辨证
左寸脉浮缓,为伤风鼻塞。右寸脉浮洪而数,为鼻衄,鼻 。一时鼻塞为伤风,时常不
闻香
臭为肺热。鼻流浊涕不止,曰鼻渊,是胆经移热于脑也。时流臭黄水而脑亦时痛者,有
虫食脑。
通窍汤(治感冒) 羌防 本升麻兼,干葛芎苍各一钱,麻椒细辛三分用,惟有白芷五
分添。
丽泽汤(治鼻不闻香臭) 黄 八分炙草四,羌独苍防椒葛升,白芷六分八味等,冬月
麻黄留
苍耳散 治鼻渊。
苍耳二钱五分(炒) 辛夷五钱 白芷一两 薄荷叶一钱 为末,葱茶汤调服二钱。
天竺黄丸 治鼻渊。
人参 当归 川芎 白芷 茯苓 麦冬 防风 荆芥 苍耳子 薄荷 香附 蔓荆子
秦艽 甘草各一两 天竺黄三钱蜜丸,如梧子大,米汤下三四十丸。
洗肺散
治鼻中生疮。
天冬 麦冬(并去心)一钱 黄芩 半夏各二钱 杏仁八分 五味子七分 甘草五分生
姜煎服。
单方
治鼻流黄水。丝瓜藤,近根三尺,烧灰存性,为末,酒调服。
又方
治鼻渊 黄木香花,铺头顶,以帽笼之,一二日即愈。
余论
鼻塞不闻香臭,或略寒便塞,多认作肺寒,用解表之药不效,或通而复塞,不知此是肺
经火邪,郁甚而致,法当清金降火。而佐以通利之剂。(鼻衄见失血,鼻 见外科)赤鼻 硫
黄、白矾等分为末。用茄汁敷之,愈。治鼻赤 薄荷一两五钱 山□花 黄芩 胡麻仁 山
栀子 防风 葛花 苦参各一两 连翘 荆芥 芍药 甘草各五钱茶清调下三钱。
又方
槐米、绿豆、糯米,等分,糊丸汤下。
又方
山栀、槐米,并炒黑,蜜丸,汤下。
又方
苦参四两,当归二两。酒糊丸,茶下。
又方
枇杷叶(去毛),苦参、面、猪油,调做如僧帽,蒸热,下一钱五分,左赤早服,右赤
晚服,外用白矾、水银、金墨各一钱,轻粉七分,杏仁、大枫子、五味子各四十九粒,白杨
头,核桃各七个,鸡子清调搽。
又方
槐花一两,青盐三钱,同炒黄研,卧时,用唾涂鼻,药末掺上,早晨以皂角洗去。
又方
茄汁调硫矾末敷。
又方
白矾末 唾搽半月,效。并治面赤。
治鼻中生臭肉(痛且臭者)
苦瓜蒂五钱 甘遂一钱 枯矾 草乌尖 白螺壳各五钱。
绵裹入鼻,坐半日即消。
又方
白矾末加 砂少许吹之。或用猪油调,绵裹塞鼻。
又方
甜瓜蒂、细辛等分为末,塞鼻。再与胜湿汤,泻白散各一帖。
治鼻痈 绿矾一钱 雄黄五分 丝瓜蒂二个 麝香少许。
为末,搐鼻。并治息肉。
辨证
左寸脉象浮而缓,是伤风导致的鼻塞。右寸脉象浮大洪数,是鼻衄(鼻出血)或鼻息肉的症状。突然出现的鼻塞属于伤风;经常闻不到香味和臭味,则是肺热的表现。鼻涕浑浊且流个不停,称为鼻渊,这是胆经的热邪移注于脑所致。时常流出臭黄水且脑部也时常疼痛的,是有虫蛀食脑髓。
通窍汤(治疗感冒引起的鼻塞):羌活、防风、藁本、升麻各兼用,干葛根、川芎、苍术各一钱,细辛三分,花椒三分,白芷五分。
丽泽汤(治疗鼻子闻不到香臭):黄芪八分,炙甘草四分,羌活、独活、苍术、防风、花椒、葛根、升麻各等分,白芷六分,共八味药剂量相等。冬季可用麻黄代替部分药物,保留苍耳子。
苍耳散:治疗鼻渊。苍耳子二钱五分(炒),辛夷五钱,白芷一两,薄荷叶一钱。研为末,用葱白茶汤调服二钱。
天竺黄丸:治疗鼻渊。人参、当归、川芎、白芷、茯苓、麦冬、防风、荆芥、苍耳子、薄荷、香附、蔓荆子、秦艽、甘草各一两,天竺黄三钱。炼蜜为丸,如梧桐子大,米汤送服三四十丸。
洗肺散:治疗鼻中生疮。天冬、麦冬(均去心)各一钱,黄芩、半夏各二钱,杏仁八分,五味子七分,甘草五分。加生姜煎服。
单方
治疗鼻流黄水:取丝瓜藤靠近根部三尺处,烧成灰但保留药性,研为末,用酒调服。
又一方
余论
鼻塞闻不到香臭,或者稍微受寒就鼻塞,很多人误认为是肺寒,使用解表药无效,或者通了之后又塞住。不知道这是因为肺经火邪郁结严重所致,治法应当清金降火,并辅以通利之剂。(鼻衄见失血篇,鼻息肉见外科篇)
赤鼻(鼻头红赤):硫黄、白矾等分为末。用茄子汁调和敷患处,可愈。
治疗鼻赤:薄荷一两五钱,山□花(原文缺字,疑为某种花卉)、黄芩、胡麻仁、山栀子、防风、葛花、苦参各一两,连翘、荆芥、芍药、甘草各五钱。茶清调下三钱。
又一方:枇杷叶(去毛),苦参、面粉、猪油,调和做成僧帽形状,蒸热后,内服一钱五分。左侧鼻赤早晨服用,右侧鼻赤晚上服用。外用白矾、水银、金墨各一钱,轻粉七分,杏仁、大枫子、五味子各四十九粒,白杨头、核桃各七个,鸡蛋清调和外搽。
又一方:槐花一两,青盐三钱,同炒黄后研磨。睡前用唾液涂鼻,将药末掺入,早晨用皂角水洗去。
治疗鼻中生臭肉(疼痛且有臭味者):苦瓜蒂五钱,甘遂一钱,枯矾、草乌尖、白螺壳各五钱。用绵裹住放入鼻中,坐半小时即能消除。
Diagnosis and Differentiation
A floating and moderate pulse at the left Cun position indicates nasal congestion due to wind-cold injury. A floating, full, rapid, and large pulse at the right Cun position indicates epistaxis (nosebleed) or nasal polyps. Sudden onset of nasal congestion is attributed to wind-cold; chronic inability to smell odors is a sign of Lung heat. Continuous flow of turbid nasal discharge is termed Bi Yuan (nasal sinusitis), caused by heat transferring from the Gallbladder meridian to the brain. Frequent discharge of foul-smelling yellow fluid accompanied by intermittent headache suggests parasitic infestation of the brain.
