Introduction: Nosebleeds that recur often are commonly caused by bleeding from the front of the nose. There are causes for acute (picking the nose, structural problems in the nose, allergies, medications, humidity, etc.) and chronic nosebleed (rupture of the blood vessels, polyp or tumor in the nose or sinuses, health conditions leading to abnormal blood clotting, etc.). In traditional Chinese medicine (TCM) nosebleeds are usually due to Heat retention in the Blood. 

Purpose: To demonstrate that patients with chronic nosebleed could have energy alterations leading to retention of Heat, as well as it could be caused by deficiency of chakras’ energies meridians, leading to this Heat retention. The treatment of these patients should be individualized and the manifestation of nosebleed could be only the symptom that a systemic energy imbalance should be treated to correct in a deeper level the root of the problem and not just treating the symptoms. 

Methods: Through one case report, A.L., 7-year-old female patient, with a history of chronic nosebleed for 6 years ago. She underwent various consultations with otorhinolaryngologist and pediatrician that suggested her to do local cauterization. Her uncle sought ancient medical tools to treat her and the Chinese physician orientate her to avoid the ingestion of dairy products, Cold water, raw foods, sweets and also, fried foods, chocolate, eggs, honey, coconut. For her surprise all these foods were very common in her diet, mainly in the meal that she usually buys in the school that all foods are made by dairy products, melted cheese and chocolate. She did auricular acupuncture with apex ear bloodletting twice a week. Chakra’s energies meridians centers were measured through radiesthesia procedure that showed all chakras in the lowest level of energy (rated one out of eight). The replenishment of these chakras was done using highly diluted medications according to Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine. 

Results: The patient improved quickly with the treatment done and never had nosebleed again. 

Conclusion: To treat patients with chronic nosebleed, it is important to understand that this is only a symptom but the cause could be in the energy level, invisible by the naked eye. The correction of all the factors leading to the energy imbalance and aggravating the formation of Heat should be done and the replenishment of the chakras energy centers using highly diluted medications according to the theory Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine and the use of crystal-based medications for at least one year or for the entire life of the patient was also important to prevent the recurrence of chronic nosebleed symptoms. 

Epistaxis or nosebleed is a common emergency encountered by primary care physicians. Up to 60% of the general population experience epistaxis, and 6% seek medical attention for it. More than 90% of cases arise from the anterior nasal circulation, and most treatments can be easily performed in the outpatient setting. [1]

Some of the causes of epistaxis are: Local Inflammatory; Chronic sinusitis; Environmental irritants; Granulomatous disease; Pyogenic granuloma; Viral illness; [1]

Structural: Septal deviation or perforation; Traumatic: Cocaine use; Foreign body; Nasal fracture; Nasal intubation; Nasal oxygen; Nose picking; Surgical procedure; Topical medications (e.g., intranasal steroids); Tumors and vascular malformations;[1]

Systemic: Anticoagulants; Coagulopathy; Hemophilia; Leukemia; Liver disease; Thrombocytopenia; Vitamin deficiencies (A, C, D, E, K). [2]

No uniform guidelines exist for diagnostic and therapeutic procedures in patients with nosebleed. However, clinically tried and tested treatment paths do emerge in hospitals and doctors’ offices, based largely on retrospective analyses, case series, and expert opinion. Only few prospective or randomized controlled studies are available for some discrete areas of epistaxis treatment. [3] 

Epistaxis ranges from light nosebleeds that are easy to manage using simple methods to life-threatening bleedings that require hospital admission and may even need surgical treatment. [3] 

In traditional Chinese medicine (TCM) understanding, nosebleeds are usually due to over-heated Blood. Persistent or recurrent nosebleeds may indicate that an internal disharmony has formed, and the source of Heat should be eliminated. Physicians will consider the characteristics of the bleeding, including the duration, interval, amount of bleeding, color and texture of the Blood, and the overall condition of the body when identifying a disharmony pattern. [4, 5]

The body's ways of releasing internal Heat are through urine, sweat, feces (diarrhea, smelly stools, rash in the anus), excessive menstruation and nasal bleeding. [4-6]

Through one case report of 7-years-old female children that was presenting chronic nose bleeding and was not improving her symptoms with the treatment using local cauterization.

Case Report

The patient is a 7-years-old female patient with history of nose bleeding since she was 2 years-old.

