肺开窍于鼻。胃脉起鼻两旁，（筋亦结鼻两旁。）交 。（即山根。）大肠脉夹鼻孔。小肠脉
抵鼻。膀胱筋结鼻下两旁。气出于鼻，气热且郁，则蒸成水而为涕；但热不郁，则
干且痛而带辛。鼻塞，一由脑冷而气化液，下凝于鼻；（如天寒呵气成水也。脑暖立通。）一由
气热蒸涕壅塞。固矣，乃极力去其涕而仍不通者，则窍之外皆涕液之所浸淫，肉理
胀满，窍窄无缝故也。风寒外束，气不外越，止从鼻窍上出，则鼻气盛而喘息有音，
初时气势上壅之甚，故化水速而多，且清；后则势略缓，故涕不即出，久蒸而成浊。
然浊涕有不由外感者，《素问》谓∶胆移热于脑，则辛 鼻渊，（鼻流浊涕，如泉不止也。）传
为衄蔑、（衄蔑，鼻出血也，热甚所致。）瞑。（目暗也。血因衄而虚，不能养目。）
由膀胱脉络脑，受脑之
热，注于胃脉，薄于 中，故鼻辣痛而浊涕下。盖脑液下渗也，俗名脑漏，防风汤。
衄血，详血症门。偶感风寒鼻塞者，自作风寒治。若平日常常鼻塞，不闻香臭；或
值寒月，或略感风寒即塞者，乃肺经素有火郁。喜热（热则行散，故喜之）恶寒，故略一感
寒即发。气壅不舒，热郁于脑，鼽、渊、 、痔。皆由此生，清金降火为主，（桑白皮
不可少。）佐以通气之剂。气有余为火，固矣。亦有脾胃气虚不能升发，郁而成火者，
补中益气汤（见气）主之。外治∶瓜蒂、细辛、麝为末，棉裹塞鼻；或萆麻仁和枣
捣塞，每日易之。
常流浊涕名鼻渊，六味丸（见虚损），甘菊、薄荷、玄参、苍耳子。脑属肾，故
用六味。又有脑痛鼻出臭黄水，俗名控脑砂，有虫食脑，用丝瓜藤近根者三五寸，
烧存性，酒服二钱，立效。外用桃叶作枕。（鼻渊又见伤风门）。
常流清涕名鼻鼽，肺热者，（肺热则气盛化水成清涕。其不为稠浊者，火性急速，
随化随流，不及
浊也。）桔梗、山栀、薄荷、麦冬、玄参、辛荑、甘草；若因脑冷所致，（脑冷则气化液下溜，
若天寒呵气成水也。）苍耳子、干姜、升麻、 本、辛荑、川芎、肉桂。
肉痔痈，鼻中肉赘，臭不可近，痛不可摇，此湿热壅盛所生，如地
湿热而蒸成芝菌也。清肺饮、羌活胜湿汤，（见伤湿。）或白茯、桔梗、山栀、黄芩、辛
荑、白芷、木通、柴胡、防风、苍术、薄荷，外用白矾末加 砂少许吹之；或瓜蒂、
细辛、麝香为末，棉裹塞鼻，即化黄水。桃叶嫩心亦可塞。又雄黄、白矾、苦丁香
为末，霜梅肉捣膏作条，入鼻内，亦效。
鼻疮，黄连、大黄、麝香为末，擦鼻中。辛荑膏亦可。内服乌犀丸。肺热鼻干
无涕，心神烦乱，犀角散、桑根白皮散。
鼻痛，葛根、竹叶、青黛、薄荷、防风、石膏、升麻、石斛。外用宣脑散，取
鼻中黄水。食物卒从鼻中缩入，介介痛不出，以牛脂或羊脂如指头大，内鼻中，
吸入须臾，脂消则物与同出。
鼻红赤或紫黑，阳明血热，多得之好酒，热气熏蒸肺叶，故鼻红赤。若为寒冷
所搏，凝结不行，则瘀浊而变为紫黑。治须融化滞血，滋生新血，去风热，丹参、
生地、当归、红花、山栀、桑白、防风、薄荷，煎服。或酒制四物汤（见血）加酒炒
片芩、陈皮、生甘草、酒红花、生姜煎，调五灵脂末。形肥气弱者，加酒黄 ，临
服入好酒数滴为引。若素不饮酒，则为肺家风热，前一方加荆芥。亦或脏中有虫，
用去虫药。外用杏仁二十个（去皮、油）、胡桃二个（连皮），瓦上焙，不可焦，大枫肉三个、
水银三分，唾津手研成黑水涂之，三两次愈。
鼻气臭，非 痔，其人病重者，乃脏坏气臭，不治。
肺开窍于鼻。胃经的经脉起始于鼻翼两旁，（足阳明胃经的筋也结聚在鼻翼两旁。）交会于山根。（即两眼之间的鼻梁根部。）大肠经的经脉夹行于鼻孔两侧。小肠经的经脉抵达鼻部。膀胱经的筋结聚在鼻下两旁。
气息出于鼻，若气热且郁结，则蒸腾津液化为涕；若只有热而无郁结，则鼻腔干燥疼痛且带有辛辣感。鼻塞，一是由于脑部寒冷导致气化生为津液，向下凝结于鼻；（就像天冷时呵气成水一样。脑暖则立刻通畅。）二是由于气热蒸腾涕液壅塞所致。如果极力清除涕液后仍然不通，那是因为鼻窍外部都被涕液浸淫，肌肉纹理胀满，导致鼻窍狭窄无缝隙。风寒外束，气机不能向外发散，只能从鼻窍向上出，则鼻气盛而喘息有声音，初起时气势上壅得很厉害，所以化水迅速且多，并且清稀；后来则势头稍缓，所以涕液不立即流出，长时间蒸腾而成浊涕。然而浊涕也有不是由外感引起的，《素问》说：胆移热于脑，则辛螫鼻渊，（鼻流浊涕，像泉水一样不止。）传变为衄蔑、（衄蔑，即鼻出血，由热甚所致。）瞑。（目暗。因鼻出血导致血虚，不能滋养眼睛。）这是因为膀胱脉络连接脑部，受脑中热邪影响，注入胃经，迫近鼻中，所以鼻子辣痛且浊涕下行。这其实是脑液下渗，俗名脑漏，用防风汤治疗。鼻出血，详见血症门。偶然感受风寒导致鼻塞的，按风寒证治疗。如果平时经常鼻塞，闻不到香臭；或者正值寒冬，或稍微感受风寒就鼻塞的，这是肺经素有火郁。喜欢热（因为热则气行散，所以喜欢热）厌恶寒，所以稍微一感寒就发作。气机壅滞不舒，热郁于脑，鼽、渊、痔等都由此产生，以清金降火为主，（桑白皮不可少。）佐以通气之剂。气有余即为火，这是肯定的。也有脾胃气虚不能升发，郁结而成火的，用补中益气汤（见气虚篇）主治。外治法：瓜蒂、细辛、麝香研为末，棉裹塞鼻；或用蓖麻仁与枣捣烂塞入，每日更换。
