1. Nose disease

2. Etiology & Pathology
The door of breathing, also the gate of evil invasion
In charge of smelling
Relationship with 5 organs
<1> lung open on the nose
<2> Liver fire & wind rebellian attacking nose ( nose bleeding)
Relationship with meridians
Hand Yang Ming Large Intestine meridian stops by the sides of nosewing
Foot Yang Ming Stomach meridian starts by the sides of nosewing
Du Meridian
Hand Tai Yang Small Intestine  nasion 鼻根 ( Jing Ming )
Foot Tai Yang UB Meridian

3. Cold Blocked nose Etiology & Pathology
Wind-cold or wind-heat attacking
Wind-cold type
Sym: severe blocked nose, with sneezing, watery nose water,
Concurrent sym: aversion to wind or cold, fever, headache, no thirsty
Tongue: thin whte coating Pulse: floating & tight
Treatment principle: Expel wind-cold, open the nose Formula
Tong Qiao Tang ( Fang Feng 12, Qiang Huo12, Bai Zhi 12, Gao Ben 12, Shen Ma 15, Ge gen 30, Cang Er Zi 10, Ma Huang 6, Gan Cao 6
Jiu Wei Qiang Huo Tang
Fang Feng tong Shen San
Wind-Heat Type:
Sym: sneezing with itching nose, heat breathing, fever, aversion to wind, sore throat, cough, sticky phlegm, thirsty
tongue: red body with yellow coating Pulse: floating & rapid
Treatment: expel wind-heat & open the nose
Yin Qiao San:
伤风鼻塞的其他疗法 1．针灸疗法
· 风寒鼻塞：取列缺、风门、风池、合谷等穴，毫针浅刺，用泻法。
· 风热鼻塞：取大椎、曲池、合谷、鱼际、外关等穴，毫针浅刺，用泻法。 2．饮食疗法
· 芫荽马蹄水：芫荽15—30克，马蹄(荸荠)250—500克，煎水代茶饮。
· 淡豉葱白煲豆腐：豆腐2～4块，淡豆豉12克，葱白15克。先将豆腐略煎，再加淡豆豉，加水l碗半煎取大半碗，再加入葱白，煎滚后取出，乘热吸用，盖被微取汗。
· 生姜芥菜汤：鲜芥菜500克，洗净切断，生姜10克切片，加清水4碗煎至2碗，用食盐少许调味，每日分2次饮用。 3．预防调护
· 适当休息，增加营养，多饮开水，食用易消化食物。
· 鼻塞时不可强行擤鼻，以防邪毒窜入耳窍，致发耳疾。
· 积极及时治疗，防止表邪入里，或变生他疾，或转为鼻窒，迁延难愈。

4. Acute and Chronic sinusitis 鼻渊 Bi Yuan
Diagnosis points
Severe blocked nose with discolored nasal mucus
Frequent headaches
Reduced sense smell
Cold symptoms
Etiology & Pathology
Lung: wind-heat attacking lung;
heat accumulation & attacking nose;
GB GB. heat
Spleen: damp-heat

5. 1. Lung heat accmulation (Acute Type )
Main Sym: blocked nose with lots discolored nasal mucus, red swollen septum
Concurrent sym: reduced sense smell, fever, aversion to wind or cold, frequent headache, cough, dry mouth with desire to drink.
Tongue: red body with thin yellow coating
Pulse: floating & rapid or slippery
Treatment principle: Clear lung heat & open the nose
Formula
Yin Qiao San + Xin Yi Hua, Bai Zhi, Huang Qin
--Yellow nasal mucus: Dong Gua Ren 15, Yu Xing Cao 15, Di Fu Zi 15
-- Cough & lots phlegm: Xing Ren 12, Qian Hu 12, Quan Gua Lou 12, Bei Mu 12

