衄而不止，脉大者逆。《灵枢》脉至而搏，血衄身热者死。《素问》病若吐衄，脉当沉细，反浮大而牢者
死。《难经》脉得诸涩濡弱，为亡血。《脉经》脉浮大数，为邪伏于经，宜发汗。大为虚，为脾虚不能统血，
宜补气，小而数，为阴虚火乘，宜滋肾。弦涩为瘀积，宜行滞。凡衄之脉，数实坚劲，或急疾不调，皆难治。
久衄脉虚大，头额痛，鼻流淡黄水者死。
〔清降〕生地黄饮子 生地 熟地 杞子 阿胶 白芍 天冬 侧柏叶 地骨皮 黄芩 各等分，水煎。
〔清降〕茜根散 茜根 阿胶 黄芩 侧柏叶 生地（各一两） 甘草（五钱）
〔温摄〕理中汤 见一卷中风。
〔温摄〕黑神散 见本卷血。
〔凉泻〕犀角地黄汤 见一卷温。
〔凉泻〕七汁饮 韭汁 藕汁 鲜荷叶汁 京墨汁 侧柏叶
汁生地汁 童便各一杯，和匀服。
〔滋养〕止衄散 黄 （六钱） 当归 赤苓 白芍 生地 阿胶（各三钱） 为末，麦冬汤调服。
〔益肺〕生脉散 参 麦 五味
〔风寒〕麻黄汤 麻 杏 桂 草
〔风寒〕桂枝汤 桂 芍 草 姜 枣
〔伤脾〕归脾汤 见本卷劳瘵。
〔气虚〕补中益气汤 见一卷中风。
〔气血〕当归补血汤 炙 （一两） 当归（二钱）
〔喘逆〕都气丸 见一卷火。
〔补火〕八味丸 见一卷中风。
〔补火〕镇阴煎 熟地（一两） 牛膝（二钱） 泽泻（一钱五分） 炙草 桂心（各一钱） 制附子（七分）
水煎冷服。
〔阴虚〕六味丸 见一卷中风。
〔调营〕养营汤 见本卷劳瘵。
〔酒沸〕四生丸 生艾叶 生荷叶 生侧柏叶 生地黄 捣丸如鸡子大，水煎，去渣服。
〔伤中〕保元汤 见一卷火。
〔虚寒〕千金当归汤 当归（一钱） 炮姜（五分） 白芍 阿胶 黄芩（各一钱半）
〔病后〕石膏牡蛎汤 石膏（五钱） 牡蛎（一两） 研末酒服，日三次。
〔停瘀〕加味犀角地黄汤 地 芍 丹 犀角 再加 归 桔 陈 草 红花 藕汁
〔降火〕玉女煎 见一卷温。
〔降气〕苏子降气汤 见本卷失音。
〔外治〕单方 以大蒜头捣如泥，作饼如钱大，贴足心，左衄贴右，右衄贴左，两孔俱衄，左右俱贴，
即止。
单方 用线扎中指中节，左孔衄扎左中指，右孔衄扎右中指，两孔俱衄两指俱扎。
单方 黑山栀 牡蛎 龙骨 京墨 百草霜 血余
炭等分为末，用茅花水蘸药末入鼻孔，立止。
单方 用湿纸搭额上立止。
〔耳衄〕柴胡清肝散 小柴胡汤去半夏、枣、姜，加 栀子、川芎、连翘、桔梗。
〔眼衄〕滋阴地黄丸 二地 芩 连 参 草 归 五味 柴枳 天冬 地骨皮 蜜丸，茶下。
〔眼衄〕驻景丸 杞子 车前子（各二两） 熟地（五两） 菟丝子（八两） 蜜丸，酒下。
〔齿衄〕甘露饮 二地 二冬 石斛 茵陈 黄芩 枳壳 枇杷叶 甘草
〔齿衄〕清胃散 生地（四钱） 升麻（钱半） 丹皮（五钱） 当归 川连（各三钱） 为末，分三服。
〔外敷〕冰玉散 硼砂 元明粉（各五钱） 辰砂（六分）
〔便秘〕调胃承气汤 大黄 芒硝 炙草
〔风肿〕消风散 见本卷失音。
〔肾虚〕七味丸 六味丸加桂心。
〔阳虚〕安肾丸 便制香附（二两） 炮川乌 川椒（各一两） 青盐炒 小茴香（三两） 熟地（四两）
川楝子（三钱） 酒糊丸。
〔舌衄〕黄 六一散 黄 （六两） 甘草（一两）
〔舌衄〕涂舌丹 乌贼骨 蒲黄 等分研末，涂舌上。
〔肌衄〕当归六黄汤 当归 黄 生地 熟地（各一钱） 黄芩 黄连 黄柏（各五分）
〔肌衄〕黄 建中汤 桂 芍 草 姜 枣 饴糖
〔红汗〕妙香散 人参 黄 远志 茯苓 茯神（各一两） 桔梗（三钱） 甘草（二钱） 木香（钱半）
麝香（一钱） 辰砂（二钱）
〔九窍〕侧柏散 侧柏叶（蒸干二两半） 荆芥炭 人参（各一两） 每末三钱，入白面三钱调服。
〔九窍〕犀角汤 犀角汁 黄连 荆芥炭 小蓟（各一钱） 生龙骨（八分） 黄芩（钱半）
〔遍身〕五花汤 水芦花 红蓼花 槐花 茅花 白鸡冠花 人参 等分，水煎，入侧柏汁和服。
〔血溢〕黄连泻心汤 大黄 黄连
〔血溢〕十全大补汤 见一卷中风。
Epistaxis that does not stop, with a large pulse, indicates an adverse prognosis. *Ling Shu* states: If the pulse is forceful and bounding, accompanied by epistaxis and fever, death ensues. *Su Wen* states: In cases of vomiting or epistaxis, the pulse should be deep and fine; if it is instead floating, large, and firm, death ensues. *Nan Jing* states: Pulses presenting as various forms of choppy, soggy, or weak indicate blood loss. *Mai Jing* states: A floating, large, and rapid pulse indicates