经常流浊涕称为鼻渊，用六味丸（见虚损篇），加甘菊、薄荷、玄参、苍耳子。脑属肾，所以用六味丸。又有脑痛鼻出臭黄水，俗名控脑砂，是有虫食脑，用丝瓜藤靠近根部三五寸，烧至存性，酒送服二钱，立效。外用桃叶做枕头。（鼻渊又见于伤风门）。
经常流清涕称为鼻鼽，肺热者，（肺热则气盛化水成清涕。其不为稠浊的原因，是火性急速，随化随流，来不及变浊。）用桔梗、山栀、薄荷、麦冬、玄参、辛荑、甘草；如果是因脑冷所致，（脑冷则气化液下溜，就像天冷呵气成水一样。）用苍耳子、干姜、升麻、藁本、辛荑、川芎、肉桂。
鼻中生肉赘如痔状痈肿，鼻中肉赘，气味臭不可近，疼痛不可触碰摇动，这是湿热壅盛所生，就像地里湿热蒸腾长出芝菌一样。用清肺饮、羌活胜湿汤（见伤湿篇），或用白茯、桔梗、山栀、黄芩、辛荑、白芷、木通、柴胡、防风、苍术、薄荷，外用白矾末加少许硇砂吹入；或用瓜蒂、细辛、麝香研为末，棉裹塞鼻，即可化出黄水。桃叶嫩心也可塞入。还有雄黄、白矾、苦丁香研为末，霜梅肉捣膏做成条状，纳入鼻内，也有效。
鼻疮，用黄连、大黄、麝香研为末，擦涂鼻中。辛荑膏也可以。内服乌犀丸。肺热导致鼻干无涕，心神烦乱，用犀角散、桑根白皮散。
鼻痛，用葛根、竹叶、青黛、薄荷、防风、石膏、升麻、石斛。外用宣脑散，吸取鼻中黄水。食物突然从鼻中缩入，隐隐作痛出不来，用牛脂或羊脂如指头大小，放入鼻中，吸入片刻，油脂融化则异物随之而出。
鼻红赤或紫黑，是阳明血热，大多得自好酒，热气熏蒸肺叶，所以鼻红赤。如果被寒冷所搏，凝结不行，则瘀浊而变为紫黑。治疗须融化滞血，滋生新血，去风热，用丹参、生地、当归、红花、山栀、桑白皮、防风、薄荷，煎服。或用酒制四物汤（见血证篇）加酒炒片芩、陈皮、生甘草、酒红花、生姜煎，调五灵脂末。形体肥胖气弱的，加酒制黄芪，临服时入好酒数滴为引。如果平时不饮酒，则是肺家风热，前一方加荆芥。也可能是脏中有虫，用驱虫药。外用杏仁二十个（去皮、油）、胡桃二个（连皮），瓦上焙，不可焦，大枫肉三个、水银三分，唾液和手研成黑水涂之，两三次痊愈。
The Lung opens into the nose. The Stomach meridian originates beside the sides of the nose, (and its sinews also knot at the sides of the nose.) and intersects at Shangen (the root of the nasal bridge between the eyes). The Large Intestine meridian runs alongside the nostrils. The Small Intestine meridian reaches the nose. The sinews of the Bladder meridian knot below the nose on both sides. Qi emerges from the nose; if the Qi is hot and stagnant, it steams fluids into mucus; if there is heat without stagnation, the nose becomes dry, painful, and acrid. Nasal congestion arises from two causes: one is cold in the brain causing Qi transformation into fluid, which condenses downward into the nose (similar to breath turning into water in cold weather; warmth in the brain restores patency immediately); the other is heat steaming mucus causing obstruction. If vigorous removal of mucus still fails to clear the passage, it is because the area outside the orifice has been infiltrated by mucus, causing swelling of the muscle texture and narrowing the orifice without gaps. When Wind-Cold binds externally, Qi cannot diffuse