罗谦甫云。耳内生疮者。为足少阴。是肾之经也。其气上通于耳。其经虚。风热乘之。随脉入于耳。与
气相搏。故令耳门生疮也。曾青散主之。黄连散亦可。内服黍粘子汤。
曾青散
曾青（五分） 雄黄（七分半） 黄芩（二分半） 有脓水搓胭脂拭干。细末一分。裹绵纳耳中。
黄连散
黄连（五分） 枯矾（七分） 细末。绵裹纳耳中。
薛氏云。耳疮属手少阳三焦经。或足厥阴肝经血虚风热。或肝经暴火风热。或肾经风火等因。若发热
痛。属少阳厥阴风热。用柴胡栀子散。若内热痒痛。属前二经血虚。用当归川芎散。若寒热作痛。属肝经风
热。小柴胡汤加山栀川芎。若内热口干。属肾经虚火。用加味地黄丸。如不应。用加减八味丸。余当随证治之。
耳脓即 耳。用红绵散麝香散。内服柴胡聪耳汤、通气散
俱可。如壮盛之人。积热上攻。脓水不住。则上二散不宜用。恐收敛太过也。用三黄散有效。
有一小儿患耳脓。经年屡月。服药不效。殊不知此肾疳也。用六味丸加桑螵蛸。服之即愈。
黄 丸方
黄 （一两） 沙苑蒺藜（炒） 羌活（各半两） 黑附子（大一个） 羯羊肾（一对焙干） 上为细末。
酒糊丸如桐子大。每服四十丸。空心食前。煨葱盐汤下。
柴胡聪耳汤 治耳中干耵。耳鸣致聋。
柴胡（三钱） 连翘（四钱） 水蛭（半钱炒另研） 虻虫（三个去翅足研） 麝香（少许研） 当归
身炙甘草 人参（各二钱） 上除另研外。以水二盏。姜三片。煎至一盏。少热下水蛭等末。再煎一二沸。
食少远热服。
透水散
川大黄（去粗皮） 山栀子（去皮） 蔓荆子（去白皮） 白茯苓（去皮） 益智子（去皮） 葳灵仙
（去芦头洗焙干） 白芷（各半两） 香墨（烧醋淬干细研） 麝香（研一钱） 茯神（去木半两） 川乌（二
两用河水浸半月切作片焙干用盐炒） 天麻（去苗） 仙灵脾叶（洗焙各三钱） 上为细末。炼蜜和如麦饭相
似。以真酥涂。杵臼捣万杵。如干旋入蜜令得所。和成剂。每服旋丸。如桐子大。用薄荷自然汁。同温酒。化
下两丸。如卒中风。涎涌昏塞。煎皂荚白矾汤。温化两丸。
虫入耳痛。将生姜擦猫鼻。其尿自出。取尿滴内。虫即出而愈。
有一人耳内不时作痛。痛而欲死。痛止如故。就诊于立斋先生。诊之六脉皆安。非疮也。话间痛忽作。
意度其有虫。令急取猫尿滴耳。果出一臭虫。遂不复痛。或用麻油滴之。则虫死难
出。或用炒芝麻枕之。则虫亦出。但不及猫尿之速也。
Luo Qianfu stated that sores inside the ear are caused by issues in the Foot-Shaoyin (Kidney Meridian). The Qi of this meridian connects upward to the ear. When the meridian is deficient, wind-heat pathogens take advantage of this weakness, entering the ear along the vessels and struggling with the body's Qi, thereby causing sores at the ear gate. The primary treatment is Zengqing San (Azurite Powder), while Huanglian San (Coptis Powder) is also effective. Internally, Shuniuzi Tang (Buddleja Seed Decoction) should be administered.
Zengqing San (Azurite Powder)
Ingredients: Zengqing (Azurite, 5 fen), Xionghuang (Realgar, 7.5 fen), Huangqin (Scutellaria Root, 2.5 fen). If pus or fluid is present, first wipe clean with Zhigan (Rouge) and dry thoroughly. Then, grind the ingredients into a fine powder (1 fen), wrap in cotton, and insert into the ear.
Huanglian San (Coptis Powder)
Ingredients: Huanglian (Coptis Rhizome, 5 fen), Kufan (Alum, Calcined, 7 fen). Grind into a fine powder, wrap in cotton, and insert into the ear.
Xue Ji (Xue Shi) stated that ear sores belong to the Hand-Shaoyang Triple Energizer Meridian. They may also result from blood deficiency and wind-heat in the Foot-Jueyin Liver Meridian, sudden fire and wind-heat in the Liver Meridian, or wind-fire in the Kidney Meridian. If accompanied by fever and pain, it belongs to wind-heat in the Shaoyang and Jueyin meridians; use Chaihu Zhizi San (Bupleurum and Gardenia Powder). If there is internal heat, itching, and pain, it belongs to blood deficiency in the aforementioned two meridians; use Danggui Chuanxiong San (Angelica and Ligusticum Powder). If there is alternating chills and fever with pain, it belongs to wind-heat in the Liver Meridian; use Xiaochaihu Tang (Minor Bupleurum Decoction) added with Shanzhi (Gardenia Fruit) and Chuanxiong (Ligusticum Rhizome). If there is internal heat and dry mouth, it belongs to deficient fire in the Kidney Meridian; use Jiawei Dihuang Wan (Modified Rehmannia Pill). If ineffective, switch to Jiawei Bawei Wan (Modified Eight-Ingredient Pill). Other cases should be treated according to specific syndromes.
