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(Nasal Diseases: Rhinorrhea, Ozena, Nasal Polyps, Nasal Ulcers, Nasal Fungus/Erosion, Nasal Pain, Erythema of the Nose, Purplish-Black Discoloration of the Nose)

The Classics state: The Lung opens into the nose. Lung Qi communicates with the nose. When Lung Qi is harmonious, the nose can distinguish odors. The five odors enter the nasal cavity and are governed by the Heart and Lung. If there is pathology in the Heart or Lung, olfaction becomes impaired. In the Five Elements, the West corresponds to White, its energy connects to the Lung, it opens into the nose, and stores essence within the Lung. The Lung governs smell; in the Zang organs, it is the Lung; in the sensory orifices, it is the nose.

The Foot-Yangming Stomach Meridian runs alongside the nose and connects to the eyes. If Heat from the Gallbladder transfers to the Brain, it leads to Bi Yuan (Nasal Sinusitis/Ozena), characterized by nasal congestion and turbid discharge.

The Classics also say: Zong Qi (Pectoral Qi) travels to the nose to produce the sense of smell. Zong Qi is the ascending and transforming Qi generated by the Spleen and Stomach. Due to irregular diet or overexertion damaging the Spleen and Stomach, the transporting Qi fails to ascend, allowing Pathogenic factors to block the orifices. Consequently, the nose becomes obstructed and unable to perceive sweet and foul odors. Li Ze Tong Qi Tang (Leeze Qi-Opening Decoction). During cold months, dispersing methods must be used. One may add Ephedrae Herba (Mahuang) and Asari Radix (Xixin) to Shengma Tang (Cimicifugae Decoction). In spring and summer, Scallion White (Congbai) and Angelica Dahurica Root (Baizhi) may be used, assisted with Scorched Scutellaria Root (Kuhuang) and Perilla Leaf (Zuye). Adding large amounts of Platycodon Root (Jiegeng) as a guiding agent may lead to success. After dispersing treatment, if nasal obstruction is not fully resolved, and the pulse is surging and forceful with dry mouth and dry nose, use Acrid-Cool herbs to clear heat, such as Wine-fried Scutellaria Root (Jiu Huangqin), Gardenia Fruit (Zhizi), and Mint (Bohe). Still assist with Schizonepeta Spike (Jingjie), Saposhnikovia Root (Fangfeng), Cimicifuga Rhizome (Shengma), and Angelica Dahurica Root (Baizhi). Do not abruptly use Cold-Cooling herbs. Danxi stated: The nose is the orifice of the Lung. Disease in the Lung causes nasal dysfunction. There are Cold and Heat patterns. Sudden onset is usually Cold; long-standing stagnation transforms into Heat. Cold injures the skin and hair, causing Qi obstruction and congestion; Heat congests the Clear Orifices, preventing Qi circulation. First, disperse the exterior with Scallion White, Angelica Dahurica Root, Fermented Soybean (Chidouchi), Notopterygium Rhizome (Qianghuo), Saposhnikovia Root (Fangfeng), Perilla Leaf (Zisu), Asari Radix (Xixin), and Magnolia Flower (Xinyi). Later, clear fire with Wine-fried Scutellaria Root, Coptis Rhizome (Lian), Ginger-processed Blackened Gardenia Fruit, Raw Licorice Root (Gancao), Gypsum (Shigao), Mint, and Sichuan Pepper (Chuanjiao). Self-healing will follow. Modern practitioners use Magnolia Flower (Xinyi) for nasal congestion regardless of new/old or Cold/Heat patterns. They fail to realize that if Lung and Stomach Yang Qi is deficient and cannot ascend to the brain, causing Turbid Yin to invade the Clear Yang position and cause blockage, Xinyi's Acrid-Warm and aromatic penetrating nature is indeed suitable. However, if Damp-Heat steams upward, brewing into Fire and causing blockage, only the light, floating, drying-clearing nature of Gardenia Seed (Shanzhiren) can open it. For sudden Wind-Cold blockage, severe cases use Li Ze Tong Qi Tang; mild cases use Scallion White, Fermented Soybean, Asari Radix, Notopterygium Rhizome, Mint, and Schizonepeta Spike. Treatment must be adjusted according to the severity of Cold and Heat; one must not treat indiscriminately without careful assessment. Wang Ruyan said: Nasal congestion with loss of smell, worsening in winter or triggered by slight Wind-Cold exposure, recurring frequently, is often mistaken by laypeople as Lung Cold. Using Acrid-Warm exterior-releasing and unblocking herbs is ineffective. This is actually pre-existing Fire pathogen in the Lung Meridian; severe Fire stagnation causes blockage upon Cold exposure and flare-ups upon stimulation. Treatment should focus on clearing Lung and descending Fire, assisted by unblocking agents. For chronic nasal congestion similar to usual presentations, assess the patient's constitution and treat as Lung Heat. Clear Metal, drain Fire, resolve Phlegm. Use pills held in the mouth or fine powders taken gently. Slow, long-term administration yields results. If there is no history of nasal congestion, but sudden obstruction with heavy voice or clear discharge occurs due to accidental Wind-Cold, treat as Wind-Cold. Xue Lizhai said: If the previous condition was caused by dietary irregularity or overexertion damaging the Spleen and Stomach, preventing the ascending Qi from rising and allowing pathogens to harm the orifices, resulting in poor airflow and loss of smell, it is appropriate to nourish the Spleen and Stomach so Yang Qi ascends, thereby opening the nose. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Magnolia Flower (Xinyi) and Gardenia Fruit (Zhizi).

