（附论）
夫时气鼻衄者。由五脏结热所为。心主于血。邪热中于手少阴之经。客于足阳明之络。
故衄血也。衄者。血从鼻中出也。
方
石膏饮子（出圣惠方）治时气鼻衄血。烦躁不止。头痛气逆。
石膏（捣碎二两） 竹茹（二两） 甘草（五钱炙微赤锉） 桂心（五钱） 赤芍药（一
两） 黄
芩（一两） 柴胡（去苗一两） 生地黄（三两） 上锉碎。和匀。每服半服。先以水一大
盏半。
侵伏龙肝二两。澄清一大盏。煎至五分。去滓。不拘时候。温服。
治时气心肺中热。鼻衄不止。（出圣惠方）
胡粉（炒黑细研） 干姜（炮制为末） 乱发灰（细研） 釜底墨（细研） 伏龙肝（细
研各少
许） 上药末少许。吹入鼻中便止。若吹一大豆许更效。
治时气鼻衄。心膈躁闷。面赤目黄。起卧不定。（出圣惠方）
乌贼鱼骨（二两） 刺苏（二两） 蒲黄（二两） 上为散。每服不计时候。以冷粥饮
调下二
钱。顿服。以定为度。
治时气鼻衄。诸药无效者。宜用此方。（出圣惠方）
白马通（七枚绞取浓汁） 阿胶（半两槌碎炒令黄燥研为末） 上同和熟搅。以滴鼻中。
仍
用新汲水微浸足。即止。
治时气鼻衄。日夜不止。面色如黄金。（出圣惠方）
取韭根一握。捣取汁。纳于瓶中。用绳悬于井内浸良久。急取出。滴二七滴鼻中。即止。
治时气卒患鼻衄不止（出圣惠方）
以郁金为末服。不拘时候。以冷水调下二钱。以定为度。
又方（出圣惠方）
熟艾（一鸡子大） 牛皮胶（一片如手大杵碎炒令黄燥） 上以豉汁二大盏。煎至一大
盏。
去滓。分温二服。
清凉散 治时气头目昏疼。久积热毒。鼻口中出血。
大黄（锉一两） 芍药（一两） 麻黄（去根节煎去沫一两） 上为散。每服一钱。以
沙糖冷
水调下。食后服。
生地黄饮 治时疾壮热头疼。鼻血不止。
生地黄汁 生藕汁 生姜汁 生蜜（三合） 上和匀。分作三服。每服微煎过。食后临
卧
服。
治天行毒病鼻血。是热毒血下数升者。病源。天行衄血者。五脏热结所为。心主于
血。邪热中于手少阴之经。客于足阳明之络。故衄血者。血从鼻出也。（出肘后方）
上勿疗自瘥。亦无所苦。亦可取好松烟墨捣之。以鸡子白和丸如梧桐子大。水下。一服
十丸。并无所忌。或用生地黄汁下二十丸。
大病瘥后。小劳便鼻衄方。（出肘后方）
左顾牡蛎（十分） 石膏（五分） 上捣为末。酒服方寸匕。三四日。亦可蜜丸如梧桐
子大。
服之。
龙骨散（出严氏济生方）治时气鼻衄三升以上。恐多。宜此药止。
龙骨（不拘多少） 上为细末。用少许吹入鼻中。九窍出血。皆用此药吹之。
【附论】
所谓时气鼻衄（因感受时令邪气导致的鼻出血），是由于五脏郁结热邪所致。心主司血液，邪热侵入手少阴心经，客居于足阳明胃经的络脉。
因此出现鼻出血。所谓“衄”，是指血液从鼻腔流出。
方剂
石膏饮子（出自《圣惠方》）：治疗时气鼻衄血。症状包括烦躁不止、头痛、气逆上冲。
药材：石膏（捣碎，二两）、竹茹（二两）、甘草（炙至微赤并锉碎，五钱）、桂心（五钱）、赤芍药（一两）、黄芩（一两）、柴胡（去苗，一两）、生地黄（三两）。
制法与用法：将上述药材锉碎，混合均匀。每次服用半服剂量。先取水一大盏半，浸泡伏龙肝二两，澄清后取一大盏水，煎煮至剩余五分水量，滤去药渣。不拘泥于特定时间，温服。
另一法（出自《圣惠方》）：治疗时气导致的心肺热盛，鼻衄不止。
药材：胡粉（炒黑并细研）、干姜（炮制后研为末）、乱发灰（细研）、釜底墨（细研）、伏龙肝（细研，各取少许）。
用法：取上述药末少许，吹入鼻中即可止血。若吹入如大豆大小的药量，效果更佳。
另一法（出自《圣惠方》）：治疗时气鼻衄，伴有心膈部躁动闷胀，面色红赤，目睛发黄，坐卧不安。
药材：乌贼鱼骨（二两）、刺苏（二两）、蒲黄（二两）。
制法与用法：将上述药材研为散剂。每次服用不拘时间，用冷粥汤调下二钱，一次性服完，以症状停止为度。
另一法（出自《圣惠方》）：治疗时气鼻衄，其他药物无效者，宜用此方。
药材：白马通（马粪，七枚绞取浓汁）、阿胶（半两，槌碎后炒至黄燥，研为末）。
制法与用法：将两者混合熟搅匀，滴入鼻中。同时用新汲取的井水轻微浸湿双脚，即可止血。
另一法（出自《圣惠方》）：治疗时气鼻衄，日夜不止，面色呈现金黄色。
用法：取韭菜根一把，捣烂取汁，装入瓶中。用绳子悬挂在井内浸泡较长时间，迅速取出，向鼻中滴入十四滴，即可止血。
另一法（出自《圣惠方》）：治疗时气突然患鼻衄不止。
用法：将郁金研为末服用，不拘时间，用冷水调下二钱，以症状停止为度。
又一方（出自《圣惠方》）
药材：熟艾（如鸡蛋大小）、牛皮胶（一片如手掌大，捣碎后炒至黄燥）。
制法与用法：用豆豉汁两大盏，煎煮至一大盏，滤去药渣，分两次温服。
清凉散：治疗时气引起的头目昏痛，久积的热毒，以及鼻口出血。
药材：大黄（锉碎，一两）、芍药（一两）、麻黄（去根节，煎煮去沫，一两）。
制法与用法：将上述药材研为散剂。每次服用一钱，用沙糖和冷水调下，饭后服用。
生地黄饮：治疗时行疾病（流行性热病）壮热、头疼，鼻血不止。
药材：生地黄汁、生藕汁、生姜汁、生蜜（三合）。
制法与用法：将上述材料混合均匀，分为三次服用。每次服用前微微煎煮，饭后临睡前服用。
治疗天行毒病（流行性传染病）引起的鼻血，热毒迫血下行，出血数升的情况。（出自《肘后方》）
