〔世〕久衄。炒糯米为末，水调服神妙。（详见衄。）
〔垣〕黄 芍药汤治鼻衄血，面多黄，眼涩多眩，手麻木。张彦明男衄血多岁，不效，用
此方。
黄 （一两） 甘草（炙，二两） 升麻（一两） 葛根 羌活（各半两） 白芍药（二钱）
上为粗末，每服半两，水二盏，煎至一盏，去滓，温服，二十五帖而愈。
六脉细弦而涩，按之空虚，其色必白而夭不泽者，脱血也。此大寒证，以辛温补之，以养
血。以甘温润之剂佐之，即愈。此脱血伤精气之证也。六脉俱大，按之空虚，心动面赤，善惊
上热，乃手少阴心之脉也。
此因气盛多而亡血，以甘寒镇坠之剂，泻火与气，以坠浮气。以辛温微苦，峻补其血，再用
三黄补血汤。
三黄补血汤
熟地（二钱） 生地（三钱） 当归 柴胡（各钱半） 白芍药（五钱） 川芎（二钱） 牡丹皮
升麻 黄 （各一钱。补之，治血溢者上竭。）
上为粗末，每服半两，水二盏，煎五沸，去渣温服，食前。两手脉芤，两头则有，中间全
无而虚曰芤。血至胸中，或衄血吐血，以犀角地黄汤主之。
〔罗〕地黄散治衄血往来久不愈。
生地 熟地 枸杞子 地骨皮（各等分）
上为细末，每服二钱，蜜汤调下，日三服。
〔世〕治鼻血常发者，于发时，用生姜杵碎，合额上一日，如痒就搔之，永不再发。
〔《肘》〕治人少小鼻衄，小劳辄出。桑耳无多少，炒令焦捣末，每衄发以杏仁大塞鼻中，数度
可。
大病瘥后，小劳便鼻衄。牡蛎一分，石膏五分，捣末酒服方寸匕，日三四服。亦可蜜丸，
如桐子大服之。
[Shi's Experience] Chronic epistaxis. Roasted glutinous rice is ground into powder and taken with water, yielding miraculous results. (For details, see the entry on "Epistaxis".)
[Dongyuan Li's Experience] Huangqi Shaoyao Tang (Astragalus and White Peony Decoction) treats nasal bleeding accompanied by a sallow complexion, dry eyes with frequent dizziness, and numbness in the hands. Zhang Yanming’s son suffered from epistaxis for over a year without success from other treatments; this formula cured him.
Ingredients: Astragali Radix (Huangqi, 黄耆) (1 liang), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) (2 liang, honey-fried), Cimicifugae Rhizoma (Shengma, 升麻) (1 liang), Puerariae Radix (Gegen, 葛根), Notopterygii Rhizoma et Radix (Qianghuo, 羌活) (each 0.5 liang), Paeoniae Radix Alba (Baishaoyao, 白芍药) (2 qian).
Preparation and Administration: The above herbs are coarsely crushed. Each dose consists of 0.5 liang, boiled in two zhen of water until reduced to one zhen. Strain and take warm. After taking 25 doses, the patient recovered.
Pulse Analysis: If the six pulses are fine, wiry, and choppy, feeling empty upon deep pressure, and the complexion is pale and lusterless, this indicates blood loss. This is a severe cold syndrome; it should be treated with acrid-warm tonifying methods to nourish the blood. Assisted by sweet-warm moistening agents, recovery occurs. This is a syndrome of blood loss damaging essence and qi. If all six pulses are large but empty upon deep pressure, accompanied by palpitations, flushed face, susceptibility to fright, and heat in the upper body, this corresponds to the pulse of the Hand-Shaoyin Heart meridian.
Pathogenesis and Treatment: This arises from excessive qi leading to blood loss. Sweet-cold sinking agents should be used to purge fire and qi, suppressing floating qi. Then, use acrid-warm slightly bitter agents to vigorously tonify the blood, followed by Sanhuang Buxue Tang.
Sanhuang Buxue Tang (Three Yellows Blood-Nourishing Decoction)
Ingredients: Rehmanniae Radix Praeparata (Shudihuang, 熟地黄) (2 qian), Rehmanniae Radix (Shengdihuang, 生地黄) (3 qian), Angelicae Sinensis Radix (Danggui, 当归), Bupleuri Radix (Chaihu, 柴胡) (each 1.5 qian), Paeoniae Radix Alba (Baishaoyao, 白芍药) (5 qian), Chuanxiong Rhizoma (Chuanxiong, 川芎) (2 qian), Moutan Cortex (Mudanpi, 牡丹皮), Cimicifugae Rhizoma (Shengma, 升麻), Astragali Radix (Huangqi, 黄耆) (each 1 qian. Used here for tonification, treating blood effusion and upper exhaustion.)
Preparation and Administration: The above herbs are coarsely crushed. Each dose consists of 0.5 liang, boiled in two zhen of water for five boils. Strain and take warm before meals. A Kou pulse (Kou Mai, 芤脉) feels like having pulses at both ends but completely empty in the middle. If blood surges to the chest, or if epistaxis and hematemesis occur, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) should be the primary treatment.
[Luo Tianyi's Experience] Dihuang San (Rehmannia Powder) treats recurrent epistaxis that persists for a long time.
Ingredients: Rehmanniae Radix (Shengdihuang, 生地黄), Rehmanniae Radix Praeparata (Shudihuang, 熟地黄), Lycii Fructus (Gouqizi, 枸杞子), Dictamni Cortex (Digupi, 地骨皮) (equal parts).
Preparation and Administration: The above herbs are ground into fine powder. Each dose is 2 qian, taken with honey-water, three times daily.
[Shi's Experience] To treat frequently recurring epistaxis, during an episode, crush fresh ginger and apply it to the forehead for one day. If itching occurs, scratch it; this can prevent recurrence permanently.
[From *Zhou Hou Bei Ji Fang*] To treat children and adolescents with epistaxis triggered by slight exertion, use Auricularia Judae (Sanger, 桑耳) in any quantity. Stir-fry until scorched, grind into powder, and insert an amount the size of an almond into the nostril each time bleeding occurs. Repeated applications are effective.
After recovering from a major illness, epistaxis occurs upon slight exertion. Use Oyster Shell (Muli, 牡蛎) 1 fen and Gypsum Fibrosum (Shigao, 石膏) 5 fen, grind into powder, and administer with wine using a measure of one cun bi. Take three to four times daily. Alternatively, prepare as honey pills the size of paulownia seeds and take orally.