大意
肺脏位高体脆。性恶寒。又畏热。鼻为肺窍。若心肺有病。则气息不利。（丹溪）
内因
人身水升火降。荣卫调和。则鼻司呼吸。往来不息。苟或寒伤皮毛。则鼻塞不利。火郁清道。则香臭不知。（入门）
外候
有新久之别。新者偶感风寒。鼻塞便发。乃肺伏火邪。郁甚则喜热恶寒。故略感冒而亦发。又有不待外感。
时常鼻塞干燥者。乃肺有痰火也。（入门）
鼻涕外候
鼻乃清气出入之道。塞则气壅热郁。清浊混乱。为鼽为渊。鼽者鼻流清涕。热微。渊者鼻流清涕。热重。间有
属寒者。必涕清不臭。但觉腥秽。宜辛温填补。禁用凉剂。但郁热者多。脑寒者少。须审别施治。（汇补）
鼻 外候
好饮热酒。血热入肺。复被风寒外郁。则血凝于内。赤见于外而为鼻 之候。得热愈红。得冷则紫。或有不
好饮而病此者。乃肺风血热也。（丹溪）
鼻酸外候
鼻内酸痛。壅塞不利。由肺气空虚。火邪内攻。有制于肺也。（绳墨）又有气虚人每遇严寒。感寒鼻酸。此气虚
而易于招寒。内火不得泄越。相搏作酸。常服辛辣物则暂止者。以辛能发散故也。（汇补）
鼻痛外候
因风邪入鼻。与正气相搏。或痰火冲肺。或胃火上攻。俱令鼻梁作痛。（绳墨）
鼻痔外候
胃中食积热痰。流注肺中。令浊气凝结而生 肉。（丹溪）其形如枣。塞滞鼻中。气息不利。香臭不知。甚者又
名鼻 。（入门）
脉法
左寸浮缓。为伤风鼻塞。右寸浮洪。为肺火鼻 。
鼻病治标
鼻病。除伤风发散之外。皆由火热所致。俱用清金降火之法。（绳墨）
鼻病治本
凡鼽渊疮痔久不愈者。非心血亏。则肾水少。养血则阴生而火自降。补肾则水升而金自清。又鼻塞久不
愈者。亦有内伤肺胃。清气不能上升。非尽外感也。（入门）
用药
主以防风汤。外风。加羌活、荆芥、薄荷、细辛、辛夷、白芷。内火。加山栀、连翘、花粉、桔梗、元参、桑皮。
内外兼病。用双解散。内热过盛。用凉膈散。清气不升。补中益气汤。肾真不朝。六味丸。
【附脑砂】
胆移热于脑。鼻流浊涕。或时出黄水。甚者脑亦作痛。俗名脑砂。此是虫食脑中。
用丝瓜藤近根五尺。烧灰存性。为末。酒调服。外用白牛尾毛、橙叶。焙干各等分为末。吹鼻内。若虚寒者。
川乌散主之。
鼻病选方
防风汤 统治鼻病在标者。
防风 川芎 黄芩 桔梗 甘草 大力子
防风通圣散
治表清热。用此以双解。（见火症）
凉膈散 清火导热。
栀子 连翘 薄荷 黄芩 甘草 赤芍
大黄 芒硝
地黄煎 滋阴清火。用此以养真。
地黄汁（二合） 麦冬汁（三合） 生姜汁（一合） 川芎（二钱）
加盐花煎膏。
加味四物汤 治鼻 。
四物汤加陈皮、红花、酒芩、苍耳。加好酒数滴。调入五灵脂末服之。
快捷方式方
用凌霄花、山栀等分为末。每茶调服二钱。日再服。夜卧用凌霄花、朴硝为末。酒调涂。或凌霄花末和密
陀僧。用唾调敷。又方。用狗头骨烧灰。加 砂少许为末。吹入鼻中。 肉自化。又用地栗粉入冰片
少许点入。
清肺散（秘方） 治鼻中作痒。清晨打嚏。至午方住。明日亦然。屡效。
桑白皮 枯黄芩（各一钱酒炒） 生甘草（三分） 辛夷花（一钱） 苦桔梗（一钱） 凤凰壳（一个 临吃调）
水二钟。加灯心十二茎。煎服。
【大意】
肺脏位置高，质地脆弱。其性质厌恶寒冷，又畏惧炎热。鼻是肺的窍道。如果心、肺发生病变，就会导致气息运行不畅。（出自朱丹溪）
【内因】
人体内的水液上升，火气下降，营气与卫气调和，鼻子才能正常司职呼吸，气息往来不息。倘若寒邪损伤皮毛，就会造成鼻塞不通；火热郁结于清肃之通道（呼吸道），则会导致嗅觉丧失。（出自《医宗入门》）
【外候】
病情有新病和久病的区别。新病患者偶尔感受风寒，鼻塞随即发作，这是因为肺气中潜伏着火邪，郁结严重时喜欢热而厌恶寒，所以稍微感冒就会引发症状。还有的人不待外感风寒，时常感到鼻塞干燥，这是肺中有痰火所致。（出自《医宗入门》）
【鼻涕外候】
鼻子是清气出入的通道。若鼻塞，则气机壅滞，热气郁结，清浊之气混乱，从而形成“鼽”（qiú，鼻流清涕）或“渊”（yuān，鼻流浊涕）。所谓“鼽”，是指鼻流清涕，热象轻微；所谓“渊”，也是指鼻流清涕，但热象较重。间或有属于寒证的，必定鼻涕清稀且不臭，只是感觉腥秽。适宜用辛温药物填补，禁用凉性药剂。但郁热者多，脑寒者少，必须仔细辨别后施治。（出自《证治汇补》）
【鼻衄外候】
喜好饮用热酒，导致血热入肺，又被风寒在外部郁闭，使得血液凝滞于体内，赤色显现于外部，这就是鼻衄（nà，鼻出血）的症状。遇热颜色更红，遇冷则呈紫色。也有不喝酒却患此病的人，这是由于肺风血热所致。（出自朱丹溪）
【鼻酸外候】
鼻内感到酸痛，壅塞不通利，这是由于肺气空虚，火邪向内攻冲，制约了肺的功能。（出自《医宗绳墨》）又有气虚之人，每逢严寒，感受寒邪后鼻部发酸，这是因为气虚容易招致寒邪，体内的火气无法宣泄，与寒邪相搏结而产生酸痛感。常服用辛辣食物可以暂时止住，因为辛味能发散的缘故。（出自《证治汇补》）
【鼻痛外候】
由于风邪侵入鼻腔，与正气相搏结，或者痰火冲犯肺部，或者胃火上攻，都会导致鼻梁疼痛。（出自《医宗绳墨》）
【鼻痔外候】
胃中的食积热痰，流注到肺中，使浊气凝结而生出赘肉。（出自朱丹溪）其形状像枣子，堵塞在鼻中，气息不利，闻不到香味和臭味。严重的又叫做“鼻䖝”（chóng，鼻息肉）。（出自《医宗入门》）
【脉法】
左寸脉浮缓，是伤风鼻塞的表现；右寸脉浮洪，是肺火引起的鼻衄。
【鼻病治标】
鼻病，除了伤风需要发散解表之外，大多由火热引起。都采用清金（清肺）降火的方法治疗。（出自《医宗绳墨》）
【鼻病治本】
