热咳嗽不止。恐成痨瘵。用团鱼丸。疏理肺气。滋利肝血。攻补兼用。方法最善。
一痨虫咳。心中郁郁微烦。面色乍赤乍白。喉中痒不可耐。咳嗽不止。不知香臭。宜用月华丸。调肺杀虫治
之。究虫之生。乃由瘀血停聚。热蒸湿腐。又被肝风扇动。是以化生痨虫。既变成虫。则从虫治之。而亦须兼
去瘀血。以除其根。清湿热以涤其源。息风木以靖其机。聚毒药以杀其类。此方数法兼备。于治痨虫已得
大概。另详痨虫门。参看自知。
又有肺痈咳嗽。吐脓血者。另详吐脓门。
又有食积之火。冲肺作咳。其火多在五更。流入肺中而咳。此病不关血分。然虚人往往有之。随用小柴胡
逍遥散。加山楂神曲麦芽莱菔子山栀麦冬。黄昏咳嗽。为阳将入阴。浮火不能内敛。入肺而咳。宜用五味
子川文蛤兜铃等治之。
其余杂血咳嗽。不关血证者。自有方书可查。兹不具论。
鼻为肺窍。鼻根上接太阳经脉。鼻孔下夹阳明经脉。内通于肺。以司呼吸。乃清虚之道。与天地相通之门
户。宜通不宜塞。宜息不宜喘。宜出气不宜出血者也。今乃衄血何哉。金匮谓热伤阳络则衄血。热伤阴络
则便血。阴络者。谓躯壳之内。脏腑油膜之脉络。内近肠胃。故主便血。阳络者。谓躯壳之外。肌肉皮肤脉络
之血。从阳分循经而上。则乾清道。而为衄也。然则阳络者。太阳阳明之络脉也。盖太阳阳明。统走人身躯
壳之外。阳络之血。伤于太阳者。由背上循经脉。至鼻为衄。仲景所谓春夏发太阳者是也。伤于阳明者。由
胸而上。循经至鼻。仲景所谓秋冬发阳明者是也。今分两条论之。
太阳主开。春夏阳气。本应开发。若一郁闭。则邪气壅而为衄。其证鼻塞头痛。寒热昏愦。或由素有郁热应
春夏开发之令而动。或由风瘟暑疫。攻发而动。又有伤寒失汗。邪无出路。因由血分泄而为衄。此名红汗。
乃邪欲自愈。医者不可不知。然即红汗论之。可知太阳之气。不得泄于皮毛。则发为红汗。即可知太阳之
热。不得发越于外者。必逼而为鼻衄也。皮毛者。肺之合。太阳之气。外主皮毛。内合于肺。鼻又为肺之窍。欲
治太阳之衄者。必以治肺为主。观伤寒论。治太阳。用麻杏理肺。则知治肺即治太阳矣。法宜清泻肺火。疏
利肺气。肺气清。则太阳之气自清。而衄不作矣。风寒外来。皮毛洒淅无汗者。麻黄人参芍药汤如肺火壅
盛。头昏痛气喘。脉滑大数实者。人参泻肺汤。加荆芥粉葛蒲黄茅根生地童便。久衄血虚。用丹溪止衄散。
加茅花黄芩荆芥杏仁。以上数方。鼻塞者。俱加麝香黄连。盖风寒杂证。鼻塞多是外寒闭之。此证鼻塞者
尤多。乃是内火壅之。如用羌活。则鼻愈塞矣。故用黄连麝香。以开火之闭。衄血既止。宜多服止衄散原方。
及六味地黄汤以收功。又有肾经虚火。浮游上行。干督脉经而衄血者。必见腰痛项脊痛。头昏足厥冷等
证。所以然者。肾经虚火上行故也。宜用止衄散。去黄 。加碎补牛膝续断粉葛鹿角尖童便元参治之。盖
督脉丽于太阳。故以治太阳者。兼治督脉。亦犹冲脉丽于阳明。而以治阳明者。兼治冲脉也。太阳为少血
之经。督脉乃命元之主。其血均不可损。衄止后。即宜用地黄汤。加天冬阿胶血余五味以补之。
阳明。主阖秋冬阴气。本应收敛。若有燥火伤其脉络。热气浮越。失其主阖之令。逼血上行。循经脉而出于
鼻。其证口渴气喘。鼻塞孔干。目眩发热。或由酒火。或由六气之感。总是阳明燥气。合邪而致衄血。盖阳明
本气原燥。病入此经。无不化而为燥。治法总以平燥气为主。泻心汤。加生地花粉枳壳白芍甘草。或用犀
角地黄汤。加黄芩升麻。大解热毒。鼻衄止后。宜用玉女煎。加蒲黄以滋降之。再用甘露饮多服以调养之。
肆饮梨胶藕汁莱菔汁白蜜等。皆与病宜。
以上两条。治法各异。然鼻总系肺经之窍。血总系肝经所属。故凡衄家。目必昏黄。仲景云。目黄者衄未止。
目了慧者。其衄已止。以肝开窍于目。血扰肝经。故目黄也。治宜和肝。而其血犯肺窍出。又宜和肺。今且不
