Epistaxis is a symptom and sign of bleeding inside the ear. It is mostly caused by trauma or hyperactivity of liver fire. It can be seen in acute pus ear, intracranial injury, ear trauma, herpetic tympanitis, jugular vein bulboma, middle ear cancer and so on. Clinical treatment should be based on the type of epistaxis and its symptoms. If the type of epistaxis as the main symptom cannot be determined, epistaxis can be temporarily investigated as a preliminary diagnosis, and the identification of evidence and symptomatic treatment can be carried out. [Mechanism analysis] 1, trauma: cranial trauma, injury to cranial brain and ear orifices, breakage of blood vessels and eardrum, resulting in bleeding in the ear. 2, exogenous six uncontrolled, heat into the liver and gallbladder, steamed up through the meridian, qi and blood congestion, heat over the meat rot, pus and blood out. 3, there is phlegm and heat in the ear, resulting in the growth of new organisms in the ear; compounded by emotional disorders, liver fire, steamed in the ear, new organisms in the ear blood broken, blood spillage, from the Qingqiao and out. Diagnosis] 1. Symptoms: Fresh blood or bloody discharge from the ear. 2.Concomitant symptoms: mostly accompanied by earache or headache, or with symptoms or signs such as pus flowing from the ear and flesh growing in the ear. 3.Questioning：Attention should be paid to the causes of epistaxis, such as whether there is trauma, the number of times of bleeding and the amount of bleeding, whether it is accompanied by plasma or purulent secretion, and what are the accompanying symptoms. 4.Examination: pay attention to observe the external auditory canal, tympanic membrane, there is no damage, congestion, neoplastic, ulceration and other signs of lesions, if the tympanic membrane perforation, pay attention to observe the tympanic mucosa there is no congestion, ulceration, neoplastic. If there is a newborn material brittle and easy to bleed suspected of malignant tumors, attention should be paid to check whether there is cervical lymph node metastasis or systemic metastases such as lungs and liver. 1, one side of the ear pain, and see the eardrum red, swollen, perforation, overflow a little bloody pus or yellowish pus, accompanied by fever, most of the acute pus ear. 2, a side of the ear deep pain, and see the surface of the eardrum or the external auditory canal deep single yellowish or dark purple blood blisters, ulcerated plasma or bloody overflow, after healing, without scar, can be complicated by sensorineural deafness, occurring in adolescents, occurring in the fall and winter, most of the eardrum sores (hemorrhagic maculopapular tympanitis). 3.Frequent pus in the ear, sometimes with blood, examination of the eardrum large perforation, the tympanic cavity with active retention of secretions, and polyps or granulation, mostly chronic purulent mastoiditis of the middle ear combined with the middle ear polyps or granulation caused by. If necessary, histopathological examination. 4.Suddenly there is a lot of bleeding in the ear, or ear pus with blood, there was a tinnitus in line with the pulse, and the examination shows that the eardrum is perforated, and there is a new granulation tissue-like organism inside the tympanic cavity or external auditory canal, and it is easy to bleed and hard to stop by touching it, and it is mostly jugular venous bulbous tumors. Histopathologic examination should be carried out. 5.If there is history of chronic ear abscess, ear pus with blood or sudden flow of blood in the ear canal, polyps and granules in the tympanic chamber or ear canal, brittle and easy to bleed; if the middle ear granules and polyps recur very soon after surgical removal, and the progress is rapid, accompanied by vertigo and difficulty in opening the mouth, it is mostly malignant tumor of the middle ear. Histopathological examination should be carried out. 6.If there is history of head trauma, unconsciousness, bleeding in the ear canal or watery or medullary material, it is mostly caused by craniocerebral trauma.