鼻为阳明之部，气血俱多之乡，冲任又附于阳明为经血之海，或邪盛于经遏热动血，或血虚于里阳旺迫血，
皆能令人血出于鼻而谓之衄，衄久不止，天癸亦致涩少，且鼻为肺窍，火刑金者必兼咳嗽而渐甚。
浮洪者邪盛于经，涩数者血虚于脏，虚数乃血为热迫，软数是血不归经。
邪盛于经者清之疏之，血虚于脏者滋之止之，血不归经补气摄血以引其归脏，血为热迫清热养血以吸其归经。
主以举轻古拜散，血热犀角地黄汤，血虚四物汤，血虚热上迫滋肝凉八味，经寒血上走白芍理阴煎，伤温黑
膏法，分解伤寒建中汤加黄 。
加味举轻古拜散
治鼻衄，脉浮数者。
荆芥（一两，炒黑） 生地（五两） 黄芩（一两） 当归（二两） 白芍（一两，炒） 丹皮（一两）
茜草（二两） 枳壳（六钱，炒黑） 甘草（六钱）
制为散，茅根汤下三钱（古方荆芥一味炒即名举轻古拜散）。
风热伤于营分致蕴热内迫而血动于经，故衄血而身热不解，天癸不调焉。黑荆疏风理血，生地壮水凉血，
黄芩清热止血，白芍敛阴和血，当归养血脉益营，丹皮平相火凉血，枳壳泻滞气以降下，茜草化滞血以止衄，生
草泻火以缓其中也。为散以散之，茅根以凉之，俾风热外解，则经气清和而营血自固，鼻衄无不上，身热无不解，
何天癸不渐调哉。风动迫血，一味黑荆亦可止。
凉八味丸
治相火鼻红脉虚尺旺者。
生地（五两） 萸肉（一两半） 泽泻（一两） 丹皮（一两半） 茯苓（一两半） 山药（三两，炒）
黄柏（一两半，盐水炒） 知母（一两半，盐水炒）
制为末蜜丸，茅花汤下三五钱。
肾水不足相火上炎而血不能藏，故鼻衄淋漓，经血渐少将成
损疾焉，生地壮水滋阴，萸肉涩精秘气，黄柏清湿热以坚肾脏，知母清燥火以益肾水，茯苓清肺气，山药壮脾阴，
丹皮平相火以凉血热，泽泻利膀胱以降浊阴，蜜丸以润燥，金茅花汤以止衄血也，使肾水充足则相火退藏而阴血
宁静，何有鼻衄淋漓经血渐少之患乎。
理阴煎
治阳虚血走，脉细数者。
熟地（五钱） 当归（三钱，醋炒） 炮姜（五分，盐水炒） 肉桂（五分，盐水炒）
水煎去渣温服。
阳虚之人脉络空虚而荣血散溢，故血得上出于鼻，天癸不能下行焉。熟地补阴以吸经血之上溢，当归养血
以归营血之乱行，肉桂盐水炒以统摄其血，炮姜盐水炒以止涩其血也。水煎温服，使血暖阳回，则阳能统血而血
不外走，何有衄血之患，天癸无不渐来矣。
The nose is the region governed by the Yangming channel, a place where both Qi and Blood are abundant. The Chong and Ren vessels attach to the Yangming channel, serving as the sea of menstrual blood. If pathogenic factors become excessive in the channels, stifling heat and disturbing blood; or if there is internal Blood deficiency with hyperactive Yang forcing blood to move recklessly, all can cause blood to flow from the nose, which is called "Nu" (epistaxis). If epistaxis persists for a long time, Tian Gui (menstrual function and reproductive essence) will also become scanty and sluggish. Moreover, the nose is the orifice of the Lung; when Fire insults Metal (Lung), it must be accompanied by coughing that gradually worsens.
A floating and surging pulse indicates pathogenic excess in the channels; a choppy and rapid pulse indicates Blood deficiency in the Zang organs; a deficient and rapid pulse indicates Blood being forced by Heat; a soft and rapid (Ruo Shu) pulse indicates Blood failing to return to its vessels.
For pathogenic excess in the channels, clear and disperse it; for Blood deficiency in the Zang organs, nourish and stop bleeding; for Blood failing to return to its vessels, tonify Qi to control Blood and guide it back to the Zang organs; for Blood being forced by Heat, clear Heat and nourish Blood to draw it back into the vessels.
The primary treatment is Ju Qing Gu Bai San (Light Lifting Ancient White Powder); for Blood Heat, use Xi Jiao Di Huang Tang (Rhino Horn Rehmannia Decoction); for Blood deficiency, use Si Wu Tang (Four Substances Decoction); for Blood deficiency with Heat pressing upward, use Zi Gan Liang Ba Wei (Nourish Liver Cool Eight Ingredients Pill); for Cold in the channels causing Blood to flow upward, use Bai Shao Li Yin Jian (White Peony Nourishing Yin Decoction); for Warm injury, use Hei Gao Fa (Black Plaster Method); for resolving Taiyang disease, use Jian Zhong Tang (Establish the Middle Decoction) plus Huang Qin (Scutellaria Root).
