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Epistaxis is caused by the accumulation of heat in the five Zang organs. Blood follows Qi in its circulation, flowing freely through the Zang and Fu organs. When cold and heat are harmonious and within normal limits, there is no stagnation, nor does blood overflow. Blood coagulates when exposed to cold and scatters when exposed to heat. When heat attacks the blood, the blood rises with Qi and overflows from the nasal cavity, resulting in epistaxis. Additionally, epistaxis may occur due to Cold Damage or plague, where the Yang meridians are affected, sweating fails to occur, heat has no outlet for discharge, and thus blood issues from the nose.

For epistaxis occurring in spring and winter, fresh Rehmanniae Radix (Sheng Di Huang) juice can be extracted by grinding, mixed with a small amount of fresh Polygoni Cathayici Herba (Sheng Pu Huang), rock sugar, and well water, then taken after soaking; this cures the condition. For epistaxis occurring in autumn and summer, take a handful of fresh Plantaginis Herba (Che Qian Cao), wash it clean, grind it together with fresh Zingiberis Rhizoma (Sheng Jiang) to extract juice, add one spoonful of fresh honey; first, pack the nasal cavity with the residue mixed with the juice, then drink a mixture of fresh drawn water, honey, Plantaginis Herba juice, and Zingiberis Rhizoma juice; this cures the condition. Another method: crush the root of fresh Raphani Fructus (Sheng Luo Bo) to obtain natural juice, tilt the head back and drip the juice into the nasal passage to stop bleeding immediately, then drink a mixture of fresh drawn water, honey, and Raphani Fructus juice for good effect.

Xue Ji stated: For epistaxis caused by fright leading to the dispersion of Qi, leaving blood without restraint, use Yigong San (Isolated Efficacy Powder) added with Bupleuri Radix (Chai Hu) and Gardeniae Fructus (Shan Zhi). If the left cheek is bluish-green and red, first use Chaihu Qinggan San (Bupleurum Liver-Clearing Powder), followed by Dihuang Wan (Rehmannia Pill). If the right cheek is red, it indicates excess heat in the Lung and Large Intestine; use Xiebai San (Drain White Powder). If the nose is red, it indicates excess heat in the Spleen and Stomach; use Xiehuang San (Drain Yellow Powder). If slightly red, it indicates deficiency heat in the Spleen meridian; use Yigong San added with Cimicifugae Rhizoma (Sheng Ma) and Bupleuri Radix (Chai Hu). If deep yellow, use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) from *Jisheng Fang*, followed by Yang Shi Dihuang San (Yang's Rehmannia Powder). If pale white, use Liujunzi Tang (Six Gentlemen Decoction). If the chin area is red, use Siwu Tang (Four Substances Decoction) added with Gardeniae Fructus (Shan Zhi). If very red, use Wulin San (Five Strangury Powder). If urine is red, use Liuwei Wan (Six-Ingredient Pill with Rehmannia) and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If lips are white, use Liujunzi Tang (Six Gentlemen Decoction). If chronic and unhealed, use Maimendong Yinzi (Ophiopogon Drink).

If at the onset of illness, Yuan Qi (Original Qi) is not depleted, milk and food intake are normal, fever or high fever is present, stool and urine are constipated, thirst with desire to drink water exists, and eyes do not open during sleep, all these indicate that both form and disease are excess patterns; treat the pathogenic factor. If the illness has been prolonged and Yuan Qi is depleted, food intake is scant with fever, mouth is dry with desire for hot drinks, vomiting and diarrhea occur, limbs feel cold, and eyes remain open during sleep, all these indicate that both form and disease are deficiency patterns; tonifying Zheng Qi (Upright Qi) is essential.

Tang Shi Dihuang Tang (Tang's Rehmannia Decoction): Treats heat in Ying (Nutritive) level, Lung obstruction, epistaxis with sores, and all types of erysipelas.
Ingredients: Sheng Di Huang (Fresh Rehmanniae Radix), Chi Shao Yao (Red Peony Root), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (equal parts).
Preparation: Cut into pieces. Decoct in water, remove dregs, adjust dosage according to age. For epistaxis, add a small amount of Sheng Pu Huang (Polygoni Cathayici Herba) near the end of decoction. For sores, add Huang Lian (Coptidis Rhizoma) in equal parts. For erysipelas, add Fang Feng (Saposhnikoviae Radix) in equal parts and decoct together; repeatedly proven effective.

Chaihu Qinggan San (Liver Heat) | Dihuang Wan (Kidney) | Xiebai San (Spleen/Lung*) | Xiehuang San (Spleen) | Yigong San (Vomiting/Diarrhea) | Liujunzi Tang (Spleen) | Wulin San (Strangury) | Liuwei Wan (Kidney, i.e., Dihuang Wan)

*Note: In standard TCM, Xiebai San targets Lung heat, but the source text lists it under Spleen context or implies a specific categorization here. I will translate faithfully to the text's grouping or standard association if ambiguous. The text says "泻白散（脾）", which is technically unusual as Xiebai San clears Lung heat, but I must follow the source text's annotation.* -> Correction: The source text explicitly annotates "泻白散（脾）". I will translate it as annotated in the source, though clinically it is Lung. However, looking closely at the list: "柴胡清肝散（肝热） 地黄丸（肾） 泻白散（脾）...". This seems to be a list of formulas and their indicated organ/pathology in this specific context. I will translate the annotations as given.

Maimendong Yinzi (Ophiopogon Drink): Treats hematemesis that persists for a long time.
Ingredients: Wuweizi (Schisandrae Fructus, 10 berries), Maimendong (Ophiopogonis Radix, heart removed), Huangqi (Astragali Radix, 1 qian), Danggui Shen (Dang Gui body, 5 fen), Renshen (Ginseng Radix, 5 fen), Sheng Di Huang (Rehmanniae Radix, 5 fen).
Preparation: Decoct in water and take orally.

Longdan Wan (Gentian Pill): Treats persistent epistaxis in children.
Ingredients: Huanglian (Coptidis Rhizoma), Longdancao (Gentianae Radix) (equal parts).
Preparation: Grind into powder, make pills with paste, size of small beans. Children aged three take 30 pills. Alternatively, make into powder and take with strong salt water.

Bapi Tang (Cypress Bark Decoction): Treats epistaxis in children.
Ingredients: Bapi (Cupressi Cacumen/Bark), Shanzhizi (Gardeniae Fructus) (each 1 liang), Gancao (Licorice Root, roasted, 0.5 liang).
Preparation: Cut into pieces. For a three-year-old child, take 1 qian, decoct in one cup of water until reduced to one-third, remove dregs, and take.

Huaihua San (Sophora Flower Powder): Treats epistaxis.
Ingredients: Huaihua (Sophorae Flos, stir-fried, 1 liang), Puhuang (Pollen Typhae, 0.5 liang), Chuanmianjiang (River Wheat Ginger? Likely a typo for a specific ginger type or just ginger, translated as Ginger), 1 fen.
Preparation: Pound and sieve into fine powder. Take half a qian each time, mixed with fresh water.

Jiaohuang San (Gelatin and Polygonum Powder): Treats severe epistaxis in children, with continuous bleeding from mouth, nose, and ears. Common in adolescents aged fifteen or sixteen due to excessive Yang.
Ingredients: Ejiao (Donkey-hide Gelatin, 1 liang), Puhuang (Polygoni Cathayici Herba, 0.5 liang).
Preparation: Grind into powder. For a three-year-old child, take half a qian, mix with Sheng Di Huang juice, gently warm, and take before meals.