夫伤寒病衄血者。此由五脏结热所为也。心主于血。热邪伤于心。故衄血也。衄者鼻出
血也
必
汗出则寒栗而振。脉紧。发热。其身无汗。自衄者愈也。
治伤寒上焦壅热。心神烦躁。鼻衄不止。宜服黄芩散方。
黄芩（三分） 川大黄（三分锉碎微炒） 栀子仁（一分） 犀角屑（半两） 石膏（三
分） 羚
羊角屑（半两） 蓝叶（三分） 川朴硝（一两） 甘草（半两炙微赤锉）
上件药。捣筛为散。每服五钱。以水一大盏。煎至五分。去滓。不计时候温服。以瘥为
度。
治伤寒心肺热毒。鼻衄不止。或兼唾血。宜服黄连散方。
黄连〔二（三）分去须〕 黄芩（一两） 栀子仁（半两） 甘草（半两炙微赤锉） 伏
龙肝（
三分） 淡竹茹（一两）
上件药。捣筛为散。每服五钱。以水一大盏。入生姜半分。煎至五分。去滓。入生地黄
汁一合。乱发灰一钱。搅令匀。更煎三两沸。不计时候。放温频服之。以瘥为度。
治伤寒衄血及吐血。连日不绝。欲死。宜服艾叶汤方。
艾叶（半两细锉炒微黄） 生干地黄（半两） 阿胶（一分杵碎炒令黄燥为末）
上件药。都和令匀。分为二服。每服。以水一中盏。煎至五分。去滓。下赤马通汁一合
半。搅令匀。不计时候。放温频服。以瘥为度。
治伤寒衄血不止。宜服羚羊角散方。
羚羊角屑（三分） 犀角屑（二分） 牛黄（一分细研） 人参（半两去芦头） 白茯
苓（一两）
麦门冬（三分去心） 黄 （三分锉） 栀子仁（三分） 甘草（一两炙微赤锉） 紫菀
（三分去
苗土）
上件药。捣筛为散。每服五钱。以水一大盏。煎至六分。去滓。入牛黄末一字。搅令匀
。不计时候。放温频服之。以瘥为度。
治伤寒鼻衄不止。头痛壮热。宜服升麻散方。
川升麻（一两） 青蒿（半两） 犀角屑（半两） 紫苏茎叶（一两） 麦门冬（一两
去心） 川
朴硝（一两）
上件药。捣筛为散。每服四钱。以水一中盏。煎至五分。去滓。下地黄汁一合。更煎一
两沸。不计时候。温温服之。
治伤寒鼻衄不止。兼唾血。宜服刺蓟散方。
刺蓟（一两） 黄连〔二（三）分去须〕 黄芩（一两） 栀子仁（三两） 乱发灰（一
分） 紫
苏茎叶（半两） 阿胶（二两杵碎炒令黄燥） 甘草（三分炙微赤锉） 羚羊 角屑（三分）
上件药。捣粗罗为散。每服五钱。以水一大盏。煎至五分。去滓。下生地黄汁。生姜汁
。各半合。和令匀。不计时候服之。以瘥为度。
治伤寒发汗而不快。致内有蓄热。及鼻衄血不尽。内有余血者。面色黄。大便赤
。消化
生干地黄（四两） 赤芍药（一两） 牡丹（三两） 犀角屑（一两） 黄芩（一两） 茜
根（一
两）
上件药。捣筛为散。每服五钱。以水一中盏。煎至五分。去滓。不计时候温服。以瘥为
度。
治伤寒衄血数升不住者。飞雪汤方。
麻黄（三两去根节） 石膏（三两杵碎） 芫花（一两） 川大黄（二两）
上件药都锉。以水一斗半。煮取七升。放冷。披发仰卧。以淋其囟。血住即止。
治伤寒鼻衄苦参散方。
苦参（三两锉） 黄连（二两去须） 栀子仁（二七枚） 川大黄（一两锉碎微炒） 生
干地黄
（一两） 石榴花（半两微炒）
上件药。捣筛为散。每服五钱。以水一中盏。煎至五分。去滓。不计时候温服。以瘥为
度。
治伤寒鼻衄不止。心胸烦闷。宜服此蒲黄散方。
蒲黄（三分） 犀角屑（半两） 子芩（三分） 紫苏茎叶（半两） 侧柏叶（半两） 甘
草（一
分炙微赤锉）
上件药。捣粗罗为散。每服五钱。以水一大盏。煎至六分。去滓。以伏龙肝半两。水浸
。取清一合。相和令匀。不计时候。分为二服。以瘥为度。
又方。
生地黄汁（三合） 白药末（半两） 生藕汁（二合） 刺蓟汁〔二（一）合〕
上件药相和。煎三二沸。放温。不计时候。分为三服。
又方。
甘草（一两炙微赤锉） 紫苏茎叶（一两） 淡竹叶〔一两（握）〕
上件药。捣碎。以水一大盏半。煎至八分。去滓。不计时候。分为二服。以瘥为度。
治伤寒衄血不止方。
阿胶（一两杵碎炒令黄燥） 贝母（半两煨令微黄）
上件药。捣筛为散。每服。不计时候。以温水调下一钱。
又方。
赤芍药（赤马粪）（半两烧为灰） 石耳（半两） 龙骨（半两）
上件药。捣细罗为散。更研令极细。取少许吹入鼻内。未定。相续用之。
治伤寒口鼻俱出血。可及三五升。宜服此方。
乱发灰（半两） 伏龙肝〔二（一）两〕
上件药。同研令细。每服。不计时候。以新汲水调下二钱。频服。以瘥为度。
