论
《内经》曰∶西方白色，入通于肺，开窍于鼻。又曰∶鼻者肺之外侯。丹溪曰∶肺之为脏，其位高，其体脆，性恶
寒，又恶热。是故好饮热酒者，始则伤于肺脏，郁热久则见于外而为鼻 淮赤之候，得热愈红，得寒则黑，此谓热极似
水之象，亢则害承乃制也。其或触冒风寒，始则伤于皮毛，而成鼻塞不通之候，或为浊涕，或流清汁，久而不已，名曰
鼻渊，此为外寒束内热之证也，《原病式》曰肺热则出涕是也。又有胆移热于脑，则为辛额鼻渊，鼻中浊涕如涌泉下
渗而下，久而不已，则为鼻蔑、衄血、 肉、鼻痈等证，医者宜各以类推而治之，无忽也。
脉法
右寸脉浮洪而数，为鼻衄鼻 。左寸脉浮缓，为伤风鼻塞，鼻流清涕。
方法
丹溪曰∶鼻为肺之窍，因心肺上病而不利也，有寒有热。寒邪伤于皮毛，气不利而壅塞；热壅清道，气不宣通。寒
则表之，麻黄、桂枝之类；热则清之，芩、连、栀子之类。
面鼻紫黑，面为阳中之阳，鼻居面之中，一身之血运到面鼻，皆为至清至精之血。多酒之人，酒气熏蒸，面鼻得酒，
血为极热，热血得寒，污浊凝结而不行，故色紫黑。治宜化滞血，生新血，四物加片芩（酒炒）、红花（酒浸）、茯苓、
陈皮、甘草、生姜煎，调五灵脂末服。气弱者，加黄 （酒浸）。
酒 鼻乃热血入肺（治用前方），用梧桐子桐油，入黄连，以天吊藤烧油，热敷之。
又方 用山硫黄（入萝卜内煨）、乳香、轻粉、乌头尖，酥调敷。或用胆矾敷之。
又方 用山栀为末，蜜蜡丸如弹子大，空心嚼一丸，白汤下。
鼻 肉乃肺气盛，用枯矾研为末面，脂调绵裹塞鼻中，数日自消。
又方 木通、附子炮、细辛，蜜和绵裹塞鼻中。又用防风通圣散加京三棱、山茱萸肉、海藻，并用酒浸，炒为
末，每服一钱五分，酒调服之。
鼻渊，胆移热于脑则辛 鼻渊，防风通圣散一两，加薄荷、黄连各二钱五分，水煎服。
（以上丹溪方法凡八条）
防风汤（宣明） 治鼻渊脑热，渗下浊涕不止，久而不已，必成衄血之疾。
黄芩 人参 甘草（炙） 川芎 麦门冬（去心，各一两） 防风（去芦，一两五钱）
上为细末，每服二钱，沸汤调服，食后服，日三服。
丽泽通气汤（东垣） 治鼻不闻香臭。
黄 （八分） 苍术 羌活 独活 防风 升麻 葛根（各六分） 炙甘草（四分） 麻黄（不去节，冬月加） 川
椒白芷（各二分）
上细切，作一服，加生姜三片，枣二枚，葱白三寸，水二盏，煎至一盏，温服食远。忌一切冷物，及风寒凉处坐卧。
温肺汤（东垣） 治鼻不闻香臭，多眵泪。
丁香（二分） 防风 炙甘草 葛根 羌活（各五分） 升麻 黄 （各七分半） 麻黄（不去节，一钱五分）
上细切，作一服，水二盏，葱白三根，煎至一盏，食后温服。
御寒汤 治寒气风邪伤于皮毛，令鼻壅塞，咳嗽上喘。
黄连 黄柏 羌活（各二分） 炙甘草 佛耳草 款冬花 白芷 防风（各三分） 升麻 人参 陈皮（各五分） 苍
术（七分） 黄 （一钱）
上细切，作一服，水二盏，煎至一盏，去渣食后服。
（祖传方）
治鼻中时时流臭黄水，甚者脑亦时痛，俗名控脑砂，有虫食脑中。
用丝瓜藤近根三、五寸许，烧存性，为细末，酒调服之即愈。
又治方 用白牛毛枨叶（如白杨木叶，香辣者是）焙干为末，吹入鼻中，立愈。
论
《黄帝内经》说：西方对应白色，内通于肺脏，开窍于鼻。又说：鼻子是肺脏在体外的征象。朱丹溪说：肺作为脏器，位置高，质地脆弱，性质厌恶寒冷，也厌恶炎热。因此，喜欢饮用热酒的人，起初会损伤肺脏，郁积的热邪日久会在外部表现为鼻部及周围皮肤发红发赤的症状，遇热更红，遇寒则变黑，这叫做热极似水的现象，即亢盛则为害，承制则平衡的道理。如果触犯风寒，起初损伤皮毛，从而形成鼻塞不通的症状，或者流出浊涕，或者流出清稀液体，久治不愈，称为鼻渊（一种以流浊涕为主的鼻病），这是外寒束缚内热的证候，《原病式》说肺热就会出涕。又有胆经移热于脑，则导致前额辛辣感、鼻渊，鼻中浊涕如涌泉般下渗不止，久治不愈，就会发展为鼻痔（鼻内赘生物）、衄血（鼻出血）、鼻肉（鼻息肉）、鼻痈等病症，医生应当各自类推而治疗，不可轻视。
脉法
右寸脉浮洪而数，主鼻衄（鼻出血）和鼻痔。左寸脉浮缓，主伤风鼻塞，鼻流清涕。
方法
朱丹溪说：鼻子是肺的窍道，因心肺上部病变而导致不利，有寒证和热证。寒邪损伤皮毛，气机不利而壅塞；热邪壅滞清道，气机不宣通。寒证用发散表邪的方法，如麻黄、桂枝之类；热证用清热的方法，如黄芩、黄连、栀子之类。
面部和鼻子紫黑，面为阳中之阳，鼻子位于面部中央，全身血液运行到面鼻，都是极其清纯精微的血液。多饮酒的人，酒气熏蒸，面鼻受酒气影响，血液变得极热，热血遇到寒气，污浊凝结而不流通，所以颜色紫黑。治疗宜化解瘀滞之血，生成新血，用四物汤加片芩（酒炒）、红花（酒浸）、茯苓、陈皮、甘草、生姜煎煮，调服五灵脂末。气虚者，加黄芪（酒浸）。
酒渣鼻乃热血入肺（治疗用前方），用梧桐子大小的桐油，加入黄连，用天吊藤炼油，热敷患处。
又一方：用山硫黄（放入萝卜内煨熟）、乳香、轻粉、乌头尖，用酥油调和敷贴。或用胆矾敷贴。
又一方：用山栀研为末，蜜蜡制成如弹子大的丸药，空腹嚼服一丸，白开水送下。
鼻息肉乃肺气盛，用枯矾研为末涂面，用脂膏调和绵裹塞入鼻中，数日后自然消退。
又一方：木通、炮附子、细辛，蜂蜜调和绵裹塞入鼻中。又用防风通圣散加京三棱、山茱萸肉、海藻，均用酒浸泡，炒后研为末，每服一钱五分，酒调服。
鼻渊，胆移热于脑则致前额辛辣、鼻渊，用防风通圣散一两，加薄荷、黄连各二钱五分，水煎服。
（以上丹溪的方法共八条）
防风汤（出自《宣明论方》） 治疗鼻渊脑热，渗下浊涕不止，久治不愈，必成衄血的疾病。
黄芩、人参、甘草（炙）、川芎、麦门冬（去心，各一两）、防风（去芦，一两五钱）
上药研为细末，每服二钱，沸水调服，饭后服用，每日三次。
丽泽通气汤（李东垣方） 治疗鼻子闻不到香臭。
黄芪（八分）、苍术、羌活、独活、防风、升麻、葛根（各六分）、炙甘草（四分）、麻黄（不去节，冬季加用）、川椒、白芷（各二分）
上药细切，作一剂服，加生姜三片，大枣二枚，葱白三寸，水两盏，煎至一盏，温服，饭后服用。忌食一切冷物，以及避免坐卧于风寒凉处。
温肺汤（李东垣方） 治疗鼻子闻不到香臭，多眼屎流泪。
丁香（二分）、防风、炙甘草、葛根、羌活（各五分）、升麻、黄芪（各七分半）、麻黄（不去节，一钱五分）
