【歌】鼻窍应知与肺通，鼻 血热准头红。鼻疮鼻痔皆
因热，热结从教发鼻痈。鼽衄根据经从火治，鼻渊浊涕脑流空。鼻中 肉能填窍，鼻塞风寒与热攻。
【论】夫鼻为肺之窍，所以司嗅也。鼻 ，赤鼻也，由饮酒血热熏肺，外遇风寒，血凝不散而赤色。亦有
不饮自赤者，肺风血热故也。鼻疮、鼻痔、鼻痈者，皆肺热所致，但有浅深之不同。日久不已，结成 肉，
如枣塞滞鼻中，气息不通，不知香臭。丹溪云∶胃中有食积热痰流注，故浊气凝结而生 肉也。鼽者，鼻流清
水也。衄者，鼻流血也。《原病式》云∶皆以为属少阴君火之病。鼻渊者，浊涕流下不止，如彼水泉。《内
经》云∶胆移热于脑，则辛 鼻渊，传为衄蔑瞑目，故得之气厥也。鼻塞者，有外伤风寒鼻塞流涕者；有风热
壅盛郁于肺而鼻塞声重者。凡此之类，皆鼻病也，故并及之。
【脉】右寸洪数，鼻衄鼻 。左寸浮缓，鼻涕风邪。
鼻塞
鼻塞外感证及内火炽盛证。（俱详伤风条下。）鼻塞不闻香臭，通草膏主之。
通草膏
治鼻塞。
通草（一钱） 附子（炮，一钱） 细辛（一钱）
蜜丸，绵裹塞鼻。
鼻疮痈
鼻中生疮，辛夷为末，入麝香、冰片少许，绵裹塞鼻中，或枇杷叶拭去毛煎汤调消风散（方见咳嗽。）服。
鼻痈有 肉，不闻香臭，通草膏。（见前。）鼻痔，以瓜蒂甘遂丸塞之。
瓜蒂甘遂丸
瓜蒂（二钱） 甘遂（二钱） 枯白矾（二钱五分） 螺青（二钱五分） 草
乌（二钱五分）
末之，芝麻油搜合，硬不可烂，旋丸，纳鼻孔中，到痔上，其痔化为臭水，皆烂下。
鼻鼽衄
鼻鼽者，鼻中流水不止，千金细辛膏。肺热鼻塞流清水，抑金散。鼻衄证。（详见血证衄血条下。）
千金细辛膏
黑附子（炮，去皮、脐，一钱五分） 川椒（去目，炒，一钱五分） 川芎（一钱五分） 细辛（一钱
五分） 干姜（一钱五分） 吴茱萸（一钱五分） 桂心（三钱五分） 皂角（一钱二分）
用猪脂二两煎油，先一宿用米醋浸药，取入猪油内同煎，以附子色黄为度，用绵蘸药塞鼻中。
抑金散
治肺热鼻塞。
细辛（八分） 白芷（八分） 防风（去芦，八分） 羌活（去芦，八分） 当归（一钱） 半夏（八分，
姜制） 川芎 （八分） 桔梗（去芦，八分） 陈皮（七分） 茯苓（去皮，八分）
加薄荷、姜煎服。
鼻渊 肉
鼻渊不止，辛夷荆芥散。鼻流浊涕不止者，苍耳散、防风散或防风通圣散。（方见中风。）鼻中 肉，
由胃中食积热痰流注者，蝴蝶散纳鼻中，或用轻黄散 鼻中。
辛夷荆芥散
辛夷（一钱） 荆芥（八分） 黄芩（酒炒，八分） 神曲（炒，七分） 南星（八分，姜制） 半夏（八分，
姜制） 苍术（米泔浸，炒，八分） 白芷（八分）
锉一剂，水二盏，煎至八分，食后温服。
苍耳散
苍耳根茎苗子烧灰，醋泥调涂极效。
防风散
治鼻渊。
防风（去芦，三两） 黄芩（二两） 麦门冬（去心二两） 人参（去芦，二两） 甘草（炙，二两） 川
芎（二两）
末之，每服二钱。
蝴蝶散
去鼻中 肉。
蝴蝶（一味，不拘多寡 ）
绵裹一字，纳入鼻中。
轻黄散
治鼻臭、 肉。
杏仁（去皮，一钱） 轻粉（一钱） 雄黄（五分） 麝香（少许）
研细末，临卧时以箸点一米许于内。
鼻
鼻 ，四物加酒芩、酒 煎，调炒五灵脂末服。（方见血证。）
[Verse]
The nasal orifice is known to connect with the Lung; red nose (Chibi) indicates blood-heat and a reddish tip of the nose. Nasal sores (Bichuang) and nasal polyps (Bingzhi) are all caused by heat; when heat accumulates, it gives rise to nasal carbuncle (Biyong). Rhinorrhea (Qiu) and epistaxis (Nü) should be treated according to the meridians based on fire syndromes. Biyuan presents as continuous flow of turbid discharge, resembling fluid flowing from an empty cavity in the brain. Polyps growing in the nose can fill the orifice; nasal congestion (Bisai) is attacked by wind-cold or heat.
