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Treats deficiency of the Liver and Kidney, dim vision, frequent occurrence of black spots (floaters) in vision, and excessive tearing.
Gouqi Zi (Lycii Fructus, 3 liang), Rongrong (Cistanche Caulis, soaked in wine and stir-fried), Bajie (Morinda Officinalis Radix, 1 liang each), Ganju (Chrysanthemi Flos, 2 liang). Make honey pills, size of Sophora seeds. Take 50 pills per dose, administer after meals with a decoction of wine and salt.

Treats pain in the eyeballs, which worsens at night, or cases where application of bitter-cold medicines causes intensified pain; this is highly effective. This is because Prunella Vulgaris (Xiakucao) withers when Yin begins to generate at the Summer Solstice; it possesses pure Yang Qi to overcome turbid Yin, nourishes the blood vessels of the Jueyin channel, thus treating severe eye pain caused by stagnant fire in the Jueyin channel with miraculous effect.
Xiakucao (Prunellae Spica, 1 liang), Xiangfuzi (Cyperi Rhizoma, 1 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 4 qian). Grind into powder. Take 1.5 qian per dose, mix with clear tea water. Pain reduces immediately upon swallowing.

Treats internal cataracts. For men with Kidney deficiency, dim vision, or seeing black spots, regular use brightens the eyes, warms the Water Organ (Kidney), invigorates blood, preserves youthfulness, and strengthens sinews and bones.
Ganju (Chrysanthemi Flos, 1 liang), Shudi (Rehmanniae Radix Praeparata, 1 liang), Gouqi (Lycii Fructus, 4 liang), Shanyao (Dioscoreae Rhizoma, 5 qian). Grind into powder, make honey pills, size of Sophora seeds. Take 30-40 pills per dose, administer on an empty stomach and after meals.

Treats eye conditions in patients with smallpox/rashes, as well as dim vision and visual obstructions (cataracts/pterygium).
Tu Shi (Leporis Faeces, 2 qian), mix with clear tea water for oral administration, or swallow directly. Must be taken only after the rash has healed. This is a medicine for the Foot Jueyin and Foot Yangming channels. The rabbit is the essence of the bright moon, inheriting Metal Qi. Its feces are called "Wansha," capable of detoxifying and killing parasites, thus specifically brightening the eyes and also treating consumptive disease with intestinal parasites (Laoguan).
For flying silk or dust entering the eye, use thickly ground aged Jingmo (Chinese Ink) to apply locally.

The *Classic* states: The ear is the opening of the Kidney. The Kidney stores Essence. Therefore, when Essence is depleted, the cheeks turn black and deafness occurs. The ear is the gathering place of numerous meridians. From the perspective of the orifice, it belongs to Water. From the perspective of sound, it belongs to Metal. From the perspective of meridians, both the Hand-Shaoyang and Foot-Shaoyang converge there. Deafness arising from internal pathology relates to the Zang organs (primary); deafness arising from external invasion relates to the meridians (secondary). When Kidney Qi is harmonious, one can hear the five tones.
It is also said: Deafness accompanied by shortness of breath and dry throat indicates Lung deficiency. It is also said: Headache, tinnitus, and dysfunction of the nine orifices arise from the Stomach and Intestines. Deficiency of the Stomach and Intestines leads to weak Qi that fails to fill the orifices. This symptom often follows Shanghan (Cold Damage) and major illnesses; treat with Buzhong Yiqi Tang (Spleen-Raising Qi-Supplementing Decoction). Deafness accompanied by fear indicates Liver deficiency. The *Classic* states: Liver deficiency leads to blurred vision, deafness, and timidity. Treat with Siwu Tang (Four Substances Decoction), adding Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Chaihu (Bupleuri Radix), Changpu (Acori Tatarinowii Rhizoma), and Fushen (Poria with Hostwood).

Deafness generally belongs to Heat, but must be differentiated by side: left-sided deafness, right-sided deafness, or bilateral deafness. Left-sided deafness is due to Shaoyang Fire; treat with Longdan Xiegan Wan (Gentian Liver-Draining Pill). Right-sided deafness is due to Taiyang Fire; treat with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill). Bilateral deafness is due to Yangming Fire; treat with Fengtong Sheng San (Wind-Unblocking Reaching Powder) or Guntan Wan (Rolling Phlegm Pill). Excessive anger stirs Shaoyang Gallbladder Fire, starting from the left, causing left-sided deafness. Excessive sexual desire stirs Taiyang Bladder Ministerial Fire, starting from the right, causing right-sided deafness. Excessive consumption of rich alcohol and food stirs Yangming Stomach Fire, starting from the center, causing bilateral deafness. Left-sided deafness is common in women due to frequent anger. Right-sided deafness is common in men due to frequent sexual indulgence. Bilateral deafness is common among the wealthy due to excessive intake of rich and sweet foods.

