Spontaneous bleeding from the nose. Nosebleed is attributable to lung heat congesting in the upper body, stomach heat steaming upward, effulgent liver fire, head wind, liquor damage, lung-stomach yīn vacuity, repelled yáng, or external injury.
Patterns
Lung heat (肺热 fèi rè) nosebleed is associated with dry nose and cough with scant phlegm.
Medicinal therapy: Clear and drain lung heat with Mulberry Leaf and Chrysanthemum Beverage (桑菊饮sāng jú yǐn) minus mint (Menthae Herba, 薄荷bò hé) and platycodon (Platycodonis Radix, 桔梗jié gěng) and plus scutellaria (Scutellariae Radix, 黄芩huáng qín), gardenia (Gardeniae Fructus, 山栀子shān zhī zǐ), and imperata flower (Imperatae Flos, 白茅花bái máo huā).
Acumoxatherapy: Base treatment mainly on GV and LU. Select GV-23 (Upper Star, 上星 shàng xīng), LI-4 (Union Valley, 合谷 hé gǔ), LU-11 (Lesser Shang, 少商 shào shāng), GV-16 (Wind Mansion, 风府 fēng fǔ), and LU-3 (Celestial Storehouse, 天府 tiān fǔ); needle with drainage.
Stomach fire (胃火 wèi huǒ) nosebleed is associated with dry mouth, bad breath, vexation and thirst with taking of fluids.
Medicinal therapy: Clear heat and drain stomach heat with Jade Lady Brew (玉女煎yù nǚ jiān).
Acumoxatherapy: Base treatment mainly on GV, LI, and ST. Select GV-23 (Upper Star, 上星 shàng xīng), LI-2 (Second Space, 二间 èr jiān), ST-44 (Inner Court, 内庭 nèi tíng), ST-45 (Severe Mouth, 厉兑 lì duì), CV-12 (Center Stomach Duct, 中脘 zhōng wǎn), and SP-1 (Hidden White, 隐白 yǐn bái); needle with drainage.
Liver fire (肝火 gān huǒ) nosebleed is associated with headache, dizziness, red eyes, and irascibility.
Medicinal therapy: Clear and drain liver fire with Gentian Liver-Draining Decoction (龙胆泻肝汤lóng dǎn xiè gān tāng).
Acumoxatherapy: Base treatment mainly on GV, LR, and KI. Select GV-27 (Extremity of the Mouth, 兑端 duì duān), LR-2 (Moving Between, 行间 xíng jiān), LR-8 (Spring at the Bend, 曲泉 qū quán), KI-1 (Gushing Spring, 湧泉 yǒng quán), and BL-40 (Bend Center, 委中 wěi zhōng); needle with drainage.
Head wind (头风 tóu fēng) nosebleed is a pouring nosebleed.
Medicinal therapy: Calm the liver, course wind, and stanch bleeding with Peony and Licorice Decoction (芍药甘草汤sháo yào gān cǎo tāng) plus cimicifuga (Cimicifugae Rhizoma, 升麻shēng má) and imperata flower (Imperatae Flos, 白茅花bái máo huā).
Acumoxatherapy: Base treatment mainly on GV, GB, LI, and LU. Select GV-23 (Upper Star, 上星 shàng xīng), GV-16 (Wind Mansion, 风府 fēng fǔ), GB-20 (Wind Pool, 风池 fēng chí), LI-4 (Union Valley, 合谷 hé gǔ), LI-19 (Grain Bone-Hole, 禾髎 hé liáo), LU-7 (Broken Sequence, 列缺 liè quē), and SI-3 (Back Ravine, 后溪 hòu xī); needle with drainage.
Liquor damage (伤酒 shāng jiǔ) nosebleed is a persistent nosebleed due to lung-stomach accumulated heat and is associated with yellow tongue fur and rough breathing.
Medicinal therapy: Clear lung and stomach heat, resolve liquor, and stanch bleeding with Lophatherum and Gypsum Decoction (竹叶石膏汤zhú yè shí gāo tāng) plus pueraria flower (Puerariae Flos, 葛花gé huā) and honey tree fruit (Hoveniae Fructus seu Semen, 枳椇子zhǐ jù zǐ).
Acumoxatherapy: Base treatment mainly on GV, LU, LI, and ST. Select GV-23 (Upper Star, 上星 shàng xīng), LI-4 (Union Valley, 合谷 hé gǔ), LI-2 (Second Space, 二间 èr jiān), ST-44 (Inner Court, 内庭 nèi tíng), ST-45 (Severe Mouth, 厉兑 lì duì), LU-11 (Lesser Shang, 少商 shào shāng), GV-16 (Wind Mansion, 风府 fēng fǔ), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), and SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo); needle with drainage.
Yīn vacuity (阴虚 yīn xū) nosebleed, which is due to insufficiency of kidney and lung yīn, is accompanied by tidal heat, night sweating, dizziness, tinnitus, incessant cough, and a fine rapid pulse.
Medicinal therapy: Enrich yīn and nourish lung and kidney yīn with Anemarrhena, Phellodendron, and Rehmannia Pill (知柏地黄丸zhī bǎi dì huáng wán) plus scrophularia (Scrophulariae Radix, 玄参xuán shēn) and eclipta (Ecliptae Herba, 墨旱莲mò hàn lián).
Acumoxatherapy: Base treatment mainly on GV, LU, and KI. Select GV-23 (Upper Star, 上星 shàng xīng), LI-4 (Union Valley, 合谷 hé gǔ), BL-13 (Lung Transport, 肺俞 fèi shù), BL-23 (Kidney Transport, 肾俞 shèn shù), BL-43 (Gāo-Huāng Transport, 膏肓俞 gāo huāng shù), KI-3 (Great Ravine, 太溪 tài xī), and LU-5 (Cubit Marsh, 尺泽 chǐ zé); needle with supplementation.
Repelled yáng (格阳 gé yáng) nosebleed arises when there is yīn vacuity in the lower body and yáng floats upward. It is associated with a forceless large floating pulse at all six positions of the wrist with pronounced weakness at the two cubits.
Medicinal therapy: Conduct the fire back to the origin and subdue floating yáng. Use Golden Cabinet Kidney Qì Pill (金匮肾气丸jīn guì shèn qì wán) plus achyranthes (Achyranthis Bidentatae Radix, 牛膝niú xī) and raw tortoise shell (Testudinis Plastrum Crudum, 生龟版shēng guī bǎn).
Acumoxatherapy: Base treatment mainly on GV, LU, and KI. Needle with drainage at GV-23 (Upper Star, 上星 shàng xīng), LI-4 (Union Valley, 合谷 hé gǔ), KI-6 (Shining Sea, 照海 zhào hǎi), KI-1 (Gushing Spring, 湧泉 yǒng quán), and HT-8 (Lesser Mansion, 少府 shào fǔ), and with supplementation at BL-23 (Kidney Transport, 肾俞 shèn shù), KI-3 (Great Ravine, 太溪 tài xī), and LR-3 (Supreme Surge, 太冲 tài chōng). For incessant nosebleed, add moxa at GV-22 (Fontanel Meeting, 囟会 xìn huì) and GV-23 (Upper Star, 上星 shàng xīng).
External injury (外伤 wài shāng) nosebleed is treated by stuffing the nose with a wad of gauze soaked in a suitable preparation. See spontaneous external bleeding.