Nasal Polyps: Lung Qi flows into the nose and nourishes the head and face. If Wind-Cold lodges in the head, Qi flow is blocked. Long-standing stagnation generates Heat, which condenses body fluids, causing thick mucus to accumulate, leading to loss of smell and forming nasal polyps. Xiong Qusan (Angelica and Ligusticum Powder). Externally, use Qianjin Chubi Fa (Thousand Golden Snuff Method) or a powder of Momordica Seed (Gua Di), Coptis Rhizome (Huanglian), and Adzuki Bean (Chixiaodou) with a little Menthol (Longnao) blown into the nose. Discharge of water clears the stagnant Fire. If ineffective, it is not Fire but Dampness. Use a powder of Momordica Seed (Gua Di), Veratrum Rhizome (Lilu), and Soap Pod (Zao Jiao) with a little Musk (Shexiang) and Menthol (Longnao) blown into the nose to remove water and dissipate Dampness.

Bí Qiú (Sneezing/Clear Rhinorrhea): Clear fluid discharges from the nose. Wind-Cold injures the skin and hair, causing pore closure. Disperse Wind and clear the Lung. Xiang Su San (Perilla and Cyperus Powder) added with Ligusticum Rhizome (Chuanxiong), Sichuan Pepper (Shujiao), Asari Radix (Xixin), Acute Cinnamon Bark (Lagui), and Chebula Fruit (Hezi). If ineffective, it is not Wind but Cold. Xinyi San (Magnolia Powder) minus Akebia Caulis (Mutong), Saposhnikovia Root (Fangfeng), and Cimicifuga Rhizome (Shengma); add Ligusticum Wallichii Rhizome (Ben), Cinnamon Twig (Guizhi), Prepared Aconite Root (Fuzi), Vitex Fruit (Manjingzi), Chebula Fruit (Hezi), and Atractylodes Macrocephala Rhizome (Baizhu). If blood and mucus discharge together, it is called Qiú Nü (Epistaxis with Rhinorrhea). Harmonize Ying and descend Fire. Danggui Neibu Jianzhong Tang (Danggui Internal Restoration and Middle-Supporting Decoction) added with Fermented Soybean (Chidouchi) and Child's Urine (Tongbian) is most rapid. Follow with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) combined with Shengmai San (Generate the Pulse Powder) for regulation. Nasal congestion, cold head, clear discharge: Use Qianjin Tongcao Xinyi Chubi Fa (Thousand Golden Tassel Magnolia Snuff Method). Nasal polyps causing obstruction: Blow Fan Shi Liliu San (Alum and Veratrum Powder) into the nose.

Bi Yuan (Ozena/Sinusitis): Turbid mucus discharges from the nose, known today as Brain Leakage. The Classics state: Heat transferring from the Gallbladder to the Brain leads to Bi Yuan, which may transmit to epistaxis and closed eyes. All are caused by latent Fire in the Yangming. Disperse with Wind-dispelling herbs. Xinyi San (Magnolia Powder) added with Xanthium Fruit (Cang Er) and Mint (Bohe). In summer, add Scutellaria Root (Huangqin) and Gypsum (Shigao). If ineffective, it is not Fire but Turbid Phlegm above the diaphragm, belonging to Damp-Heat. Shuangjie San (Double Release Powder) added with Magnolia Flower (Xinyi). Differentiate Bi Yuan and Bi Qiu by Cold and Heat. Thick, foul-smelling discharge indicates Yuan (Heat); disperse with Cooling herbs. Clear, non-foul discharge indicates Qiu (Deficiency-Cold); regulate with Acrid-Warm agents. Frequent discharge of foul yellow water, sometimes with headache, is colloquially called Kong Nao Sha (Drilling Brain Sand). Burn the lower part of Loofah Vine (Sigua Teng) near the root until charred but preserved in nature, grind to fine powder, mix with wine, and take orally for cure. For Bi Yuan and Brain Leakage, grind Raw Aconite Root (Sheng Fuzi) to powder, mix with juice from roasted scallions into a paste, apply to Yongquan (KI1) acupoint at night. Another method: Dry an intact adolescent male organ, burn it in a spouted pot, and smoke the nose through the spout. Smoke the right nostril for left leakage, and vice versa. Another method: Roast fish brain (from Large Yellow Croaker), mix with Raw Alum (Baishi) and Musk/Menthol, snuff into the nose. Another method: Roast dried white fish head until dry, grind to powder, place in a spouted pot with fire, cover tightly, and inhale the smoke through the spout. Divide into seven days of fumigation; cured when finished.