治伤寒鼻衄不止。鸡冠花散方。
鸡冠花（一两） 麝香（一分细研）
上件药。捣细罗为散。与麝香同研令匀。以生地黄汁一合。冷水半盏。搅令匀。不计时
候。调下二钱。频服。以瘥为度。
治伤寒。胸膈间有余热。衄血不止方。
牡蛎（二两烧为粉） 石膏（二两）
上件药。捣细罗为散。每服。不计时候。以生姜汤调下二钱。频服。以瘥为度。
治伤寒。气毒热盛。鼻衄不止。宜服刺蓟散方。
刺蓟（半两） 土瓜根（半两） 子芩（半两） 蜡面茶（一分） 麝香（半钱研）
上件药。捣细罗为散。入麝香研令匀。每服。不计时候。以冷蜜水调下二钱。以瘥为度。
治伤寒鼻衄。可及一斛以来。不止方。\x
黄药（一两）
上件药。捣细罗为散。每服。不计时候。以新汲水调下二钱。
In the course of cold damage disease, epistaxis occurs due to heat accumulation in the five zang organs. The Heart governs blood; when pathogenic heat injures the Heart, epistaxis results. "Nu" refers to bleeding from the nose.
If sweating inevitably occurs, it is accompanied by chills and tremors, a tight pulse, fever, and absence of sweat on the body. If epistaxis occurs spontaneously, the condition tends to resolve itself.
For upper jiao (upper burner) congestion and heat in cold damage, accompanied by mental restlessness and persistent epistaxis, Huangqin San (Scutellaria Powder) is indicated.
Ingredients: Huangqin (Radix Scutellariae) (3 fen), Chuan Dahuang (Radix et Rhizoma Rhei) (3 fen, crushed and lightly stir-fried), Zhizi Ren (Semen Gardeniae) (1 fen), Xijiao Xie (Cornu Rhinocerotis) (0.5 liang), Shigao (Gypsum Fibrosum) (3 fen), Lingyangjiao Xie (Cornu Saigae Tataricae) (0.5 liang), Lanye (Folium Isatidis) (3 fen), Chuan Puxiao (Natrii Sulfas) (1 liang), Gancao (Radix Glycyrrhizae) (0.5 liang, honey-fried until slightly reddish and crushed).
Preparation and Administration: Crush and sieve the above ingredients to make a powder. Take 5 qian per dose, decoct with one da zhen (approx. 200ml) of water until reduced to 0.5 zhen. Strain and take warm at any time. Continue until cured.
For heat-toxin in the Heart and Lungs due to cold damage, with persistent epistaxis or hemoptysis, Huanglian San (Coptis Powder) is indicated.