pathogenic factors lodged in the meridians, suitable for diaphoresis (sweating therapy). A large pulse indicates deficiency, specifically Spleen Qi deficiency failing to control blood, suitable for tonifying Qi; a small and rapid pulse indicates Yin deficiency with Fire hyperactivity, suitable for nourishing Kidney Yin. A wiry and choppy pulse indicates blood stasis accumulation, suitable for promoting stagnation resolution. Generally, for epistaxis, pulses that are rapid, excess, firm, and strong, or hurried and irregular, are difficult to treat. Chronic epistaxis with a deficient and large pulse, accompanied by headache in the forehead, and pale yellow fluid flowing from the nose, indicates a fatal prognosis.
[Clearing and Descending] Shengdi Huang Yin Zi (Rehmannia Decoction): Sheng Di Huang (Radix Rehmanniae Preparata), Shu Di Huang (Radix Rehmanniae Preparata), Gou Qi Zi (Fructus Lycii), E Jiao (Colla Corii Asini), Bai Shao (Radix Paeoniae Alba), Tian Dong (Rhizoma Asparagi), Ce Bai Ye (Cacumen Platycladi), Di Gu Pi (Cortex Lycii), Huang Qin (Radix Scutellariae), equal parts, decocted in water.
[Clearing and Descending] Qian Gen San (Qian Cao Powder): Qian Gen (Radix Rubiae Cordifoliae), E Jiao (Colla Corii Asini), Huang Qin (Radix Scutellariae), Ce Bai Ye (Cacumen Platycladi), Sheng Di Huang (Radix Rehmanniae Preparata) [each 1 liang], Gan Cao (Radix Glycyrrhizae Uralensis) [5 qian].
[Warming and Astringing] Lizhong Tang (Regulate the Middle Decoction): See Volume 1, Stroke Chapter.
[Warming and Astringing] Hei Shen San (Black Divine Powder): See this volume, Blood Chapter.
[Cooling and Purging] Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction): See Volume 1, Warm Disease Chapter.
[Cooling and Purging] Qi Zhi Yin (Seven Juices Drink): Jiu Zhi (Juice of Allium tuberosum), Ou Zhi (Juice of Rhizoma Nelumbinis), Xian He Ye Zhi (Juice of Fresh Folium Nelumbinis), Jing Mo Zhi (Juice of Beijing Ink), Ce Bai Ye Zhi (Juice of Cacumen Platycladi), Sheng Di Huang Zhi (Juice of Radix Rehmanniae Preparata), Tong Bian (Child's Urine), each one cup, mixed evenly and taken.