outward but exits only through the nasal orifice, resulting in abundant nasal Qi and noisy breathing. Initially, the upward congestion is severe, so fluid transforms rapidly and abundantly, remaining clear; later, the momentum slows, so mucus does not discharge immediately, and prolonged steaming turns it turbid. However, turbid mucus may also arise without external contraction. *Su Wen* states: "When Gallbladder heat transfers to the Brain, it causes acridity and Bi Yuan (nasal sinusitis with profuse turbid discharge like a spring)." This may transmit into Nu Mie (epistaxis caused by excessive heat) and Ming (dim vision due to blood deficiency from epistaxis failing to nourish the eyes). This occurs because the Bladder meridian connects to the Brain; receiving Heat from the Brain, it injects into the Stomach meridian, pressing upon the nose, causing burning pain and turbid discharge. This is essentially Brain fluid seeping downward, commonly known as "Brain Leak," treated with Fangfeng Tang. Epistaxis is detailed in the Epistaxis chapter. Occasional nasal congestion due to Wind-Cold is treated as Wind-Cold. Frequent nasal congestion with loss of smell, or congestion triggered by cold months or slight Wind-Cold exposure, indicates pre-existing Fire Stagnation in the Lung Meridian. Patients prefer heat (as heat promotes dispersion) and dislike cold, so even slight cold triggers symptoms. Qi stagnation and discomfort, with Heat stagnating in the Brain, give rise to Qiu, Yuan, and hemorrhoids. The primary treatment is clearing Metal and descending Fire (Sangbaipi is essential), assisted by agents that unblock Qi. Excess Qi constitutes Fire, certainly. There are also cases where Spleen-Stomach Qi deficiency prevents ascending and dispersing, leading to stagnation and Fire formation, treated with Buzhong Yiqi Tang (see Qi Deficiency). External treatment: Gouti, Xixin, and Shexiang ground into powder, wrapped in cotton and inserted into the nose; or castor kernels and dates mashed and inserted, changed daily.