Ingredients: Huanglian (Rhizoma Coptidis) (2-3 fen, remove stamens), Huangqin (Radix Scutellariae) (1 liang), Zhizi Ren (Semen Gardeniae) (0.5 liang), Gancao (Radix Glycyrrhizae) (0.5 liang, honey-fried until slightly reddish and crushed), Fulonggan (Lapis Longii Preparatus) (3 fen), Danzhuru (Caulis Bambusae in Taeniam) (1 liang).
Preparation and Administration: Crush and sieve the above ingredients to make a powder. Take 5 qian per dose, decoct with one da zhen of water and 0.5 fen of Shengjiang (Rhizoma Zingiberis Recens) until reduced to 0.5 zhen. Strain, then add Shengdihuang Zhi (Jus Radicis Rehmanniae Recens) (1 he) and Luankuihui (Cinis Crinis Humani) (1 qian). Mix well and boil for two or three boils. Take frequently while warm at any time. Continue until cured.
For continuous epistaxis and hematemesis in cold damage lasting several days, approaching death, Aiyе Tang (Mugwort Decoction) is indicated.
Ingredients: Aiye (Folium Artemisiae Argyi) (0.5 liang, finely crushed and stir-fried until slightly yellow), Sheng Gan Dihuang (Radix Rehmanniae Preparata) (0.5 liang), Ejiao (Colla Corii Asini) (1 fen, crushed, stir-fried until yellow and dry, then powdered).
Preparation and Administration: Mix evenly and divide into two doses. For each dose, decoct with one zhong zhen (approx. 150ml) of water until reduced to 0.5 zhen. Strain, then add Chi Matong Zhi (Succus Stercoris Equi Rubri) (1.5 he). Mix well. Take frequently while warm at any time. Continue until cured.
For persistent epistaxis in cold damage, Lingyangjiao San (Saiga Antelope Horn Powder) is indicated.
Ingredients: Lingyangjiao Xie (Cornu Saigae Tataricae) (3 fen), Xijiao Xie (Cornu Rhinocerotis) (2 fen), Niuhuang (Calculus Bovis) (1 fen, finely ground), Renshen (Radix Ginseng) (0.5 liang, remove rhizome), Baifuling (Poria) (1 liang), Maimendong (Tuber Ophiopogonis) (3 fen, remove heart), Huangqi (Radix Astragali) (3 fen, crushed), Zhizi Ren (Semen Gardeniae) (3 fen), Gancao (Radix Glycyrrhizae) (1 liang, honey-fried until slightly reddish and crushed), Ziwan (Radix Asteris) (3 fen, remove roots and soil).
Preparation and Administration: Crush and sieve the above ingredients to make a powder. Take 5 qian per dose, decoct with one da zhen of water until reduced to 0.6 zhen. Strain, then add Niuhuang Mo (Powdered Calculus Bovis) (one zi). Mix well. Take frequently while warm at any time. Continue until cured.
For persistent epistaxis in cold damage accompanied by headache and high fever, Shengma San (Cimicifuga Powder) is indicated.
Ingredients: Chuan Shengma (Rhizoma Cimicifugae) (1 liang), Qinghao (Herba Artemisiae Annuae) (0.5 liang), Xijiao Xie (Cornu Rhinocerotis) (0.5 liang), Zisu Jingye (Folium et Caulis Perillae) (1 liang), Maimendong (Tuber Ophiopogonis) (1 liang, remove heart), Chuan Puxiao (Natrii Sulfas) (1 liang).
Preparation and Administration: Crush and sieve the above ingredients to make a powder. Take 4 qian per dose, decoct with one zhong zhen of water until reduced to 0.5 zhen. Strain, then add Dihuang Zhi (Jus Radicis Rehmanniae) (1 he). Boil for one or two boils. Take warm at any time.
For persistent epistaxis in cold damage accompanied by hemoptysis, Ciji San (Cardiocrinum/Thistle Powder) is indicated.