The nose bleeding appeared unrelated to physical exercise, food or stress, in dry or humid times. The only exception is that it occurs when she is swimming in a pool where the temperature is around 32 degrees and this often happened.

Nose bleeding was quite common, almost every week. She went to several pediatricians, ear, nose and throat (ENT) doctors and even hematologists.

There was even the hypothesis suggested by an ENT of making an intra nasal cauterization, but that could wait to be done at a later age.

Her aunt was already my patient due to facial paralysis and she was treating using acupuncture and she decided to take her niece to my office to do the treatment with me.

In the first appointment, her Chinese medicine’s diagnosis was Kidney Yin, Blood deficiency and Heat retention. The first step was to orientate her diet according to Chinese dietary counseling avoiding the ingestion of:

1)  dairy products, Cold water, raw foods, sweet (to do not imbalance the Spleen and pancreas energy meridian, responsible for the absorption of nutrients and formation of Blood)

2) fried foods, chocolate, eggs, honey and coconut, alcoholic beverages and melted cheese (to do not imbalance the Liver and Gallbladder energy center and increase the formation of internal Heat).

3) Coffee, soda and mate tea (to do not imbalance the Kidney responsible for the formation of Yin and Yang energy).

For her surprise all these foods were very common in her diet, mainly in the meal that she usually buys in the school, that all foods are made by dairy products, melted cheese and chocolate. 

She began the treatment using auricular acupuncture with apex ear bloodletting twice a week. The auricular acupuncture points were made by mustard seeds applied through small adhesive tapes in each ear point, as you can see in the Figure 1 

Figure 1 – Auricular acupuncture points used in the treatment of chronic nosebleed

In the Figure 2, you can see the apex ear bloodletting when I use a small insulin needle to prink the apex of the ear to take out about 5 drops of blood.

Figure 2- Apex ear bloodletting

Chakra’s energies meridians centers were measured through radiesthesia procedure, using a crystal pendulum to evaluate how was the energy situation of the internal five massive organs (according to TCM’s reasoning) . In this procedure, when measuring the chakras’ energy centers, I am measuring the internal five massive organs in traditional Chinese medicine, that showed all chakras in the lowest level of energy (rated one out of eight). This result means that all the internal five massive organs were in the lowest level of energy and for this reason, her body was not producing the energy necessary for the maintenance of her health. In this case of energy deficiency, her body begins to produce internal Heat, that is the cause of nose bleeding in this patient because the body in an attempt to try to release this excessive Heat formation (and one of the forms to release them is through nose) and I will discuss better in the discussion section.

Figure 3 – Chakras’ energy centers measurement using radiesthesia procedure.

The replenishment of these chakras was done using highly diluted medications such as homeopathies according to the theory created by me (2020) entitled Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine and crystal-based medications, as you can see in the Table 1. 

Table 1 - Homeopathy and crystal-based medications used to replenish the chakras’ energy centers.

Results of the treatment of case report

After following the Chinese dietary counseling strictly and performing auricular acupuncture with apex ear bloodletting twice a week, the patient did not have any more nose bleeding.

Throughout the treatment, she had nose bleeding only when she ate from the snacks in the school that has chocolate, melted cheese or fried foods.

She continued the treatment until the beginning of the COVID-19 pandemic (March 2020) and was loving the treatment because she never had a treatment that resolve her nose bleeding problem efficiently, in the words of her aunt, because she no longer had to worry about the occurrence of this symptom that could happen anywhere. She is currently asymptomatic, even playing in a hot water pool.

This article will be written by the influences of Hippocrates (c. 460 bce - c. 375 bce) thoughts that said that “foolish the doctor who despises the knowledge acquire by the ancients.” For this reason, all the reasoning used in the treatment of this children with chronic nose bleeding was based on traditional Chinese medicine that exists for more than 5000 years. [7]

To explain why I treat my patients looking at the energy imbalances that has in the back ground of all symptoms, I will briefly tell you the history of one patient that I treated in 2006 and became the cornerstone of all my treatment since then. [8]

He was a 70-year-old male patient, who searched for me because of his leg pain that did not improve with the use of anti-inflammatory medications during the last 6 months of treatment. He looked for the treatment using acupuncture and other Chinese medicines’ tools. According to TCM, he was diagnosed with Kidney-Yang deficiency. He started the treatment with Chinese dietary counseling, auricular acupuncture with apex ear bloodletting and systemic acupuncture. [8]