6. 2. GB damp-heat accmulation: ( Acute type)
Main Sym: yellow greasy nasal mucus, lots quantity & reduced sense smell, red swollen septum
Concurrent sym: severe headache, fever, swimming, tinnitus or deaf, bad sleeping with lots dream, easy to lose temper,
tongue: red body with yellow coating
Pulse: wiry & rapid
Treatment: clear GB damp-heat, open the nose
Formular: Long Dan Xie Gan Tang
-- headache: Gao Ben; Bai Zhi; Man Jing Zi; Ge Gen;
-- Heat excess: Long Dan Cao; Shui Niu Jiao;
-- Constipation: Da Huang

7. 3. Lu Qi def cold: ( deficient type)
Main Sym: white sticky nasal mucus, reduced sense smell, lightly red swollen septum, blocked nose & worse in cold.
Concurrent sym: aversion to cold, short of breath, cough with thin white sputum
tongue: thin white coating
Pulse: slow & weak
Treatment: warm the lung & disperse the wind cold
Formular: Weng Fei Zhi Liu Dan plus
Dang Shen 12, Bai Shao 10, Fang Fen 10, Ke Zi 10, Xin Yi Hua 10, Jin Jie 10, Jie Gen 10, Xi Xin 3
-- headache: Gao Ben; Chuan Xiong
-- Qi Def.: Huang Qi;

8. 4. Spleen & Stomach damp-heat accmulation:
Main Sym: yellow nasal mucus, lots quantity & blocked nose & reduced sense smell, red swollen septum
Concurrent sym: heavy head & dizziness, severe headache, tired body, bad appetite, abdominal distension, deep color urine,
tongue: red body with yellow greasy coating
Pulse: slippery & rapid
Treatment: expel damp-heat, open the nose
Formular: Gan Lu Xiao Du Dan plus
Huang Qin 15, Hua Shi 15, Mu Tong 15, Fu Ling 15, Ju Hua 12, Xin Yi Hua 10, Bai Zhi 10, Yu Xin Cao 20, Gan Cao 6,
-- yellow mucus: Dong Gua Ren 15, Gua Lou Ren 15, Di Fu Zi 10, Ma Bo 10, Zao Jiao Ci 10;
-- tinnitus & deaf: Shi Chang Pu; Huo Xiang; Pei Lan;
急鼻渊的其他疗法 1．针刺治疗 (1)针刺：选取迎香、印堂、太阳、合谷、风池、曲池、足三里等穴位，每次选用2—3穴，强刺激，每日1次。 (2)穴位注射：取肺俞穴，进针3-5分，注入鱼腥草注射液0．5～1毫升，每日或隔日1次。 2．饮食疗法 (1)青茶叶2克，加水1碗，煎后加蜂蜜1汤匙，徐徐服，每日2～3次。 (2)冬瓜仁60克，芦根30克，水煎，早晚分服。