[Discussion]
The nose is the orifice of the Lung, thus governing the sense of smell. "Red nose" refers to erythema of the nose, caused by blood-heat steaming the Lung due to alcohol consumption, combined with external wind-cold, leading to blood coagulation that does not dissipate, resulting in redness. There are also cases where redness occurs without drinking, which is due to Lung wind and blood-heat. Nasal sores, nasal polyps, and nasal carbuncles are all caused by Lung heat, differing only in depth. If prolonged, they form polyps like dates blocking the nasal cavity, obstructing airflow and causing loss of olfaction. Danxi stated: Food stagnation and phlegm-heat in the Stomach flow downward, causing turbid qi to condense and generate polyps. "Qiu" refers to clear fluid dripping from the nose. "Nü" refers to bleeding from the nose. *Yuan Bing Shi* states: These are considered diseases of the Shaoyin Ministerial Fire. Biyuan involves continuous flow of turbid discharge, like a spring. The *Neijing* states: When Gallbladder heat transfers to the Brain, it causes nasal pungency and Biyuan, transmitting into Nü, dimness, and blindness; thus, it arises from Qi reversal. Nasal congestion includes cases of external wind-cold causing congestion and runny nose; and cases of wind-heat excess stagnating in the Lung causing congestion and heavy voice. All these are nasal diseases, hence discussed together.
[Pulse Diagnosis]
Right Cun pulse is surging and rapid, indicating Epistaxis and Red Nose. Left Cun pulse is floating and moderate, indicating nasal discharge and Wind pathogen causing Nasal Congestion.
**Nasal Congestion**
External contraction syndromes and excessive internal fire syndromes of nasal congestion. (See details under Wind-Cold Common Cold section.) For nasal congestion with loss of smell, use Tongcao Gao.
**Tongcao Gao**
Treats nasal congestion.
Tongcao (1 qian), Fuzi (processed, 1 qian), Xixin (1 qian).
Make honey pills, wrap in cotton, and insert into the nose.
**Nasal Sores and Carbuncles**
For sores in the nose, powder Xinyi, add a small amount of Shexiang and Bingpian, wrap in cotton, and insert into the nose. Alternatively, decoit Pipaye after removing hairs, mix with Xiaofeng San (see Cough section), and take orally.
For nasal carbuncles with polyps and loss of smell, use Tongcao Gao (see above). For nasal polyps, insert Goudi Gansui Wan.
**Goudi Gansui Wan**
Goudi (2 qian), Gansui (2 qian), Ku Baifan (2.5 qian), Luoqing (2.5 qian), Caowu (2.5 qian).
Grind into powder, knead with Sesame Oil until firm but not rotting, form into pills, insert into the nostril until reaching the polyp. The polyp will transform into foul-smelling water and slough off completely.
**Nasal Rhinorrhea and Epistaxis**
For nasal rhinorrhea with continuous clear fluid, use Qianjin Xixin Gao. For Lung heat causing nasal congestion with clear fluid, use Yijin San. Epistaxis syndrome. (See details under Blood Syndrome Epistaxis section.)
**Qianjin Xixin Gao**
Hei Fuzi (processed, peeled, navel removed, 1.5 qian), Chuanjiao (de-eyed, fried, 1.5 qian), Chuanxiong (1.5 qian), Xixin (1.5 qian), Ganjiang (1.5 qian), Wuzhuyu (1.5 qian), Guixin (3.5 qian), Zaojiao (1.2 qian).
Fry pig lard (2 liang) to extract oil. Soak herbs in rice vinegar overnight beforehand. Add to pig oil and fry together until Fuzi turns yellow. Dip cotton in the medicine and insert into the nose.
**Yijin San**
Treats Lung heat nasal congestion.
Xixin (0.8 fen), Baizhi (0.8 fen), Fangfeng (de-rhizome, 0.8 fen), Qianghuo (de-rhizome, 0.8 fen), Danggui (1 qian), Banxia (0.8 fen, ginger-processed), Chuanxiong (0.8 fen), Jiegeng (de-rhizome, 0.8 fen), Chenpi (0.7 fen), Fuling (peeled, 0.8 fen).
Add Bohe and Jiang, decoct, and take orally.
**Biyuan and Polyps**
For persistent Biyuan, use Xinyi Jingjie San. For continuous turbid nasal discharge, use Cang'er San, Fangfeng San, or Fangfeng Tongsheng San. (See Stroke section for formulas.) For nasal polyps caused by food stagnation and phlegm-heat flowing from the Stomach, use Hudie San inserted into the nose, or apply Qinghuang San to the nose.
**Xinyi Jingjie San**
Xinyi (1 qian), Jingjie (0.8 fen), Huangqin (wine-fried, 0.8 fen), Shenqu (fried, 0.7 fen), Nanxing (0.8 fen, ginger-processed), Banxia (0.8 fen, ginger-processed), Cangzhu (soaked in rice wash water, fried, 0.8 fen), Baizhi (0.8 fen).
Cut into pieces for one dose, decoct in two zhan of water until reduced to 0.8 zhan, take warm after meals.
**Cang'er San**
Burn roots, stems, leaves, and seeds of Cang'er to ash, mix with vinegar mud, and apply topically; highly effective.
**Fangfeng San**
Treats Biyuan.
Fangfeng (de-rhizome, 3 liang), Huangqin (2 liang), Maidong (de-heart, 2 liang), Renshen (de-rhizome, 2 liang), Gancao (roasted, 2 liang), Chuanxiong (2 liang).
Grind into powder, take 2 qian per dose.
**Hudie San**
Removes nasal polyps.
Hudie (single herb, quantity unrestricted).
Wrap in cotton equivalent to one zi, insert into the nose.
**Qinghuang San**
Treats nasal odor and polyps.
Xingren (peeled, 1 qian), Qingfen (1 qian), Xionghuang (0.5 qian), Shexiang (a little).
Grind into fine powder. Before sleep, use a chopstick to place a grain-sized amount inside the nose.
**Epistaxis**
For epistaxis, use Siwu Tang plus Jiuhuangqin and Jiuhuanglian decocted, mixed with Chao Wulingzhi powder and taken orally. (See Blood Syndrome section.)