With the treatment done, the pain in the legs diminished and he returned to my clinic to be reevaluated. In this interview, 30 days after the treatment, the patient revealed that his eye pressure had also lowered, from 40 mmHg to 17 mmHg, as his ophthalmologist confirmed. During the treatment, he had not reported to be treating glaucoma in the last 40 years with no improvement of his condition. This unusual case became the cornerstone of all my studies trying to comprehend how the treatment focused on the root of the problem (that are the energy imbalances) could treat different diseases and symptoms simultaneously and using the same methods. [8]

           The symptoms and treatments in Western medicine of nosebleed are treated in the leaf level of the tree, that is the metaphor that I usually use in all my presentations. This tree represents the human being. This tree has a trunk with several branches. Coming out of each branch, you can see many leaves. Each leaf represents one symptom and diseases treated by each medical specialty. In this case, nose bleed is cared by Western medicine as a localized treatment, and the specialty that usually treats is the otorrinlaringologist or head and neck surgeon (ENT) or pediatrician. [6]

Figure 4 - Metaphor of the tree showing the different viewpoints between Western and traditional Chinese medicine

But in traditional Chinese medicine, as I showed in the case of patient with leg pain and glaucoma, when I treat the root (that are the energy imbalances between Yin, Yang, Qi and Blood), I can treat all the patients’ conditions at the same time, even the doctor do not know that the patient has such symptoms. [9]

Figure 5- Yin Yang Qi and Blood

Yin and Yang are two forces that exists in all the things in our Universe. They are opposites but complementary such as good and bad, men and women, day and night, sun and moon, etc. In traditional Chinese medicine, all the treatments are based on the balance between these two forces. [9]

Figure 6-Yin and Yang symbol

There is the necessity of two other forces (Qi and Blood) to Yin and Yang circulate inside the energy meridians and their interrelationship is demonstrated in the Figure 2. [10]

Qi is the energy that circulates through out the body. When there is Yin, Yang and Blood in adequate amount, there is naturally Qi in normal quantity too. This energy is important to keep Blood circulation inside the blood vessels. This schematic relationship was presented in the Acupuncture Research Conference in 2015, that was held in the Harvard Medical school in Boston, United States, where I presented a study showing that , if we treat all these energy imbalances in the root of the tree, regulating these four energies, we can treat all the patients symptoms at the  same time, even the doctor does not know that the patient has such symptoms. [6, 8]

When there is energy deficiency in one or a combination of energy deficiencies between these energies, there is the formation of internal Heat, that is in this case, the cause of the bleeding process ocurring in the nose, because it is one of the way that the body has to release the Heat inside the body. [5] 

Figure 7: Yin, Yang, Qiand Blood and formation of internal Heat.
 

The second theory is the Five Elements theory, which explains the functioning of nature and the interconnection between the massive organs inside the body.  In this theory, all organs are interconnected, and everything that happens with an organ on the energy level will influence the other organs and the whole system. This is very important to understand, regarding the symptoms and complications of any disease and the treatment done nowadays, because in Western medicine, the symptoms are treated separately, while in TCM they all come from the same root. [6]

Figure 8– Five Elements theory

On the theory of the Five Elements, the elements are Fire, Earth, Metal, Water and Wood and they are representing the five internal massive organs, which are Heart, Spleen, Lungs, Kidney and Liver, respectively. [9] 

Each element provides the energy and control the other element on the generation and the control cycles, and the explanations of all these cycles are well done as I wrote (2019) in the article Why Are Diabetic Patients Still Having Hyperglycemia Despite Diet Regulation, Antiglycemic Medication and Insulin? [6, 11]

In addition to the five elements, one massive organ has a hollow organ, and they command one external sensory organ, an emotion, a color, among other characteristics, as you can see in the Table 2. [9, 11]

Table 2. Characteristics of the Five Elements and the internal five massive organs that corresponds to it. 