9. Nose Bleeds (Bi Niu) Diagnosis points Bleeding from nose
Vomiting blood
Etiology & Pathology
Lung, St & Liver excess fire
Liver & Kidney Yin def. fire
鼻衄即鼻出血，是多种疾病的常见症状，本节只讨论内因引起的鼻衄；出血严重者又称鼻洪。鼻衄甚者，口鼻皆出血，称为鼻大衄、脑衄，若鼻衄经久不愈，称为鼻 久衄。导致鼻衄的原因很多，可发生于多种疾病(如伤寒、时气、热病、温病、虚劳等)、不同性别、不同年龄、不同时间和不同季节。轻者仅涕中带血丝，严重者 可危及生命
Nose Bleeds
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Nose bleeds are often the result of common events, usually trauma, but nose bleeds can be a warning of other problems. Nose bleeds are caused by a small blood vessel rupturing. There are two main types of nose bleed, upper and lower septum nose bleeds.
Lower nose bleeds Most nose bleeds occur within the lower end of the nose in the lower septum. The septum is the semi-rigid wall separating the two channels of the nose that contain blood vessels. These blood vessels lie close to the surface, making them susceptible to injury. Lower nose bleeds do not usually require medical attention unless the bleeding cannot be stopped or it happens in the very young.
Causes of lower end nose bleeds The most common cause of nose bleeds is trauma. A blow, smack, or sometimes just picking the nose. Dryness inside of the nose can also cause bleeding. High altitudes, colds, allergies and medications are all responsible for nose bleeds.
Treatment of lower end nose bleeds Sit up straight and pinch the nostrils together firmly for 10 minutes. You can place a cold compress or an ice pack across the bridge of your nose. Vaseline can be used if the cause of the nose bleed is dryness. When the bleeding stops do not jump up and down, take things easy, do not blow your nose or it will dislodge the clot and will probably start your nose bleed again.
If a nose bleed does not stop after 10 to 20 minutes of direct pressure.
More urgent medical attention is required if;
the blood loss is heavy if you get nose bleeds often if the injury/trauma is severe The person is an infant or child, or if the person is already sick or elderly. If you are at all worried about the nose bleed seek further medical advice.Upper septum nose bleeds Upper septum nose bleeds are much more rare. Bleeding begins high within the nose and blood flows down the back of the mouth and throat even when the person is sitting up or standing. These nose bleeds can be very serious and do require urgent medical attention.
Causes of upper septum nose bleeds
High blood pressure Disease of the arteries such as atherosclerosis Side effects of medications and drugs such as aspirin, cocaine Bleeding disorders Nasal tumors, cancerous and non-cancerous Serious trauma such as a displaced broken nose from car crashes, falls etc Leukemia Osler-Weber-Rendu syndrome, a hereditary disease where a growth like a birth mark is located in the nose. Infection Nose bleeds can occur for no apparent reason.Treatment of upper septum nose bleeds Treatment is initially the same as for lower end nose bleeds. Your doctor may have pack the nose with gauze or an inflatable latex balloon if the bleeding does not stop. Cauterization of the bleeding blood vessel may be required. This involves an electrical or heated device to burn the ruptured blood vessel to stop the bleeding. The doctor uses a local anaesthetic before he or she begins this procedure.

10. Main Sym: dripping nose bleeding, flesh color, dry nasal cavity
1. Lung heat excess
Main Sym: dripping nose bleeding, flesh color, dry nasal cavity
Concurrent sym: cough with less sputum, dry mouth & fever
Tongue: red tip body with thin white dry coating
Pulse: floating & rapid
Treatment principle: Clear heat & cool blood & stop bleeding
Formula : Sang Ju Yin plus
Sang Ye 12, Ju Hua 12, Lian Qiao 12, Huang Qin 12, Jie Gen 12, Dan Pi 15, Bai Mao Gen 15, Lu Gen 15, Zhi Zi Tan 10, Gan Cao 6
--cough with thick sputum: Gua Lou Ren 15, Zhe Bei Mu 15, Gua Lou Pi 15
　这一天，班里有个叫刘玉良的孩子，十三岁，突然鼻子出血，这在中医叫衄血，一天出了四次。大家本来正在上自习，突然有孩子来喊张锡纯："老师你快来看看吧，刘玉良鼻子出血了，出了好多血啊，堵不住了！" 　　张锡纯来了一看，血果然流得很厉害，于是赶快让人把他家长找来。 　　那个年头不用电话、手机什么的，都是一个村里的，很容易找家长，于是一个孩子一溜烟跑去找了。 　　这个时候，张锡纯给孩子诊脉（瞧人家这班主任当的，还兼诊脉），觉得脉象还是很平和的。他就问孩子："心里有什么感觉吗？觉得身上凉还是热？" 　　孩子说："不知道，没有感觉。" 　　这就是给孩子看病的难处，孩子自己说不出来有什么地方不适。 　　张锡纯一想，衄血大多数都是热的，而且现在是夏天，天热，同时小儿是少阳之体，生发迅速，估计是热证的可能性很大。 　　于是，就稍微开了一点凉血、止血的药物，这个时候，正好刘玉良的家长也来了，于是就按照张班主任的方子去抓了一副药。 　　但是，熬好了药给孩子服下去以后，不但鼻子出血的症状没有好转，反而是更重了，刘玉良的家长马上告诉张锡纯："张老师，好像没有效果啊。" 　　张锡纯赶快再给孩子诊脉，突然发现，这脉搏也似乎是比开始的时候弱了一点。他恍然大悟，原来，这个孩子是个寒证啊！ 　 　大家要记住了，任何的病症都至少要分为寒、热两种，这个鼻子出血，多数是因为热证出现的，但是也有寒证的，清代的著名医学家黄元御对此十分有心得。而张 锡纯正是受了黄元御的启发，创立了一个方子，叫温降汤，这个方子专门治疗因为胃气虚寒，导致胃气不降，从而引起吐血、鼻子出血之证。这种患者，食物都停滞 在胃部不容易消化。 　　这个温降汤的组成是：白术、清半夏、生山药、干姜、生赭石（轧细）、生白芍、川厚朴、生姜。 　 　这个方子里面，白术是补脾的，生山药除了补脾之外，还有收敛固涩的作用，清半夏是降逆的药物，赭石是降下的药物，此时胃气上逆，用半夏、赭石可以镇冲 气；方子里面用白芍，张锡纯解释是怕干姜太热，热入肝经，肝为藏血之脏，得白芍的凉润滋养，则可以宁谧收敛，这样血就不妄行了。 　　此时，张锡纯确认了病症，就开出了这个自创的温降汤，让家长抓了药，给孩子服了下去。 　　结果，一剂而愈，孩子的这个病就治好了。

