I. Experience in treating nasal abscess The nasal abscess is firstly found in the Nei Jing, and the Su Wen Qi Symposium says: “The nasal abscess is a condition in which turbid mucus goes down more than once.” It is mainly characterized by nasal runny nose with more than one volume, often accompanied by headache, nasal congestion and loss of sense of smell.
The weather is connected to the lung, and the lung is open to the nose. The nasal runny nose, with a large amount of mucus, nasal congestion and unfavorable airway, is blamed on the lung. The causes of the disease are external evil and internal heat. External evil includes feeling wind-cold or wind-heat. Nasal congestion is the result of external evil attacking the lung orifices. The wind evil attacking from outside will disturb the lungs and block the clear yang, hence the headache. The lung is in the liquid as snot, the nasal runny nose with more than one volume is the lesion of lung liquid. The snot is from thin to thick, and the amount is more than one, first of all, the fluid is not properly distributed, and the lung qi is blamed for the failure of propagation and purification, and the snot changes from clear to turbid; it is the change of fluid decay and turbidity, and it involves phlegm, heat, filth, and silt, which is internal heat. Internal heat mostly originates from the lung, stomach, liver, gallbladder and large intestine organs. Lung fever is caused by external wind and cold, which closes the Wei Qi and accumulates heat, or the external cold enters the heat, or the fluids are not distributed, and the phlegm and heat accumulate in the lungs. The stomach vein starts in the nasal junction O, and the large intestine vein goes up to the nostrils. Diet, stagnant food, frying and cooking, fat, sweet and thick taste, sorghum alcoholic wine, brewing phlegm and damp heat, damp heat, phlegm heat congestion gastrointestinal, so the stomach and large intestine heat, up smoked in the lungs can also occur nasal abyss. All diseases are born in qi, the seven emotions of qi depression into fire and heat, liver heat forced on the lungs, or as the “Su Wen Qi Convulsions” says: “bile heat moves heat to the brain, then Xin O nasal abyss.”
In the treatment of nasal abyss, Mr. Gao emphasized the methods of promoting the lung and clearing the orifices, resolving phlegm and dispelling dampness, and clearing heat and detoxifying toxins. The Suwen Sun Yangming said, “Those injured in the wind, the upper first suffer.” External evil should be dispersed, and the lung should be propagated to the same orifice, commonly using Xin Yi, Bai Zhi, Peppermint, Sclerotium, Qiang Wu, and Hsiang Xin. Cang Er Zi San is from “Jisheng Fang”: half a tael of Xin Yi Ren, two and a half taels of Cang Er Zi, one tael of Angelica dahurica, half a tael of peppermint leaves, dried on top, as a fine powder, two taels per serving, after eating with onion, tea clear mix down, to take its effect of dredging wind and relieve pain, open the nasal passage. To resolve phlegm and dispel dampness, almonds, coix seeds, winter melon seeds, rhizome, guavas, bile star, zhebei mother and other medicines are often used. Clearing heat and detoxification commonly used dandelion, wild chrysanthemum, septoria, grass, half a lotus, fishy grass, golden buckwheat and other drugs, the choice of Wu Wei disinfectant drink plus or minus. If the disease has been prolonged and difficult to heal, every use of blood circulation products, or such as Chuanxiong, peach kernel, whole scorpion and other drugs. Mr. Gao flexibly used the three methods of promoting lung circulation, removing phlegm and dampness, and clearing heat and detoxifying the toxin, with good results.