Tong Qiao Tang (for treating cold-induced nasal congestion): Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Gao Ben (Ligustici Chuanxiong Rhizoma), Sheng Ma (Cimicifugae Rhizoma) are used together; Ge Gen (Puerariae Lobatae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Cang Zhu (Atractylodis Rhizoma) each one qian (3g); Xi Xin (Asari Radix et Rhizoma), Hua Jiao (Zanthoxyli Pericarpium) each three fen (0.9g); Bai Zhi (Angelicae Dahuricae Radix) five fen (1.5g).
Li Ze Tang (for treating anosmia due to nasal obstruction): Huang Qi (Astragali Radix) eight fen (2.4g), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) four fen (1.2g); Qiang Huo, Du Huo (Angelicae Pubescentis Radix), Cang Zhu, Fang Feng, Hua Jiao, Ge Gen, Sheng Ma in equal amounts; Bai Zhi six fen (1.8g). The eight ingredients are of equal dosage. In winter, Ma Huang (Ephedrae Herba) may be retained, along with Cang Er Zi (Xanthii Fructus).
Cang Er San: For treating Bi Yuan. Cang Er Zi two qian 5 fen (8.75g, stir-fried), Xin Yi (Magnoliae Flos) five qian (15g), Bai Zhi one liang (30g), Bo He Ye (Menthae Haplocalycis Folium) one qian (3g). Grind into powder, take two qian (6g) mixed with green onion tea decoction.
Tian Zhu Huang Wan: For treating Bi Yuan. Ren Shen (Ginseng Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong, Bai Zhi, Fu Ling (Poria), Mai Dong (Ophiopogonis Radix), Fang Feng, Jing Jie (Schizonepetae Spica), Cang Er Zi, Bo He, Xiang Fu (Cyperi Rhizoma), Man Jing Zi (Vittariae Semen), Qin Jiao (Gentianae Macrophyllae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma) each one liang (30g); Tian Zhu Huang (Bambusae Concretio Silicea) three qian (9g). Honey-pilulated, size of wu zi (buckwheat seed), swallow thirty to forty pills with rice water.
Xi Fei San: For treating sores in the nose. Tian Dong (Asparagi Radix), Mai Dong (each heart removed) each one qian (3g); Huang Qin (Scutellariae Radix), Ban Xia (Pinelliae Rhizoma Praeparatum) each two qian (6g); Xing Ren (Armeniacae Semen Amarum) eight fen (2.4g); Wu Wei Zi (Schisandrae Chinensis Fructus) seven fen (2.1g); Gan Cao five fen (1.5g). Decoct with fresh ginger and take.
