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Nosebleeds (Epistaxis)

How Chinese medicine differentiates nosebleeds, the six patterns you'll actually meet in practice, and the points for each. Acupuncture only — no herbs.

This page is educational, for practitioners and students — it is not a diagnostic tool and does not replace a proper in-person assessment. Heavy, one-sided, or recurrent nosebleeds, or bleeding with no clear trigger, need a medical evaluation to rule out a bleeding disorder, high blood pressure, or a structural cause before assuming it is a simple Heat pattern.
General Acupuncture Points

Acupuncture points traditionally used for nosebleeds — 13 key points, used across the patterns below rather than tied to just one.

PointKey action
LU-10Clears Lung-Heat, promotes the descending of Lung-Qi.
LU-5Clears Lung-Heat, promotes the descending of Lung-Qi, resolves Phlegm.
ST-44Clears Heat, regulates the Intestines and resolves Damp-Heat.
ST-37Regulates the Stomach and Intestines, eliminates Damp-Heat.
LR-3Subdues Liver-Yang, extinguishes interior Wind, invigorates Blood.
LR-2Drains Liver-Fire and subdues Liver-Yang, cools Blood and stops bleeding.
G.B.-43Subdues Liver-Yang, resolves Damp-Heat.
ST-36Tonifies Qi and Blood, tonifies Stomach and Spleen.
SP-3Strengthens the Spleen, resolves Dampness.
SP-1Regulates the Spleen, stops bleeding, calms the Mind.
KI-3Tonifies the Kidneys (both Yin and Yang), benefits Essence.
SP-6Nourishes Blood and Yin, cools Blood.
SP-10Cools Blood, invigorates Blood and eliminates stasis.
P-3Clears Heat and cools Blood, calms the Mind.
The Six Patterns

↑ reinforcing   ↓ reducing   ⊥ even method.

1. Lung Heat

Clinical manifestations: Profuse, bright-red bleeding; dry nose and throat; fever or body heat sensation; intense thirst with cold drink cravings; thick yellow phlegm cough.
Tongue: Red body, especially at the tip, yellow dry coating. Pulse: Rapid, may be slippery or overflowing at the right cun.
Treatment principle: Clear Heat from the Lungs and stop bleeding.
Note: no moxa. Matched on the internal pattern to Lung-Heat — the deck slide's own "flaring of nostrils" sign reflects the same Lung-opens-into-the-nose logic, even though the slide itself is framed around cough rather than bleeding.

2. Bright Yang Stomach Heat

Clinical manifestations: Profuse, bright-red bleeding; intense thirst with cold drink cravings; foul breath; constipation or dry stools; flushed red face.
Tongue: Red body with a yellow, dry coating. Pulse: Overflowing and surging, rapid, forceful.
Treatment principle: Clear blazing Stomach Fire and cool the Blood to stop bleeding.
Note: no moxa. Matched on the internal pattern to Stomach-Heat — shares the thirst-for-cold-drinks, foul breath, and dry-stools core, though the deck slide is epigastric-framed.

3. Liver Fire Blazing View full pattern →

Clinical manifestations: Nosebleeds triggered by anger or frustration; sudden, heavy, bright-red bleeding; throbbing headache at temples; red, burning eyes; bitter taste and dry mouth; intense irritability.
Tongue: Red body with redder sides, dry yellow coating, possible red prickles. Pulse: Wiry and rapid, forceful at left Guan.
Treatment principle: Drain Liver Fire and clear blazing Heat from the upper body.
Note: no moxa. Direct match — the deck slide names epistaxis explicitly among its symptoms.

4. Spleen Not Controlling Blood View full pattern →

Clinical manifestations: Slow, oozing bleed of pale-red blood; pale or sallow complexion; chronic fatigue; poor appetite and loose stools; weak overall constitution.
Tongue: Pale, puffy body with teeth marks, thin white coating. Pulse: Fine and weak, especially at the right Guan.
Treatment principle: Tonify Spleen Qi and nourish Blood.
Note: moxa applicable, especially SP-1. Direct match — the deck slide names blood spots under the skin and blood in urine/stools among its symptoms.

5. Kidney and Liver Yin Deficiency View full pattern →

Clinical manifestations: Slow, oozing pale-red bleeding; dry mouth and throat, especially at night; afternoon/evening flushed cheeks; heat sensation in palms, soles, and chest; dizziness, sore back and knees, ringing ears.
Tongue: Red, thin body with cracks, little or no coating, dry surface. Pulse: Fine and rapid, possibly wiry, weak at the deep level.
Treatment principle: Nourish Yin fluids and subdue empty-heat.
Note: no moxa. Direct match, first use of this specific combined slide — dizziness, tinnitus, backache, dry throat and night sweating are the same markers named there.

6. Heat in the Blood

Clinical manifestations: Profuse, bright-red bleeding; internal heat sensation worse at night; restlessness and irritability; may accompany bleeding gums or skin bruises.
Tongue: Deep-red body with red spots or prickles, thin yellow dry coating. Pulse: Rapid, wiry, forceful.
Treatment principle: Clear Heat from the Blood level, stop reckless bleeding.
SP-10 ↓ P-3 ↓ DU-28 (Yinjiao) ↓
Note: no moxa. No deck on this site has a standalone Heat-in-the-Blood slide, so no pattern link is given here.
Related conditions

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