小儿有忽然气塞耳聋，此由风入于脑，停滞于太阳经。古法主疏风清火（如导赤散加防风，煎服）或用通窍
丸（如 雄石一
钱、真麝香五厘，共为细末，以枣研烂，和为一丸，如枣核大），棉裹塞鼻中。又以生铁一小块，热酒泡过，含
口内，须臾气即通，亦即不聋矣。
〔真按〕小儿耳忽暴聋，不过火盛气逆，非若中年老年之气虚血虚肾虚者可比。内以菊花、木通、石菖蒲，
煎服。外以细辛、木通，石菖蒲各一分，真麝香二厘，共为细末，棉裹塞耳中即通。或用虎耳草，又名倒垂莲，捣
汁，略加枯矾，灌入耳中，则耳窍开，而自不聋矣。
小儿耳中忽作大痛，如有虫在耳内奔走，或出血水，或干痛者，古法主蛇蜕散（如蛇蜕烧灰存性为末）吹入
耳中。取蛇之善脱，以解散郁火也。
〔真按〕小儿耳痛，无非肾中火热，泻之则安。但用黄柏、青盐、甘草，煎服；外用黄鱼牙齿，瓦上炙存
性为末，放土地上退火气，加入干胭脂研极细末，再加梅花冰片少许，菜油调，以鸡毛蘸入耳中，即不痛矣。
小儿有因肾经气实，其热上冲于耳遂使津液壅而为脓，或为清汁。亦有因沐浴水入耳中灌为脓者。古法主内
服蔓荆子散（如蔓荆子、粉干葛、赤芍、前胡、桑白皮、木通、生地、白芍、赤苓、升麻、甘草，灯芯为引），外
用龙骨散（如 龙骨、明白矾、真铅丹、胭脂胚、当门子，共为末），先以棉展干耳内脓，将药吹耳即愈。
〔真按〕小儿耳内闷肿出脓，必先验其脓色∶耳疳则出黑色臭脓；震耳则出青脓；缠耳则出白脓，停耳则出黄脓。
以上四症，俱由胃湿与肝火相兼而成。但以野菊花、马兜
铃、通草，煎服。是以清肺泻肝。外用 龙骨、炒五倍子、乳香、枯矾、血余炭，各等分，共研细末，吹之即干。
若耳内有虫，脓血不止，则用鸡蛋一个，猪肝五钱，俱用香油炒，再以黑芝麻一两，炒研共捣融，微火烘暖，
摊绸上贴耳外，血虫出尽即干。
惟风耳则出红脓。
此偏于肝经血热。宜内服四物汤加丹皮、石菖蒲。耳内有脓先绞净，再以桑螵蛸五分，烧存性，和麝香五厘，
研末掺入，其效如神。
Pediatric cases of sudden deafness due to qi obstruction are caused by wind pathogen invading the brain and stagnating in the Taiyang meridian (Taiyang channel disease). Ancient methods primarily advocate dispersing wind and clearing fire (such as Daochi San [Carpesium Seed Decoction] with Fangfeng added, decocted for oral administration), or using Tongqiao Wan (Piastrum cum Moscho [Dragonfly Pill with Musk], prepared with Xionghuang one qian, Zhen Muxiang five li, ground into fine powder, mixed with jujube flesh into a pill the size of a jujube seed), wrapped in cotton and inserted into the nostril. Alternatively, take a small piece of raw iron, soak it in hot wine, hold it in the mouth; after a moment, qi will flow freely, and deafness will cease.
[Chen Shouzhen's Note:] Sudden deafness in children is merely due to excessive fire and rebellious qi, unlike middle-aged or elderly individuals who suffer from deficiency of qi, blood, or kidney essence. Internally, decoct Juhua (Dendranthema Flos), Mutong (Akebiae Caulis), and Shichangpu (Acori Tatarinowii Rhizoma) for oral administration. Externally, mix Xixin (Asari Radix et Rhizoma), Mutong, and Shichangpu, each one fen, with Zhen Muxiang two li, grind into fine powder, wrap in cotton, and insert into the ear canal to restore hearing. Alternatively, use Huercao (Bergeniae Rhizoma), also known as Daochuilian, crush to extract juice, add a little Kufan (Alumen), and instill into the ear; the ear orifice will open, and deafness will resolve.
Sudden severe pain in the pediatric ear, feeling like insects running inside, or accompanied by bleeding and discharge, or dry pain, ancient methods primarily use Shedispersion (Shetui San [Snake Slough Powder], prepared by burning shed snake skin until carbonized but retaining its properties, then grinding into powder) blown into the ear. This utilizes the property of snakes shedding their skin to dissipate stagnant fire.
[Chen Shouzhen's Note:] Pediatric ear pain is invariably due to heat-fire in the Kidney; purging it brings relief. Internally, simply decoct Huangbai (Phellodendri Cortex), Qingyan (Natrii Chloridum), and Gancao (Glycyrrhizae Radix et Rhizoma). Externally, roast yellow fish teeth on a tile until carbonized, grind into powder, place on the ground to remove fire toxicity, add Ganyanzhi (Lac Rubrum) ground into extremely fine powder, add a little Meihua Bingpian (Borneolum Syntheticum), mix with vegetable oil, dip a chicken feather, and apply into the ear to stop pain.
Some children have excess qi in the Kidney meridian, with heat rushing upward to the ear, causing body fluids to stagnate and transform into pus or clear fluid. Others develop pus due to water entering the ear during bathing. Ancient methods primarily prescribe Manjingzi San (Manjingzi San [Vitex Fruit Powder] containing Manjingzi, Fen Gange, Chishao, Qianhu, Sangbaipi, Mutong, Shengdi, Baishao, Chiling, Shengma, Gancao, with Dengxincao as an guide) internally, and Longgu San (Longgu San [Dragon Bone Powder] containing Longgu, Mingfan, Zhenqiandan, Yanzhipei, Dangmenzi, ground into powder) externally. First, dry the pus in the ear with cotton, then blow the medicine into the ear for cure.
[Chen Shouzhen's Note:] For pediatric ear stuffiness, swelling, and pus discharge, first examine the pus color: Ergan (Ear Gangrene) presents with black, foul-smelling pus; Zhen'er (Thunder Ear) presents with green pus; Chan'er (Entwined Ear) presents with white pus; Ting'er (Stopping Ear) presents with yellow pus. The above four conditions are all caused by a combination of Stomach dampness and Liver fire. Internally, decoct Yejuhua (Wild Dendranthema Flos), Madouling (Aristolochiae Fructus), and Tongcao (Tetrapanacis Medulla) to clear Lung heat and purge Liver fire. Externally, use equal parts of Longgu, Chao Wubeizi (Stir-fried Chinese Gallnut), Ruxiang (Olibanum), Kufan, and Xuyutanh (Carbonized Human Hair), grind into fine powder, and blow into the ear to dry it. If there are insects in the ear with continuous pus and blood discharge, use one egg and five qian of pig liver, stir-fry both in sesame oil, add one liang of black sesame seeds, stir-fry, grind, and mash together. Warm slightly over low fire, spread on silk, and apply to the outside of the ear; once blood and insects are expelled, it will dry.
Only Feng'er (Wind Ear) presents with red pus. This leans towards blood-heat in the Liver meridian. Internally, Siwu Tang (Four Substances Decoction) with Danpi and Shichangpu is suitable. First, thoroughly clean the pus from the ear, then use Sangpiaoxiao (Mantis Egg Case) half a qian, roasted to retain properties, mixed with five li of Muxiang, ground into powder, and applied; the effect is miraculous.