Single Prescriptions
For treating yellow nasal discharge: Take the vine of Loofah (Luffae Fructus) near the root for three chi (approx. 1 meter), burn to ash while preserving its properties, grind into powder, and take with wine.
Another prescription for Bi Yuan: Spread Huang Mu Xiang Hua (flowers of Aquilaria sinensis or similar aromatic wood) on the top of the head, cover with a hat, and it will heal in one to two days.
Additional Remarks
Nasal congestion and loss of smell, or congestion triggered slightly by cold, are often mistaken for Lung cold. If exterior-releasing herbs fail, or if relief is temporary followed by re-congestion, it is unknown that this is caused by severe stagnation of fire-evil in the Lung meridian. The treatment method should involve clearing Metal and descending fire, assisted by agents that promote free flow. (Epistaxis is discussed under Hemorrhage; Nasal Polyps under Surgery.)
For Red Nose (Rhynophyma/Redness): Liu Huang (Sulfur) and Bai Fan (Alumen) in equal parts, ground into powder. Apply with eggplant juice to cure.
For treating nasal redness: Bo He fifteen qian 5 fen (48.75g), Shan [Missing Character] Hua (Flower name incomplete), Huang Qin, Hu Ma Ren (Sesami Semen), Shan Zhi Zi (Gardeniae Fructus), Fang Feng, Ge Hua (Puerariae Flos), Ku Shen (Sophorae Flavescentis Radix) each one liang (30g); Lian Qiao (Forsythiae Fructus), Jing Jie, Shao Yao (Paeoniae Radix Alba), Gan Cao each five qian (15g). Take three qian (9g) mixed with clear tea decoction.
Another prescription: Huai Mi (Sophorae Japonicae Flos Bud), Lv Dou (Phaseoli Radiati Semen), Nuo Mi (Oryzae Glutinosa Semen) in equal parts. Form pills with paste, take with water.
Another prescription: Shan Zhi Zi, Huai Mi, stir-fried until black, honey-pilulated, take with water.
Another prescription: Ku Shen four liang (120g), Dang Gui two liang (60g). Form pills with wine paste, take with tea.
Another prescription: Pi Pa Ye (Loofah Leaf, hairs removed), Ku Shen, flour, pig fat. Mix to form a shape resembling a monk's cap, steam until hot, take one qian 5 fen (4.5g) internally. For left-sided nasal redness, take in the morning; for right-sided, take in the evening. Externally: Bai Fan, Shui Yin (Mercurius), Jin Mo (Gold Ink) each one qian (3g); Qing Fen (Calomel) seven fen (2.1g); Xing Ren, Da Feng Zi (Crotonis Fructus), Wu Wei Zi each forty-nine grains; Bai Yang Tou (Populus White Twig), Tao He (Prunus Persica Seed) each seven pieces. Mix with egg white and apply externally.
Another prescription: Huai Hua (Sophorae Japonicae Flos) one liang (30g), Qing Yan (Halitum) three qian (9g). Stir-fry together until yellow, grind. Before sleep, apply saliva to the nose, sprinkle the powder inside, and wash off with soap pod solution in the morning.
Another prescription: Apply powder of Liu Huang and Bai Fan mixed with eggplant juice.
Another prescription: Bai Fan powder applied with saliva for half a month is effective. Also treats facial redness.
For treating foul-smelling fleshy growths in the nose (painful and odorous): Ku Gua Di (Momordicae Fructus Peduncle) five qian (15g), Gan Suan (Euphorbiae Pekinensis Radix) one qian (3g); Ku Fan (Alumen Calcined), Cao Wu Jian (Aconiti Radix Lateralis Preparata tip), Bai Luo Ke (Concha Meretricis et Cyclinae) each five qian (15g). Wrap in cotton, insert into the nose, sit for half a day for it to dissolve.
Another prescription: Blow Bai Fan powder with a small amount of Pi Shuang (Arsenic Trioxide) into the nose. Or mix with pig fat, wrap in cotton, and plug the nose.
Another prescription: Tian Gua Di (Momordicae Fructus Peduncle) and Xi Xin in equal parts, ground into powder, insert into the nose. Additionally, administer Sheng Shi Tang (Dampness-Dispelling Decoction) and Xie Bai San (White-Lung-Purging Powder), one dose each.
For treating Nasal Furuncle (Bi Yong): Lü Fan (Melanteritum) one qian (3g), Xiong Huang (Realgar) five fen (1.5g); Si Gua Di two pieces; She Xiang (Moschus) a small amount. Grind into powder, insufflate into the nose. Also treats polyps.