病因：天行衄血（流行性鼻出血），是由五脏热结所致。心主司血液，邪热侵入手少阴心经，客居于足阳明胃经络脉，因此出现鼻出血，即血液从鼻腔流出。
处理：上述情况无需治疗可自行痊愈，也不会造成痛苦。也可以取优质的松烟墨捣碎，用鸡蛋清调和制成梧桐子大小的丸剂，温水送服。每次十丸，没有饮食禁忌。也可以用生地黄汁送服二十丸。
大病初愈后，稍加劳累便引发鼻衄的方剂。（出自《肘后方》）
药材：左顾牡蛎（十分）、石膏（五分）。
制法与用法：捣碎研为末，用酒送服方寸匕大小的药量。连续三四日。也可以制成蜜丸，如梧桐子大小服用。
龙骨散（出自严氏《济生方》）：治疗时气鼻衄，出血量达三升以上，担心失血过多，宜用此药止血。
药材：龙骨（不限数量）。
制法与用法：研为细末，取少许吹入鼻中。九窍出血，均使用此药吹入。
[Supplementary Discussion]
The condition known as seasonal qi epistaxis (nosebleed caused by pathogenic seasonal factors) arises from the accumulation of heat in the five zang organs. The Heart governs blood. When pathogenic heat invades the Hand-Shaoyin (Heart) meridian and lodges in the collaterals of the Foot-Yangming (Stomach) meridian, it leads to bleeding from the nose. "Nu" refers to blood flowing from the nasal cavity.
Prescriptions
Shigao Yinzi (Gypsum Decoction), sourced from *Shenghui Fang*, treats seasonal qi epistaxis accompanied by incessant irritability, headache, and rebellious qi.
Ingredients: Shigao (Gypsum Fibrosum, 2 liang, crushed), Zhuru (Bambusae Caulis in Taeniam, 2 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 5 qian, honey-fried until slightly reddish and chopped), Guixin (Cinnamomi Cortex, 5 qian), Chishaoyao (Paeoniae Radix Rubra, 1 liang), Huangqin (Scutellariae Radix, 1 liang), Chaihu (Bupleuri Radix, 1 liang, radix removed), Shengdihuang (Rehmanniae Radix Recens, 3 liang).
Preparation and Administration: Chop the ingredients finely and mix evenly. For each dose, take half a serving. First, add 1.5 large bowls of water and soak Fulonggan (Draconis Os, 2 liang). Clarify the liquid to obtain 1 large bowl. Decoct until only 0.5 parts remain. Strain the dregs. Take warm, without restriction on time.
Another method (from *Shenghui Fang*): Treats excessive heat in the Heart and Lungs due to seasonal qi, causing incessant epistaxis.
Ingredients: Hufen (Cerussa, stir-fried black and finely ground), Ganjiang (Zingiberis Rhizoma, processed into powder), Luangfa Hui (Ash of tangled hair, finely ground), Fudi Mo (Soot from the pot bottom, finely ground), Fulonggan (Draconis Os, finely ground; take a small amount of each).
