Nosebleedsaccording to TCM
Symptom family: Nasal Disorders and Symptoms
Sub-symptom(s): Frequent Nosebleeds
What is Nosebleeds?
Nosebleeds, medically known as epistaxis, are a common condition where bleeding occurs from the nostrils, nasal cavity, or nasopharynx. This symptom can be spontaneous or caused by trauma, and while often benign, can sometimes indicate more serious health issues. Frequent nosebleeds may be particularly concerning and require medical evaluation. Managing nosebleeds involves understanding both the immediate triggers—such as dry air or nasal congestion—and any underlying disorders that may predispose someone to bleed more easily.
How Does TCM View Nosebleeds?
Traditional Chinese Medicine (TCM) perceives nosebleeds as a manifestation of disharmony within the body. Unlike Western medicine, which often focuses on local factors like dry mucosa or external injuries, TCM explores underlying imbalances that lead to a predisposition for such symptoms.
It emphasizes the importance of identifying distinct patterns of disharmony—be it from Heat, Wind, or Blood Stagnation—to tailor treatment effectively. This holistic approach seeks not only to stop the bleeding but also to address the root causes preventing future occurrences.
Root Causes of Nosebleeds in TCM
In TCM, nosebleeds are most commonly associated with Heat in the Blood and Liver Fire, both of which lead to the overheating of Blood which then "jumps" the vessels. Heat in the Blood can manifest as spontaneous bleeding, a feeling of heat, red skin eruptions, and a rapid pulse.
Alternatively, Liver Wind agitating Internally due to Liver Fire might present with symptoms such as severe headaches, irritability, red eyes, and a bitter taste in the mouth, reflecting an internal excess that needs cooling and calming. Treatments focus on nourishing Yin and subduing Yang to restore balance between the body's energetic forces.
Explore below more details about what might cause Nosebleeds according to TCM.
- By Syndrome
- By Organ
- Heat
- Wind
- Mind Disturbance
- View More Causes
Heat
In TCM "Heat" signifies an excess of Yang energy, leading to an imbalance where heat predominates over the body's cool Yin aspects. This condition is metaphorically akin to an internal over-heating. Symptoms indicative of Heat can include feelings of warmth, fever, sweating, irritability, red face, thirst with a preference for cold drinks, and a rapid pulse. The tongue may appear red with a yellow coating. Unlike the common interpretation of heat in terms of temperature, in TCM, it represents a state of hyperactivity or inflammation in the body.... see more
Heat Patterns That Can Lead to Nosebleeds
Common Symptoms: Thirst Vomiting Blood Cough Of Blood Irritability Flushed Face Dark Urine Dry Stools Bitter Taste In The Mouth
| Pattern Name | Relevant Symptoms | Relevant Formulas |
|---|---|---|
| Heat in the Blood | Bloody nose, Feeling of heat, Red skin eruptions, Thirst, Frequent bleeding, Bloody sputum, Hematochezia, Hematuria, Vomiting blood, Cough of blood, Nosebleeds, Excessive menstruation... see more | Xi Jiao Di Huang Tang | Gu Jing Wan | Shi Hui San | Bai He Di Huang Tang | Hua Ban Tang | Qing Ying Tang | Qing Re Gu Jing Tang |
| Heat victorious agitating Blood | Epistaxis, Restlessness, High fever, Mania, Macules, Vomiting blood, Nosebleeds, Hematochezia, Hematuria... see more | Xi Jiao Di Huang Tang |
| Liver Fire Blazing | Epistaxis, Irritability, Anger, Tinnitus, Deafness, Temporal headache, Dizziness, Flushed face, Eye hyperemia, Thirst, Bitter taste in the mouth, Vivid dreaming, Constipation, Dry stools, Dark urine, Nosebleeds, Cough of blood, Vomiting blood... see more | Long Dan Xie Gan Tang | Dang Gui Long Hui Wan | Xie Qing Wan |
| Liver Wind agitating Internally due to Liver Fire | Epistaxis, Tremors, Irritability, Anger, Tinnitus, Deafness, Temporal headache, Dizziness, Flushed face, Eye hyperemia, Thirst, Bitter taste in the mouth, Vivid dreaming, Constipation, Dry stools, Dark urine, Nosebleeds, Vomiting blood, Cough of blood... see more | Ling Jiao Gou Teng Tang | Zi Xue Dan | Feng Yin Tang |
| Wind Cold with Internal Heat | Nosebleeds, High fever, Severe chills, Lack of sweating, Headaches, Feeling of heaviness, General sensation of tightness, Flushed face, Eye hyperemia, Dry nose, Thirst, Irritability, Insomnia, Cough of blood, Mottled skin... see more | Shi Gao Tang |
TCM Herbal Formulas for Nosebleeds
To treat nosebleeds, TCM recommends formulas that address the underlying patterns. For Heat in the Blood, Xi Jiao Di Huang Tang, which includes ingredients like Water Buffalo Horns (Shui Niu Jiao), is used to cool the Blood and stop bleeding. This formula is ideal for cases where there is also restlessness, fever, or skin eruptions.
