鼻通于脑。血上溢于脑。所以从鼻而出。凡鼻衄。并茅花汤调止衄散。时进折二泔。仍
令其以麻油滴入鼻。或以萝卜汁滴入亦可。茅花白芍药对半。尤稳。
诸失血而发热甚者难治。十仅可一二全者。
有头风才发。则自衄不止。宜芎附饮。间进一字散。
有因虚致衄。此为下虚上盛。不宜过用凉剂。宜养正丹。及紫霞丹。仍佐以四物汤。芎
归汤。磨沉香服。
伤湿而衄。肾着汤。加川芎名除湿汤。
伤胃致衄者。名为酒食衄。 扑致衄者。名为折伤衄。外喜怒忧思诸气。皆能动血。以
此致
衄者。名五脏衄。上膈极热而衄者。金沸草散。去麻黄半夏。加茅花如荆芥数。或用黄芩芍
药汤。加茅花一撮。虚极者。茯苓补心汤。
饮酒过多。及食热物而衄。先用茅花汤。衄愈甚。则理中汤加干葛川芎各半钱。或止川
芎。不必干葛。或于理中汤去干姜。用干葛。或只根据本方。并芎不必加。或止用干姜甘草二味。
而衄不止。苏合香丸一丸。或以小乌沉汤一钱。白汤调下。或煎浓苏汤。独调小乌沉
汤。或
添入黑神散一钱。盐汤调下。亦得仍蓦然以水喷其面。使载惊则止。小乌沉浓苏汤调。非特
而衄。而五窍出血皆治。不因 而衄者亦治。诸窍血。皆可以水沃 。惊则血止。
曾病衄愈后。血因旧路。一月或三四衄。又有洗面而衄。日以为常。此即水不通借路
之意。
并宜止衄散。茅花煎汤调下。或四物汤。加石菖蒲阿胶蒲黄各半钱。煎熟。调火 石膏末一
匙头许。兼进养正丹。前诸证、服不效。大衄不止者。养正丹多服。仍佐以苏子降气汤。使
血随气下。
衄后头晕。四物汤。或芎归汤。十全大补汤。
伏暑而衄者。茅花汤调五苓散。伏暑吐血者。亦治。有先因衄血。衄止而变生诸证。或
寒热间作。或喘急无寐。病状不一。渐成劳惫。当于虚损诸证详之。后吐血同上治法。
The nose communicates with the brain. Blood overflows upwards to the brain, thus exiting from the nose. For any case of epistaxis (nosebleed), use Maohua Tang (Maidenhair Flower Decoction) to administer Zhizhi San (Stop Bleeding Powder). Administer Zhe Er Jiang (a rice wash preparation) frequently. Instruct the patient to drip Sesame Oil into the nostrils, or Radish Juice may also be used. Using equal parts of Maidenhair Flowers and White Peony Root is particularly stable.
For various types of blood loss accompanied by severe fever, treatment is difficult; only one or two out of ten patients may recover.
In cases where Head Wind (Headache due to wind pathogen) just begins, causing continuous epistaxis, Xiong Fu Yin (Ligusticum and Aconite Drink) is suitable, with intermittent administration of Yizi San (One-Character Powder).
For epistaxis caused by deficiency, this indicates lower deficiency and upper excess. It is inappropriate to overuse cold-natured medicines. Yangzheng Dan (Nourish Righteousness Pill) and Zixia Dan (Purple Rosy Clouds Pill) are suitable, assisted by Siwu Tang (Four Substances Decoction) and Xiong Gui Tang (Ligusticum and Angelica Decoction), taken with ground Agarwood powder.
For epistaxis caused by injury from dampness, Shenzhuo Tang (Kidney Dampness Decoction) is used; adding Chuanxiong Rhizome transforms it into Chushi Tang (Remove Dampness Decoction).
Epistaxis caused by stomach injury is named Jiushi Ni (Alcohol-Food Epistaxis); epistaxis caused by external trauma is named Zheshang Ni (Traumatic Epistaxis). Furthermore, emotions such as anger, joy, worry, and anxiety can all disturb blood qi, leading to epistaxis known as Wuzang Ni (Five Viscera Epistaxis). For epistaxis caused by extreme heat in the upper jiao (upper burner), Jinfeicao San (Boiling Herb Powder) is used, removing Ephedra Stem and Pinellia Tuber, adding Maidenhair Flowers in quantities similar to Schizonepeta Spike. Alternatively, Huangqin Shaoyao Tang (Scutellaria and White Peony Decoction) is used with a pinch of Maidenhair Flowers added. For cases of extreme deficiency, Fuling Buxin Tang (Poria Nourishing Heart Decoction) is used.
For epistaxis caused by excessive alcohol consumption or eating hot-natured foods, first use Maohua Tang. If the bleeding worsens, Lizhong Tang (Regulate the Middle Decoction) is used with added Kudzu Root and Ligusticum Rhizome, half qian each. Or use only Ligusticum Rhizome, without Kudzu Root. Or remove Dried Ginger from Lizhong Tang and use Kudzu Root instead. Or follow the original formula without adding Ligusticum Rhizome. Or use only Dried Ginger and Licorice Root. If bleeding continues, one pill of Suhe Xiang Wan (Styrax Pill) is used, or one qian of Xiao Wuchen Tang (Minor Black Stagnation Decoction) is taken with warm water. Alternatively, decoct strong Perilla Leaf Soup to take Xiao Wuchen Tang alone. Or add one qian of Heishen San (Black Divine Powder) and take it with salt water. Suddenly spraying water on the face to startle the patient will stop the bleeding. Xiao Wuchen Tang taken with strong Perilla Leaf Soup treats not only epistaxis but also bleeding from the five orifices. It also treats epistaxis not caused by fright. Bleeding from various orifices can be stopped by pouring water over the head to induce fright.
After recovering from previous epistaxis, blood may flow again through the old pathway, occurring three or four times a month. There are also cases of nosebleeds while washing the face, becoming a daily habit; this implies that when water pathways are blocked, blood takes alternative routes. All such cases should be treated with Zhizhi San, administered with Maidenhair Flower decoction. Alternatively, Siwu Tang (Four Substances Decoction) is used, adding Calamus Rhizome, Donkey-hide Gelatin, and Lygodium Spore, half qian each. After decocting, mix in approximately one spoonful of calcined Gypsum Powder, and concurrently administer Yangzheng Dan (Nourish Righteousness Pill). For the aforementioned conditions where medication is ineffective, or for massive continuous bleeding, administer large doses of Yangzheng Dan, assisted by Suzi Jiangqi Tang (Perilla Seed Descending Qi Decoction) to make blood descend with qi.
For dizziness after epistaxis, use Siwu Tang (Four Substances Decoction), or Xiong Gui Tang (Ligusticum and Angelica Decoction), or Shiquan Dabu Tang (Ten Thousand Complete Tonifying Decoction).
For epistaxis caused by latent summerheat, use Maohua Tang to administer Wuling San (Five Ingredient Powder with Poria). This also treats vomiting blood due to latent summerheat. Sometimes, after epistaxis stops, various symptoms arise: alternating chills and fever, or panting and insomnia. The clinical presentation varies, gradually developing into consumptive fatigue. These should be diagnosed and treated in detail according to deficiency-consumption syndromes. Subsequent vomiting blood is treated using the same methods as above.