11. 2. Stomach heat excess
Main Sym: nose bleeding, lots quantity, flesh deep red color, dry nasal cavity
Concurrent sym: dry mouth, bad smell, irritability & thirsty, dry stools, short deep color urine
Tongue: red body with dry thick yellow coating
Pulse: big & rapid
Treatment principle: Clear st. heat, Cool blood & stop bleeding
Formula : Xi Jiao Di Huang Tang plus
Shen Di 15, Chi Shao 15, Mu Dan Pi 15, Zhi Mu 15, Shi Gao 30, Shui Niu Jiao 60, Gan Cao 6
--Cool blood & stop bleeding: Bai Mao Gen 15, Ce Bai Ye 15, Han Lian Cao 15
-- Constipation: Da Huang 10, Gua Lou Ren 15
Niu Huang Jie Du Pian

12. 3. Liver fire goes up
Main Sym: large quantity nose bleeding, deep red color
Concurrent sym: headache, dizziness, dry throat, bitter taste, distention in the chest, red face & eyes, easy to lose temper
Tongue: red body with yellow coating
Pulse: wiry & rapid
Treatment principle: Clear liver fire, cool blood & stop bleeding
Formula : Long Dan Xie Gan Tang Plus
Long Dan Cao 15, Zhi Zi 15, Huang Qin 15, Sheng Di 15, Chi Shao 15, Chai Hu 10, Che Qian Zi 10, Shui Niu Jiao 60.
--Stop Bleeding: Bai Mao Gen15, Xian He Cao 15,
-- Dry Mouth: Mai Dong 15, Xuan Shen 15, Zhi Mu 15, Ge Gen 30

13. 4. Liver & Kidney Yin def.
Main Sym: nose bleeding repeatedly occurred, small quantity
Concurrent sym: dizziness, blurred vision, tinnitus, palpitation, insomnia,
Tongue: red body with less coating
Pulse: fine & rapid
Treatment principle: Nourish Liver & kidney, cool blood & stop bleeding
Formula : Zhi Bai Di Huang Tang plus
Zhi Mu 12, Huang Bai 12, Mu Dan Pi 15, Ze Xie 15, Shan Zhu Yu 12, Sheng Di 15, Han Lian Cao 15, Ou Jie 15, E Jiao 10

