论曰耳聋有脓者，盖肾脏虚，劳伤血气，与津液相搏，热气乘之，则结聚于耳中，腐化
脓汁，气不开窍，则致耳聋。
治耳聋出脓，黄 丸方
黄 （锉） 升麻 栀子仁 犀角镑 玄参 木香 黄芩（去黑心） 芒硝（各一两半）
干
姜（炮） 芍药 人参（各一两） 大黄（锉炒二两）
上一十二味，捣罗为末，炼蜜丸如梧桐子大，每服二十丸，至三十丸，煎枸杞根汤下，
食后良久服。
治耳聋出脓疼痛，附子丸方
附子（炮裂去皮脐） 菖蒲（米泔浸一宿锉焙） 矾石（熬令汁枯） 蓖麻子仁（研） 松
脂（
研各一两） 杏仁（去皮尖双仁炒二两） 染烟脂（半两）
上七味，捣研为末，熔黄蜡和拈如枣核大，针穿一孔子令透，塞耳中，日一换之。
治耳聋有脓，禹余粮散方
禹余粮（ 醋淬一分） 乌贼鱼骨（去甲） 伏龙肝 龙骨（各半两） 附子（炮裂去
皮脐一
两）
上五味，捣研为散，每以一钱，绵裹塞耳中，日一易，取瘥为度，如有虫，加麝香一黑
豆大，一方加铛墨半两。
治耳脓久不瘥，蚕香散方
蚕纸（已出者烧灰） 乌贼鱼骨（去甲） 染烟脂（各一钱） 麝香（研半钱）
上四味，捣研为散，满塞耳中不动，候自落，未瘥再用。
治耳聋有脓水不绝臭秽方
肉苁蓉（一两） 龙胆（一两） 白茅根（一两）
上三味，共烧为灰研细，以少蜜和令匀，后入鲤鱼胆汁三枚，搅令稀，即以绢捩取汁，
沥入耳中，其捩干滓，捻作挺子，以薄绵裹塞耳，不过三两上愈。
治肾热耳聋，有脓血溜，日夜不止方。
鲤鱼脑（一枚） 鲤鱼肠（一具） 乌麻子（一升）
上三味，先捣乌麻令碎，次入二味相和，微火熬，以暖布裹薄耳，两食顷开之，当有白
虫出，复更作药，若两耳并脓，分药于两耳中用，若一耳，即于一面薄之，不过三度，瘥。
治耳聋有脓水不止方
麻子（一合） 花烟脂（一分）
上二味，共研为细末，满耳塞，药以绵轻 三两上，愈。
又方
矾石（熬令汁枯一两） 铅丹（炒一钱）
上二味，同研匀细，每用半字，渗入耳中。
又方
地骨皮（半两） 五倍子（一分）
上二味，捣为细末，每用少许，渗入耳中。
治耳内脓水，疼痛不止，矾黄散方
矾石（晋州者熬令汁枯半两） 雄黄（好者一分）
上二味，同研极细，每用手指甲，挑半字，先以绵枚子，拭耳内令干，却滴生麻油一二
点，入耳内，仍以绵枚子惹药末在耳中，不拘久近，只一二度瘥。
治耳内出脓水，二圣散方
白附子（炮） 羌活（去芦头各一两）
上二味，同为细散，用猪羊肾各一只切开，每只入药末半钱，不得着盐，湿纸裹煨熟，
五更初，温酒嚼下，续吃粥压。
治耳聋脓出，久不瘥，速效散方
地龙（一条盛在白葱管内当门挂阴干）
上一味，同麝香少许，研为细散，渗在耳中。
治耳聋出脓，或有虫，鱼醋膏方
鲤鱼肠（一具切） 醋（三合）
上二味，合捣如膏，取少许绵裹塞耳，二食顷当闷痛，或白虫出，即易之，虫尽乃止。
治耳聋有脓，桂骨散方
桂（去粗皮） 鱼骨（各一两）
上二味合捣为散，渗入耳中，瘥。
Discourse states: Deafness accompanied by purulent discharge is caused by Kidney deficiency. Labor and injury to Qi and Blood, combined with the struggle between fluids and pathogenic factors, allow heat to invade and accumulate in the ear. This accumulation corrupts tissues, transforming them into pus. When Qi fails to open orifices and blockages occur, deafness results.