Nasal Polyps: Generated by long-standing accumulation and stagnation of Heat in the Upper Jiao, manifesting externally from internal pathology. Internally, administer Fire-clearing and Diaphragm-unblocking herbs. Modify Liangge San (Cool the Diaphragm Powder). Abstain from alcohol and rich foods. Han Shi said: For nobles with nasal polyps that are foul-smelling and painful to touch, leading to despair, blow a mixture of Alum powder, Fermented Parasitic Herb (Awei), Menthol, and Musk onto them. They dissolve into water and disappear shortly. Internally, administer Dampness-vanquishing and Lung-clearing herbs. This is caused by rich foods trapping Heat, steaming the Lung gate, like mushrooms growing after rain. Polyps and Nasal Hemorrhoids (Bi Zhi) are similar but distinct. Extreme pain without drooping indicates Polyps, caused by excess Blood Heat. Awei guides Blood stasis; Alum cleanses filth; combined with Menthol and Musk to open knots and benefit orifices. Nasal Hemorrhoids droop without pain, caused by excess Damp-Heat. Food stagnation and Hot Phlegm in the Stomach flow downward. Internally, use Pinellia Tuber (Banxia), Atractylodes Rhizome (Cangzhu), Wine-washed Scutellaria and Coptis, Medicated Leaven (Shenqu), Magnolia Flower (Xinyi), Asari Radix (Xixin), Angelica Dahurica Root (Baizhi), and Licorice Root (Gancao) to resolve Phlegm and stagnation. Externally, use胆矾 (Danfan), Calcined Alum (Kufan), Magnolia Flower (Xinyiren), Asari Radix (Xixin), and Almond (Xingren) as powder, add Menthol and Musk, mix with Male Black Dog Gallbladder or Pig Fat, wrap in cotton, insert into nose, change frequently until resolved. For ulcers in the nose, use Realgar (Xionghuang), Alum (Baifen), Momordica Seed (Gua Di), and Asari Radix (Xixin) as powder to snuff. For complete nasal obstruction, use Bitter Clove (Kudingxiang), Mother Clove (Mu Dingxiang), and Adzuki Bean (Chixiaodou) as powder to snuff. These are excellent external treatments.

Nasal Ulcers: Internally, Ganlu Yin (Sweet Dew Decoction) added with Rhino Horn (Xijiao), Coptis Chinensis Rhizome (Hulian), and Bupleurum Root (Chaihu). For deficiency, add Ginseng (Renshen). Externally, grind Phellodendron Bark (Huangbai), Sophora Root (Kushen), and Betel Nut (Binglang) to powder, mix with pig fat for application. Or grind Indigo Naturalis (Qingdai), Sophora Flower (Huaihua), Almond (Xingren), Calomel (Qingfen), and Calcined Alum (Kufan) for application.

Nasalis Fungus/Erosion: Internally, use Toosendan Root (Chungen), Scallion White (Congbai), Fermented Soybean (Douchi), and Sichuan Pepper (Chuanjiao). Boil three sheng of rice-washing water with one cup of vinegar, add a little salt, and drink. Effect seen when foul matter is discharged. Externally, burn Chinese Aconite Root (Caowu) to ash, mix equally with Musk, grind extremely fine, and apply sparingly to the ulcer.

Dry Nose without Secretions: Use Rhino Horn (Xijiao), Astragalus/Honeysuckle (context implies clearing heat/nourishing yin, likely Huangqi or similar, text says "Huang "), Akebia Caulis (Mutong), Almond (Xingren), Ophiopogon Tuber (Maidong), Honey-fried Licorice Root (Zhigancao), Cimicifuga Rhizome (Shengma), Kudzu Root (Gegen), Mulberry Bark (Sangpi), Gypsum (Shigao), and Cinnabar (Zhusha). For accumulated Heat, add Saltpeter (Yaxiao) and Rhubarb (Dahuang).