Ingredients: Ciji (Herba Cirsii Japonici) (1 liang), Huanglian (Rhizoma Coptidis) (2-3 fen, remove stamens), Huangqin (Radix Scutellariae) (1 liang), Zhizi Ren (Semen Gardeniae) (3 liang), Luankuihui (Cinis Crinis Humani) (1 fen), Zisu Jingye (Folium et Caulis Perillae) (0.5 liang), Ejiao (Colla Corii Asini) (2 liang, crushed, stir-fried until yellow and dry), Gancao (Radix Glycyrrhizae) (3 fen, honey-fried until slightly reddish and crushed), Lingyangjiao Xie (Cornu Saigae Tataricae) (3 fen).
Preparation and Administration: Coarsely crush and sieve the above ingredients to make a powder. Take 5 qian per dose, decoct with one da zhen of water until reduced to 0.5 zhen. Strain, then add Shengdihuang Zhi (Jus Radicis Rehmanniae Recens) and Shengjiang Zhi (Jus Rhizomatis Zingiberis Recens), 0.5 he each. Mix well. Take at any time. Continue until cured.
For cold damage where sweating was ineffective, leading to internal heat retention and incomplete resolution of epistaxis with residual blood, presenting with sallow complexion and red stool, this formula is indicated.
Ingredients: Sheng Gan Dihuang (Radix Rehmanniae Preparata) (4 liang), Chishaoyao (Radix Paeoniae Rubra) (1 liang), Mudan Pi (Cortex Moutan) (3 liang), Xijiao Xie (Cornu Rhinocerotis) (1 liang), Huangqin (Radix Scutellariae) (1 liang), Qiangen (Radix Rubiae Cordifoliae) (1 liang).
Preparation and Administration: Crush and sieve the above ingredients to make a powder. Take 5 qian per dose, decoct with one zhong zhen of water until reduced to 0.5 zhen. Strain and take warm at any time. Continue until cured.
For massive, unceasing epistaxis in cold damage, Feixue Tang (Flying Snow Decoction) is indicated.
Ingredients: Mahuang (Herba Ephedrae) (3 liang, remove root and nodes), Shigao (Gypsum Fibrosum) (3 liang, crushed), Yuanhua (Flos Genkwa) (1 liang), Chuan Dahuang (Radix et Rhizoma Rhei) (2 liang).
Preparation and Administration: Crush all ingredients. Decoct with 1.5 dou (approx. 15 liters) of water until reduced to 7 sheng (approx. 7 liters). Cool. Let the patient lie supine with hair loose, and pour the liquid over the fontanelle (top of the head). Stop once bleeding ceases.
For cold damage epistaxis, Kushen San (Sophora Powder) is indicated.
Ingredients: Kushen (Radix Sophorae Flavescentis) (3 liang, crushed), Huanglian (Rhizoma Coptidis) (2 liang, remove stamens), Zhizi Ren (Semen Gardeniae) (14 pieces), Chuan Dahuang (Radix et Rhizoma Rhei) (1 liang, crushed and lightly stir-fried), Sheng Gan Dihuang (Radix Rehmanniae Preparata) (1 liang), Shiliuhua (Flos Granati) (0.5 liang, lightly stir-fried).
Preparation and Administration: Crush and sieve the above ingredients to make a powder. Take 5 qian per dose, decoct with one zhong zhen of water until reduced to 0.5 zhen. Strain and take warm at any time. Continue until cured.
For persistent epistaxis in cold damage accompanied by chest and heart vexation, Puhuang San (Typha Pollen Powder) is indicated.
Ingredients: Puhuang (Pollen Typhae) (3 fen), Xijiao Xie (Cornu Rhinocerotis) (0.5 liang), Ziqin (Radix Scutellariae) (3 fen), Zisu Jingye (Folium et Caulis Perillae) (0.5 liang), Ce Baiye (Folium Platycladi) (0.5 liang), Gancao (Radix Glycyrrhizae) (1 fen, honey-fried until slightly reddish and crushed).
Preparation and Administration: Coarsely crush and sieve the above ingredients to make a powder. Take 5 qian per dose, decoct with one da zhen of water until reduced to 0.6 zhen. Strain. Soak 0.5 liang of Fulonggan (Lapis Longii Preparatus) in water, extract 1 he of clear liquid, and mix with the decoction. Divide into two doses and take at any time. Continue until cured.
