论曰大衄者、口耳皆血出是也。盖血为荣而藏于肝，气为卫而主于肺，肺开窍于鼻。三
者相为流通，若热气乘血而甚，则气血妄行与气冲激，错溢于上窍，故鼻衄不已，而口耳皆
出血也。
治大衄不止。远志汤方
远志（去心） 天门冬（去心焙） 麦门冬（去心焙） 阿胶（炙燥） 当归（切焙） 藕
节（洗净） 甘草（炙） 大黄（锉炒） 芎 （各半两） 桂（去粗皮） 没药（研） 麻
黄（去节） 桃核仁（汤浸去皮尖炒令黄色各一分
上一十五味，粗捣筛，每服三钱匕，以水一盏，煎至七分，去滓空心温服。
治血妄行，九窍皆出，服药不住者，南天竺饮方
南天竺草（生瞿麦者是拇指大一把锉） 山栀子（三十枚去皮） 生姜（一块如拇指大）
大枣（去核五枚） 甘草（炙半两） 灯草（如小指一大把）
上六味锉。水一大碗，煮至半碗，去滓通口服。
治大衄口耳皆血出不止。苦参汤方
苦参（锉） 黄连（去须各一两） 大黄（炒一两） 栀子（去皮七枚）
上四味，粗捣筛，每服三钱匕，水一盏，入生地黄汁一合，煎至七分，去滓温服。
治大衄口耳皆出血不止。阿胶汤方
阿胶（炙燥一两） 蒲黄（半两）
上二味，粗捣筛，每服二钱匕，水一中盏，入生地黄汁一合，煎至六分，温服，急以帛
系乳，随衄左右系之。两鼻窍俱出，则尽系两乳，不计时候。
治鼻衄至一斗，并大衄。圣效方
线（五两） 人中白（一团如鸡子黄大）
上二味，烧为灰研细，每服二钱匕，温水调下，
治大衄口耳鼻俱出血，牡蛎散方
左顾牡蛎（烧赤一分） 石膏（碎研一两一分）
上二味，捣罗为散，每服一钱匕，温酒调下，早晨日午晡时，各一服，亦可蜜丸。如梧
桐子大，每服三十丸、酒下。
治大衄不止，莱菔酒方
莱菔（不拘多少用）
上一味，每细锉一合，用酒一盏，先煎百沸，次下莱菔，再煎一两沸，放温滤去滓顿服
治大衄，玉浆散方
白面（不拘多少）
上一味，每服三钱匕，用冷水调下。
治九窍出血，刺蓟饮方
刺蓟
上一味，每用一握，绞取自然汁。以酒半盏相和，顿服之，如无青汁。只捣干者为末，
冷水调下三钱匕。
治鼻中及耳，皆出血不止，黑神散方
白刺 皮（烧灰存性半两） 人中白（半钱）
上二味，细研为散，每用少许，吹鼻中。
治大衄。口鼻出血，血上心胸气急劳热，生地黄饮方
生地黄（四两） 黄芩（去黑心） 赤芍药 竹茹（各三两） 蒲黄（三大合） 地骨
皮（五两）
上六味。除蒲黄外， 咀如麻豆，每服五钱匕，水一盏半，煎至八分，去滓温服，食后
日二。
治大衄不止方
龙骨
上为末，用芦管吹入鼻中、立止。
Discussion states: Da Nu (Major Hemorrhage) refers to the condition where blood flows from both the mouth and ears. This is because blood belongs to Ying Qi (Nutritive Qi, essence circulating within the vessels), which is stored in the Liver; Qi belongs to Wei Qi (Defensive Qi, qi circulating outside the vessels), which is governed by the Lung; the Lung opens into the nose. These three interact and circulate mutually. If heat pathogen attacks the blood causing it to become excessive, leading to reckless movement of Qi and Blood and collision with Qi, they erratically overflow into the upper orifices. Thus, Bi Nu (Nosebleed) does not cease, and subsequently, blood flows from both the mouth and ears.
Yuanzhi Tang Decoction for treating persistent Da Nu:
Polygalae Radix (Yuanzhi, 远志) [decentered], Asparagi Radix (Tianmendong, 天门冬) [decentered and roasted], Ophiopogonis Radix (Maimendong, 麦门冬) [decentered and roasted], Colla Corii Asini (Ejiao, 阿胶) [roasted until dry], Angelicae Sinensis Radix (Danggui, 当归) [sliced and roasted], Node of Lotus Rhizome (Oujie, 藕节) [washed clean], Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [roasted], Rheum Palmatum Radix et Rhizoma (Dahuang, 大黄) [cut and stir-fried], Ligustici Chuanxiong Rhizoma (Chuanxiong, 川芎) [each half liang], Cinnamomi Ramulus (Guizhi, 桂枝) [bark removed], Myrrha (Moyao, 没药) [pounded], Ephedrae Herba (Mahuang, 麻黄) [nodes removed], Persicae Semen (Taoren, 桃仁) [soaked in water, skin and tip removed, fried until yellow] [each one fen].
The above fifteen ingredients are coarsely pounded and sieved. Each dose consists of three qianbi, decocted in one zhan of water until reduced to seven-tenths. Strain the dregs and take warm on an empty stomach.
