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The nose is the orifice of the lungs, responsible for respiration. Additionally, as the Yangming meridian passes near the nose, we can clinically discern the pathological changes of the lung and stomach meridians through the odors emanating from the nose.
① Foul Odor from the Nose
【Olfactory Diagnosis】A foul odor is present when exhaling from the nasal cavity, while the patient themselves cannot detect any scent.
【Clinical Significance】This indicates a deficiency of lung and spleen qi, with pathogenic toxins retained. Due to lung deficiency, there is insufficient qi and fluids, leading to a lack of nourishment for the nose, making it susceptible to pathogenic invasion. The retention of toxins in the nasal orifice causes stagnation in the meridians, leading to a gradual depletion of yin fluids. The mucous membranes become dry, resulting in a foul odor from the nose. Furthermore, as the spleen is the mother of the lung, responsible for the transformation and transportation of nutrients, a deficiency in the spleen affects the lung. A weak spleen fails to transform dampness, leading to damp-heat that dries out the mucous membranes, causing a foul nasal odor. This condition is comparable to modern medicine’s “atrophic rhinitis.” Additionally, if there are ulcers or necrosis in the nasal area, the decaying flesh and putrid blood can emit a foul odor, making it difficult to approach, as seen in conditions like “syphilis,” “leprosy,” or cancer. This often results from exposure to foul air and internal toxins that gradually erode the nasal area, causing internal injury to qi and blood.
【Treatment Method】For lung deficiency, it is advisable to nourish yin and moisten the lungs, dispersing pathogens with the formula Qing Zao Jiu Fei Tang (Clear Dryness and Rescue the Lungs Decoction); for spleen qi deficiency, it is recommended to tonify the spleen and boost qi, using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with modifications.
② Fishy Odor from the Nose
【Olfactory Diagnosis】There is a constant flow of greenish-yellow nasal discharge, accompanied by a fishy odor in the nasal cavity.
【Clinical Significance】This is caused by nasal phlegm-heat. It usually results from external pathogens causing internal heat or from wind-cold invasion, which over time transforms into heat that ascends to the nasal orifice, transmitting to the lungs, leading to lung heat and pathogenic heat rising along the meridians. This condition is comparable to modern medicine’s “sinusitis.”
【Treatment Method】It is advisable to use aromatic herbs to open the orifices, clear the lungs, and dispel wind-heat, employing the formula Cang Er Zi San (Xanthium Powder) with modifications.
③ Urine-like Odor from the Nose
【Olfactory Diagnosis】The exhalation from the nose has a urine-like odor.
【Clinical Significance】This is commonly seen in patients with late-stage water qi disorders, usually caused by the decline of the organ’s essence and the upward flow of turbid heat.
【Treatment Method】Treatment should be based on the specific clinical condition, selecting appropriate methods and formulas.
① Pungent Garlic Odor
【Olfactory Diagnosis】There is a pungent garlic odor in the nose.
【Clinical Significance】This is often seen in cases of organophosphate poisoning.
【Treatment Method】Treatment should be based on the specific clinical condition, selecting appropriate methods and formulas.
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