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Nasal Qi (Qi of the nose) can communicate with the brain. When blood overflows upward into the brain, it exits through the nose; this condition is named Bi Nu (Epistaxis). If caused by Wind-Cold, Summerheat, Dampness, or pathogenic factors spreading through the meridians and turbating the clear pathways, these are all external causes. If caused by accumulated anger injuring the Liver, accumulated sorrow injuring the Lung, vexatious thinking injuring the Spleen, loss of will injuring the Kidney, or sudden excessive joy injuring the Heart—all of which can disturb blood and cause it to overflow upward following the ascending Qi—these are all internal causes. If caused by excessive alcohol consumption, eating roasted/spicy/hot foods, or trauma from falling from a carriage or being struck, these are all neither-internal-nor-external causes. The *Yuan Bing Shi* states: "Nu occurs when Yang-Heat is constrained in the Foot-Yangming Meridian." Danxi said: "Nu blood originates from the Lung"; speaking of the Lung refers to the nasal orifice. Speaking of the Yangming Meridian refers to it being the Sea of Blood. There is also a case where epistaxis occurs while washing the face, becoming a daily occurrence, like wind moving water, with facial heat and rising Fire of the Yangming Meridian, causing blood to follow it upward. If, after childbirth, black gas appears around the mouth and nose accompanied by epistaxis, it is called Wei Jue (Stomach Exhaustion); this syndrome is mostly incurable. In such cases, urgently take one red thread and two hairs from the vertex of the parturient's head, tie them tightly around the middle joint of the middle finger to stop the bleeding. If epistaxis does not stop and sweating occurs on the head, it is a death sign.

Any blood oozing from between the teeth or from the gum roots is called Chi Nu (Gum Epistaxis). It can be due to Wind Congestion (Wind Pathogen Stagnation) or Kidney Deficiency. For Wind Congestion, use Xiao Feng San externally to dispel wind, and apply Qu Feng Ya Cha San to rub the teeth. For Kidney Deficiency, since the Kidney governs bones and teeth are the surplus of bones, if deficiency-Fire flares upward and taking cooling medicines worsens the condition, this belongs to Lower Deficiency and Upper Excess of the Kidney Meridian. It is appropriate to administer An Shen Wan delivered with salted water, and still use Qing Yan stir-fried Xiang Fu (Cyperi Rhizoma) until black, ground into powder, applied topically. However, the Shaoyin Meridian has abundant Qi but scarce Blood, so its blood must ooze drop by drop, and the teeth ache faintly; those with excessive sexual desire often suffer from this. There are also cases of gum rupture and bleeding due to Stomach Heat; the Yangming Meridian has abundant Qi and Blood, and when Fire is vigorous, blood surges like a tide; those who enjoy drinking often suffer from this. It is appropriate to clear the Heat, using Qing Wei San as the principal formula.

Bleeding from hair follicles is called Ji Nu (Cutaneous Epistaxis). This is because Yang-Qi is constrained internally and cannot diffuse outward, causing Yin-Blood to ascend to the Yang aspect, lingering and infiltrating the Cou Li (interstices). After a long time, when Yang-Qi opens up, Yin-Blood cannot return to the vessels, so blood exits from the hair follicles. It is appropriate to use formulas that resolve stagnation, clear Qi, and cool Blood. If Minister-Fire moves internally and attacks the Yin aspect, causing blood to boil and surge, it is appropriate to use formulas that nourish Yin and descend Fire. Predecessors emphasized treating Lung Heat, as the Lung governs skin and hair. One can use ash from burned male fetal remains applied topically. There are also cases where excessive joy injures the Heart; joy causes Qi to scatter, and blood overflows to the exterior following Qi. It is appropriate to cool the Heart to astringe it.

There is a pore on the chest that frequently leaks bloody fluid, called Xin Lou (Heart Fistula). Use tender Lu Rong (Cervus Nippon Cornu), de-haired and fried with butter, Pao Zhi Fu Zi (Aconiti Lateralis Radix Praeparata), peeled and navel removed, and Yan Hua (Salt Flower), ground together into powder, formed into pills with jujube paste. Take thirty pills per dose, administered with wine on an empty stomach; it also treats Kidney Deficiency lower back pain with miraculous effect.

She Nu (Tongue Epistaxis) refers to tongue bleeding without obvious cause, flowing like a continuous thread or from tube-like pores. It is appropriate to drink one sheng of Xiang Ru juice, three times a day. Externally, apply dry powder of stir-fried Huai Hua (Sophorae Flos).

Bleeding from the ears indicates movement of Shaoyin Fire. Burn Long Gu (Fossilia Ossis Mastodi) to ash and insufflate it into the ear to stop the bleeding.

Blood disorders are divided into upper, middle, and lower parts, with medications varying in potency. Xi Jiao Di Huang Tang (Rhino Horn and Rehmannia Decoction) treats upper bleeding, such as hematemesis and epistaxis; Tao Ren Cheng Qi Tang (Peach Kernel and Magnolia Bark Decoction) treats middle bleeding, such as blood stasis accumulating in the Middle Jiao presenting as dysentery with pus and blood; Di Dang Tang/Wan (Di Dang Decoction/Pill) treats lower bleeding, such as blood stasis accumulation presenting with mania. These are the general principles for treating excess-type blood disorders.