Case 1: Female patient, 35 years old, bank employee, first diagnosed on January 2, 2012. Recurrent episodes of nasal congestion, headache and pus for more than 2 years, aggravated for 3 months. 2 years ago, she had nasal congestion, pus and headache caused by cold, and was diagnosed with sinusitis by sinus CT examination. Now he has nasal congestion, forehead pain, yellowish pus, postnasal drip, decreased sense of smell, dizziness, nasal breath heat, thirst, no bitterness, no heartburn, poor appetite, dry stool, 1 line in 2 days, red tongue tip, thick yellow moss at the root, thin and slightly counted pulse. This is a case of external attack by wind and heat in the lung and stomach. The treatment is to remove wind and heat, clear the orifices and detoxify the toxins. Prescription: Angelica dahurica 10g, Radix Angelicae Sinensis 10g, Radix Peppermint 6g, Cang Er Zi 6g, Rhizoma Chuanxiong 6g, Radix Qiang Wu 10g, Dandelion 30g, Radix Sulforaphane 30g, Scutellaria Baicalensis 10g, Radix Silybin 3g. 7 doses in water, 1 dose daily.
On January 9, 2012, the patient’s second diagnosis: the pus is obviously reduced, the color of snot turns from yellow to white, the headache is relieved, the nasal congestion at night, the nasal breath is not hot, the thirst is improved, the stool is one line per day, the tip of the tongue is slightly red with thin yellow coating, the pulse is fine. The disease seems to have a turnaround, keep the law again, above add Citrus Aurantium 10g, to harmonize the stomach qi. 7 doses, decoction with water, 1 dose daily.
On January 16, 2012, the third diagnosis: occasional white snot, headache significantly reduced, occasional nasal congestion, 1 line of stool daily, slightly red tongue, thin white fur, thin pulse. Followed by 14 doses for consolidation.
Comment: The headache is caused by the external attack of wind evil, which disturbs the head through the meridians and blocks the qi of clear yang. Therefore, Cang Er Zi San plus or minus is used for its efficacy in relieving wind and pain and clearing the nasal passages.
Case 2: Zhang, female, 25 years old, was first diagnosed on February 3, 2009.
She has been suffering from postnasal congestion, with phlegm and snot coming out of the pharynx or with blood for more than 1 year. She developed bleeding from nasal examination after a cold, and usually had a cold about once a month. She has had irregular menstruation for more than 1 year. Ultrasound revealed polycystic ovaries and abdominal pain on the first day of menstruation, and her last menstruation was 4 months ago. She had a cold a few days before and her nasal congestion worsened. The postnasal blockage, no runny nose, phlegm or phlegm in the throat, hemoptysis or blood, dark red tongue, yellow moss, string pulse. He was diagnosed as having nasal abscess, with evidence of pulmonary phlegm-heat, deregulation of Xuanjiang, and liver depression and blood deficiency.
On February 10, 2009, the second diagnosis: discomfort at the back of the throat when the cold is not present, sleep at night and dreamy, heartburn is still possible, menstruation is about to start, the tongue is light and dark with a red tip and thin yellow coating, the pulse is thin and stringent on the left. Treatment is to nourish Blood and regulate menstruation. Radix Bupleurum 10g, Radix Paeoniae Alba 15g, Radix Angelicae Sinensis 10g, Rhizoma Ligustici Chuanxiong 6g, Radix Rehmanniae 10g, Radix Aconiti 30g, Radix Aconiti 18g, Radix Cyperus 10g, Radix Aconiti 10g, Radix Aconiti 10g, Rhizoma Silkworm 10g, Radix Longmu 30g. 7 doses in water, 1 dose daily.
On February 24, 2009, the third diagnosis: the nasal abscess is slightly improved, the nasopharynx is distended and blocked, night sleep with dreams, dry stool, menstruation is clean, the tongue is red with thin yellow coating, the pulse is thin and string. Continue to promote the lung and resolve phlegm.
Diagnosis on March 5, 2009: Sleeping well at night, with white and sticky nasal discharge with blood, red tongue with yellow fur, sunken and thin pulse.
After 3 months of treatment, the patient’s condition has stabilized and her menstruation has become regular, and she has not caught any cold.
Note: The patient’s nasal abscess with phlegm-heat in the lung, deregulation of Xuandu, liver depression and blood deficiency, and menstrual irregularity. The main treatment is to promote the lung and resolve phlegm on weekdays, and to nourish the blood during menstruation with Siwu Tang and to regulate menstruation with Si Wu Thian Bone Yiru Wan, so that the two diseases are balanced and focused.