问春夏。不分秋冬。总以调治肝肺为主。生地黄汤治之。服后衄止。再服地骨皮散以滋之。盖不独衄血宜
治肝肺。即一切吐咯。亦无不当治肝肺也。肝主血。肺主气。治血者必调气。舍肝肺而何所从事哉。
又凡衄血。久而不止。去血太多。热随血减。气亦随血亡矣。此如刀伤。血出不止。则气亦随亡。而血尽则死
也。急用独参汤救之。手足冷。气喘促。再加附子。以引气归根。如其人鼻口黑黯。面目茄色。乃血乘肺脏之
危候。缓则不救。二味参苏饮治之。此等危证。在所不治。用参苏饮。亦理应如是救济耳。其效与否。非敢期必。
按病在肠胃者。药到速。病在经脉者。药到缓。衄血病在经脉。兼用外治法。亦能取急效。用十灰散塞鼻。并
吞咽十灰散。为极稳妥。或用人爪甲。 为末。吹鼻止衄。或用壁钱窠塞鼻。取其脉络以维护之。龙骨吹鼻。
能干结血孔免衄。白矾吹鼻。性走窜截血。醋和土敷阴囊。囊为肝所属。肝主血。敷囊以收敛肝气。则肝血
自止。上病取下。治尤有理。鳝血滴鼻中。鳖血点鼻。温水浸足。使热气下引。捆病患中指。用湿纸贴脑顶。熨
斗熨纸令干。乃汤熨取火之法。数者或效或不效。备录其方。以资采择。
衄家不可发汗。汗则额陷。仲景已有明禁。以此例推。可知一切血证。均不宜发汗。医者慎之。
虽与吐咳诸证不同。然其为血一也。宜参看各门。庶治之百不失一。
热邪引起的咳嗽持续不止，担心会发展为肺痨（慢性消耗性疾病）。使用团鱼丸，以疏理肺气、滋利肝血。攻补兼施，方法最为妥善。
有一种是痨虫咳嗽，心中郁郁微烦，面色忽红忽白，喉中瘙痒难忍，咳嗽不止，嗅觉失灵。适宜使用月华丸，调理肺部并杀灭痨虫进行治疗。探究痨虫的产生，是由于瘀血停滞积聚，热气蒸腾湿气腐败，又被肝风煽动，从而化生为痨虫。既然已经变成虫子，就应当按治虫的方法处理，但也必须兼顾去除瘀血，以除病根；清除湿热以涤荡源头；平息肝风以安定病机；聚集毒药以杀灭虫类。这个方子几种方法兼备，对于治疗痨虫已经有了大致的法则。另外详细记载在“痨虫门”中，参考自知即可。
又有肺痈咳嗽，吐出脓血的情况，另见“吐脓门”。
又有因食积产生的火气，冲犯肺部导致咳嗽，这种火气多在五更天发作，流入肺中引起咳嗽。此病不关乎血分，但体虚之人往往会有这种情况。随症用小柴胡汤合逍遥散，加入山楂、神曲、麦芽、莱菔子、山栀、麦冬。黄昏时咳嗽，是因为阳气即将入阴，浮火不能内敛，进入肺部而致咳。适宜用五味子、川文蛤、兜铃等药物治疗。
其余杂乱的出血性咳嗽，不属于血证范畴的，自有方书可以查阅，这里不再详细论述。
鼻子是肺的窍道。鼻根上方连接太阳经脉，鼻孔下方夹持阳明经脉，内部通于肺，主管呼吸。这是清虚之道，是与天地相通门户。宜通畅不宜堵塞，宜安静不宜喘息，宜出气不宜出血。现在却出现鼻衄（鼻出血），为什么呢？《金匮要略》说热伤阳络则鼻衄，热伤阴络则便血。阴络，是指躯壳之内，脏腑油膜之间的脉络，内近肠胃，所以主便血。阳络，是指躯壳之外，肌肉皮肤之间的脉络，血液从阳分循经而上，干犯清道，就成为衄血。那么阳络，就是太阳和阳明的络脉。大概太阳和阳明经脉，统管人身躯壳之外。阳络之血，损伤于太阳经的，由背部循经脉上行至鼻而为衄，这就是张仲景所说的春夏季节发病多属太阳经的情况。损伤于阳明经的，由胸部向上，循经脉至鼻，这就是张仲景所说的秋冬季节发病多属阳明经的情况。现在分两条来论述。