14. 5. Spleen fail its function to control the blood.
Main Sym: slow nose bleeds, light red color
Concurrent sym: yellow face color, no appetite, feel tired to talk,
Tongue: thin white coating
Pulse: slow & weak
Treatment principle: Nourish spleen Qi, control blood & stop bleeding
Formula : Gui Pi Wan
Dang Shen 15, Huang Qi 15, Fu Ling 15, Dang Gui 10, Bai Zhu 10, Yuan Zhi 10, Ai Ye 10, E Jiao 10, Ce Bai Ye 12, Di Yu Tan 12, Zhi Gan Cao 6
鼻衄的外治法 对鼻出血病人，治疗上要遵照“急则治其标”之原则，使用各种止血方法，使鼻衄停止。常用的外用止血法如下： 1．冷敷法 以冷水浸湿的毛巾或冰袋敷于患者的前额或颈部。 2．压迫法 用手指揉按患者入前发际正中线1-2寸处，或紧捏一侧或两侧鼻翼，以达止血目的。 3．导引法 令病人双足浸于温水中，或以大蒜捣烂，敷于足底涌泉穴上，有引热下行，协助止血的功效。 4．滴鼻法 用香墨研浓汁，滴人鼻中，也可用滴鼻灵或1％～3％麻黄素液等滴鼻。 5．吹鼻法 用血余炭、马勃、百草霜、三七末、云南白药等药末吹人鼻腔，也可将上述药物放在棉片上，贴于出血处，或填塞鼻腔。 6．鼻腔填塞法 用上述方法而未能止血者，可用明胶海绵或凡士林纱条填塞患侧鼻腔；若仍未达止血目的，可行后鼻孔填塞法。
鼻衄的其他疗法 1．针刺疗法 (1)实证鼻衄：主穴取合谷、上星。配穴，心火亢盛者取后溪；肺经热盛者取尺泽，并刺少商出血；胃热炽盛者取上巨虚；肝火亢逆者取太冲、丘墟。毫针刺用泻法。 (2)虚证鼻衄：取上星、三阴交。方法：患者取半坐卧位，先针上星，再针三阴交，轻刺激，留针20一30分钟；上星穴针后不灸，三阴交针后可灸3—5壮。 2．饮食疗法 (1)藕汁蜜糖露：鲜藕适量洗净，榨汁100。150毫升，加入蜂蜜15～30克，调匀内服。每日1次，连服数日。 (2)茅根竹蔗水：白茅根60～120克，竹蔗100～300克，煎水代茶饮。 (3)韭菜根90克，捣汁，用童便或冷开水冲服。 (4)鲜韭菜一小把，洗净切碎，置干净研钵中捣烂，用布包裹后拧取其汁，放于开水内炖热，每次服1酒杯。 (5)乌豆圆肉大枣汤：乌豆50克，龙眼肉15克，大枣50克，加清水3碗煎至2碗，早晚分服。 (6)岗稔果煲瘦猪肉：鲜岗稔果60克(干品用15克)，猪瘦肉60克，加清水3-4碗煎至l碗，分服。 (7)早莲草红枣汤：旱莲草50克，红枣8-10枚，加清水2碗煎至1碗，去渣饮汤。 说明：(1)一(3)适用于实证鼻衄。(4)～(7)适用于虚证鼻衄。

15. Allergic Rhinitis ( Hay fever )
An inflammation of the nasal passages, usually associated with watery nasal discharge and itching of the nose and eyes.
Description of Allergic Rhinitis
Allergic rhinitis affects about 20 percent of the American population and ranks as one of the most common illnesses in the U.S. The symptoms occur in the nose and eyes and usually occur after exposure to dust, danders, or certain seasonal pollens in people that are allergic to these substances.
Two-thirds of all patients have symptoms of allergic rhinitis before the age of 30, but onset can occur at any age. Allergic rhinitis has no sexual predilection, although boys up to the age of 10 are twice as likely to have symptoms as girls.
There is strong genetic predisposition to allergic rhinitis. One parent with a history of allergic rhinitis has about a 30 percent chance of producing offspring with the disorder; the risk increases to 50 percent if both parents have a history of allergies.
Patients can be severely restricted in their daily activities, resulting in excessive time away from school or work. Millions of dollars are spent each year on physician services and medication for treatment of this chronic illness.

