鼻气能通于脑，血上溢于脑，故从鼻而出，名为鼻衄。若因风寒暑湿，流传经络，
涌泄清道而致者，皆外所因，积怒伤肝，积忧伤肺，烦思伤脾，失志伤肾，暴喜伤心，
皆能动血，随气上溢而致者，皆内所因，饮
酒过多炙爆辛热，或坠车损扑而致者，皆不内外因也。《原病式》曰∶衄者。阳热怫郁
于足阳明经。丹溪曰∶衄血出于肺，言肺者，以窍言也。言阳明者，以血海言也。又
有洗面而衄，日以为常，犹风行水动，面热而阳明之火上升，血亦随之也。若产后口鼻
有黑气及鼻衄者，名胃绝，此症多不可治。遇有此者，急取绯线一条，并产妇顶心发两
条，紧系中指节即止。衄不止而头汗者，死。
凡血从齿缝中，或齿根出者，谓之齿衄。有风壅，有肾虚，风壅者，消风散外，
以祛风擦牙散。肾虚者，以肾主骨，齿者骨之余，虚火上炎，服凉药而愈甚者，此属肾
经下虚上盛，宜盐汤下安肾丸，仍用青盐炒香附黑色为末，擦之。然少阴气多血少，故
其血必点滴而出，齿亦隐隐而痛，多欲者犯之，亦有胃热而牙断出血者，阳明气血俱
多，火旺则血如潮涌，善饮者多犯此，宜清其热，清胃散主之。
有毛窍中出血者，名曰肌衄。因阳气怫郁于内，不能敷扬于外，致阴血上乘阳分，
留淫腠理，日久阳气开发，则阴血不能归经，故血从毛窍出也。宜开郁清气凉血之
剂，如相火内动，而乘阴分以致热血沸腾者，宜滋阴降火之剂，前人主乎肺热，以肺
主皮毛也。用男胎发烧灰扑之，有因大喜伤心，喜则气散，血随气而溢于表者，宜凉心
以敛之。
胸前有一孔，常出血水，名曰心漏，用嫩鹿茸去毛，酥炙，附子，炮，去皮、脐，
盐花共末，枣肉为丸，每服三十丸，空心酒下，兼治肾虚腰痛如神。
舌衄者，舌上无故出血如线不止，或如管孔者是也。宜香薷汁一升，日三服，外以
槐花炒末，干掺之。
耳中出血，少阴火动也。龙骨烧灰，吹入即止。
血分三部，药有轻重。犀角地黄汤，治上血，如吐衄之类；桃仁承气汤，治中血，
如血蓄中焦下痢脓血之类；抵当汤丸，治下血，如蓄血如狂之类，此治有余血症之大概也。
鼻气能够通达于脑，血液向上溢出至脑部，因此从鼻腔流出，这种病症称为鼻衄（鼻出血）。如果是由于风寒暑湿等邪气，流传于经络，涌泄清道而导致的，都属于外因；因长期愤怒损伤肝脏，长期忧伤损伤肺脏，烦乱思虑损伤脾脏，意志失落损伤肾脏，突然大喜损伤心脏，这些情况都能扰动血液，随着气机上逆溢出而导致的，都属于内因；饮酒过多、食用炙烤辛辣热性食物，或因坠车跌扑受伤而导致的，都属于不内外因。《原病式》中说：衄血是因为阳热郁结在足阳明经。朱丹溪说：衄血源于肺，说肺是指鼻窍而言；说阳明经，是指其为血海而言。还有人在洗脸时发生鼻衄，每天如此，如同风动水波，面部发热且阳明之火上升，血液也随之上溢。如果在产后口鼻出现黑气并伴有鼻衄的，称为胃绝，这种症状大多难以治愈。遇到这种情况，紧急取一根红线和产妇头顶的两根头发，紧紧系在中指关节处即可止血。如果鼻衄不止且头部出汗的，为死证。
凡是血液从齿缝中或齿根渗出的，称为齿衄。有风壅（风邪壅滞）和肾虚两种类型。风壅者，外用消风散祛风，并用祛风擦牙散擦拭牙齿。肾虚者，因为肾主骨，牙齿是骨的余气，虚火上炎，服用凉药后病情反而加重的，这属于肾经下虚上盛，宜用盐汤送服安肾丸，同时用青盐炒香附至黑色研成粉末，涂抹患处。然而少阴经气多血少，所以其血液必定点滴而出，牙齿也隐隐作痛，房事过度者容易患此病。也有因胃热导致牙龈断裂出血的，阳明经气血俱多，火旺则血液如潮水般涌出，喜好饮酒的人多患此病，宜清热治疗，以清胃散为主治方剂。
毛孔中出血的，称为肌衄。这是因为阳气郁结在内，不能宣发于体表，导致阴血上乘于阳分，留滞浸淫于腠理之间，日久阳气开发，阴血不能回归经脉，所以血液从毛孔渗出。适宜使用开郁、清气、凉血的药剂。如果相火在内妄动，侵犯阴分导致热血沸腾的，适宜使用滋阴降火的药剂。前人主张治疗肺热，因为肺主皮毛。可用男胎发烧成的灰烬扑撒患处。也有因大喜伤心，喜则气散，血液随着气机溢出于体表的，宜用凉心药以收敛之。
胸前有一个孔洞，经常流出血水，称为心漏。用嫩鹿茸去毛，用酥油炙烤，附子炮制后去皮和脐，与盐花共同研成细末，用枣肉制成丸药，每次服用三十丸，空腹时用酒送服，兼治肾虚腰痛，效果如神。
舌衄，是指舌头无故出血，如线状不止，或者像管孔状出血的情况。适宜服用一升香薷汁，每日三次，外用槐花炒成粉末，干掺于患处。
耳朵中出血，是少阴火动的表现。将龙骨烧成灰，吹入耳中即可止血。
血证分为上、中、下三部，用药有轻重之分。犀角地黄汤，治疗上部出血，如吐血、衄血之类；桃仁承气汤，治疗中部出血，如瘀血蓄积在中焦、下痢脓血之类；抵当汤丸，治疗下部出血，如瘀血蓄积导致发狂之类，这是治疗实证血症的大概原则。
Nasal Qi (Qi of the nose) can communicate with the brain. When blood overflows upward into the brain, it exits through the nose; this condition is named Bi Nu (Epistaxis). If caused by Wind-Cold, Summerheat, Dampness, or pathogenic factors spreading through the meridians and turbating the clear pathways, these are all external causes. If caused by accumulated anger injuring the Liver, accumulated sorrow injuring the Lung, vexatious thinking injuring the Spleen, loss of will injuring the Kidney, or sudden excessive joy injuring the Heart—all of which can disturb blood and cause it to overflow upward following the ascending Qi—these are all internal causes. If caused by excessive alcohol consumption, eating roasted/spicy/hot foods, or trauma from falling from a carriage or being struck, these are all neither-internal-nor-external causes. The *Yuan Bing Shi* states: "Nu occurs when Yang-Heat is constrained in the Foot-Yangming Meridian." Danxi said: "Nu blood originates from the Lung"; speaking of the Lung refers to the nasal orifice. Speaking of the Yangming Meridian refers to it being the Sea of Blood. There is also a case where epistaxis occurs while washing the face, becoming a daily occurrence, like wind moving water, with facial heat and rising Fire of the Yangming Meridian, causing blood to follow it upward. If, after childbirth, black gas appears around the mouth and nose accompanied by epistaxis, it is called Wei Jue (Stomach Exhaustion); this syndrome is mostly incurable. In such cases, urgently take one red thread and two hairs from the vertex of the parturient's head, tie them tightly around the middle joint of the middle finger to stop the bleeding. If epistaxis does not stop and sweating occurs on the head, it is a death sign.