太阳经主开泄，春夏阳气本应开发，如果一旦郁闭，则邪气壅滞而导致衄血。其症状有鼻塞头痛，寒热昏愦。或者由于素体有郁热，顺应春夏开发的时令而动；或者由风瘟暑疫，攻发而动。又有伤寒失于发汗，邪气没有出路，因而由血分泄出而为衄血。这名叫“红汗”，是邪气想要自愈的表现，医者不可不知道。然而即使从红汗的角度来看，也可以知道太阳之气如果不能发泄于皮毛，就会发为红汗；由此也可知太阳的热邪如果不能发散于外，必定逼迫血液上逆而为鼻衄。皮毛是肺的外合，太阳之气外主皮毛，内合于肺，鼻子又是肺的窍道。想要治疗太阳经的衄血，必须以治肺为主。观察《伤寒论》，治疗太阳病用麻杏石甘汤理肺，就知道治肺即是治太阳了。治法适宜清泻肺火，疏利肺气。肺气清肃，则太阳之气自然清肃，衄血就不会发生了。如果是风寒外来，皮毛洒淅恶寒无汗者，用麻黄人参芍药汤；如果肺火壅盛，头昏痛气喘，脉滑大数实者，用人参泻肺汤，加荆芥、粉葛、蒲黄、茅根、生地、童便。久患衄血导致血虚者，用丹溪止衄散，加茅花、黄芩、荆芥、杏仁。以上几个方子，如果有鼻塞症状的，都加麝香、黄连。大概风寒杂证导致的鼻塞多是外寒闭塞所致，此证导致的鼻塞更多是内火壅塞所致。如果用羌活，则鼻子会更塞。所以用黄连、麝香来开通火气的闭塞。衄血既已停止，适宜多服用止衄散原方，以及六味地黄汤以收功。又有肾经虚火，浮游上行，干扰督脉经脉而导致衄血的，必然见到腰痛、项脊痛、头昏、足厥冷等症状。之所以这样，是因为肾经虚火上行的缘故。适宜用止衄散，去掉黄柏，加入碎补、牛膝、续断、粉葛、鹿角尖、童便、元参治疗。大概督脉依附于太阳经，所以治疗太阳经的同时兼治督脉，也如同冲脉依附于阳明经，治疗阳明经的同时兼治冲脉一样。太阳经是少血的经脉，督脉是命元的主宰，它们的血都不可以受损。衄血停止后，即宜用地黄汤，加天冬、阿胶、血余、五味子来补益。
阳明经主阖藏，秋冬阴气本应收敛，如果有燥火损伤其脉络，热气浮越，失去主阖的职能，逼迫血液上行，循经脉而出于鼻。其症状有口渴、气喘、鼻塞孔干、目眩发热。或者由饮酒之火引起，或者由六气之感引起，总是阳明燥气，合邪而导致衄血。大概阳明本气原为燥，病入此经，无不化而为燥。治法总以平抑燥气为主。可用泻心汤，加生地、花粉、枳壳、白芍、甘草。或用犀角地黄汤，加黄芩、升麻，大解热毒。鼻衄停止后，适宜用玉女煎，加蒲黄以滋阴降火。再用甘露饮多服以调养。肆意饮用梨胶、藕汁、莱菔汁、白蜜等，都对病情适宜。
以上两条，治法各异。然而鼻子总归是肺经的窍道，血总归是肝经所属。所以凡是患有衄血的人，眼睛必然昏黄。张仲景说，眼睛黄的，说明衄血未止；眼睛清澈明亮的，说明衄血已止。因为肝开窍于目，血扰肝经，所以眼睛发黄。治疗适宜调和肝脏，而其血侵犯肺窍流出，又适宜调和肺脏。现在不管春夏还是秋冬，总以调治肝肺为主。用生地黄汤治疗。服药后衄血停止，再服地骨皮散以滋养。大概不仅衄血适宜治肝肺，就是一切吐血、咯血，也没有不应当治肝肺的。肝主血，肺主气，治血的人必须调气，除了肝肺还能从哪里着手呢？
另外凡是衄血，久而不止，失血太多，热随血减，气也随血亡了。这就像刀伤，血出不止，则气也随之亡失，而血尽则死。急用独参汤抢救。如果手足冷，气喘急促，再加附子，以引气归根。如果其人鼻口黑黯，面目呈茄子色，这是血乘肺脏的危重征候，迟缓则无法救治。用二味参苏饮治疗。这种危重证候，属于在所不治之列，使用参苏饮，也是理应如此进行救济罢了。疗效如何，不敢期望必效。
按：病在肠胃者，药到速效；病在经脉者，药到缓效。衄血病在经脉，兼用外治法，也能取得紧急效果。用十灰散塞鼻，并吞咽十灰散，极为稳妥。或者用人爪甲研为末，吹鼻止衄。或者用壁钱窠塞鼻，取其脉络以维护止血。龙骨吹鼻，能干结血孔避免衄血。白矾吹鼻，性走窜截血。醋和土敷阴囊，阴囊为肝所属，肝主血，敷囊以收敛肝气，则肝血自止。上病取下，治疗尤其有理。鳝血滴鼻中，鳖血点鼻，温水浸足，使热气下引。捆扎病患中指，用湿纸贴脑顶，用熨斗熨纸令干，这是汤熨取火的方法。这些方法有的有效有的无效，记录在此以备采择。
