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1. For epistaxis (nosebleed) presenting as the Ge Yang syndrome (floating yang due to yin deficiency), it is caused by yin deficiency in the lower jiao leading to floating of yang qi upwards. If examination reveals six pulses that are fine and minute, with no signs of heat; or if the pulse appears floating, deficient, and large/hollow, accompanied by upper heat and lower cold with continuous nosebleed, these all constitute this syndrome. Treatment should focus on tonifying the source of fire (mingmen fire) to guide fire back to its origin. The ancient formula Ba Wei Di Huang Tang (Eight-Ingredient Rehmannia Pill) is an appropriate prescription for this condition. I have also formulated Zhen Yin Jian (Yin-Securing Decoction), which yields even more rapid results. This syndrome occurs not only in internal injury diseases but also in Shang Han (Cold Damage) diseases, provided the patient has a history of excessive sexual activity or consumption that damages true yin. I once treated a young man who indulged excessively in sexual desires. Seven days after contracting Shang Han, he suddenly experienced severe epistaxis. Initially, I thought it was a sign of impending resolution. However, from morning until evening, he lost over one dou of blood. His nasal respiration and pulse were nearly imperceptible, his body was cold as ice, his eyes were fixed and staring, yet the bleeding continued incessantly, and his breathing was critical. His parents cried out for help. I urgently administered one dose of Zhen Yin Jian, after which the bleeding stopped and his body warmed up. Subsequent regulation led to his recovery. Since then, every case of this syndrome I treated responded effectively, which is truly miraculous.

2. Bleeding from the gum margins and interdental spaces is termed Chi Nu (gingival bleeding). This pathology involves the Hand-Yangming Large Intestine meridian, Foot-Yangming Stomach meridian, and Foot-Shaoyin Kidney meridian. The Hand-Yangming meridian enters the lower teeth, while the Foot-Yangming meridian enters the upper teeth. Furthermore, the Kidney governs the bones, and teeth are considered the culmination of bone tissue. Although these meridians can all cause dental diseases, bleeding originating from the vessels primarily relates to the Yangming meridians. Therefore, when Yangming fire is exuberant, symptoms such as halitosis, rotting/swollen/painful gums, or gushing bleeding without tooth mobility occur. This typically affects individuals who habitually consume rich, sweet, spicy, and hot foods, or those who drink alcohol heavily and have strong stomach qi, presenting with excess heat in the Yangming. Internal administration of Chou Xin Yin (Fire-Withdrawing Decoction) or Qing Wei San (Stomach-Clearing Powder) is indicated, along with external application of Bing Yu San (Ice-Jade Powder).

3. In cases where Yangming excess heat is severe, accompanied by constipation and impaction, and gingival bleeding persists, Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct Downward Magnolia Bark Decoction) should be used to purge the accumulation downward.

4. When kidney water is insufficient, manifesting as no bad breath, no toothache, but rather loose/unstable teeth or mild pain, with frequent bleeding from the gum margins, this indicates insecure kidney yin with occasional stirring of deficient fire. Treatment should focus on strengthening the kidney, primarily using Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) or Zuo Gui Wan (Left Restoring Pill). If there is deficiency of yang in the lower jiao causing deficient fire to float upward, Ba Wei Wan (Eight-Ingredient Pill) or Xiao An Shen Wan (Small Calming Kidney Pill) should be used.

5. For gingival bleeding caused by yin deficiency with fire, symptoms may include excessive dryness and thirst, emaciation, mental fatigue, scanty and turbid urine with a sensation of heat, or six pulses that are floating, large, and hollow. Although this presents with Yangming excess, it also involves Shaoyin insufficiency. Yu Nu Jian (Jade Woman Decoction) is the primary treatment. This decoction is most effective for yin deficiency with fire, but it is strictly indicated only for patients with frequent solid stools. If there is loose stool/diarrhea, fine pulse with aversion to cold, or absence of fire in the lower origin, the condition may be due to Ge Yang syndrome. In such cases, refer to the treatment principles for Ge Yang syndrome described in the preceding section on hematemesis.

Spontaneous bleeding from the tongue resembling threads occurs because the meridians of the Heart, Spleen, and Kidney all connect to the tongue. If fire exists in these meridians, it can cause tongue bleeding. Puhuang (Pollen Typhae) can be charred, powdered, and applied topically. Alternatively, fried Huaihua (Flos Sophorae) powder can be sprinkled. Bing Yu San (Ice-Jade Powder) is also applicable. If the fire is severe, herbal decoctions or drinks must still be used to clear the fire of the three yin meridians.