Frequent discharge of turbid mucus is called Bi Yuan. Liuwei Wan (see Deficiency Damage) is used, supplemented with Ganju, Bohe, Xuanshen, and Can'erzi. Since the Brain belongs to the Kidney, Liuwei Wan is employed. Another condition involves Brain pain and discharge of foul yellow water, commonly called Kongnaosha (indicating worms eating the Brain), treated with Si Gua Teng (near the root, 3-5 cun), calcined to retain its nature, taken with wine (2 qian), yielding immediate results. Externally, peach leaves make a pillow. (Bi Yuan is also discussed in the Wind Injury chapter).
Frequent discharge of clear mucus is called Bi Qiu. For Lung Heat (where Lung Heat causes abundant Qi to transform into clear mucus; it remains clear rather than turbid because Fire's nature is rapid, flowing away before it can become turbid), use Jiegeng, Shanzhi, Bohe, Maidong, Xuanshen, Xinyi, and Gancao. If caused by Brain Cold (where Brain Cold causes Qi to transform into fluid that flows down, like breath condensing in cold weather), use Can'erzi, Ganjiang, Shengma, Gaoben, Xinyi, Chuanxiong, and Rougui.
Nasal polyps resembling hemorrhoids or abscesses, with foul odor intolerable to proximity and pain intolerable to touch, arise from severe Damp-Heat stagnation, similar to mushrooms growing from damp-heat in soil. Treat with Qingfei Yin or Qianghuo Shengshi Tang (see Damp Injury). Alternatively, use Baifu, Jiegeng, Shanzhi, Huangqin, Xinyi, Baizhi, Mutong, Chaihu, Fangfeng, Cangzhu, and Bohe. Externally, blow Baifan powder mixed with a little Naosha; or insert cotton wrapped with Gouti, Xixin, and Shexiang powder to dissolve yellow fluid. Tender peach leaf hearts can also be inserted. Additionally, Xionghuang, Baifan, and Kudingxiang ground into powder, combined with frost plum flesh mashed into a paste formed into strips and inserted into the nose, is also effective.
For nasal ulcers, apply Huanglian, Dahuang, and Shexiang powder to the nose. Xinyi Gao is also suitable. Internally, Wu Xi Wan. For Lung Heat causing dry nose without mucus and mental restlessness, use Xijiao San or Sanggen Baipi San.
For nasal pain, use Gegen, Zhuye, Qingdai, Bohe, Fangfeng, Shigao, Shengma, and Shihu. Externally, Xunao San extracts yellow fluid from the nose. If food accidentally enters the nose causing lingering pain, insert beef or sheep fat (size of a finger) into the nose; upon inhalation, the fat melts, bringing the object out with it.
Redness or purplish-black discoloration of the nose indicates Yangming Blood Heat, often resulting from alcohol consumption where heat steams the Lung lobes. If constrained by cold, coagulation fails, leading to stasis and purplish-black color. Treatment requires resolving stasis, generating new blood, and dispelling Wind-Heat using Danshen, Shengdi, Danggui, Honghua, Shanzhi, Sangbai, Fangfeng, and Bohe, decocted and taken. Or, use Jiuzhi Siwu Tang (see Blood Disorders) added with Jiuchao Pianhuang, Chenpi, Sheng Gancao, Jiuhonghua, and Shengjiang, decocted and mixed with Wulingzhi powder. For obese individuals with weak Qi, add Jiuzhi Huangqi, adding a few drops of good wine before taking. If the patient does not drink alcohol, it is Lung Wind-Heat; add Jingjie to the previous formula. It may also be internal worms, treated with vermifuges. Externally, grind 20 Xingren (peeled, oiled), 2 Hutao (with skin), bake on tile until not burnt, mix with 3 Da Fengrou and 3 fen Shuiyin, rub with saliva and hand into black water, and apply; heals in two or three applications.
Foul breath from the nose, if not due to nasal hemorrhoids, indicates severe disease with organ failure and foul Qi, which is untreatable.