患有衄血的人不可发汗，发汗则额部凹陷，张仲景已有明确禁忌。以此类推，可知一切血证，均不宜发汗。医者务必谨慎。
虽然与吐血、咳嗽诸证不同，但它们同为出血证。适宜参考各门内容，这样才能治疗百不失一。
Cough caused by heat pathogens persists without cessation, raising the fear of developing into *Lao Zhai* (consumptive disease). Use *Tuan Yu Wan* (Soft-shelled Turtle Pill) to soothe and regulate Lung Qi and nourish and benefit Liver Blood. Employing both attacking and tonifying methods simultaneously, this approach is most excellent.
One type is cough due to *Lao Chong* (tubercle bacillus/worm), characterized by a feeling of depression and slight irritability in the chest, complexion alternating between red and pale, unbearable itching in the throat, persistent cough, and loss of smell. It is appropriate to use *Yue Hua Wan* (Moonlight Pill) to regulate the Lungs and eliminate the worm for treatment. Investigating the origin of the worm, it arises from the stagnation and accumulation of Blood stasis, where heat steams dampness causing putrefaction, further agitated by Liver Wind, thus transforming into the *Lao Chong*. Once transformed into a worm, treatment should follow the method of eliminating worms, yet it is also necessary to concurrently remove Blood stasis to eradicate the root, clear damp-heat to purify the source, pacify Liver Wood/Wind to stabilize the mechanism, and gather toxic drugs to kill the species. This formula combines several methods and has grasped the general principles for treating *Lao Chong*. For details, refer to the section on *Lao Chong*; self-study will clarify.
