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Rhino Horn (sliced, 1.5 qian) Sheng Dihuang (Rehmanniae Radix Praeparata, 4 qian) Mudanpi (Moutan Cortex) Maidong (Ophiopogonis Radix) Baishao (Paeoniae Radix Alba) (each 1.5 qian)
Decoct in water and take orally.

Bi nosebleed (Nosebleed) refers to bleeding from the nasal cavity. When cold pathogen initially invades the meridians, blood coagulates and stagnates without flowing; how can nosebleed occur? The appearance of nosebleed now indicates that the cold pathogen is about to dissipate, Ying blood (Nutritive Blood) resumes its circulation, and the disease should resolve. This aligns with the ancient saying that "blood is red sweat." However, nosebleed cases differ between exterior and interior patterns. If the cold pathogen is in the meridians, accompanied by headache, fever, and nosebleed, it is an exterior pattern, suitable for mild diaphoresis (releasing the exterior through sweating), primarily treated with Jia Wei Xiang Su San (Modified Elsholtzia and Perilla Powder). If the pathogen enters the interior, causing dryness, thirst, irritability, and nosebleed, urgent clearing of heat is required, primarily treated with Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction). One might ask: How to distinguish Dong Yin Xue (Disturbance of Yin Blood) from nosebleed? The answer is: Dong Yin Xue is a transmitted interior syndrome where extreme heat causes counterflow cold (Jue Ni); if physicians mistakenly diagnose it as cold and administer Gan Jiang (Dried Ginger) and Fuzi (Prepared Aconite Root), adding fire to fire, forcing blood to flow recklessly, leading to bleeding from the ears, eyes, mouth, or nose, it is called Dong Yin Xue, also known as Lower Counterflow and Upper Exhaustion, which is difficult to treat. This is vastly different from nosebleed.

Passing pus and blood in stool results from heat forcing blood downward, caused by transmitted heat pathogens; the treatment method should be clearing heat. If stasis blood condenses, causing lower abdominal pain, tenderness upon pressure, and normal urination, purgation (attacking with purgatives) is indicated. However, there are also cases of dysentery with pus and blood due to yin-cold pathology, resulting from deficiency-cold in the lower jiao and instability of the intestines and stomach. Like water freezing into ice during cold weather and frozen ground, it cannot be resolved without warm tonifying agents; this is primarily treated with Fuzi Lizhong Tang (Aconite and Poria Decoction) added with Dang Gui (Angelica Sinensis) and Baishao (White Peony Root). These two conditions—one involving blood-heat and the other blood-cold—must be clearly distinguished during clinical practice.

Xu Xue (Accumulated Blood) refers to stasis blood accumulating in the lower jiao. Zhang Zhongjing stated: If Taiyang syndrome does not resolve, heat binds to the Bladder, and the patient exhibits manic behavior; if blood discharges spontaneously, recovery occurs. If the exterior remains unresolved, attack is contraindicated; one must first resolve the exterior. Once the exterior is resolved, if only lower abdominal urgency and binding remain, attack may proceed, preferably using Taohe Chengqi Tang (Peach Kernel and Magnolia Bark Decoction). This represents a mild case of Xu Xue where exterior signs have just been cleared and stasis begins to gather. If exterior pathogens are completely gone and interior heat is profound, it is a severe case of Xu Xue, treated with Didang Tang (Definite Attack Decoction). However, Xu Xue syndrome resembles but differs from Lin syndrome (difficulty/painful urination) and Dry Stool syndrome; treatments must be differentiated. In Typhoid diseases, if the lower abdomen is distended and full but painless upon pressure, with difficulty urinating, it is Lin syndrome. If pressure around the navel reveals hardness and pain, with scanty urine and constipation, it is Dry Stool. If pressure on the lower abdomen reveals hardness and pain, with normal urination, or black stools, forgetfulness, and manic behavior, it is Xu Xue. This is the general principle of differentiation.