凡是鼽、渊、疮、痔长久不愈的，不是心血亏虚，就是肾水不足。养血则阴液生成而火自降；补肾则肾水上济而肺金自清。另外，鼻塞长久不愈的，也有因内伤肺胃，清气不能上升导致的，并不全是外感引起。（出自《医宗入门》）
【用药】
主方使用防风汤。若是外风，加羌活、荆芥、薄荷、细辛、辛夷、白芷。若是内火，加山栀、连翘、花粉、桔梗、元参、桑皮。内外兼病，使用双解散。内热过盛，使用凉膈散。清气不升，使用补中益气汤。肾真阳不朝（肾阳虚衰），使用六味丸。
【附：脑砂】
胆经的热邪移注于脑，导致鼻流浊涕，有时流出黄水，严重的脑部也会疼痛，俗名叫“脑砂”。这是虫类啃食脑中所致。
用靠近根部的丝瓜藤五尺，烧成灰但保留药性，研为粉末，用酒调服。外用白牛尾毛、橙叶，焙干后各等分研末，吹入鼻内。如果是虚寒证，以川乌散为主方。
【鼻病选方】
防风汤：统治鼻病在标（表象/急性期）者。
防风、川芎、黄芩、桔梗、甘草、大力子（牛蒡子）
凉膈散：
清火导热。
栀子、连翘、薄荷、黄芩、甘草、赤芍、大黄、芒硝
地黄煎：
滋阴清火，用此方以滋养真阴。
地黄汁（二合）、麦冬汁（三合）、生姜汁（一合）、川芎（二钱）
加入盐花煎制成膏。
加味四物汤：治疗鼻䖝（鼻息肉）。
四物汤加陈皮、红花、酒芩（酒炒黄芩）、苍耳。加入好酒数滴，调入五灵脂末服用。
快捷方式方：
用凌霄花、山栀等分为末，每次用茶调服二钱，每日两次。夜间睡觉前，用凌霄花、朴硝研末，用酒调匀涂抹。或者用凌霄花末混合密陀僧，用唾液调敷。另一方法，用狗头骨烧灰，加少许硇砂研末，吹入鼻中，赘肉自然化解。又用地栗粉（荸荠粉）加入少许冰片点入。
清肺散（秘方）：治疗鼻中作痒，清晨打喷嚏，直到中午才停止，第二天也是如此，屡试屡效。
桑白皮、枯黄芩（各一钱，酒炒）、生甘草（三分）、辛夷花（一钱）、苦桔梗（一钱）、凤凰壳（一个，临吃时调入）
用水两钟，加入灯心草十二茎，煎服。
[General Principle]
The Lung organ is located high in the body and has a delicate constitution. Its nature dislikes cold and fears heat. The nose is the orifice of the Lung. If pathologies occur in the Heart and Lung, the movement of Qi and respiration will be obstructed. (Zhu Danxi)
[Internal Causes]
In the human body, when Water ascends and Fire descends, and Ying (Nutritive) Qi and Wei (Defensive) Qi are harmonious, the nose can perform its function of respiration, with breath flowing continuously. If Cold damages the skin and hair pores, nasal congestion and obstruction will occur; if Fire stagnates in the clear passages (respiratory tract), olfaction will be lost. (Yi Zong Ru Men)
[External Manifestations]
There is a distinction between new-onset and chronic conditions. In new-onset cases, occasional exposure to Wind-Cold causes immediate nasal congestion due to latent Fire pathogens in the Lung Qi. When stagnation is severe, the patient prefers warmth and dislikes cold, so even slight exposure to Wind-Cold triggers symptoms. Others experience frequent nasal congestion and dryness without external exposure, which is caused by Phlegm-Fire in the Lung. (Yi Zong Ru Men)
[Manifestations of Nasal Discharge]
