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The nose is the orifice of the Lung, also called Tianping (Heavenly Nostril), and is the pathway of Zongqi (Gathering Qi), serving as the gateway for the Heart and Lung. Therefore, the classics state: "When the Heart and Lung are diseased, the nose becomes obstructed." However, the meridians passing through the nose primarily belong to the Yangming channel. From the Shangen point (Mountain Root) upwards, it connects with the Taiyang channel and the Du vessel, communicating with the brain. Thus, diseases of these meridians can all affect the nose. If pathological changes occur in the nose, obstruction is called Qiu (rhinorrhea with nasal congestion); frequent discharge of turbid mucus with a foul odor is called Biyuan (nasal sinusitis), also known as Naolou (brain leakage); growths obstructing the airway are called Nasal Polyps; and conditions such as sneezing, epistaxis, rhinophyma, and erythema of the nose should each be differentiated and treated accordingly. In summary, nasal diseases are none other than either external contraction of Wind-Cold or internal flaming-up of Fire. For external contractions, treatment should employ Acrid-Dispersing methods; for internal heat, Cooling methods are appropriate. Understanding these two principles encompasses the general outline for treating nasal diseases.

1. There are two types of nasal congestion: When caused by Wind-Cold, cold closes the interstices (Couli), causing meridian obstruction leading to frequent nasal congestion and sneezing. This pattern mostly involves the Taiyang channel and should resolve spontaneously with Acrid-Dispersing and Exterior-Releasing methods. Formulas such as Chuanxiong San, Shenyu San, and herbs like Ephedrae Herba (Mahuang), Perillae Folium (Zisu), Schizonepetae Spica (Jingjie), and Allii Fistulosi Bulbus (Congbai) may be selected. If caused by Fire pathogen flaming upward, only Clearing Fire is suitable. Mild fire, often located in the Upper Jiao originating from the Heart and Lung, is treated with Qinghua Yin or Huangqin Zhimu Tang. Severe fire, often arising from the Yangming channel, possibly accompanied by mild headache, is treated with Zhuye Shigao Tang or Liangge San. If Wind-Cold is combined with Fire, Fangfeng Tongsheng San may also be used. Generally, chronic congestion is mostly due to Fire, while sudden congestion is mostly due to Wind-Cold; differentiation should be based on this.

2. Excessive nasal discharge is mostly due to Fire, hence it is said: "Severe Lung Heat causes nasal discharge." By analogy, excessive tearing and salivation without cause also mostly belong to Fire of the Liver and Spleen, being of the same category.

3. The Biyuan (Nasal Sinusitis) pattern is generally caused by Fire of the Taiyang channel and Du vessel. Severe cases extend upward to the brain, causing continuous dripping, hence the name Naolou (Brain Leakage). This condition often results from indulgence in alcohol and rich/greasy foods, long-term consumption of hot-natured substances, or Fire constrained by Cold, leading to Damp-Heat steaming upward. Body fluids overflow and drip down, leaving the vessels and becoming putrefied, resulting in odors ranging from slight to unbearable. Liu Hejian treated this with Fangfeng Tongsheng San (1 liang) plus Bohe (2 qian) and Huanglian (2 qian). Ancient methods used Can'er San. However, in my view, since this is Fire flaming upward, using Acrid-Dispersing methods in treatment is inappropriate, which is why efficacy is often poor. It is better to solely clear Deficient Fire while simultaneously nourishing Yin, allowing natural recovery over time. This follows the principle of "Suppressing what is high." I commonly use Qinghua Yin added with Tribuli Fructus (Baijili, 5 qian or 1 liang) and Xanthii Fructus (Cangerzi, 2-3 qian). If the Fire is severe, Cooling formulas are modified and used, often achieving full recovery. Alternatively, the intent of Fangfeng Tang from *Xuanming Lun* may be adopted. Once this condition appears, one must immediately observe dietary restrictions and treat early; if prolonged, it becomes difficult to manage. Although Biyuan/Naolou is a Heat pattern, if discharge persists for a long time, even after the Fire pathogen is eliminated, discharge may continue because the fluid pathways fail to close securely. Thus, new-onset cases are mostly due to Heat, but chronic cases are not necessarily entirely Heat patterns; careful examination is required. Adhering rigidly to Cold/Cooling drugs may induce other diseases. If leakage is excessive, damaging the Sea of Marrow, Qi deficiency occurs in the upper body, manifesting as dull headache and dizziness/restlessness. This requires tonifying Yang, treated with Shiquan Dabu Tang or Buzhong Yiqi Tang. Additionally, a secret formula for Brain Leakage in *Yixue Zhengzhuan* can be consulted.

4. Nasal Polyps block the clear passages. Although the nose is the orifice of the Lung, the obstruction and harm are diseases of the meridians and muscles, actually caused by stagnation and accumulation of Yangming Heat. Internal treatment should focus on Clearing Fire and Qi; external treatment should utilize Huangbai San, or the Xionghuang San from the *Qianjin* Polyp Removal Formula, or similar formulas from the *Jianyi* text.

5. Rhinophyma (Alcoholic Red Nose) is mostly caused by individuals fond of alcohol, where Damp-Heat attacks the Lung, steaming the face and nose, resulting from Blood Heat. Alternatively, it may arise from pre-existing Wind-Heat in the Lung channel, leading to red-black complexion and boils. Internal treatment should Cool the Blood and Clear Fire; external treatment should use Liuhuang San or Baifan San.

6. Epistaxis (Nosebleed) is detailed in the Chapter on Blood Disorders.