Modified Ju Qing Gu Bai San
Treats epistaxis with a floating and rapid pulse.
Jing Jie (Schizonepetae Spica, 1 liang, stir-fried until black), Sheng Di (Rehmanniae Radix, 5 liang), Huang Qin (Scutellariae Radix, 1 liang), Dang Gui (Angelicae Sinensis Radix, 2 liang), Bai Shao (Paeoniae Radix Alba, 1 liang, stir-fried), Dan Pi (Moutan Cortex, 1 liang), Qian Cao (Rubiae Cordifoliae Radix et Rhizoma, 2 liang), Zhi Ke (Aurantii Fructus Immaturus, 6 qian, stir-fried until black), Gan Cao (Glycyrrhizae Radix et Rhizoma, 6 qian).
Process into powder, take 3 qian with Zhu Gen Tang (Imperatae Rhizoma Decoction). (In ancient formulas, Jing Jie alone stir-fried was named Ju Qing Gu Bai San).
Wind-Heat injuring the Ying level causes latent Heat to press internally, moving Blood in the channels, thus causing epistaxis and unresolved body heat, leading to irregular Tian Gui. Black Jing Jie disperses Wind and regulates Blood; Sheng Di strengthens Water and cools Blood; Huang Qin clears Heat and stops bleeding; Bai Shao astringes Yin and harmonizes Blood; Dang Gui nourishes blood vessels and benefits Ying; Dan Pi calms Ministerial Fire and cools Blood; Zhi Ke drains stagnant Qi to direct it downward; Qian Cao transforms stagnant Blood to stop epistaxis; Gan Cao drains Fire to moderate the center. Made into powder to disperse, and Zhu Gen Tang to cool, so that Wind-Heat resolves externally, the channel Qi becomes clear and harmonious, and Ying Blood naturally consolidates. Epistaxis will not fail to heal, body heat will not fail to resolve, how could Tian Gui not gradually regulate? Even if Wind moves and forces Blood, a single dose of Black Jing Jie can also stop bleeding.
Liang Ba Wei Wan (Cool Eight Ingredients Pill)
Treats ministerial fire rising causing nasal redness, with a deficient pulse and vigorous Chi position.
Sheng Di (Rehmanniae Radix, 5 liang), Yu Rou (Corni Fructus, 1.5 liang), Ze Xie (Alismatis Rhizoma, 1 liang), Dan Pi (Moutan Cortex, 1.5 liang), Fu Ling (Poria, 1.5 liang), Shan Yao (Dioscoreae Rhizoma, 3 liang, stir-fried), Huang Bo (Phellodendri Cortex, 1.5 liang, salt-water stir-fried), Zhi Mu (Anemarrhenae Rhizoma, 1.5 liang, salt-water stir-fried).
Process into powder, make pills with honey, take 3-5 qian with Mao Hua Tang (Miscanthi Flower Decoction).
Kidney Water is insufficient, Ministerial Fire flares upward, causing Blood to fail to store, thus resulting in dripping epistaxis and gradually decreasing menstrual blood, potentially developing into a consumptive disease. Sheng Di strengthens Water and nourishes Yin; Yu Rou astringes Essence and secures Qi; Huang Bu clears Damp-Heat to strengthen the Kidneys; Zhi Mu clears Dryness-Fire to benefit Kidney Water; Fu Ling clears Lung Qi; Shan Yao strengthens Spleen Yin; Dan Pi calms Ministerial Fire to cool Blood Heat; Ze Xie promotes urination in the Bladder to descend turbid Yin; Honey pills moisten dryness; Mao Hua Tang stops epistaxis. If Kidney Water is sufficient, Ministerial Fire retreats and hides, Yin Blood becomes tranquil, what harm would there be of dripping epistaxis and gradually decreasing menstrual blood?
Li Yin Jian (Nourishing Yin Decoction)
Treats Yang deficiency causing Blood to wander, with a fine and rapid pulse.
Shu Di (Prepared Rehmanniae Radix, 5 qian), Dang Gui (Angelicae Sinensis Radix, 3 qian, vinegar-stir-fried), Pao Jiang (Prepared Zingiberis Rhizoma, 5 fen, salt-water stir-fried), Rou Gui (Cinnamomi Cortex, 5 fen, salt-water stir-fried).
Decoct in water, remove dregs, and take warm.
In individuals with Yang deficiency, collaterals are empty, and Nutritive Blood scatters and overflows, thus Blood flows upward from the nose, and Tian Gui cannot descend. Shu Di tonifies Yin to attract upward overflowing menstrual Blood; Dang Gui nourishes Blood to restore orderly movement of Nutritive Blood; Rou Gui stir-fried with salt water controls and directs Blood; Pao Jiang stir-fried with salt water astringes and stops Blood. Decoct in water and take warm, so that Blood warms and Yang returns, then Yang can control Blood and Blood does not flow outward. What harm would there be of epistaxis? Tian Gui will undoubtedly come gradually.