[Nourishing] Zhi Nu San (Stop Epistaxis Powder): Huang Qi (Radix Astragali Membranacei) [6 qian], Dang Gui (Radix Angelicae Sinensis), Chi Ling (Poria Cum Radio), Bai Shao (Radix Paeoniae Alba), Sheng Di Huang (Radix Rehmanniae Preparata), E Jiao (Colla Corii Asini) [each 3 qian], powdered, taken with Mai Dong Tang (Asparagus Decoction).
[Benefiting Lung] Sheng Mai San (Generate Pulse Powder): Ren Shen (Radix Ginseng), Mai Dong (Rhizoma Asparagi), Wu Wei Zi (Fructus Schisandrae Chinensis).
[Wind-Cold] Ma Huang Tang (Ephedra Decoction): Ma Huang (Herba Ephedrae), Xing Ren (Semen Armeniacae Amarum), Gui Zhi (Ramulus Cinnamomi), Gan Cao (Radix Glycyrrhizae Uralensis).
[Wind-Cold] Gui Zhi Tang (Cinnamon Twig Decoction): Gui Zhi (Ramulus Cinnamomi), Shao Yao (Radix Paeoniae Alba), Gan Cao (Radix Glycyrrhizae Uralensis), Sheng Jiang (Rhizoma Zingiberis Recens), Da Zao (Fructus Jujubae).
[Spleen Injury] Gui Pi Tang (Restore the Spleen Decoction): See this volume, Consumption Chapter.
[Qi Deficiency] Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction): See Volume 1, Stroke Chapter.
[Blood and Qi Deficiency] Dang Gui Bu Xue Tang (Angelica Tonifying Blood Decoction): Zhi Huang Qi (Prepared Radix Astragali Membranacei) [1 liang], Dang Gui (Radix Angelicae Sinensis) [2 qian].
[Asthma and Reversal] Du Qi Wan (Du Qi Pill): See Volume 1, Fire Chapter.
[Supplementing Fire] Ba Wei Wan (Eight-Ingredient Pill): See Volume 1, Stroke Chapter.
[Supplementing Fire] Zhen Yin Jian (Settling Yin Decoction): Shu Di Huang (Radix Rehmanniae Preparata) [1 liang], Niu Xi (Radix Achyranthis Bidentatae) [2 qian], Ze Xie (Rhizoma Alismatis Orientales) [1.5 qian], Zhi Gan Cao (Prepared Radix Glycyrrhizae Uralensis), Rou Gui Xin (Cortex Cinnamomi) [each 1 qian], Zhi Fu Zi (Prepared Radix Aconiti Lateralis Preparata) [7 fen], decocted in water and taken cold.
[Yin Deficiency] Liu Wei Wan (Six-Ingredient Pill): See Volume 1, Stroke Chapter.
[Regulating Ying] Yang Ying Tang (Nourish Ying Decoction): See this volume, Consumption Chapter.
[Alcohol Heat] Si Sheng Wan (Four Raw Ingredients Pill): Sheng Ai Ye (Folium Artemisiae Argyi), Sheng He Ye (Folium Nelumbinis), Sheng Ce Bai Ye (Cacumen Platycladi), Sheng Di Huang (Radix Rehmanniae Preparata), pounded into pills the size of chicken eggs, decocted in water, dregs removed, and taken.
[Middle Injury] Bao Yuan Tang (Preserve Origin Decoction): See Volume 1, Fire Chapter.
[Deficient Cold] Qian Jin Dang Gui Tang (Thousand Gold Angelica Decoction): Dang Gui (Radix Angelicae Sinensis) [1 qian], Pao Jiang (Prepared Rhizoma Zingiberis) [5 fen], Bai Shao (Radix Paeoniae Alba), E Jiao (Colla Corii Asini), Huang Qin (Radix Scutellariae) [each 1.5 qian].
[Post-Illness] Shi Gao Mu Li Tang (Gypsum and Oyster Shell Decoction): Shi Gao (Gypsum Fibrosum) [5 qian], Mu Li (Concha Ostreae) [1 liang], powdered, taken with wine, three times daily.
[Stagnant Stasis] Jia Wei Xi Jiao Di Huang Tang (Modified Rhinoceros Horn and Rehmannia Decoction): Di Huang (Radix Rehmanniae), Shao Yao (Radix Paeoniae Alba), Dan Pi (Cortex Moutan), Xi Jiao (Cornu Rhinocerotis), plus Dang Gui (Radix Angelicae Sinensis), Jie Geng (Radix Platycodonis), Chen Pi (Pericarpium Citri Reticulatae), Gan Cao (Radix Glycyrrhizae Uralensis), Hong Hua (Flos Carthami), Ou Zhi (Juice of Rhizoma Nelumbinis).