Another prescription.
Ingredients: Shengdihuang Zhi (Jus Radicis Rehmanniae Recens) (3 he), Baiyao Mo (Powdered White Medicine) (0.5 liang), Sheng Ou Zhi (Jus Rhizomatis Nelumbinis) (2 he), Ciji Zhi (Jus Herbae Cirsii Japonici) (1-2 he).
Preparation and Administration: Mix ingredients and boil for two or three boils. Take warm at any time, divided into three doses.
Another prescription.
Ingredients: Gancao (Radix Glycyrrhizae) (1 liang, honey-fried until slightly reddish and crushed), Zisu Jingye (Folium et Caulis Perillae) (1 liang), Danzhuye (Folium Bambusae) (1 liang).
Preparation and Administration: Crush ingredients. Decoct with 1.5 da zhen of water until reduced to 0.8 zhen. Strain. Divide into two doses and take at any time. Continue until cured.
Formula for persistent epistaxis in cold damage.
Ingredients: Ejiao (Colla Corii Asini) (1 liang, crushed, stir-fried until yellow and dry), Beimu (Bulbus Fritillariae Cirrhosae) (0.5 liang, baked until slightly yellow).
Preparation and Administration: Crush and sieve to make a powder. Take 1 qian per dose, mixed with warm water, at any time.
Another prescription.
Ingredients: Chishaoyao (Radix Paeoniae Rubra) (burned with red horse manure to ash) (0.5 liang), Shi'er (Lichen Umbilicaria) (0.5 liang), Longgu (Os Mastodi seu Femoris) (0.5 liang).
Preparation and Administration: Finely grind and sieve to make a powder, then grind extremely fine. Blow a small amount into the nostrils. Repeat if necessary.
For simultaneous bleeding from mouth and nose in cold damage, up to 3-5 sheng, this formula is indicated.
Ingredients: Luankuihui (Cinis Crinis Humani) (0.5 liang), Fulonggan (Lapis Longii Preparatus) (1-2 liang).
Preparation and Administration: Grind together until fine. Take 2 qian per dose, mixed with fresh well water, at any time. Take frequently. Continue until cured.
For persistent epistaxis in cold damage, Jiguanhua San (Celosia Cristata Powder) is indicated.
Ingredients: Jiguanhua (Flos Celosiae Cristatae) (1 liang), Shexiang (Moschus) (1 fen, finely ground).
Preparation and Administration: Grind the herb into a fine powder and mix thoroughly with Shexiang. Mix with 1 he of Shengdihuang Zhi (Jus Radicis Rehmanniae Recens) and half a zhen of cold water. Take 2 qian per dose, mixed well, at any time. Take frequently. Continue until cured.
For cold damage with residual heat in the chest and diaphragm and persistent epistaxis.
Ingredients: Muli (Concha Ostreae) (2 liang, calcined to powder), Shigao (Gypsum Fibrosum) (2 liang).
Preparation and Administration: Finely grind and sieve to make a powder. Take 2 qian per dose, mixed with Shengjiang Tang (Zingiber Decoction), at any time. Take frequently. Continue until cured.
For cold damage with severe qi-toxin and heat, causing persistent epistaxis, Ciji San (Thistle Powder) is indicated.
Ingredients: Ciji (Herba Cirsii Japonici) (0.5 liang), Tuguagen (Radix Trichosanthis Kirilowii) (0.5 liang), Ziqin (Radix Scutellariae) (0.5 liang), Lamian Cha (Tea Leaves) (1 fen), Shexiang (Moschus) (0.5 qian, ground).
Preparation and Administration: Finely grind and sieve the herbs, then mix with Shexiang. Take 2 qian per dose, mixed with cold honey water, at any time. Continue until cured.
For cold damage epistaxis, with volume reaching up to one hu (approx. 10 liters), unceasing.
Ingredients: Huangyao (Yellow Medicine) (1 liang).
Preparation and Administration: Finely grind and sieve to make a powder. Take 2 qian per dose, mixed with fresh well water, at any time.