耳病，少阳证也。足少阳支脉，从耳后入耳中。少阳为相火，宜清之。
验案
一人耳聋，服益气汤、十全汤，病愈后，喉中作痒有痰，一二月复耳鸣。诊之脉浮滑。
此痰气留于脾胃也，无火不动痰。用补中益气汤加黄柏三分，菖蒲一分。
一人耳痒，胸膈饱闷，火郁于少阳胆也。用柴胡、半夏、黄 、白芍各一钱，人参、甘
草、紫苏、陈皮各五分，姜、枣煎服。以散火固表。
一人久劳，腰痛耳聋，心胸不开，尝有火发。六味汤加细辛二分，菖蒲三分，煎服。
目痛，血热有火，用当归、生地、柏子仁各四钱，蒺藜、甘菊各二钱，杞子五钱，黄柏
五分，川连、黄芩各三分，生姜三片，灯心二十段，竹叶二十片，水三碗，煎一碗半服。
目胀高出寸许，出脓血，名曰目脔。因脾胃不能生金制木，肝邪上乘于目也。初起，黄
当归补血汤可治。若日久，宜 以保肺扶阳，茯苓去脾中湿热，木贼疏肝，归身养血，白术扶
脾，陈皮醒脾，木香以通之，川芎以行之，桂制芍以敛之，可安也。后再以逍遥散调之。老
人眼昏，因肝热叶枯，胆汁减，宜资心火以补肝，用生姜、陈皮、细辛补之，芍药、大黄泻
之。目疾因脾胃有痰饮，渍浸于肝，久则昏眩。神曲四两，朱砂一两， 磁石二两，蜜丸，
米饮下五十丸，日进三服。一方加夜明砂。
验案
一人丧子悲哀太过，两目肿痛，用独参汤而愈。盖悲哀则伤肺，金虚则木寡于畏，肝火
上逆而目痛。人参补肺，肺旺则木沉火降也。
一人六月间劳役过度，患左眼痛，白珠红如血，皮肿浓难开，脔肉攀黑珠，足冷过膝，
当面不见人，诸药不效。予诊之，心火乘脾也。用杞子、柏子仁各五钱，归身、生地各四钱，
甘菊、蒺藜各二钱，黄连、黄芩、黄柏各二分，竹叶十片，姜三片，大枣二枚，十帖愈。
鼻塞，用荜澄茄、薄荷、白芷三味，同煎服。
鼻中壅塞，涕出不已，气不通。用辛夷、细辛、 本、川芎、升麻、木通、防风、苍耳
、羌活、白芷、甘草，姜、水煎。
鼻流清涕，过夜结成长条似葱白，此脑寒胃热也。宜白芷、辛夷、荆芥、连翘之属。
鼻流浊涕，名曰鼻渊，胆移热于脑也。宜小柴胡汤，外用吹药。
Ear diseases belong to the Shaoyang syndrome. The branch meridian of the Foot-Shaoyang Gallbladder Meridian enters the ear from behind it. The Ministerial Fire (Xiang Huo) of Shaoyang should be cleared.
Clinical Cases
A patient suffered from deafness. After taking Yiqi Tang (Qi-Supplementing Decoction) and Shiquan Tang (Ten Complete Decoctions), the illness subsided, but he experienced itching in the throat with phlegm. One or two months later, tinnitus recurred. His pulse was floating and slippery.
This is caused by phlegm-qi stagnating in the Spleen and Stomach; without fire, phlegm does not move. Use Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) with added Huangbai (Phellodendri Cortex) 3 fen and Shichangpu (Acori Tatarinowii Rhizoma) 1 fen.
Another patient had an itchy ear and a sensation of fullness and oppression in the chest and diaphragm. This indicates fire郁 (stagnation) in the Shaoyang Gallbladder. Use Chaihu (Bupleuri Radix), Banxia (Pinelliae Rhizoma), Huangqin (Scutellariae Radix), and Baishao (Paeoniae Radix Alba) each 1 qian; Renshen (Ginseng Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), Zisu (Perillae Folium), and Chenpi (Citri Reticulatae Pericarpium) each 5 fen. Decoct with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus) for administration. This disperses fire and consolidates the exterior.
A third patient, due to long-term overexertion, suffered from lower back pain and deafness, with a blocked feeling in the heart and chest, and occasional sensations of internal heat. Use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) with added Xixin (Asari Radix et Rhizoma) 2 fen and Shichangpu (Acori Tatarinowii Rhizoma) 3 fen, decocted for administration.
Eye pain is caused by blood heat and fire. Use Danggui (Angelicae Sinensis Radix), Shengdihuang (Rehmanniae Radix Preparata), and Baiziren (Biota Semen) each 4 qian; Jili (Tribuli Fructus) and Ganju (Chrysanthemi Flos) each 2 qian; Gouqi (Lycii Fructus) 5 qian; Huangbai (Phellodendri Cortex) 5 fen; Huanglian (Coptidis Rhizoma) and Huangqin (Scutellariae Radix) each 3 fen; Shengjiang (Zingiberis Rhizoma Recens) 3 slices; Dengxincao (Junci Medulla) 20 segments; Zhuye (Bambusae Folium) 20 leaves. Decoct with 3 bowls of water until 1.5 bowls remain for administration.
