ophiopogon Tuber) cured him.
Yangshi Dihuang San treats heat in the Ying level and Lung obstruction causing epistaxis.
Sheng Dihuang (Raw Rehmannia Root), Chi Shaoyao (Red Peony Root), Danggui Shen (Dong Quai Root Tip), Chuanxiong (Szechwan Lovage Rhizome) (equal parts).
Take 2-3 qian per dose, decoct in water, add a little Puhuang (Typha Pollen). In spring/summer epistaxis, add raw Dihuang juice and Puhuang; in autumn/winter epistaxis, add Cheqiancao juice (Plantago Leaf Juice).
Maidong Yinzi treats persistent hematemesis.
Wuweizi (10 berries), Maidong (heart removed), Huangqi (Astragalus Root) (each 1 qian), Danggui Shen, Renshen (Ginseng Root), Sheng Dihuang (each 5 fen).
Decoct in water and take.
Buzhong Yiqi Tang (Formula see Xu Lei)
Qingwei San
Yigong San (Two formulas see Neidiao, i.e., Wuwei Yigong San)
Renshen Pingfei San (Formula see Cough)
Chaihu Qinggan San (Formula see Heat Symptoms)
Xiebai San (Formula see Lung Organ)
Xiehuang San (Formula see Spleen Organ)
Xijiao Dihuang Tang (i.e., Shengji Xijiao Dihuang Tang, Formula see Hematochezia and Visceral Bleeding)
Wulin San (Formula see Five Stranguries)
Sizijunzi Tang (Formula see Neidiao)
Bazhen Tang (Combination of Sizijunzi and Siwu Tangs; Sizijunzi see Tiandiao, Siwu see Jijing)
Siwu Tang (Formula see Jijing)
Xingxing San
Chaihu Yinzi (Two formulas see Heat Symptoms)
Simi Fei'er Wan (Formula see Vomiting)
Jiawei Xiaoyao San (Formula see Neidiao)
Liuyi Dihuang Wan (Formula see Kidney Organ)