There is also *Fei Yong* (lung abscess) with cough and expectoration of pus and blood; see the section on Expectoration of Pus for details.
There is also cough caused by fire from food retention rushing up to disturb the Lungs. This fire often manifests at dawn (5-7 AM), flowing into the Lungs to induce cough. This condition does not involve the Blood level, but it often occurs in deficient individuals. Prescribe *Xiao Chai Hu Tang* (Minor Bupleurum Decoction) combined with *Xiao Yao San* (Free and Easy Wanderer Powder), adding *Shan Zha* (Crataegi Fructus), *Shen Qu* (Massa Medicata Fermentata), *Mai Ya* (Hordei Fructus Germinatus), *Lai Fu Zi* (Raphani Semen), *Zhi Zi* (Gardeniae Fructus), and *Mai Dong* (Ophiopogonis Radix). Cough occurring at dusk indicates that Yang Qi is about to enter Yin, but floating fire cannot be contained internally, entering the Lungs to cause cough. Treat with *Wu Wei Zi* (Schisandrae Fructus), *Chuan Wen Ge* (Meretrix Shell), and *Dou Ling* (Loquat Leaf).
Other miscellaneous bloody coughs unrelated to Blood disorders have their own records in medical texts and are not discussed here.
The nose is the orifice of the Lungs. The root of the nose connects superiorly to the Taiyang (Greater Yang) meridian, while the nostrils are flanked inferiorly by the Yangming (Yang Brightness) meridians, internally connecting to the Lungs to govern respiration. It is a pathway of clarity and emptiness, a portal communicating with Heaven and Earth. It should be unobstructed rather than blocked, quiet rather than wheezing, allowing Qi out rather than bleeding. Why does nasal bleeding (*Nu Xue*) occur now? The *Jin Gui Yao Lue* states: "Heat injuring the Yang collaterals causes nasal bleeding; heat injuring the Yin collaterals causes rectal bleeding." Yin collaterals refer to the vessels within the body shell, specifically those in the fatty membranes of the Zang-Fu organs, close to the intestines and stomach, hence governing rectal bleeding. Yang collaterals refer to the vessels outside the body shell, in the muscles and skin. Blood from the Yang levels circulates upward along the meridians, invading the clear pathways, resulting in nasal bleeding. Thus, Yang collaterals are the collaterals of the Taiyang and Yangming meridians. Generally, the Taiyang and Yangming meridians traverse the exterior of the body shell. If Yang collateral blood is injured by the Taiyang meridian, it follows the back meridians upward to the nose, causing nasal bleeding; this corresponds to Zhang Zhongjing's statement that spring and summer diseases often originate from the Taiyang. If injured by the Yangming meridian, it rises from the chest upward along the meridians to the nose; this corresponds to his statement that autumn and winter diseases often originate from the Yangming. Now, let us discuss these two categories separately.
The Taiyang meridian governs opening. In spring and summer, Yang Qi should naturally expand and open. If it becomes depressed and closed, pathogenic factors accumulate, leading to nasal bleeding. Symptoms include nasal congestion, headache, aversion to cold and fever, and confusion. This may arise from pre-existing internal heat moving in response to the seasonal command of expansion, or from wind-warmth, summerheat, or epidemics attacking and triggering it. Additionally, if Cold Damage (*Shang Han*) fails to induce sweating, pathogenic factors have no exit and leak out through the Blood level as nasal bleeding. This is called "Red Sweat" (*Hong Han*), indicating the pathogen is attempting to resolve itself spontaneously; physicians must understand this. Even analyzing this as "Red Sweat," we can infer that if Taiyang Qi cannot vent through the skin and hair, it manifests as Red Sweat; similarly, if Taiyang Heat cannot disperse outward, it must force blood upward, causing nasal bleeding. Skin and hair are the exterior correspondence of the Lungs. Taiyang Qi governs the exterior skin and hair and internally correlates with the Lungs. Since the nose is the orifice of the Lungs, treating nasal bleeding from the Taiyang meridian must focus primarily on treating the Lungs. Observing the *Shang Han Lun*, treatments