New-onset deafness is mostly Heat, due to Shaoyang and Yangming Fire. Chronic deafness is mostly Deficiency, due to chronic Kidney insufficiency. One requires dispersing Wind and clearing Heat; the other requires nourishing Kidney and unblocking orifices. Post-illness deafness requires nourishing Yin and descending Fire. However, post-illness involves Qi and Blood deficiency; pulse diagnosis of both hands is necessary to determine dominance. If the pulse is large but forceless, or fine/small/deep/weak on the right, it indicates severe Yang deficiency. Use sweet-warm formulas, following the principle of "Yang generating Yin," with minor additions of Blood-nourishing herbs. If mistakenly treated solely as Yin deficiency using Yin-nourishing and Fire-descending formulas, Yang will weaken further, worsening deafness and potentially causing nausea, chest fullness, and diarrhea.
The *Classic* states: The Kidney opens into the ears. The Kidney is a Water organ. Heaven generates One Water; thus, at conception, two Kidneys form first, storing one Yin. Additionally, Ministerial Fire resides in the Mingmen (Gate of Life), often riding the momentum of Sovereign Fire to oppress what it cannot overcome, as described in the *Classic*: "One Water cannot overcome Two Fires." Moreover, unrestrained desires and overwork, especially after middle age or major illness, deplete Kidney Water, causing Yin Fire to flare upward, resulting in daily ear itching and tinnitus. The *Classic* states: Yang Qi makes all things flourish and leap upward, hence tinnitus. Thus, tinnitus may be loud like cicadas, unilateral or bilateral, or intermittent blockage. Some cases treated as Kidney deficiency fail. Why? This is due to Phlegm-Fire ascending and stagnating in the ear, causing blockage. For those who drink alcohol and eat rich foods, having pre-existing Phlegm-Fire in the Upper Jiao, treat by clearing Phlegm and descending Fire. This often arises from prior Phlegm-Fire combined with anger, which causes Qi to ascend and Shaoyang Fire to lodge in the ear. In Kidney deficiency tinnitus, it is also driven by Bladder Ministerial Fire rising; the sound is usually mild, associated with hypersexuality and symptoms of consumptive weakness.

Deafness due to Qi rebellion has two types. Hand-Taiyang Qi rebellion causes deafness with a sensation of fullness/Qi in the ear. Hand-Shaoyang Qi rebellion causes deafness with a muffled, humming sensation. Both are deafness due to Qi rebellion. Treat with Siwu Tang (Four Substances Decoction) plus herbs that descend Fire and promote Qi flow. However, Zang-Qi rebellion causing Jue-deafness presents with dizziness/fainting; Wind-deafness presents with headache. Fatigue damaging Qi and Blood, and lust consuming Essence, leads to "Fatigue Deafness" (Laolong), characterized by mental fogginess. Deficiency syndromes present with roaring tinnitus and visual floaters, termed "Deficiency Deafness."

Deafness due to Damp-Heat, Phlegm, and Excess Qi should be purged with Binglang Wan (Areca Nut Pill) or Shenxiong Wan (Divine Angelica Pill). For damp-swelling and painful ears, use Liangge San (Cooling the Chest Powder) modified with Jiudahuang (Rhubarb Radix et Rhizoma, wine-fried), Huangqin (Scutellariae Radix, wine-soaked), Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Spica), and Qianghuo (Notopterygii Rhizoma et Radix).