16. Allergic Rhinitis Diagnosis points
Acute onset itching nose, sneeze, lots thin white nasal mucus, blocked nose, repeatedly occurred, long time ill history
Defierent with wind-cold type blocked nose
Etiology & Pathology
Liver, Spleen & Kidney def. but more related with lung

17. 1. Lung Qi def. cold
Main Sym: extremely itchy nose, sneeze, blocked nose, reduced sense smell
Concurrent sym: aversion to wind in usual, short of breath, being quiet, lower voice, spontaneous sweating, white face color
Tongue: lightly red with thin white coating
Pulse: weak
Treatment principle: warm the lung, expel wind-cold
Formula : Wen Fei Zhi Liu Dan
Dang shen 15, Huang Qi 15, Bai Zhu 10, Fang Fen 10, Xin Yi Hua 10, Cang er Zi 10, Xi xin 3, Gan Cao 6
-- sweating with shoulder pain: Gui Zhi 8, Ge Gen 30
-- cough thin white sputum: Ban Xia 12, Zhi Ma Huang 10, Xin Ren 20
Tuo Ming Tang
Zi Cao 10, Qian Cao 10, Xu Chang Qin 10, Han Lian Cao 10, Chan Tui 3

18. 2. Lung & Spleen Qi def.
Main Sym: severe blocked nose with lots of thin white nasal mucus, reduced sense of smell
Concurrent sym: long time illness, repeatedly occurred, heavy head, tireness & weakness. Short of breath, aversion to cold, bad appetite, loose stools
Tongue: big tongue with teeth mark on sides, white coating
Pulse: soft & weak
Treatment principle: tonify Lung & spleen qi
Formula : Bu Zhong Yi Qi Tang plus
Dang Shen 15, Huang Qi 15, Fu Ling 15, Bai Zhu 10, Shen Ma 10, Chai Hu 10, Zhi Gan Cao 6, Chen Pi 6, Yi Ni Ren 30, Wu Wei Zi 12
-- sneeze: Chan Tui 6, Di Long 6
-- continuely thin white nasal mucus with sweating: Fu Xiao Mai 30, Ru Dao Gen 30

19. 3. Kidney Yang def.
Main Sym: itchy nose, sneeze, thin white nasal mucus
Concurrent sym: long time illness, repeatedly occurred, cold limbs, pale face color, sore lower back & knees, night urine
Tongue: thin white coating
Pulse: deep, fine & weak
Treatment principle: Warm kidney Yang, tonify Qi to defent body
Formula : Sheng Qi Wan plus
Shu Di 15, Lu Jiao Shuang 15, Shan Yao 15, Zhi Fu Zi 10, Shan Yu rou 12, Zhi Gan Cao 6, Rou Gui 3,
-- sneeze: Xi xin 3, Wu Zhu Yu 10
-- wheezing: Ge Jie 10, Zhi Ma Huang 6, He Tao Rou 10

20. Concurrent sym: cough, itching throat, dry mouth, irritability
4. Lung Heat accmulation
Main Sym: distension of nose, blocked nose with itching, continuely sneeze with thin white mucus
Concurrent sym: cough, itching throat, dry mouth, irritability
Tongue: red body with white coating
Pulse: wiry or slippery
Treatment principle: Clear away lung heat
Formula : Xin Yi Qing Fei Yin
Huang qin 12, Zhi Mu 12, Sang Bai Pi 12, Zhi Zi 12, Sheng Ma 15, Mai Dong 15, Bai He 15, Xin Yi Hua 10, Di Long 10
-- sneeze: Chan Tui 10, Jiang Chan 10, Wu Mei 12
-- headache: Man Jing Zi 10, Bai Ji Li 15
．饮食疗法 (1)北芪杞子炖乳鸽：北黄芪30克，枸杞子15克，乳鸽1只(去内脏，切块)，放炖盅内加水适量，隔水炖熟，饮汤吃鸽肉，每周1—2次。有补气固表，滋阴养血的作用。 (2)胡椒根煲蛇肉：胡椒根40～60克，蛇肉250克，加清水煲汤，食肉饮汤。有温经散寒，祛风活血，滋补强壮的作用。 4．按摩疗法 双手鱼际互相摩擦至发热后，贴于鼻两侧，沿鼻根至迎香穴往返按摩，至局部发热为止，然后再由攒竹穴向太阳穴推擦至局部发热，每日2～3次。也可用两手中指 于鼻梁两边揩擦20-30次，令表里俱热，每日早晚各揩擦一回。并以掌心按摩面部及颈后、枕部皮肤，轻柔，每次10—15分钟。

