脉
左寸脉浮缓为伤风鼻塞，鼻流清涕；右寸脉浮洪而数，为鼻衄、鼻 。
病
鼻塞不闻香臭，或但遇寒月多塞，或略感风寒便塞，不时举发者，世俗皆以为肺寒，而用表解通利辛
温之药不效，殊不知此是肺经多有火邪，郁甚则喜多热，而恶见寒，故遇寒便塞，遇感便发。
治
治法清金降火为主，而佐以通利之剂。若如常鼻塞不闻香臭者，再审其平素，只作肺热治之，清肺火，
泻火消痰，或丸药噙化，或末药轻调缓服，久服无不效。又平素原无鼻塞之病，一时偶
感风寒，而致鼻塞声重，或流清涕者，只作风寒治之。
方
丽泽通气汤 治鼻不闻香臭。
黄 （一分） 苍术 羌活 独活 防风 升麻 葛根（各六分） 炙甘
草（四分） 白芷 川芎（各二分） 麻黄（不去节，冬月加）
上锉作一剂，生姜三片，枣二枚，葱白三根，水煎，食远温服。忌冷物，风寒凉处坐卧。
通窍汤〔批〕（按此方治不闻香臭之剂） 治感风寒，鼻塞声重流涕。
防风 羌活 本 升麻 干葛 川芎 苍术（各一钱） 麻黄 白芷（五分） 川椒 细辛 甘草（各三分）
上锉一剂，生姜三片，葱白一根，水煎热服。
苍耳散 治鼻流浊涕不止，名曰鼻渊，是胆移热于脑也。
辛夷仁（五钱） 苍耳子（一钱半，炒） 白芷（一两） 薄荷叶（一钱）
上为末，葱、茶调下二钱。
黄连通圣散 治脑漏，胆移热于脑，则辛额鼻渊，即防风通圣
散加黄连、薄荷，水煎热服。
天竺黄丸（秘方） 治鼻渊。
当归 川芎 白芷 人参 茯苓 麦门冬 防风 荆芥 薄荷
苍耳子 香附子 蔓荆子 秦艽 甘草（各二两） 天竺黄（三钱）
上为细末，炼蜜为丸，如梧桐子大。每服三四十丸，米汤送下。
〔批〕（按此方治鼻渊之剂） 治鼻中时时流臭黄水，甚者脑下时痛，俗名控脑砂，有虫食脑中。
用丝瓜藤近根三尺许，烧存性，为末，酒调服。
洗肺散 治鼻中生疮。
天门冬（去心） 麦门冬（去心，各一两） 黄芩（二钱） 半夏（二钱） 杏仁
（去皮，一钱） 五味子（一钱半） 甘草（五分）
上锉一剂，生姜五片，水煎，食后服。
清肺饮子（秘方） 治鼻红肺风。
山茶花（一两） 黄芩（二两） 胡麻仁（二两） 山栀子（二两） 连翘（一两） 薄
荷（三两） 荆芥（一两） 芍药（一两） 防风（一两） 葛花（二两） 苦参（二两） 甘草（二两）
上为末，茶清调服三钱，后用搽药。
搽鼻去红方（秘方） 治鼻红肺风。
白矾（一钱） 杏仁（四十九个） 水银（一钱） 轻粉（七分） 白杨（七个） 大枫子
（四十九个） 京墨（一钱） 五味子（四十九个） 核桃（七个）
上共为末，鸡子清调搽患处。
治鼻中肉赘，臭不可近，痛不可摇，以白矾末加 砂少许，吹其上，顷之化水而消，与胜湿汤、泻白
散二帖，此浓味拥湿热蒸于肺门，如雨霁之地突生芝兰也。
参归丸 治酒渣鼻，乃血热入肺。
苦参（净末，四两） 当归（净末，二两）
上用酒糊丸，如梧桐子大。每服七八十丸，食后热茶下。
Pulse Diagnosis
A floating and moderate pulse at the left Cun position indicates wind injury causing nasal congestion and clear nasal discharge; a floating, full, and rapid pulse at the right Cun position indicates epistaxis (nosebleed) or nasal polyps.
Pathology
Nasal congestion with loss of smell and taste, or congestion occurring mainly in cold months, or triggered by slight exposure to wind-cold, recurring intermittently: laypeople often attribute this to lung cold and use diaphoretic, unblocking, acrid-warm herbs without effect. They fail to realize that this is due to fire pathogen in the Lung channel. When depression is severe, there is a preference for heat and aversion to cold; thus, congestion occurs upon exposure to cold, and attacks occur upon external contraction.
Treatment Principles
The treatment principle focuses on clearing Metal (clearing the Lungs) and descending fire, assisted by unblocking agents. For chronic nasal congestion with loss of smell, review the patient's constitution and treat as lung heat: clear lung fire, drain fire, resolve phlegm. Administer pills to be held in the mouth until dissolved, or fine powders taken gently and slowly over time; long-term use yields efficacy. Conversely, if there was no prior history of nasal congestion but sudden onset following wind-cold exposure, resulting in heavy voice and clear discharge, treat strictly as wind-cold.
