《内经》谓“胆移热于脑则辛 鼻渊。” 者，鼻通脑之径
路也。辛 ，则 中觉刺戟也。鼻渊者，鼻流浊涕如渊之不竭也。盖病名鼻渊，而其病灶实在于 ，因
中粘膜生炎，有似腐烂，而病及于脑也。其病标在上，其病本则在于下，故《内经》谓系胆之移热。
而愚临证品验以来，知其热不但来自胆经，恒有来自他经者。而其热之甚者，又恒来自阳明胃腑。胆经之热，
大抵由内伤积热而成。胃腑之热，大抵由伏气化热而成。临证者若见其脉象弦而有力，宜用药清其肝胆之热，
若胆草、白芍诸药，而少加连翘、薄荷、菊花诸药辅之，以宣散其热，且以防其有外感拘束也。若见其脉象
洪而有力，宜用药清其胃腑之热，若生石膏、知母诸药，亦宜少加连翘、薄荷、菊花诸药辅之。且浊涕常流，
则含有毒性，若金银花、甘草、花粉诸药皆可酌加也。若病久阴虚，脉有数象者，一切滋阴退热之药皆可
酌用也。后世方书治此证者，恒用苍耳、辛夷辛温之品，此显与经旨相背也。夫经既明言为胆之移热，则不
宜治以温药可知。且明言 辛鼻渊，不宜更用辛温之药助其 益辛，更可知矣。即使证之初得者，或因外感
拘束，宜先投以表散之药，然止宜辛凉而不可用辛温也。是以愚遇此证之脉象稍浮者，恒先用西药阿斯匹林
瓦许汗之，取其既能解表又能退热也。拙着石膏解中，载有重用生石膏治愈此证之案数则，可以参观。又此证
便方，用丝瓜蔓煎汤饮之，亦有小效。若用其汤当水煎治鼻渊诸药，其奏效当尤捷也。
《黄帝内经》说：“胆经的热邪移注于脑，就会引起鼻渊。”鼻是通向脑部的通道。所谓“辛”，是指鼻腔中感觉到的刺痛感。鼻渊这个病名，指的是鼻涕浑浊如泉水般流个不停。大概是因为病名虽叫鼻渊，但病灶实际上在鼻腔内部，因为鼻腔黏膜发生炎症，看起来像腐烂一样，并且病情波及到了脑部。这个病的表象在上面，根本原因在下面，所以《黄帝内经》说这是胆经移热所致。
然而，根据我临床验证的经验，知道这种热邪不仅来自胆经，也常常来自其他经络。而且热邪严重的，往往来自阳明胃腑。胆经的热邪，大抵是由于内伤积热形成的；胃腑的热邪，大抵是由于伏气化热形成的。临证时如果见到脉象弦而有力，适宜用药清泻肝胆之热，比如龙胆草、白芍等药，并少量加入连翘、薄荷、菊花等药辅助，以宣散热邪，同时防止外感束缚肌表。如果见到脉象洪大而有力，适宜用药清泻胃腑之热，比如生石膏、知母等药，也应当少量加入连翘、薄荷、菊花等药辅助。况且浊涕常流，其中含有毒性，金银花、甘草、天花粉等药都可以酌情加入。如果病程长久导致阴虚，脉象呈现数象的，一切滋阴退热的药物都可以酌情使用。
后世的方书治疗此证，常常使用苍耳子、辛夷这些辛温性质的药物，这明显与经典旨意相违背。既然经典明确说明是胆经移热，那么就不宜用温药治疗，这是显而易见的。而且经典明确提到“辛”和“鼻渊”，更不宜再用辛温的药物助长其“辛”烈之气，这也更加清楚了。即使是在病症初起时，可能是因为外感束缚肌表，适宜先投予解表发散的药物，但也只宜用辛凉之品，不可用辛温之品。因此，我遇到此类病症且脉象稍浮的患者，常常先用西药阿司匹林少许让他发汗，取其既能解表又能退热的功效。我的著作《石膏解》中，记载了重用生石膏治愈此证的几个案例，可以参考。另外，此证有一个简便方，用丝瓜藤煎汤饮用，也有小效。如果用丝瓜藤汤作为水来煎煮治疗鼻渊的其他药物，疗效应当更加迅速。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "When heat from the Gallbladder channel shifts to the brain, it causes Biyuan (nasal sinusitis)." The nose is the pathway connecting to the brain. "Xin" refers to a stinging or burning sensation felt in the nasal cavity. Biyuan, named for this condition, refers to the continuous flow of turbid nasal discharge like an unfailing spring. Generally, although the disease is named Biyuan, the lesion is actually located within the nasal cavity; because inflammation occurs on the nasal mucosa, resembling putrefaction, and the pathology extends to the brain. The manifestation of the disease is superior, while its root lies inferiorly; hence, the *Neijing* attributes it to heat shifting from the Gallbladder.
However, based on my clinical experience and verification, I know that this heat does not only originate from the Gallbladder channel but often comes from other channels. Moreover, when the heat is severe, it frequently originates from the Stomach organ of the Yangming channel. Heat in the Gallbladder channel generally arises from accumulated internal injury heat, whereas heat in the Stomach organ generally arises from latent pathogenic factors transforming into heat. In clinical practice, if the pulse is wiry and forceful, it is appropriate to use herbs to clear heat from the Liver and Gallbladder, such as Gentian Root (Longdan Cao) and White Peony Root (Baishao), supplemented with small amounts of Forsythia Fruit (Lianqiao), Mint (Bohe), and Chrysanthemum Flower (Juhua) to disperse heat and prevent constraint by external pathogens. If the pulse is surging and forceful, it is appropriate to use herbs to clear heat from the Stomach organ, such as Raw Gypsum (Sheng Shigao) and Anemarrhena Rhizome (Zhimu), also supplemented with small amounts of Forsythia Fruit, Mint, and Chrysanthemum Flower. Furthermore, since turbid discharge flows continuously, it contains toxicity; therefore, Honeysuckle Flower (Jinyinhua), Licorice Root (Gancao), and Trichosanthes Root (Huafen) can be added as appropriate. If the disease has persisted for a long time leading to Yin deficiency, with a rapid pulse, all herbs that nourish Yin and reduce fever can be used as appropriate.
Later medical texts treating this syndrome often employ Cang'erzi (Xanthium Fruit) and Xinyi (Magnolia Flower), which are acrid-warm substances; this clearly contradicts the principles of the classics. Since the classics explicitly state it is heat shifting from the Gallbladder, it is evident that warm herbs should not be used. Moreover, given the explicit mention of "stinging" and "Biyuan," it is even more clear that acrid-warm herbs should not be used to exacerbate the acridity. Even if the syndrome is newly acquired due to external constraint, requiring initial release of the exterior, only acrid-cool herbs should be used, never acrid-warm ones. Therefore, when I encounter patients with this syndrome whose pulses are slightly floating, I often administer a small dose of Aspirin to induce sweating, taking advantage of its ability to both release the exterior and reduce fever. My work *Shigao Jie* (Explanation of Gypsum) records several cases where heavy doses of Raw Gypsum successfully cured this syndrome, which can be consulted. Additionally, a simple prescription for this syndrome involves decocting Luffa Vine (Sigua Man) for drinking, which yields minor effects. If the Luffa Vine decoction is used as water to decoct other herbs for treating Biyuan, the therapeutic effect would likely be even more rapid.