Epistaxis

Etiology and Pathogenesis

The lung qi flows up to the nose . The Foot - Yangming Meridian starts at the side of the nose . If there is accumulated wind heat in the lung or pathogenic fire in the stomach , they would rush upward to the nose . If there is yin deficiency leading to up flaring of the asthenic fire , the blood would flow up together with the fire . All of these cause blood to rush out of the vessels , resulting in epistaxis .

Differentiation

a ) Extreme heat in lung and stomach : Main manifestations : Epistaxis accompanied by fever , cough , reddened tongue , superficial and rapid pulse ; or dire thirst with preference for cold drink , constipation , foul breath , reddened tongue with yellow coating , forceful and rapid pulse .

Analysis : Extreme heat in the lung goes up to the nose , forcing blood to rush out of the vessels . The heat also causes dysfunction of the lung in spreading and descending of qi . The reverse flow of qi results in cough . Reddened tongue and rapid pulse are signs of heat in the lung . Sometimes epistaxis occurs when the stomach fire flares up along the meridians to the nose , and injures the blood vessels . Thirst and preference for cold drinking are caused by the stomach heat consuming the fluid . Exhaustion of fluid causes constipation . The stomach heat makes foul breath . Irritability and restlessness are due to extreme heat in the Yangming Meridians disturbing the heart mind . Reddened tongue with yellow coating and forceful rapid pulse are signs of the stomach heat .

b ) Deficiency of yin with preponderance of fire

Main manifestations : Epistaxis accompanied by malar flush , dryness of the mouth , feverish sensation of the palms and soles , afternoon fever , night sweating , thready and rapid pulse .

Analysis : When deficiency of the kidney yin causes the asthenic fire to flare up to the nose , blood vessels are injured , resulting in epistaxis . Malar flush , dryness of the mouth , feverish sensation of the palms and soles , and afternoon fever are manifestations of the asthenic fire associated with yin deficiency . Night sweating is also due to the asthenic fire that forces the moisture to be given off . Thready and rapid pulse is a sign of yin deficiency .

Treatment

Method : Points of the Hand - Yangming and Du Meridians are selected as the principal points . The reducing method is applied to clear off the heat and stop bleeding for extreme heat in the lung and stomach . The even movement is used to nourish yin and descend the fire for deficiency of yin with preponderance of fire .

Prescription : Yingxiang ( Li20 ) , Hegu ( Li4 ) , Shangxing ( Du 23 ) .

Supplementary points : Heat in the lung : Shaoshang ( L II ) . Heat in the stomach : Neiting ( S 44 ) . Deficiency of yin with preponderance of fire ; Zhaohai ( K . 6 ) .

Explanation : The Hand - Yangming Meridian and Hand - Taiyin Meridian are exteriorly and interiorly related . The Hand - Yangming Meridian connects with the Foot - Yangming Meridian . So Yingxiang ( Li20 ) and Hegu ( Li4 ) are seclected to clear offbeat and stop bleeding . The Du Meridian is the sea of all the yang meridians . Extreme yang forces blood to rush out . So Shangxing ( Li20 ) is used to reduce heat of the Du Meridian . The lung has its specific body opening in the nose . Shaoshang ( L11 ) , the Jing - ( Well ) Point of the Lung Meridian , is used to reduce heat of the lung . Neiting ( S 44 ) , the Ying - ( Spring ) Point of the Stomach Meridian , is good for eliminating the stomach fire . Zhaohai ( K 6 ) , one of the Confluential Points of the Eight Extra Meridians , has the action of nourishing yin and reducing fire .

Remarks

Epistaxis may be caused by trauma , nasal disorders and acute febrile diseases . In addition to acupuncture treatment , other therapeutic measures should be adopted according to its primary cause .