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Huangqin (Scutellariae Radix, stir-baked) Baishao Yao (Paeoniae Radix Alba, wine-fried) Gancao (Glycyrrhizae Radix et Rhizoma, each 3 qian)
When Yin fire (deficiency fire generated by yin deficiency) carries blood upward, causing persistent epistaxis (nosebleed), this formula is also indicated.
The bitterness of Huangqin can descend fire; the sourness of Shaoyao can astringe yin; the sweetness of Gancao can relieve urgency.

Huangqi (Astragali Radix, 6 qian) Chifuling (Polyporus, 3 qian) Baishao Yao (Paeoniae Radix Alba, 3 qian) Danggui (Angelicae Sinensis Radix, 3 qian) Shengdihuang (Rehmanniae Radix Recens, 3 qian) Ejiao (Colla Corii Asini, 3 qian)
When hunger, fatigue, and overwork stir up deficiency fire, leading to persistent epistaxis, this formula is indicated.
That hunger, fatigue, and overwork stir up fire indicates that the person's constitution was originally deficient. Deficiency fire can be treated by tonification; therefore, Huangqi, Danggui, and Ejiao—substances with sweet-warm properties—are used to tonify it. However, Chifuling can guide Bing-Ding (heart fire) downward, Baishao Yao can astringe yin qi, and Shengdihuang can cool blood heat. These three substances remove heat from the blood; their nature is mild and harmonious, quite different from the bitter-cold preparations of Huangqin and Lian. Excess fire is suitable for treatment with Lian and Huangqin, whereas deficiency fire is best treated with such formulas. One might ask: How are deficiency fire and excess fire distinguished? I say: A loud voice and robust breath indicate excess fire; a faint voice with repetitive murmuring throughout the day indicates deficiency fire.

Renshen (Ginseng Radix, 1.5 qian) Huangqi (Astragali Radix, 1.5 qian) Maimendong (Ophiopogonis Radix, 1 qian) Danggui (Angelicae Sinensis Radix, 1 qian) Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian) Baishao Yao (Paeoniae Radix Alba, 1 qian) Wubeizi (Schisandrae Fructus, 9 grains)
For epistaxis occurring during the summer months, this formula is indicated.
The *Neijing* states: "One must first consider the seasonal qi and not disrupt the harmony of heaven and humanity." Thus, when in the summer season, Lung Metal is controlled, leading to a time of qi deficiency; logically, one should clear the metal (lungs) and tonify qi. To clear the lung, Maimendong and Wubeizi are used. To tonify qi, Gancao, Renshen, and Huangqi are used; the sourness of Shaoyao serves to astringe yin. The pungency of Danggui serves to return blood to its vessels. This is also an example where deficiency fire can be treated by tonification.

Baiye Liuhua (Lythri Flos, dried and powdered)
For persistent epistaxis, blow this powder into the nose to stop bleeding immediately.
The red color of Lythri Flos has the property of guiding medicine into the blood level. Its astringent nature can stop bleeding. Just as "one man guarding a pass" holds off thousands, this medicine approximates such efficacy.

Qingdai (Indigo Naturalis, levigated) Gualou Ren (Trichosanthis Semen, oil removed) Hezi Rou (Terminaliae Fructus, flesh only) Haifen (Spongilla, sand removed) Shanzhi (Gardeniae Fructus, stir-baked until black, equal parts)
For coughing with blood-stained sputum, this formula is made into honey pills to be held in the mouth and dissolved slowly.
The Lung is the most pure organ, tolerating no impurity; when there is rebellious qi and fire, there is cough; when there is phlegm and blood, there is expectoration. "Ke" (cough) refers to the sound, while "Sou" (expectoration) refers to the presence of matter. Qingdai and Shanzhi serve to descend fire; Gualou and Haifen serve to move phlegm; Hezi serves to astringe the Lung. Although there are no specific hemostatic herbs in this formula, once the fire is eliminated, the blood stops naturally.