Nantianzhu Yin Drink for treating reckless movement of blood where all nine orifices bleed and medication fails:
Plantaginis Herba (Nantianzhucao, 南天竺草) [fresh Plantago asiatica, thumb-sized, one bunch, cut], Gardeniae Fructus (Shanzhizi, 山栀子) [thirty fruits, skin removed], Zingiberis Rhizoma Recens (Shengjiang, 生姜) [one piece thumb-sized], Jujubae Fructus (Dazao, 大枣) [five fruits, pits removed], Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) [roasted, half liang], Junci Medulla (Dengcao, 灯草) [one bunch finger-sized].
The above six ingredients are cut. Decoct in one large bowl of water until reduced to half a bowl. Strain and drink orally.
Kushen Tang Decoction for treating persistent Da Nu with bleeding from mouth and ears:
Sophorae Flavescentis Radix (Kushen, 苦参) [cut], Coptidis Rhizoma (Huanglian, 黄连) [mustards removed, each one liang], Rheum Palmatum Radix et Rhizoma (Dahuang, 大黄) [stir-fried, one liang], Gardeniae Fructus (Zhizi, 栀子) [skin removed, seven fruits].
The above four ingredients are coarsely pounded and sieved. Each dose consists of three qianbi, decocted in one zhan of water with one he of fresh Rehmanniae Radix juice (Shengdihuang Zhi, 生地黄汁). Reduce to seven-tenths, strain, and take warm.
Ejiao Tang Decoction for treating persistent Da Nu with bleeding from mouth and nose:
Colla Corii Asini (Ejiao, 阿胶) [roasted until dry, one liang], Pteridis Spora (Puhuang, 蒲黄) [half liang].
The above two ingredients are coarsely pounded and sieved. Each dose consists of two qianbi, decocted in one zhongzhan of water with one he of fresh Rehmanniae Radix juice. Reduce to six-tenths, strain, and take warm. Urgently tie the breasts with cloth strips; tie the left breast if bleeding is from the left nostril, and the right breast if from the right. If both nostrils bleed, tie both breasts regardless of time.
Shengxiao Formula for treating Bi Nu amounting to one dou and Da Nu:
Thread (Xian, 线) [five liang], Nuzhongbai (Renzhongbai, 人中白) [one clump size of chicken egg yolk].
The above two ingredients are burned to ash and finely ground. Each dose consists of two qianbi, taken with warm water mixed.
Muli San Powder for treating Da Nu with bleeding from mouth, nose, and ears:
Ostrea Concha (Muli, 牡蛎) [left-facing, calcined red, one fen], Gypsum Fibrosum (Shigao, 石膏) [crushed and ground, one liang one fen].
The above two ingredients are pounded and sifted into powder. Each dose consists of one qianbi, taken with warm wine. Take once in the morning, at noon, and in the evening. Alternatively, make honey pills the size of Sophorae Japonicae Fructus (Wutongzi, 梧桐子). Each dose is thirty pills, taken with wine.
Laifu Wine for treating persistent Da Nu:
Raphani Fructus (Laifu, 莱菔) [radish, any amount].
One ingredient. Each dose uses one he of finely cut radish, decocted in one zhan of wine. First boil vigorously, then add the radish, boil for one or two more boils, let cool slightly, strain, and take in one go.
Yujiang San Powder for treating Da Nu:
Tritice aestivi Farina (Baifmian, 白面) [white flour, any amount].
One ingredient. Each dose consists of three qianbi, taken mixed with cold water.
Ciji Yin Drink for treating bleeding from all nine orifices:
Cirsii Japonici Herba (Ciji, 刺蓟).
One ingredient. Use one handful, squeeze out natural juice. Mix with half a zhan of wine and take in one go. If green juice is unavailable, grind the dried herb into powder, mix with cold water, and take three qianbi.
Heishen San Powder for treating persistent bleeding from nose and ears:
Rhamni Prinosae Cortex (Baici Pi, 白刺皮) [burned to ash retaining nature, half liang], Nuzhongbai (Renzhongbai, 人中白) [half qian].
The above two ingredients are finely ground into powder. Use a small amount, insufflate into the nose.
Shengdihuang Yin Drink for treating Da Nu with oral/nasal bleeding, blood rushing to chest/heart causing shortness of breath, fatigue, and heat:
Rehmanniae Radix Praeparata (Shengdihuang, 生地黄) [four liang], Scutellariae Radix (Huangqin, 黄芩) [black heart removed], Paeoniae Radix Rubra (Chishaoyao, 赤芍药), Bambusae Caulis in Taenia (Zhuru, 竹茹) [each three liang], Pteridis Spora (Puhuang, 蒲黄) [three large he], Lycii Cortex Radicis (Digupi, 地骨皮) [five liang].
The above six ingredients. Except for Puhuang, chop the others like hemp seeds. Each dose consists of five qianbi, decocted in one and a half zhan of water until reduced to eight-tenths. Strain and take warm, twice daily after meals.
Formula for treating persistent Da Nu:
Fossilia Ossis Mastodi (Longgu, 龙骨).
Grind into powder. Insufflate into the nose using a reed tube; bleeding stops immediately.