21. Nasal polyp Bi Xi Rou ( 鼻息肉）
What are nasal polyps? The 'paranasal sinuses' are the air cavities within the skull that open into the nose. If the soft tissue lining of the sinuses becomes swollen, it fills the available space and can then expand into the nose forming a growth called a polyp. As there are a number of small sinuses between the eye and the nose, when polyps do occur, there will usually be several of them.

22. 1. Damp-heat accmulation
Main Sym: continued block nose with thick nasal mucus
Concurrent sym: dizziness & headache
Tongue: red with white or white greasy coating
Pulse: wiry & slippery
Treatment principle: disperse Lung Qi, expel damp heat
Formula : Xin Yi Qing Fei Yin Plus
Huang Qin 12, Zhi Zi 12, Xin Yi Hua 10, Sheng Ma 15, Pi Pa Ye 12, Zhi Mu 12, Bei Mu 12, Gan Cao 6
-- lots mucus or sputum: Gua Lou Ren 12, Dong Gua Ren 12, Yu Xing Cao 15
-- heavy head: Bai Zhi 12, Man Jing Zi 10, Ban Xia
-- dark deep red nasal proply: Tao Ren 10, Chi Shao 10
Steaming formula: Dang Gui 10, Chuan Xiong 10, Xiang Fu 10, Xi Xin 6, Xin Yin Hua 6, Jin Jie 10
鼻息肉的外治法 1．外用药末点敷 用有腐蚀收敛、化湿杀虫、消肿散结的药物粉末点于息肉的表面或根部，使息肉组织内的水分消散，因而缩小或消失，或将其根部腐蚀，使之脱落。每日1次，7一14次为1个疗程。或于息肉摘除术后1周敷药，可减少复发。常用的点敷药物有硇砂散，明矾散等。 2．中药熏鼻 用芳香通窍、活血祛瘀的药物或祛风通络的药物，边煎煮边蒸汽吸人或超声雾化吸人，利用蒸汽的物理作用和药力，以达到减少鼻涕，使鼻腔通畅的目的。熏药处方如下： (1)当归10克，川芎10克，香附10克，细辛6克，辛夷花6克，荆芥10克。煎煮作蒸汽吸入。 (2)白芷10克，藿香10克，苍耳子10克，藁本10克，薄荷6克，冰片1．5克。煎煮作蒸汽吸入。 3．超声雾化吸入 可选用柴胡注射液、鱼腥草液做超声雾化吸入，每次用药液4毫升，每次15～20分钟，每日1—2次。 4．滴鼻 可用鼻炎滴剂、滴鼻灵、呋喃西林麻黄素滴鼻液等滴鼻，每日3—4次。 5．手术摘除 这是常用而较有疗效的方法，能改善鼻腔通气，通畅引流。手术摘除1周后敷药，减少或预防息肉的复发。
鼻息肉的其他疗法 1．饮食疗法 (1)鱼腥草煲猪肺：鲜鱼腥草60克，猪肺约200克，加清水适量煲汤，用食盐少许调味，饮汤食猪肺。 (2)米醋煮海带：海带(干)60克，加米醋适量煮吃。注意：胃溃疡、十二指肠溃疡、胃酸过多者忌用。 (3)辛夷花煲鸡蛋：辛夷花lO。12克，鸡蛋2只，加清水适量同煮，蛋熟后去壳再煮片时，饮汤吃蛋。