[Descending Fire] Yu Nu Jian (Jade Woman Decoction): See Volume 1, Warm Disease Chapter.
[Descending Qi] Su Zi Jiang Qi Tang (Perilla Seed Descending Qi Decoction): See this volume, Aphonia Chapter.
[External Treatment] Single Prescriptions: Pound garlic cloves into paste, form into cakes the size of coins, apply to the soles of the feet; left epistaxis applied to right foot, right epistaxis applied to left foot, bilateral epistaxis applied to both feet, stops immediately.
Single Prescription: Tie a thread around the middle phalanx of the middle finger; left nasal bleeding ties left middle finger, right nasal bleeding ties right middle finger, bilateral bleeding ties both fingers.
Single Prescription: Black Gardenia Fruit (Hei Shan Zhi), Oyster Shell (Mu Li), Dragon Bone (Long Gu), Beijing Ink (Jing Mo), Hundred Grass Frost (Bai Cao Shuang), Hair Charcoal (Xue Yu Tan), equal parts powdered, dip powder in Mugwort Flower Water (Mao Hua Shui) and insert into nostrils, stops immediately.
Single Prescription: Place wet paper on the forehead, stops immediately.
[Ear Epistaxis] Chai Hu Qing Gan San (Bupleurum Clearing Liver Powder): Xiao Chai Hu Tang (Minor Bupleurum Decoction) minus Ban Xia (Rhizoma Pinelliae Preparata), Zao (Fructus Jujubae), Jiang (Rhizoma Zingiberis Recens), plus Zhi Zi (Fructus Gardeniae Jasminoidis), Chuan Xiong (Rhizoma Chuanxiong), Lian Qiao (Fructus Forsythiae Suspensae), Jie Geng (Radix Platycodonis).
[Eye Epistaxis] Zi Yin Di Huang Wan (Nourishing Yin Rehmannia Pill): Er Di (Sheng Di Huang and Shu Di Huang), Huang Qin (Radix Scutellariae), Lian Lian (Radix et Rhizoma Coptidis), Ren Shen (Radix Ginseng), Gan Cao (Radix Glycyrrhizae Uralensis), Dang Gui (Radix Angelicae Sinensis), Wu Wei Zi (Fructus Schisandrae Chinensis), Chai Hu (Radix Bupleuri), Zhi Ke (Fructus Aurantii Immaturus), Tian Dong (Rhizoma Asparagi), Di Gu Pi (Cortex Lycii), honey pills, taken with tea.
[Eye Epistaxis] Zhu Jing Wan (Residing Vision Pill): Gou Qi Zi (Fructus Lycii), Che Qian Zi (Semen Plantaginis) [each 2 liang], Shu Di Huang (Radix Rehmanniae Preparata) [5 liang], Tu Si Zi (Semen Cuscutae) [8 liang], honey pills, taken with wine.
[Dental Epistaxis] Gan Lu Yin (Sweet Dew Decoction): Er Di (Sheng Di Huang and Shu Di Huang), Er Dong (Tian Dong and Mai Dong), Shi Hu (Herba Dendrobii), Yin Chen (Herba Artemisiae Scopariae), Huang Qin (Radix Scutellariae), Zhi Qiao (Fructus Aurantii), Pi Pa Ye (Folium Loquatae), Gan Cao (Radix Glycyrrhizae Uralensis).
[Dental Epistaxis] Qing Wei San (Clear Stomach Powder): Sheng Di Huang (Radix Rehmanniae Preparata) [4 qian], Sheng Ma (Rhizoma Cimicifugae Foetidae) [1.5 qian], Dan Pi (Cortex Moutan) [5 qian], Dang Gui (Radix Angelicae Sinensis), Chuan Lian (Radix et Rhizoma Coptidis) [each 3 qian], powdered, divided into three doses.
[External Application] Bing Yu San (Ice Jade Powder): Peng Sha (Borax), Yuan Ming Fen (Natrii Sulfas), each 5 qian; Chen Sha (Cinnabar) [6 fen].
[Constipation] Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct Downward Decoction): Da Huang (Radix et Rhizoma Rhei), Mang Xiao (Natrii Sulfas), Zhi Gan Cao (Prepared Radix Glycyrrhizae Uralensis).
[Wind Swelling] Xiao Feng San (Expel Wind Powder): See this volume, Aphonia Chapter.
