Clear or thick
Some noses run every spring. Some block every time the air conditioning comes on. Some have been stuffed for so long that food has stopped tasting like anything. They are usually called allergies, sinusitis, or rhinitis, and those names are fair. What they don't explain is why antihistamines help one person and do nothing for the next, or why a "sinus infection" keeps coming back after every course of antibiotics.
The Donguibogam, the 1613 master text, gives the nose its own chapter, and it sorts nose complaints by details a patient can usually answer in a sentence: what the discharge looks like, how long it has been going on, and what sets it off. We translated it in full.
[→ The Nose — full translated chapter]
The nose belongs to the Lung
The chapter's whole argument fits in one line, quoted from the Classic of Difficulties:
> The lung qi passes through to the nose, and when the lung is harmonious the nose can know scent from stench.
Every treatment in the chapter is an attempt to bring the Lung back into harmony, and the test of success is the simplest one there is: whether you can smell again. It is also why we treat the nose with points on the hands, the back, and the head, not only beside the nostrils.
The first question: clear, or thick?
The chapter's most useful rule is a pair of sentences. A nose running clear discharge belongs to cold. A nose running thick, turbid discharge belongs to heat. It holds even through an ordinary cold — clear at the start, thick as it turns.
**Clear and watery, with sneezing** — this is what most people call allergies. The text names it separately and describes it exactly: in wind damage, clear discharge runs from the nose in a stream. It is read as cold in the Lung, and treated by warming and scattering. Seasonal hay fever, the morning sneezing fit, the nose that starts running the moment you step outside — these mostly fall here.
**Thick, yellow or green, that will not stop** — this is what the chapter calls the nasal deep-source: a spring that runs and will not stop. It describes a stinging ache at the bridge of the nose with it, which anyone with sinusitis will recognize. A later author adds a description that fits the stubborn cases precisely: cold outside binding heat within. That is the sinus infection that flares after every chill, and the reason cooling alone or warming alone doesn't settle it.
The chapter records one such case. A man's nose ran thick, foul-smelling discharge. The physician first applied moxibustion at three points — at the hairline, below the knee, and on the hand — then gave a formula in seven packets. He recovered completely.
The second question: new, or long-standing?
**Blocked for a few days, with sneezing and a heavy voice** — a chill caught. Treated by releasing the surface, and usually quick to settle.
**Blocking at the least draught, year after year** — a different problem. The chapter gives two readings: heat banked up in the nasal passage, which needs clearing; or a weak defensive surface that lets every draught in, which needs strengthening rather than more dispersing. Telling those apart is most of the work in chronic rhinitis, and it is why the same nose spray or the same formula doesn't work for everyone.
**Can't smell** — given its own formulas. The chapter treats loss of smell as the clearest sign that the Lung is not harmonious, and as the thing to measure progress by.
One thing to do every day
The chapter's section on cultivation has a single practice that anyone can try this minute: rub both sides of the bridge of the nose with your middle fingers, twenty or thirty times, until it feels warm inside and out. It calls this irrigating the central peak, to moisten the Lung. It is still taught, and patients with a chronically stuffy nose often find it opens things up for a while.
What treatment looks like here
Acupuncture is used for both allergies and sinus problems. The point the chapter names first for a blocked nose is LI20 Yingxiang, beside the nostril — its name means "welcoming fragrance," and the name is the indication. With it come GV23 Shangxing at the hairline, often warmed with moxibustion, and LI4 Hegu on the hand. For a nose that doesn't respond, the chapter moves to the back of the head and the upper back: GV20 Baihui, GB20 Fengchi, BL12 Fengmen, and GV14 Dazhui. For thick, foul-smelling discharge it adds BL4 Quchai.
Herbal formulas follow the pattern. From the chapter:
[Cheoncho-san 川椒散] — for clear, running discharge
[Ijin-tang 二陳湯], modified — for clear discharge with sneezing
[Changi-san 蒼耳散] — for thick discharge and sinus congestion
[Hyeonggaeyeongyo-tang 荊芥連翹湯] — for the stubborn, recurring sinus picture
[Hwangryeontongseong-san 黃連通聖散] — for thick discharge with strong heat
[Onwi-tang 溫衛湯] and [Onpye-tang 溫肺湯] — for a nose that blocks with every draught and can't smell
[Yeotaektonggi-tang 麗澤通氣湯] — for loss of smell
For seasonal allergies, treatment works best when it starts several weeks before the season rather than in the middle of it. Chronic sinus problems usually need a longer course, and progress is measured the way the chapter measures it — by whether the nose clears and the sense of smell returns.
## Please read this part
Some nose and sinus problems need a physician first, and not later.
**Get urgent evaluation if you have:** swelling or redness around the eye, a change in vision, or pain moving the eye; a severe headache with a stiff neck, high fever, or confusion; or difficulty breathing. Sinus infections can spread to the eye socket or beyond, and these signs are time-sensitive.
**Get evaluated before starting here if you have:** blockage or bleeding on one side only that keeps returning, sinus symptoms that have lasted more than three months, a sudden loss of smell, wheezing or shortness of breath with your allergies, or symptoms that keep returning after repeated antibiotics.
The 1613 chapter has its own version of this boundary. It describes stinking yellow discharge that runs constantly with headache, and treats it as something eating away inside the head — the tradition's way of naming a sinus infection that had gone deep. It also recognizes nasal polyps, a growth "the size of a jujube" blocking the nose. Both are reminders that a nose that won't clear deserves a proper look inside.
**This approach may help if you're dealing with:** seasonal allergies and hay fever · sneezing fits with clear, runny discharge · recurring sinus infections · thick post-nasal drip · a nose that blocks in air conditioning or cold air · pressure at the bridge of the nose · reduced sense of smell · chronic rhinitis that hasn't responded to sprays.
The Donguibogam translation project at formulas.raahacupuncture.com is researched and translated by Eui Young (Justin) Chung, L.Ac., Dipl. O.M. — the same clinician you'll see in the treatment room.