23. Brandy nose Rosacea ( 酒渣鼻）
Chronic inflammatory disorders usually characterized by papules, erythema and pustules forming primarily on and around the nose but also on the cheeks and possibly the forehead. Most commonly found on middle aged women.
What is rosacea?
Rosacea is a chronic inflammation of the skin on the face, which affects men and women between the ages of 30 and 50. Its exact cause is unknown, but many patients who present with it often have a history of reddened skin and acne or pimples. It is more common among fair-skinned people of Northern European ethnic backgrounds than among Asians and Africans.
What are the symptoms?
Rosacea usually occurs over the middle of the face. It gives rise to a flushed appearance across the middle of the face, which may even extend to the lower forehead and chin.
'Rosacea causes a flushed appearance across the middle of the face'.
Other symptoms include:
inflamed acne-like bumps on the face. Despite the fact that they may look unsightly these bumps are usually superficial, although they can be deep and painful in a minority of patients.
swelling of the skin on the cheeks and nose. This is caused either by a thickening of the oil glands under the surface of the skin or by swelling of the tiny blood vessels on the face.
How is it diagnosed?
The condition is diagnosed by simple inspection of the skin. Blood tests may sometimes be taken to determine if any underlying condition may be present.
How is it treated?
Rosacea can be treated in a number of different ways. Some patients may benefit from steroid or sulphur-based creams, which can be applied directly to the skin. Others may need oral antibiotics. Laser treatment is sometimes used if the cosmetic effects of the condition are particularly noticeable.
Can it be avoided?
Rosacea cannot be prevented. However, there are known to be certain trigger factors, which may make the condition worse. These should be avoided as much as possible.
They include:
exposure to strong heat and sunlight.
hot spicy foods.
alcohol.
anxiety and stress.
Are there long-term effects?
The main long-term effect of rosacea is facial scarring. This is more common among men than women as they seem to be more prone to develop thickened tissue in the area of the nose. The scarring can lead to loss of self-esteem and self-consciousness about one's physical appearance. Laser therapy can be very helpful in such cases.
All visible signs of rosacea may clear up with medication, but the general redness of the skin, and the tendency to sudden flushing may be a permanent feature. Rosacea is not contagious and poses no risk to others.

24. TCM - Rosacea is typically caused by hyperactive Yang Heat relating with stress, diet and local infections
3 stages:
1-red local area, slightly enlarged vessels upon close observation
2-red eruptions appear, possible pusy eruptions, itchy, hot, slightly purple, enlarged pores
3-thick red skin with bee hive like pores, purple skin

25. 1. Blood heat due to alcohol toxin
Main Sym: Red color, greasy shiny nose skin. Coarse & hyperplasia skin like orange peel.
Concurrent sym:
Tongue: purple deep color with thick coating
Pulse: sink & Hesitant
Treatment principle: Clear heat, cool blood, resolves toxin & move the blood stasis
Formula : Huang Qin Qin Fei Yin 黄芩清肺饮
Huang Qin 15， Sheng Di 15, Dang Gui 15, Tian Hua Fen 15, Fang Fen 9, Ge Gen 9, Chi Shao 15, Chuan Xiong 9, Tao Ren 9, Hong Hua 9, Mu Dan Pi 15, Xia Ku Cao 15

26. 1. Damp-heat accmulate in the spleen
Main Sym: Bright Red color, worse in windy days. Clear vessels on the skin. Thick skin.
Concurrent sym: greasy mouth taste, oppressed feeling in the chest
Tongue: thick greasy coating
Pulse: slippery pulse
Treatment principle: clear damp-heat in the spleen, move blood stasis
Formula : Liang Xue Si Wu Tang 凉血四物汤
DangGui 15, Sheng Di Huang 15, Chi Shao 15, Chuan Xiong 9, Huang Qin 15, Chen Pi 9, Fu Ling 15, Hong Hua 9, Sheng Shi Gao 30, Yi Yi Ren 30, Zhi Shi 15, Xia Ku Cao 15