Administration: Blow a small amount of the powdered medicine into the nostrils to stop bleeding immediately. If a quantity the size of a soybean is blown in, the effect is even better.
Another method (from *Shegui Fang*): Treats seasonal qi epistaxis with restlessness and oppression in the heart and diaphragm, flushed face, yellow eyes, and inability to sit or lie still.
Ingredients: Woumeiyu Gu (Sepiae Endoconcha, 2 liang), Cisù (Perillae Folium, 2 liang), Puhuang (Typhae Pollen, 2 liang).
Preparation and Administration: Grind into a powder. Take at any time, mixing 2 qian with cold congee water, taken in one dose. Stop when symptoms cease.
Another method (from *Shenghui Fang*): For seasonal qi epistaxis unresponsive to other medicines.
Ingredients: Baimatong (Equi Stercus, juice extracted from 7 pieces), Ejiao (Colla Corii Asini, 0.5 liang, pounded, fried until yellow and dry, ground into powder).
Preparation and Administration: Mix thoroughly and stir well. Drip into the nostrils. Simultaneously, soak the feet slightly in fresh well water to stop bleeding.
Another method (from *Shenghui Fang*): For seasonal qi epistaxis continuing day and night, with a golden-yellow complexion.
Method: Take a handful of Jiugen (Allii Tuberosi Radix), crush to extract juice, and store in a bottle. Suspend the bottle in a well for a long time. Remove quickly and drip 14 drops into the nostrils to stop bleeding.
Another method (from *Shenghui Fang*): For sudden onset of incessant epistaxis due to seasonal qi.
Method: Take Yujin (Curcumae Radix) powder, mixed with cold water (2 qian), taken at any time. Stop when symptoms cease.
Another Prescription (from *Shenghui Fang*)
Ingredients: Shuai (Artemisiae Argyi Folium, prepared, size of an egg), Niupijiao (Colla Corii Asini, one piece palm-sized, pounded and fried until yellow and dry).
Preparation and Administration: Decoct in 2 large bowls of Douzhi (Vicia faba fermentum decoction) until reduced to 1 large bowl. Strain and divide into two warm doses.
Qingliang San (Cooling Powder): Treats dizziness and pain in the head and eyes due to seasonal qi, long-standing accumulated heat-toxin, and bleeding from the nose and mouth.
Ingredients: Dahuang (Rhei Radix et Rhizoma, chopped, 1 liang), Shaoyao (Paeoniae Radix, 1 liang), Mahuang (Ephedrae Herba, roots and joints removed, boiled to remove foam, 1 liang).
Preparation and Administration: Grind into a powder. Take 1 qian per dose, mixed with rock sugar and cold water. Take after meals.
Shengdihuang Yin (Rehmannia Drink): Treats high fever and headache during epidemic febrile diseases, with incessant epistaxis.
Ingredients: Shengdihuang Zhi (Juice of Rehmanniae Radix Recens), Sheng'ou Zhi (Juice of Nelumbinis Rhizoma), Shengjiang Zhi (Juice of Zingiberis Rhizoma Recens), Shengmi (Honey, 3 he).
Preparation and Administration: Mix evenly. Divide into three doses. Slightly heat each dose before taking. Take after meals and before sleep.
Treating epistaxis caused by epidemic toxic disease, where heat-toxin forces blood downward resulting in several sheng of blood loss. (From *Zhouhou Fang*)
Pathogenesis: Epidemic epistaxis is caused by heat accumulation in the five zang organs. The Heart governs blood; pathogenic heat invades the Hand-Shaoyin meridian and lodges in the collaterals of the Foot-Yangming meridian, causing blood to flow from the nose.
Management: This condition may resolve spontaneously without treatment and causes no distress. Alternatively, use high-quality pine-soot ink, pounded and mixed with egg white to form pills the size of paulownia seeds. Swallow with water, 10 pills per dose. There are no dietary restrictions. Alternatively, swallow 20 pills using Shengdihuang juice.
Formula for epistaxis occurring after slight exertion following recovery from severe illness. (From *Zhouhou Fang*)
Ingredients: Zuogu Muli (Ostreae Concha, 10 fen), Shigao (Gypsum Fibrosum, 5 fen).
Preparation and Administration: Pound and grind into powder. Take a square-inch spoonful (fangcunbi) with wine. Continue for three to four days. Alternatively, make honey pills the size of paulownia seeds and take them.
Longgu San (Dragon Bone Powder), from Yan Shi's *Jisheng Fang*: Treats seasonal qi epistaxis with blood loss exceeding 3 sheng, fearing excessive hemorrhage. Use this medicine to stop bleeding.
Ingredients: Longgu (Fossilia Ossis Mastodi, any amount).
Preparation and Administration: Grind into fine powder. Blow a small amount into the nostrils. For bleeding from all nine orifices, use this powder blown into the affected orifice.