Formula for Huangqi Wan (Cassia Twig Pill) to treat deafness with purulent discharge:
Huangqi (Radix Astragali, sliced) 1.5 liang, Shengma (Rhizoma Cimicifugae) 1.5 liang, Zhizi Ren (Semen Gardeniae) 1.5 liang, Xijiao (Cornu Rhinocerotis, shaved) 1.5 liang, Xuanshen (Radix Scrophulariae) 1.5 liang, Muxiang (Radix Aucklandiae) 1.5 liang, Huangqin (Radix Scutellariae, black heart removed) 1.5 liang, Mangxiao (Natrii Sulfas) 1.5 liang, Ganjiang (Rhizoma Zingiberis Preparatum, processed) 1 liang, Shaoyao (Radix Paeoniae Alba) 1 liang, Renshen (Radix Ginseng) 1 liang, Dahuang (Radix et Rhizoma Rhei, sliced and stir-fried) 2 liang.
The above twelve ingredients are crushed, sifted into fine powder, and mixed with refined honey to form pills the size of Sophora japonica seeds. Take 20–30 pills per dose, administered with a decoction of Goji root (Gouqigen), taken well after meals.
Formula for Fuzi Wan (Aconite Pill) to treat deafness with purulent discharge and pain:
Fuzi (Radix Aconiti Lateralis Preparata, processed, cracked, skin and umbilicus removed) 1 liang, Changpu (Rhizoma Acori Tatarinowii, soaked overnight in rice wash water, sliced, and dried) 1 liang, Fanshi (Alumen, boiled until juice dries) 1 liang, Bimazi Ren (Semen Ricini, pounded) 1 liang, Songzhi (Pini Resina, pounded) 1 liang, Xingren (Semen Armeniacae Amarum, skin and tip removed, double-kernel varieties stir-fried) 2 liang, Ran Yanzhi (Lipstick/Red Ochre pigment) 0.5 liang.
The above seven ingredients are pounded and ground into powder. Melted yellow beeswax is used to bind the powder into pill shapes resembling jujube pits. A needle is used to pierce a hole through the center for ventilation. Insert into the ear canal; replace once daily.
Formula for Yuyuliang San (Yuyu Grain Powder) to treat deafness with pus:
Yuyuliang (Haematitum) 1 fen, Uzeiyu Gu (Os Sepiae, shell removed), Fulonggan (Caulis Longan? Note: Traditionally Calcined Soil from Cooking Stove), Longgu (Os Draconis, each 0.5 liang), Fuzi (Radix Aconiti Lateralis Preparata, processed, cracked, skin and umbilicus removed) 1 liang.
The above five ingredients are pounded and ground into a powder. Take 1 qian per dose, wrap in cotton, and insert into the ear canal. Replace once daily. Continue until healed. If insects are present, add Moschus (Shexiang) the size of a black soybean; an alternative version adds Dangmo (Ink from a cauldron) 0.5 liang.
Formula for Canxiang San (Silkworm Incense Powder) to treat chronic purulent otitis:
Canzhi (Paper from hatched silkworm cocoons, burnt to ash), Uzeiyu Gu (Os Sepiae, shell removed), Ran Yanzhi (Lipstick/Red Ochre pigment) (each 1 qian), Moschus (Shexiang, pounded) 0.5 qian.
The above four ingredients are pounded and ground into a fine powder. Pack tightly into the ear canal and leave undisturbed until it falls out naturally. Repeat if not healed.
Formula for persistent foul-smelling purulent otorrhea:
Roucongrong (Cynomorii Herba) 1 liang, Longdan (Radix Gentianae) 1 liang, Baimaogen (Radix Imperatae Cylindricae) 1 liang.