Any blood oozing from between the teeth or from the gum roots is called Chi Nu (Gum Epistaxis). It can be due to Wind Congestion (Wind Pathogen Stagnation) or Kidney Deficiency. For Wind Congestion, use Xiao Feng San externally to dispel wind, and apply Qu Feng Ya Cha San to rub the teeth. For Kidney Deficiency, since the Kidney governs bones and teeth are the surplus of bones, if deficiency-Fire flares upward and taking cooling medicines worsens the condition, this belongs to Lower Deficiency and Upper Excess of the Kidney Meridian. It is appropriate to administer An Shen Wan delivered with salted water, and still use Qing Yan stir-fried Xiang Fu (Cyperi Rhizoma) until black, ground into powder, applied topically. However, the Shaoyin Meridian has abundant Qi but scarce Blood, so its blood must ooze drop by drop, and the teeth ache faintly; those with excessive sexual desire often suffer from this. There are also cases of gum rupture and bleeding due to Stomach Heat; the Yangming Meridian has abundant Qi and Blood, and when Fire is vigorous, blood surges like a tide; those who enjoy drinking often suffer from this. It is appropriate to clear the Heat, using Qing Wei San as the principal formula.
Bleeding from hair follicles is called Ji Nu (Cutaneous Epistaxis). This is because Yang-Qi is constrained internally and cannot diffuse outward, causing Yin-Blood to ascend to the Yang aspect, lingering and infiltrating the Cou Li (interstices). After a long time, when Yang-Qi opens up, Yin-Blood cannot return to the vessels, so blood exits from the hair follicles. It is appropriate to use formulas that resolve stagnation, clear Qi, and cool Blood. If Minister-Fire moves internally and attacks the Yin aspect, causing blood to boil and surge, it is appropriate to use formulas that nourish Yin and descend Fire. Predecessors emphasized treating Lung Heat, as the Lung governs skin and hair. One can use ash from burned male fetal remains applied topically. There are also cases where excessive joy injures the Heart; joy causes Qi to scatter, and blood overflows to the exterior following Qi. It is appropriate to cool the Heart to astringe it.
There is a pore on the chest that frequently leaks bloody fluid, called Xin Lou (Heart Fistula). Use tender Lu Rong (Cervus Nippon Cornu), de-haired and fried with butter, Pao Zhi Fu Zi (Aconiti Lateralis Radix Praeparata), peeled and navel removed, and Yan Hua (Salt Flower), ground together into powder, formed into pills with jujube paste. Take thirty pills per dose, administered with wine on an empty stomach; it also treats Kidney Deficiency lower back pain with miraculous effect.
She Nu (Tongue Epistaxis) refers to tongue bleeding without obvious cause, flowing like a continuous thread or from tube-like pores. It is appropriate to drink one sheng of Xiang Ru juice, three times a day. Externally, apply dry powder of stir-fried Huai Hua (Sophorae Flos).
Bleeding from the ears indicates movement of Shaoyin Fire. Burn Long Gu (Fossilia Ossis Mastodi) to ash and insufflate it into the ear to stop the bleeding.
Blood disorders are divided into upper, middle, and lower parts, with medications varying in potency. Xi Jiao Di Huang Tang (Rhino Horn and Rehmannia Decoction) treats upper bleeding, such as hematemesis and epistaxis; Tao Ren Cheng Qi Tang (Peach Kernel and Magnolia Bark Decoction) treats middle bleeding, such as blood stasis accumulating in the Middle Jiao presenting as dysentery with pus and blood; Di Dang Tang/Wan (Di Dang Decoction/Pill) treats lower bleeding, such as blood stasis accumulation presenting with mania. These are the general principles for treating excess-type blood disorders.