for Taiyang conditions use formulas like *Ma Xing Shi Gan Tang* (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction) to regulate the Lungs; thus, treating the Lungs is equivalent to treating the Taiyang. The method should involve clearing and draining Lung Fire and soothing and facilitating Lung Qi. When Lung Qi is clear, Taiyang Qi naturally clears, and nasal bleeding ceases. If external Wind-Cold causes chills and anhidrosis, use *Ma Huang Ren Shen Shao Yao Tang* (Ephedra, Ginseng, and Peony Decoction). If Lung Fire is congested and abundant, causing dizziness, headache, asthma, and a slippery, large, rapid, and excess pulse, use *Ren Shen Xie Fei Tang* (Ginseng and Lung-Draining Decoction), adding *Jing Jie* (Schizonepetae Herba), *Ge Gen* (Puerariae Radix), *Pu Huang* (Typhae Pollen), *Mao Gen* (Imperatae Rhizoma), *Sheng Di Huang* (Rehmanniae Radix), and *Tong Bian* (Human Urine). For chronic nasal bleeding leading to Blood deficiency, use Danxi's *Zhi Nu San* (Hemostatic Powder), adding *Mao Hua* (Bamboo Mite/Flower), *Huang Qin* (Scutellariae Radix), *Jing Jie*, and *Xing Ren* (Armeniacae Semen Amarum). For the above formulas, if nasal congestion is present, add *She Xiang* (Musk) and *Huang Lian* (Coptidis Rhizoma). Generally, nasal congestion from Wind-Cold mixed disorders is due to external Cold closure, whereas in this condition, it is mostly due to internal Fire congestion. Using *Qiang Huo* (Notopterygii Rhizoma et Radix) would worsen the congestion. Therefore, use *Huang Lian* and *She Xiang* to open the Fire blockage. Once nasal bleeding stops, it is appropriate to take more of the original *Zhi Nu San* and *Liu Wei Di Huang Tang* (Six-Ingredient Rehmannia Pill) to consolidate recovery. There is also nasal bleeding caused by Deficient Fire of the Kidney meridian floating upward and disturbing the Du Mai (Governor Vessel). Symptoms necessarily include lower back pain, neck and spine pain, dizziness, and cold feet. This occurs because of the upward movement of Kidney Deficient Fire. Treat with *Zhi Nu San*, removing *Huang Bo* (Phellodendri Cortex), and adding *Sui Bu* (Ecliptae Herba), *Niu Xi* (Achyranthis Bidentatae Radix), *Xu Duan* (Dipsaci Radix), *Ge Gen*, *Lu Jiao Jian* (Deer Antler Glue), *Tong Bian*, and *Xuan Shen* (Scrophulariae Radix). Since the Du Mai attaches to the Taiyang meridian, treating the Taiyang also treats the Du Mai, just as treating the Yangming treats the Chong Mai (Penetrating Vessel) which attaches to it. The Taiyang meridian is one of scant blood, and the Du Mai is the master of vital essence; neither's blood should be damaged. After nasal bleeding stops, immediately use *Di Huang Tang* (Rehmannia Decoction) added with *Tian Dong* (Asparagi Radix), *E Jiao* (Colla Corii Asini), *Xue Yu* (Calamitatis Carbo), and *Wu Wei Zi* to tonify.
The Yangming meridian governs closing. In autumn and winter, Yin Qi should naturally converge. If Dryness-Fire damages its collaterals, causing floating heat and loss of the closing function, blood is forced upward and exits through the nose via the meridians. Symptoms include thirst, asthma, dry nasal passages, vertigo, and fever. This may result from alcohol-induced fire or the influence of the Six Qi. Ultimately, it is always the Dryness Qi of the Yangming combining with pathogens to cause nasal bleeding. The Yangming's intrinsic nature is Dryness; once disease enters this meridian, it invariably transforms into Dryness. Treatment generally focuses on calming Dryness Qi. Use *Xie Xin Tang* (Drain the Epigastrium Decoction) added with *Sheng Di Huang*, *Hua Fen* (Trichosanthis Radix), *Zhi Ke* (Aurantii Fructus), *Bai Shao* (Paeoniae Radix Alba), and *Gan Cao* (Glycyrrhizae Radix). Or use *Xi Jiao Di Huang Tang* (Rhinoceros Horn and Rehmannia Decoction) added with *Huang Qin* and *Sheng Ma* (Cimicifugae Rhizoma) to greatly resolve heat toxicity. After nasal bleeding stops, use *Yu Nu Jian* (Jade Woman Decoction) added with *Pu Huang* to nourish and descend. Subsequently, take *Gan Lu Yin* (Sweet Dew Drink) frequently for recuperation. Drinking pear glue, lotus root juice, radish juice, and white honey freely is beneficial for the condition.