上药细切，作一剂服，水两盏，葱白三根，煎至一盏，饭后温服。
御寒汤 治疗寒气风邪损伤皮毛，导致鼻部壅塞，咳嗽气喘。
黄连、黄柏、羌活（各二分）、炙甘草、佛耳草、款冬花、白芷、防风（各三分）、升麻、人参、陈皮（各五分）、苍术（七分）、黄芪（一钱）
上药细切，作一剂服，水两盏，煎至一盏，去渣，饭后服用。
（祖传方）
治疗鼻中时时流出臭黄水，严重者脑部也时常疼痛，俗名控脑砂，认为是有虫蛀食脑中。
用丝瓜藤靠近根部三、五寸许，烧存性，研为细末，酒调服即愈。
又治方：用白牛毛枨叶（形状像白杨树叶，有香辣气味的是）焙干研为末，吹入鼻中，立即痊愈。
Discussion
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: The West corresponds to the color white, internally connecting with the Lung organ, and opening into the nose. It further states: The nose is the external manifestation of the Lung. Zhu Danxi said: As an organ, the Lung is located high, its structure is fragile, and its nature dislikes both cold and heat. Therefore, those who enjoy drinking hot wine initially injure the Lung organ; if the stagnant heat persists for a long time, it manifests externally as redness and flushing of the nose and surrounding skin. The condition becomes redder when exposed to heat and blacker when exposed to cold. This is described as the phenomenon where extreme heat resembles water, illustrating the principle that hyperactivity causes harm, while subduing forces bring balance. If one is exposed to wind-cold, the exterior (skin and hair) is initially injured, leading to nasal congestion and obstruction. This may present as turbid discharge or clear fluid. If untreated for a long time, it is called Bi Yuan (Nasal Sinusitis/Chronic Rhinitis with turbid discharge), which is a syndrome of external cold binding internal heat. The *Yuan Bing Shi* (Treatise on the Original Causes of Disease) states that lung heat causes rhinorrhea. Additionally, if heat from the Gallbladder shifts to the brain, it causes a burning sensation in the forehead and Bi Yuan, with turbid nasal discharge seeping down like a gushing spring. If prolonged, it may develop into Bi Zhi (nasal polyps), epistaxis (nosebleed), Bi Rou (nasal flesh/polyps), or Bi Yong (nasal abscess). Physicians should treat these conditions by analogy and not neglect them.
Pulse Diagnosis
A floating, surging, and rapid pulse at the Right Cun position indicates Epistaxis and Bi Zhi. A floating and moderate pulse at the Left Cun position indicates Wind-Cold invasion causing nasal congestion and clear rhinorrhea.
Methods
Zhu Danxi stated: The nose is the orifice of the Lung. Dysfunction arises from pathology in the upper Jiao (Heart and Lung), manifesting as either Cold or Heat syndromes. Cold pathogen injuring the exterior leads to Qi stagnation and obstruction; Heat pathogen obstructing the clear pathways leads to failure of Qi diffusion. For Cold syndromes, use exterior-releasing methods, such as Ephedrae Herba (Mahuang) and Cinnamomi Ramulus (Guizhi); for Heat syndromes, use heat-clearing methods, such as Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), and Gardeniae Fructus (Zhizi).
