bubble_chart Concept

Bad breath from the nostrils is called nasal odor. It is commonly seen in nasal atrophy and sinusitis, and in severe cases, there may be a foul odor, which is distinctive and commonly referred to as "ozena."

bubble_chart Pattern Analysis

1. Liver-gallbladder Dampness-heat︰Yellow-green nasal discharge with foul odor, nasal congestion, headache, decreased sense of smell, localized tenderness in the nostrils, or dizziness, flushed face, red eyes, dry mouth and throat, dry stools, dark yellow urine, red tongue with yellow coating, and wiry-slippery pulse. This is caused by liver-gallbladder dampness-heat stagnation ascending along the meridians to disturb the nasal orifices. Due to dampness accumulation and heat steaming, resolving putridity turns into pus, hence the foul-smelling discharge. Bitter taste in mouth, dry throat, accompanied by fullness and discomfort in the chest and hypochondrium, red tongue with yellow greasy coating, and other signs of liver-gallbladder dampness-heat. Treatment should focus on clearing and purging liver-gallbladder dampness-heat, assisted by removing toxin and relieving stuffy orifices. The recommended formula is Gentian Liver-Draining Decoction supplemented with heat-clearing and toxin-removing herbs such as Lonicera, Dandelion, Tokyo Violet Herb, and Magnolia.
2. Spleen Deficiencydampness-heat︰The nose emits a foul odor, which is unpleasant and hard to bear. There are dry yellow-green crusts inside the nostrils, accompanied by a diminished sense of smell or an inability to detect scents. Symptoms also include abdominal distension and fullness, headache, drowsiness, mental fatigue and lack of strength, dry mouth without a desire to drink, a tongue coating that is white and greasy or yellow and dry, and a soggy and rapid pulse. This condition arises from spleen deficiency impairing transportation, leading to the accumulation of dampness turbidity that obstructs the middle burner. As a result, clear yang fails to ascend, and turbid yin fails to descend. Prolonged stagnation of dampness transforms into heat, resulting in the binding of dampness-heat, accompanied by the resolution of putridity into pus, which emits a foul odor. Treatment should focus on resolving dampness and clearing heat. The recommended formula is Three-Kernel Decoction with modifications.

The former condition belongs to the excess heat pattern (liver-gallbladder dampness-heat); the latter belongs to the root deficiency and branch excess pattern (spleen deficiency with dampness transforming into heat), and they are not difficult to differentiate clinically. The nose is the orifice of the lung, so both conditions are closely related to the lung.

bubble_chart Documentation

1. Jingyue QuanshuVolume 27: "Sinusitis is generally caused by the fire of the taiyang governor vessel. In severe cases, it extends to the brain and continuously secretes, hence it is also called sinusitis. This condition is often due to medicinal wine and rich, sweet foods, or prolonged use of hot substances, or fire caused by cold stagnation, leading to dampness-heat rising and body fluids dissolving and overflowing. When they deviate from their normal path, they become foul, some with a strong stench that is unbearable to smell."