Formulas
Lize Tongqi Decoction (Li Ze Qi Tong Tang): Treats loss of smell.
Huangqi (1 fen), Cangzhu, Qianghuo, Duhuo, Fangfeng, Shengma, Gegen (each 6 fen), Zhi Gancao (4 fen), Baizhi, Chuanxiong (each 2 fen), Mahuang (without joints, added in winter).
Crush into one dose. Add three slices of fresh ginger, two jujubes, and three stalks of scallion white. Decoct in water, take warm after meals. Avoid cold foods and sitting/lying in windy, cold places.
Tongqiao Tang [Commentary] (Note: This formula treats loss of smell): Treats wind-cold contraction causing nasal congestion, heavy voice, and discharge.
Fangfeng, Qianghuo, Gaoben, Shengma, Gange, Chuanxiong, Cangzhu (each 1 qian), Mahuang, Baizhi (5 fen), Chuanjiao, Xixin, Gancao (each 3 fen).
Crush into one dose. Add three slices of fresh ginger and one stalk of scallion white. Decoct in water and take hot.
Cangersan Powder: Treats continuous flow of turbid nasal discharge, known as Biyuan (nasal sinusitis), which results from gallbladder heat transferring to the brain.
Xinyi Ren (5 qian), Cang'erzi (1.5 qian, stir-fried), Baizhi (1 liang), Bohe Ye (1 qian).
Grind into powder. Take 2 qian mixed with scallion and tea.
Huanglian Tongsheng San: Treats Naolou (brain leakage/nasal drip). When gallbladder heat transfers to the brain, it causes frontal pain and Biyuan. This is Fengwang Tongsheng San plus Huanglian and Bohe, decocted in water and taken hot.
Tianzhuhuang Wan (Secret Formula): Treats Biyuan.
Danggui, Chuanxiong, Baizhi, Renshen, Fuling, Maidong, Fangfeng, Jingjie, Bohe, Cang'erzi, Xiangfu, Manjingzi, Qinjiao, Gancao (each 2 liang), Tianzhuhuang (3 qian).
Grind into fine powder. Make pills with refined honey, size of Sophora japonica seeds. Take 30-40 pills per dose with rice soup.
[Commentary] (Note: This formula treats Biyuan): Treats frequent discharge of foul-smelling yellow fluid from the nose. Severe cases involve periodic pain below the brain, colloquially called Kongnaosha, attributed to worms eating the brain.
Use Si Gua Teng (Gynostemma vine) near the root, about 3 chi long. Charcoalize (burn to retain carbonized nature), grind into powder, and take with wine.
Xifei San: Treats sores in the nose.
Tianmendong (remove heart), Maidong (remove heart, each 1 liang), Huangqin (2 qian), Banxia (2 qian), Xingren (remove skin, 1 qian), Wuweizi (1.5 qian), Gancao (5 fen).
Crush into one dose. Add five slices of fresh ginger. Decoct in water and take after meals.
Qingfei Yinzi (Secret Formula): Treats nasal redness and Lung Wind.
Shanchahua (1 liang), Huangqin (2 liang), Huma Ren (2 liang), Shanzhizi (2 liang), Lianqiao (1 liang), Bohe (3 liang), Jingjie (1 liang), Shaoyao (1 liang), Fangfeng (1 liang), Ge Hua (2 liang), Kushen (2 liang), Gancao (2 liang).
Grind into powder. Take 3 qian mixed with clear tea water, followed by topical application.
Chabi Quhong Fang (Secret Formula): Treats nasal redness and Lung Wind.
Bai Fan (1 qian), Xingren (49 kernels), Shuiyin (Mercurius, 1 qian), Qingfen (Calomelas, 7 fen), Baiyang (7 pieces), Dafengzi (49 kernels), Jingmo (1 qian), Wuweizi (49 kernels), Hetao (7 nuts).
Grind all together into powder. Mix with egg white and apply topically to the affected area.
For nasal polyps with unbearable odor and pain, apply Bai Fan powder mixed with a small amount of Pisha (Arsenic sulfide) via insufflation. It will liquefy and dissolve shortly. Combine with Shengshi Tang and Xiebai San (two doses). This condition arises because rich flavors obstruct damp-heat steaming at the Lung gate, similar to orchids sprouting suddenly on land after rain clears.
Shengu Wan: Treats Rhinophyma (wine-red nose), caused by blood heat entering the Lungs.
Kushen (cleaned powder, 4 liang), Danggui (cleaned powder, 2 liang).
Make pills using wine paste, size of Sophora japonica seeds. Take 70-80 pills per dose with hot tea after meals.