The nose is the pathway for the entry and exit of Clear Qi. Obstruction leads to Qi stagnation and Heat retention, causing confusion between Clear and Turbid substances, resulting in Qiu (rhinorrhea of clear fluid) or Yuan (rhinorrhea of turbid fluid). "Qiu" refers to the flow of clear nasal discharge with mild Heat; "Yuan" also refers to clear nasal discharge but with heavier Heat. Occasionally, it may belong to Cold patterns, characterized by clear, odorless discharge that smells fishy or foul. Warm and acrid tonifying methods should be used, while cooling agents are contraindicated. However, patterns of stagnant Heat are common, whereas Brain Cold is rare; treatment must be tailored after careful differentiation. (Zheng Zhi Hui Bu)
[Manifestations of Epistaxis]
A preference for drinking hot wine leads to Blood Heat entering the Lung. When combined with external Wind-Cold stagnation, Blood coagulates internally, manifesting externally as redness, which is the sign of Epistaxis (nosebleed). The color becomes redder with heat and purplish with cold. Some who do not drink alcohol still suffer from this condition due to Wind-Heat in the Lung and Blood Heat. (Zhu Danxi)
[Manifestations of Nasal Soreness]
Soreness and pain inside the nose with obstruction and difficulty in breathing result from Empty Lung Qi and internal attack by Fire pathogens, which constrain Lung function. (Yi Zong Sheng Mo) Additionally, individuals with Qi deficiency often experience nasal soreness upon exposure to severe cold. This is because Qi deficiency makes one susceptible to Cold, and internal Fire cannot vent freely, clashing with Cold to produce soreness. Taking spicy foods temporarily relieves this because acrid flavors can disperse. (Zheng Zhi Hui Bu)
[Manifestations of Nasal Pain]
Wind pathogens entering the nose clash with Righteous Qi, or Phlegm-Fire rushes to the Lung, or Stomach Fire attacks upward, all causing pain in the nasal bridge. (Yi Zong Sheng Mo)
[Manifestations of Nasal Polyps]
Food stagnation and Heat-Phlegm in the Stomach flow into the Lung, causing Turbid Qi to condense and form fleshy growths. (Zhu Danxi) These growths resemble dates, block the nasal cavity, hinder respiration, and impair olfaction. Severe cases are called Bi Chong (nasal polyps). (Yi Zong Ru Men)
[Pulse Diagnosis]
A floating and moderate pulse at the Left Cun position indicates Wind-Cold nasal congestion. A floating and surging pulse at the Right Cun position indicates Epistaxis due to Lung Fire.