Nasal Pain: Wind and Fire stagnating upward cause pain. Initially, disperse with Cimicifuga Rhizome (Shengma), Kudzu Root (Gegen), Scallion White (Congbai), and Angelica Dahurica Root (Baizhi). For pain due to Qi channel obstruction, use Ligusticum Rhizome (Chuanxiong), Kudzu Root (Gegen), Licorice Root (Gancao), Platycodon Root (Kugeng/Gardenia context implies Platycodon here as Kugeng usually refers to Platycodon in some contexts or just bitter gourd, but standard is Platycodon/Kujie), Gardenia Fruit (Zhizi), Mint (Bohe), Ginger, Jujube, and Scallion White. If pain persists despite medication, fluctuating intensity, or accompanied by purplish-red cheeks, this is Damp-Heat and Blood Stagnation. Use Rhino Horn (Xijiao), Scrophularia Root (Xuanshen), Forsythia Fruit (Lianqiao), Gardenia Fruit (Zhizi), Moutan Bark (Danpi), Red Peony Root (Chishao), and Raw Licorice Root (Shenggancao). For Wind affecting the Lung, with withered complexion, intermittent red cheeks, dry skin, dry nasal pain, this is Deficient Wind. Decoct and take Dictamnus Root Bark (Baixianpi), Ophiopogon Tuber (Maidong), Poria (Fuling), Almond (Xingren), Mulberry Bark (Sangpi), Angelica Dahurica Root (Baizhi), Asari Radix (Xixin), and Gypsum (Shigao). If food accidentally enters the nose from behind, causing central brain pain, insert finger-sized Beef Fat or Sheep Fat into the nose to absorb the object via nasal suction. Once the fat melts, the object exits with it.

Erythema of the Nose: Colloquially known as Rosacea (Jiu Zao Bi). Caused by Blood Heat entering the nose. In frequent drinkers, pathogenic Heat steams the Lung orifice, lingering unresolved, manifesting on the nose. Even non-drinkers may have red noses if they have pre-existing Wind-Heat in the Lung. Use Loquat Leaf (Pilaye), remove hairs, decoct strongly, cool, and mix with Xiaofeng San (Dispel Wind Powder) to take after meals and before bed. Or take Xieqing Wan (Drain Green Pill). Or mix equal parts of Ginger-processed Blackened Gardenia Fruit and Almond Paste, form honey pills, and take. Also rub with white salt occasionally. External treatment: Equal parts Raw Alum (Sheng Baishi), Sulfur (Huang), and Mirabilite (Xuanmingfen) as powder, add a little Musk, and rub. Or use Sulfur, Calomel, and Almond as powder, mix with saliva before bed, and apply to the nose. Or put Sulfur inside a large radish, roast, grind, and apply. Or grind Raw Alum, place in palm with wine during face washing, rub the affected area; whiteness returns in days. Or use one liang of Sulfur, five qian each of Calomel and Alum, grind to powder. Put one bowl of distilled liquor in a flask, place medicine in silk bag, suspend in flask, immerse in hot water, simmer slowly for 1-2 hours, cool. Apply liquor daily, sediment powder at night.

Purplish-Black Discoloration of the Nose: All Yang meridians converge at the head, making the face the Yang among Yangs. The nose is central on the face, where Yangming begins, representing the purest essence. In heavy drinkers, alcohol fumes heat the face and nose, causing extreme Blood Heat. When hot Blood meets Cold, it is constrained by Yin, stagnating and failing to circulate, turning purple then black. Use two liang of Gardenia Seeds soaked in Ginger Juice and stir-fried black, two qian of Dry Ginger stir-fried black, and one liang of Forsythia Seeds. Grind to powder, make honey pills, take two and a half qian with Centella Tea (Dengxin Tang) before bed to clear Heat from Lung Blood. Jiang Yingsu treated a case of nasal obstruction, thick sticky discharge, unresponsive to drugs for three years. Pulses at both Cun positions were floating and rapid. He diagnosed Fire Stagnation. The patient asked why it differed from previous Brain Cold diagnoses. The Classics state: All Qi stagnations belong to the Lung. Yue Ren stated: Severe Lung Heat causes discharge of mucus. This is Heat stagnating Qi, blocking flow. Prescribed Shengyang Sanhuo Tang (Raise Yang and Scatter Fire Decoction). After several doses, the illness vanished.