The above two categories have different treatment methods. However, the nose is fundamentally the orifice of the Lung meridian, and blood belongs to the Liver meridian. Therefore, anyone suffering from nasal bleeding will inevitably have yellowish/dim vision. Zhang Zhongjing said: "Yellow eyes indicate nasal bleeding has not stopped; clear eyes indicate nasal bleeding has ceased." Because the Liver opens into the eyes, blood disturbance affects the Liver meridian, causing yellow eyes. Treatment should harmonize the Liver. Since the blood invades the Lung orifice and flows out, it is also necessary to harmonize the Lungs. Regardless of season, the primary strategy is to regulate the Liver and Lungs. Treat with *Sheng Di Huang Tang* (Rehmannia Decoction). After nasal bleeding stops upon administration, take *Di Gu Pi San* (Lycium Bark Powder) to nourish. Not only is nasal bleeding treated by regulating the Liver and Lungs, but all forms of hematemesis and hemoptysis should also be treated this way. The Liver governs Blood, and the Lungs govern Qi. Those treating Blood must regulate Qi; where else can one begin but with the Liver and Lungs?
Furthermore, when nasal bleeding persists for a long time without stopping, excessive blood loss occurs. Heat decreases with the blood, and Qi perishes with the blood. This is like a knife wound: if blood flows continuously, Qi perishes with it, and death ensues when blood is exhausted. Immediately use *Du Shen Tang* (Single Ginseng Decoction) to rescue. If hands and feet are cold and breathing is rapid and short, add *Fu Zi* (Aconiti Lateralis Radix Praeparata) to guide Qi back to its root. If the patient has black and dark nose and mouth, and a violet-colored face, this is a critical sign of blood overwhelming the Lungs; delay means no salvation. Treat with *Er Wei Shen Su Yin* (Two-Ingredient Ginseng and Perilla Drink). Such critical conditions are considered untreatable; using *Shen Su Yin* is merely an attempt at rescue as duty requires. Efficacy is not guaranteed.
Note: Diseases in the intestines and stomach respond quickly to medicine; diseases in the meridians respond slowly. Nasal bleeding involves the meridians; combining external therapies can yield urgent results. Stuffing the nose with *Shi Hui San* (Ten Charcoals Powder) and swallowing it is extremely safe. Alternatively, grind human fingernails into powder and insufflate into the nose to stop bleeding. Or stuff the nest of the wall spider (*Bi Qian*) into the nose, utilizing its network-like structure to maintain hemostasis. Insufflating *Long Gu* (Fossilized Bones) can dry and seal blood vessels to prevent bleeding. Insufflating *Bai Fan* (Alumen) has a penetrating nature to intercept blood. Applying vinegar-mixed earth to the scrotum works because the scrotum belongs to the Liver, which governs Blood; applying to the scrotum converges Liver Qi, thereby stopping Liver Blood. Treating upper pathology by acting on the lower is highly logical. Dipping eel blood into the nose, applying turtle blood to the nose, soaking feet in warm water to draw heat downward, binding the patient's middle finger, placing wet paper on the vertex, and ironing the paper dry with a hot iron (a method of warming and drawing fire) are other techniques. Some may work, others may not; they are recorded here for reference.
Patients with nasal bleeding must not undergo diaphoresis (sweating therapy); inducing sweat leads to sunken forehead pits, a strict prohibition established by Zhang Zhongjing. By analogy, it is known that all Blood disorders should avoid diaphoresis. Physicians must be cautious.
Although distinct from hematemesis and coughing blood, they are all Blood disorders. Refer to various sections for comprehensive understanding, ensuring accurate treatment in every case.