In situations involving Liver Fire or Wind Heat, practitioners might choose formulas that pacify the Liver and clear Heat, such as Ling Jiao Gou Teng Tang or Shi Gao Tang. These formulas help regulate the energy flow and cool the blood, providing relief from symptoms.
Explore below some TCM herbal formulas used to address nosebleeds, organized by cause and by formula type.
- By Cause
- By Formula Type
- Heat
- Wind
- Mind Disturbance
- View More Causes
Top Formula for Heat:
Xi Jiao Di Huang Tang
Suitable for Heat patterns that may cause nosebleeds, such as Heat in the Blood or Heat victorious agitating Blood
Learn moreAll Formulas Recommended for Nosebleeds Caused by Heat
| Formula | Patterns Suitable For |
|---|---|
| Xi Jiao Di Huang Tang | Heat in the Blood, Heat victorious agitating Blood |
| Gu Jing Wan | Heat in the Blood |
| Shi Hui San | Heat in the Blood |
| Bai He Di Huang Tang | Heat in the Blood |
| Hua Ban Tang | Heat in the Blood |
| Qing Ying Tang | Heat in the Blood |
| Qing Re Gu Jing Tang | Heat in the Blood |
| Long Dan Xie Gan Tang | Liver Fire Blazing |
| Dang Gui Long Hui Wan | Liver Fire Blazing |
| Xie Qing Wan | Liver Fire Blazing |
| Ling Jiao Gou Teng Tang | Liver Wind agitating Internally due to Liver Fire |
| Zi Xue Dan | Liver Wind agitating Internally due to Liver Fire |
| Feng Yin Tang | Liver Wind agitating Internally due to Liver Fire |
| Shi Gao Tang | Wind Cold with Internal Heat |
Acupoints for Nosebleeds
TCM also incorporates acupuncture as a treatment for nosebleeds, targeting specific points that can help control acute symptoms and correct underlying imbalances. For example, Chengjin BL-56 and Feiyang BL-58 are points on the Bladder meridian that can relax sinews and strengthen Kidney Qi, respectively, both of which are beneficial for managing blood flow and systemic Heat.
Other points like Fengmen BL-12 and Ganshu BL-18 are used to expel Wind and nourish Liver Blood, directly influencing factors that contribute to nasal bleeding. These targeted interventions are part of a broader strategy to harmonize the body’s energies and prevent the recurrence of nosebleeds.
Explore below some acupoints used to address nosebleeds, organized by meridian.
- By Meridian
- Bladder Channel
- Governing Vessel
- Large Intestine Channel
Qucha BL-4
0.5 cun superior to the anterior hairline and 1.5 cun lateral to the anterior midline, at the junction of the medial third and lateral two-thirds of the distance from anterior midline to Touwei ST-8.
Fengmen BL-12
1.5 cun lateral to the lower border of the spinous process of the 2nd thoracic vertebra (T2).
Geshu BL-17
1.5 cun lateral to the lower border of the spinous process of the 7th thoracic vertebra (T7).
Ganshu BL-18
1.5 cun lateral to the lower border of the spinous process of the 9th thoracic vertebra (T9).
Shangliao BL-31
In the 1st posterior sacral foramen, about midway between the posterior superior iliac spine (PSIS) and the midline.
Yixi BL-45
3 cun (about 4 finger-breadths) lateral to the lower border of the spinous process of the 6th thoracic vertebra (T6).
Chengjin BL-56
5 cun inferior to Weizhong BL-40 which is the midpoint of the popliteal crease. In the center of the belly of gastrocnemius muscle, midway between Heyang BL-55 and Chengshan BL-57.
Feiyang BL-58
On the posterior border of fibula, about 1 cun inferior and lateral to Chengshan BL-57, 7 cun directly above Kunlun BL-60.
Zutonggu BL-66
In the depression distal and inferior to the 5th metatarsophalangeal joint, at the lateral border of the foot.