The above three ingredients are burnt to ash and ground finely. Mix with a small amount of honey until uniform. Add bile from three carp (Li Yu Dan). Stir until thin. Extract the juice using silk cloth and drip into the ear. The remaining dry residue is shaped into a suppository, wrapped in thin cotton, and inserted into the ear. Healing occurs within no more than three applications.
Formula for Kidney Heat causing deafness with continuous day-and-night purulent and bloody discharge:
Li Yu Nao (Brain of Carp) 1 unit, Li Yu Chang (Intestine of Carp) 1 set, Wuma Zi (Semen Sesami Nigrum) 1 sheng.
First, pound the Wuma Zi until broken. Mix with the other two ingredients. Simmer over low heat. Wrap the ear with a warm cloth. After approximately one meal's time, remove the wrap; white worms should emerge. Prepare medication again. If both ears are affected, divide the medication between both ears. If only one ear is affected, apply to that side only. Healing occurs within no more than three treatments.
Formula for persistent purulent otorrhea:
Mazi (Semen Cannabis) 1 he, Hua Yanzhi (Flower-colored Ochre/Pigment) 1 fen.
Grind the above two ingredients into a fine powder. Pack fully into the ear canal. Gently wipe with cotton after application. Healing occurs within no more than three applications.
Another formula:
Fanshi (Alumen, boiled until juice dries) 1 liang, Qiandan (Minium, stir-fried) 1 qian.
Grind the above two ingredients together until very fine. Use half a zi (a very small measure) per application, inserting it into the ear.
Another formula:
Digupi (Cortex Lycii) 0.5 liang, Wubeizi (Fructus Terminaliae Chebulae) 1 fen.
Pound the above two ingredients into a fine powder. Use a small amount per application, inserting it into the ear.
Formula for Fanhuang San (Alum and Realgar Powder) to treat painful persistent purulent otorrhea:
Fanshi (Alumen from Jinzhou, boiled until juice dries) 0.5 liang, Xionghuang (Realgar, high quality) 1 fen.
Grind the above two ingredients extremely finely. Using a fingernail, pick up half a zi of powder. First, dry the ear canal with a cotton swab. Then, drip 1–2 drops of raw sesame oil into the ear. Use a cotton swab to introduce the powder into the ear. Regardless of duration, healing typically occurs within one or two applications.
Formula for Ersheng San (Two Sages Powder) to treat purulent otorrhea:
Baifuzi (Radix Typhonii Flagellaris Preparata, processed), Qianghuo (Rhizoma et Radix Notopterygii, rhizome removed) (each 1 liang).
Grind the above two ingredients into a fine powder. Take one pig or sheep kidney, slice it open. Insert 0.5 qian of powder into each kidney. Do not add salt. Wrap in wet paper and roast/bake until cooked. At dawn (Wu geng), chew the medicated kidney and swallow with warm wine, followed by porridge to settle the medicine.
Formula for Su Xiao San (Rapid Effect Powder) for chronic purulent otitis:
Dilong (Pheretima, placed inside a green onion tube, hung in a doorway to dry in shade) 1 piece.
Combine with a small amount of Moschus (Shexiang), grind into a fine powder, and insert into the ear.
Formula for Yu Cu Gao (Carp Vinegar Paste) for deafness with purulent discharge and possible insects:
Li Yu Chang (Intestine of Carp, sliced) 1 set, Cu (Vinegar) 3 he.
Pound and mix the above two ingredients into a paste. Wrap a small amount in cotton and insert into the ear. After approximately one meal's time, there may be a sensation of stuffiness/pain, or white worms may emerge. Replace immediately. Continue until all worms are expelled.
Formula for Gui Gu San (Cinnamon Bone Powder) for deafness with pus:
Gui (Ramulus Cinnamomi, coarse bark removed), Yu Gu (Fish Bone) (each 1 liang).
Pound the above two ingredients together into a powder and insert into the ear. Healing ensues.