Facial and nasal purple-black discoloration: The face represents Yang within Yang, and the nose is centrally located. Blood circulating to the face and nose is extremely pure and refined. In individuals who consume much alcohol, the fumes of alcohol cause the blood in the face and nose to become excessively hot. When this hot blood encounters cold, the impurities coagulate and fail to circulate, resulting in a purple-black color. Treatment should focus on resolving stasis and generating new blood. Use Si Wu Tang (Four Substance Decoction) added with Scutellariae Radix (Huangqin, stir-fried with wine), Carthami Flos (Honghua, soaked in wine), Poria (Fuling), Citri Reticulatae Pericarpium (Chenpi), Glycyrrhizae Radix et Rhizoma (Gancao), and Zingiberis Rhizoma (Shengjiang). Decoct and take with powder of Trogopterori Faeces (Wulingzhi). For Qi deficiency, add Astragali Radix (Huangqi, soaked in wine).
Jiu Zha Bi (Rosacea/Rhinophyma): Caused by hot blood entering the Lung (treat with the formula above). Prepare tung oil in quantities the size of a paulownia seed, add Coptidis Rhizoma (Huanglian), and extract the oil using the stem of Thunbergia laurifolia (Tiandiao Teng). Apply warm compresses to the area.
Another prescription: Use native sulfur (roasted inside a radish), Boswelliae Resina (Ruxiang), Calomelas (Qingfen), and the tip of Aconiti Lateralis Radix Preparata (Wutou). Mix with butter and apply topically. Alternatively, use Chalcanthum (Danfan) for topical application.
Another prescription: Powderize Gardeniae Fructus (Shanzhi), mix with beeswax to form pills the size of a bullet. Chew one pill on an empty stomach and swallow with warm water.
Bi Rou (Nasal Polyps): Caused by excessive Lung Qi. Powder Calcined Alum (Kufan), mix with ointment, wrap in cotton, and insert into the nostril. It will naturally resolve after several days.
Another prescription: Akebiae Caulis (Mutong), prepared Aconiti Lateralis Radix (Fuzi), and Asari Radix et Rhizoma (Xixin). Mix with honey, wrap in cotton, and insert into the nostril. Another method: Use Fangfeng Tongsheng San (Saposhnikovia Decoction) added with Sparganii Rhizoma (Sanleng), Corni Fructus (Shanzhuyu), and Sargassum (Haizao). Soak all in wine, stir-fry, and powder. Take 1.5 qian per dose, mixed with wine.