Although the Foot-Shaoyin Kidney channel governs the ear, ten of the twelve meridians (excluding Foot-Taiyang and Hand-Jueyin) enter the ear. Since the Kidney opens into the ear, treatment focuses on the Kidney. However, the Heart also opens into the ear. The Heart's primary orifice is the tongue; since the tongue lacks a distinct orifice, it shares function with the ear. The Kidney is the master of the ear's interior (Yin), and the Heart is the guest of the ear's exterior (Yang). Clear, refined Qi ascends to the orifices, granting acute hearing. Disharmony between these two meridians and Yin-Yang imbalance causes sudden deafness. The Five Zang open into five regions: Liver and Kidney belong to Yin, governing Eyes and Ears via Yin Essence. Heart, Spleen, and Lung belong to Yang, governing Mouth, Nose, and Tongue via Yang Essence. Disharmony of the Five Zang blocks the seven orifices. Any excess or deficiency Qi entering the ear disrupts hearing, referring to acute disease. Chronic deafness differs by Kidney deficiency/excess: Left Kidney (Yin) governs Essence; Right Kidney (Yang) governs Qi. Essence deficiency and Qi excess lead to Deficiency deafness. Thin individuals with dark complexion and strong sinews/bones have Excess Essence and Qi; solid organ closure causes Excess deafness, a sign of longevity. Both are constitutional. Deafness with black cheeks indicates Essence depletion and Kidney exhaustion; use Anshen Bawei Rongrong Wan (Kidney-Anchoring Eight-Ingredient Cistanche Pill). Kidney channel deficient Fire with red face, dry mouth, and phlegm-heat is treated with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), addressing Yin deficiency. Yang deficiency also causes deafness. The *Classic* states: Clear Yang emerges from the upper orifices. Stomach Qi, Clear Qi, Yuan Qi, and Spring-rising Qi are synonymous. Dietary irregularity and fatigue damage Spleen-Stomach Qi, preventing ascent and causing downward flow into Liver-Kidney. Yang Qi becomes blocked, Earth Qi obscures clarity, and pathogenic factors harm the orifices, causing dull eyes and ears. This is Yang-deficiency deafness, treated with Dongyuan's Buzhong Yiqi Tang (Spleen-Raising Qi-Supplementing Decoction). Heart Qi disharmony (deficiency failing to control Yang, leading to Yin interaction; or excess relying on Yang strength, severing Yin connection, as stated: "Extreme Yin deficiency cuts off Heavenly Qi") is treated with Xinbu Wan (Heart-Nourishing Pill) modified. Earth Qi obscuring clarity due to unresolved sorrow, Yin blockage preventing Yang communication, or internal/external Damp-Phlegm blocking Qi升降 (ascending/descending), causing red, muffled ears, is treated with Yang-raising and Damp-draining formulas. Regarding Yin Essence and Yang Qi, the eyes and ears are governed by Yin Essence, favoring coolness and disliking irritant heat. They are governed by Yang Qi, favoring warmth and disliking cold. Elder Jiegu stated that eyes and ears should not be tonified with warm herbs.
*Renzhi Zhizhi Fang* states: The Kidney connects to the ear, governing Essence. Harmonized Essence and sufficient Kidney Qi grant acute hearing. Proper regulation of Qi and Blood alleviates deafness. Lack of self-restraint, labor, unchecked desire, anger, alcohol, and spicy/rich foods render medication ineffective.

Ear pain, tinnitus, itching, suppuration, and sores should be treated according to Cold, Heat, Deficiency, and Excess from the Shaoyin proper orifice, not merely as Fire or external pathogens. Tinnitus relieved or silenced by pressure indicates true Deficiency. Tinnitus exacerbated by pressure indicates Fire Excess. Wang Wanli suffered ear pain; Wei Wenjing advised Qingyan Lurong Jian Xiongfu (Green Salt Deer Antler Decoction with Realgar and Aconite). He explained: Kan hexagram represents ear pain; Kan Water resides in the Kidney, opens to the ear, and corresponds to Fear. Fear injures the Kidney, causing ear pain. Yang Qi moves visibly; Yin Blood flows obscurely. Blood in the body is like water in heaven and earth; thus Kan is the Blood hexagram. This pathology was recorded in the classics, and he recovered.

The human body has nine orifices: Seven Yang orifices (eyes, ears, nose, mouth) and two Yin orifices (anterior and posterior urethra/anus). Yang Qi ascends to upper orifices; if it descends to Yin positions, it causes urinary leakage and abdominal rumbling. Yin Qi descends to lower orifices; if it ascends to Yang positions, it causes obstruction and tinnitus. In the elderly, Kidney Water is exhausted, True Fire is exposed, and Kidney Qi escapes easily, floating to upper orifices. Sounds within the orifices resemble frog drums or mosquito gongs, mixing with external sounds and causing unclear hearing. In advanced age, internal Yin Essence is depleted, unable to ascend, leading to loss of hearing. Unlike the young, whose turbid Yin blocks orifices preventing external sound entry, the elderly require aromatics like Changpu (Acori Tatarinowii Rhizoma) and Shexiang (Moschus) to penetrate and guide Qi. Treatment for rebellious Qi in the elderly relies primarily on Cishi (Magnetitum), which is heavy, sinks downward, and attracts Yin. It is assisted by Yin-nourishing herbs like Dihuang (Rehmanniae Radix) and Guijiao (Colla Corii Asini) and Wubeizi (Terminalia Chebula Retusa) and Shanzhuyu (Corni Fructus) for their sour astringency, strengthening Yin in its root and preventing it from harassing Yang orifices. This creates emptiness and openness, allowing the ear to receive sound like a valley receives echoes. The efficacy of hearing lies in emptiness and receptivity.