In the case reported in this article, the patient was having nose bleed due to Heat retention caused by energy deficiency in all the internal massive organs, as I am showing in the Figure 6. [5]

Figure 9- Chakras energy deficiency leading to the formation of internal Heat
 

For this reason, the use of traditional Chinese medicine reasoning nowadays, associating with Western medicine’s reasoning, can make the physician to have more wholistic view of the human being, instead of only having a localized view ( in the leaf level) of the problem presented by the patient, as I am showing in the tree metaphor, in the Figure 1 [6]

In an article written by me ( 2021) entitled Energies Alterations and Chakras’ Energies Deficiencies as One Cause of Abnormal Uterine Bleeding in Women, I showing that patients with abnormal vaginal bleeding can be caused by energy deficiency in the internal massive organs in traditional Chinese medicine ( Heart, Spleen, Lung, Kidney and Liver) that is corelated to the energy of the chakras’ energy centers and the treatment taking put the Heat and replenishment of all these organs was important to reduce or stop the bleeding process in the women. [12]

In another article that I (2021) wrote entitled Energies Alterations and Chakras’ Energies Deficiencies as the Main Cause of Radiation-induced Rectal Bleeding Post-Prostate Cancer Surgery, I reported a patient that was submitted to a prostatectomy surgery due to cancer and also received radiation therapy. After few days after this procedure, the patient began to have rectal bleeding and I measured his chakras’ energy centers and it was all depleted in energy, rated one out of eight. The treatment replenishing all the chakras’ energy centers using homeopathy medications according to the theory Constitutional Homeopathy of the Five Elements based on Traditional Chinese Medicine and crystal-based medications, associated with Chinese dietary counseling and auricular acupuncture with apex ear bloodletting was important to stop the rectal bleeding. In this case, the rectal bleeding process was caused by the formation of internal Heat due to the energy deficiency in the internal massive organs. The rectal bleeding was the way that the body found to release the Heat formation. [5, 13]

Depending on the organ that is affected by the Heat, there are different characteristics of the nosebleed, according to TCM. [5, 12]

If the Heat is affecting the Lung meridian, there will be bright red nasal drippings, burning sensations and extreme dryness, dry mouth, dry coughing, red tongue, yellow covered coating, pulse floating and rapid. Often occur during dry season or Cold weather. The medications used in this situation should clear the Heat in the Lungs and take out the Heat in the Blood. [12]

If the Heat in affecting the Liver, the characteristics of the bleeding is profuse nasal bleeding and the blood is deep red, can accompanied by headache, bitter taste, blurred vision, dryness in the mouth, red face, irritability, bloodshot eyes, discomfort in the rib sides. The tongue is covered by yellow coating and red, and the pulse is rapid and taut. Is very common this pattern of disharmony in hypertensive patients and the medication used in this situation needs to treat taking out the Heat from the Liver and from the Blood also. [14]

In the case of the Heat affecting Kidney and Liver, the clinical characteristics is to have mild nosebleeds, dryness in the mouth, dizziness, era ringing, palpitations, insomnia, warm soles and palms, blurred vision. The tongue can be deep red and or tender and only little coating and the pulse is rapid and thread. This condition is common in person with exhausted state with very chronic condition of energy deficiency and the remedy indicated in this case is to nourish Kidney and Liver and take out Heat from the Blood. [14]

When the bleeding is caused by Spleen deficiency, the characteristics of the bleeding is persistent but only mild and can have bleeding gum, bleedings under the skin, paleness, shortness of breath, dizziness, poor appetite, loose bowels and fatigue. The pulse is weak and the tongue is pale. This kind of disharmony is common in people recovering from major illness or in patients that has bleeding disorders. The medication in this case should invigorate the Spleen and replenish Qi and the ability to adstringent Blood. [12]

In the case reported, the nosebleed was caused by the wrong eating habits, as all school meals are foods that cause internal Heat, for example: cheese bread, hamburger with melted cheese, chocolate, fruits in their normal state. [6] 

The fruits and vegetables must be dried or cooked in order not to generate internal Heat, because the majority of fruits and vegetables has Cold energy ( with the exception  of apple, papaya, and lemon) , when ingested by the person, can induce the formation of internal Heat, and generate nose nosebleed. [5]

The temperature of the water is also important, once the energy of the water is Cold, the patient must ingest warm water (putting the water to boil in the stove) and not drink Cold or natural water and the individual needs to drink at least 1 L per 25 kg per day of water. [15]