Ear suppuration (Er Nong) can be treated externally with Hongmian San (Red Silk Powder) or Shexiang San (Musk Powder), and internally with Chaihu Cong'er Tang (Bupleurum Ear-Auditing Decoction) or Tongqi San (Qi-Unblocking Powder). In robust individuals where accumulated heat attacks upward causing continuous pus discharge, the aforementioned two astringent powders should not be used, as excessive astringency may hinder the expulsion of pathogens. In such cases, Sanhuang San (Three Yellows Powder) is effective.
A child suffered from ear suppuration for over a year despite medication without effect. It was actually a case of Kidney Gan Disease (Ren Gan). Treatment with Liuwei Wan (Six-Ingredient Pill) added with Sangpiaoxiao (Mantis Egg Case) resulted in a cure.
Huangqi Wan (Astragalus Pill) Formula
Ingredients: Huangqi (Astragalus Root, 1 liang), Shayuan Jili (Aster Tataricus Seed, stir-fried), Qianghuo (Notopterygium Rhizome, each half liang), Hei Fuzi (Prepared Aconite Root, one large piece), Jieyang Shen (Ram Kidney, one pair, baked dry). Grind all into a fine powder. Make pills using wine paste, sized like paulownia seeds. Take 40 pills per dose, on an empty stomach before meals, washed down with decocted scallion and salt water.
Chaihu Cong'er Tang (Bupleurum Ear-Auditing Decoction)
Indications: Dry cerumen in the ear, tinnitus leading to deafness.
Ingredients: Chaihu (Bupleurum Root, 3 qian), Lianqiao (Forsythia Fruit, 4 qian), Shuizhi (Leech, 0.5 qian, stir-fried and separately ground), Mengchong (Bladderfly Larva, three, wings and feet removed, ground), Shexiang (Musk, a small amount, ground), Danggui Shen (Angelica Sinensis Root Body), Zhi Gancao (Prepared Licorice Root), Renshen (Ginseng Root, each 2 qian). Except for the separately ground leech and bladdlerfly, add the remaining herbs to two cups of water with three slices of ginger. Decoct until one cup remains. Add the pre-ground leech and bladdlerfly powders when the liquid is slightly warm. Boil for one or two more boils. Take after meals, avoiding hot temperatures.
Toushui San (Water-Penetrating Powder)
Ingredients: Chuan Dahuang (Rhubarb Root, remove coarse skin), Shanzhizi (Gardenia Fruit, remove skin), Manjingzi (Vitex Fruit, remove white skin), Baifuling (Poria Cocos, remove skin), Yizhiren (Bitter Apricot Seed, remove skin), Weilingxian (Clematis Root, remove rhizome head, wash, bake dry), Baizhi (Angelica Dahurica Root, each half liang), Xiangmo (Ink Stick, burnt and quenched in vinegar, finely ground), Shexiang (Musk, 1 qian, ground), Fushen (Poria Cocos with Pine Wood, remove wood core, half liang), Chuanwu (Aconitum Carmichaelii Root, 2 liang, soaked in river water for half a month, sliced, baked dry, stir-fried with salt), Tianma (Gastrodia Rhizome, remove sprout), Xianlingpi Ye (Epimedium Leaf, wash and bake dry, each 3 qian). Grind all into a fine powder. Mix with refined honey to a consistency similar to wheat dough. Apply real butter (Su) and pound in a mortar ten thousand times. If too dry, add honey appropriately. Form into pills, sized like paulownia seeds. Dissolve two pills in natural mint juice mixed with warm wine. For sudden stroke with phlegm surging and coma, dissolve two pills in decocted soap pod and alum water, taken warm.
For pain caused by insects entering the ear, rub fresh ginger on a cat's nose to induce urination. Collect the urine and drip it into the ear; the insect will exit, and the pain will cease.
A patient experienced intermittent severe ear pain, agonizing enough to wish for death, resolving completely between episodes. He consulted Master Lizhai (Xue Ji). The pulse was calm in all six positions, indicating no sore. During conversation, the pain suddenly returned. Suspecting an insect, he ordered cat urine to be dripped into the ear immediately. A foul-smelling insect was expelled, and the pain ceased thereafter. Alternatively, dripping sesame oil may kill the insect but makes expulsion difficult. Sleeping on fried sesame seeds may also expel the insect, though not as quickly as cat urine.