Bi Yuan: Caused by Gallbladder heat shifting to the brain, leading to frontal burning and Bi Yuan. Use Fangfeng Tongsheng San (1 liang), added with Menthae Haplocalycis Herba (Bohe) and Coptidis Rhizoma (Huanglian) (2.5 qian each). Decoct in water and take orally.
(Above are eight methods from Danxi.)
Fangfeng Tang (from *Xuanming Lun*) Treats Bi Yuan with brain heat, persistent turbid discharge, which if prolonged leads to epistaxis.
Scutellariae Radix (Huangqin), Ginseng Radix (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao, prepared), Ligustici Chuanxiong Rhizoma (Chuanxiong), Ophiopogonis Radix (Maidong, heart removed) [each 1 liang], Saposhnikoviae Radix (Fangfeng, awn removed) [1.5 liang].
Grind into fine powder. Take 2 qian per dose, mixed with boiling water. Take after meals, three times daily.
Lize Tongqi Tang (Li Dongyuan's formula) Treats anosmia (loss of smell).
Astragali Radix (Huangqi) [8 fen], Atractylodis Rhizoma (Cangzhu), Notopterygii Rhizoma et Radix (Qianghuo), Angelicae Dahuricae Radix (Duquohuo - *Note: Du Huo usually refers to Angelicae Pubescentis Radix*), Saposhnikoviae Radix (Fangfeng), Cimicifugae Rhizoma (Shengma), Puerariae Radix (Gegen) [each 6 fen], Glycyrrhizae Radix et Rhizoma (Gancao, prepared) [4 fen], Ephedrae Herba (Mahuang, stems not removed, add in winter), Zanthoxyli Pericarpium (Chuanjiao), Angelicae Dahuricae Radix (Baizhi) [each 2 fen].
Cut finely, prepare as one dose. Add three slices of Zingiberis Rhizoma Recens (Shengjiang), two dates, and three cun of Allii Fistulosi Bulbus (Congbai). Decoct two cups of water to one cup. Take warm after meals. Avoid all cold foods and sitting/sleeping in cold, windy places.
Wenfei Tang (Li Dongyuan's formula) Treats anosmia and excessive eye discharge/tearing.
Symplocos Radix (Dingxiang) [2 fen], Saposhnikoviae Radix (Fangfeng), Glycyrrhizae Radix et Rhizoma (Gancao, prepared), Puerariae Radix (Gegen), Notopterygii Rhizoma et Radix (Qianghuo) [each 5 fen], Cimicifugae Rhizoma (Shengma), Astragali Radix (Huangqi) [each 7.5 fen], Ephedrae Herba (Mahuang, stems not removed) [1.5 qian].
Cut finely, prepare as one dose. Decoct two cups of water with three roots of Allii Fistulosi Bulbus (Congbai) to one cup. Take warm after meals.
Yuhan Tang Treats injury to the exterior by cold-wind pathogens, causing nasal congestion, cough, and wheezing.
Scutellariae Radix (Huangqin), Phellodendri Cortex (Huangbai), Notopterygii Rhizoma et Radix (Qianghuo) [each 2 fen], Glycyrrhizae Radix et Rhizoma (Gancao, prepared), Petasitae Flos (Foercao), Farfarae Flos (Kuandonghua), Angelicae Dahuricae Radix (Baizhi), Saposhnikoviae Radix (Fangfeng) [each 3 fen], Cimicifugae Rhizoma (Shengma), Ginseng Radix (Renshen), Citri Reticulatae Pericarpium (Chenpi) [each 5 fen], Atractylodis Rhizoma (Cangzhu) [7 fen], Astragali Radix (Huangqi) [1 qian].
Cut finely, prepare as one dose. Decoct two cups of water to one cup. Strain and take after meals.
(Ancestral Prescription)
Treats frequent discharge of foul yellow fluid from the nose, with severe cases experiencing occasional headaches. Commonly known as Kongnao Sha, attributed to worms eating the brain tissue.
Use the part of Luffae Volubilis Caulis (Siguateng) near the root, about 3-5 cun in length. Char it until carbonized but retaining its nature, grind into fine powder, and take mixed with wine. Recovery follows immediately.
Another treatment: Use leaves of Populus alba var. pyramidalis (Bai Niuchangye - described as resembling white poplar leaves, having a spicy fragrance). Dry by roasting, grind into powder, and insufflate into the nostrils. Cure is immediate.