In the case of this patient reported in this article, she had deficiency in all internal massive organs (that is the second cause of the formation of internal Heat). For this reason; it was used medications to tone all five internal massive organs instead of treating only one or two organs. This new pattern of energy deficiency in all internal five internal massive organs could be happening in quite the whole population of the planet nowadays, due to one research that I did in my clinic in Brazil, analyzing 1000 chakras’ energy centers. From this group of patients, I could study only 409 files of these patients. The conclusion of this study was that 90% of the patients’ studied was in the lowest level of energy in all five internal massive organs and the remaining 10% of the population have energy in one or a combination of energies among them. The results of both studies can be find in the article written by me (2021) entitled Energy Alterations and Chakras’ Energy Deficiencies and Propensity to SARS-CoV-2 Infection and in the article also written by me (2021) entitled Are We Vaccinating Immunocompetent or Immunocompromised People for COVID-19? You can see the results of both articles in the Table 1 and 2. [16, 17]

Table 3: Results of the research analyzing 409 files of the 1000 chakras’ energy centers patients’ measurements. 

Table 4- Results of remaining 10% of the patients analyzed and the possible combination of energy in some internal five massive organs presented by them. 

The treatment and replenishment of all the chakras’ energy centers were done in these patients according to the theory Constitutional Homeopathy of the Five Elements based on Traditional Chinese Medicine and also, the use of crystal-based medications. The homeopathies should be prescribed firstly in 30 CH XX-20, in the sequence of the generation cycle and after one month, should be prescribed in 200 CHXX-20. After one month, another sequence should be used by the patient, now in 1000CHXX-20 and in the next month, after 30 days, another sequence of 10.000CHXX-20. After 6 weeks, another sequence of homeopathy medications should be used, now in 50.000CHXX-20. And after this sequence, the medications used should be prescribed every 6 or 8 weeks, depending on the clinical necessity to replenishing earlier or not. In my clinical practice, I usually orientate my patients to continue use the medications prescribed to replenish the chakras’ energy centers for the entire life, to prevent the formation of any chronic diseases and in this case, to treat the condition that has energy deficiency in the root. These orientations are important due to this energy deficiency state in all internal massive organs, caused by the harmful influence of the electromagnetic radiation in our body. [13]

When we use all the tools recommended in this article, beginning with Chinese dietary counseling (changing the dietary aspects according to the patient’s energy imbalances and according to each energy presented by each food, instead of only looking at the components of the foods), the patient can have more equilibrium in all the internal energy, knowing which food she should eat or avoid to have a good result in the treatment. According to Hippocrates (c. 460 bce - c. 375 bce) “we need to use our food as our medicine and our medicine as our food”. [5, 6]

The second step in her treatment was to regulate the internal energy of Yin, Yang, Qi and Blood. All the auricular acupuncture points used in her treatment was well explained in the article that I (2018) wrote entitled How can you treat low back pain in your practice? and demonstrated in the Figure 1. [18]

To finalize this article, I would like to say that homeopathy and acupuncture are considered medical specialties in Brazil, by the Brazilian Federal Medical Council since 1980 and 1995 respectively. [19]

In order to treat patients not only with the diagnosis of nosebleed, but in all kind of diseases formation, in a deeper way, the physician has to comprehend the importance of the different medicine perspectives. The body, is not only physical and constituted by organs and tissues, but it is formed by energy. As said by Albert Einstein (1879-1955) all the things that exists in our Universe is composed by energy, including the human being. Nowadays, these two perspectives are separated, but they can be complementary and need to work in harmony because one depends on the other. Traditional Chinese medicine can be considered as Yang energy, and Western medicine is considered Yin energy, already materialized, in the same way of the relationship of Yin and Yang, as you can see in the Figure 9.  [6, 9]

Figure 10 – Yin and Yang Metaphor of traditional Chinese medicine and Western medicine.

The conclusion of this study is that to treat patients with chronic nosebleed, it is important to understand that this is only a symptom but the cause could be in the energy level, invisible by the naked eye. The correction of all the factors that is leading to the energy imbalance (emotions, wrong eating habits, internalization of external pathogenic factors) and to do not aggravate the formation of internal Heat, the physician need to do the replenishment of the chakras’ energy centers using homeopathy medications according to the theory Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine and crystal-based medications. All these treatments are very important to prevent the recurrence of chronic nosebleed symptoms in patients with energy deficient state, that is affecting quite the entire populations globally nowadays.