[Treating the Branch of Nasal Diseases]
Except for Wind-Cold requiring dispersing methods, most nasal diseases are caused by Fire and Heat. They are all treated with methods to clear Metal (Lung) and descend Fire. (Yi Zong Sheng Mo)
[Treating the Root of Nasal Diseases]
For chronic Qiu, Yuan, ulcers, and polyps that do not heal, the cause is either Heart Blood deficiency or Kidney Water insufficiency. Nourishing Blood generates Yin, causing Fire to subside naturally; tonifying the Kidney raises Water, clearing Lung Metal. Furthermore, chronic nasal congestion may also stem from internal injury to the Lung and Stomer, where Clear Qi fails to ascend, and is not solely due to external exposure. (Yi Zong Ru Men)
[Medication]
The main formula is Fang Feng Tang (Saposhnikovia Decoction). For external Wind, add Qiang Huo, Jing Jie, Bo He, Xi Xin, Xin Yi, and Bai Zhi. For internal Fire, add Shan Zhi, Lian Qiao, Hua Fen, Jie Geng, Yuan Shen, and Sang Pi. For simultaneous internal and external pathology, use Shuang Jie San (Double Resolution Powder). For excessive internal Heat, use Liang Ge San (Cool the Diaphragm Powder). For failure of Clear Qi to ascend, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For Kidney True Yang failing to rise, use Liu Wei Wan (Six-Ingredient Pill with Rehmannia).
[Appendix: Brain Sand]
Heat from the Gallbladder transfers to the Brain, causing turbid nasal discharge or occasional yellow fluid secretion. In severe cases, the brain itself hurts. This is commonly known as "Brain Sand," attributed to insects eating within the brain.
Use five chi of Si Gua Teng (Trichosanthes Vine) near the root, burn it to ash while preserving its properties, grind into powder, and take with wine. Externally, use equal parts of White Ox Tail Hair and Cheng Ye (Orange Leaves), dried and powdered, blown into the nose. For deficiency-cold patterns, Chuan Wu San (Aconite Powder) is the primary prescription.
[Nasal Disease Selected Formulas]
Fang Feng Tang: Governs nasal diseases at the branch level (acute/superficial stage).
Fang Feng, Chuan Xiong, Huang Qin, Jie Geng, Gan Cao, Da Li Zi (Niu Bang Zi)
Fang Feng Tong Sheng San:
Treats exterior and interior heat simultaneously using this double-resolution formula. (See Fire Syndromes)
Liang Ge San:
Clears Fire and guides Heat downward.
Zhi Zi, Lian Qiao, Bo He, Huang Qin, Gan Cao, Chi Shao, Da Huang, Mang Xiao
Di Huang Jian:
Nourishes Yin and clears Fire to nourish True Yin.
Di Huang Zhi (Rehmannia Juice, 2 he), Mai Dong Zhi (Ophiopogon Juice, 3 he), Sheng Jiang Zhi (Fresh Ginger Juice, 1 he), Chuan Xiong (2 qian)
Add Yan Hua (Salt Flower) and simmer into an ointment.
Jia Wei Si Wu Tang: Treats Bi Chong (nasal polyps).
Si Wu Tang plus Chen Pi, Hong Hua, Jiu Huang Qin (Wine-fried Huang Qin), Cang Er. Add a few drops of good wine, mix with Wu Ling Zhi powder, and take.
Quick Method Formula:
Grind Ling Xiao Hua and Zhi Zi into equal parts powder. Take 2 qian mixed with tea twice daily. At night, mix Ling Xiao Hua and Po Xiao (Mirabilite) powder with wine and apply topically. Alternatively, mix Ling Xiao Hua powder with Mi Tuo Seng (Litharge) and apply with saliva. Another method: Burn Dog Head Bone to ash, add a small amount of Nao Sha (Sal Ammoniac), powder it, and blow into the nose; the fleshy growth will dissolve. Also, use Di Li Fen (Water Chestnut Powder) with a little Bing Pian (Borneol) applied nasally.
Qing Fei San (Secret Recipe): Treats nasal itching and sneezing in the morning until noon, repeating the next day. Highly effective.
Sang Bai Pi, Ku Huang Qin (each 1 qian, wine-fried), Sheng Gan Cao (3 fen), Xin Yi Hua (1 qian), Ku Jie Geng (1 qian), Feng Huang Ke (1 piece, added before consumption).
Use 2 zhong of water, add 12 stems of Deng Xin Cao (Juncus Effusus), decoct and take.