If the eyes swell and protrude by about one cun, discharging pus and blood, it is called "Mu Luan" (Eye Caruncle/Pterygium). This occurs because the Spleen and Stomach fail to generate Metal (Lung Qi) to control Wood (Liver), allowing Liver pathogenic factors to ascend to the eyes. In the early stage, Huangqi Danggui Buxue Tang (Astragali Radix and Angelicae Sinensis Radix Blood-Nourishing Decoction) can be used. If the condition persists for a long time, it is appropriate to protect the Lung and support Yang. Use Fuling (Poria) to drain damp-heat from the Spleen; Muzei (Equiseti Herba) to soothe the Liver; Dangguishen (Angelicae Sinensis Radix) to nourish blood; Baizhu (Atractylodis Macrocephalae Rhizoma) to strengthen the Spleen; Chenpi (Citri Reticulatae Pericarpium) to invigorate the Spleen; Muxiang (Aucklandiae Radix) to promote qi circulation; Chuanxiong (Ligustici Chuanxiong Rhizoma) to promote blood circulation; Guizhi (Cinnamomi Ramulus) to constrain Baishao (Paeoniae Radix Alba) for astringency. This will bring stability. Subsequently, use Xiaoyao San (Free and Easy Wanderer Powder) to regulate. For elderly patients with dim vision, this is due to Liver heat causing the Liver leaves to wither and bile secretion to decrease. It is necessary to supplement the Liver by supporting Heart Fire. Use Shengjiang (Zingiberis Rhizoma Recens), Chenpi (Citri Reticulatae Pericarpium), and Xixin (Asari Radix et Rhizoma) to tonify; Baishao (Paeoniae Radix Alba) and Dahuang (Rhei Radix et Rhizoma) to purge. Eye diseases caused by phlegm-fluid retention in the Spleen and Stomach, which infiltrates the Liver, may lead to dizziness and blurred vision over time. Use Shenqu (Massa Medicata Fermentata) 4 liang, Zhusha (Cinnabaris) 1 liang, Cishi (Magnetitum) 2 liang. Make pills with honey, take 50 pills with rice water, three times daily. Another formula adds Yemingsha (Tabu Cat Faecalia).
Clinical Cases
A patient suffered from excessive grief after the loss of a son, resulting in swollen and painful eyes. He recovered after taking Dushen Tang (Single Ginseng Decoction). Grief injures the Lung; when Lung Metal is deficient, it fails to restrain Liver Wood, causing Liver fire to rebel upward and leading to eye pain. Renshen (Ginseng Radix et Rhizoma) tonifies the Lung; when Lung Qi is robust, Liver Wood sinks and fire descends.
Another patient suffered from excessive labor in June, developing left eye pain. The sclera was red as blood, the eyelids were swollen and purulent, making them difficult to open, and pterygium grew over the cornea. His feet were cold above the knees, he could not see people facing him, and various medicines were ineffective. Upon diagnosis, I determined that Heart Fire was invading the Spleen. Use Gouqi (Lycii Fructus) and Baiziren (Biota Semen) each 5 qian; Dangguishen (Angelicae Sinensis Radix) and Shengdihuang (Rehmanniae Radix Preparata) each 4 qian; Ganju (Chrysanthemi Flos) and Jili (Tribuli Fructus) each 2 qian; Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), and Huangbai (Phellodendri Cortex) each 2 fen; Zhuye (Bambusae Folium) 10 slices; Shengjiang (Zingiberis Rhizoma Recens) 3 slices; Dazao (Jujubae Fructus) 2 pieces. Ten doses cured the condition.
Nasal congestion: Use Bidengqie (Litseae Fructus), Bohe (Menthae Haplocalycis Herba), and Baizhi (Angelicae Dahuricae Radix), decocted together for administration.
Nasal obstruction with continuous discharge and blocked airflow: Use Xinyi (Magnoliae Flos), Xixin (Asari Radix et Rhizoma), Gaoben (Ligustici Wallichii Rhizoma et Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengma (Cimicifugae Rhizoma), Mutong (Akebiae Caulis), Fangfeng (Saposhnikoviae Radix), Cang'erzi (Xanthii Fructus), Qianghuo (Notopterygii Rhizoma et Radix), Baizhi (Angelicae Dahuricae Radix), and Gancao (Glycyrrhizae Radix et Rhizoma). Decoct with Shengjiang (Zingiberis Rhizoma Recens) and water.
Clear nasal discharge that hardens overnight into long strips resembling scallion whites: This indicates Cold in the Brain and Heat in the Stomach. Suitable herbs include Baizhi (Angelicae Dahuricae Radix), Xinyi (Magnoliae Flos), Jingjie (Schizonepetae Spica), and Lianqiao (Forsythiae Fructus).
Turbid nasal discharge is called "Bi Yuan" (Nasal Pool/Guttural Polyp), caused by Gallbladder Heat transferring to the Brain. Suitable treatment is Xiaochaihu Tang (Minor Bupleurum Decoction), with external application of medicated powder.