[Kidney Deficiency] Qi Wei Wan (Seven-Ingredient Pill): Liu Wei Wan (Six-Ingredient Pill) plus Rou Gui Xin (Cortex Cinnamomi).
[Yang Deficiency] An Shen Wan (Calming Kidney Pill): Bian Zhi Xiang Fu (Salt-processed Rhizoma Cyperi Rotundi) [2 liang], Pao Chuan Wu (Prepared Radix Aconiti Kusnezoffii), Chuan Jiao (Pericarpium Zanthoxyli) [each 1 liang], Qing Yan Chao Xiao Hui Xiang (Green Salt-fried Fructus Foeniculi) [3 liang], Shu Di Huang (Radix Rehmanniae Preparata) [4 liang], Chuan Lian Zi (Fructus Toosendan) [3 qian], wine paste pills.
[Tongue Epistaxis] Huang Qi Liu Yi San (Astragalus Six-to-One Powder): Huang Qi (Radix Astragali Membranacei) [6 liang], Gan Cao (Radix Glycyrrhizae Uralensis) [1 liang].
[Tongue Epistaxis] Tu She Dan (Apply Tongue Elixir): Hai Zhe Gu (Os Sepiae), Pu Huang (Pollinis Typhae), equal parts powdered, applied to the tongue.
[Cutaneous Epistaxis] Dang Gui Liu Huang Tang (Angelica Six-Yellow Decoction): Dang Gui (Radix Angelicae Sinensis), Huang Qi (Radix Astragali Membranacei), Sheng Di Huang (Radix Rehmanniae Preparata), Shu Di Huang (Radix Rehmanniae Preparata) [each 1 qian]; Huang Qin (Radix Scutellariae), Huang Lian (Rhizoma Coptidis), Huang Bo (Cortex Phellodendri) [each 5 fen].
[Cutaneous Epistaxis] Huang Qi Jian Zhong Tang (Astragalus Regulate the Middle Decoction): Gui Zhi (Ramulus Cinnamomi), Shao Yao (Radix Paeoniae Alba), Gan Cao (Radix Glycyrrhizae Uralensis), Sheng Jiang (Rhizoma Zingiberis Recens), Da Zao (Fructus Jujubae), Yi Tang (Maltose).
[Red Sweat] Miao Xiang San (Miraculous Fragrance Powder): Ren Shen (Radix Ginseng), Huang Qi (Radix Astragali Membranacei), Yuan Zhi (Radix Polygalae Tenuifoliae), Fu Ling (Poria), Fu Shen (Poria cum Radice) [each 1 liang], Jie Geng (Radix Platycodonis) [3 qian], Gan Cao (Radix Glycyrrhizae Uralensis) [2 qian], Mu Xiang (Radix Aucklandiae) [1.5 qian], She Xiang (Moschus) [1 qian], Chen Sha (Cinnabar) [2 qian].
[Orifice Bleeding] Ce Bai San (Platycladus Powder): Ce Bai Ye (Cacumen Platycladi, steamed and dried 2.5 liang), Jing Jie Tan (Carbonized Herba Schizonepetae), Ren Shen (Radix Ginseng) [each 1 liang], take 3 qian powder per dose, mix with 3 qian white flour, and take.
[Orifice Bleeding] Xi Jiao Tang (Rhinoceros Horn Decoction): Xi Jiao Zhi (Juice of Cornu Rhinocerotis), Huang Lian (Rhizoma Coptidis), Jing Jie Tan (Carbonized Herba Schizonepetae), Xiao Ji (Herba Cirsii Japonici) [each 1 qian], Sheng Long Gu (Os Draconis) [8 fen], Huang Qin (Radix Scutellariae) [1.5 qian].
[Whole Body Bleeding] Wu Hua Tang (Five Flowers Decoction): Shui Lu Hua (Flores Phragmitis Communis), Hong Liao Hua (Flores Polygoni Orientalis), Huai Hua (Flos Sophorae Flavae), Mao Hua (Flores Imperatae Cylindercae), Bai Ji Guan Hua (Flos Celosiae Cristatae), Ren Shen (Radix Ginseng), equal parts, decocted in water, mixed with Ce Bai Zhi (Juice of Cacumen Platycladi) and taken.
[Blood Overflow] Huang Lian Xie Xin Tang (Coptis Draining Heart Decoction): Da Huang (Radix et Rhizoma Rhei), Huang Lian (Rhizoma Coptidis).
[Blood Overflow] Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction): See Volume 1, Stroke Chapter.